Emergency and Critical Care Nursing (Small Animal) Flashcards
(162 cards)
1
Q
What is the first question you should ask when accepting a telephone triage?
A
Caller name + number
2
Q
What 5 things would constitute as an emergency when taking a telephone triage?
A
- Respiratory compromise
- Severe bleeding
- Toxin exposure
- Acute changes in neurologic status
- Excessive heat/cold exposure
3
Q
a process of sorting ill or injured animals into groups based on their need for or likely benefit from immediate medical treatment
A
Triage
4
Q
What are the 3 degrees of urgency when performing in-hospital triage?
A
- Needs immediate care or stabilization
- Needs passage to treatment area > bleeding, vomiting, contagious
- Can wait until appt
5
Q
gives brief information on the most important aspects of the patient’s ABCs
A
Primary Survey
6
Q
ABCs stands for _____
A
A = Airway/Attitude
B = Breathing / Bleeding
C = Circulation / Cardiovascular
7
Q
Primary Survey actions:
1.
2.
3.
A
- Look
- Listen
- Feel
8
Q
BAR
A
bright, alert, responsive
9
Q
difficulty breathing
A
Dyspnea
10
Q
increased respiratory rate
A
Tachypnea
11
Q
decreased respiratory rate
A
Bradypnea
12
Q
(Tachypnea/Bradypnea) may indicate hypoxemia, thoracic trauma, shock
A
Tachypnea
13
Q
(Tachypnea/Bradypnea) may indicate toxin exposure or elevated intracranial pressure
A
Bradypnea
14
Q
long, slow inspirations with short exhalations
A
Inspiratory Dyspnea
15
Q
_____ can indicate extrathoracic airway obstruction such as laryngeal paralysis
A
Inspiratory Dyspnea
16
Q
_____ can indicate intrathoracic airway obstruction such as inhaled foreign body or mass compressing airway
A
Expiratory Dyspnea
17
Q
breathing that is prolonged and deep
A
Labored Breathing
18
Q
breathing that is fast, short and shallow
A
Restrictive Breathing
19
Q
______ can indicate impaired ability to expand lungs due to rib fractures, pleural space disease, or lung tissue disease
A
Restrictive Breathing
20
Q
accumulation of fluid in the interstitial spaces
A
Edema
21
Q
accumulation of fluid in a body cavity
A
Effusion
22
Q
the condition of maintaining a specific posture to ease breathing
A
Orthopnea
23
Q
A
Orthopnea
24
Q
Evaluating MM Color:
Blue, purple, dusky
A
Immediate supplemental oxygen needed
25
Evaluating MM Color:
Brick red, brown, or injected (mottled pink, purple, red)
Evaluate closer > may indicate carbon monoxide poisoning, heat stroke, sepsis
26
Evaluating MM Color:
Icteric
High bilirubin levels > can wait if otherwise stable
27
Evaluating MM Color:
