Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

X Clinical Veterinary Nursing Theory > Diseases of The Respiratory System > Flashcards

Diseases of The Respiratory System Flashcards

(354 cards)

Start Studying
1
Q

what forms the upper respiratory tract?

A

from the nose to the thoracic inlet (includes nasal cavity, oral cavity and cervical portion of trachea)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what makes up the lower respiratory tract?

A

trachea, bronchi, bronchioles and alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

define medical condition

A

abnormality/malfunction of a body system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what can give an idea of potential causes/differential diagnoses of medical conditions?

A

a through history and clinical exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is used to confirm a diagnosis?

A

diagnostic and labs tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what can be formulated after a diagnosis is reached?

A

treatment plan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is happening during acute respiratory failure?

A

lungs are unable to oxygenate blood or exchange carbon dioxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

is acute respiratory failure an emergency?

A

yes - patient will die without intervention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are some common causes of respiratory failure?

A 
airway obstruction (e.g. BOAS)
ruptured diaphragm
pulmonary oedema/haemorrhage
pneumo/pyo/haemo/chylothorax
neoplasia
infection
toxin ingestion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is chylothorax?

A

chest filled with lymphocyte rich fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the signs of respiratory failure?

A 
cyanosis
distress
inspiratory dyspnoea
expiratory dyspnoea
dyspnoea
tachypnoea
orthopnoea
tachycardia
weak pulses
collapse
unconciousness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what type of dyspnoea is associated with upper respiratory tract noises?

A

inspiratory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what sounds are associated with inspiratory dyspnoea?

A

snoring
stertor
stridor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is stridor?

A

high pitched sound from the larynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what sounds are associated with expiratory dyspnoea?

A

wheezes

crackles on auscultation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is orthopnoea?

A

position adopted by dogs and cats when they are dyspnoeic

abduction of elbows and extension of neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how may oxygen be administered to the conscious patient?

A 
flow by
nasal catheter
nasal prongs
face mask
oxygen tent
oxygen cage or incubator
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what may be needed if oxygen is being provided to the conscious patient?

A

sedation (butorphanol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how does a nasal catheter provide oxygen?

A

inserted into the nasal passages and connected to an oxygen supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what can an oxygen tent be formed from?

A

cage covered in cling film or buster collar with cling film covering

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what must be ensured if creating an oxygen tent?

A

that there is an escape route for expired gas/heat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

how may oxygen be administered to the unconscious patient?

A

endotracheal intubation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is ensured by ET tube use?

A

patent airway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how can you ensure that your patient has a patent airway?

