VNSA6 Flashcards
What are the 5 needs of the AWA2006?
- need for a suitable environment
- need for a suitable diet
- need to exhibit normal behaviour patterns
- need to be housed, with or apart from other animals
-need to be protected from pain, suffering, injury and disease
Who is responsible for an animal under AWA2006 ?
Anyone! Who takes responsibility (even temporarily).
Hospital accommodation
-Designed for short stay only.
-smaller than a boarding facility (provides restriction for observation and rest)
-animals staying for boarding or grooming should be housed separately.
RCVS Practice Standards Scheme states: ‘ there must be a range of suitable accommodation of a suitable size for the number and species routinely treated.’
‘Inpatient facilities must be of a suitable size, securable, sturdy, escape proof without potentially dangerous faults and easily cleanable’.
Types of non-permeable material for construction of housing cats and dogs
-wood
-concrete blocks/bricks
-melamine - plastic coated chipbaord
-wire mesh
-glass
-stainless steel
-plastic/fibre glass
Properties: impervious, draught proof, durable, indestructible, easy to clean
Key points to consider for accommodation
-comfort
-noise absorption
-temperature maintenance
-cost to install and maintain
-ease of observation of patient
-safe and securable
Minimum recommended size of hospital kennels for dogs and cats
Cat: H = 45.72cm. W = 45.72cm. D = 72.29cm
Small dog: H = 45.72cm. W = 45.72cm. D = 72.39cm
Med dog: H = 76.20cm. W = 76.20cm. D = 72.39cm
Lrg dog: H = 76.20cm. W = 121.92cm. D = 72.39cm
Giant dog: H = 91.44cm. W = 152.40cm. D = 72.39cm
Walk in kennel: H = 180cm. W = 140cm. D = 110cm
Maintenance and maintaining a suitable environment
To consider:
-species
-age
-reason for admission
-individual needs
-temperament
These include:
-heating
-ventilation
-lighting
-bedding
-position
-feedstuffs
-access to clean water
-waste disposal
-exercise
How to provide extra heat
-fluid therapy
-lab incubators
-microwave
-sink of hot water
-bair hugger IV line insulation
-incubators
-heat lamps
-electric heat pads
-warm enemas
-hot gloves/hands/water bottles
-microwave wheat pads
-ambient temperature
-coats/jumpers
-bubble wrap/emergency blanket
Ideal kennel temperatures
Adult dog: 7-26°
Adult cat: 10-26°
Hospital or isolation: 18-22°
Parturition: 18-21°
Neonates: 25° for the first 2wks and then 20° until weaning
Why is sufficient ventilation so important in the hospital accommodation?
-to provide a good oxygen supply
-to reduce the likelihood of airborne infections spreading
-remove stale air containing ammonia, methane and unpleasant smells from faeces, carbon dioxide, exhalation and water vapour from respiration.
-prevent animals from overheating
-prevent problems arising from high humidity
What is the minimum amount of air changes per hour?
4-8
Name types of active ventilation
-extractor fan
-air conditioning
Name types of passive ventilation
-window
-vent
Why is good lighting required?
-mimic animals natural conditions (dimmable)
-duration of lighting
-intensity of lighting
-it is a heat source
-for examination and observation
Basic requirements and qualities of a bed
Requirements = raised off the floor, easy access for animal, protect from draughts
Qualities = warmth, comfort, security, protection, absorbency, shouldn’t harbour pathogens, demarcates the animals territory, small mammals and cats need a hide, recumbent animals need a foam mattress or orthopaedic mattress.
Types of beds
Wicker basket, bean bags, fabric covered, raised frame, radiator cat beds, moulded plastic, sleeping benches, blankets, vet beds, covered foam pads, newspaper, shredded paper, straw or hay
Types of cat litter
Mineral based - Advantage = clumping form - easy to remove soiled litter. Disadvantage = lots of product needed to allow clumping
Fullers Earth, clay - Advantage = non clumping. Disadvantage = whole tray needs to be removed when soiled.
Wood based - Advantage = lightweight, biodegradable, highly absorbent, smells nice. Disadvantage = messy and bulky
Vegetable based - Advantage = clumping and biodegradable. Disadvantage = more difficult to obtain + expensive
Paper based - Advantage = recycled and biodegradable. Disadvantage = messy, newspaper ink can stain
Types of bowls
Plastic - pros = cheap and heatable. Cons = chewable, breeds bacteria, can’t autoclave
Ceramic - pros = can disinfect, bite resistant, sometimes microwave safe. Cons = can’t autoclave
Metal - pros = can autoclave. Cons = cannot be heated, animal can see their reflection
Exotics accommodation.
-only hospitalise when necessary. Stress is very important to consider
-surgical patients should be discharged asap. Owners taught how to syringe feed and medicate
-if hospitalisation is necessary the animals own cage is best. If not possible it should be mimicked as closely as possible.
