Module 5: Surgical Nursing PowerPoint for Vet Tech Essentials

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© bluedoor, LLC
Veterinary Nursing
Module 5

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Lesson 1: Basic Nursing Principles
n Bathing/grooming
n Trimming nails
n Expressing anal sacs
n Cleaning ears
n Administering oral medications
© bluedoor, LLC
n Care for and monitor the condition of animals in hospital
n Provide routine care to outpatients
n Basic care includes:

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Bathing and Grooming
n Front to back © bluedoor, LLC
n Preparation
n Remove mats
n Ophthalmic ointment into eyes
n Cotton into ears
n Warm (not hot) water
n Check shampoo label for any special instructions (e.g. timing
of application)
n Wet the animal, then work in shampoo in systematic manner

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Bathing and Grooming (Cont.)
LLC
n Rinse thoroughly
n Heavily coated breeds require extra rinsing
n Rinse axillary and inguinal areas well
n Towel dry first, bluedoor, then place in cage
n Monitor carefully!
n vs. hyperthermia if using cage dryer
n vs. hypothermia if very young or very small
n Brush/© comb when dry
n Clean equipment after each use

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Trimming Nails
n Painful to walk on
n Can cause abscess © bluedoor, LLC
n Importance of nail care:
n Avoid lameness by keeping foot in proper position
n Avoid snagging or actual loss of nail
n Partial nail tear is very painful for animal
n Avoid ingrown nails

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Trimming Nails (Cont.)
n Firm, steady pressure
n Silver nitrate stick or styptic powder
© bluedoor, LLC
n Proper restraint necessary
n Cutting surface of trimmer should be parallel to surface of
toe pad in dog
n In cat, hold paw and push on skin of each toe to expose the
nail
n Try to visualize, and avoid, the “quick”
n Stop any bleeding with:

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Expressing Anal Sacs
LLC
n Anal sacs = paired glands on either side of anus
n Can become impacted
n Two methods:
n External expression
n Internal expression
bluedoor, n Cats: usually external
n Dogs: either external or internal
©

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Cleaning the External Ear Canal
n Avoid touching tip of medication bottle to skin of ear © bluedoor, LLC
n Collect any samples needed before cleaning
n Insert cotton-tipped applicator and gently roll it within ear
n Then roll applicator onto clean glass slide
n To clean ear:
n Flush ear cleaning solution into the ear canal
n Massage ear and remove debris with cotton balls
n If excessive wax is present, you may need to instill a
wax-softening agent first, and lavage ear canal with
warm water, using rubber bulb syringe
n Follow with topical medication, if needed

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Oral Medications
n Animal is vomiting
n Animal does not have protective gag reflex in place
© bluedoor, LLC
n Liquid, tablets, or capsules
n Potential problems:
n Animal may spit out medication
n Aspiration of liquids
n Contraindicated if:

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Liquid Oral Medications
LLC
n Measure with bluedoor, syringe for accurate dose
n Tilt animal’s head up slightly
n Hold mouth closed until swallowing occurs
© n Place small amounts of liquid into pocket formed by upper
and lower lips at corner of mouth

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Hand-Pilling for Dogs and Cats
LLC
n Easier with:
n Pet piller or pill pocket treat
n Coating of cream cheese, peanut butter, liverwurst, etc.
n Hold pill in fingers of dominant hand
n Use other hand bluedoor, to grasp over animal’s upper jaw
n Press lips over upper teeth to open mouth
n Place pill on back of tongue
n Close animal’s © mouth
n Stimulate swallowing reflex while holding mouth closed

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Lesson 2: Nursing Principles for
Ill Patient
LLC
n Obtain thorough patient history
n Perform complete physical exam
n Obtain objective bluedoor, patient data (TPR, auscultation of chest, etc.)
n Recognize abnormal clinical signs
n Administer medications as directed
©

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Patient Identification
LLC
n MUST have identification on hospitalized pets!
n Temporary collars frequently used
n Best if animal bluedoor, is permanently identified with tattoo or
microchip
n Microchips © can help in matching up a lost pet with its owner
n Microchip or tattoo numbers are entered onto patient’s chart
n National registries for microchip numbers

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Patient Signalment
LLC
n Signalment = important part of medical record
n Species
n Breed
n Age
n Gender
bluedoor, n Reproductive status
n Physical description
n Color and markings
n Some © clinics take photos of animal
n Scan for microchip and check for tattoo

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Physical Examinations
LLC
n Part of all routine and non-routine procedures
n Wellness exam
n Pre-surgical/pre-dental
n Presented for illness or injury
n Daily or more bluedoor, frequently if hospitalized
n Critical patients require almost constant monitoring
n TPR, capillary refill, mentation
n Requires a consistent, systematic approach to ensure
accuracy © and completeness of exam

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Parenteral Medications
n Intraosseous
n Intraperitoneal © bluedoor, LLC
n Enteral = given by oral route
n Parenteral = given by a route other than the GI tract
n Routine sites for parenteral injections:
n Subcutaneous
n Intramuscular
n Intravenous
n Non-routine sites:

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Preparing Medications
n Remove proper amount of medication
n Expel any air bubbles before use
© bluedoor, LLC
n Multi-dose vials
n Swab top of vial with alcohol to prevent contamination of vial
n Avoid creating hole in rubber stopper
n Insert needle around the center rather than in the center

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Preparing Medications
n Withdraw the liquid from one vial
n Inject it into the vial that has the powdered portion of the vaccine
n Gently shake the vial to dissolve the vaccine
n Withdraw the vial contents
n Expel any air bubbles before use
© bluedoor, LLC
n Reconstituting vaccines

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Subcutaneous Injections
LLC
n For non-irritating medications, many vaccinations
n Needle gauge of 22 g to 25 g for dogs and cats
n Dorsum from shoulders to rump has loosest skin
n Hospitals have protocols for vaccination sites
n Pick up skin with bluedoor, thumb and forefinger to make a “tent”
n Swab injection area
n Insert needle through skin in loose area
n Aspirate, © then inject medication under the skin
n Massage area gently to distribute the medication

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Subcutaneous Fluid Administration
n No more than 10 mL/kg of body weight at any one site
n No more than 60 mL/kg of body weight total
© bluedoor, LLC
n For mild dehydration
n Less stressful than IV administration
n Warm fluids to body temperature
n Can use multiple sites
n Only isotonic fluids in small volumes:

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Lesson 3: Nursing Principles for
the Medical Patient – Diagnostics
LLC
n Samples collected for various diagnostic tests:
n Blood
n Skin scrapings
n Urine
n Ocular diagnostics:
bluedoor, n Schirmer tear test
n Fluorescein staining
n Tonometry
n Careful © procedure required to obtain useful samples
n Proper patient restraint/handling is vital to success

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Venipuncture
LLC
n Use needle and bluedoor, syringe or vacuum-tube system
n Most commonly:
n 1–3 mL syringe
n 20- to 25-gauge needle
n Insert needle with the bevel facing up
n Use mild suction to pull blood into syringe
n Apply removing © gentle digital pressure to venipuncture site after
needle to avoid hematoma formation

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Blood Collection Tubes
LLC
n Different colored bluedoor, stoppers indicate additive in tube
n Best to fill tube from syringe without stopper and needle
n Prevents hemolysis
n If additive, fill tube as completely as possible
n Prevents artifacts or inaccurate test results
n If anticoagulant, © mix by gentle inversion of tube

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Blood Collection
n To avoid spike in glucose caused by cortisol release
© bluedoor, LLC
n Use large vein
n Collect minimum of 2.0 mL whole blood
n Usually yields ~1.0 mL of serum
n Dehydrated patients have a higher hematocrit
n Higher percentage of cells
n Need more whole blood to yield 1.0 mL serum
n If possible, collect blood 8–12 hours after last meal
n Helps to reduce or avoid lipemic sample
n Minimize stress/excitement

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Blood Artifacts: Lipemia
n Can cause hemolysis
© bluedoor, LLC
n Lipemia = milky-looking serum from circulating fats
n Common in obese or unfasted animal
n Can affect accuracy of several tests
n Increases red cell fragility

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Blood Artifacts: Hemolysis
n Gentle, not excessive, suction on syringe so vein does not
collapse
n Reposition needle so bevel is not against wall of vein
n Transfer blood directly to tube instead of forcing through needle
© bluedoor, LLC
n Hemolysis = breakdown of red cells, causing red tinge to
serum
n Avoid or minimize by smoothing the flow of blood cells:

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Skin Scraping
n Should see small amount of blood
© bluedoor, LLC
n Purposes:
n Check for presence of mites
n Evaluation of skin lesion
n Identify mycotic infection
n Mineral oil on #10 blade and on microscope slide
n Pinch skin; hold blade perpendicular to skin and scrape across
n Dab material from scraping onto slide
n If mites suspected, scrape a bit deeper and use several sites

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Schirmer Tear Test
n Fold at notch
n Place folded end into conjunctival sac of lower lid
n Gently hold eye closed for 60 seconds without touching paper
n Determine distance the tears traveled from the notch
© bluedoor, LLC
n Evaluates tear production
n Do before other tests or application of medications
n Uses sterile paper strips

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Fluorescein Staining
n Ulcer will show up as green spot
© bluedoor, LLC
n Allows visualization of ulcer on cornea
n Uses test strips containing fluorescein dye (orange)
n Tip of strip moistened with sterile saline
n Tip gently touched to cornea
n Immediately remove excess dye by rinsing with sterile irrigation
solution
n Intact outer corneal layers will not retain dye
n Deeper corneal tissue (stroma) will retain dye

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Tonometry
n Apply a drop of topical anesthetic to cornea
n Hold Tonopen perpendicular to cornea
n Gently tap the tip against cornea several times
n Tonopen will average the readings
© bluedoor, LLC
n Tonometry = measuring intraocular pressure
n Uses a specialized instrument called a tonometer
n Tonopen is most commonly used brand
n Has disposable tip cover

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Cleaning the Eye
LLC
n Use extreme bluedoor, care
© n Never touch tip of bottle to any part of the eye
n Use sterile isotonic cleaning solutions specifically labeled for
eye, at room temperature
n Liberally moisten cotton ball with solution
n Pull eyelid up or down to expose conjunctiva
n Gently wipe inner lid/conjunctiva with wet cotton ball
n Irrigate eye using eyewash directly from bottle

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Applying Ophthalmic Medications
LLC
n Hold medication container in dominant hand
n Rest hand on animal’s head close to eye
n Use other hand to pull lower eyelid down to create a gap
n Place drops into bluedoor, conjunctival sac
n Ointment: place a 3-mm long strip inside eyelid
n Never © touch tip of container to any part of the eye

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Free-Catch Urine Collection
LLC
n Container used depends on size and sex of animal:
n Cup attached to stick
n Soup ladle
n Aluminum pie pan
n Plastic lid for bluedoor, food storage container
n Container must be clean and dry
n Cats: clean, © dry litter pan with plastic beads as litter n Walk dog on leash and slip collection container under dog
(if female) or into urine stream (if male)

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Lesson 4: Nursing Principles for
the Medical Patient – Therapeutics
n Intramuscular (IM)
n Intravenous (IV)
© bluedoor, LLC
n Wound management
n Bandaging
n Injections

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Types of Wounds
n Contusion = bruise © bluedoor, LLC
n Open wound
n Abrasion = scrape, damages epidermis, +/- blood oozing
n Avulsion = tissue torn from underlying attachments
n Incision = slice, smooth edge, minimal damage to other tissues
n Laceration = rip, irregular edge, damage to surrounding tissue
n Puncture = penetrating wound
n Closed wound

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Wound Healing
n Patient factors (age, nutrition, health)
n Infection
n Foreign body
n Anti-inflammatory drugs
© bluedoor, LLC
n Four phases of wound healing:
n Inflammatory phase
n Debridement phase
n Repair phase
n Maturation phase
n Influenced by:

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Initial Wound Presentation
LLC
n First, focus on overall patient status
n Stabilization bluedoor, of patient is main focus!
n Cover exposed wounds with sterile dressing
n Pressure bandage for actively bleeding wounds
n Address © life-threatening issues before assessing wound

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Lavage
n Gentle, not excessive, pressure
© bluedoor, LLC
n Lavage = flushing (irrigation) of a wound
n To rinse bacteria, foreign material, blood clots from the wound
n Lavage solution: sterile, isotonic, body temperature
n Normal saline (0.9% NaCl) commonly used
n Tap water okay for heavy contamination
n Antiseptic solutions sometimes added
n Avoid hydrogen peroxide
n Use bulb syringe, large syringe, or squeeze fluid bag

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Debridement
LLC
n Debridement = excision of diseased/damaged tissue and
foreign matter
n Usually done at same time as lavage
n Goal is to leave bluedoor, only viable tissue with good blood supply
n Dead tissue left in a wound will retard healing
n Extent of debridement depends on the injury
©

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Debridement Methods
n Requires anesthesia © bluedoor, LLC
n Enzymatic
n Uses chemical agents to remove dead tissue
n Follow with wet gauze sponge to remove remaining debris
n Wet-dry bandage
n Wet bandage applied to wound
n Dead tissue adheres to bandage as it dries
n Debridement occurs when bandage removed
n May require sedation; can be painful
n Surgical

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Abscesses
LLC
n Will prevent bluedoor, healing unless drained
n Accumulated pus must be removed
n Drain mechanism implanted
n Often a Penrose drain (flat latex tube) sutured in place
n Drain kept in place until minimal drainage
n Suture clipped; drain slides out
n Hole from © drain can then be closed to speed healing

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Closing a Wound
n Must be bandaged for protection until healed
© bluedoor, LLC
n Closure depends on time since injury, degree of
contamination, and size and location of the wound
n Primary closure = suture immediately after cleaning and
debridement
n May include placement of drain
n Delayed primary closure = cleaning and debridement may
take a few days before sutures can be placed
n Wounds not sutured can still heal

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Bandages
n Protect from environmental contamination
n Absorb wound secretions
n Immobilize the wound
n Prevent swelling and bleeding
© bluedoor, LLC
n Functions:

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Bandage Layers
n Usually a stretch, self-adherent product (e.g., VetWrap)
© bluedoor, LLC
n Primary = in contact with the wound
n Open wounds require sterile wound dressing
n Adherent or non-adherent
n Occlusive = do not absorb fluid
n Hydrocolloidal = combine with wound fluid to form a gel
n Secondary = absorbs secretions; provides padding vs.
trauma
n Often cotton cast padding or sheet cotton, plus roll gauze
n Splint would be incorporated in this layer
n Tertiary = hold bandage in place

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Specialty Bandages
n Cast – provides high degree of immobilization
© bluedoor, LLC
n Stirrups – to keep a bandage on a limb from slipping down
n Modified Robert Jones bandage – used most often
n Velpeau sling
n Ehmer sling
n Hobble
n Mason meta-splint

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Caring for Bandages,
Casts, and Slings
n Lister bandage scissors (blunt tip)
n Cut each bandage layer separately
© bluedoor, LLC
n Must be kept clean and dry – important owner education
n Check regularly for:
n Slipping
n Wetness
n Bad odor
n Swelling of adjacent or distal tissue
n Damage by pet
n Removal

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Intramuscular Injections
LLC
n For irritating medications
n Less than 3 mL per site in average dog
n Hamstring muscles n Semimembranosus/bluedoor, are a common site
semitendinosus muscles in caudal thigh
n Aim slightly caudal to avoid sciatic nerve
n Lumbosacral muscles also used
n Insert needle perpendicular to muscle
n Retract © plunger slightly to check for blood vessel
n Inject, withdraw needle, massage gently

48. +
Intravenous Injections
n Cephalic vein (sternal recumbency)
n Medial saphenous vein (lateral recumbency)
© bluedoor, LLC
n More rapid absorption
n Dogs:
n Cephalic vein (sternal recumbency)
n Lateral saphenous vein (lateral recumbency)
n Cats:

49. +
Intravenous Injections
LLC
n Use tourniquet bluedoor, or have assistant apply pressure above
venipuncture site
© n Apply gentle pressure at venipuncture site for hemostasis
n Insert needle at 45-degree angle through skin and into vein
n Aspirate small amount of blood to ensure proper positioning
n Release pressure or tourniquet
n Slowly inject medication into vein
n Remove needle

50. +
Lesson 5: Nursing Principles of
Special Populations
LLC
n Unique needs of certain populations
n Vulnerability of newborns
n Deterioration of aging animals
n Pain issues in bluedoor, cancer patients
n Human safety risks involved with chemotherapeutic drugs
©

51. +
Neonatal Puppies and Kittens
LLC
n Thermal regulation
n Incapable for first six days of life
n Still require external heat source for 1–3 additional weeks
n No circulating antibodies
n Must receive bluedoor, these in colostrum
n Must nurse soon after birth, then every 1–2 hours
n External stimulation of genitalia needed for elimination
n Require © hand-raising if mother dies or is debilitated

52. +
Hand-raising Puppies and Kittens
LLC
n Suitable environment
n Box with high sides
n Source of warmth bluedoor, (e.g., hot water bottle in towel)
n Pups should © gain 2–4 g/day/kg; kittens 50–100 g/week
n Commercial puppy and kitten milk replacers should be fed
n Daily volume needed is based on weight of animal
n Warm to body temperature
n Minimum of 3–4 feedings per day
n Use dosing syringe, feeding tube, or nipple bottle
n Swab anogenital area to stimulate elimination

53. +
Geriatric Pet Care
LLC
n Considered geriatric at:
n Cats = 8 years
n Small dogs = bluedoor, 9 years
n Larger dogs = 7–8 years
n Non-ambulatory scalding © patients need special care to prevent urine
or decubital ulcers
n Should have physical exam, CBC/chemistry, urinalysis, fecal
at least once per year
n Hospice care may be required near end of life

54. +
Nursing of Cancer Patients
n Owner safety when handling antineoplastic agents
© bluedoor, LLC
n Cancer can involve any age animal and is a primary cause of
death in older animals
n Treatment may involve surgery, radiation, chemotherapy, or
combination
n Treat quality of life issues
n Pain
n Nausea

55. +
Technician Safety with
Antineoplastic Agents
n Good ventilation
n Chemotherapy spill clean-up kit
n Dedicated sharps containers © bluedoor, LLC
n Strict safety measures required due to toxicity
n PPE:
n Special gloves or double-glove, disposable gown
n Face shield and respirator if preparing chemotherapy agents
n Treatment area requires:

56. +
Administering Chemotherapy
Agents
LLC
n Place patient on non-absorbent pad
n Verify all dosages at start
n Variety of routes bluedoor, for administration
n Wash hands © thoroughly after removing PPE
n Place butterfly or indwelling catheter for IV administration

57. +
Lesson 6: Fluid Therapy and
Advanced Monitoring
LLC
n About 60% of total body weight is water
n Divided up into three compartments:
n Intracellular
n Intravascular
n Interstitial
bluedoor, n Osmosis = water moving across a membrane due to
concentration difference in particles (osmotic pressure)
n Concentration of osmotically active particles is called
osmolality
n Normal © plasma osmolality in dogs and cats is ~300 mOsm/kg

58. +
Patient Assessment
n Mucous membranes
n Skin turgor
n Body temperature
n Capillary refill time (CRT)
n Changes in body weight © bluedoor, LLC
n Patient history – will identify fluid loss and intake
n Evaluate hydration status to determine perfusion
n Perfusion = ability of body fluids to reach tissues and organs
in order to supply nutrients and oxygen
n Physical signs associated with hydration:

59. +
Skin Turgor Test
n Normal = skin springs back to place
n Mild dehydration (~5%) = skin slowly oozes back to place
n Severe dehydration (~12%) = skin stands in the fold
© bluedoor, LLC
n Subjective
n Ideally, same person performs the test in same place each time
n Animal in lateral recumbency
n Lift skin into a fold and measure time it takes to return to
normal

60. +
Capillary Refill Time (CRT)
n Normal CRT = 1–2 seconds
n Longer time = suggests impaired perfusion
© bluedoor, LLC
n Indication of peripheral perfusion
n Apply pressure to mucosa of gum or inner lip
n Release, then measure time it takes the blanched area to
return to pink

61. +
Packed Cell Volume (PCV)
LLC
n PCV is a ratio
n Based on blood bluedoor, in capillary tube after spinning it down
n PCV of © 20% or less have poor oxygen carrying capacity
n Height of red blood cell portion is compared to total height in
the column
n Expressed as a percentage

62. +
Albumin and Total Protein
n If TP is less than 3.5 g/dl, albumin level is low
© bluedoor, LLC
n Albumin is the primary component of intravascular oncotic
pressure
n Albumin level under 1.5 g/dl will not exert enough osmotic
pressure to keep water in the blood vessels
n Leads to hypovolemia
n No quick method to measure albumin level
n Can measure total protein level quickly

63. +
Types of Supplemental Fluids
n Contains electrolytes, vitamins, minerals, and other
calorically-dense nutrients
© bluedoor, LLC
n Crystalloids vs. Colloids
n Hypotonic
n Isotonic
n Hypertonic
n Example: Lactated Ringer’s solution = isotonic crystalloid
n TPN = total parenteral nutrition

64. +
Rehydration Volume
n Measured or estimated © bluedoor, LLC
n Rehydration volume = amount of fluid needed to bring hydration
status to normal
n Fluid deficit volume + normal maintenance volume + ongoing fluid
losses
n Fluid deficit volume:
n Estimate deficit percentage from physical signs
n Multiply % times body weight in kg to get volume in liters
n Multiply volume in liters X 1,000 to get volume in mLs
n Normal maintenance volume:
n 40–60 mL/kg/day
n Ongoing fluid losses

65. +
Route and Rate of
Administration of Fluids
n Oral
n Subcutaneously
n Intravenously
n Intraperitoneally
n Intraosseously © bluedoor, LLC
n Considerations:
n Severity of fluid losses
n Replacement volume needed
n Type of fluid replacement
n Routes:

66. +
Route and Rate of
Administration of Fluids
n Cardiovascular compromise
n Pulmonary edema
© bluedoor, LLC
n 80% of rehydration volume usually given within 24 hours
n Remainder within next 24 hours
n Rapid replacement contraindicated if patient has:

67. +
Fluid Therapy Calculations
n 30 mL/60 minute = 0.5 mL/minute X 20 drops/mL = 10 drops/minute
n 10 drops per minute is about one drop every six seconds
© bluedoor, LLC
n Drops per minute:
n First, find total volume needed, in mLs
n Divide by number of minutes available for fluid therapy
n This gives you # of mLs per minute
n Then determine which type of drip set you will be using:
n Macrodrip sets = 10, 15, or 20 drops per mL
n Microdrip set = 60 drops per mL
n Multiply # mLs per minute by # drops per mL to get # drops/minute
n Example: Need 30 mLs in the next hour

68. +
Fluid Administration
LLC
n “Shock dose”: give fast
n Dog shock volume = 90 mL/kg
n Cat shock volume = 70 mL/kg
n Macrodrip set: bluedoor, fluid bag and tubing with a rate control
device that delivers a certain number of drops per mL
(10, 15, or 20 drops/mL)
n Microdrip set: same, but at 60 drops/mL
n Syringe © pump: fluid is in syringe with pump that can be set to a
particular rate/volume/time n Infusion pump: tubing is run through a pump that can be set to a
particular rate/volume/time

69. +
Constant Rate Infusion (CRI)
n Avoids highs and lows from periodic bolus doses
© bluedoor, LLC
n Constant Rate Infusion (CRI) refers to administration of drugs
in the fluids so a measured amount of the drug is given over a
specific time period
n Expressed as # of mg over X minutes
n Some drugs do not last very long in the body
n CRI is a means of keeping the drug level in the body at a
steady rate to be constantly effective

70. +
Intravenous Catheters
n Allow simultaneous infusion of separate medications
© bluedoor, LLC
n Variety of types, lengths, and diameters
n Winged infusion (“butterfly”) catheters:
n Short-term use but not too stable
n Over-the-needle catheters:
n Most commonly used
n Easy, quick placement; can be left in place up to 72 hours
n Through-the-needle catheters:
n Longer; used primarily for central venous access
n Multi-lumen catheters:

71. +
Catheter Size
LLC
n Length and diameter of catheter affect rate of flow
n Fastest rate from larger, shorter catheter
n Longer catheters are more stable
n Less likely to cause mechanical irritation and phlebitis
n Cannot be used bluedoor, in an area of flexion
n Large catheter in small vein can disrupt venous return
n For routine treatment, use the smallest gauge catheter that
provides © adequate flow

72. +
Catheter Placement and Care
LLC
n Must be introduced and maintained aseptically
n Surgical scrub of venipuncture site
n Must be secured with tape or sutures
n Must be covered with light bandage to protect site
n Bandage must bluedoor, be kept clean and dry
n Must be flushed several times a day if not in constant use
n Monitor © for phlebitis n When being replaced, keep old catheter in place until new
one is successfully placed, secured, and checked for patency

73. +
Phlebitis and Other Problems
LLC
n Phlebitis = infection/n Redness, pain, bluedoor, inflammation of the vein
thickening, or irritation of the vessel
n Can lead to septicemia and bacterial endocarditis
n Monitor patient’s body temperature
n Check for swelling above and below bandage
n Bandage may tighten and cut off circulation
n Catheter or catheter © should be removed at first sign of phlebitis, sepsis,
malfunction

74. +
Intraosseous (Intramedullary)
Catheterization
n Neonatal bones very soft © bluedoor, LLC
n Preferred route in neonatal animals
n Proximal shaft of femur
n Proximal shaft of humerus
n Wing of ilium
n Bone marrow needles can be left in place for same duration
as IV catheters
n Standard hypodermic needles may work in neonate

75. +
Patient Monitoring
n Initial blood collection prior to treatment, if possible
n 1 EDTA tube, 1 heparin tube (plasma), 1 red top tube (serum) for
minimum data base © bluedoor, LLC
n Check hydration and urine output
n Normal urine output volume = 2 mL/kg/hour
n Check vital signs on regular basis
n Evaluate catheter patency
n Pain assessment
n Blood work as necessary

76. +
Patient Nursing
LLC
n Maintain clean, dry, comfortable bedding
n Provide adequate nutrition
n Care and comfort
n Medication administration
bluedoor, n Specific types of tests (BP, ECG, pulse oximetry, etc.)
n Repeated © bloodwork, per orders
n Physical therapy

77. +
Physical Therapy
n Thermal therapy
n Passive exercise
n Active exercise
n Therapeutic ultrasound
n Laser therapy © bluedoor, LLC
n Speeds recovery of patients
n Improves cardiovascular function and muscle tone
n Types of physical therapy:

78. +
Isolation
LLC
n For contagious patients
n Isolation ward bluedoor, has single entrance/exit
n Equipment and supplies stay in isolation ward
n Limited access to necessary staff only
n Gowns © and gloves worn over hospital uniform

79. +
Lesson 7: Dentistry
n Mucous membrane color
n Breath odor
n Lymphadenopathy © bluedoor, LLC
n Technician plays major role in dentistry:
n Cleans teeth
n Charts oral health findings
n Takes radiographs
n Educates clients on home dental care
n Oral disease can affect appetite and general health
n Oral exam can reveal other health issues

80. +
Oral Anatomy and Terminology
n Crown = exposed part, covered in enamel
n Root = submerged part, covered in cementum
n Dentin = layer underneath both enamel and cementum
n Pulp cavity = beneath the dentin; houses blood vessels, nerves,
and connective tissue © bluedoor, LLC
n Skull types:
n Dolichocephalic = long and narrow
n Mesaticephalic = medium length and width
n Brachycephalic = short and wide
n Teeth:

81. +
Oral Anatomy and Terminology
n # of upper and lower incisors, canines, premolars, and molars
© bluedoor, LLC
n Periodontium = tissues and supporting structures around the
teeth
n Gingiva
n Cementum
n Periodontal ligament
n Alveolar bone (socket)
n Gingival sulcus = space between tooth and the gingiva
n Assessed for depth during dental examination
n Dental formula = normal number and arrangement of teeth in
a species

82. +
Instruments and Equipment
LLC
n Ultrasonic scalers used to remove tartar (calculus)
n Generate heat; require constant water flow to cool
n Hand-scaling instruments:
n Scaler – to remove calculus from crown of tooth
n Curette – to bluedoor, remove subgingival deposits from the root
n Probe – to determine depth of gingival pockets
n Explorer – to detect roughened areas and lesions
n Rotary © polisher – to smooth the surface of the enamel
n PPE – gloves, face shield or goggles, and mask

83. +
Periodontal Disease: Stages
n Early stage – usually aerobic, gram pos, nonmotile cocci
n Late stage – usually anaerobic, gram neg, motile bacilli
© bluedoor, LLC
n Stage I: mild gingivitis, redness of free gingival margin
n Stage II: increasing sulcus depth, up to 25% attachment loss
n Stage III: pocket depths up to 9 mm in dogs (1,5 mm in cats);
up to 50% attachment loss
n Stage IV: larger pocket depths; more than 50% attachment
loss
n Bacteria:

84. +
Periodontal Disease
n Tooth loss
n Bacteria shed into bloodstream
n Bacterial endocarditis
n Other organ disease © bluedoor, LLC
n Goals of treatment:
n Control bacterial populations
n Minimize pocket depth
n Maintain healthy attached gingiva
n Uncontrolled periodontal disease leads to:

85. +
Dental Prophylaxis
n Comprehensive oral exam
n Scaling (hand and ultrasonic) and subgingival curetting
n Plaque-disclosing solution and flushing
n Probing/exploring
n Radiographs
n Extractions by DVM, if necessary
n Polishing and application of sealant © bluedoor, LLC
n Dental prophylaxis = the process during which teeth are
cleaned
n Preparation: physical exam, equipment and supplies in place,
selection of anesthetic protocol, induction of anesthesia
n Systematic approach:

86. +
Charting
n Right upper (right maxilla)
n Left upper (left maxilla)
n Left lower (left mandible)
n Right lower (right mandible)
© bluedoor, LLC
n Note in dental chart: variations in tooth appearance, pocket
depths, missing or retained teeth, tooth mobility, and other
lesions
n Two different charting systems used:
n Triadan system – uses 3-digit number for each tooth
n Alphanumeric system – uses letters, numbers, and number placement
n Mouth divided into quadrants:

87. +
Dental Radiography
LLC
n Indications:
n Increased gingival pocket size
n Facial swelling
n Advanced periodontal disease
n Nasal discharge
n Tooth or jaw bluedoor, fractures
n Oral growths
n Malocclusion
n Malformed teeth
n Can use © standard radiographic unit with intraoral film
n Majority of practices have dental radiographic units

88. +
Dental Radiography (Cont.)
n perpendicular to long axis of tooth
n perpendicular to film
© bluedoor, LLC
n Patient positioning:
n Lateral – for mandibular premolars and molars
n Dorsal – for mandibular incisors and canines
n Ventral – for maxillary teeth
n Techniques:
n Parallel – for mandibular premolars and molars; film placed
parallel to tooth and beam aimed perpendicular to tooth and film
n Bisecting-angle – where film cannot be placed parallel to tooth;
film placed parallel to hard palate and beam aimed midway
between:

89. +
Home Dental Care
n Wipes
n Gels
n Rinses
n Dental chews/treats
n Tartar-control diets © bluedoor, LLC
n Technician must educate client on importance of home oral
care
n Demonstrate cleaning with brush, finger brush, gauze
n Human toothpaste harmful for pets
n Special pet toothpaste is available
n Other products: