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Patient Care 1 > Clinical Examination > Flashcards

Clinical Examination Flashcards

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1
Q

SOAP?

A

Subjective
Objective
Assessment
Plan

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2
Q

Subjective?

A

personal assessment of immeasurable observations

  • eg demeanour, behaviour, posture
  • so different for everyone
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3
Q

objective?

A

factual assessment of measurable observations

  • eg TPR
  • so same for everyone
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4
Q

assessment?

A

involves progress comparison of the patient
- may include both subjective and objective observations

easy to see changes

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5
Q

plan?

A

how to treat the patient

may include specific treatment protocol
- eg medication or physical intervention
or an observation protocol
- eg frequency of TPR monitoring

vet will want to know any changes

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6
Q

beginning of an examination?

A

head to toe

observe the patient from distance 
- demeanour and posture will change when near 
examine overall coat condition
examine general condition 
- may see something not originally there for 
check respiratory rate 
- will change when near
- give time to calm down 
provide physical examination
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7
Q

what to remember when observing a patient?

A

each patient is an individual
signs that may be normal for one patient may not be normal for another
- eg frequency of eating/toileting
signs seen may be abnormal for an individual patient due to environmental factors
- eg cat + rabbit = stressed
important to ensure that the natural environment and routine of each species is maintained as closely as possible
- to minimise stress

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8
Q

assessment of patient?

A

on admission a routine health check should be carried out
- should be done regularly so a comparison is possible

general demeanour, temperament and overall condition can be assessed before completing a physical exam
- eg BAR, QAR or respiration

a routine check should be done daily through hospitalisation
- so health is recorded and charted

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9
Q

physical examination

head area considerations?

A

posture
- looking around, lifting head, alert?
moist nares
patient airway
- noisy is normal for some species/breeds
nasal discharge
- causes can be allergies, foreign body, virus, infection, abscess
epistaxis
- nose bleed
- caused by trauma, foreign body, tumour
sneezing or dyspnoea

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10
Q

physical examination

mouth considerations?

A

signs of dental disease
- bad breath, inflamed/red gums, avoid playing with mouth, tarter
tongue
breath
- from uraemia (urine in blood) caused by kidney disease
- from diabetes mellitus with pear drops smell
jaw misaligned
- caused by trauma - fractured/dislocated?
- can they open without difficulty?
any congenital deformities
- deformities from birth

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11
Q

physical examination

mucous membrane considerations?

A

should be moist and pink
- cats naturally paler
indicates adequate blood flow and therefore oxygenation of tissues
- so any change may indicate an issue
capillary refill time
- should be less than 2 seconds in a healthy animal

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12
Q

physical examination

mucous membrane pettechiae?

A

small pinpoint haemorrhages

seen in patients with clotting disorders

often seen those poisoned with rodenticides (warfin)

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13
Q

physical examination

mucous membrane colour - pale, grey or white?

A

poor perfusion

shock
circulatory collapse
haemorrhage 
anaemia 
severe vasoconstriction 
dehydration
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14
Q

physical examination

mucous membrane colour - red?

A

congestion - over oxygenation of tissues

sepsis
fever
congestion
extensive tissue damage

or because of post-exercise or excitement

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15
Q

physical examination

mucous membrane colour - blue or purple?

A

blue = cyanosis
from severe hypoxaemia - low blood oxygen

respiratory difficulty
poisonings
severe dehydration

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16
Q

physical examination

mucous membrane colour - yellow?

A

jaundice

liver disease - bile flow obstruction
increase in red blood cell destruction 
- increased amount of bilirubin  
neonatal isoerythrolysis 
- antibodies in mare fighting RBCs in foetus
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17
Q

physical examination

mucous membrane colour - orange?

A

jaundice disease
blood cell disorders
synthetic haemoglobin products

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18
Q

physical examination

mucous membrane colour - chocolate brown?

A

paracetamol poisoning in cats and dogs

  • cats cant have any
  • dogs can have small amount
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19
Q

physical examination

mucous membrane colour - cherry red

A

poisoning

heatstroke

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20
Q

physical examination

eyes considerations?

A 
Ulcers?
Opaque? 
Ocular discharge?
Conjunctivitis?
Foreign bodies? 
Scratching?
Increased vascularity?

May become disorientated
Make room dark

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21
Q

physical examination

eyes - blepharospasm?

A

Involuntary blinking or twitching

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22
Q

physical examination

eyes - anisocoria

A

Unequal pupil size

Caused by:

  • glaucoma - damaged optic nerve
  • chemosis - swelling of conjunctiva
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23
Q

physical examination

eyes - exophthalmos?

A

Abnormal protrusion od eyeball

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24
Q

physical examination

eyes - proptosis?

A

Prolapsed eyeball

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25
physical examination | eyes - entropion?
Inversion of eyelids
26
physical examination | eyes - ectropion?
Eversion of eyelids
27
physical examination | Ears considerations?
Check pinnae for inflammation and wounds Check ear canal for foreign bodies, erythema (redness of skin) or infection If fur clipped away from arears infection is likely as less protection from foreign bodies
28
physical examination | Lymph node considerations?
Will be enlarged in cases of neoplasia (tumour) or infection
29
physical examination | Skin and coat?
``` Dryness Scaliness Greasiness Pyoderma - skin infection Urticaria (hives) Alopecia (hair loss) Tenting - indication of dehydration Ectoparasutes - eg ticks, flies, mites - itching, hair loss, lumps Wounds - open or closed? - may be more than 1 Allergies ```
30
physical examination | forelimbs considerations?
``` Range of motion Weight bearing Atrophy (shrinkage of muscle) Lameness Wounds Crepitus (popping, clicking or crunching sounds of bones) Fractures Dicomfort Heat or swelling Foreign bodies - can't remove until x-ray shows where goes ```
31
physical examination | thorax considerations?
Gently feel ribs and thoracic vertebra for any fractures or swelling Heart best can be felt more easily on the left side of the ventral chest - between ribs 3 and 6 - just below elbow Allows for assessment of rate, strength and quality Crackles and rales (clicking/bubbling) when listening to chest suggests: - pulmonary oedema - pneumonia - bronchitis
32
physical examination | abdomen considerations?
Assess for distension (dilation) Gently palpate checking for tenderness, pain or swelling - using ends of fingers - not fingertips Kidneys, bladder, spleen and intestines may be felt - but difficult to locate in tense or obese patients
33
physical examination | pelvis and hindlimbs?
Pelvis and hindlimbs same way as forelimbs Femoral pulse can be assessed - medial aspect of proximal femur
34
physical examination | tail and anus?
Ensure tail can move voluntary Tail should be assessed for wounds or damage Check coxygeal vertebrae ``` Anus should be checked for signs of: - soiling - trauma - discharge Anal glands may become infected and/or impacted - signs include scooting and fishy smell ```
35
physical examination | male reproductive organs?
penis and testicles should be check for signs of trauma or abnormal swelling entire dogs should have two descended testicles - if young and only 1 give time - if doesn't descend surgery needed to remove entire horses and cats should have two palpable testicles check sheath of geldings (castrated male horse) - need frequent cleaning - may attract flies and magots
36
physical examination | female reproductive organs?
check for swelling of the vulva check for vulval discharge in bitches - discharge unlikely in cats and horses check if breeding mares may have undergone caslicks surgery - surgery to correct conformation on the vulva - stops faeces entering so no infection - stitches need to be removed when partuition is close teats should be checked - lactation - mastitis - inflammation from infection
37
vulval discharge in bitches?
``` blood red = pro-oestrus straw-coloured = oestrus dark green/brown = parturition is soon black = death of foetus purulent green or pale coffee-coloured = pyometra ```
38
normal vital signs in dogs?
temp - 38-39 pulse - 60-120 resps - 10-30
39
normal signs in cats?
temp - 38-39 pulse - 110-180 resps - 20-30
40
normal vital signs in rabbits?
temp - 38-40 pulse - 130-325 resps - 30-60
41
normal vital signs in horses?
temp - 37-39 pulse - 36-42 resps - 8-15
42
how and where to know pulse?
manual palpate and count stethoscope ultrasound ECG femoral artery - medial aspect of femur digital arteries - palmar and plantar surfaces coccygeal artery - ventral aspect of base of tail lingual artery - ventral aspect of tongue
43
TPR terminology | pyrexic?
high temperature
44
TPR terminology | tachycardia/bradycardia
fast heart rate/slow heart rate
45
TPR terminology | bradypnoea/tachypnoea?
slow breathing/fast breathing
46
TPR terminology | apnoea?
no breathing
47
TPR terminology | dyspnoea?
difficulty breathing
48
TPR terminology | paradoxical breathing?
diaphragm moves in the opposite direction than it should | - ribs move in when breathing
49
physiological changes?
as well as a physical examination the following should be monitored - appetite changes - urination patterns - defecation patterns - vomiting - coughing - signs of pain - stress and behavioural changes - mobility
50
physiological change examination | reason for changes in appetite?
change in routine change in environment change in diet - presence of disease medication - either side effect or require to eat (eg pain relief)
51
physiological change examination | different abnormalities of appetite?
dysphagia - difficulty eating, especially swallowing anorexia - loss of appetite for food pica - craving for natural articles of food capricious - irregular/picky eater coprophagia - eating of faecal material inappetence - lose of desire to eat
52
how can you ensure adequate nutrition?
talk to owners about diet and nutrition - educate provide food supplements (fluids) ensure balanced diet test, check and support any illness
53
physiological changes examination thirst requirements? polydipsia/adipsia?
voluntary water intake varies with species, individual and diet requirement 50ml/kg/24hr - young may need more polydipsia - increased thirst - cushings cause thirst adipsia - lack of first
54
physiological changes examination urination monitoring? normal? appearance?
daily monitoring of urine is important - can catheterise to measure amount - use non-absorbent cat litter and pippet normal urine output - 1-2ml/kg/hr should be clear, pale, yellow - cloudier in rabbits and horses - carbonate crystals no red - sign of cystitis (inflammation of bladder) or trauma
55
physiological changes examination | abnormalities or urination?
micturition - passing urine dysuria - passing of urine is difficult and uncomfortable polyuria - passing larger volumes or more frequently oliguria - reduction in daily production of urine haematuria - blood in urine stranguria - passing of urine is painful anuria - no urine produced
56
physiological changes examination | changes in defecation?
appearance varies between species and diet | - eg grass or hay
57
what to monitor in faecal output?
must be daily - amount - frequency - colour - shape - soft or hard - colour - blood - parasites
58
physiological changes examination | abnormalities of bowel activity?
tenesmus - painful, ineffectual straining constipation - hardened faeces and difficulty emptying diarrhoea - rapid expulsion of soft non-formed material melaena - dark, tarry faeces sometimes with music (evidence of blood loss in upper GI tract) haematochezia - fresh, red blood
59
physiological changes examination | vomiting? types? risks
``` emesis types - projectile without retching (pyloric obstruction) - bilious (bile) - cyclic (keeps happening - retching (ineffective attempts) ``` risk of patient aspirating food particles or fluid causing pneumonia can cause serious electrolyte imbalances
60
physiological changes examination | vomiting definitions?
vomiting - forceful removal of stomach contents via mouth - often along with retching, abdominal contractions, hypersalivation and licking lips regurgitating - passive movement of food/liquid from trachea to mouth - without warning haematemesis - vomiting material containing blood stercoraceous - vomiting a faecal matter
61
physiological changes examination | coughing?
``` distinguish type/reason - allergies or disease think about possibly being contagious - isolation and barrier nursing - kennel cough, influenza, strangles, equine asthma consider when developed ``` provide management - eg inhalers, antihistamines, vaccines
62
physiological changes examination | why important to recognise pain?
ethical perspective no positive effects for the patient - however sometimes stop movement and further damage impedes recovery
63
physiological changes examination | signs of pain?
``` vocalising - predators do, pray don't - pray species often hide pain until too late tense eyes - look sad/in pain teeth grinding ```
64
physiological changes examination | colic pain signs?
``` flank watching lip curling stretching as if to urinate inappetane teeth grinding sweating lying down grunting/groaning ```
65
physiological changes examination | lameness pain signs?
inability to bear weight weight shifting persistent resting of limbs standing abnormally
66
physiological changes examination | how to reduce pain?
``` analgesia increase comfort - raising food and water bowls - padding area keep clean ```
67
physiological changes examination | how to reduce stress?
``` quiet area blanket or t-shirt from home sit with them - provide TLC keep away from other species have home buddy if beneficial provide hides for prey species provide pheromone sprays and diffusers ```

Patient Care 1 (22 decks)

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