Shared Flashcard Set

Details

VETT 130 - Veterinary Nursing Care II
Wk 6 - Neonatal, Geratric, Nursing Care, Recognizing pain
51
Veterinary Medicine
Not Applicable
06/24/2012

Additional Veterinary Medicine Flashcards

 


 

Cards

Term
the single most important predictor of neonatal survival
Definition
birth weight
Term
The neonatal development can be divided into specific time periods
Definition
the neonatal period (birth-2 weeks); the transitional period (2-4 weeks); the socialization period (4-12 weeks), and the juvenile period (12 weeks-puberty). During the late socialization period and juvenile period, most puppies and kittens are growing versions of the adult.
Term
What fxns are decreased for the first 3-4 weeks?
Definition
Both hepatic function and renal function
Term
What is problematic in the neonate and a common complicating cause of death?
Definition
Thermoregulation is problematic in the neonate and a common complicating cause of death. The shivering reflex and
peripheral vasoconstriction response are not fully developed until at least 1 week. Their
relatively large body surface area of non-cornified skin, plus the lack of insulating fat,
promotes rapid heat loss by conduction, convection, radiation, and evaporation.
Term
What is always a concern with a sick neonate?
Definition
Dehydration is always a concern with a sick neonate but skin turgor is not an accurate indicator of hydration
Term
As small birth weight puppies and kittens are often physiologically dysmature, those neonates that are < 25% of the litter average weight, are at high risk for
Definition
hypoglycemia, hypothermia, hypoxia, bacterial septicemia and pneumonia
Term
Why is environmental temperature exposure can be critical to the newborn?
Definition
a
healthy newborn can only maintain a body temperature 12° > than that of the
surrounding environment.
Term
Why are newborns extremely susceptible to dehydration?
Definition
Neonates are 75% water with a disproportionately large body surface area is covered with non-cornified skin combined with an inability to concentrate their urine. Water turnover is
2-3X that of an adult. Unlike an adult, hydration status cannot be accurately assessed using skin turgor. Estimates of the degree of dehydration must be determined by dryness of the oral mucus membranes and eyes, plus the urine specific gravity.
Term
Determining kitten gender
Definition
Male kitten's perineal region look like a colon ":" and the female's appears as a semi-colon ";".
Term
The heart rate in the neonatal pup
Definition
200 b/minute
Term
The heart rate in the neonatal kitten
Definition
averages 250 b/minute
Term
Volume of replacement formulas for wks 1 - 4
Definition
week 1 60 mls. of formula / pound of body weight
week 2 70 mls. of formula / pound of body weight
week 3 85 mls. of formula / pound of body weight
week 4 100 mls. of formula / pound of body weight
divided into 4 equal feeding for the first week, then 3 feedings for weeks 2 through weaning. The premature pups, weak pups, immature, and most toy breeds will require more frequent feedings.
It is very important you recommend diluting the formula by adding 25% more water for the first 2 days. This adjustment will minimize the diarrhea commonly associated with dietary changes or the client's temptation to overfeed. Green or yellow watery stools are more commonly associated with overfeeding than an unrelated disease. If diarrhea does occur, dilute the formula by adding 33% more water for a couple of days.
Term
Apnea
Definition
absence of breathing
Term
Coupage
Definition
massaging the thorax to aid in removal of secretions
Term
cyanosis
Definition
a bluish color of the skin or mm that is usually the result of an increased amt of deoxygenated hemoglobin in the blood
Term
dyspnea
Definition
rapid, shallow breathing
Term
lipoma
Definition
a benign tumor that consists of fat cells
Term
orthopnea
Definition
labored breathing while in an upright position
Term
syncope
Definition
fainting episodes
Term
thromboembolism
Definition
formation in a blood vessel of a clot (thrombus) that breaks loose and is carried by the blood stream to plug another vessel
Term
In addition to the typical questions asked when obtaining a patient history for an ill puppy or kitten, what additional questions should be asked?
Definition
Pg 244 Mcurnin
Obtain comphrehensive hx of parents, littermates and other relatives
Term
What is the normal body temp of neonates during the first week of life?
Definition
Body temp at birth ( 94.5 F to 97.3 F) is lower than in adults and rises to 94.7 to 100.1 F during the 1st wk of life
Term
What are some common concerns and disorders in the puppy and kittens?
Definition
Hypothermia
Dehydration
Hypoglycemia
Neonatal isoerythrolysis
Malnutrition
Term
What contributes significantly to hypothermia in the neonate?
Definition
Hypoxia contributes significantly to hypothermia so the neonate should be provided with O2 or proper ventilation
Term
What are some clinical signs of a hypothermic neonate?
A chilled neonate with a body temp >88 F –
Definition
A chilled neonate with a body temp >88 F –
restlessness,
continuous crying,
red mm,
skin cool to touch.
Muscle tone still good,
RR >40 breaths/min,
HR >200 bpm
Term
What are some clinical signs of a hypothermic neonate?
A chilled neonate with a body temp 78 - 85 F –
Definition
A chilled neonate with a body temp 78 - 85 F –
lethargic and uncoordinated but responsive,
moisture around corners of lips,
HR below 50 bpm
RR <>20 – 25 breaths/min
No abdominal sounds heard
Metabolism impaired, resulting hypoglycemia
Term
What are some clinical signs of a hypothermic neonate?
A chilled neonate with a body temp below 70 F
Definition
A chilled neonate with a body temp below 70 F –
Neonate appears to be dead
If extreme measures of arousal result in a response, tx may be attempted
Term
How to tx hypothermia in the neonate?
Definition
tx consists of slowly (2 F/hr)reheating the pt by providing the appropriate ambient temp and humidity. Warm IV fluids can be given but at mo more than 2 F above body temp.
Term
When can the hypothermic neonate be given anything orally?
Definition
when the pt has audible gut sounds and is moderately rewarmed
Term
What are some problems that occur if a puppy or kitten becomes hypothermic?
Definition
Gut motility slows w/ a decreasing body temp, ultimately causing ileus. When hypothermic neonates are tube fed, the milk replacer is either regurgitated and aspirated resulting in pneumonia, or the ingesta ferments, leading to bloat
Term
Define hypoglycemia in the neonate
Definition
Hypoglycemia – lower than normal levels of blood glucose resulting in lack of fuel to the brain and other organ systems. Risk is great because the neonate is born with little glycogen stores and has poor gluconeogenesis in the liver. As long as healthy, can maintain normal BG for up to 24 hrs w/o nursing.