A

ET tube
head and neck extension
tracheostomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what is required if a patient has a tracheostomy tube?
constant monitoring
26
when may a tracheostomy tube be placed?
with profound disease which affects the larynx/pharynx making intubation impossible
27
what are the key nursing considerations for a patient with acute respiratory failure?
``` observe and monitor medication (sedation) care of drains patient is likely to recumbent change in environment where possible exercise inhalation therapies feeding barrier nursing ```
28
what are the 3 main sections of the respiratory system?
upper respiratory tract lower respiratory tract pleural cavity
29
what are the clinical signs of upper respiratory tract diseases?
``` nasal discharge (uni/bilateral) sneezing reverse sneezing stertor/snoring systemic or CNS signs ```
30
what is reverse sneezing?
rapid inspiration of a large volume of air
31
how may nasal discharge appear?
serous mucopurulent haemorrhagic
32
what are you looking for in the physical examination of a patient with upper respiratory tract diseases?
``` listen for noises nasal discharge facial deformity/pain nasal planum depigmentation assess airflow bilaterally assess regional lymph nodes retropulsion of the eyeballs (exophthalmia) look for dental disease look for ophthalmic disease ```
33
what are the inflammatory differential diagnoses for nasal disease?
idiopathic allergic irritation
34
what are the main differential diagnoses for nasal disease?
``` inflammatory infectious neoplastic trauma/fracture foreign body systemic causes misc. ```
35
what are the infectious differential diagnoses for nasal disease?
bacterial (secondary) virus fungal parasitic
36
how can nasal disease be investigated without GA?
routine bloods tests for bleeding disorders serology for fungal diseases viral testing in cats
37
what tests are available for bleeding disorders?
platelet count | PT/APTT
38
what investigations of nasal disease may be performed under anaesthesia?
full oral exam dental probing nasopharyngeal swab in cats
39
what imaging techniques may be used to investigate nasal disease?
x rays CT scan of the head endoscopy
40
what x-ray views are most helpful when assessing nasal disease?
intra-oral nasal views
41
where should endoscopic investigation of the nasal cavity be started with?
retrograde view of the nasopharynx
42
what is nasal flush useful for?
both diagnosis and therapy
43
what must be done when performing a nasal flush?
pack pharynx appropriately
44
how can nasal biopsy be performed?
blind or endoscopic
45
why must you be careful when performing nasal biopsy?
ensure that biopsy is taken of the nasal cavity and not the brain (due to degeneration of cribriform plate)
46
why should you check coagulation times before you perform a nasal biopsy?
the nasal cavity is highly vascular and so bleeding is likely
47
what are the nursing considerations associated with rhinoscopy?
nose will bleed alot be prepared biopsy will often be needed consider topical agents
48
what level of anaesthesia is required for rhinoscopy?
requires GA | local blocks LA/IV
49
what can be done to aid slowing of bleeding that occurs during rhinoscopy?
ice packs on the nose intranasal adrenaline - both to lead to vasoconstriction
50
what are the key elements of nursing care for nasal disease?
``` treat dyspnoea first if present try and stop haemorrhage remove foreign object if present monitor food/fluid intake correct and adequate nutrition removal of dried nasal discharge grooming decongestant therapy isolate if infection suspected ```
51
how can nasal haemorrhage be stopped?
ice packs, pressure and adrenaline soaked swabs
52
what is sino-nasal aspergillosis most commonly caused by in dogs?
Aspergillus fumigatus
53
what dogs are predisposed to aspergillosis?
meso/dolichocephalic breeds
54
what is the effect of aflatoxins produced by aspergillosis on the nasal cavity?
profound inflammatory response | extensive turbinate and bone destruction
55
what can aspergillosis be secondary to?
tumor or foreign body
56
what is sino-orbital aspergillosis in cats due to?
Aspergillis felis
57
what cat breeds are predisposed to aspergillosis?
brachycephalic breeds
58
what are the common clinical signs of aspergillosis?
mucopurulent nasal discharge or epistaxis (uni/bilateral) sneezing nasal pain nasal depigmentation
59
what are the uncommon clinical signs of aspergillosis?
stertor facial deformity CNS signs
60
how can aspergillosis be diagnosed?
``` challenging! serology PCR imaging rhinoscopy cytology histopathology fungal culture ```
61
how can rhinoscopy aid diagnosis of aspergillosis?
visualisation of plaque
62
what imaging modalities may be used for diagnosis of aspergillosis?
radiography MRI CT
63
what is shown on MRI or CT images of a patient with aspergillosis?
turbinate destruction increased soft tissue opacity increased soft tissue density in frontal sinuses
64
when is trephination required to treat aspergillosis?
if frontal sinuses only involved
65
what is trephination?
catheters inserted into frontal sinus
66
how is aspergillosis treated?
mechanical debridement endoscopically topical antifungal oral itraconazole (not generally effective) refurral needed
67
when should topical antifungal not be used to treat aspergillosis?
if cribriform plate is not intact as the brain is exposed
68
what is the preferred treatment method for aspergillosis?
