Medical Nursing Week 1

External Cardia Massage

Internal Cardiac Massage

basically means low blood volume

Complete absence of QRS lines

complete lack of unrecognizable P waves and QRS- T complexes

is a rhythm in which fewer than the normal number of impulses arise from the sinoatrial (SA) node

Acting as the heart's natural pacemaker

Fast heartbeat (tachycardia) that occurs because of overly rapid firing by the sinoatrial node

is a rapid heartbeat that starts in the ventricles

• Age,
• Breed
• sex, Neutered? Spayed?

• cheif complaint
• Vomitting- GI tract
• Diarrhea- GI tract
• Eating
• Changed diet
• Previous illness, surgery
• medication

• Vaccine history
• Indoor. outdoor
• other pets
• diet
• toxin exposure, medication laying around

• TPR + weight
• weight
• Temp
• pulse
• respiration
• mucous membrane
• capillar refill time

• less than 3 seconds
• show blood pressure

• Inspection
• palpation
• percussion
• auscultation

• subjective
• objective
• assessment
• plan

• B.A.R   Bright Alert Responsive
• Q.A.R Quiet Alert Responsive
• Depressed
• Neuro
• Stupor

• 102.5
• >103.5 febrile (pyrexia)
• < 99 degree hypothermia

Hair loss

Itching

• Scabs
• Masses

• Redness
• Inflammation

• Oiliness
• Scabs

Fleas and Ticks

Tearing

is a condition where the tubules of the kidneys do not function properly.

in the tears

Jerky oscillation of the eye

unequal pupils

(ear infection)

• 1. Bronchial Sounds – Trachea and larynx
• 2.Vesicular Sounds – Lungs and Alveoli

is excess fluid that accumulates between the two pleural layers, the fluid-filled space that surrounds the lungs.

• A.  Dog – 16-24 breaths per min.
• B.  Cat – 16-30 breaths per minute

Brick Red

• 70-180 beats per minute
• 160-240 beat per minute

anemia or poor perfusion

blue (lack of Oxygen)

Jaundice or liver disorder

methemoglobinemia (acetomenophin toxicity)

coagulopathy (clotting) or bleeding disorder, bruising

Pulmonic Valve

Aorta

• 1. Ventral to Sternum
• Mitral Valve

Tricuspid Valve

Heart beat not the same as femoral pulse

esophagus, stomach, and duodenum

• Small Intestine:
• Large Intestine:
• Cecum:
• Colon: absorb water, but it also contains bacteria that produce beneficial vitamins like Vitamin K.
• Rectum
• Anus

A disease of the kidney. Also called renopathy

swelling of the kidneys when urine flow is obstructed

• calculus or loose teeth
• gingivitus- Redness and swollen gums

symetrical- XII Hypoglossal Nerve

• 1. IX- Glosspharyngeal Nerve
• 2. X-Vargus
• 3. XI- Accessary

• 1. Facial Paralysis
•  VII - Facial

• A. Distended Stomach
• 1. Bloat
• B. Large Liver Spleen
• C. Pendulus
• 1. Fluid
• D. Acute Abdomen
• 1.Pain

• Anul sacs
• Rectal
• 1. symmetrical prostate
• 2. Fecal appearance

• Male- Tesicles
• Cryptorchid
• Female-
• Vulvar Discharge -Possible pyometra if intact female
• Mammary Glands- breast Tumors

• Should be small and symmetrical
• Neck- Mandibular
• Prescapular
• Axillary
• Behind knee cap- Inguinal popliteal

• Limping
• Muscle atrophy
•   Symmetry
• Flexing and extension
•   Shows dysplasia and arthritis

• Conscious proprioception (CP) of 4 legs
• Spinal pain
• Anal and tail tone
• Sciatic and patellar reflexes

• 1. Cachexia- Emaciated
• a. Generally referred to emaciated 2nd to Cancer
• b. Symptoms 
•      1. Weakness, lethargy, anorexia, muslce atrophy, wasting and pysical debilitation, edema, and anemia.
• 1-5 or 1-9

Eating, drinking, Vomiting?, diarrhea?, coughing?, sneezing?

