VTT 256 FINAL!

Hyperthermic patients should not be cooled past the temperature of __________.

103.5 degrees F

Refeeding syndrome is observed in patients that do not eat for more than __________ days.

14

While a transfusion is administered, vitals should be monitored every _______________.

15 minutes

Most transfusions are administered over ______________, with the product given slowly over the first ________________.

2-4 hours, hour

Feline blood types

A, B, AB

Is it necessary to check for compatible blood type for the FIRST transfusion a dog receives?

No

A patient with anemia may be stabilized with the administration of ___________________.

OXYGEN

The __________________________ bandage is appropriate for fracture stabilization prior to splint application.

Robert Jones

Is it necessary to check for compatible blood type for the FIRST transfusion a cat receives?

Yes

Is it necessary to check for compatible blood type for the SECOND transfusion a dog receives?

Yes

ABC

airway, breathing, circulation

Normal levels of _______________ are required to maintain oncotic pressure and keep fluid in the intravascular space.

albumin (protein)

To relieve urticaria & facial swelling, the drugs administered are _____________________.

antihistamines such as diphenhydramine (Benadryl); glucocorticoids (dexamethasone, prednisone)

Clients can transport a large, recumbent patient using a ___________________ in place of a stretcher.

blanket

open (compound) fracture

bone exposed through skin

closed fracture

bone is NOT exposed through skin

While dogs are typically tachycardic when in shock, cats instead present as _________________.

bradycardic

Transverse fracture

break at 90 degree angle

Oblique fracture

break at ~45 degree angle

Hypertension is commonly seen in ________________.

cats with renal disease or hyperthyroidism

hypovolemic shock

caused by reduction in blood volume from bleeding, dehydration, effusion

Signs that an allergic reaction is severe include ______________________.

collapse, vomiting, pale MM

septic shock

compensatory mechanisms are overwhelmed, so tissues are not perfused despite aggressive treatment

cryoprecipitate

concentrated, freeze-dried clotting factors; may consist of isolated immunoglobulins

Hypothermia causes blood vessels to _____________.

constrict

treatment for penetrating chest trauma

cover with occlusive dressing to create seal, +/- chest bandage

cardiogenic shock

decreased cardiac output caused by congestive heart failure, cardiomyopathy, arrhythmias

Hyperthermia causes blood vessels to _____________.

dilate

Untreated anaphylaxis may result in ___________________.

disseminated intravascular coagulation (DIC)

xenotransfusion

donor and recipient species differ

For severe anaphylaxis, the treatment is _______________________.

epinephrine

packed red blood cells

erythrocytes (60-80% PCV) in anticoagulant solution

While most fractures are not life threatening, ______________ fractures can shear the associated arteries and cause massive bleeding.

femur

sepsis signs

fever, hypoglycemia, liver dysfunction, hypoalbuminemia

signs of transfusion reaction

fever, injected MM, increased HR & RR, urticaria, facial swelling, nausea/vomiting

Packed RBCs and whole blood should never be administered using a _____________________, because it __________________.

fluid pump, damages the cells

Before final closure with suture, wounds should be _____________________ well with ______________________.

flushed, Lactated Ringer's solution (or equivalent)

After 1 year of storage, fresh frozen plasma becomes __________________ and can be stored for up to ___________________.

frozen plasma, 5 years from date of collection

Unlike FRESH frozen plasma, frozen plasma does not contain _________________.

functional platelets

Plasma must be _______________ prior transfusion.

gently warmed to room temperature using cool water

Eye ointment should be applied to hospitalized patients when _______________.

given opioids, dehydrated

Warming device should be placed under the patient's ___________ to achieve ______________.

heart; central re-warming

electrolytes derangements with refeeding syndrome

hypophosphatemia, hypomagnesia, hypokalemia

>12% dehydration

hypovolemic shock, death

major cross-match results

if antigens AGAINST donor RBCs are present in plasma, they will begin to stick together; the clumping is called AGGLUTINATION; the presence of agglutination means that the cross-match is POSITIVE and the transfusion is INCOMPATIBLE

Immune-Mediate Hemolytic Anemia (IMHA) pathophysiology

immune system attacks its own RBC, spleen begins to destroy them

treatment for IMHA

immunosuppressive drugs (steroids, chemotherapeutics), anticoagulants, blood transfusions

Mass casualty incidents

incident in which resources are overwhelmed by the number and severity of casualties

Greenstick fracture

incomplete break

signs of compensated shock

increased heart & respiratory rate, rapid CRT (1s), brick red (injected) MM, bounding pulses

5-8% dehydration

inelasticity of skin, tacky MM

systemic inflammatory response syndrome (SIRS)

inflammatory cytokines begin to cause injury to body, affect cardiac and renal systems, AKA pre-sepsis

Disseminated Intravascular Coagulation (DIC) definition

inflammatory mediators cause HYPERcoagulable state followed by HYPOcoagulable when platelets & clotting factors have run out

polytrauma definition

injuries to multiple body systems

ileus

lack of peristalsis, contributes to abdominal discomfort and nausea

LOC

level of consciousness (BAR, QAR, depressed, obtunded, semicomatose, comatose)

distributive shock

maldistribution of blood flow due to vasodilation caused be anaphylaxis, heatstroke, envenomation

Field medicine

medicine practiced on the site of a catastrophe with limited resources

major cross-match protocol

mix DONOR red blood cells with RECIPIENT plasma

Comminuted fracture

multiple fragments

Dog blood donors should be _______________ for the antigen ________________________.

negative, DEA 1.1

Simple fracture

one break with minimal displacement

Multiple Organ Dysfunction Syndrome (MODS)

organ failure secondary to SIRS or sepsis

sepsis definition

overwhelming systemic inflammation with evidence of infection

Fissured fracture

partial break with no displacement

Pain control is important because ________________.

patients heal faster, more likely to recover

Disseminated Intravascular Coagulation (DIC) signs

petechiation, ecchymosis, epistaxis, hemmorhage into body cavities, decreased platelets & RBC counts

fresh frozen plasma

plasma that contains platelets and clotting factors, separated from cells and frozen immediately after collection

shock

poor blood flow creating impaired oxygen delivery to the tissues

purpose of early nutritional intervention

prevents ileus, maintain healthy balance of GI bacteria, keep intestinal microvilli alive

An ECG is indicated during triage when _________________.

pulse deficits are palpated

Type B cats are typically _______________.

purebred

AFAST

quick ultrasound of abdomen; looks for evidence of abdominal effusion or bleeding, organomegaly, masses, intact bladder

TFAST

quick ultrasound of thorax; looks for evidence of pleural effusion, pericardial effusion, pneumothorax, and cardiac disease

causes of anemia

renal failure, zinc toxicity, hemoabdomen (hemangiosarcoma), feline leukemia, IMHA

Patients with decreased ___________________ may require lower drug doses.

renal or hepatic function

clinical signs of anaphylaxis

restlessness, urticaria, nausea, weakness, dyspnea, hypotension, injected MM

obstructive shock

restriction of blood flow due to blockage (GDV, saddle thrombus, etc)

"shock gut"

results from hypoperfusion to intestinal lining; presents as vomiting, diarrhea (sometimes with blood)

Performing rounds results in:

shorter hospital stays, decreased mortality, less expense for the client

8-10% dehydration

skin tents for several seconds, eyes slightly sunken, dry MM

Open wounds should be instilled with ____________________ and _____________________ on entry into the hospital.

sterile lubricant, covered

An abdominal hernia can result in _____________________ of the intestines or mesentery.

strangulation

anaphylaxis

systemic reaction mediated by immunoglobins which releases vasoactive substances from mast cells & basophils; results in massive vasodilation & hypotension

A glucose reading should be obtained during triage when _________________.

the patient's mentation is dull; the patient is having seizures

A blood pressure measurement is indicated during triage when _________________.

the pulse cannot be palpated

A ________________________ can be applied to slow bleeding caused by a ruptured spleen or liver.

tight abdominal bandage

<5% dehydration

undetectable on physical exam, based on history (vomiting, diarrhea, not drinking, etc.)

neurogenic shock

vasodilation following injury to brain or spinal cord

10-12% dehydration

very delayed tenting of skin, prolonged CRT (3 seconds or more), dull mentation, tachycardia

signs of uncompensated shock

weak pulses, rapid heart rate, delayed CRT (>2s), pale MM, hypothermia, dull mentation, hypotension

Banadages should be checked every 6 hours for _____________.

wetness, slippage, swollen toes, strike-through

auto-tranfusion

when blood removed from a patient's body cavity is replaced in the veins

dogs SIRS signs

HR >120 bpm, RR >20 bpm, hypothermia or fever, low or high WBC

IMHA is most common in _______________________.

Cocker Spaniels

diagnostic test for IMHA

Coombs' test

signs of IMHA

Decreased PCV, increased WBC, jaundice, tachypnea; on blood smear, high number of reticulocytes, spherocytes, anisocytosis

von Willebrand's Disease

Deficiency of clotting factor vWD

von Willebrand's Disease is most common in _________________________.

Dobermans

cats SIRS signs

HR <140 bpm OR >225 bpm, RR >40 bpm, hypothermia or fever, low or high WBC