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Diseases 25 Exam > Critical Care > Flashcards

Critical Care Flashcards

(74 cards)

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1
Q

Triage

A

Identifying a minor emergency or severe life-threatening
emergency

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2
Q

PARENTERAL NUTRITION

A

IV administration of essential amino acids,
lipids, carbohydrates, vitamins and minerals to maintain nutrition

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3
Q

Patients parenteral nutrition is used for

A

Intestinal obstruction, ileus
Severe d+ v+
Unconscious
Acute pancreatitis or hepatitis

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4
Q

The maximum rate of infusion for PN

A

30ml/hr

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5
Q

Parenteral nutrition rate first, second and 3+ hours

A
  • Hour 1- 10ml/hour
  • Hour 2- 20ml/hour
  • From hour 3- 30ml/hour
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6
Q

Parenteral Nutrition Metabolic complications

A
  • Hyper/hypoglycaemia
  • hyperlipidaemia
  • electrolytes: K, P, Mg, Ca imbalances
  • Azotaemia
  • Hyperammonaemia
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7
Q

Parenteral Nutrition catheter complications

A
  • Premature removal, kinking, malpositioning of catheter
  • Vascular thrombophlebitis
  • Catheter infection
  • Contamination of PN mixture
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8
Q

How to make up a PN solution

A

fresh daily
mixed in order under aseptic conditions
1. amino acid and dextrose
2. electrolyte and mineral solutions
3. multivitamins
4. lipid emulsion.
No separation visible

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9
Q

Peripheral parenteral nutrition Day 1 and 2

A

Day 1: 50% RER;
Day 2: 100% RER

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10
Q

PN percentages Dogs

A

5-25% of RER as protein calories.
The remaining calories as 50:50 = lipids and sugars

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11
Q

PN percentages Cats

A

25-35% of RER as protein calories.
The remaining calories:60/40% lipid & dextrose

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12
Q

Opisthotonus

A

Severe hyperextension and spasticity in which the pet’s head, neck
and spinal column enter into a complete “arching”
position

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13
Q

List the Postural adaptations in respiratory distress

A

Open mouth breathing
Orthopnoea
Standing
Sternal recumbency

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14
Q

Tube Feeding daily amounts

A

Day 1 = 1/3 RER
Day 2 = 2/3 RER
Day 3 = 3/3 RER

Food should not exceed 10ml/kg per meal

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15
Q

PN final osmolarity

A

400-550
mOsm/L

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16
Q

PN length of use

A

10 days (usually 3-4 days)

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17
Q

Central Lines vein most used

A

Jugular

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18
Q

Types of catheters used for central lines

A
  • Through the needle catheter
  • Peel-away sheath technique
  • Over-the-wire catheters
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19
Q

Seldinger technique

A

Technique used in placing central lines
use of a guide wire to pass the
vasodilator and central line into the vessel

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20
Q

Nursing A Patient With A Central Line

A

Monitor for
blockage: regular flushing
inflammation/infection
dressing changes
Aseptic techniques
Physical exam (inc T) bid
Blood sampling/culture e.o.d.

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21
Q

The components of an intra-arterial monitoring system

A
  • the measuring apparatus-arterial cannula connected to tubing containing saline which conducts the pressure wave to the transducer.
  • the transducer- converts signal in waveform and BP
  • the monitor =displays the arterial waveform
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22
Q

normal CVP in dogs and cats

A

0-7cmH2O

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23
Q

Advantages of Arterial Blood Pressure measuring

A

Most accurate- Weak BP
Beat to beat assessment
Monitoring cardiac arythmias.

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24
Q

The Intra arterial line is also connected to a flushing system consisting of a bag of saline pressurised to

A

300 mmHg

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25
BP cuff width
40% of circumference
26
Electromechanical Dissociation
Detects electrical activity of the heart when heart not beating
27
Depolarisation
Contraction of myocardium
28
Repolarisation
Relaxation of cells after depolarisation
29
ECG Waves
P: Contraction of atria QRS: Contraction of Ventricules T: Relaxation of ventricules * Atrial repolarisation is hidden by QRS complex
30
Signs of damage to the cerebrum and brain stem can include
mental deterioration. pacing. seizures. Depression coma, head turn or circling in one direction
31
Signs of damage to the cerebellum
head tilt, bobbing, tremors, or other unusual head movements
32
Paresis
Muscular weakness
33
Plegia
Paralisis
34
Quadriplegia
paralysis in all four limbs
35
* Paraplegia
Hindlimb paralysis
36
* Hemiplegia
Paralysis of one side of the body
37
* Hypermetria
the overshooting of limbs
38
Qualitative urinanalysis
pH, protein, glucose, bilirubin, haemoglobin, ketone, urobilinogen and creatinine levels
39
Quantitive urinalysis
Investigation of renal function metabolic function nutritional requirements
40
Disseminated Intravascular Coagulation ( DIC)
a condition in which blood clots form throughout the body's small blood vessels. Causing Internal and external (under skin) bleeding
41
Conditions that cause DIC
* Septic shock * Pancreatitis * Heat stroke
42
Treatment of DIC
Blood transfusion
43
Hypoproteinaemia
Decreased serum protein (globulins –mainly albumin) leading to loss of fluid from the blood vessels and intravascular space, resulting in oedema.
44
Hypoproteinaemia Causes of reduced production and increased Loss
REDUCED PRODUCTION- Liver disease and malabsorption INCREASED LOSS Renal disease (only albumin) GI disease Haemorrhage burns Sepsis
45
When is blood and its products indicated?
Reduction in blood volume Reduction in oxygen carrying capacity Reduction in tissue perfusion
46
A donor must be
Between 1 – 8 years old * Blood typed * Regularly screened for diseases, wormed and vaccinated * Not received a blood transfusion in the past
47
Dog Donors Specifics
Minimum weight of 25 kgs * Minimum PCV of 40% * Adequate vWF (von Willebrand factor)
48
von Willebrand factor
Clotting factor
49
Cat Donor Specifics
Minimum weight of 4.5 kgs Minimum PCV of 35% FeLV and FIV tested before each donation
50
Rabbit Donor Specifics
Minimum weight of 2.5kg
51
Blood Collection amounts
* Dog 19ml/kg * Cat 11ml/kg * Rabbits 11ml/kg
52
Blood volume for Dogs cats and rabbits
88ml/kg dogs 66ml/kg for cats and rabbits
53
Universal donors dogs
DEA 1.1 negative (about 30% of dogs)
54
Blood Typing - Cats
* A, B, AB * Typing in cats is ESSENTIAL
55
Major cross matching
Recipient plasma antibodies to donor RBC antigens
56
Minor cross matching
Donor plasma antibodies to recipient RBC antigens
57
Cross Matching results
Positive result - Cells at or near top of tube * Do not transfuse! Negative result - Cells at or near the bottom of the tube * Unlikely to cause a reaction
58
Tracheostomy tube
60-70% tracheal diameter
59
Whole blood Storage and use
Fresh, Used within 6 hours of collection Cells, clotting factors and platelets
60
Packed red blood cells Storage and use
Blood is centrifuged and RBC are separated off * Stored at 1-6˚C
61
Plasma Storage and use
Fresh frozen plasma Stored frozen plasma Used in burns and hypoproteinaemia
62
Administration of Blood Products
warmed to body temperature (37°C) Blood clot filter speed : 2-3 mls/kg/hr (first 30min 0.25-1 ml/kg/hr)
63
Monitoring vital signs during transfusion
every 15-30 min after transfusionthen 1hr, 12hr and 24hrs
64
Signs of Transfusion Reaction
Tremors Facial oedema Tachypnoea or dyspnoea Tachycardia or bradycardia Vomiting Increased temperature Collapse Haematuria
65
Acute Haemolytic Transfusion Reaction
The recipient has antibodies to the antigens on the donor RBC, causing their destruction
66
Acute Haemolytic Transfusion Reaction major concern to which species
Cats with type B, transfused with type A
67
Lysis
red blood cell destruction or hemolysis,
68
Acute Allergic Reaction
Seen within seconds -45min Erythema, pruritus and urticaria(hives
69
Febrile Non-Haemolytic Transfusion Reaction
body temperature increases by 1degrees C + Mild reaction
70
Haemolytic reactions support
IV fluids Oxygen therapy
71
Mild allergic reactions Support
Corticosteroids or antihistamines and slow infusion rate
72
Severe allergic or anaphylactic reaction support
Aggressive IVFT Adrenaline Corticosteroids and antihistamines
73
Nasal Catheter oxygen supply %
30 - 60%
74
O2 flow rate for oxygen mask
2 to 5 L/min

Diseases 25 Exam (12 decks)

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