Revision Guide For Student Nurses - Part 2

Anonymous — Thu, 13 Nov 2014 20:39:44 GMT

Current Revision posted to Revision Guide For Student Nurses - Part 2 by Anonymous on 11/13/2014 8:39:44 PM

resuscitation for cardiac arrest

sarah garland — Fri, 02 Aug 2013 18:43:37 GMT

Current Revision posted to Revision Guide For Student Nurses - Part 2 by sarah garland on 8/2/2013 6:43:37 PM

Resuscitation for cardiac arresset

Producing A Radiographic Image - Answers

Lisa Spencer-Weiss — Tue, 05 Jul 2011 14:35:48 GMT

Current Revision posted to Revision Guide For Student Nurses - Part 2 by Lisa Spencer-Weiss on 7/5/2011 2:35:48 PM

ANSWERS

Define radiography.
The production of diagnostic films by exposure to x-rays.
Define radiology.
Radiation physics, although commonly defined as the interpretation of the radiographic image.
Which 2 members of the electromagnetic spectrum possess the highest frequency and the shortest wavelength?
- X-rays.
- Gamma rays.
What are electromagnetic radiations made up of?
Discrete energy packets known as photons or quanta.
What 4 properties are possessed by all the members of the electromagnetic spectrum?
- They can pass through a vacuum.
- They travel at a uniform speed through a vacuum (3 x 10 to the power of 8 m/s).
- They are able to interact with matter by being absorbed or scattered.
- A medium is not required for transmission.
What 3 special properties do x-rays possess?
- The ability to penetrate substances opaque to visible light.
- The ability to produce an image on photographic film.
- The ability to cause certain substances to fluoresce.
What is an atom?
The smallest particle of an element that retains all the properties of that element. It consists of a positively charged nucleus with negatively charged electrons moving around it in orbit.
What is meant by the "atomic number" of an element?
The unique number of protons possessed by each element.
What is a compound?
A combination of 2 or more elements. One usually possesses positive ions, whilst the other possesses negative ions.
X-rays are generated in the tube head of the x-ray machine. Name the 2 types of tube head available.
- Stationary or fixed anode.
- Rotating anode.
Why is a rotating anode superior to a stationary anode?
- More efficient means of heat removal.
- Allows longer exposure times.
A rotating anode is mounted upon a molybdenum rod which spins at speeds of up to 10,000 rpm. Why is molybdenum used?
It is a poor conductor, and therefore prevents the heater from overheating.
At what angle is the target area set on a rotating anode?
6-20 degrees.
What is the cathode?
The negatively charged electrode of the tube head consisting of a coiled tungsten wire filament.
Why is tungsten the material of choice for the cathode?
Its high atomic number means that it has a very high melting point and it also a good emitter of electrons.
What is the anode?
The positively charged electrode of the tube head. This is made of tungsten or rhenium tungsten since its atoms are large and efficient at impeding the incident electrons.
How are x-ray photons produced within the tube head?
Fast moving incident electrons are produced by the cathode (filament) which collide with the atoms of the anode (target). These collisions generate x-ray photons. The faster the incident electrons, the more energy they have to lose, and thus the greater the intensity of the primary beam.
What 2 factors increase the speed of the electrons travelling from the filament to the target?
- A high electrical potential distance applied between the filament and target.
- A glass envelope containing a vacuum enclosing the cathode, anode and part of the copper stem.
What is the glass envelope contained within and why?
An oil bath, which acts as a heat sink and electrical insulator.
What is the term used to describe a small electrical current passed through a filament and the subsequent release of an electron cloud following heat generation?
Thermionic emission.
What is the function of the step-down or filament transformer?
This decreases the mains current since only a small current is required to heat the filament.
What is the function of the step-up or high-tension transformer?
This increases the voltage of the mains supply.
What is the function of the focusing cup?
This forms the electrons into a narrow beam.
What is the focusing cup made of?
Nickel or molybdenum.
Why is the target set in a copper stem in a stationary anode tube?
Copper is a good heat conductor and is therefore efficient at removing heat from the target.
What is meant by the terms "actual focal spot" and "effective focal spot"?
- Actual focal spot - the area of the target upon which the electrons impinge; this is the area over which heat is produced.
- Effective focal spot - this should ideally be a point source; the x-ray beam appears to originate from a much smaller area as a result of the angulation of the target.
How is focal spot size adjusted?
Some x-ray machines have 2 different sized filaments at the cathode. The fine focus is produced by the smaller of the two; a narrower electron beam is generated and thus a smaller effective and actual focal spot size. The coarse (or broad) focus is produced by the larger filament, resulting in a larger effective and actual focal spot size.
What is the advantage of the fine focus?
Very fine radiographic definition is produced, making it suitable for areas such as the limbs.
What is the advantage of the coarse (or broad) focus?
Higher exposures may be selected, making it suitable for dense areas of the anatomy such as the chest and abdomen.
What is the main disadvantage of the fine focus?
Exposure factors are limited due to the large amount of heat generated over a very small area.
What is the main disadvantage of the coarse (or broad) focus?
Image definition is poorer than that produced with the fine focus.
Define the "penumbra effect".
Blurring of the margins of an image related to the geometry of the primary beam.

Anaesthetic Circuits - Key Notes

Anonymous — Mon, 04 Apr 2011 14:46:20 GMT

Current Revision posted to Revision Guide For Student Nurses - Part 2 by Anonymous on 4/4/2011 2:46:20 PM

Name	Type	Weight Range	Bag	Co-Axial	Nitrous	Gas flow
Circle system	Closed	10kg and above	Re-Breathing closed	No	No	5-10mls per kg if closed (+10mls if low flow)
To & fro (Waters)	Closed	10kg and above	Re-breathing closed	No	No	5-10mls per kg if closed (+10mls if low flow)
Magill	Semi-closed	7-35kg	Reservoir closed	No	Yes	Circuit factor 1-1.5
Lack	Semi-closed	7-40kg	Reservoir closed	Yes	Yes	Circuit factor 1-1.5
Parallel Lack	Semi-closed	7-40kg	Reservoir closed	No	Yes	Circuit factor 1-1.5
Ayres T piece	Semi-closed	Up to 10kg	None	No	Yes	Circuit factor 2.5-3
Ayres with Jackson Rees mod.	Semi-closed	Up to 10kg	Reservoir open-ended	No	Yes	Circuit factor 2.5-3
Bain D	Semi-closed	10-30kg	Reservoir closed	Yes	Yes	Circuit factor 2.5-3
Bain E	Semi-closed	Up to 10kg	None	Yes	Yes	Circuit factor 2.5-3
Bain F	Semi-closed	Up to 10kg	Reservoir open-ended	Yes	Yes	Circuit factor 2.5-3

The Operating Theatre

Anonymous — Thu, 07 Oct 2010 15:51:01 GMT

Current Revision posted to Revision Guide For Student Nurses - Part 2 by Anonymous on 10/7/2010 3:51:01 PM

QUESTIONS

List the items of theatre clothing that should be worn by all theatre personnel.
In addition to the items listed in Q1, what additional attire should be worn by the surgical team?
Why is a well-ventilated theatre essential?
In addition to the operating theatre itself, list the other areas which comprise the theatre suite.
List 10 essential properties of the theatre.
List desirable features of the theatre.
Every practice will have its own set of local rules drawn up with regard to theatre procedures. Can you name some common sense rules that will be similar across the board?
List 6 hazards that may pose a risk to theatre personnel.
Briefly outline the duties of the scrubbed nurse.
Briefly outline the duties of the circulating nurse.

Urine Collection & Tests - Answers

James Colver Cert. Ed, RVN — Thu, 04 Mar 2010 16:22:00 GMT

Current Revision posted to Revision Guide For Student Nurses - Part 2 by James Colver Cert. Ed, RVN on 3/4/2010 4:22:00 PM

ANSWERS

What is the name of the yellow pigment which gives urine its yellow colour?
Urochrome.
What is the normal urinary output (per kg/day) of an adult dog and cat?
- Dog = 25-60mls/kg/24 hours.
- Cat = 10-20mls/kg/24 hours.
What is the term used to describe the excess production of urine?
Polyuria.
What is meant by oliguria?
Decreased urine production
What is meant by dysuria?
Painful or ineffective attempts to urinate (this term my also apply to defecation).
What is the term used to describe blood in the urine?
Haematuria
What is meant by the turbidity of urine?
Clearness of the sample; a cloudy sample is likely to contain sediment.
What causes the "pear drop" smell of the urine in ketotic patients?
Acetone.
Why should a urine sample be as fresh as possible?
The bacteria in urine will replicate quickly, and therefore an old sample will not provide a true representation. Urine may be stored for a few hours in the refrigerator, but tests should ideally be performed as soon as possible following sample collection.
List methods of collecting a urine sample from a cat.
- Natural micturition (via a metabolic cage or specially designed litter tray).
- Manual bladder expression.
- Catheterisation.
- Cystocentesis.
The veterinary surgeon asks you to obtain a free flow urine sample from a dog; why should you collect the sample mid-stream?
A mid-stream sample is less likely to be contaminated with epithelial cells or mucous from the urinary tract.
What preservative is suitable for bacteriology tests on a urine sample?
Boric acid.
What is the normal specific gravity range of urine in dogs and cats?
- Dogs = 1.018-1.045
- Cats = 1.020-1.040
What is the specific gravity of urine measured with?
A refractometer. A hydrometer may also be used, but this is less accurate.
What conditions may be indicated by a high urine specific gravity?
- Dehydration.
- Acute renal failure.
- Shock.
What conditions may be indicated by a low urine specific gravity?
- Increased water intake (polydipsia).
- Diabetes insipidus.
- Pyometra.
- Chronic hepatic dysfunction.
- Chronic renal dysfunction.
What is the normal pH range of urine in dogs and cats?
- Dogs = 5.2-6.8
- Cats = 6-7
Why are dipsticks not ideal for testing urine samples?
- Prone to contamination.
- Can only provide an estimation rather than an accurate result.
- Not reliable for pH readings.
- Very ineffective on stale samples.
What parameters are measured with a Combur 7 Test (BM Test-7)?
- pH.
- Protein.
- Glucose.
- Ketones.
- Urobilinogen.
- Bilirubin.
- Haemoglobin.
List 3 methods of measuring the pH of urine; which is the most reliable?
- Litmus paper.
- Reagent sticks.
- Electrode meter.
The electrode meter is without doubt the most reliable method.
List possible causes of haematuria.
- Cystitis and associated infection/inflammation of the urinary tract.
- Urolithiasis.
- Nephritis.
- Thrombocytopaenia.
- Trauma.
- Bladder masses.
- Drug reactions (e.g. some chemotherapeutic agents).
What is haemoglobinuria?
The presence of lysed blood in the urine.
List possible causes of haemoglobinuria.
- Autoimmune haemolytic anaemia.
- Systemic lupus erythrematosus.
- Leptospirosis.
- Babesiosis.
Urine collected free flow, from manual bladder expression or via catheterisation usually contains a small amount of protein as a result of secretions from the urogenital tract. Protein levels may also rise following parturition or during oestrus. However, true proteinuria is likely to be indicative of a clinical problem. List some causes.
- Nephritis.
- Congestive heart failure.
- Cystitis.
- Urethral inflammation.
- Vaginitis.
Name the 2 main techniques used to examine urine microscopically and state the stain used for each.
- Wet preparation - uses Sedistain (optional).
- Dry preparation - uses Leishman's stain.
List items of interest which may be observed upon the microscopic examination of urine.
- Crystals.
- Casts.
- Mucus threads.
- Spermatozoa.
- Bacteria.
- Funghi.
- Yeasts.
- Epithelial cells.
- Transitional cells.

revision guide

Anonymous — Wed, 04 Nov 2009 15:05:26 GMT

Current Revision posted to Revision Guide For Student Nurses - Part 2 by Anonymous on 11/4/2009 3:05:26 PM

updates

Obstetrics & Paediatrics - Glossary

Arlo Guthrie — Tue, 21 Apr 2009 12:16:19 GMT

Current Revision posted to Revision Guide For Student Nurses - Part 2 by Arlo Guthrie on 4/21/2009 12:16:19 PM

Acute phase protein = Protein released during pregnancy which is the basis for commercial pregnancy testing kits. However, these proteins are also released in inflammatory conditions such as pyometra.

Acyclic = Occurring independently of a natural cycle of events. The menstrual cycle is an example.

Agenesis = Failure of a structure to develop properly. Examples are ovarian agenesis and uterine agenesis in the bitch.

Allantoamnion = The inner membrane formed when the membrane of the allantois fuses with the chorion during embryonic development.

Allantois = A membranous sac projecting from the ventral surface of the embryo which receives urine from the foetal kidneys. It eventually helps to form the placenta.

Amnion = The innermost membrane of the embryo which encloses the amniotic fluid.

Anorchia = Complete absence of testes.

Aplasia = Incomplete development of a tissue or organ or absence of growth.

Atresia = Absence of a natural opening. Examples are anal or vaginal atresia.

Breech = Foetus positioned in dorsal, posterior longitudinal presentation. The hind limbs are usually flexed and directed towards the dam's head. This may be a cause of foetal dystocia.

Bulbo-urethral glands = A pair of glands present only in the tom cat which produce a fluid that contributes to the semen.

Caesarean = Surgical operation involving an incision through the abdominal wall and uterus for delivery of the foetus/foetuses if a normal birth is not possible.

Chorio-allantois = The outer membrane formed when the allantois and chorion fuse during embryonic development.

Chorion = The outer layer of the developing embryo; the placenta.

Colostrum = A viscous, yellow fluid representing the accumulated secretions of the mammary glands over the final weeks of pregnancy. This contains immunoglobulins necessary for passive immunity of the foetus.

Congenital defect = A defect present at birth which is not necessarily inherited from ancestry.

Corona radiata = The outer protective layer of the ovum made of small follicular cells.

Corpus luteum = A solid structure developed from the follicle after ovulation which releases the hormones progesterone and relaxin.

Cryptorchidism = Testes retained within the abdomen; may be unilateral or bilateral.

Cystic endometrial hyperplasia = Small cystic lesions which develop in older females in response to progesterone during metoestrus. This may make the uterus more prone to infection and can lead to pyometra.

Dioestrus = Phase of the oestrus cycle following oestrus. In the queen this is represented by mature luteal phase, but in the bitch is often used synonymously with metoestrus (early luteal phase) to reflect the luteal phase of the cycle following standing oestrus.

Dystocia = Difficult birth. See key notes.

Encephalocoele = A congenital defect caused by a failure of the bones of the cranium to fuse. This results in a defect of the skull through which a portion of the brain bulges.

Endometrium = The mucous membrane lining the uterus.

Falciform ligament = The remains of the umbilical vein in an adult; a fat filled structure which runs from the umbilicus to the liver.

Fimbriae = The irregular processes found at the ovarian end of the oviduct.

First fraction = Clear fluid originating from the prostate ejaculated by the male prior to mounting. Its purpose is to flush urine and cellular debris from the urethra.

Follicle stimulating hormone = Hormone produced by the anterior pituitary which controls the maturation of the graafian follicles in the ovary.

Foramen ovale = A hole in the interatrial septum allowing mixing of blood from both sides of the heart. This closes shortly after birth.

Gravid = Pregnant.

Hereditary defect = A defect derived from ancestry. This may be congenital (present at birth) or develop later in life.

Hypocalcaemia = Low blood calcium levels. Also known as puerperal tetany or eclampsia. This is a serious condition that may affect the queen or bitch during pregnancy or lactation.

Hypogonadism = A rare condition resulting in poor development of gonadal tissue due to a primary abnormality in the secretion of pituitary hormones.

Interoestrus = Stage of non-receptivity in the oestrus cycle of the queen. This occurs in the absence of mating or if the mating does not result in ovulation.

Intromission = This follows ejaculation of the first fraction. The male sustains a full erection, mounts the female and his penis enters her vagina.

Lutenising hormone = Hormone produced by the anterior pituitary gland in late anoestrus which initiates the growth of follicles within the ovaries and subsequently causes them to release oestrogen.

Marginal haematoma = Vulval discharge post parturition which is green in the bitch and brown in the queen. It results from the degeneration of the maternal endothelium at the edges of the placenta.

Metoestrus = The early luteal phase of progesterone production.

Micropthalmos = A congenital abnormality in which the eyes are very small. It occurs most often in Pekinese. A hereditary type may occur in Great Danes and Collies.

Misalliance = Unwanted pregnancy.

Monoestrus = One oestrus period in each breeding season. The bitch is monoestrus.

Monorchidism = Describes an animal with a single testicle.

Multigravid = Pregnancy which is not the first.

Multiparous = Several young developing in one uterus.

Myometrium = The muscle tissue of the uterus.

Oestrogen = Hormone produced in the ovary which prepares the genital tract for coitus and reception of the fertilised eggs. (It is also produced in the testis).

Oestrus = Season; heat. Ovulation occurs during this phase of the reproductive cycle.

Orchitis = Inflammation of the testes as a result of trauma or bacterial infection.

Oxytocic = Drug which stimulates uterine contractions. Oxytocin may be given in cases of uterine inertia providing dystocia is not obstructive.

Paraphimosis = Failure to retract the penis into the prepuce.

Parturition = The act of giving birth.

Phimosis = Inability to extrude the penis.

Placenta = Vascular structure inside the gravid uterus which supplies the foetuses with nourishment via the umbilical cord. Post parturition, this is the afterbirth.

Poikilothermic = Body temperature which varies with that of the ambient temperature. Neonates are unable to regulate their own body temperature and are described as poikilothermic.

Polyoestrus = Multiple oestrus cycles within the breeding season. Queens are described as seasonally polyoestrus which means that they have oestrus cycles throughout their breeding season (February to September).

Polytocious = Numerous offspring produced in each litter.

Prepartum Hypothermia = Decline of about 2°C in the bitch's body temperature which precedes the onset of parturition by 24-36 hours. This occurs as a result of a sudden drop is plasma progesterone concentration.

Priapism = Persistent enlargement of the penis in the absence of sexual excitement.

Primigravid = First pregnancy.

Proestrus = The first stage of the reproductive cycle; plasma concentrations of oestrogen increase. The female is receptive to the male but will not allow mating.

Progesterone = Hormone produced by the corpus luteum of the ovary; essential for the maintenance of pregnancy.

Prolactin = Hormone produced by the anterior pituitary which stimulates milk production during late pregnancy and lactation.

Pseudocyesis = False pregnancy. In bitches non-fertile matings result in ovulation without conception during metoestrus.

Puerperium = The return of the reproductive organs to their normal state following pregnancy.

Pyometra = Infection of the uterus. This is a very serious condition. Open pyometra is characterised by a vulval discharge. Bitches must be speyed immediately.

Split oestrus = An endocrinological disease of the bitch; signs of proestrus which do not terminate in ovulation. A normal cycle follows 2-12 weeks later.

Standing oestrus = The bitch is receptive to the dog and stands to be mated.

Tie = The period following ejaculation when the dog and bitch remain in sexual contact. The dog dismounts from the female and turns through 180° with his penis still penetrating the bitch. The two remain back to back for at least 20 minutes and must not be separated. The purpose is to allow the third portion of ejaculate to flush sperm forwards through the cervix and into the uterus.

Uniparous = A single foetus developing in the uterus.

Vestibule = A space or cavity at the entrance to another structure. The vaginal vestibule is caudal to the vagina and continues into the vulva.

Zona pellucida = The glycoprotein inner membrane of the ovum.

Zonary placenta = The band around the middle of the extra-embryonic membranes of the placenta.

Neutering - Answers

Arlo Guthrie — Tue, 21 Apr 2009 12:15:34 GMT

Current Revision posted to Revision Guide For Student Nurses - Part 2 by Arlo Guthrie on 4/21/2009 12:15:34 PM

ANSWERS

If an owner is not intending to breed from a bitch, list 5 advantages of spaying?
- Unwanted puppies are prevented.
- False pregnancy is avoided.
- Pyometra (accumulation of pus within the uterus - a very serious bacterial infection) is avoided.
- The risk of mammary neoplasia is reduced.
- There will be none of the mess and hassle associated with seasons.
What is the medical term for the removal of the uterus and ovaries?
Ovariohysterectomy.
Why is an ovariohysterectomy preferential to an ovariectomy?
An ovariectomy is removal of the ovaries. The uterus is left intact. The main disadvantage of this method is that pyometra remains a risk.
When is the best time to spay a bitch?
Either before her first season (at approximately 6 months of age) or when she is midway between seasons.
Why should a bitch not be spayed during pseudocyesis (false pregnancy)?
It is possible that she may remain psychologically in a state of false pregnancy for the rest of her life.
What alternative to spaying will prevent the occurrence of oestrus?
Medical inhibition of a season by progestogen/androgen compounds. Depot injections may be administered during anoestrus to prevent the next anticipated heat.
List side effects that may arise from the medical inhibition of heat.
- Increased appetite and subsequent weight gain.
- Lethargy.
- Mammary enlargement.
- Coat changes.
- Possible temperament changes.
- The risk of inducing pyometra.
Many owners have reservations about spaying. Give examples of 2 potential disadvantages and how they might be overcome.
- Weight gain - regulate with dietary control.
- Urinary incontinence - this affects only a small percentage of bitches and successful medical treatment is available to treat this condition.
List 3 advantages of cat castration.
- The tendency to roam is reduced.
- Spraying to mark territory is reduced (and the urine smells less pungent).
- The cat is less likely to catch diseases such as feline leukaemia transmitted in blood and saliva and associated with mating and fighting.
List 3 advantages of dog castration.
- Prevention of testicular neoplasms.
- Reduced incidence of prostatic cancer.
- Reduction of excessive libido which may lead to dominance and aggression in some dogs.

Neutering

Arlo Guthrie — Tue, 21 Apr 2009 12:14:48 GMT

Current Revision posted to Revision Guide For Student Nurses - Part 2 by Arlo Guthrie on 4/21/2009 12:14:48 PM

QUESTIONS

If an owner is not intending to breed from a bitch, list 5 advantages of spaying?
What is the medical term for the removal of the uterus and ovaries?
Why is an ovariohysterectomy preferential to an ovariectomy?
When is the best time to spay a bitch?
Why should a bitch not be spayed during pseudocyesis (false pregnancy)?
What alternative to spaying will prevent the occurrence of oestrus?
List side effects that may arise from the medical inhibition of heat.
Many owners have reservations about spaying. Give examples of 2 potential disadvantages and how they might be overcome.
List 3 advantages of cat castration.
List 3 advantages of dog castration.

The Normal Neonate - Key Notes

Arlo Guthrie — Tue, 21 Apr 2009 12:13:56 GMT

Current Revision posted to Revision Guide For Student Nurses - Part 2 by Arlo Guthrie on 4/21/2009 12:13:56 PM

NORMAL BODY TEMPERATURE - PUPPIES:

Age In Weeks	Temperature Range °C
0-2	34.5-36
2-4	36-37
4 plus	37-38.5

NORMAL BODY TEMPERATURE - KITTENS:

Age In Weeks	Temperature Range °C
0-2	35-36.5
2-4	36.5-37.5
4 plus	37.5-38.7

NORMAL RESPIRATORY RATE - PUPPIES AND KITTENS:

Age	Breaths per Minute
0-24 hrs	8-18
1-35 days	15-35

NORMAL HEART RATE - PUPPIES AND KITTENS:

Age	Beats per Minute
0-24 hrs	120-150
1-35 days	220

NUTRITIONAL REQUIREMENTS:

Species	Kcal per 500g of body weight per day
Puppies	60
Kittens	200

(Orphan formula milk contains approximately 1 kcal/ml)

NORMAL BIRTH WEIGHTS:

Species	Weight in Grams
Toy breeds	100-200
Medium breeds	200-300
Large breeds	400-500
Giant breeds	500-700
Kittens	700 plus

EXPECTED INCREASES IN BODY WEIGHT:

Species	Should double in birth weight within
Puppies	10-12 days
Kittens	14 days

Generally, an increase of 10-15% of birth weight per day in the first week of life is normal, and a 20-25% increase per day thereafter.

Another useful guide is that puppies should gain 2-4g/kg of their anticipated adult weight per day.

Care Of Lactating Dam & Litter - Answers

Arlo Guthrie — Tue, 21 Apr 2009 12:12:23 GMT

Current Revision posted to Revision Guide For Student Nurses - Part 2 by Arlo Guthrie on 4/21/2009 12:12:23 PM

ANSWERS

Define paediatrics.
The branch of medicine relating to the young, including their development and care, and diseases which may affect them.
What is the term used to describe the return of the reproductive tract to its non-pregnant state following parturition?
The puerperium.
What are the 3 main causes of fading puppy/kitten syndrome?
- Dehydration.
- Hypoglycaemia
- Hypothermia.
After parturition, by how much should the dam's food be increased?
- Week 1 - 1.5 x maintenance.
- Week 2 - 2 x maintenance.
- Week 3 plus - 3 x maintenance.
At what age should puppies and kittens first be wormed?
2 and a half to 3 weeks of age.
What type of diet is ideal for nursing queens and bitches and why?
A proprietary growth food. Feeding a high quality complete food will ensure that optimum levels of all nutrient groups are met.
List criteria important to the diet of a lactating queen or bitch.
- The food must be palatable.
- It must provide sufficient energy to meet her increased requirements.
- It must provide optimum levels of all nutrient groups.
- The protein content should be of a high biological value.
At what age may weaning commence?
From 3 weeks, this is a gradual process.
Describe the process of weaning in puppies.
- Weaning begins once the litter's eyes have opened - usually at about 3-4 weeks of age.
- A suitable food designed for growth should be made into a gruel and warmed to body temperature.
- Gradually decrease the amount of water until the puppies are on solids.
- By 5 weeks of age, the pups should be eating 5 meals a day, with the bitch separated from them for short intervals to accustom them to being without her and to feed from the food bowl.
Why should cow's milk not be given to puppies and kittens?
It has a high lactose content which may cause diarrhoea and lead to dehydration.
What signs may indicate that all is not well with the neonates?
- Excessive vocalisation.
- Not gaining weight.
  During the first few weeks of life it is normal for neonates to just eat and sleep.
What criteria are important in raising a healthy litter?
- The health status and nutrition of the dam.
- A warm environment with a suitable nest (neonates are poikilothermic and unable to control their body temperature).
- Early ingestion of colostrum to provide the immunoglobulins necessary for passive immunity.
How can thermoregulation of the litter be controlled?
- Birth should take place in a warm environment.
- Keep the litter dry.
- Provide a well insulated nest box with an additional heat source such as an electric heat pad.
- Ensure that food intake is adequate.
- Encourage huddling which reduces the overall surface area.
  Neonates have very little subcutaneous fat and consequently their insulation is poor. Heat loss is greater in smaller animals since the surface area to body unit weight is greater.
How much more energy (on a per kg basis) do growing puppies require compared to adults?
Twice as much.
Why is food limited feeding considered preferential over free choice feeding for large breed puppies?
Free choice feeding can lead to excessive dietary energy. This may support a growth rate that is too fast for proper skeletal development. In addition to skeletal disorders, a predisposition to juvenile obesity may result.

Care Of Lactating Dam & Litter

Arlo Guthrie — Tue, 21 Apr 2009 12:11:36 GMT

Current Revision posted to Revision Guide For Student Nurses - Part 2 by Arlo Guthrie on 4/21/2009 12:11:36 PM

QUESTIONS

Define paediatrics.
What is the term used to describe the return of the reproductive tract to its non-pregnant state following parturition?
What are the 3 main causes of fading puppy/kitten syndrome?
After parturition, by how much should the dam's food be increased?
At what age should puppies and kittens first be wormed?
What type of diet is ideal for nursing queens and bitches and why?
List criteria important to the diet of a lactating queen or bitch.
At what age may weaning commence?
Describe the process of weaning in puppies.
Why should cow's milk not be given to puppies and kittens?
What signs may indicate that all is not well with the neonates?
What criteria are important in raising a healthy litter?
How can thermoregulation of the litter be controlled?
How much more energy (on a per kg basis) do growing puppies require compared to adults?
Why is food limited feeding considered preferential over free choice feeding for large breed puppies?

Orphans' Feeding Requirements - Practical Task

Arlo Guthrie — Tue, 21 Apr 2009 12:10:38 GMT

Current Revision posted to Revision Guide For Student Nurses - Part 2 by Arlo Guthrie on 4/21/2009 12:10:38 PM

INTRODUCTION
There is no better diet for a neonate than the natural milk of the dam. This is why a foster mother (such as a bitch in pseudo-pregnancy) is the preferred source of nutrition for orphaned neonates. However, it could prove difficult to find a suitable infection-free bitch or queen and therefore it may be necessary to hand rear the litter using milk substitutes. It is vital that the veterinary nurse is able to advise clients accurately since the livelihood of the neonates will be at stake. It may be that you are personally involved in the undertaking of hand rearing in instances such as complications in the dam following Caesarean. In the Practical Examination, you may be required to demonstrate preparation of milk substitutes and show a good knowledge of feeding techniques and quantities to be fed.

In the first few hours after birth, the neonate must receive colostrum. This is a yellow viscous fluid that represents the accumulated secretions of the mammary glands over the final weeks of pregnancy. Colostrum contains high concentrations of immunoglobulins which are necessary for 90% of the new-born's passive immunity (the other 10% is derived transplacentally). Neonates need colostrum within their first few hours since immunoglobulins are large molecules which can only be taken in by pinocytosis. The small intestine ceases to absorb large molecules after a limited period. Milk substitutes do not contain colostrum, therefore it is recommended that 1-5mls of serum is obtained from the dam and injected subcutaneously into the neonate or mixed with the milk substitute and given orally. If this is not possible, deep frozen or freeze-dried colostrum from other dams may be used.
Commercial milk formulas are preferable to home-made milk substitutes since the exact nutritional constituents are known. They are also quicker and easier to prepare. Cimicat for kittens and Welpi for puppies are often recommended and should be made up according to the manufacturer's instructions. Using boiled water to reconstitute the milk can reduce the risk of infection. The milk should be fed at body temperature (37 °C).
If commercial diets are not available, home-made substitutes are acceptable. In an emergency, powdered evaporated cow's milk (made up to double the strength recommended for babies) supplemented with 8g calcium phosphate per litre is suitable for both puppies and kittens. Proprietary growth diets may be blended in a food processor and mixed with milk. Cow's milk alone is unsuitable since it contains 15% less protein than bitches milk, 30% less protein than queen's milk and half the required amount of calcium and phosphorous. Cow's milk contains significantly more lactose which can cause diarrhoea in some puppies and kittens. Other home-made diets include:
- 3 Parts evaporated milk with 1 part water (puppies).
- 1L Full fat cow's milk, 4 egg yolks & 1 tablespoon corn oil (puppies).
- 800mls Cow's milk, 200mls single cream, 1 egg yolk, 6g sterilised bone flour & 4g Citric acid (puppies).
- 500mls Cow's milk, 1 egg yolk, multivitamin drops (e.g. Abidec) & calcium supplementation (kittens).
It is essential that the neonate receives the correct balance of calcium and phosphorous for healthy bone growth. Vitamins A and D are also of great importance. Remember however that over-supplementation can be just as harmful as too little. This is also an important factor in adult diets.
Having established a suitable milk substitute, a feeding regime must be organised. During the first week of life neonates require feeds every 2 hours during the day and every 4 hours at night. At 1-3 weeks of age feeds are reduced to every 4 hours during the day and every 6 hours at night. By the fourth week, feeds should be given at 8 hourly intervals.
There are several methods of administering the milk substitute to the neonate. Syringes are only really suitable in an emergency due to the danger of aspiration pneumonia. Orogastric or nasogastric feeding tubes are convenient but do not allow the puppy or kitten to suckle. Bottles or feeders with a nipple are ideal, but care must be taken to avoid feeding too much too quickly. Again, avoid aspiration. Hand feeding is a messy business, and if the neonate becomes wet with milk, ensure that it is cleaned, dry and warm before replacing in the incubator. It is advisable to keep the neonate wrapped in a warm towel during feeds and sensible for the nurse to wear a protective apron.
Puppies require 60 kcal/500g body weight per day, while kittens require 200 kcal/500g per day. Milk substitutes contain approximately 1 kcal/ml. Neonates will stop feeding when they are full. After a meal, the abdomen should feel enlarged but not distended. Never feed more than 50ml/kg in one feed if using an orogastric or nasogastric feeding tube. Puppies and kittens should gain 2-4g/kg/day of their anticipated adult body weight. Healthy neonates spend most of their time eating and sleeping. A very vocal puppy or kitten is likely to be hungry, cold or both and requires immediate attention. After a feed, gently wipe the genital area with warm wet cotton wool to simulate the action of the dam's tongue. This stimulates urination and defecation and is a very important aspect of neonate care.

Orphans' Feeding Requirements

Arlo Guthrie — Tue, 21 Apr 2009 12:10:03 GMT

Revision 1 posted to Revision Guide For Student Nurses - Part 2 by Arlo Guthrie on 4/21/2009 12:10:03 PM

In the first few hours after birth, the neonate must receive colostrum. This is a yellow viscous fluid that represents the accumulated secretions of the mammary glands over the final weeks of pregnancy. Colostrum contains high concentrations of immunoglobulins which are necessary for 90% of the new-born's passive immunity (the other 10% is derived transplacentally). Neonates need colostrum within their first few hours since immunoglobulins are large molecules which can only be taken in by pinocytosis. The small intestine ceases to absorb large molecules after a limited period. Milk substitutes do not contain colostrum, therefore it is recommended that 1-5mls of serum is obtained from the dam and injected subcutaneously into the neonate or mixed with the milk substitute and given orally. If this is not possible, deep frozen or freeze-dried colostrum from other dams may be used.
Commercial milk formulas are preferable to home-made milk substitutes since the exact nutritional constituents are known. They are also quicker and easier to prepare. Cimicat for kittens and Welpi for puppies are often recommended and should be made up according to the manufacturer's instructions. Using boiled water to reconstitute the milk can reduce the risk of infection. The milk should be fed at body temperature (37 °C).
If commercial diets are not available, home-made substitutes are acceptable. In an emergency, powdered evaporated cow's milk (made up to double the strength recommended for babies) supplemented with 8g calcium phosphate per litre is suitable for both puppies and kittens. Proprietary growth diets may be blended in a food processor and mixed with milk. Cow's milk alone is unsuitable since it contains 15% less protein than bitches milk, 30% less protein than queen's milk and half the required amount of calcium and phosphorous. Cow's milk contains significantly more lactose which can cause diarrhoea in some puppies and kittens. Other home-made diets include:
- 3 Parts evaporated milk with 1 part water (puppies).
- 1L Full fat cow's milk, 4 egg yolks & 1 tablespoon corn oil (puppies).
- 800mls Cow's milk, 200mls single cream, 1 egg yolk, 6g sterilised bone flour & 4g Citric acid (puppies).
- 500mls Cow's milk, 1 egg yolk, multivitamin drops (e.g. Abidec) & calcium supplementation (kittens).
It is essential that the neonate receives the correct balance of calcium and phosphorous for healthy bone growth. Vitamins A and D are also of great importance. Remember however that over-supplementation can be just as harmful as too little. This is also an important factor in adult diets.
Having established a suitable milk substitute, a feeding regime must be organised. During the first week of life neonates require feeds every 2 hours during the day and every 4 hours at night. At 1-3 weeks of age feeds are reduced to every 4 hours during the day and every 6 hours at night. By the fourth week, feeds should be given at 8 hourly intervals.
There are several methods of administering the milk substitute to the neonate. Syringes are only really suitable in an emergency due to the danger of aspiration pneumonia. Orogastric or nasogastric feeding tubes are convenient but do not allow the puppy or kitten to suckle. Bottles or feeders with a nipple are ideal, but care must be taken to avoid feeding too much too quickly. Again, avoid aspiration. Hand feeding is a messy business, and if the neonate becomes wet with milk, ensure that it is cleaned, dry and warm before replacing in the incubator. It is advisable to keep the neonate wrapped in a warm towel during feeds and sensible for the nurse to wear a protective apron.
Puppies require 60 kcal/500g body weight per day, while kittens require 200 kcal/500g per day. Milk substitutes contain approximately 1 kcal/ml. Neonates will stop feeding when they are full. After a meal, the abdomen should feel enlarged but not distended. Never feed more than 50ml/kg in one feed if using an orogastric or nasogastric feeding tube. Puppies and kittens should gain 2-4g/kg/day of their anticipated adult body weight. Healthy neonates spend most of their time eating and sleeping. A very vocal puppy or kitten is likely to be hungry, cold or both and requires immediate attention. After a feed, gently wipe the genital area with warm wet cotton wool to simulate the action of the dam's tongue. This stimulates urination and defecation and is a very important aspect of neonate care.

Orphaned Neonates - Answers

Arlo Guthrie — Tue, 21 Apr 2009 12:08:52 GMT

Current Revision posted to Revision Guide For Student Nurses - Part 2 by Arlo Guthrie on 4/21/2009 12:08:52 PM

ANSWERS

What is the alternative to hand rearing?
Finding a suitable foster mother, either a bitch with her own litter or a bitch in pseudocyesis.
Why is a foster mother more beneficial to an orphan than hand rearing?
- It is closer to a natural upbringing and therefore less stressful.
- An orphan may develop significant psychological problems due to lack of contact with a mother and litter mates.
List behavioural problems that may manifest in hand reared orphans in later life.
- Fear of their own species.
- Aggression to their own species.
- Excessive human orientation.
- Sexual attention directed at humans.
- Over-dependence on humans leading to separation anxiety.
Why is colostrum so important?
It contains immunoglobulins necessary for 90% of the neonate's passive immunity.
If an orphan has not received colostrum from the dam, what alternative source may be used?
Deep frozen or freeze-dried colostrum from other dams.
Why must the neonate receive colostrum within the first few hours after birth? Immunoglobulins are large molecules which can only be taken in by pinocytosis. The small intestine ceases to absorb large molecules after a limited period.
Why are commercial milk formulas preferable over home-made milk substitutes?
- They are nutritionally balanced.
- They are easier to prepare.
How frequently should an orphaned neonate be fed during the first week of life?
Every 2 hours during the day, and every 4 hours at night.
Why is the provision of a warm environment essential in the hand rearing of an orphan?
Neonates are poikilothermic and unable to regulate their own body temperature. An orphan will have no mother or littermates to snuggle up against to keep warm, therefore a suitable heat source, clean dry bedding and a warm ambient temperature are vital.
In addition to feeding and providing warmth, what other aspects of nursing care are beneficial to an orphan?
- Stimulation and plenty of TLC.
- Prevention of infection - the orphan should be housed well away from any infectious animals and barrier nursing carried out.
- Keeping the orphan clean and dry.
- Stimulation of urination and defecation by gently wiping the genital area with wet cotton wool.
- Early socialisation with other humans and animals.

Orphaned Neonates - Answers

Arlo Guthrie — Tue, 21 Apr 2009 12:08:28 GMT

Revision 1 posted to Revision Guide For Student Nurses - Part 2 by Arlo Guthrie on 4/21/2009 12:08:28 PM

ANSWERS

What is the alternative to hand rearing?
Finding a suitable foster mother, either a bitch with her own litter or a bitch in pseudocyesis.
Why is a foster mother more beneficial to an orphan than hand rearing?
- It is closer to a natural upbringing and therefore less stressful.
- An orphan may develop significant psychological problems due to lack of contact with a mother and litter mates.
List behavioural problems that may manifest in hand reared orphans in later life.
- Fear of their own species.
- Aggression to their own species.
- Excessive human orientation.
- Sexual attention directed at humans.
- Over-dependence on humans leading to separation anxiety.
Why is colostrum so important?
It contains immunoglobulins necessary for 90% of the neonate's passive immunity.
If an orphan has not received colostrum from the dam, what alternative source may be used?
Deep frozen or freeze-dried colostrum from other dams.
Why must the neonate receive colostrum within the first few hours after birth? Immunoglobulins are large molecules which can only be taken in by pinocytosis. The small intestine ceases to absorb large molecules after a limited period.
Why are commercial milk formulas preferable over home-made milk substitutes?
- They are nutritionally balanced.
- They are easier to prepare.
How frequently should an orphaned neonate be fed during the first week of life?
Every 2 hours during the day, and every 4 hours at night.
Why is the provision of a warm environment essential in the hand rearing of an orphan?
Neonates are poikilothermic and unable to regulate their own body temperature. An orphan will have no mother or littermates to snuggle up against to keep warm, therefore a suitable heat source, clean dry bedding and a warm ambient temperature are vital.
In addition to feeding and providing warmth, what other aspects of nursing care are beneficial to an orphan?
- Stimulation and plenty of TLC.
- Prevention of infection - the orphan should be housed well away from any infectious animals and barrier nursing carried out.
- Keeping the orphan clean and dry.
- Stimulation of urination and defecation by gently wiping the genital area with wet cotton wool.
- Early socialisation with other humans and animals.

Orphaned Neonates

Arlo Guthrie — Tue, 21 Apr 2009 12:08:05 GMT

Current Revision posted to Revision Guide For Student Nurses - Part 2 by Arlo Guthrie on 4/21/2009 12:08:05 PM

QUESTIONS

What is the alternative to hand rearing?
Why is a foster mother more beneficial to an orphan than hand rearing?
List behavioural problems that may manifest in hand reared orphans in later life.
Why is colostrum so important?
If an orphan has not received colostrum from the dam, what alternative source may be used?
Why must the neonate receive colostrum within the first few hours after birth?
Why are commercial milk formulas preferable over home-made milk substitutes?
How frequently should an orphaned neonate be fed during the first week of life?
Why is the provision of a warm environment essential in the hand rearing of an orphan?
In addition to feeding and providing warmth, what other aspects of nursing care are beneficial to an orphan?

Revive Neonate Post Caesarian - Practical Task

Arlo Guthrie — Tue, 21 Apr 2009 12:07:03 GMT

Current Revision posted to Revision Guide For Student Nurses - Part 2 by Arlo Guthrie on 4/21/2009 12:07:03 PM

It is essential that a veterinary nurse is familiar with the practical knowledge required in order to revive a neonate following birth by Caesarean section, since survival of the new-born is dependent on the rapid onset of spontaneous respiration. In the Practical Examination you may be presented with a soft toy or beanbag representing the neonate and asked to demonstrate how you would perform resuscitation.

As with all emergencies; remember the first priority is the patient's airway. Holding the neonate in a warm towel, clear the mouth, nose and pharynx of any attached foetal membrane, fluid and mucus. Using your fingers is the easiest method and does not require any equipment, although a simple suction device such as a syringe may also be utilised.
Next hold the neonate with the head lower than the hind limbs and supporting the head with fore-finger and thumb, swing from side to side or up and down. This will dislodge any fluid that may have accumulated lower down in the respiratory tract. Gently use your fingers to remove.
Briskly rub the chest of the neonate. This provides warmth and helps to dry the new-born in addition to stimulating respiration.
If the neonate is hypoxic, administer oxygen via a mask. In addition, blowing gently into the mouth and nostrils may encourage respiration.
Neonates are more resistant to hypoxia than adults, and natural methods should be used to stimulate the respiratory system during the first minute. If apnoea persists for more than one minute, commence artificial respiration with external cardiac massage (closed chest resuscitation) if required. Massage the heart by compressing the ribs at a rate of 80-100 compressions per minute between thumb and forefinger. Deliver 2-3 lung inflations for every 15 chest wall compressions.
Dopamine (Dopram drops) may be used if myocardial depression is present. Place one drop on the neonate's tongue and continue resuscitation.
If normal respiration is not present after 2-3 minutes, the neonate's chances of survival are poor. If normal spontaneous respiration results, place the neonate in an oxygen rich incubator at 30°C. The neonate may be dried with a hair drier, but take care not to overheat. Remember that new-born puppies and kittens are poikilothermic and are unable to regulate their own body temperature; this means that their body temperature varies with the ambient temperature. Try to provide humidification to the area.
Monitor respiratory rate, heart rate and mucous membrane colour.

Dystocia - Key Notes

Arlo Guthrie — Tue, 21 Apr 2009 12:05:49 GMT

Current Revision posted to Revision Guide For Student Nurses - Part 2 by Arlo Guthrie on 4/21/2009 12:05:49 PM

Type	Cause
Primary uterine inertia	Poor condition of uterine musculature in old, obese or debilitated dams
	Over-stretching of uterus due to large litter size
	Poor stimulus for parturition if very small litter size
	Poor stimulus for parturition if low plasma calcium concentrations
Secondary uterine inertia	Uterine exhaustion after contractions have started
	Causative factors may be as for primary uterine inertia
	Obstructive dystocia such as deformity of the pelvic bones or soft tissue defects

Type	Cause
Foetal oversize	Small litter of large foetuses
Breed conformation	Large head size (eg. Bull Dog)
Developmental defect	Hydrocephalus or Oedema
Abnormal foetal alignment	Faulty presentation, position or posture