White
Depends on mentation
Normal > less concern
Altered/Non-responsive > more concern
28
______ may indicate diaphragmatic hernia, severe pulmonary contusions, pneumothorax, or pleural effusion
Decreased/dull lung sounds
29
______ may indicate pulmonary edema or mild pulmonary contusions.
Increased/harsh lung sounds or crackles
30
characteristic growling or rumbling sounds made by the stomach and intestines as food, fluids, and gas pass through them
Borborygmi
31
inappropriately fast heart rate
Tachycardia
32
Dogs in shock are often (tachycardic/bradycardic)
tachycardic
33
inappropriately slow heart rate
Bradycardia
34
Cats in shock are often (tachycardic/bradycardic)
bradycardic
35
Extremely elevated potassium levels in animals with a urethral obstruction can result in (tachycardia/bradycardia)
bradycardia
36
a description of how quickly pulse pressure changes and how long each pulse lasts
Pulse Quality
37
the difference between systolic and diastolic pressures
Pulse Pressure
38
a pulse that has lower than normal pulse pressure and is often in conjunction with tachycardia
Weak/Thready Pulse
39
(Thready/Snappy) pulse can indicate hypotension, hypovolemia, or decompensated shock
Thready Pulse
40
a pulse that has a very large pulse pressure with an extremely rapid rise and fall
Snappy Pulse
41
(Thready/Snappy) pulse can indicate anemia, patent ductus arteriosus, or severe aortic regurgitation
Snappy Pulse
42
MAP
mean arterial pressure
43
TBI
traumatic brain injury
44
mentation in which the animal is alert and interactive with its environment
Normal
45
mentation in which the animal is interactive with its environment but is not bright and eager to interact
Dull/Depressed
46
mentation in which the animal reacts appropriately to stimuli, but at a lower level or slower pace than normal
Obtunded/Delirious
47
mentation in which the animal is completely disconnected from the environment and reacts only to noxious (painful or prolonged) stimuli
Stuporous
48
mentation in which the animal is completely disconnected from the environment and does not react to any stimulus at all
Comatose
49
Pupils can indicate ______ and _____ of the brain injury
extent and location
50
Unresponsive, large, mydriatic pupils may indicate ______
irreversible midbrain lesion
51
term used to describe fixed and dilated pupils
Mydriatic
52
Unresponsive, midrange pupils may indicate ______
medullary lesion
53
Anisocoria may indicate ______
acute cerebral injury or Horner syndrome
54
asymmetry in pupil size
Anisocoria
55
a condition in which the nerves controlling the pupil are affected but the brain is not injured
Horner Syndrome
56
posture related to neurologic injury that is characterized by extreme rigidity of all four legs, may involve arching of back and neck, and is accompanied by stuporous to comatose mentation
Decerebrate Posture
57
posture related to neurologic injury that is characterized by rigid forelimbs and flexed hindlimbs, but the patient has normal mentation
Decerebellate Posture
58
posture related to neurologic injury that is characterized by rigid forelimbs and flexed hindlimbs when side lying, normal mentation, and can often ambulate when picked up and placed on its feet
Schiff-Sherrington Posture
59
posture indicating severe abdominal pain in which the forelimbs are down and stretched in front of them, while hind legs remain standing
Praying Posture
60
a high-pitched, hollow sound produced when an intestinal structure is gas filled
Abdominal Tympany
61
Common lab abnormalities with dehydration include
1.
2.
3.
4.
1. Hemoconcentration
2. Elevated albumin
3. Hypernatremia
4. Azotemia
62
abnormally high levels of sodium in the blood
Hypernatremia
63
abnormally high levels of nitrogen waste in the blood
Azotemia
64
a condition in which the kidneys cannot concentrate or dilute urine and thus produces urine with the same specific gravity as protein free blood plasma
Isosthenuria
65
Rapid rehydration can cause ______
cerebral edema
66
Restoring a fluid deficit for normal dehydration should occur over _____ hours
4-24
67
Restoring a fluid deficit for severe dehydration should occur over _____ hours
48-72
68
Dehydration Levels:
mild mucous membrane dryness
5%
69
Dehydration Levels:
Dry mucous membranes, mild loss of skin turgor
7%
70
Dehydration Levels:
Dry mucous membranes, pronounced loss of skin turgor, tachycardia, sunken eyes
10%
71
the loss of intravascular volume
Hypovolemia
72
ultrasonography performed to quickly determine whether free fluid or air is present in the abdomen or thorax
Focused Assessment with Sonography in Trauma (FAST)
73
FAST
Focused Assessment with Sonography in Trauma
74
High PCV and TP can indicate _____
severe dehyration
75
Low PCV can indicate ______
RBC loss or destruction
76
Normal blood pH = ___
7.4
77
Low blood pH can indicate ______ due to ______
acid build up due to diabetic ketoacidosis
78
High blood pH can indicate _____ due to ______
excess base or loss of acid due to severe vomiting
79
Elevated CO2 can indicate _____
upper airway obstruction or hypoventilation
80
Decreased CO2 can indicate ______
hyperventilation
81
Blood lactate below 2 mg/dL can indicate _____
poor perfusion
82
Normal PaO2 is ___-___ mm Hg
80-100 mm Hg
83
Normal systolic BP in dogs/cats is ____-____ mm Hg
100-140 mm Hg
84
Normal diastolic BP in dogs/cats is ___-___ mm Hg
60-80 mm Hg
85
Normal MAP in dogs/cats is ___-___ mm Hg
70-100
86
an instrument that determines the percent saturation of hemoglobin with oxygen
Pulse Oximeter
87
Why is the pulse ox measurement not reliable in cases of smoke inhalation or CO poisoning?