trephination and flushing with saline followed by clotrimazole flush and instillation of clotrimazole cream
69
are repeated aspergillosis treatments required?
often yes
70
what are BOAS conditions the result of?
poor breeding and body confirmation in dogs with short noses
71
what breeds is BOAS common in?
french bulldogs english bulldogs pugs
72
what is BOAS?
brachyocephalic obstructive airway syndrome
73
what are the primary abnormalities found in animals with BOAS?
excessive soft tissues in skin and airways stenotic nares elongated/thick soft palette hypoplastic trachea
74
are BOAS associated congenital defects normal presentations?
no - severely compromise quality of life
75
why is an elongated soft palette problematic in brachycephalic dogs?
soft palate passes epiglottis and can block airway
76
what secondary problems can be caused by BOAS?
respiratory and digestive issues
77
what is the main digestive issue caused by BOAS?
hiatal hernia leading to regurgitation
78
what is the main secondary respiratory issue caused by BOAS?
laryngeal collapse
79
how do patients compensate for BOAS issues?
pull harder on inspiration which creates negative pressure in the throat, neck and chest leading to secondary respiratory and digestive problems
80
what are the presenting signs of BOAS syndrome?
``` load breathing exercise intolerance sleep deprivation gagging regurgitation vomiting ```
81
how is BOAS diagnosed?
``` physical exam and owner history exam under sedation fluroscopy/barium swallow CT of head rhinoscopy chest x-rays CT scan ```
82
what are the key elements of nursing care involved with BOAS patients?
``` owner education discourage ownership/breeding keep calm and stress free avoid excessive heat often require surgery use harness instead of collar to prevent breathing difficulties ```
83
what are the main causes of laryngeal paralysis?
congenital trauma nerve infiltration
84
in what type of dog does laryngeal paralysis often occur?
older, large breed dog
85
why is it thought that laryngeal paralysis occurs in older dogs?
decline in nerve function
86
how does laryngeal paralysis present?
exercise intolerance soft, ineffectual cough inspiratory stridor may present as an emergancy
87
how is laryngeal paralysis diagnosed?
laryngeal exam under sedation/GA
88
what are the main nursing considerations for laryngeal paralysis?
``` keep animal calm - sedate avoid collar/anything around neck keep animal cool provide oxygen as long as it doesnt cause stress provide steroids may require surgical intervention ```
89
what should patients with laryngeal paralysis be monitored for?
aspiration pneumonia dysphagia megaoesophagus
90
why may laryngeal paralysis patients be given steroids?
to reduce laryngeal oedema
91
in what types of animal is tracheal collapse seen?
small / toy breeds
92
whereabouts on the trachea does tracheal collapse most often occur?
any part possible but most often at thoracic inlet
93
what appears to predispose patients to tracheal collapse?
obesity
94
what is the key sign of tracheal collapse?
goose honking cough
95
how is tracheal collapse diagnosed?
physical exam | x-ray / fluoroscopy
96
how does x-ray / fluoroscopy aid tracheal collapse diagnosis?
shows tracheal positioning
97
what are the key nursing considerations associated with tracheal collapse?
``` sedation (butorphanol) provide medication cage rest exercise restriction harness only - no collar oxygen therapy possibly intubate if acute ```
98
what are the long term changes needed for a patient with tracheal collapse?
weight loss | surgery with possible stent
99
what medication may be given to a patient with tracheal collapse?
antitussive corticosteroids bronchodilators
100
why is intubation risky in patients with tracheal collapse?
will lead to further inflammation which may worsen condition
101
define cough
sudden expiratory effort against a closed glottis - results in sudden noisy expulsion of air from lungs
102
define dyspnoea
difficulty breathing, increased respiratory effort
103
define tachypnoea
increased rate of breathing
104
define hyperpnoea
increased respiratory effort without dyspnoea
105
define orthopnoea
adapting posture to facilitate breathing - often sit or stand with elbows abducted and neck extended
106
what is a key sign of lower respiratory tract disease?
cough
107
what is the aim of a cough?
protective reflex to clear excess secretions / foreign material
108
where are the majority of cough receptors located?
in large airways
109
where are fewer cough receptors located?
nose, sinuses, pharynx and pleura
110
what is detected in the respiratory tract by mechanical receptors?
mucous | foreign body
111
what is detected in the respiratory tract by chemical receptors?
acid | heat
112
what nerves form the afferent pathway of the cough reflex?
sensory vagus nerve
113
where is the cough centre located in the brain?
medulla oblongata
114
what nerves make up the efferent cough reflex pathway?
vagus, phrenic and spinal motor nerves
115
what muscles are supplied by efferent cough reflex pathways?
diaphragm | abdominal wall
116
what is cough associated with aside from LRT disease?
congestive heart failure
117
why is a cough associated with congestive heart failure?
airways begin to fill with fluid which stimulates mechanorecptors
118
what effect does oedema have on the respiratory system?
more tachypnoea
119
what are the main harmful effects of a cough?
