Test 3 Flashcards
How do you do a skin turgor test in horses?
pinch skin on lateral side of neck
How do you do a skin turgor test in small animals?
pinch skin on lateral chest
What does a normal skin turgor test look like?
skin returns promptly to normal position 1 sec or less
A snap back with a >1 sec return means what?
> 5% dehydration
A snap back with a >8 sec return means what?
severe dehydration
Skin turgor is less reliable in what kind of patient?
obese
Thin horses and older than 15 years have what kind of skin snap?
delayed regardless of hydration
CRT is more accurate for assessing hydration than what?
skin turgor
CRT reflects cardiac output which is directly affected by what?
hydration status
Prolonged CRT usually means what?
low CO, most commonly result of inadequate hydration
What is a normal CRT?
<2.5 sec
What is an abnormal CRT?
> 2.5 sec
What is the CRT for a severely dehydrated animal?
5-8 sec
What do dry, tacky MM mean?
dehydration unless they have been panting
What do moist MM mean?
normal
What do slick MM mean?
nausea
What do pale MM mean?
lack of blood flow. Could be due to dehydration, hypovolemia
What does yellow urine mean?
concentrating=dehydration
Rapid weight gain means what?
possibility of overhydration or urine output has suddenly stopped
Rapid weight loss means what?
dehydrated, blood loss, urine losses increased over fluid input
What is a lung characteristic of pulmonary edema?
“crackles” sounds “wet”, “gurgling”
What can cause the lungs to sound “wet”?
too many fluids, can occur with congestive heart failure
Decreased lung sounds can happen when?
obesity, effusions and hypovolemia
What does a bounding pulse strength mean?
overhydrated and low BP
What does a thready pulse strength mean?
dehydrated and low BP
Rapid HR may mean what?
hypovolemia, hypoxia
Slow HR may mean what?
hypovolemia
Cool limbs indicate what?
hypovolemia (dehydration)
What does is mean when the eyelid and scleral conjunctiva will be puffy and fluid filled?
edema
What can Chemosis be an indicator of?
over hydration
What is Chemosis?
conjunctival edema
What can be seen with peripheral edema?
swollen head, limbs, and paws
What are some non-invasive monitoring equipment?
EKG, Indirect blood pressure
What are some invasive monitoring equipment?
PCV, TP, Direct blood pressure, CVP measurement
Which monitoring tool is most accurate?
direct blood pressure
What is a normal systolic range?
100-150 mm Hg
What is an ideal mean arterial BP?
75-90 mm Hg
What does a systolic BP of >175 mm Hg mean?
hypertension
What can increase BP in animals?
stress of illness and hospitalization
What can you use to monitor BP indirectly
oscillometric and Doppler
Oscillometric BP assessment can be combined with what?
EKG and pulse Oximeter
What is Oscillometric often used with?
Ax or monitoring sedentary animal
A Doppler uses what to audibly locate the arterial pulse?
ultrasound crystal and monitor
BP cuff determines what?
systolic, diastolic, mean arterial pressures
You can program BP cuffs to do what?
record at intervals
BP cuff diameter should approximate what?
40% of the circumference of the limb at the site of cuff placement
Where can you place a BP cuff?
metacarpus, metatarsus, tail
You should not use arterial catheters for what?
injections
Catheterize artery= what?
an “a-line”
No medications should be administered via what?
intrarterial injection
You should do what to arterial catheters to prevent what?
confusion
Flush arterial catheter regularly and slowly to prevent what?
clots
What is CVP?
BP in central veins, as the thoracic vena cava
CVP measurement helps assess/monitor what?
hydration and the efficacy of fluid therapy
What is a normal CVP?
0-5 cm H2O
What does a CVP of <0 cm H2O mean?
hypovolemia, dehydration, inadequate fluid therapy
CVP values trending upward to 8-10 cm H2O mean?
increase in vascular volume and adequate fluid therapy
Sudden increases or values of CVP >10 cm H2O means what?
venous congestion, increased thoracic pressure, volume overload
How can you evaluate CVP?
HR, MM appearance, skin turgor
What equipment is needed for direct BP monitoring?
3-way stopcock, manometer filled with saline, saline filled syringe, extension set filled with saline, patient central line catheter
You should get a PCV and TP before what?
fluids are started
Increased PCV indicates what?
dehydration
Decreased PCV indicates what?
over hydration
What is a normal PCV for a dog?
37-55%
What is a normal PCV for a cat?
30-45%
What is a normal PCV in a horse?
32-48%
What is a normal PCV for cows?
24-46%
High TP means what?
dehydration
Low TP means what?
overhydration
What is a normal TP for a dog?
6.0-7.5 g/dl
What is a normal TP for a cat?
6.0-7.5 g/dl
What is a normal TP for horses?
6.0-8.5 g/dl
What is a normal TP for cows?
6.0-8.0 g/dl
What does proper hydration provide?
perfusion of tissues with delivery of nutrients, removal of wastes, delivery of drugs
Are SQ fluids reliable in a dehydrated animal?
probably not
Dehydration causes peripheral what?
vasoconstriction
What routes can you deliver fluids?
oral, SQ, IV, IO, IP
Which route is the best for fluids?
oral
What are some contraindications of oral delivery of fluids?
vomiting, esophageal disease, aspiration pneumonitis, shock
What fluids should be delivered SQ?
only isotonic
Why should Dextrose or other hypertonic solutions be administered SQ?
draws fluids into it, not absorbed, and may cause an abcess
What size needle is used for SQ fluid administration?
16-22 g depending on size of animal
What other size of needle can be used for SQ fluid administration in a dog or cat?
18-20 g
What amount of fluids should be administered SQ?
15ml/lb maximum
How many ml should be administered SQ to a cat?
10-20 ml/kg/site
How many ml should be administered SQ to a large dog?
can tolerate >200ml/site
SQ is not recommended for what kind of patient?
hypovolemic
When is IV route used for administration of fluids?
for mild to severe dehydration, hypotension, shock, vomit, where significant continuing losses occur
What does administration of fluids IV require?
close monitoring, asepsis, special care of catheters
What technique is used for administration of fluids IP?
aseptic
Where are IP fluids administered?
near umbilicus
IO administration of fluids is good when?
in emergency
What is needed for an aseptic fluid administration technique?
lidocaine, 16g needle in neonate, spinal needle+stylet if <4 mo. or bone marrow needle+stylet if >4 mo.
How much fluids should be given to a dog in a critical situation?
40 ml/#
How much fluids should be given to a cat in a critical situation?
20 ml/#
For critical patients, total blood volume should be divided into how many parts?
4
PCV less than what indicates a need for transfusion
20%
TP less than what of starting value indicates a need for transfusion
50%
In a critical situation fluids are given over how long?
an hour
In a therapeutic situation fluids are given over how long?
24 hours
What is oliguria?
urine output is lower than normal
oliguria can indicate what?
renal insufficiency or dehydration
What is calor?
heat/hot
What is dolor?
pain
What is rugor?
redness
What is turgor?
swelling
“hot packs” can encourage abscess to what?
liquefy, point and open
How warm should the towel be for abscesses?
no hotter than you can stand to hold on your own skin
“pack” abscesses for how long?
5 minutes several times a day
What can help reduce swelling and promote blood flow into the area?
epsom salts at the rate of 1-2 T/Cup water
What does an EKG measure?
the electrical conductance of the heart
What do EKGs NOT measure?
arteries, veins, valves, pericardium
In normal lead II complexes, Q and S waves are not always what?
present
P and R waves are what?
positive
T wave is usually what in Lead II?
positive
How do you measure EKG duration?
from baseline to baseline
How do you measure EKG amplitude?
from baseline to top of wave
A relationship should exist between what in EKGs?
every P and QRS
R-R intervals are used to detect what?
rhythm vs. arrhythmias
What kind of arrhythmias are okay, especially in large breeds/ deep chested dogs?
sinus arrhythmias
A prolonged P-R interval means what?
1st degree heart block
What is a 1st degree heart block?
delayed impulse SA through AV node
