Nursing Lab final exam

What are the two main routes of medication administration mentioned in the lecture?

Enteral and Parenteral

What is the enteral route of administration?

Administration of medication by mouth or through feeding tubes (GI tract) ex. tablets/capsules, liquid, feeding lubes, nasogastric/orogastric

what is the absorption rate for SQ injections?

20 mins

what is the absorption rate for IM injections?

5-10 mins

what is the absorption rate of IV meds?

Immediate, within seconds

what is the parenteral route of administration?

IV, IM, SQ,IP,ID

What are common forms of medication for the enteral route?

Tablets, capsules, and liquids.

What is a pro and con of the enteral route?

Pro: Easy administration; Con: Slower absorption rate.

What does SQ refer to in the context of medication administration?

Subcutaneous route.

What is the injection angle for subcutaneous administration?

30-45 degrees.

What type of fluids can be administered subcutaneously?

Isotonic fluids like 0.9% NaCl and Lactated Ringer Solution.

What is the maximum volume of medication typically administered subcutaneously per site?

50-100 mls.

What are the indications for using the intradermal route (ID) of medication administration?

Allergy testing and local anesthetic application.

What is the injection angle for intradermal administration?

10 to 15 degrees.

What is the preferred site for intramuscular (IM) injections?

Lumbosacral musculature, quadriceps muscle, and triceps muscle.

What is the maximum volume for IM injections?

Less than 5 mls per site.

What is the angle of injection for intramuscular administration?

90 degrees.

What precautions must be taken when performing intravenous (IV) injections?

Consider where to inject, how to do it, rate of administration, and the pros/cons.

What is the purpose of cleaning an affected ear before administering otic medication?

To remove debris, reduce bacterial load, and ensure effective medication application.

What is the procedure for cleaning an ear prior to otic medication administration?

Hold the pinna up, apply cleaning solution, massage the base, and wipe away debris.

What should be done while applying ophthalmic medication?

Restrain the patient, pull the upper eyelid, and apply medication carefully to avoid contamination.

AS

left ear

AD

right ear

OS

left ear

OD

right ear

what is a "coaptation”

joining or reuniting of two surfaces

what is an “External coaptation”

Application of external appliance to join or reunite two surfaces

what is an example of external coaptation techniques?

splint, cast, Robert jones/modified Robert jones bandage

Robert Jones Bandage

A bandage used to restrict motion, reduce soft tissue swelling, and provide temporary stabilization of fractures below the elbow or stifle.

Indication of Robert Jones Bandage

Used for temporary stabilization of fractures until definitive repair can be performed or until swelling subsides.

Open Reduction

require surgical interventions to repair the fracture of the two bones.

pros: faster healing, less complications on the bones alignment during healing.

cons: higher surgical/anesthesia associated complications, higher cost, risk of infection on incision site or from surgical implants

Closed Reduction

A non-surgical procedure to realign fractured bones without making an incision. It usually involves manipulation or traction to restore the proper position for healing.

pros: lower cost, less disruption of the fracted site and better preservation of blood supply because this technique requires no surgery

cons: slower healing and higher risk of misalignment because the bones are not rigidly held together, wont work if the bone is fractured into many pieces or is exposed outside of the skin

what is a non-union and what are some complications of this?

the two surfaces heal on its own but do not unite

common causes: infection, inadequate blood flow to the bone, separation of the fractured ends of the bone, inadequate stabilization of the fracture, improper splinting technique

Malunion

the two surfaces united but misaligned some common causes inadequate immobilization of the fracture, misalignment at the time of immobilization, improper splinting technique, premature removal of the splint/cast

Decubitus ulcer

A sore that develops due to prolonged pressure on the skin; prevented by inserting cotton or gauze between the digits.

pros and cons of a splint

pros: easily removed/adjusted, easier to change

cons: less stable and rigid compared to a cast

pros and cons of a cast

stronger than splints/bandages and better able to maintain reduction, more durable than splints/bandages

sedation is usually required for cast removal

Ehmer Sling

it is used to maintain the head of the femur in the acetabulum following treatment (closed reduction) of coxofermoral luxation

it prevents weight bearing on the injured hips

Velpeau sling

it is used to prevent weight bearing on a forelimb and management of shoulder luxations

spica splint

it is used to immobilizing the entire forelimb and less commonly, the pelvic limb in extension (limbs not flexed) through application of bandaging material and strong lateral support splint that curves over the shoulder or pelvis

indication: temporary support for femoral/humoral fractures, particularly useful for upper limb immobilization, stabilization of scapular fractures or to support surgical stabilization of elbow luxation, wound management over the point of elbow or stifle

What are some examples of external coaptation techniques?

Splint, Cast, Bandages (e.g., Robert Jones/modified Robert Jones bandage).

What are the purposes of applying external coaptation on a fractured bone?

To stabilize and reduce further damage to the fracture and surrounding soft tissues, reduce blood loss, and reduce pain.

What are the pros of Closed Reduction techniques?

Lower cost, less disruption of blood supply, and better preservation of blood supply.

What are the cons of Closed Reduction techniques?

Slower healing and higher risk of misalignment.

What is 'Non-union' in the context of external coaptation?

When the two surfaces heal on their own but do not unite.

What can cause Non-union?

Infection, inadequate blood flow, separation of fractured ends, inadequate stabilization, or improper splinting.

What is 'Malunion'?

When two surfaces unite but are misaligned.

What can cause Malunion?

Inadequate immobilization, misalignment during immobilization, or premature removal of the splint/cast.

What are complications associated with external coaptation?

Skin irritation, ulcerations, infection, delayed union, prolonged healing.

What are the characteristics of a cast?

Custom-made with fiberglass or plaster, circulates around the injury, stronger and more durable than splints.

What are the pros and cons of using a splint?

Pros: Easily removed/adjusted. Cons: Less stable and rigid compared to a cast.

What care should be taken for splints, casts, or bandages after application?

Monitor carefully, keep it clean and dry, and check for signs of tightness or irritation.

What is the function of the Ehmer Sling?

To maintain the head of the femur in the acetabulum and prevent weight bearing on injured hips.

What is the function of the Velpeau Sling?

To prevent weight bearing on a forelimb and manage shoulder luxations.

What is a Spica Splint used for?

To immobilize the entire forelimb or pelvic limb, providing temporary support for fractures.

What are common errors leading to bandage complications?

Application too tight or loose, minimal or excessive padding, incorrect materials used.

What should clients be educated about in caring for their pets with coaptations?

Keeping pets confined, daily exams for irritation or moisture, and monitoring for signs of infection.

What are the main indications for using a peripheral IV catheter?

Induction of anesthesia, IV fluid therapy, IV drugs.

What is a Butterfly Infusion Set?

A 'winged' needle that is easy to place but difficult to maintain, used for short term purposes such as blood collection and administration of non-irritating medications.

SQ fluids for pediatrics, exotics, small wildlife

Describe the characteristics of Over The Needle Catheters.

They are the most common type, inexpensive, easy to place, with the needle point extending about a millimeter beyond the catheter tip.

How often should an IV catheter be replaced?

As needed (p.r.n), case by case.

What should be prepared before placing an IV catheter?

Clippers, cleaning solutions (antiseptic scrub, alcohol), tape, bandage material, catheter(s), and a positive attitude.

What are important aspects of IV catheter maintenance?

Use sterile technique during placement, inspect the IV site daily to every 48 hours, and flush every 4 hours with saline if not connected to fluid.

What is phlebitis? and what are some signs indicating it?

Phlebitis is the inflammation of a vein, often due to irritation from an IV catheter. Signs include redness, swelling, warmth, and purulent discharge at the insertion site.

How can the risk of infection during catheter management be minimized?

Using strict aseptic technique, following hand hygiene protocols, and limiting disconnections of the catheter.

swelling proximal to catheter can indicate what?

IV extravasation - the accidental leakage of powerful IV medication out of a vein into the surrounding tissue

swelling distal to the catheter can indicate what?

tape and or bandage too tight

What are the main indications for placing a surgical drain?

To establish a drainage route, remove unwanted fluid and air, prevent seroma formation, relieve pressure, prevent wound breakdown, promote healing, and monitor for complications.

What is a seroma?

an accumulation of fluid in a tissue or organ that can occur after surgery or injury.

What is a passive drain and how does it work?

A passive drain is an open system that works by capillary action to remove fluid. requires gravity, overflow gradients, body movement to remove fluid from would.

What are the care requirements for a passive drain?

Requires good dressing management, frequent bandage changes, hand washing, and cleaning the exit hole. E-collar is usually necessary.

What is an active drain and its primary function?

An active drain is a closed system that collects fluid into a reservoir and creates negative pressure to suction out fluid and gas.

What is the common type of active drain used in veterinary nursing?

The Jackson-Pratt drain, also known as the Grenade drain.

What are some advantages of using active drains?

Lower risk of infection, closed collection system, easier monitoring of drainage volume, and less frequent bandage changes.

when should you empty a Active drain?

when chamber is half full, or minimum of q6hr

When should a surgical drain be removed?

When production decreases to 1ml/Kg/24hrs or when fluid is significantly reduced.

What characteristics describe different types of drain fluid?

Serous - thin, watery;

Sanguineous - bloody;

Serosanguineous - semi-thick reddish fluid; serum and blood

Purulent - thick, cloudy drainage with white blood cells and bacteria, pus

What steps should be taken when removing a Penrose drain?

Clean the area, cut the proximal end, and cut as close to the skin as possible before removing.