Hemoglobin bound to CO registers as saturated on pulse ox
88
Normal pulse ox = _____
95-100%
89
a more detailed physical examination conducted to address non-life-threatening problems
Secondary Survey
90
the place where emergency drugs are kept
Crash Cart
91
a bag resuscitator
Ambubag
92
All items in the crash cart must be inspected at minimum ______ for proper function
once a month
93
a life-threatening condition of circulatory failure and hypoxia caused by altered blood flow or impaired oxygen delivery to tissues
Shock
94
the type of shock that occurs from decreased intravascular fluid volume and is most commonly seen in cats and dogs
Hypovolemic Shock
95
the type of shock that occurs from misdistribution of blood flow, due to inappropriate vasodilatation leading to pooling of blood in capillaries
Distributive Shock
96
the type of shock that occurs from impaired venous return to the heart
Obstructive Shock
97
the type of shock that occurs secondary to problems in the heart itself
Cardiogenic Shock
98
the type of shock that occurs from severe infections or severe tissue damage
Septic Shock
99
when the distended stomach impairs venous return from the abdomen
GDV
100
when the heart cannot fill properly due to fluid collecting in the pericardial sac and often results in a dramatic drop in BP
Cardiac (Pericardial) Tamponade
101
a condition characterized by widespread tissue damage, hypoxia, and inflammation that can accompany shock
Systemic Inflammatory Response Syndrome (SIRS)
102
SIRS
Systemic Inflammatory Response Syndrome
103
Dogs must meet ____ or more criteria to fit a SIRS diagnosis. Cats must meet ____ or more.
Dogs = 2 or more
Cats = 3 or more
104
a life-threatening condition characterized by simultaneous thrombosis and uncontrolled bleeding as a complication of shock
Disseminated Intravascular Coagulation (DIC)
105
DIC
Disseminated Intravascular Coagulation
106
a life-threatening condition characterized by two or more organ systems failing as a complication of shock
Multiple Organ Dysfunction Syndrome (MODS)
107
MODS
Multiple Organ Dysfunction Syndrome
108
Systemic Inflammatory Response Syndrome can progress into _____ and _____
DIC and MODS
109
Why should you minimize handling and stressful procedures in dyspneic animals?
Can cause patient to decompensate into cardiac arrest
110
____ MM color does not always mean normal
Pink
111
Pulse ox clip-probes are attached to ____ and ____ areas
vascular and poorly haired
112
the measurement of CO2 levels
Capnography
113
the amount of CO2 present in expired air at the end of exhalation
End-Tidal Carbon Dioxide
114
ETCO2
End-Tidal Carbon Dioxide
115
Increased ETCO2 can indicate _______ or _______
patient hypoventilating
OR
rebreathing CO2 in an anesthesia circuit with exhausted soda lime
116
Decreased ETCO2 can indicate ______ or ______
patient hyperventilating
OR
has decreased cardiac output
117
a means of providing long-term intensive respiratory support to critically ill dogs and cats
Mechanical Ventilation
118
ventilator that allows for fine alterations in breathing support and oxygen delivery
Critical Care Ventilator
119
ventilator that delivers oxygen mixed with room air and is used for short-term mechanical ventilation
Standard Anesthesia Ventilator
120
Continuous monitoring of ventilator patients includes:
1.
2.
3.
4.
5.
6.
7.
1. Arterial catheterization
2. Direct BP monitoring
3. ETCO2 monitoring
4. Pulse oximetry
5. Temperature
6. Placing central line
7. Placing indwelling urinary cath
121
Nursing care every 4-6 hours for ventilator patients includes:
1.
2.
3.
4.
5.
6.