Failure to suckle results in hypoglycemia after 24 – 36 hrs as a result of the depletion of hepatic stores
Term
list some of the clinical signs of hypoglycemia
Definition
Variety of clinical signs in the hypoglycemic pt (serum glucose <30 mg/dl) –
Tremors
Crying
Irritability
Increased appetite
Dullness
Lethargy
Coma
Stupor
seizures
Term
Why are puppies and kittens susceptible to hypoglycemia?
Definition
Risk is great because the neonate is born with little glycogen stores and has poor gluconeogenesis in the liver. As long as healthy, can maintain normal BG for up to 24 hrs w/o nursing.

Failure to suckle results in hypoglycemia after 24 – 36 hrs as a result of the depletion of hepatic stores
Term
What can be given orally to counteract hypoglycemia?
Definition
Dextrose 1 – 2 mls of a 5% to 15% dextrose soln. Dextrose should never be given SQ because may cause tissue damage.
Term
Describe Fading Puppy or Kitten Syndrome and list some of the clinical signs
Definition
Characterized by anorexia, lethargy, emaciation, death, and birth defects

May be stillborn or born small, weak, and unable to nurse, resulting in dehydration, hypothermia, hypoglycemia, and death within the first few days of life. Other neonates appear healthy during the first few wks of life; become weak, depressed and anorectic; and die of starvation at time of weaning
Term
Why do neonates rapidly lose heat?
Definition
The shivering reflex and peripheral vasoconstriction response are not fully developed until at least 1 week. Their relatively large body surface area of non-cornified skin, plus the lack of insulating fat, promotes rapid heat loss by conduction, convection, radiation, and evaporation. The vulnerable young must relay on the ambient temperature, the dam's mothering instincts, and littermates for warmth. Environmental temperature exposure can be critical as a healthy newborn can only maintain a body temperature 12° > than that of the surrounding environment
Term
At what age to puppies and kittens begin to open their eyes?
Definition
Generally the eyelids open at 10-14 days revealing a cloudy cornea which clears within 24 hours. For the first 3 weeks vision is poor. The corneal reflex is present as soon as the eyes open however the menace reflex is poor to absent for the first 3 weeks. Although the pupillary light reflexes are present within 24 hours of the lid separation, they are difficult to evaluate until about 21 days of age. Reflex lacrimation begins when the eyelids open. The true iris color is complete by week 8.
Term
At what age should the umbilical cord fall off?
Definition
The umbilical cord should be visualized checking for evidence of infection/inflammation and should dry up and fall off by day 3.
Term
Where does the neonate obtain passive maternal immunity
Definition
95% of the neonate's passive maternal immunity is derived from the colostrum within the first 24 hours of nursing
Term
Why would young puppies cry?
Definition
Puppies cry when hungry, neglected (separated or culled), in pain, and especially when cold
Term
At what age can you start weaning a puppy?
Definition
The earliest you can start weaning a puppy is 3 weeks for a normal breed or 4 weeks for toy breeds. The food gruel-like consistency is derived from water or milk; dry puppy food / water 1:3; canned puppy food / water 2:1; cow's milk or milk-replacer instead of water.
Use a shallow disk, warm the mixture, then gently push their face in it or finger feed them. Gradually decrease the amount of dry food until at 6 weeks >50 % of nutrition is
dry kibble and by 7-8 weeks they are completely weaned. Potential early weaning issues are while is less stressful to the bitch, it is more stressful to the puppy plus increases the likelihood of littermate separation- behavioral problems
Term
At what age can you start weaning a kitten?
Definition
Kittens can be started on the weaning process at 4 weeks of age. The food gruel-like consistency is derived from dry kitten food / milk (water) 1:3; or canned kitten food / milk (water) 2:1.