exacerbate airway inflammation and irritation emphysema pneumothorax weakness and exhaustion of respiratory muscle dissemination of infections
120
what are the signs of lower respiratory tract disease?
``` cough tachypnoea dyspnoea exercise intolerance weakness cyanosis syncope ```
121
when diagnosing a patient with LRT disease what should be assessed first?
patient - are they getting enough oxygen and how can stress be reduced
122
what must be considered when trying to reduce stress in respiratory patients?
offering sedation | calm environment
123
what must be done with a LRT patient following triage?
stabilise (e.g. oxygen tent)
124
what should be observed about the patient with suspected LRT disease?
posture | rate and rhythm of breathing
125
what must be observed about the LRT patients respiratory rate and rhythm?
is there inspiratory or expiratory effort / both | shallow or labored breathing
126
when observing a LRT patient from a distance what are you looking for?
``` URT noise (e.g. stertor/stridor) wheezing ```
127
when should thoracic auscultation only take place?
when patient is stable
128
when auscultating the chest what are you listening for?
``` crackles wheezes HR and rhythm heart murmur muffled or lack of heart sounds ```
129
what are you listening for while percussing the chest?
increased or decreased resonance
130
what investigations may be performed on a patient to diagnose LRT disease?
``` clinical pathology assessment of oxygenation laryngeal exam imaging of chest assessment of pleural space disease advanced techniques ```
131
what test can be used for lungworm?
faecal smear
132
how does a faecal smear for lungworm work?
faeces are suspended in water and viewed under the microscope to check for worms
133
how can a patients oxygenation be assessed?
``` pulse oximetry (SpO2) arterial blood gas analysis (PaO2) ```
134
what is being assessed when performing laryngeal exam?
``` structure of larynx (any masses/collapse) function (any paralysis) ```
135
when is a laryngeal exam performed?
under GA
136
what are you looking for when performing radiography of the chest?
pulmonary patterns (bronchial, alveolar, interstitial) heart and vessels appearance masses pleural space
137
when may a CT scan of the thorax be used?
more sensitive so can show things not seen on x ray
138
when may an ultrasound be used to assess LRT disease?
looking for thoracic mass | T-FAST for thoracic fluid
139
what is bronchoscopy used for?
collection of brochoalveolar lavage view of lower airways foreign body removal
140
what must cats be pre-treated with before bronchoscopy?
terbutaline
141
what can samples collected through BAL be used for?
cytology culture PCR
142
what can be performed if no bronchoscope available?
blind BAL and tracheal wash
143
what equipment is needed for bronchoscopy?
``` endoscope sterile saline in syringes collection pots for BAL mouth gag (or can go through ET tube) urinary catheter emergency box/induction agent ```
144
what are the key nursing considerations associated with bronchoscopy?
requires several people needs to be quick react fast if things go wrong as they can quite quickly coupage will be required monitor patient carefully until fully recovered easy access to emergency drugs / oxygen thoracocentesis may be required
145
what is coupage?
pressing on left and right sides of chest
146
what is the most common cause of coughs in dogs?
canine chronic bronchitus
147
what is canine chronic bronchitis?
chronic bronchial inflammation with over secretion of mucous
148
in what age of dog is canine chronic bronchitis common?
middle aged to older
149
what co-morbidities are seen with canine chronic bronchitis?
tracheal / bronchial collapse mitral valve disease pulmonary hypertension
150
what are the initial predisposing factors to canine chronic bronchitis?
history of kennel cough environmental irritants or allergens parasites
151
what happens during canine chronic bronchitis?
smaller airways become obstructed by mucous alteration of the mucocilliary escalator inflammation of the lower airways
152
what does obstruction of smaller airways by mucous during canine chronic bronchitis lead to?
progressive narrowing of airway
153
what causes an alteration in the mucociliary escalator during canine chronic bronchitis?
due to narrowing of airway this is less effective
154
what may patients become prone to is the mucociliary escalator is damaged?
concurrent bacterial infections
155
what does inflammation of the lower airways during canine chronic bronchitis lead to?
narrowing of the lower airways
156
what is bronchomalacia?
weakened cartilage of bronchi
157
what is bronchiectasis?
extreme dilation of bronchi - end stage change
158
what are the clinical signs of canine chronic bronchitis seen on exam?
chronic cough (>2 months) - often productive +/- dyspnoea and tachypnoea +/- gagging and retching +/- pyrexia if concurrent pneumonia
159
what are the clinical signs of canine chronic bronchitis seen on thoracic auscultation?
wheezes | +/- crackles if concurrent pneumonia / emphysema
160
when investigating canine chronic bronchitis what are you looking for on x ray or CT scan?
``` bronchial pattern (doughnuts or tramlines) possible interstitial pattern (net curtain) ```
161
what may be seen in healthy older dogs on x ray?
mild broncho-interstitial pattern
162
what are you looking for when examining a dog with suspected canine chronic bronchitis with bronchoscopy?
mucosal erythema | excessive mucous
163
what is mucosal erythema?
redness of MM
164
what will be found on BAL of a patient with canine chronic bronchitis?
mucous neutrophils +/- bacteria
165
what is suggested if eosinophils are found during BAL of a patient with canine chronic bronchitis?
underlying bacterial disease
166
what are the nursing management considerations of a patient with canine chronic bronchitis?
weight control to reduce fat in chest cavity harness only avoid tobacco smoke, dust and airway irritants
167
what medication is needed to treat canine chronic bronchitis?
``` lowest possible does glucocorticoids bronchodilators antibiotics if required antitussives mucolytics ```
168
what are glucocorticoids used for in the treatment of canine chronic bronchitis?
anti-inflammatory
169
what bronchodilators are used to treat canine chronic bronchitis?
theophylline
170
why may antibiotic be required when treating canine chronic bronchitis?
concurrent bacterial infection
171
when would antimicrobials be indicated in canine chronic bronchitis patients?
depends on BAL and severity of signs
172
what is the main antimicrobial used to treat canine chronic bronchitis?
Doxycycline
173
what is essential to remember when giving doxycycline?
must be given with food or water as can cause oesophageal stricture
174
how long are animals with canine chronic bronchitis treated with Doxycycline if needed?
7-10 days
175
what should happen if there is a positive response to Doxycycline treatment after 7-10 days?
continue for an additional 7 days past resolution of clinical signs
176
what drugs may be given to canine chronic bronchitis patients via inhaled therapy?
corticosteroids and bronchodiator
177
is inhaled therapy recommended for antimicrobials?
no
178
when should inhaled therapy for canine chronic bronchitis patients begin?
once clinically stabilised or if mild signs
179
what is the prognosis for patients with canine chronic bronchitis?
chronic and progressive condition | can live for years if managed
180
when is prognosis of canine chronic bronchitis worse?
if bronchiectasis or bacterial pneumonia due to degeneration of mucociliary escalator
181
what diseases may e seen concurrently with canine chronic bronchitis?
mitral valve disease and/or pulmonary hypertension
182
what is canine infectious tracheobronchitis also known as?
kennel cough
183
what is the cause of canine infectious tracheobronchitis?
a complex of several viruses, bacteria and other microorganisms
184
what are the main viruses that cause canine infectious tracheobronchitis?
canine adenovirus 2 canine parainfluenza virus canine herpes virus
185
what is the main bacterial causal agent of canine infectious tracheobronchitis?
Bordatella bronchiseptica
186
when do most cases of canine infectious tracheobronchitis resolve?
within 14-21 days
187
what must be done if canine infectious tracheobronchitis is suspected?
animal should be kept away from other animals as disease is highly contagious wait in the car rather than waiting room
188
how is canine infectious tracheobronchitis treated?
anti-biotic/anti inflammatory treatment | cough suppressants may be used
189
what can prevent canine infectious tracheobronchitis?
client education and vaccination protocol
190
what diseases are on the spectrum of feline lower airway disease?
feline asthma and feline bronchitis
191
what occurs during feline lower airway disease?
chronic bronchial inflmmation (neutrophillic and eosinophillic) with mucous hypersecretion
192
in what cats is feline lower airway disease most often seen?
young/middle aged cats | siamese seem over represented
193
what is the difference between cats and dogs in terms of LRT disease?
cats will present with bronchoconstriction - emergancy
194
what is bronchoconstriction?
severe sudden narrowing of airways
195
what are the initial predisposing factors of feline lower airway disease?
``` bacteria viruses parasites irritants allergens ```
196
what is the cause of feline lower airway disease?
type 1 hypersensitivity
197
what happens during a type 1 hypersensitivity reaction?
histamine and seratonin produced by mast cells which leads to smooth muscle contraction, oedema and eosinophillic inflammation of the lower airways and mucous hypersecretion
198
what is the effect of type 1 hypersensitivity mediated smooth muscle contraction?
bronchoconstriction
199
what do all the effects of type one hypersensitivity reaction in the lungs lead to?
obstruction of bronchus
200
what immunoglobulin mediates type 1 hypersensitivity?
IgE
201
what are the signs of feline lower airway disease?
``` wide spectrum (none - asthmatic crisis) cough dyspnoea tachypnoea open mouth breathing cyanosis ```
202
what will be found on thoracic auscultation of a patient with feline lower airway disease?
wheezes +/- crackles if emphysema +/- dull lung sounds if pneumothorax
203
what may be found on the chest x ray/CT scan of a feline lower airway disease patient?
``` generalised bronchial pattern with possible interstitial or alveolar patterns overinflated lungs flattened diaphragm possible pneumothorax may be normal! ```
204
what are the risks associated with bronchoscopy in cats?
can cause bronchoconstriction
205
what can be given the night and morning before bronchoscopy to cats to reduce bronchoconstriction risk?
SC terbutaline
206
what are you looking for during bronchoscopy of a patient with feline lower airway disease?