1. Admin eye lubricant
2. Swab oral cavity to remove secretions
3. Inspect all caths
4. Inspect + maintain ET or tracheostomy tube
5. PROM exercises
6. Reposition to prevent pressure ulcers
122
CPR
cardiopulmonary resuscitation
123
CPR Techniques:
Cats + small dogs
One hand
124
CPR Techniques:
Medium to Large Dogs
Two Hand
125
CPR Techniques:
Larger Dogs and Keel Chested Dogs
Cardiac Pump
126
CPR Techniques:
Round Chested Dogs
Thoracic Pump
127
CPR Techniques:
1. Caregivers hand encircles the ventral chest
2. Compressions directly over heart
One Hand
128
CPR Techniques:
1. Interlocked hands
2. Straight arms in line with the shoulders
3. Heels of hands over compression point
Two Hand
129
CPR Techniques:
1. Compressions to heart directly
2. Approx 5th intercostal space
Cardiac Pump
130
CPR Techniques:
1. Compressions over widest part of the chest
2. Approx 7th intercostal space
Thoracic Pump
131
ROSC
return of spontaneous circulation
132
Return of spontaneous circulation is indicated by a sudden increase in ETCO2 from _____ mmHg to above ____ mmHg
0 to above 10-15 mmHg
133
a technique used to enhance venous return to the heart during CPR by compressing the abdomen during the recoil phase of chest compression
Interposed Abdominal Compressions
134
the direct massaging of the heart from apex to base, by making an incision in the left 5th intercostal space and free the heart from its attachments
Open-Chest CPR
135
In giant breed dogs, patients with trauma, and patients with anesthetic arrest, use _____ CPR
open-chest
136
When securing the patient airway, admin _____ respirations per min with ____ sec inspirations and ____ sec expirations
10 respirations per min
1 sec inspiration
5 sec expiration
137
If patient still in CPA after 1st CPR cycle, can admin ____, ____, or _____
epinephrine, vasopressin, atropine
138
the complete cessation of all mechanical and electrical activity in the heart
Asystole ("flatline")
139
the cardiac arrest rhythm in which the electrical system of the heart is functioning but no mechanical heartbeat occurs in response to electrical stimulation
Pulseless Electrical Activity (PEA)
140
PEA
Pulseless Electrical Activity
141
Can see complexes on ECG but no physical beating seen
Pulseless Electrical Activity (PEA)
142
the cardiac arrest rhythm in which the heart contracts too fast, preventing the ventricles from filling with blood, and stopping blood flow to the body
Pulseless Ventricular Tachycardia (Pulseless VT)
143
Often precedes V-fib
Pulseless ventricular tachycardia
144
the cardiac arrest rhythm in which the ventricles contract in a very rapid and highly disorganized manner
Ventricular Fibrillation (V-fib)
145
The arrest rhythm in which the ventricles quiver
Ventricular Fibrillation
146
Sodium bicarbonate should NOT be admin via
ET tube
147
Drugs safe for ET Tube
1.
2.
3.
4.
5.
NAVEL
1. Naloxone
2. Atropine
3. Vasopressin
4. Epinephrine
5. Lidocaine
148
Avoid ____ near defibrillation paddles because it is a _____ risk
alcohol
fire risk
149
Drugs for the Post-Arrest Patient:
Antiarrhythmic and systemic analgesia
Lidocaine
150
Drugs for the Post-Arrest Patient:
Decrease cerebral edema
Mannitol
151
Drugs for the Post-Arrest Patient:
Peripheral vasoconstriction to improve BP
Dopamine
152
Drugs for the Post-Arrest Patient:
Enhances cardiac contractility to increase cardiac output
Dobutamine
153
Drugs for the Post-Arrest Patient:
Improves BP in hypotensive patients
Vasopressin
154
Drugs for the Post-Arrest Patient:
Causes volume contraction to improve cardiogenic pulmonary edema or fluid overload
Furosemide
155
CRI
constant rate infusion
156
a decrease in the volume of body fluid
Volume Contraction
157
Why should furosemide NOT be used in hypovolemic patients?
It's a loop diuretic used to increase urine output and they already have low fluid volume
158
the amount of pressure the blood is exerting against the artery walls when the heart contracts
Systolic Pressure
159
the amount of pressure the blood is exerting against the artery walls when the heart rests
Diastolic Pressure
160
the average pressure the blood exerts against the arteries during a single cardiac cycle
Mean Arterial Pressure
161
BP cuff size should be approx. ___% of limb circumference at site of cuff placement
40%
162
the sudden onset of abdominal pain that is often severe and of unknown cause
Acute Abdomen
