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Vet Nurse Small Animal Diploma CQ > SA13 Medical Nursing > Flashcards

SA13 Medical Nursing Flashcards

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1
Q

What is an incision wound?

A
  • Clean cut
  • Caused by sharp object
  • Glass, scalpel blade, etc
  • Profuse bleeding, especially in deep/larger wounds
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2
Q

What is a laceration wound?

A
  • Tearing of tissue
  • Uneven edges
  • Barbed wire, etc
  • Less sever bleeding than incision
  • Contaminated
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3
Q

What is an abrasion wound?

A
  • Superficial wound
  • Doesn’t penetrate full skin thickness
  • Contamination with dirt and foreign material
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4
Q

What is a puncture wound?

A
  • Small external wound
  • Often with significant deeper damage
  • Dog/cat bites
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5
Q

What is a contusion wound?

A
  • Blunt blow
  • Ruptured capillaries below surface
  • Can have deeper injuries
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6
Q

What is an avulsion wound?

A
  • Wound with skin flap
  • Skin flap becomes necrotic
  • Delays healing if not removed
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7
Q

What is a fracture?

A
  • Break in bone
  • Can be classed as open if wound present
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8
Q

What is a rupture wound?

A
  • Injured organ
  • Causes internal bleeding
  • Life threatening
  • Liver, spleen, etc
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9
Q

What is a haematoma?

A
  • Blood filled pocket
  • Aural, organ (liver, spleen)
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10
Q

What is a clean wound?

A
  • Surgical wound
  • Made under aseptic conditions
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11
Q

What is a clean contaminated wound?

A
  • Surgical wound
  • Made under aseptic conditions
  • With mild contamination
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12
Q

What is aetiology?

A

Cause

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13
Q

What is a contaminated wound?

A
  • Fresh traumatic wound
  • Surgical wound with major break in asepsis
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14
Q

What is a dirty wound?

A
  • Traumatic wound over 6 hours old
  • Any wound where ongoing infection in present prior to surgery
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15
Q

How can wounds be classified?

A
  • Open/closed
  • Clean/dirty
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16
Q

What is ischaemic?

A

Restriction in blood supply

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17
Q

What different degrees of damage are there in wounds?

A
  • Resolution
  • Regeneration
  • Organisation
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18
Q

What is resolution in terms of wounds?

A
  • No tissue destruction
  • Very minor inflammatory phase
  • Tissue returns to original state
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19
Q

What is regeneration in terms of wounds?

A
  • Complete replacement of damaged tissue
  • Connective tissue and blood supply must be intact
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20
Q

What is organisation in terms of wounds?

A
  • Formation of scar tissue
  • As unable to heal by regeneration
  • Often results in loss of normal function
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21
Q

What are the stages of the healing process?

A
  • Haemostasis
  • Inflammatory
  • Proliferative
  • Remodelling/maturation
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22
Q

What is the haemostasis stage of wound healing?

A

Clots form to stop blood loss

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23
Q

What is the inflammatory stage of wound healing?

A
  • Blood clot attracts neutrophils
  • Clear up bacteria, necrotic tissue, foreign material
  • Macrophages (monocytes) perform final debridement
  • Exudate, swelling and redness seen
  • 24-48 hr for clean surgical wound
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24
Q

What is the proliferative stage of healing?

A
  • Fibroblasts lay new tissue
  • Endothelial cells lay new blood vessels
  • Epithelial cells migrate over wound to replace epidermis
  • Granulation and wound contraction seen
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25
Q

What is the golden period to treat an open wound?

A
  • Optimal time of treatment of open wound
  • Within 0 - 6 hours
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26
Q

What happens 6 - 12 hours after an open wound is caused?

A
  • Bacteria multiplies
  • Early stages of infection
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27
Q

What happens 12 hours + after an open wound is caused?

A
  • Tissues will be infected
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28
Q

What is granulation tissue?

A
  • Bright red, vascular
  • Seen 3-5 days in large wounds
  • Can take weeks-months to fully develop
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29
Q

What is the remodelling/maturation stage in wound healing?

A
  • Scar formation
  • Strengthening and hair regrowth
  • 7-10 days in clean surgical wound
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30
Q

What are labile cells?

A
  • Epithelial, lymph, etc
  • High ability to regenerate
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31
Q

What is first intention healing?

A
  • Rapid healing can take place in incised wounds
  • Only occurs if edges of wound are held together
  • Only happens in clean wounds
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32
Q

What is second intention healing?

A
  • Granulation
  • Slower healing
  • Happens where tissue is lost or presence of foreign material or infection
  • Epithelial tissue tissue grows across to close wound
  • Speed of this growth determined by wound environment
  • Warm, moist environment encourages epitheialisation
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33
Q

Do wounds need surgical intervention immediately?

A
  • Some wounds can be managed as open wound
  • Once granulation is established can have surgical secondary closure
  • Wounds without surgical closure must be dressed and bandaged appropriately until full healing
  • Can take weeks-months depending on tissue deficit
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34
Q

How long does wound healing take in tendons and muscles?

A
  • Several weeks
  • Gradual reintroduction to exercise
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35
Q

How long does wound healing take in GI, urinary and reproductive tissues?

A
  • 3-4 days
  • Urinary bladder heals fastest
  • Colon heals slowest
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36
Q

What factors can delay wound healing?

A
  • Movement
  • Infection
  • Impaired circulation/perfusion
  • Patient/client interference
  • Poor nutrition
  • Systemic disease
  • Poor wound management
  • Surgical factors
  • Drug therapy
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37
Q

What is erythema?

A

Reddening of tissue

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38
Q

Where does movement especially delay healing?

A

Over joints

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39
Q

How does infection delay healing?

A
  • Bacteria destroys healing tissue
  • Causes inflammation and pus
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40
Q

How does impaired circulation and poor perfusion delay healing?

A
  • Tissue dies at wound edges
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41
Q

How does poor nutrition delay healing?

A
  • Decreased vitamin K (affects clotting)
  • Insufficient protein intake (affects cell growth and repair)
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42
Q

What systemic diseases can delay healing?

A
  • Hypothyroidism (Decreased metabolism, slow cells)
  • Cushings (Increased cortisol, slows healing)
  • Renal (Increased toxins, weakened clotting)
  • Hepatic disease (Reduced clotting factors)
  • Diabetes mellitus (Increased blood glucose, slows healing)
  • Severe cardiovascular disease (Poor perfusion, WBC can’t get to wound effectively)
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43
Q

How can poor wound management delay healing?

A
  • Inappropriate primary dressing
  • Poor bandage technique
  • Unprotected bandages
  • Infrequent bandage changes
  • Patient interference
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44
Q

What surgical factors can delay healing?

A
  • Wound infection
  • Tight sutures
  • Inappropriate suture material
  • Poor suturing technique
  • Poor aseptic technique
  • Lack of drainage
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45
Q

What is delayed primary closure?

A
  • Closed after 1 - 3 days
  • Contaminated so need to be managed as open wound to begin with
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46
Q

What is secondary closure?

A
  • Closed after 3+ days
  • Heavily contaminated so needs to be managed as open wound for longer
47
Q

What drugs can delay healing?

A
  • Corticosteroids
  • Chemotherapy
  • Radiotherapy
48
Q

Fluid build up in surgical wound?

A

Seroma

49
Q

What is the primary dressing layer?

A
  • In contact with the wound
  • Can debride wound, absorb fluid, stimulate granulation tissue, promote epithelialisation, contract wound
50
Q

What are the functions of a wound dressing?

A
  • Absorption of exudate
  • Analgesia
  • Protection
  • Prevention of infection
  • Promotion of wound healing
  • Maintaining correct humidity for healing
51
Q

What is the secondary dressing layer?

A
  • Wool and conforming bandage
  • Absorbant
  • Easy to apply
  • Apply in spiral with even 50% overlap
  • Conforming bandage compresses wool
  • Holds primary layer in place
  • Provides padding and stability
52
Q

What is the tertiary dressing layer?

A
  • Elastic and cohesive
  • Apply in even 50% overlap
  • Protection from soiling and mutilation
53
Q

When can casts be used?

A
  • Stable fractures
  • Greenstick, simple, spiral fractures
  • Fractured bone is close to in-tact bone
  • Can be used post operatively
  • Arthrodesis, internal fixations, tendon repair
54
Q

What is another name for casts?

A

External coaptation

55
Q

What are the properties of cast materials?

A
  • Comfortable
  • Easy to apply
  • Strong/hard wearing
  • Radiolucent
  • Lightweight, not bulky
  • Easy to remove
  • Water resistant, breathable
  • Economical
56
Q

What are some examples of cast materials?

A
  • Polypropylene impregnated with resin (Dynacast)
  • Fibreglass impregnated with resin (Vetcast Plus)
  • Thermoplastic polymer mesh (Vet-lite, Runlite SA)
  • Plaster of Paris
57
Q

What are some important things to remember when applying a cast?

A
  • Apply in close proximity to bone for optimal support
  • Too much padding causes slippage
  • Too little padding causes decubital ulcers
  • Joints above and below fracture must be included
58
Q

How is a cast applied?

A
  • Cover wounds with non-adherent dressing
  • Apply stockinette to avoid creases
  • Apply cast padding with 50% overlap
  • Pad bony areas with ‘doughnuts’
  • Immerse one roll of cast into water and squeeze several times
  • Squeeze excess water and apply to limb with even pressure and 50% overlap
  • Repeat until cast complete
  • Leave pads and toes of digits 2 + 3 exposed
  • Leave 1-2cm of padding exposed at top and bottom
  • Turn stockinette and padding edges over ends of cast once hardened
59
Q

How should a cast be cared for?

A
  • Replace if excessively chewed or damaged
  • Replace every week if animal young
  • Administer medication as prescribed
  • Cover bottom when taking patient outside
60
Q

What should be monitored for when casts are used?

A
  • Swelling of limbs and toes
  • Chafing
  • Staining with discharges
  • Foul odour
  • Slippage
  • Chewing shows signs of discomfort
  • Collapse or bending
  • General patient demeanour; appetite, lethargy, depression
61
Q

How should a cast be removed?

A
  • Take radiographs to assess healing
  • Sedate or GA if using oscillating saw
  • Can use plaster shears to cut cast fro, distal to proximal ends
  • Two cuts make a cutting line
  • Saw cuts through cast, not padding
  • Remove padding once cast removed
  • Blade can become hot, caution must be taken
62
Q

What are the aims of managing chronic wounds?

A
  • Prevent further contamination
  • Decontaminate as much as possible
  • Debridement of necrotic tissue
  • Infection control
  • Healthy wound bed allows healing
63
Q

What causes congestive heart failure?

A
  • Pooling blood in venous system
  • Due to damming back effect
  • Due to cardiac disease
64
Q

What does left sided congestive heart failure cause?

A
  • Congestion of vessels in lungs
  • Fluid leaking causes pulmonary oedema
65
Q

What does right sided congestive heart failure cause?

A
  • Congestion of venous circulation
  • Particularly vessels returning from abdomen and chest cavity
  • Results in ascites and pleural effusion
66
Q

What clinical sign can cats show with either side congestive heart failure?

A

Pleural effusion

67
Q

What are the clinical signs of congestive heart failure?

A
  • Dyspnoea
  • Tachypnoea
  • Exercise intolerance
  • Cough
  • Syncope (collapse)
  • Weight loss
  • Pale/bluish MMs
  • Ascites
  • Dull breath sounds with effusion
  • Increased breath sounds with pulmonary oedema
68
Q

Why can coughing occur in congestive heart failure?

A

Oedema or cardiomegaly pressing on main stem of bronchi

69
Q

What is a foramen oval?

A
  • Opening in septum between right and left atria and ventricles
  • Blood bypasses lungs and passes from right ventricle to left
  • Should close shortly after birth
  • Seen in neonates
70
Q

What is Ductus Arteriosa?

A
  • Connects pulmonary artery and aorta
  • Blood bypasses lungs from right to left
  • Closes shortly after birth as lungs expand
  • Seen in neonates
71
Q

What is Ductus Venosus?

A
  • Venous shunt within liver
  • Connects umbilical vein to caudal vena cava
  • Blood bypasses foetal liver
  • Mothers liver already metabolised nutrients
  • Seen in neonates
72
Q

What differences are seen in neonatal circulation?

A
  • Foramen Ovale
  • Ductus Arteriosa
  • Ductus Venosus
73
Q

What is PDA?

A
  • Patent Ductus Arteriosus
  • Failure of Ductus to close after birth
74
Q

What are the signs of Patent Ductus Arteriosus?

A
  • Often detected as machinery type murmur as first vaccination
  • Often no clinical signs at that stage
75
Q

What are the long term effects of Patent Ductus Arteriosus?

A
  • High resistance in systemic circulation
  • Blood passes from aorta to pulmonary artery
  • Leads to over circulation to lungs and left side of heart
  • Ultimately leads to left sided heart failure
76
Q

What is the treatment for Patent Ductus Arteriosus?

A
  • Surgical closure
  • Treatment for congestive heart failure if diagnosed late
77
Q

What are artial and ventricular septal defects?

A
  • Failure of foramen ovale to close
78
Q

What are the clinical signs of atrial and ventriculare septal defects?

A
  • Similar to PDA
  • Systolic murmur is heard
  • Bigger hole = quieter murmur
79
Q

What is the treatment for atrial and ventricular septal defects?

A
  • Symptomatic treatment for congestive heart failure
  • Open heart surgery
  • Surgery requires heart bypass, is very expensive and not commonly done
80
Q

What is aortic stenosis?

A
  • Narrowing of the outflow (valve) of the left ventricle?
81
Q

What are the signs of aortic stenosis?

A
  • Typically a left sided murmur
  • Output failure leads to fainting/collapse
  • Congestive heart failure
  • Sudden death due to cardiac dysrhythmias
82
Q

What is the treatment for aortic stenosis?

A
  • Symptomatic treatment with anti dysrhythmic drugs and beta blockers
  • Mild cases may not require treatment
83
Q

What is pulmonic stenosis?

A

Narrowing of pulmonary valve or artery leaving the heart

84
Q

What are the signs of pulmonic stenosis?

A
  • Typically right sided murmur
  • Congestive heart failure
85
Q

What is the treatment for pulmonic stenosis?

A
  • Severe cases require dilation of artery
  • Symptomatic treatment in non-surgical cases
86
Q

What is mitral/tricuspid dysplasia?

A

Underdevelopment of the mitral or tricuspid valve

87
Q

What is tetralogy of fallot?

A
  • 4 heart defects
  • Pulmonic stenosis
  • Ventricular septal defect
  • Abnormally positioned aorta
  • Often have more than one congenital defect
88
Q

What is myocarditis?

A

Inflammation of heart muscle

89
Q

What causes myocarditis?

A
  • Parvovirus in puppies
90
Q

What are signs of myocarditis?

A
  • Acute heart failure
  • Death
91
Q

What is dilated cardiomyopathy (DCM)?

A
  • Thinning of myocardium
  • Leads to loss of contractility
  • Enlargement of heart chambers
92
Q

What causes dilated cardiomyopathy?

A
  • Common in Dobermans
  • Often idiopathic
  • Seen in taurine deficiency
  • Was common in cats
93
Q

What are the signs of dilated cardiomyopathy?

A
  • L+R congestive heart failure
  • Ascites and pulmonary oedema in dogs
  • Pleural effusions + pulmonary oedema in cats
94
Q

What is the treatment for dilated cardiomyopathy?

A
  • Symptomatic treatment for congestive heart failure
  • Taurine supplementation
94
Q

What is hypertrophic cardiomyopathy (HCM)?

A
  • Thickening of cardiac muscle
  • Reduction in heart chamber size
  • Most common cardiac disease in cats
95
Q

What does stenosis mean?

A

Narrowing

96
Q

What are the signs of hypertrophic cardiomyopathy?

A
  • Congestive heart failure
  • Sudden death
97
Q

What is the treatment for hypertrophic cardiomyopathy?

A
  • Drugs to slow heart and improve chamber filling
  • Congestive heart failure treatment
98
Q

What is myxomatous valvular disease (MVD)?

A
  • Mitral valve disease
  • Degeneration of atrio-ventricular valves
  • Most common in mitral valve
  • Faulty valve function
  • Blood leaking through valves when closed
  • Common in CKCS
99
Q

What are the signs of myxomatous valvular disease?

A
  • Progressing murmur
  • Congestive heart failure
100
Q

What is the treatment for myxomatous valvular disease?

A

Symptomatic treatment

101
Q

What is pericarditis?

A
  • Inflammation of pericardium
  • Causes pericardial effusion
102
Q

What is pericardial effusion?

A
  • Fluid accumulation inside pericardial sac
  • Prevents heart filling during diastole
  • More often in dogs (Golden retrievers)
103
Q

What are the causes of pericardial effusion?

A
  • Idiopathic
  • Secondary to tumours or infection
104
Q

What are the signs of pericardial disease?

A
  • Lethargy
  • Dyspnoea
  • Muffled heart sounds
  • Weak pulses
  • Pale MMs
  • Jugular distension
  • Ascites
105
Q

What is the treatment for pericardial disease?

A
  • Drainage of fluid around the heart (pericardiocentesis)
  • Removal of part of the pericardium (pericardectomy)
106
Q

What is auscultation?

A

LISTEN FOR
- Heart rate and rhythm
- Murmurs
- Dullness
- Respiratory sounds

107
Q

What is ECG?

A
  • Measures electrical conductivity of the heart
  • Gives info on rate and rhythm
  • Gives crude indications of cardiac chamber size
108
Q

What is the wave in an ECG?

A

P
- Depolarisation of the atria
- Starting from SA node
QRS WAVE
- Depolarisation of ventricles
- From AV node
T
- Repolarisation of ventricles

109
Q

What positions are the ECG leads attached to the patient?

A
  • RED = Right
  • YELLOW = Left
  • GREEN = Below sun
  • BLACK = Right hind
110
Q

How should the patient be positioned for an ECG?

A
  • Non-conductive table cover (vetbed)
  • Dogs in right lateral
  • Cats sitting or standing
  • Turn off other electrical equipment in room
  • Apply conductive gel/spirit to pads/clips
  • Don’t allow leads to touch
  • Reduce patient movement and purring
  • Keep patient as calm as possible
  • Avoid chemical restraint
111
Q

How can radiography be used to look at the heart?

A
  • Shows size and shape of heart
  • Can show congestion signs
  • Always take DV view first
  • Followed by lateral view (usually right)
  • Sedation required
  • Forelegs out of way
  • Take standard inspiratory views
112
Q
A

Vet Nurse Small Animal Diploma CQ (13 decks)

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