patient care Flashcards
what’s the most important aspect of patient care?
effective observation
(W) TPR
(weight) Temperature, Pulse, Respiration
3 pillars of care for a hospitalized patient
clean, dry, comfortable
how to keep stress at a minimum for patients?
separate species as much as possible, away from traffic, keep barking to a minimum, make food + water available unless contraindicated
parenteral route includes all drugs that
are injected and not absorbed by GI tract
always double check drugs by checking
the drug type, dosage, time, and route of administration
what signs can help estimate hydration?
dry/tacky mucous membranes, skin turgor, position of the eye in the orbit, body temperature, poor pulse quality and changes in weight
true or false: heart and lungs shouldn’t be auscultated before the onset of fluid therapy and throughout treatment
false; you should be doing these things
cardio + resp evaluation entails:
mm color, CRT, heart/pulse rate, pulse strength/character
most easily accessible/palpable arteries for pulse are:
femoral, dorsal metatarsal, and ulnar arteries
heartbeat + artery pulse should be in sync, true or false?
true
emergency fluid therapy for shock in dogs
60-90ml/kg/hr only for first 1-2 hours
calculation of dehydration replacement volume
% dehydration x kg x 10
fluid maintenance requirement
40-60 ml/kg/day
when is rapid fluid therapy contraindicated?
pulmonary contusions, existing pulmonary edema, brain injury, congestive heart failure
crystalloid fluids (LRS, Normosol-R, .9% NaCl(saline))
contain small molecules that pass trhu a semi-permeable membranes
artificial colloids
include hydroxyethyl starches, dextrans, gelatins which contain large molecules that do not readily pass thru a semipermeable membrane
why are artificial colloids better than crystalloids at expanding blood volume?
they are limited to the intravascular compartment - they promote better tissue perfusion and maintain colloid oncotic pressure - not used for initial shock txt - often used in conjunction w/ a crystalloid
artificial colloids are given subq, true or false
false, they’re given via IV
5 different types of blood products
whole blood, plasma, packed RBCs, platelet rich plasma, oxyglobin
fresh whole blood
only good up to 8 hrs
contains RBCs, WBCs, platelets, plasma proteins, and coagulation factors
used in patients w/ thrombocytopenia, anemia w/ coagulopathies, Disseminated intravascular coagulation, and massive hemorrhage
disseminated intravascular coagulation (basic info)
body goes thru a clotting process, something triggers typical clotting cascade which is effective until suddenly it’s not and the patient starts bleeding out
cause really unknown + not much of a remedy is possible
routes of fluid administration
oral, SQ, IV, intradmedullary
oral fluid administration
through mouth, contraindicated if patient is vomiting
SQ fluid administration
good for mild dehydration - give only isotonic solutions, no dextrose
IV fluid administration
for severe dehydration and shock
intramedullary fluid administration
into the bone marrow, not typical usually only seen in kittens and small puppies
SPO2
pulse oximeter goes on tongue during surgery, or ear, or toes
picks up % of how oxygenated the blood is - should be over 95%
blood loss = lower pulse ox
hypoxia
deficiency of oxygen at tissue level
o2 therapy is used for
hypoxia, pulmonary edema, severe bronchopneumonia, upper airway disease in brachy dogs, pulmonary trauma
signs of hypoxemia or hypoxia include:
cyanosis, tachycardia, arrhythmias, increased respiration, open mouthed breathing or dyspnea
cns results to cause drowsiness, increased excitability, altered motor abilities
cold extremities
methods of o2 therapy
o2 cages, human pediatric incubators, masks, nasal catheters, endotracheal tubes and intratracheal catheters
routes of nutrition
oral
orogastric
nasogastric
pharyngeal
esophageal
gastric
artificial milk replacers
esbilac 4 puppies and KMR 4 kittens
feed neonates how much?
small amounts at atime, their stomachs are tiny
size of clipper blade recommended for removing matts
7, 10, 15 blade (NOT 40 - surgical blade)
enema
an infusion of liquid into the lower GI tract through the anus
whats the point of an enema?
relieve constipation, irrigate colon after poisoning, or empty colon to prepare for radiographs
why should you check catheters often?
make sure they weren’t pulled out and that the tape wasn’t wrapped too tightly (swelling) and to flush them with heparin flush
when fluids are being given, observe and record what?
urination
check urinary catheter often and measure urine production
signs of infection
edema, pus, fever, neutrophilia, pain, color change of skin, exudates, odor
