Unit 1 Flashcards
clinical problem solving starts with:
problem identification
four steps in case management
1: data base collection
2: problem identification
3: plan formulation
4: assessment and follow-up
what is the most important step in case management and what does it entail
data base collection! entails a thorough history and physical exam at first, then later the results of tests
what three components are within the plan for each problem in a case
- diagnostic (Dx) plan
- therapeutic (Rx) plan
- client education (CE) plan
what is the diagnostic plan
you list the differential diagnoses (ddx) for each problem and decide which diagnostic tests/procedures will rule-in or rule-out the proposed causes
what is the therapeutic plan
specific or symptomatic treatment indicated for each problem
when making the client education plan, what are some factors we should consider
- what should we tell the client about the problem?
- what do we recommend?
- what is the prognosis and estimated cost?
what does SOAP stand for
Subjective Data
Objective Data
Assessment
Plan
normal canine temperature
100 - 102.5
normal canine heart rate
< 120
what is PaO2 and PaCO2
the partial pressure of arterial oxygen and arterial CO2
what is FiO2
fraction of inspired O2
room air = 21%
what is SaO2
saturation of hemoglobin with oxygen
what is SpO2
Saturation of hemoglobin with oxygen as determined by pulse oximetry
tachypnea
increased respiratory rate
hyperpnea
increase in depth and rate of respiration
orthopnea
dyspnea that improves with altering body position
dyspnea
the sensation of distressed breathing; “oxygen hunger”
cyanosis
blue/purple coloration of tissue due to hypoxemia
hypercapnia (aka hypercarbia)
increased PaCO2 (partial pressure of arterial CO2)
hypoxemia
decreased PaO2 (partial pressure of arterial O2)
hypoxia
decreased O2 delivered to the tissues
tidal volume
volume of gas passing into and out of lung with each respiratory cycle
minute ventilation
volume of gas passing in and out of lung in 1 minute
two main chemoreceptors that control breathing
- central chemoreceptors (medulla) responds to changes in PaCO2
- peripheral chemoreceptors (carotid bodies) respond to change in PaO2
five main causes of hypoxemia
1: hypoventilation
2: V/Q mismatch
3: diffusion barrier/impairment
4: low inspired O2
5: right to left shunt
what value of PaCO2 is indicative of respiratory failure
PaCO2 > 60 mmHg
what values indicate hypoventilation (and hypercapnia) of dogs? cats?
dogs: PaCO2 > 45mmHg
cats: PaCO2 > 40mmHg
respiratory pattern of upper airway distress
increased effort on inspiration
respiratory pattern of lower airway distress
increased effort on expiration with an abdominal push
respiratory pattern for pulmonary parenchyma disease
mixed inspiratory and expiratory effort with crackling sounds
describe stertor
shorty bulldog noise produced in the nasopharynx
describe stridor
high pitched, harsh noise produced in the larynx/pharynx
list some common look-a-like diseases that cause tachypnea
metabolic acidosis anemia stress neurological disease feline hyperthyroidism
four important steps of stabilizing dyspnea
- oxygen
- minimize stress
- butorphanol +/- acepromazine
- treat underlying disease
four common causes of unilateral nasal discharge
- foreign body
- early neoplasia
- tooth root abscess
- early fungal infection
four common causes of bilateral nasal discharge
- rhinitis (inflammation)
- systemic disease
- late neoplasia
- late fungal
five common signs of nasal disease
- epistaxis (nasal bleeding)
- reverse sneezing
- facial/nasal symmetry
- ocular signs (discharge, squinting)
how to check for nasal airflow
use a slide, stethoscope, or unraveled cotton
how is nasal neoplasia treated
- radiation therapy
- palliative care (NSAIDs especially)
