Ag421

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Purpose of history and exam: Minimum Data Base
Obtain diagnosis
Formulate diagnostic plan
Formulate nursing plan
Monitor response to therapy
Triage
Signalment: Species
Breed
Age
Sex
Reproductive status
History of present illnes: Duration
Severity
Progression
Frequency
Trigger Situations
Time of day
Character of problem
Systems Review: General
Integument
Respiratory
Cardiovascular
GI
Genitourinary
Musculoskeletal
Neurological
Special senses
RPT: Resp rate
Dog 8-20 Cat 8-30
Pulse
Dog >25kg 70-100
Dog <25kg 90-160
cat 150-210
Temp
Dog cat- 100-102 F.
Mucous membrane colors: pink= normal
pale= anemia, hypo-tension, hypothermia, pain
bright red= toxic phase of infection
muddy= septic
yellow= icteric-liver
blue=cyanotic-lack of o2
petichia= coag disorder
brown=tylenol poisoning
Heart murmurs: Grade
1 can barely hear
2 audible but soft
3 low to mod
4 loud w/o thrill
5 loud w/ thrill
6 heard off chest
Dehydration: <5 %= undetectable
5-6= skin slightly doughy, inelastic, tacky mm
6-8= skin definitely inelastic, eyes slightly sunken
10-12= inc skin turgor, sunken eyes, dry mm, inc CRT
12-15=shock, imminent death
Medical Record should contain: Client name, address, phone #
Patient signalment
Prior med records
Vaccination history
Primary complaint
Physical exam
Diagnosis or T/Dx list
Treatment inc RX
Labwork
Reports
Prognosis
Surgical, dental record
Client aftercare, education
Discharge instructions
Fee estimates
Consent forms
Medical Record Formats: Conventional- Chronological, source oriented.

Problem Oriented Veterinary Medical Record-POVMR-
-Defined Database
-Problem list
-Plans section
Progress section in SOAP
-------Subjective
-------Objective
-------Assessment
-------Plan
what are units of measurement for metric system: meter= length
liter= volume
gram= mass
mcg/ug: 1/1,000,000 of a gram
how many grams is a kilogram: 1000g
how many mcg is a mg?: one mg= 1000 mcg
How many mg is one grain?: one grain = 60mg.
how many oz. in a lb: 16
how many ml in a tsp: 5
how many drops in 5 ml: 60
how many ml. in one oz: 30
how many ounces/ ml in 1 cup: 8 oz/ 240ml
how many cups/ ml in one pint: 2 cups/ 480ml.
how many pints / ml in 1 quart: 2 pints/ 960ml (app 1 liter)
how many quarts in a gallon: 4 guarts/ 3.84 L.
one oz = how many Tbs: 2
To convert F. to C. To convert C. to F.: F= (1.8X C) + 32.

C= F-32/ 1.8
What are the seven parts of a drug order?: Name of patient
Name of drug
Doseage of drug
Route
Time/frequency
Date and time of order
Signature of person writing order
What are the six patient rights?: Right Patient
Drug-check label 3 times
Dose
Route
Time
Frequency
What is a solute: Substance being dissolved or diluted
What is concentration?: Amount of solute dissolved in solvent or
Mass/Volume
What is the drug concentration of a 1:1000 solution?: 1 mg/ ml
What is the drug concentration of a 1:10,000 solution?: 0.1 mg/ml
Formula for determining volume added, etc?: Va X Ca= Vf X Cf
How much of body's weight is water?: 60 %
How is water distributed?: Intracellular= 60%
Extracellular-
Interstitial=30%
Intravascular= 10%
What route does IV fluid take?: Intravascular- interstitial- intracellular
Where do fluid losses come from first?: Interstitial- then intravascular then intracellular.
What is an electrolyte?: Solute that breaks down into + or - particles, ie ions.
+ = cation
- = anion
most abundant cation in ECF anion?: sodium

chloride, bicarbonate
most abundant cation in ICF? anion?: potassium (K), magnesium

Phosphates, proteins
What are two methods of measuring electrolytes?: As a percentage

As Meq- tendency of particle to combine with another particle.
What is osmolality / osmalarity?: the number of solute particles per Kg/Liter of solution
what is the 0smolality of isotonic fluid?: 300 mOsm/L
what is the effect on cellular volume of hypotonic fluid?: cell swells- fluid enters cell
What is the effect of hypertonic fluid?: Fluid goes from interstitial to vascular
What is the systemic effect of hypotonic fluid?: Fluid leaves blood vessel- goes to interstitial area
what fluid should be used to correct dehydration?: isotonic or hypotonic
what fluid should be used to correct decreased intravascular volume?: hypertonic
what are most effective osmoles for fluid therapy?: Sodium. Glucose
What is Starlings Law?: Equilibrium exista at the capillary membrane when fluid leaving equals fluid entering the circulation.
factors maintaining equilibrium at capillary membrane.: hydrostatic and colloid osmotic, membrane pore size
what is a colloid?: a nondiffusable substance- a solute suspended in solution. Ex= plasma proteins
What is hydrostatic?: The pressure exerted by a stationary fluid. The same forces that maintain blood pressure- cardiac output, fluid volume, vascular resistance.
What is hypopyon?: pus in the anterior chamber of the eye
What is ptosis?: Drooping of upper eyelid
What is miosis?: Contraction of pupil
What is mydriasis?: Dilation of pupil.
What is anisocoria?: Uneven size of pupils.
What is Horner's syndrome?: protrusion of 3rd eyelid.
How do you figure out the rate of fluid administration?: Hydration deficit= Wt in Kg. X %dehydration X 1000.
Maintenance= 60ml/Kg/day
Contemporary losses=Est X 2
What is the shock fluid rate?: Dog= 80-90 ml/Kg/hr
Cat= 40-60 ml/Kg/hr
Use isotonic
What is the maximum infusion rate for potassium chloride?: Max= 0.5 mEq/Kg/hr
How much should maintenance fluid rates be increased in response to fever?: Increase fluid rates 10% for each 1.8 F. rise in body temp.
What are crystalloid solutions?: They contain electrolyte and non-electrolyte substances that can pass thru cell membranes.
What is 0.45 Saline and 2.5%Dex?: Hypotonic.
Crystalloid.
Should .45 Sal/2.5 Dex be used for shock?: No- water redistributes too rapidly.
What is a good choice for maintenance?: Hypotonic (half saline, 2.5Dex) with KCl
Why do you not use isotonic fluids for maintenance?: Isotonic(saline, LRS)have high sodium, osmalality and inadequate potassium. They don't stay in the intravascular space very long.

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