Cow's milk or milk-replacer should be considered instead of water. Use a shallow disk, warm the mixture, then smear on their face (avoid the nose) or feet. Gradually decrease the amount of dry food until at 6 weeks they are completely weaned. Potential early weaning issues are while is less stressful to the queen it is more stressful to the kitten plus increases the likelihood of littermate separation- behavioral problems i.e., slow learning, cautious / timid, and aggression.
Term
Care for older dogs and cats should focus on what topics?
Definition
Owner education
Dz prevention strategies
Detection of medical and behavioral problems at the earliest possible stage when the prognosis is better and numerous tx options still exist
Term
What are decubital ulcers, what causes them, and how can you treat them?
Definition
Bedsores – develop over bony prominences as a result of continuous pressure and damage to the overlying skin

Complicate recovery and can also be a source of sepsis which can lead to the demise of the pt.

To treat – thoroughly clean with surgical scrub. Surgical debridement of necrotic tissue may be needed. After cleaning, completely dry. Soak area 2 – 4 times daily with a mild astringent to keep area dry. Area of the sore should be padded to prevent further injury but sore itself should remain exposed to the air to prevent retention of moisture
Term
What are some of the signs that an animal is in pain?
Definition
Signs of pain categorized as physiologic or behavioral.

Physiologic –
Increased HR and BP
Oncreased RR
Vocalization

Behavioral –
General restlessness
Decreased appetite
Not sleeping
Resenting handling
Not assuming a normal position

Clinical signs most commonly reported –
Tachycardia
Increased RR
Restlessness
Increased temp
Increased BP
Abnormal posturing
Inappetence
Aggression
Frequent movement
Facial expression
Trembling
Depression
insomnia
Term
What in the body are affected if pain is not controlled?
Definition
Most, if not all, of the body’s major systems are affected

Increased cortisol levels may interfere with wound healing and reduce the immune system’s ability to work effectively

Increased sympathiomemetic nervous system activity may result in increased catabolism and metabolic rate, anorexia, ileus and atelectasis

Cardiovascular – increased heart rate and BP, irregular heart rhythms and coagulopathies
Term
In addition to the use of medications, list some ways that pain can be treated.
Definition
Nursing care: bedding, nutrition
Physiotherapy: massage, ice, heat
PT: therapeutic and routine therapy
Acupuncture
Neutraceuticals: so called cartilage protectants
Analgesics: pain meds
Term
What are the basic principles that are important when managing pain?
Definition
Multimodal therapy – the use of multiple pain therapies to control pain, result is synergistic, meaning it has a better effect that any one therapy alone can achieve

Pre-emptive therapy – the use of analgesics (pain-relieving) meds prior to the onset of pain (ie before sx). The result is a lower overall level of pain because the pain response is dampened
Term
What 3 classes of drugs may be used to help alleviate pain?
Definition
Most commonly used are:
Alpha 2 agonists such as medetomidine, xylazine
Opiods such as morphine, fentanyl, tramadol
NSAIDS (Non-steroidal Anti-Inflammatory drugs) - lessen pain by reducing inflammation and are used to treat both acute and chronic pain
Term
What are some side effects that may be seen with long term use of corticosteroids?
Definition
Damage to kidney or liver and GI ulceration
Term
Assessment of pain in an animal depends on what factors?
Definition
- Knowledge of the degree of pain associated with a particular sx procedure or illness
- familiarity with species/breed
- recognition of the signs of stress and pain
- individual behavior
Supporting users have an ad free experience!