Lab 4-IV & IV and Urinary Catheters & Monitoring PDF

ATE 2655L Small Animal Nursing Lab 1 Lab Report 4 Name: _________________________ Date : _______________ Exercise 1: Set up the IV fluid bag & line Exercise 2: Monitoring devices -Pulse Oximeter: -Turn on instrument and place on a...

ATE 2655L Small Animal Nursing Lab 1 Lab Report 4 Name: _________________________ Date : _______________ Exercise 1: Set up the IV fluid bag & line Exercise 2: Monitoring devices -Pulse Oximeter: -Turn on instrument and place on a finger- record the reading. -Readings are inaccurate in the presence of carboxyhemoglobin and methemoglobin- why? -What other patient situations cause a reduced signal? - Electrocardiogram Use: ECG/ EKG Normal parameters of ECG: 1. young animals may have faster rates and shorter intervals 2. athletes may have slower rates and longer intervals 3. leaner animals may have higher amplitudes while obese animals or those with heavy muscle mass may have lower amplitudes 4. typically, feline rates are faster, intervals are shorter and amplitudes are lower than dogs 5. age, species, body size conditioning and degree of excitation must be considered when evaluating ECG Abnormal ECG’s caused by artifacts: 1. Sawtooth appearance of baseline: improper grounding of patient, ECG or source a. may obscure small wave forms b. methods to correct 1) reapply electrodes and contact medium 2) avoid contact with attendant and electrodes 3) prevent hair/skin contact with electrodes on adjacent limb 4) place nonconducting surface under patient 5) remove collars and halters 6) clean clips and attach securely 2. Tremor of patient: muscle fasciculations, panting, shivering or purring produces an irregular, rapid sawtooth vibration of the baseline that is greater in amplitude as the motion increases. a. attempts to calm patient may help to decrease 3. wandering baseline: severe movements of the limbs a. improve restraint 4. electrode misplacement Lead Application: (read the tabs!) Place patient in right lateral recumbency and attach clips to skin caudal to elbows and on the stifles: White = RF 1  Black = LF Green = RR Red = LR - Capnograph: -Turn on instrument and try to record your end-tidal CO2: -Useful when using controlled ventilation, why would they be inaccurate in hypoventilation? Exercise 3: Cystocentesis Specific indications: 1. Hematuria, dysuria, pyuria 2. Distention of the urinary bladder 3. Routine collection of urine Complications: 1. Rupture of bladder 2. Minimal hemorrhage Contraindications: 1. Bleeding disorders 2. Potential pyometra or prostatic abscess that could be inadvertently ruptured by this technique 3. Bladder cancer that may be seeded to the peritoneum by this technique 4. Animals with urinary outflow obstruction, or animals likely to have urinary outflow obstruction before the hole created in the bladder by this technique has a chance to heal Site: Ventral abdomen just cranial to the pubis Patient is restrained in dorsal or lateral recumbency or standing Exercise 3: Urinary Catheters Purpose: 2  1. To collect urine for analysis or bacterial culture if percutaneous sample cannot be obtained 2. To administer medication or radiographic contrast media directly into the urinary bladder 3. To provide closed continuous drainage of urine 4. To relieve urethral obstructions Complications: 1. Trauma to urethra or urinary bladder 2. Urinary tract infections Placement of Urethral Catheter on Male Dog: Materials needed: 1. cotton 2. chlorhexidine or povidine-iodine surgical scrub 3. sterile surgeon’s gloves 4. sterile urinary catheter 5. sterile lubricating jelly 6. container for urine 7. Procedure: 1. Gently cleanse area around prepuce using surgical scrub. 2. Select catheter of appropriate size 3. Wash hands thoroughly and glove using closed gloving technique 4. Examine catheter for flaws 5. Estimate length of catheter needed to enter the bladder 6. Assistant: place dog in lateral recumbency & abduct dog’s upper rear leg. Then retract the dog’s prepuce such that distal 1-2 “ of glans penis is exposed. Cleanse glans penis with mild soap. 7. Operator: Lubricate end of catheter literally and insert catheter tip into urethral orifice at the distal end of the glans penis. 