• NPO- Nothing per os (nothing Orally)
• Diet Types
• Heart disease- Low sodium = H/D
• Diabetes- No Sugar = W/D
• Kidney or liver- low protein = K/D and L/D
• Gastrointestinal- Bland Diet = I/D or D/D
• Puppies, kittens, or pregnancy- high protein = P/D or A/D

• Note on record if urinating, deficating or vomiting before cleaning
• 1. Bloody urine
•      cystitis
• 2. Feces
•    a. Black tarey -melena indicated blood (upper GI Bleed)
•   b. Blood with mucous- colitis (lower GI Bleed)
•   c. Diarrhea
• 3. Vomit or regurgitation
•      a. Food
•      b. Yellow- bile empty stomach
•      c. Bloody- GI ulcer, hematemesis, hematokesia
•      d. Saliva and flem- couching, cardia and respiratory
• B. Clean Cages, bowls, and towels with disinfectant
•      a. Rocal, Parvosal, Bleach

• A. Minimum Daily TPR
• B. Hypothermia (cold)
•    1. heated cage or incubator
•    2. HEated pads or bottles
•    3. Temperature <99

• A. Decubital ulcers (bed sores)
•    1. Due to pressure points
•    2. Paralyzed or recumbent patients that cannot stand
•    3. Keep cages padded with frequent bedding changes
• B. Urine scald or rash
•    1. Not changing bedding, patient laying in urine and feces
• C. Turn every 2 hours from side to side to sternum,  to prevent pneumonia, pressure sores and edema

• IV catheters
•   1. Check daily for patency, flush with heparnized saline every 4-6 hours to prevent clotting
•   2. check leg and foot for swelling, pain, redness, cellulitis or edema around the elbow or joint
•     a. Infection
•     b. Blown Catheter- SQ fluids
• 3. IV catheters should not be left in any longer than 3 days (3-5) in practice
• 4. Jugular Catheters should not stay in any longer that 5 days (5-7 in Practice)

• A. Check to see if flowing (patent) and not obstructed
• B. Flush catheter with 0.9% Nacl
• C. Record urination volume and color
• D. Closed system (attache to bag)
• E. e-collar

• 1. Check suture site daily for discharge and inflammation
• 2. Infection is seen within 3-4 days post surgery
•     a. Swelling
•     b. Erythema
•     c. Pain
•     d. Fever
•    e. Discharge
• 3. Dehiscence-incision and suture break down
• 4. E-collar to prevent self-trauma

• 1. Check bandage daily for wetness from urine or feces
•      a. Causes tissue scalding and ulceration
• 2. E-collar to prevent chewing
• 3. Check toes for swelling and loss of circulation (cold)
• 4. Wrap bandages in plastic bog to revent wetness

• 1. Moniter fluids for correct rate and volume
• 2. Check for correct fluid type and additives (spikes)
• 3. Ivac machine is set up correctly for rate and volume
• 4. Should not exceeed 90 ml/kg/hr (pulmonary edema)

• 1. Penrose- check daily for draining, clean and flush
•   a. Abscess
•   b. Seroma
•    c. Drain removal 2-3 days
•   d. warm compress tid for 3-5 min

• 1. Nasal oxygen
•    a. Flow rate 1-3 liters
• 2. Tracheostomy tube
•     a. Suction and clean out every 4-6 hours
•        1. Mucous blocks breathing
•    Monitor patient over heating and humidity in oxygen cage
• 4. Ventilator
•    a. Make sure set up correctly

• 1. Risk pneumothorax and infection (pyothorax)
• 2. Suction tubes
•     a. Make sure 3 way stop cock is closed to prevent air   entering the checst cavity
• 3. Heimlich chest valve

• cephalic vein
• 72 hours max placement

• Catheter inserted into large veins as the superior and inferior vena cava and right atrium
• Used for hypertonic fluid administration as Total parenteral nutrition (TPN), partial parenteral nutrition (PPN), chemotherapy and frequent blood withdrawals-DKA
• Primarily used for Dialysis or Central Venous pressure (CVP)
• Double or triple lumen
•   1. Catheter has multipe parallel compartments              (Lumens)

• Catheters placed into peripheral (jugular, saphenous or femoral) and advanced towards the heart or vena cava
• Used for TPN, PPN, chemotherapy, blood withdrawels,
• Double or triple lumen

• PICC lines placed in peripheral veins with Seldinger technique and guide wires.
• Used for long term intravenous use as TPN, PPN, blood withdraws, chemotherapy

• Central Venous line that does not have an external connection, instead a reservoir port covered with silicone.
• Can be left in place for years
• Able to give IV medications in the port
• surgically implanted inder the skin

Make sure all catheters are flushed with heparnized saline solution. (prevent clotting)

• All central line catheters not in use or when animals go home with catheters should be heparin locked.
•    a. 0.1 ml heparin +0.9 ml Saline (1:10), then lock with volume directed on size on catheter insert
•    b. normal heparin flush (5 units heparin/ml)

• 1. Cellulitis- connective tissue infection and inflammation
• 2. Phlebitis- vein infection and inflammation
• 3. Sepsis- body inflammation and infection
• 4. Extravasation- fluid leaking into tissue from catheter out  of vein
• Hemorrage- bleeding
• Hematoma- bruising
• Air embolism- air in the blood vessels