Exam 3 Vet Nursing Review

What does DKA stand for? Why does it occur?

Diabetic ketoacidosis 

• complicated form of diabetes mellitus due to a severe insulin deficiency whic forces the body to break down fat for energy (produces high levels of acidic ketones

What are clinical signs of DKA?

• Weakness

• Depression to stupor

• Tachypnea or Kussmaul respirations

• Anorexia

• Vomiting

• Acetone smell to breath

Stress hormones like cortisol and catecholamines promote gluconeogenesis and beta oxidation creating ketoacids = _______

Acidosis

What diagnosis is related to a patient who has a deficiency in the production of mineralocorticoids (aldosterone), glucocorticoids (cortisol), or both, by the adrenal glands

Hypoadrenocorticism OR Addisonian crisis

What is addisonian crisis?

a life-threatening, emergency collapse resulting from a severe deficiency of adrenal hormones, typically cortisol and aldosterone

Severe electrolyte imbalances and dehydration results in shock + cardiac effects often seen in what life threatening medical emergency?

Addisonian crisis

What test do we use to help diagnose addisons disease (hypoadrenocorticism)?

• ACTH (cosyntropin) stimulation test

• Labs

  • ↓ Cortisol

  • ↑ ACTH (in primary adrenal insufficiency)

  • ↓ Sodium, ↑ Potassium

What diuretic is best to used with hypercalcemia cases?

• Loop diuretics ( furosemide)

  • They increase calcium excretion

What is the most common cause of hypocalcemia?

Hypoalbuminemia

What is hypoalbuminemia?

decrease in albumin in the blood

• below 2.0–2.5 g/dL

• less than 1.5 g/dL increases risk of edema + effusion

Normal albumin level for dogs?

3.0 - 3.9 g/dL

Normal albumin levels for cats?

2.4 - 3.8 g/dL

T/F Hypocalcemia caused by hypoalbuminemia is not treated, instead they deal with the protein issue.

true

If hypocalcemia is caused by hypoparathyroidism, puerperal tetany, or enema we use:

Calcium salt therapy

How is dextrose administered when dealing with hypogylcemia?

• Increase serum glucose with IV dextrose

  • IV 50% dextrose at 1-4 mL/kg diluted 1:1 w/ sterile water given over 15 mins (typical initial treatment)

Which substance is important in regulating body electrolyte status by promoting sodium & chloride reabsorption in exchange for potassium & hydrogen ions?

Aldosterone

What is a primary goal in treating Addisonian crisis?

treat shock rapidly

T/F Hypoadrenocorticism can be a cause of a patient’s hyperkalemia.

true

If a patient begins to have severe hypocalcemia, what do we use to treat it?

calcium gluconate

Define azotemia.

abnormally high levels of BUN (blood urea nitrogen) in the blood

What is enterohepatic recirculation?

the process where substances—such as bile acids, bilirubin, or drugs—are excreted by the liver into the bile → transported to the small intestine → reabsorbed into the bloodstream → returned to the liver

Insulinoma is a rare tumor of beta cells, commonly associated with:

hypoglycemia

Apomorphine hydrochloride is the preferred emetic agent for dogs and can be given in what form?

injectable

What emetic agents can we use when we need to induce vomiting in cats?

• Dexmeditomidine

• Xylazine

  • Always need a reversal ready to go (Yohimbine)

    • Cat could have a heart history

What emetic agents can we use when we need to induce vomiting in dogs?

• Apomorphine (gold standard)

• Clevor (small drop in eye, no IV)

• Apovomin

What is the reveral for Apomovin, a medication used to induce vomiting in dogs?

Metoclopramide

T/F Naloxone will reduce sedatives but not the vomiting aspect. We can use cerenia to reduce nausea / vomiting in cats / dogs.

True

When we need to induce vomiting, what drugs can we use to help protect the stomach lining of our patients?

• Sucrulfate

• Omeprazole

What are some examples of toxins ingested that can be worse coming up than going down?

• Batteries

• Hydrocarbons

• Solvents / fuels

• Razor blades

What is gastric lavage?

Method of gently pumping the stomach contents out of the animal

T/F In order to perform a gastric lavage veterinary personnel are required to use general anesthesia.

True

What drugs are used in a status epileptic case?

• Diazepam

• Midazolam (CRI)

• Propfol IV

When a patient is not coming out of a seizure (true emergency) what sedative can we give IV?

Propofol

What maintenance drug is well tolerated by pets and has the least amount of side effects that we use in cats and dogs that have a history of seizures?

Levetiracetam

What maintenance drug is used in cats and dogs and is under the barbituate catergory? The side effects include liver toxicity, so blood work must be done every 6 months.

Phenobarbitol

What are some side effects of Potassium bromide?

• PU/PD

• Increase hunger / thirst

• Profound sedation (gets better after 2 wks)

• Sweating

• Vomiting

T/F When using Potassium bromide as a maintenance drug fro seizures, we change the patients diet.

false

What does the term postictal mean?

altered state of consciousness, confusion, fatigue, or neurological deficits (such as paralysis or headache) that occur immediately after a seizure

• Can last 5 - 30 mins or several hours depending on the severity of seizure

What does IVDD stand for?

Intervertebral Disc Disease

• disc herniation or disc extrusion

How can we diagnose IVDD?

MRI

What is a chronic disc extrusion?

• Harder to remove due to becoming harder material and stick to spinal cord

  • Can get surgery but can cause more trauma by messing around; warn owners that it could make it worse and not better

What is an acute disk extrusion?

• Easier to remove and better success overall

  • Usually one, can be more than one

    • Disk material will go forward (sometimes backwards but not common), sometimes it will go far enough it can cover more than one spot

Which diagnostic procedure is the best to use to test for spinal cord injuries?

MRI

What are we trying to decrease in head trauma patients (has to do with brain)?

decrease ICP (intracranial pressure)

What diuretic is used to help decrease ICP in a head trauma patient and helps improve blood flow?

Osmotic diuretic -→ mannitol

Define anisocoria.

unequal pupil size

Define miosis

constricted pupil

Define mydriasis

dilated pupils

What is used when we bathe a patient / animal with a topical toxin on them?

Dishwashing agent

• wear proper PPE - what they have on them can also be a toxin to you

What is the antidote for Acetaminophen toxicity?

N-acetylcysteine; decreases mortality / morbidity

T/F Any medication can be dangerous to an animal, depending on the dose and frequency

true

What is the antidote for organophosphate toxicity?

Atropine

What is the antidote for anticoagulant rodenticide toxicity?

Vitamin K1

What can be used to help prevent enterohepatic recircuation?

Activated charcoal