VNSA15 + 16 Flashcards
When admitting animals what needs to be included?
-handover from o
-checking when animal was last fed + if water was withheld
-Animals possessions
-what meds has been given and when
-consent (age over 18) and checking they understand procedure
-consider economics
-contact details
-providing o a time to call for progress if not heard
-create nursing record
-record any changes (behaviour, eating and drinking etc)
-allergies
-update records (numbers and weights)
Starvation periods
Puppies and kittens = 3hrs
Dogs and cats = min 6hrs
Ferrets = max 4hrs (ideal time 1-2hrs)
Rabbits = not starved
Define elective/non-urgent procedures
Routine pre-anaesthetic prep, healthy animal discharged same day.
Eg neutering
Define necessary/urgent procedures
Condition isn’t immediately life threatening
Patient to be discharged in next few days (progress dependent)
Procedure can be delayed short term to allow time for necessary patient prep
Eg - RATA, Boas surgery, grass seed removal
Define emergency/life threatening procedures
Despite increased surgical risks prep time is limited
Patient expected to be hospitalised for some time post op
Immediate surgical procedure necessary
Eg - pyo, ex lap, foreign body, RTA, c-section, blocked bladder, GDV
What is a hernia ?
Where the body part protrudes abnormally through a tear or opening in an adjacent part.
Diaphragmatic = keep head and chest slightly higher. Closely monitor cardiovascular and respiratory system.
Umbilical/inguinal = can be incarcerated. Nursing dependable.
Perineal = a swelling by anus due to breakdown of muscle forming pelvic diaphragm. Check bladder not affected.
Management of orthopaedic procedures
Analgesia
Assessment of other body systems
Keep animal mobile if poss
Weight control
Nutrition for healing
Exercise and physio
Treatment of any skin infections
Recognition of early signs of complications (osteomyelitis, inc pain, reduced limb use, depression, pyrexia)
Advantages and disadvantages of casts (fracture management)
Used in relatively stable fractures (green stick, simple oblique or spiral) or post op support.
Adv: non-invasive, stability and relives pain, prevents displacement
Dis: limb swelling, decubitus ulcers, cast loosens, prolonged immobilisation, joint laxity, re-fracture on removal.
Advantages and disadvantages of internal fixation (fracture management)
Adv: Can be used with any fracture but open fractures with extensive soft tissue injury may not be suitable. Can be used in any bone, allows accurate reduction and rigid fixation. Limb has full function
Dis: expensive, time consuming, technically demanding, risks of surgery
Advantages and disadvantages of external fixation (fracture management)
Used in long bone fractures, comminuted, open and infected, delayed unions and non-unions, mandibular
Adv: minimal instrumentation required, clamps and bars reusable, minimal disruption of soft tissue, open wound management is easy, easy to combine with other implants, adjustable ridgity/alignment, easy to rem
Dis: soft tissue problems, application process requires technique, premature pin loosening, difficult to apply to proximal limb, x-rays difficult.
Monitor signs in post-op nursing
Body temp
Monitor faecal and urinary output (is catheter needed)
Osteomyelitis (pyrexia, depression, reduction of limb use, pain)
IVFT
Wound/bandage management and interference
Nutrition
Monitor body condition
Kennel size
Bedding material
Cold compress
Supported exercise
Enrichment
Spinal procedures
Problems = pain, paresis, paralysis, loss of bladder function, deep pain perception
Surgery often involves relieving pressure on the spinal cord.
Provide analgesia (NSAID’s, opioids)
Urinary monitoring and assistance
Padded kennel/mattress, regular turning (4-6hrs) of recumbent patients to reduce hypostatic pneumonia and decubitus ulcers. More lifting assistance with larger breeds. Keeping them clean and dry.
Thoracic procedures
Often life threatening procedures. Check for obstructions, SPO2 levels, heart failure etc.
nursing symptoms: inc RR, oxygen therapy, reducing stress.
During thoracotomy IPPV needed continuously
Extubated as late as poss
Chest drains
Dressings changed
Monitor temp and fluid loss
Post op - monitor vital signs, ensure air take is sufficient, careful patient handling, O2 supplementation, IVFT.
GDV (Gastric Dilation and Volvulus)
Fatal due to hypovolaemia and toxic shock.
Commonly seen in large deep chested breeded dogs.
Stomach twists causing a one-way valve effect at the gastro-oesophageal junction allowing swallowed air to enter but not leave. Gas accumulation may result from CO2 producing bacteria and gastric acid and bicarbonate can also lead to CO2 production.
Pre-op: aggressive IVFT needed to restore circulatory volume, acid-base balance and electrolytes. Stomach needs to be decompressed using oro-gastric tube or percutaneous. Analgesia, fluids, antibiotics etc also needed.
X-rays to confirm stomach position.
A gastrostomy tube is often placed.
Post-op: focus on cardiac output, tissue perfusion, ischaemia-reperfusion injury (IRI). Analgesia, IVFT, blood analysis, urinary output and ECG required.
What are the 2 aims of ophthalmic procedures
Preserve sight if poss and reduce pain.
