ER Study Guide Exam 1 - Chapter 2 Summary
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Questions and Answers

In the context of blood gas analysis, which of the following scenarios necessitates immediate intervention to improve ventilation?

  • Normal pH levels despite abnormal $PaCO_2$ values.
  • Decreased $PaCO_2$ levels suggesting hyperventilation.
  • Elevated $HCO3^-$ levels indicating metabolic alkalosis.
  • Elevated $PaCO_2$ levels indicating hypoventilation. (correct)

A patient presents with severe dehydration. Which combination of PCV and TS values would you most likely expect to observe?

  • Increased PCV, increased TS (correct)
  • Decreased PCV, decreased TS
  • Increased PCV, normal TS
  • Normal PCV, decreased TS

A veterinary technician notes a patient's potassium level is critically low. What potential clinical sign should the technician be most vigilant in monitoring?

  • Muscle weakness (correct)
  • Increased thirst
  • Seizures
  • Cardiac arrhythmia

During a physical examination of a canine patient, a veterinary technician observes that the dog's mucous membranes are pale and its capillary refill time (CRT) is prolonged. What is indicated by these?

<p>Anemia or poor perfusion (B)</p> Signup and view all the answers

A feline patient's blood gas analysis reveals a pH of 7.2, an elevated $PaCO_2$, and a normal $HCO_3^-$. How can this be described?

<p>Respiratory acidosis, uncompensated (C)</p> Signup and view all the answers

A veterinary technician is evaluating a patient with suspected hypoventilation. Which blood gas parameter is most critical to assess in this situation?

<p>Partial pressure of carbon dioxide ($PaCO_2$) (C)</p> Signup and view all the answers

A patient's electrolyte results indicate hyponatremia. Which of the following conditions is most likely contributing to this electrolyte imbalance?

<p>Excessive fluid retention (C)</p> Signup and view all the answers

When managing a patient with metabolic acidosis, which therapeutic intervention directly addresses the underlying acid-base imbalance?

<p>Bicarbonate supplementation (C)</p> Signup and view all the answers

Which of the following findings during a physical exam would warrant immediate intervention?

<p>Labored breathing (B)</p> Signup and view all the answers

An elderly patient with chronic kidney disease is admitted. Blood work reveals elevated potassium levels. What is the primary concern?

<p>Cardiac complications (A)</p> Signup and view all the answers

In a case of septic shock, what does hypothermia most likely indicate?

<p>There is a severe progression of the disease. (D)</p> Signup and view all the answers

Why are frequent temperature checks crucial in neonates and young animals?

<p>They can quickly develop hypothermia due to immature thermoregulatory systems. (B)</p> Signup and view all the answers

In which scenario is it most appropriate to avoid taking a rectal temperature?

<p>In critically ill patient where rectal stimulation may induce vagal-mediated arrest. (B)</p> Signup and view all the answers

If a bird weighs 300 grams, approximately what is its total blood volume, using 8% of its body weight as a standard?

<p>24 mL (B)</p> Signup and view all the answers

For large dogs requiring rapid fluid administration, what size IV catheter is most recommended?

<p>14-16 gauge (A)</p> Signup and view all the answers

When monitoring a stable patient's temperature, what would be an appropriate interval for temperature checks?

<p>Every 4-6 hours. (A)</p> Signup and view all the answers

In a bird weighing 400 grams, what is the maximum amount of blood that can be safely collected at one time for hematological testing, considering that up to 10% of the total blood volume can be collected?

<p>3.2 mL (B)</p> Signup and view all the answers

What is the primary reason for choosing a central vein catheter (e.g., jugular) over a peripheral vein catheter (e.g., cephalic) for IV access?

<p>For long-term access, blood sampling, or administration of fluids. (B)</p> Signup and view all the answers

During cardiac arrest recovery, why is monitoring a patient's temperature critical and what condition are you primarily trying to identify?

<p>To detect hypothermia, a risk associated with post-resuscitation care. (C)</p> Signup and view all the answers

A patient presents with severe trauma near the rectum. Which temperature measurement method is most appropriate and why?

<p>Axillary or auricular, to avoid causing further pain or injury. (C)</p> Signup and view all the answers

Following a surgical procedure on a small geriatric dog, the patient exhibits a body temperature of 95°F (35°C). What is the most likely underlying cause for this clinical presentation?

<p>Postoperative hypothermia due to anesthetic effects and decreased metabolic rate. (C)</p> Signup and view all the answers

During a resuscitation attempt on a cat in critical condition, which temperature trend would be most indicative of improved perfusion and metabolic function?

<p>A gradual increase in body temperature towards the normal range. (C)</p> Signup and view all the answers

An athletic dog presents with elevated body temperature, excessive panting, and bright red gums after a strenuous outdoor activity on a hot day. Which of the following is the most likely cause?

<p>Heatstroke (B)</p> Signup and view all the answers

A dog presents with a history of ingesting an unknown substance. Upon examination, the dog exhibits muscle tremors, rapid heart rate, and a markedly elevated body temperature. Which of the following toxicities is the MOST likely differential?

<p>Chocolate toxicity (A)</p> Signup and view all the answers

A cat is diagnosed with hyperthyroidism. Which of the following sets of clinical signs and expected blood chemistry abnormalities is MOST consistent with this diagnosis?

<p>Weight loss, hyperactivity, and increased liver enzyme activities. (D)</p> Signup and view all the answers

When monitoring a patient's response to antibiotic therapy, what temperature trend would indicate that the treatment is effective?

<p>A gradual decrease in temperature towards the normal range. (E)</p> Signup and view all the answers

A veterinarian is preparing to collect blood from a small breed puppy for a comprehensive diagnostic workup. What is the MOST critical consideration regarding the volume of blood to be drawn?

<p>Limiting the blood draw to no more than 5-7% of the puppy's total blood volume per week to avoid iatrogenic anemia. (A)</p> Signup and view all the answers

A blood sample is collected for a chemistry panel but is visibly hemolyzed. How might hemolysis affect the accuracy and interpretation of the results?

<p>Hemolysis will falsely elevate certain analytes, such as potassium and liver enzymes, potentially leading to misdiagnosis. (D)</p> Signup and view all the answers

Following a thorough clinical evaluation, a veterinarian suspects a patient may have a clotting disorder. Which of the parameters below would be MOST useful to initially assess clotting efficiency?

<p>Prothrombin Time (PT) and Activated Partial Thromboplastin Time (aPTT) (A)</p> Signup and view all the answers

A canine patient presents with lethargy, weight gain, and a decreased heart rate. Based on these clinical signs, which endocrine disorder should be suspected?

<p>Hypothyroidism (E)</p> Signup and view all the answers

Why is aseptic technique particularly emphasized when placing jugular vein catheters?

<p>To prevent thrombophlebitis, a common complication associated with this catheter type. (B)</p> Signup and view all the answers

A 7kg cat presents with subtle skin tenting. Using the provided guidelines, what is your initial estimate for the volume of replacement fluids required?

<p>350 mL (B)</p> Signup and view all the answers

You are treating a 15 kg dog for severe dehydration and administer the initial bolus of replacement fluids. What clinical sign would be most concerning immediately following fluid administration, indicating potential fluid overload?

<p>Crackles on lung auscultation and increased respiratory effort. (D)</p> Signup and view all the answers

A 5kg cat is receiving fluid therapy. Over the past 12 hours, its urine output has been consistently below 0.5 mL/kg/hour despite adequate cardiovascular parameters. What is the most appropriate next step?

<p>Administer a diuretic like furosemide while carefully monitoring cardiovascular and hydration status. (A)</p> Signup and view all the answers

Which scenario necessitates the most immediate and aggressive fluid replacement strategy?

<p>A dog with greater than 10% dehydration presenting with sunken eyes and signs of shock. (A)</p> Signup and view all the answers

What adjustment to a fluid therapy plan is most appropriate for a patient that develops significant subcutaneous edema during fluid administration?

<p>Temporarily discontinue fluid therapy and reassess the patient's cardiovascular and hydration status. (D)</p> Signup and view all the answers

A 12 kg canine patient requires both replacement and maintenance fluids. It is estimated to be 6% dehydrated and is losing approximately 30 mL of fluid daily due to a wound. Calculate the total daily fluid volume needed for this patient.