-often prey animals - needs to be kept away from dogs and cats to minimise noises and smells.
-dimmed lighting, front of cage covered, red/blue lighting used.
Define an actual problem
Present at the time of assessment
Define potential problems
Problems that don’t exist but are likely to develop unless there is nursing interventions
Normal dog parameters
Temp = 38.3-39.2 degrees Celsius
Pulse = 70-140bpm
Respiratory = 10-30 brpm
Normal cat parameters
Temp = 38.2-38.6
Pulse = 100-200 bpm
Respiratory = 20-30 brpm
Normal rabbit parameters
Temp = 38.5-40.0
Pulse = 130-325 bpm
Respiratory = 30-60 brpm
Define pyrexia
Abnormally high temp. Usually caused by infection.
Define hyperthermia
Raised temp. Caused by exercise, excitement, heat stroke, seizures, pain and infection.
Define hypothermia
Low body temperature. Seen in hypovolaemic shock, GA or impending parturition.
Pulse (bpm)
Used to evaluate efficacy of cardiovascular system
The pulse can be palpated at any point where an artery runs close to the body surface
In normal patients an increase in pulse or inspiration and decrease on expiration is normal. This variation is known as sinus arrhythmia.
A weak threads pulse may indicate shock or diminished cardiac output.
Define arrhythmia
Irregular heart beat. Sinus arrhythmia is normal
Define Pulse deficit
Lower pulse than corresponding heat rate, present in many arrhythmias
Respiration (brpm)
Make sure the patient is at rest but not sleeping or panting.
By observing the movement of the chest, count either breaths in or breaths out, but not both, for one minute.
Depth, rhythm, and rate should be assessed by careful observation or by placing your hands on either side of chest
Define dyspnoea
Difficult or laboured breathing, caused by stenosis or obstruction of respiratory tract.
Define tachypnoea
Increased respirate = exercise, excitement, pain, shock, hyperthermia
Define bradypnoea
Decreased respirate = sleeping/hibernation, narcotic and hypnotic, poisons, brain trauma or metabolic disorders.
Signs of respiratory distress
-mouth breathing
-adducted elbows
-dilated pupils
-paradoxical abdominal movements
-cyanosis
-anxious face
Monitoring blood pressure
Blood pressure provides information about the pressure exerted on the walls of the arteries
-heart pumps blood into the arteries and around the blood circulation
-arterial wall ‘stretches’ to cope with variation in flow
-amount of blood pumped into vessels
Blood pressure is a measure of the patients cardiovascular function, providing an indirect measure of cardiac output and tissue blood flow (tissue perfusion).
Blood pressure formula
Blood pressure = cardiac output X systemic vascular resistance
Define diastolic pressure
When the heart is filling with deoxygenated blood and its at the minimum
Define systolic pressure
When the ventricles are contracting and its at its maximum
Define mean blood pressure
The average pressure between the systolic and diastolic pressures
Indirect (non-invasive) measurement of arterial blood pressure
Correct width of cuff, should be 40% of the circumference of the limb, is important to achieve accurate readings
Place the black line of the cuff directly over the chosen artery
Reading taken by these methods are less accurate than direct methods
Doppler method
A Doppler probe is placed on the palmar aspect of the metacarpus.
Cuff placed above the elbow
The sphygmomanometer measures pressure in the cuff and the Doppler probe senses blood movement within the artery which can be heard.
-cuff inflated to a pressure that occludes systolic pressure, so no pulsing is heard from the probe
-cuff is deflated, an audible pulsation returns, indicating the systolic pressure at the cuff
Advantages and disadvantages of the Doppler method
A = non-invasive, simple to use, shown to be more accurate than the oscillometric, gives an idea of pulse.
D = requires patient cooperation, less accurate than the direct method, only 1 reading.
Oscillometric method
The cuff is placed on distal limb or tail, often just proximal to the carpus and attached to the blood pressure machine via tubing.
-cuff is inflated automatically to above systolic pressure, occluding the blood flow.
-cuff pressure is slowly reduced allowing blood to pulse through the vessel, indicating systolic arterial blood pressure.
Advantages and disadvantages of the oscillometric method
A = non-invasive, set for every 3-5 mins or chosen to , gives all parts
D = automated, may not be accurate, noisy for the animal
Name condition that lead to recumbency
-fractures
-spinal trauma
-weakness
-neurological
-heart failure
-shock
Areas that need to be covered in care plans are:
-bedding
-nutrition
-hydration status and fluid balance
-urinary management
-movement
-faecal management
-eye care
-oral care
-analgesia
-physiotherapy
-cardiovascular support
-blood sampling
-respiratory
Signs of pain
-vocalising
-pacing
-teeth grinding
-anxiety
-depression
-squinting eyes
-not wanting to be touched
-not wanting to move - hunched with head below shoulder
-muzzle tight
-aggression
-not wanting to urinate and defecate
-anorexia/inappetence
-self-utilisation
-abnormal posture and gait
-lameness
-tachycardia or tachypnoea
Signs of wound infection
-pain
-erythema
-oedema
-heat
-purulent exudate
-serous exudate with concurrent inflammation
-delayed healing
-friable granulation tissue
-discolouration of tissue
-pocketing at the base of the wound
-foul odour
-wound breakdown
Why are bandages needed ?