8. Advance catheter into urinary bladder 9. Collect urine sample. Urethral Catheterization of female dog: Visual technique – procedure: 1. Prepare patient for procedure while in standing position, move tail to one side. 2. Insert lubricated sterile tuberculin syringe without needle containing 0.3 ml topical ophthalmic solution or 0.5% lidocaine approximately 1.5 to 2” into the vagina and instill anesthesia. 3. Lubricate the vaginal speculum and end of catheter liberally with sterile lubricating jelly. 4. Insert speculum into vagina with tip of speculum directed first dorsally and then cranially. 5. Introduce catheter into urethral orifice through catheter. 6. If not urine appears, try to aspirate urine. Urethral Catheterization of male cat: 3  (A) (B) Exercise 4: IV Catheterization See Videos & Practice IV Catheter Placement on Dummies Preparation for IV catheterization: Wash hands Clip hair from carpus to elbow and around Prepare clipped area as if for surgery using appropriate solution: Select 2 catheter of appropriate diameter and length and 1 smaller Open catheter but leave in the cap Remove the back of the catheter and place in sterile area Have an assistant distend the vein with blood Hold catheter so bevel of the stylet is up Insert at a 15o angle to skin Note flashback Advance catheter into vein Insert the cap you set aside Ask assistant to release vein but not leg Secure catheter with tape Swap out the cap with the male adapter port Flush with saline 4 Reading Assignment: You are responsible for this content on any quiz at any time from now. Small Animal Dental Procedures for Veterinary Technicians and Nurses Jeanne R. Perrone (Editor) Chapter 5: The Dental Cleaning 59 Julie McMahon Introduction 60 Common Instrumentation for the Dental Cleaning 61 The Dental Record 64 The Dental Cleaning Procedure 67 Purpose of the Oral Exam and Charting 67 Cleaning the Teeth Using the Power Scaler 74 Dental Cleaning with Hand Instrumentation 75 Polishing 78 Recovery 79 Home Care 80 Equipment and Instrument Care 82 Chapter 8: Feline Dentistry 143 Jennifer Crawford and Billie Jean (Jeannie) Losey Introduction 144 Gingivostomatitis 144 Jennifer Crawford Introduction 144 Symptoms of Gingivostomatitis 145 Diagnostics 147 Oral Evaluation 147 5 Treatments 148 Summary 151 Eosinophilic Granuloma Complex 151 Billie Jean (Jeannie) Losey Eosinophilic Ulcers 151 Eosinophilic Plaque 151 Collagenolytic Granuloma 152 Causes 152 Symptoms 152 Diagnostics 153 Treatments 153 Feline Tooth Resorption 154 Billie Jean (Jeannie) Losey Definition and Symptoms 154 Stages of Tooth Resorption 156 Diagnostics 158 Charting 158 Treatment 159 Questions: 1. What are the purposes of IV catheters? 2. What are the potential complications of IV catheters? 3. What types of catheters are recommended for the accessible veins? 4. Why is the winged infusion set not left in the vein for long term use? 5. Why should the leg be cleaned of any blood that is outside the catheter? 6. How often should the fluid administration set be changed if continuous IV fluid administration is maintained? 6 7. Should the catheter be flushed with heparinized saline if not on continuous fluid administration? 8. What veins are used in the dog commonly? 9. What veins are used commonly in the cat?’ 10. List the two main different types of fluids and give an example for the use of each type: 11. How long can a catheter be left in a patient? 12. How many catheters do you need to have available when preparing your tray? 13. Name everything that need to be on your tray 14. Name 5 ways to prevent catheter problems. 15. What type of urinary catheters are available for male and female cats and dogs? 16. What are the normal TPRs for dogs and cat? 17. When you note respiratory rate, what else do you need to observe (with regard to this)? 18. The length of recovery is dependent on what factors? 19. Describe the mucus membranes of a dog in shock. 20. What do you consider an anesthetic emergency? 21. What values can be read on this monitoring device. Name and point an arrow to each. 7 7. What is wrong with the yellow line? Is the patient dead? 8 9