<p>1302 mL (C)</p> Signup and view all the answers

A 5 kg patient is receiving intravenous fluids at twice the calculated maintenance rate. What is the most critical parameter to monitor in order to detect iatrogenic complications early?

<p>Respiratory rate and effort in conjunction with lung auscultation (D)</p> Signup and view all the answers

A dog presents with severe vomiting and diarrhea, leading to significant dehydration. Besides fluid volume deficit, what other critical electrolyte derangement is most likely to occur and should be addressed concurrently during fluid therapy?

<p>Hypokalemia (B)</p> Signup and view all the answers

Which of the following techniques will provide the most accurate and immediate assessment of a patient's response to a fluid bolus during the critical initial phase of resuscitation?

<p>Assessing changes in central venous pressure (CVP) and pulse quality. (D)</p> Signup and view all the answers

Flashcards

Physical Examination

A hands-on assessment to collect real-time patient data using inspection, palpation, etc.

Key Parameters

Vital signs such as respiratory rate, CRT, and mucous membrane color used in monitoring.

Respiratory Rate

The number of breaths per minute, indicating respiratory health.

Blood Gas Analysis

Test that evaluates oxygenation, ventilation, and acid-base balance.

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PaCO2

Partial pressure of carbon dioxide; indicates ventilation status.

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HCO3⁻

Bicarbonate level; reflects metabolic compensation in the body.

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Packed Cell Volume (PCV)

Blood test measuring the percentage of red blood cells, indicators of dehydration/anemia.

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Total Plasma Solids (TS)

Measures protein levels in plasma; indicates hydration or inflammation.

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Electrolytes

Minerals in the blood; crucial for numerous body functions, including fluid balance.

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Hyponatremia

Low sodium levels in blood; can indicate fluid retention or excessive losses.

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Septic Shock

A severe condition characterized by hypothermia indicating disease progression.

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Cardiac Arrest Recovery

Hypothermia poses a risk during care after cardiac resuscitation.

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Thermometer Use

Essential for patients with vomiting and diarrhea to check temperature states.

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Gastrointestinal Infections

Hypothermia or hyperthermia can signal severity in suspected infections or sepsis.

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Neonates Temperature Checks

Frequent monitoring needed due to their immature thermoregulatory systems.

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Avoiding Rectal Temp

Use alternatives in certain patients to prevent harm or distress.

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Monitoring Frequency for Stable Patients

Stable patients should be monitored every 4-6 hours as needed.

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Critically Ill Patient Monitoring

Monitor every 1-2 hours or continuously for critically ill patients.

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Bird Blood Volume Calculations

Birds have a blood volume of 6-13% of their body weight; 10% is safe to collect at once.

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IV Catheter Placement

Use peripheral veins for short-term and central veins for long-term access.

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Chloride Levels

Altered levels indicate potential acid-base imbalances.

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Chemistry Panel

Evaluates organ function, focusing on liver and kidney health.

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Clotting Panel

Includes PT and aPTT to assess clotting efficiency.

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Sampling Techniques

Correct containers and proper handling prevent sample errors.

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Pulse Oximetry

Measures oxygen saturation (SpO2) in the blood.

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Diagnosing Hypothyroidism

Mild hypothermia may indicate hypothyroidism.

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Postoperative Hypothermia

Common complication in small or elderly animals after surgery.

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Monitoring Response to Infection

Recheck temperatures to evaluate antibiotic effectiveness.

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Emergency Temperature Checks

Always measure temperature in cases of poisoning or heatstroke.

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Heatstroke Indicators

High temperatures can indicate heatstroke or other crises.

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Aseptic Technique

Methods used to prevent infection during medical procedures.

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Thrombophlebitis

Inflammation of a vein due to a blood clot, often a complication with catheters.

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Fluid Therapy Components

Includes replacement, maintenance, and ongoing losses of fluids.

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Replacement Fluids

Fluids given to address existing dehydration.

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Dehydration Calculation

Volume to replace (mL) = Body weight (kg) x % dehydration x 1000.

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Maintenance Fluids

Fluids given to meet daily hydration needs.