-hold dressings in place on a wound
-support and immobilation
-protection
-pressure
Bandaging structure
Initial layer - dressing applied directly to wound
Primary layer - providing comfort/support/absorption
Secondary layer - comforting (strength, contouring and security)
Tertiary layer - providing protection, conforming and strength
When to remove a bandage
-persistent chewing
-foul smell from dressing
-soiling or wetting of dressing
-strike through or exudate through dressing
-swelling above dressing
-slippage from original placement
Ehmer sling
Binding technique
Stabilise dislocated hind leg in dogs
Velpeau sling
Hold shoulder, elbow and carpus in flexion
Supporting the forelimb in a non-weight bearing position
Spica splint
Support elbow after closed reduction of a traumatic elbow luxation or internal fixation of olecranon fractures.
Robert Jones dressing
A bulky compression dressing
How to encourage patients to eat
-syringe feed
-hand feeding
-heating food
-feeding what they are used too (dry/wet)
-selection of food available
-appetite stimulants
-appropriate bowel type
-add water/chicken/chicken water
How to pick the correct tube feeding method
-which area of the gastrointestinal tract is compromised
-length of time tube needs to remain placed
-veterinary surgeons experience
-equipment practice has
Nasogastric tube
Tube is inserted through nostril
Passed through the pharynx to lie in the oesophagus
lies in cranial oesophagus rather than in stomach
A = well tolerated, inserted conscious, used for 3-7 days
D = irritating to eyes and nose, collar required to keep in place, limited types of food available to go through tube
Oesophagostomy tube
Surgical hole made over area of pharynx
Tube passed through hole via pharynx into oesophagus
Alternatively hole made directly into pharynx
A = well tolerated, allows most of GI tract to be used, able to syringe most food types
D = requires GA to insert, wound care required, chance of infection
Maintenance of tube feeding
To check still in place - Remove end of tube from neck wrap. Attach an empty syringe to external feeding port and pull back. If the tube is in place the plunger should move back to its starting position on its own due to negative pressure.
Flush before and after each feed to prevent blockages
Administration of food through a tube
-complete liquid foods are ideal
-however sometimes the amount to meet patients RER is too large
-pate can be mixed with water and syringed down (may struggle with nasogastric tubes)
-warm all food to body temp
-stomach capacity = cat - 45ml/kg dog - 90ml/kg
Tube feeding quantities
Day 1 = feed 1/3 of total daily requirement
Day 2 = feed 2/3 of total daily requirement
Day 3 = feed full daily requirement
Define vomiting (emesis)
Forceful evacuation of stomach contents via mouth
Define regurgitation
Passive movement of food or liquid into the mouth, without warning or signs
Types of vomiting
-projectile
-stercorarceous vomit (contains faeces)
-haematemesis
-bilious vomit
-cyclic vomiting
-retching
Causes of vomiting
-ingestion of foreign material
-viral infections
-diabetes mellitus
-pancreatitis
-pyometra
-anaesthesia
-endoparasites
-pain
-gastritis
-grass/hairballs
-tumours
-drugs
-motion sickness
-mega-oesophagus
Causes of coughing
-cardiac failure
-foreign bodies
-tracheal collapse (Yorkies)
-pulmonary oedema/haemorrhage
-lungworm infection
-asphyxia
-infection leading to pharayngitis, bronchitis, tracheitis, pneumonia
- ET tubes
Direct invasive measurement of arterial blood pressure
-most accurate reading available
-catheter is aseptically placed into an artery (often dorsal pedal), then connected to an electric transduce (kept at the level of the right atrium), which converts the pressure into: pulse waveform and systolic and diastolic blood pressure.
Advantages and disadvantages of direct (invasive) measurement of arterial blood pressure
A = accurate, allows for proper perfusion of body tissue and organs
D = invasive, stressful for the animal.
Normal blood pressure ranges for dogs and cats
Systolic = 90-120 mmHg
Diastolic = 55-90 mmHg
Mean blood pressure = 60-85mmHg
Factors that affect raised blood pressure ?
-stress
-cardiomyopathy
-blocked bladder
-hypervolaemia (Latrogenic)
-obesity
-main arterial blockage
-renal disease
-hyperthyroidism
Factors that may lower blood pressure?
-shock
-hypervolaemia
-haemorrhage
What does mmHg stand for?
Milimeteres of mercury
(Blood pressure)
