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X PPPVN > Patient Observation > Flashcards

Patient Observation Flashcards

1
Q

When does initial observation begin?

A

as soon as the patient enters the practice

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2
Q

What should be allowed for when the patient first arrives in practice?

A

adjustment time and understanding of behavior of animals in unfamiliar environments

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3
Q

What distance away from the patient should your first impressions be gained?

A

further away to observe

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4
Q

What sort of environment should be stimulated as much as possible?

A

normal

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5
Q

What information can be vital in supporting the patient and understanding what brought them to the practice?

A

owner history

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6
Q

What is an admission questionnaire?

A

short questionnaire completed by owner at the same time as admission consent form

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7
Q

What is the aim of an admission questionnaire?

A

to provide a tailored approach to hospital stay and try to reduce patient stress.

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8
Q

what sort of things may be asked on an admission questionnaire?

A

preferred food and feed times, walking schedule, an specific individual needs

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9
Q

What measures can be put in place within a kennel to reduce cat stress?

A

hiding places and pheromones like Feliway

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10
Q

What is SOAP used for?

A

assessing the patient

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11
Q

What does SOAP stand for?

A

subjective, objective, assessment, planning

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12
Q

What is involved in subjective assessment?

A

from afar gaining initial thoughts on patient (e.g. are they happy, depressed, scared, relaxed?), your first impressions

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13
Q

What is involved in an objective assessment?

A

an examination, findings are measured and recorded

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14
Q

What are two things to consider before beginning an objective assessment?

A

how will the assessment be carried out?

how will the patient be restrained?

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15
Q

What are the 13 areas to be examined in an objective assessment?

A 
head
nares and upper respiratory tract
oral cavity
mucous membranes
eyes
ears
skin and hair
thorax
abdomen
pelvis and hind limb
tail
anus and perineum
reproductive organs
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16
Q

What are you looking for during an objective assessment of the head?

A

posture: is it normal for breed and species
musculature: is it symmetrical and normal
general palpation: are there lumps or enlarged lymph nodes

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17
Q

What are you looking for during an objective assessment of the nares and upper respiratory tract?

A

no discharge: note presence and colour if there is any
moist
adequate airflow: particularly in cats and rabbits
any respiratory noise (stertor or stridor)

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18
Q

What is stertor?

A

noise on inspiration

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19
Q

What is stridor?

A

noise on expiration

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20
Q

What are you looking for during an objective assessment of the oral cavity?

A 
mouth
jaw movement and alignment
tongue
teeth
hard and soft palettes
skin and hair
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21
Q

What are you looking for during an objective assessment of the mucous membranes (mms)?

A

moist: if not indicative of dehydration

colour

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22
Q

What do mucous membranes show?

A

state of perfusion and therefore the state of circulation

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23
Q

What would pale mucous membranes indicate?

A

poor perfusion/circulation

e.g. hemorrhage or anemia

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24
Q

what would congested (red) mucous membranes indicate?

A

sepsis/fever

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25
Q

What would hypoxic or cyanotic (blue) mucous membranes indicate?

A

respiratory difficulty

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26
Q

What would icteric (jaundiced) mucous membranes indicate?

A

liver disease, RBC destruction, bile problems

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27
Q

what is normal capillary refill time?

A

less than 2 seconds

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28
Q

What is capillary refill time?

A

time taken for capillaries to refill with blood after compression for a short period

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29
Q

What are you looking for during an objective assessment of the eyes?

A 
are they open
blephrospasm
eyes the same size
discharge: note colour if present
entropian
ectropian
nictating membrane
pupil assessment: arisocoria, pupillary light reflex, sclera assessment (colour of white of the eye)
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30
Q

What is blephrospasm?

A

squinting

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31
Q

What is entropian?

A

internal rotation of eyelid margin

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32
Q

what is ectropian?

A

external rotation of eyelid margin

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33
Q

What is the nictating membrane also known as?

A

3rd eyelid

34
Q

What is arisocoria?

A

unequal pupil size

35
Q

What are you looking for during an objective assessment of the ear?

A

normal pinnae: presence of aural haematoma

vertical ear canal: and discharge, strange smell, foreign bodies, ectoparasites

36
Q

What are you looking for during an objective assessment of the skin and hair?

A 
alopecia
coat condition
skin condition
ectoparasites (e.g. ticks and fleas)
skin elasticity (tenting indicative of dehydration)
37
Q

What is alopecia?

A

hair loss

38
Q

What are you looking for during an objective assessment of the forelimbs?

A

movement and gait
rage of movement
flexion and extension: any pain or crepitus
visual changes: lumps, lacerations, bumps etc
Proprioception: if limb is displaced can patient replace limb back in normal position?

39
Q

What is crepitus?

A

crunching/ clicking of cartilage

40
Q

What are you looking for during an objective assessment of the thorax?

A 
respiration rate and effort
examine vertebra, ribs and sternum
Auscultation
visual abnormalities
sounds 
mouth breathing: particularly in obligate nasal breathers
41
Q

What are you looking for during an objective assessment of the abdomen?

A

visual abnormalities: is abdomen enlarged
palpation: can anything be felt inside
posture: pain may change a patients posture
internal organs: stomach/kidneys

42
Q

What are you looking for during an objective assessment of the pelvis and hindlimbs?

A 
as with forelimbs:
movement
musculature
flexion and extension
visual abnormalities
gait
propreoception
femoral pulse
43
Q

What are you looking for during an objective assessment of the tail?

A

presence of tail
voluntary movement
damage: drooped tail could indicate a fractured pelvis

44
Q

What are you looking for during an objective assessment of the anus and perineum?

A 
soiling
discharge
presence of mass?
anal gland problems
prolapse
perineal ruptures
45
Q

What are you looking for during an objective assessment of the reproductive organs?

A

check animal is the correct sex
two descended testicles
penis: any injuries or discharge
vulval discharge or swelling

46
Q

What should be considered when observing urine/urination?

A

colour, smell, turbidity, volume

47
Q

What is the turbidity of urine?

A

presence of sediment or clouding of urine

48
Q

What is the accepted urine output for dogs and cats per hour?

A

1-2ml per kg of body weight per hour

49
Q

What is anuria?

A

failure to produce urine

50
Q

what is dysuria?

A

abnormal, painful or difficult urination

51
Q

what is haematouria?

A

presence of blood in urine

52
Q

what is polyuria?

A

excessive or abnormally large increase in volume of urine production

53
Q

What is the accepted maintenance water requirement for cats and dogs?

A

50ml per kg of body weight over 24 hours

54
Q

what is polydipsia?

A

excessive or abnormally increased thirst

55
Q

What is an indication of polydipsia?

A

excessive drinking and urination

56
Q

What should be observed when looking at faeces or defecation?

A

colour, shape, smell, consistency

57
Q

What is diarrhoea?

A

increase in loose and watery stool

58
Q

what is tenesmus?

A

excessive straining to urinate/defecate

59
Q

what is melaena?

A

partially digested blood in faeces that makes them appear black/slimy

60
Q

what is haemtochezia?

A

fresh blood in faeces or from anus

61
Q

What does the bristol stool chart do?

A

classifies the shape/consistancy of faeces produced by patient

62
Q

What does 1 on the bristol stool chart mean?

A

hard lumps that are difficult to pass

63
Q

what does 7 on the bristol stool chart mean?

A

watery with no solid, passed rapidly

64
Q

What is the ideal rating on the bristol stool chart?

A

number 4: smooth and soft

65
Q

What does inappetance mean?

A

lack of appetite

66
Q

What does dysphagia mean?

A

swallowing difficulties or inability to swallow

67
Q

What is pica?

A

consumption of non-nutritional substances that provide no physical benefit

68
Q

what is coprophagia?

A

eating faeces

69
Q

What is vomiting?

A

ejection of matter from the stomach and upper GI tract through the mouth

70
Q

What is regurgitation?

A

bringing swallowed food from the oesophegus up again into the mouth

71
Q

What is the difference between regurgitation and vomiting?

A

regurgitation only occurs with matter in the oesophegus whereas vomiting affects the stomach and upper GI tract

72
Q

What should be noted when a patient vomits?

A

contents, volume, number of episodes

73
Q

What should be observed if a patient is coughing?

A

is it contagious
moist and productive or dry and harsh
what could the cough mean? infectious disease, respiratory distress or cardiovascular damage

74
Q

What should be noted on the patients chart about coughing?

A

saliva or discharge produced

75
Q

What is the issue with pain assessment?

A

it is subjective and challenging

76
Q

Why is pain assessment necessary?

A

welfare of the animal and ethical choices

77
Q

What are the 8 general signs of pain?

A 
reluctance to move
altered body posture
restlessness, anxiety, fear
depressed or altered mentation
aggression
guarding of the area
abnormal urination/defecation
inappetance
78
Q

What is an example of a pain scoring method?

A

glasgow composite pain scoring chart

79
Q

What does the Glasgow composite pain scoring chart show?

A

pain and tracks changes

80
Q

What can be done to alleviate pain?

A

analgesia, improved/altered bedding and kennel

X PPPVN (27 decks)

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