VTT 110: Quiz #4 final set (week 11+12)

List the purposes for orogastric intubation

administer medication and certain radiographic contrast materials, remove stomach contents, perform gastric lavage, administer nutrients

What are the possible complications of orogastric intubation?

Administration of materials into respiratory tract due to incorrect placement of tube, esophageal trauma, gastric irritation, gastric perforation

What piece of equipment is commonly used as a stomach tube for dogs and

cats?

rubber urethral catheter

What size orogastric tube should be used for a puppy?

12 F

What size orogastric tube should be used for a 28 pound adult dog?

18 F

What size orogastric tube should be used for a 70 pound adult dog?

Foal stomach tube

Define speculum

an instrument inserted into a the mouth of an animal to insert tube

When performing orogastric intubation, what is commonly used as a speculum?

roll of 2-inch-wide adhesive tape

The stomach tube must be premeasured before placement. What are the anatomical landmarks that should be used when measuring?

mouth and 10th rib

What precautions must be taken to accurately estimate the length of the

esophagus?

follow curvature of neck

Why is it extremely important that you accurately measure the length of the stomach tube that will be passed?

so tube enters stomach

You have premeasured the stomach tube and have pre-marked the length. The tube can't be passed to the premeasured mark. List the possible reasons that the tube can't be passed to the pre-marked point.

You are in the trachea/lungs, obstruction in the esophagus, or gastric volvulus occurred

You have just passed a stomach tube to the premeasured mark. Before

administering medication, you must check for proper placement. List 3 ways that

this can be performed

palpate tube within the neck, administer 5 mL of sterile saline and observe for cough, blow into tube while assistant osculates the lungs for gurgling

Why must you palpate the tube after passing a stomach tube?

to check if you feel two tube

What does it mean if you don't feel two tubes after passing a stomach tube?

you are in the trachea

What is the purpose of administering 5 mL of sterile saline and observing for a cough?

because if there is a cough, you are in the trachea

what is the purpose of blowing into a stomach tube after it passed?

because you should hear gurgling if inserted correctly

What type of tube should be used when performing orogastric intubation on an unconscious animal? Why?

A cuffed endotracheal tube to prevent aspiration of any material regurgitated

After the completion of the intubation procedure, what should be done as the tube is being removed from the esophagus? Why?

Kink the tube to prevent an administered liquid or stomach contents from leaking into the larynx

What is nasogastric intubation? What species is this procedure commonly used

in?

placement of a tube that extends through an external naris, the nasal cavity, pharynx, and esophagus, and into the stomach; cat

What piece of equipment is commonly used as a nasogastric tube

butterfly catheter

What drug should be applied into the nostril, prior to the procedure? Why?

Lidocaine or proparacaine to reduce pain and discomfort

What method of restraint is recommended when performing nasogastric intubation in a cat?

Sitting position or sternal recumbency

How far should the nasogastric tube be advanced during placement?

20-25 cm

What should be done to determine proper placement of the nasogastric tube?

instill 1mL of saline

What should be done when removing the tube to prevent leakage of foreign material into the pharynx?

Seal the end of tube with a thumb or finger

What is gastric lavage

The flushing and evacuation of stomach contents

when is gastric lavage performed?

to treat ingestion of poison, overdosage of medication, or gastric dilation

What are the possible complications when performing this procedure

Trauma to the pharynx/larynx, esophageal or stomach damage, electrolyte abnormalities, hypothermia, aspiration of gastric contents into the respiratory tract, inadvertent instillation of fluid into respiratory tract

The animal is unconscious and needs gastric lavage immediately. What important procedure needs to be performed prior to orogastric intubation?

physical examination

What substance is used to perform gastric lavage once an orogastric tube is in place?

lavage solution

List the four different methods to obtain a urine sample

Voided sample, manual expression, cystocentesis, urethral catheterization

You have just obtained a urine sample from Pete the poodle? It is 11:45 a.m. and you realize that you will not be able to perform a urinalysis on the sample until atleast 1:00 p.m. Where should the sample be stored until 1pm?

In the refrigerator

There is a 25lb animal in intensive care. You have been assigned to monitor the animal's urine output. If the animal has normal renal function, what should be its normal urine output per hour?

1-2 ml/kg/hr

You have just placed a urethral catheter to obtain a urine sample. The directions for the procedure states that the 1st 3-5 ml of urine should be drawn into a separate syringe, then detached and a new syringe attached for aspirating the sample. Why is this part of the procedure performed?

The first few mls of the sample may be contaminated

What is the "best" method of obtaining urine samples for bacterial culturing? Why?

cystocentesis because it's a sterile collection

What is the most common reason that male cats must be catheterized?

To relieve urethral obstruction

what size urethral catheter is commonly used for male cats

3.5 F

What position(s) are animals normally restrained in for cystocentesis?

Dorsal recumbency, standing or lateral

What size needle (gauge and length) should be used when performing cystocentesis?

22g X 1 1/2"

What precautions should be taken when performing cystocentesis?

Carefully palpate bladder, use hand to keep bladder in place, make sure animal is not struggling, insert needle quickly and smoothly into bladder

Physiologically, what is the purpose of the structure called urethra?

Carries urine from bladder outside of body

List the clinical applications for urethral catheterization in veterinary practice

collect urine for testing, administer medications into the bladder, radiographic studies, monitor urine output, and relieve urethral obstruction

What are two possible complications of urethral catheterization in a male dog?

iatrogenic infection and urethral or bladder trauma

What is the preferred position for urethral catheterization in the male dog?

lateral recumbency

Antiseptic solution such as Nolvasan (Chlorhexidine) is recommended for use in the urethral catheterization procedure. For what part of the procedure is it used?

cleansing the tip of the penis

You are preparing to obtain a urine sample from a male dog via urethral catheterization. The dog weighs 78lbs. What size urethral catheter should you select to perform the procedure?

12 F

List the four types of urethral catheters available

metal, rubber, polypropylene, foley

The unit of measurement that urethral catheters are measured in is?

French

Why is it important that you select the proper size urethral catheter?

to prevent urethral trauma

Describe a Foley catheter and explain when we might want to choose this type of urethral catheter

has a balloon to inject air, it helps keep the catheter in place, and used for indwelling catheter placement in dogs

What is an iatrogenic infection and what precautions should be taken to prevent it when placing a urethral catheter?

It is an infection caused by the procedure; we must use aseptic/sterile procedures such as clipping the hair, cleansing the penis, wearing sterile gloves, using sterile lubricant, and a sterile catheter

It is recommended that the approximate length that the urethral catheter must be passed in the male dog be predetermined before actual catheterization. What complication(s) could occur if not done?

Trauma to the bladder wall if too long and knotting on itself

The retractable covering over the male dogs penis is called the?

prepuce

During the urethral catheterization procedure, who should retract the dog's prepuce?

restrainer

Resistance may be encountered when passing the catheter into the male dog's urethra. At what anatomical locations is this most likely to occur?

Os penis, ischialarch, prostate gland

Many animals do not tolerate having a urethral catheter in place long term. What can be done to limit the animal's ability to remove the catheter?

place an Elizabeth collar

What steps should be taken to prevent infection if the animal has a long-termurethral catheter in place?

Clean connection between catheter and IV line, place antibiotic ointment around end of catheter.

How often should an indwelling urinary catheter be replaced?

every 4-5 days

You have obtained a diagnostic quality urine sample by urinary catheterization. What information about the procedure should you record in the pet's medical chart?

Date, time, type and size of catheter, amount of sample obtained, any medications instilled, any comments, your initials

Prior to placing a urethral catheter in a female dog, the vulva should be cleansed with an antiseptic. Give the name of a product we might use

Nolvasan or Chlorhexidine solution

The 3 different types of female urethral catheters available are?

Metal, red rubber, polypropylene

You need to catheterize a female dog named Molly. She weighs 20lbs. What sizeurethral catheter should be used?

8 F

What position is the awake female dog restrained in for urethral catheterization?

standing

What can be done prior to female catheterization to reduce the animal's discomfort?

Administer topical anesthetic into the vulva

When using a speculum to pass the urethral catheter through, why must it be directed dorsally first, then cranially?

To avoid the clitoral fossa

What is the clitoral fossa? Where is it located? Why must it be avoided when placing a urethral catheter?

Blind sac just inside the opening to the vulva, will be painful

When placing a urethral catheter in the female dog using the "visual technique", what instrument(s) can be used to locate the urethral opening?

Type of speculum with a light source such as otoscope w/speculum, laryngoscope blade, vaginal speculum

It is important to know the approximate location of the urethral opening (orifice) when placing a urethral catheter. Anatomically speaking where is the opening in relation to the vagina and vulva?

Approximately 3-5cm or 1-2 inches from the opening of the vagina/vulva

You must know the approximate length of the female dog's urethra to successfully place the urinary catheter. How long is the female dog's urethra?

3-5 inches

You must know the approximate length of the female dog's urethra to successfully place the urinary catheter. The approximate distance in inches from the vulva to the urethra opening is?

1-2 inches

You must know the approximate length of the female dog's urethra to successfully place the urinary catheter. The total approximate length the catheter must be passed to reach the bladder is?

4.5-8 inches

Manual compression of the bladder after a urethral catheter is in place is not recommended because?

You could cause the catheter to damage the wall of the bladder and possibly rupture the bladder

What information concerning the urethral catheterization procedure should be entered in the patient's medical chart?

Date, time, type an size of catheter, amount of sample obtained, any medication instilled, any comments, your initials

What information should be included on the label of a urine sample once collected?

Owner name, pet name, date & time collected, how the sample was collected

How does the tactile method for urethral catheterization differ from the visual technique?

The tactile method is a blind technique, visual is using a speculum to visualize the opening.

What is the urethral papilla? Where is it located?

It is a 05.-1.5 cm round firm mass 1-2 inches cranial to the vulva

What anatomical landmarks can be used to locate the urethral papilla?

Ventral surface of vagina floor 1-2 inches form opening of the vulva

To locate the urethral papilla how far should the index finger be inserted?

It is approximately to your second knuckle

What is the best time of day to collect a urine sample? Why?

First sample in the morning-most concentrated

what size urethral catheter do you use on a dog less than 20 lbs?

5 F

what size urethral catheter do you use for a dog 20-50 lbs?

8-10 F

what size urethral catheter do you use on a dog 50+ lbs?

10-12 F

what size stomach tube do you use on a puppy or kitten?

12 F

what size stomach tube do you use on a neonate?

3.5 F

what size stomach tube do you use on dogs and cats up to 40 lbs?

18 F

what size stomach tube do you use on a dog over 40 lbs?

24 F

List the four different methods to obtain a urine sample

Voided sample, manual expression, cystocentesis, urethral catheterization

You have just obtained a urine sample from Pete the poodle? It is 11:45 a.m. and you realize that you will not be able to perform a urinalysis on the sample until atleast 1:00 p.m. Where should the sample be stored until 1pm?

In the refrigerator

There is a 25lb animal in intensive care. You have been assigned to monitor the animal's urine output. If the animal has normal renal function, what should be its normal urine output per hour?

1-2 ml/kg/hr

You have just placed a urethral catheter to obtain a urine sample. The directions for the procedure states that the 1st 3-5 ml of urine should be drawn into a separate syringe, then detached and a new syringe attached for aspirating the sample. Why is this part of the procedure performed?

The first few mls of the sample may be contaminated

What is the "best" method of obtaining urine samples for bacterial culturing? Why?

cystocentesis because it's a sterile collection

What is the most common reason that male cats must be catheterized?

To relieve urethral obstruction

what size urethral catheter is commonly used for male cats

3.5 F

What position(s) are animals normally restrained in for cystocentesis?

Dorsal recumbency, standing or lateral

What size needle (gauge and length) should be used when performing cystocentesis?

22g X 1 1/2"

What precautions should be taken when performing cystocentesis?

Carefully palpate bladder, use hand to keep bladder in place, make sure animal is not struggling, insert needle quickly and smoothly into bladder

Physiologically, what is the purpose of the structure called urethra?

Carries urine from bladder outside of body

List the clinical applications for urethral catheterization in veterinary practice

collect urine for testing, administer medications into the bladder, radiographic studies, monitor urine output, and relieve urethral obstruction

What are two possible complications of urethral catheterization in a male dog?

iatrogenic infection and urethral or bladder trauma