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Ongoing Losses

Fluids lost through vomiting, diarrhea, and other factors.

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Total Daily Fluid Volume

Total volume = Replacement + Maintenance + Ongoing losses.

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Physical Signs Monitoring

Assessing hydration status, body weight, and other physical signs.

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Normal Urine Output

1-2 mL/kg/hour is considered normal urine output.

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Study Notes

ER Study Guide Exam 1 - Chapter 2 Summary

  • Physical Examination Monitoring: Includes inspection, palpation, auscultation, percussion, and olfaction for real-time data. Key parameters include respiratory rate, depth, effort, mucous membrane color, capillary refill time (CRT), and pain level. Trend analysis is vital. Visual observation and equipment like stethoscopes are used to detect subtle signs of deterioration.

Clinical Pathologic Monitoring

  • Blood Gas Analysis: Assesses oxygenation, ventilation, and acid-base balance.

  • pH: Indicates overall acid-base status.

  • PaCO2: High levels indicate hypoventilation (respiratory acidosis); low levels suggest hyperventilation (respiratory alkalosis).

  • HCO3¯: Reflects metabolic compensation (low in acidosis, high in alkalosis).

  • Management: For acidosis, ensure adequate ventilation or address metabolic causes (e.g., bicarbonate supplementation). For alkalosis, identify the cause (e.g., hypochloremia or overventilation) and correct accordingly.

  • Packed Cell Volume (PCV) and Total Plasma Solids (TS): PCV evaluates red blood cell mass (dehydration or anemia), and TS assesses protein levels and oncotic pressure. High levels indicate dehydration or inflammation; low levels suggest protein loss.

  • Electrolytes: Addresses sodium, potassium, and chloride.

  • Sodium: Essential for fluid balance. Hypernatremia indicates dehydration; hyponatremia suggests fluid retention or losses.

  • Potassium: Essential for neuromuscular function. Hypokalemia can cause weakness; hyperkalemia poses cardiac risks.

  • Chloride: Imbalances reflect acid-base issues.

  • Chemistry Panel: Evaluates organ function, especially liver and kidney health. Includes data on glucose, proteins, liver enzymes (ALT, AST), kidney markers (BUN, creatinine), and electrolytes.

  • Clotting Panel: Assesses clotting efficiency using prothrombin time (PT) and activated partial thromboplastin time (aPTT). Extended times indicate clotting factor deficiencies or anticoagulant toxicity.

Device-Based Monitoring

  • Pulse Oximetry: Measures oxygen saturation (SpO2). Low values (<94%) indicate hypoxemia. Calibration and sensor placement are critical.

  • Blood Pressure: Hypotension (<90 mmHg systolic) is a critical finding. Utilize Doppler or oscillometric methods for accurate readings.

  • Capnography: Tracks end-tidal CO2 (EtCO2), which reflects ventilation. Normal values are 35-45 mmHg.

Understanding Blood Parameters

  • Recognize trends rather than isolated results. Dehydration or fluid dilution can affect PCV and TS values.

  • Correlate results with clinical presentation. For example, low PaCO2 with high pH indicates respiratory alkalosis, possibly from hyperventilation. High lactate suggests tissue hypoperfusion, often seen in shock.

Managing Acid-Base and Respiratory Imbalances

  • Acidosis:

  • Metabolic Acidosis: Treat underlying causes like kidney failure or lactic acidosis. Sodium bicarbonate may be required in severe cases.

  • Respiratory Acidosis: Ensure proper ventilation; consider mechanical ventilation in severe hypoventilation cases.

  • Alkalosis:

  • Metabolic Alkalosis: Commonly caused by vomiting or hypochloremia; administer isotonic fluids with potassium chloride.

  • Respiratory Alkalosis: Reduced hyperventilation by addressing pain or anxiety.

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ER Study Guide Exam 1 PDF

Description

This quiz covers key concepts from Chapter 2 of the ER Study Guide, focusing on physical examination monitoring and clinical pathologic monitoring. You'll explore topics such as blood gas analysis, respiratory rate, and acid-base balance. Test your knowledge of vital examination parameters and management strategies for acidosis and alkalosis.

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