inflammation mucous airway narrowing
207
what can you test BAL sample for in feline lower airway disease patients?
cytology - mucous and inflammatory cells (neutrophils and eosinophils) PCR - Bordetella bronchiseptica and Mycoplasma spp faecal parasitology or PCR - Aelurostrongylus culture
208
how should the emergency feline lower airway disease patient be treated?
``` stress free supplement O2 use bronchodilators corticosteroids sedation ```
209
what corticosteroids may be used in acutely ill feline lower airway disease patients?
dexmethasone
210
what is the issue with using dexmethasone?
can impact subsequent cytology samples (balance risk vs reward)
211
what bronchodilator may be used to treat acute feline lower airway disease?
terbutaline
212
what is the main management involved in treating feline lower airway disease?
dust free litter no smoking reduce use of aerosols
213
what medication may be given to treat feline lower airway disease?
lowest effective dose glucocorticoids bronchodilators Doxycycline if Mycoplasma infection Fenbendazole if parasitic infection
214
what is not recommended for treatment of feline lower airway disease?
nebulization - may lead to bronchoconstriction
215
what may inhaled therapy be used for in treatment of feline lower airway disease?
corticosteroids and bronchodilator
216
what drugs should not be given via inhalation when treating feline lower airway disease?
antimicrobials
217
when should inhaled therapy be given to feline lower airway disease patients?
once clinically stabilised or mild signs
218
what is the prognosis of feline lower airway disease?
variable | good if chronic, acute can be fatal
219
what are the main groups of pulmonary parasites?
intestinal worms with pulmonary migration lung worms heart worms causing respiratory signs
220
what are the main worms that have pulmonary migration before the adult reaches the gut?
Toxocara | Ancylostoma
221
what are the main species of heartworms that cause respiratory signs?
Angiostrongylus vasorum
222
what is Angiostrongylus vasorum also known as?
french heartworm
223
how is Angiostrongylus vasorum infection caused?
by eating intermediate host (mollusk) or paratenic host (frog)
224
what larvae stage of Angiostrongylus vasorum travel to pulmonary vasculature from the intestines?
L3
225
where do adult Angiostrongylus vasorum worms live?
pulmonary arteries and right side of the heart
226
what happens to larvae of Angiostrongylus vasorum worms in the lungs?
migrate to alveoli and are coughed and swallowed
227
what are the clinical signs of Angiostrongylus vasorum?
wide range respiratory disease increased bleeding tendency neurologic signs
228
what are the main signs of respiratory disease resulting from Angiostrongylus vasorum?
inflammatory response - chronic cough and acute dyspnoea | severe pulmonary hypertension - syncope, abnormal right ventricular structure and function
229
what is the most common sign of Angiostrongylus vasorum?
chronic cough
230
what is increased bleeding tendency seen with Angiostrongylus vasorum infection caused by?
unknown mechanism - may be consumptive coagulopathy
231
what are the neurological signs of Angiostrongylus vasorum caused by?
CNS haemorrhage
232
what would be seen on the chest x ray/CT scan of a patient with Angiostrongylus vasorum?
combination of patchy bronchial, interstitial and alveolar patterns peripheral distribution of defects no vascular changes
233
how can Angiostrongylus vasorum be diagnosed?
``` Angio-detect - antigen detection PCR faecal smear Baermann faecal examination empirical treatment (e.g. advocate) for clinical improvement ```
234
what does a positive Angio Detect result indicate?
Angiostrongylus vasorum
235
what does a negative Angio Detect result indicate?
A. vasorum is very unlikely but another lungworm is possible
236
how can Angiostrongylus vasorum be treated?
Moxidectin - 2 doses, 30 days apart | Fenbendazole - SID for 10-20 days
237
what post treatment reaction may be seen after treatment for Angiostrongylus vasorum?
dyspnoea ascites sudden death
238
what is the prognosis of Angiostrongylus vasorum?
depends on severity of clinical signs
239
what is bacterial pneumonia caused by?
mixed flora - aerobic and anaerobic
240
how may bacterial pneumonia be spread?
``` inhaled bacteria haematogenous spread (blood vessels) ```
241
what lobes of the lung may be affected by bacterial pneumonia?
may be unilobar or multilobar
242
what are the 2 presentations of bacterial pneumonia?
acute and chronic
243
what is bacterial pneumonia associated with?
abscess pleural effusion pneumothorax
244
why are there predisposing causes for bacterial pneumonia?
should not occur if the mucociliary escalator is working
245
what are the predisposing causes of bacterial pneumonia?
``` chronic bronchitis bronchiectasis immunosuppression foreign body aspiration ```
246
what may be caused by aspiration?
bacterial pneumonia | chemical pneumonitis
247
what is chemical pneumonitis?
burning of the airways by stomach acid
248
what often causes aspiration pneumonia?
brachycephalic breeds oesophageal disease laryngeal disease
249
what are the respiratory signs of bacterial pneumonia?
``` soft and productive cough mixed dyspnoea tachypnoea exercise intolerance crackles or wheezes on auscultation ```
250
what is mixed dyspnoea?
inspiratory and expiratory signs
251
what are the systemic signs of bacterial pneumonia?
pyrexia lethargy inappetance
252
does normothermia exclude bacterial pneumonia?
no
253
what investigations will be performed to diagnose bacterial pneumonia?
haematology C reactive protein SpO2 or arterial blood gas chest x rays / CT
254
what signs are you looking for in haematology tests for bacterial pneumonia?
neutrophillia (left shift) | neutropenia
255
what is C reactive protein useful for in a patient with bacterial pneumonia?
monitoring
256
at what SpO2 or PaO2 is the patient classed as hypoxic?
<94% | <80mmHg
257
what signs are you looking for in x ray or CT scans for bacterial pneumonia?
alveolar pattern with ventral distribution dorso-caudal distribution (haematogenous spread) interstitial pattern - early pneumonia
258
when may x rays for bacterial pneumonia be repeated?
48-72 hours later
259
what should you wait for if prescribing antibiotics?
culture result if possible
260
what is the empirical treatment for bacterial pneumonia?
PO doxycycline
261
what is the treatment for aspiration pneumonia?
no antibiotics if chemical pneumonitis | IV amoxycillin-clavulanic acid
262
what is the treatment for bacterial pneumonia where the patient is also septic?
IV fluroquinolones and ampicillin or clindamycin | de-escalate if possible
263
how long should bacterial pneumonia patients be treated wirth antibiotics for?
10-14 days and reassess (clinical exam, haematology and chest x rays)
264
what are the main nursing considerations during treatment of bacterial pneumonia?
``` oxygen supplementation if hypoxic fluid therapy nebulisation to increase mucous fluidity bronchodilatiors mucolytic? treatment of predisposing factors ```
265
what effect can dehydration have on mucocilliary defences?
impairment
266
what are the issues with using mucolytics?
some may cause bronchoconstriction (e.g. nebulisation of N-acetylcysteine)
267
what is the prognosis of bacterial pneumonia?
depends on severity of clinical signs
268
what may be required if the bacterial pneumonia patient has pneumothorax and abscessation?
lung lobectomy
269
what is required to keep lungs inflated?
negative intrathoracic pressure
270
what type of defect is a pleural effusion?
restrictive
271
what does pleural effusion lead to?
gradual collapse of the lungs and and increase in intrathoracic pressure which becomes positive
272
what will lead to immediate relief of pleural effusion?
removal o fluid
273
what may be seen secondary to active inflammation / pneumothorax?
pleural effusion (trapped lung)
274
what happens if pneumothorax is left untreated?
``` decreased cardiac output cardiac arrest (esp. pneumothorax) ```
275
what is the clinical presentation of pleural space diseases?
tachypnoea restrictive dyspnoea paradoxical breathing
276
what is restrictive dyspnoea?
rapid and shallow breathing
277
what diseases is restrictive dyspnoea only seen with?
pleural space diseases
278
what are the specific signs on auscultation from pleural effusion?
muffled lung sounds ventrally | decreased resonance ventrally
279
what are the specific signs associated with pneumothorax?
absent lung sounds dorsally | increased resonance dorsally
280
why are pleural effusion signs seen ventrally?
gravity pulls fluid down
281
why are pneumothorax signs seen ventrally?
air collects at highest point
282
what are the signs of respiratory distress?
``` orthopnoea (body position) mouth breathing tachypnoea/hyperpnoea respiratory noises cyanosis restrictive dyspnoea ```
283
what is inspiratory dyspnoea linked to?
upper airway obstruction (increased respiratory noises)
284
what is expiratory dyspnoea linked to?
dynamic lower airway obstruction (abnormal auscultation)
285
what is mixed dyspnoea linked to?
parenchymal (disease of the lung tissue itself) disease
286
what is mixed dyspnoea with restrictive pattern linked to?
pleural space disease
287
how serious are pleural space diseases?
life threatening
288
how are pleural cavity diseases diagnosed?
chest radiographs if the patient is stable thoracic ultrasound if not thoracocentesis fluid analysis
289
what may be seen on a chest radiograph which indicates pleural cavity diseases?
decreased details | cardiac silhouette is hard to see
290
what are the signs of chronic pleural effusion on chest x ray?
rounded lung margins
291
what are the tubes needed for analysis of fluid from the thoracocentesis?
EDTA tube for cytology | plain tube for culture and biochemistry
292
what is thoracocentesis?
aspiration of air or fluid from the pleural cavity by inserting a needle, catheter or drain via a caudal rib space
293
what area should be prepared for thoracocentesis?
around the 8th rib
294
what needle is usually required for thoracocentesis?
butterfly or simular
295
how should the area of skin be prepared for thoracocentesis?
clipped and aseptically prepped
296
what equipment is required for thoracocentesis?
``` needle 3 way tap extension set if needed sterile drapes sterile gloves surgical spirit LA blade if needed measuring drug if effusion ```
297
where should the needle for thoracentisis be placed?
cranial aspect of the rib
298
why shouldn't the needle be placed on the caudal aspect of ribs during thoraentesis?
nerves and blood vessels on caudal side
299
when may a thoracic drain be placed?
if there is a large effusion present
300
how should thoracic drains be cared for?
aseptic | good hand hygiene - sterile equipment
301
how should thoracic drains be dressed?
sterile dressing, stocking and buster collar to prevent patient interference
302
what can be understood by analysing the fluid from thoracocentesis?
why the fluid accumulated
303
what are the 4 types of fluid that can be collected from thoracentesis?
pure transudate modified transudate exudate miscellaneous
304
describe pure transudate
protein poor | clear fluid
305
what is the total protein of pure transudate?
<20 g/L
306
what is the total nucleated cell count of pure transudate?
<1.5x10^9
307
describe modified transudate
protein rich | yellow blood tinged fluid
308
what is the total protein of modified transudate?
>20g/L
309
what is the total nucleated cell count of pure transudate?
<5x10^9/L
310
describe exudate
turbid fluid
311
what condition is associated with pure transudate?
hypoalbuminaemia
312
what are the main causes of hypoalbuminaemia?
liver failure protein loosing enteropathy protein loosing neuropathy
313
what diseases can lead to modified transudate within pleural fluid?
congestive heart failure pericardial disease neoplasia diaphragmatic rupture
314
in what animals is modified transudate often found in pleural fluid during CHF?
cats
315
what cardiac marker may be used to detect cardiac related pleural effusion in cats?
NT pro-BNP
316
what can diagnose neoplasia from thoracentesis?
cytology of sample
317
what are the 2 types of exudate?
non-septic | septic
318
what cells will be seen in non-septic exudate?
neutrophils marcophages eosinophils lymphocytes
319
is there any evidence of organisms in non-septic exudate?
no
320
what are the causes of non-septic exudate?
``` FIP neoplasia diaphragmatic hernia lung lobe torsion resolving pyothorax ```
321
what are the levels of TP and globulin seen in patients with FIP?
high total protein in effusion | high globulins in blood
322
what cells are seen in septic exudate?
degenerate neutrophils
323
what is the cause of septic exudate?
pyothorax
324
what bacteria may been seen in septic exudate?
intra or extracellular bacteria | anaerobic (foul smelling)
325
how is sepsis treated?
IVFT | antibiotics
326
what are the causes of septic exudate?
bite foreign body iatrogenic (thoracentesis) parapneumonic
327
describe the appearance of chylothorax?
milky
328
what is the TP of chylothorax?
>25 g/L
329
describe the total nucleated cell count of chylothorax
variable - small lymphocytes but may be some neutrophils id ongoing inflammation
330
is the triglyceride in chylothorax effusion higher or lower than plasma?
higher
331
what are the causes of chylothorax?
``` idiopathic cardiac disease cranial vena cava thrombosis/mass heartworm disease neoplasia ```
332
what is the haematocrit of haemothorax?
>20% | or >50% of patient haematocrit
333
what does haemothorax lead to?
hypovolaemia
334
what are the causes of haemothorax?
``` anticoagulant rodenticide coagulopathy lung lobe torsion trauma neoplasia (rib) ```
335
what are the complications of thoracocentesis?
particularly with chronic effusion pyothorax pneumothorax
336
how are pleural effusions diagnosed and treated?
thoracocentesis (with drain) | treatment of underlying disease
337
how is lung neoplasia treated?
depends on tumor type - chemo or surgery
338
how is lung lobe torsion treated?
lobectomy
339
in what animals is lung lobe torsion the most common?
narrow, deep chested dogs | also reported in pugs
340
what may lung lobe torsion occur secondary to?
other causes of effusion
341
how is diaphragmatic rupture treated?
surgrey
342
how is pyothorax treated?
IV fluroquinolone and penacillin or clindamycin de-escalate antimicrobials where possible therapeutic drain lavage if drain present surgery
343
how is chylothorax treated?
manage underlying disease Rutin to stiulate macrophages to remove lipids from effusion surgery if idiopathic spontaneous heal if traumatic rupture of thoracic duct
344
what surgery is used to treat chylothorax?
thoracic duct ligation | +/- pericardiectomy
345
what is pneumothorax?
accumulation of air in the pleural space
346
what are the causes of pneumothorax?
trauma spontaneous iatrogenic
347
what are the spontaneous causes of pneumothorax?
blebs and bullae | chronic airway disease (asthma in cats)
348
what are blebs and bullae?
blistered lesions of the lungs
349
what are the signs of pneumothorax seen on physical exam?
no lung sounds audible on dorsal aspect | hyper-resonant percussion
350
how is pneumothorax diagnosed?
radiography | ultrasound
351
how is pneumothorax treated?
``` rest thoracocentesis as required chest drain (rapid accumulation) O2 therapy continuous drainage and exploratory thoracotomy may be required ```
352
what are the main nursing considerations associated with pneumothorax?
``` delay diagnostics until stable low stress SpO2 monitoring supplement O2 if hypoxaemia (<95%) consider sedation if needed thoracocentesis prep (e.g. clipping) cover any obvious chest wounds to prevent entry of air ```
353
what is the role of the VN in caring for pleural space disease patients?
``` chest drain care O2 therapy obs and monitoring medication including analgesia care of wounds and drains fluid therapy shock treatment recumbent patient care feeding and exercise adjustments ```
354
describe how to perform thoracocentesis
7th to 8th intercostal space costochondral junction for fluid, higher for air enter chest cranial to rib then redirect caudally

X Clinical Veterinary Nursing Theory (70 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions