Neonatal Care and Medicine 2

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kris10leejmu
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187683
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Neonatal Care and Medicine 2
Updated:
2012-12-06 22:49:22
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Clinical Practice ll
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Clinical Practice ll
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  1. What should puppies look like and how should they act?
    • puppies should be fat and sleek
    • should sleep contentedly and nurse frequently
  2. When should we monitor body weight of puppies?
    • at birth
    • 12 hours later
    • daily for 2 weeks
  3. Failure to gain weight is often the first sign of _____.
    illness
  4. When do the puppies eyes open?
    12 - 14 days old
  5. When do the puppies ears open?
    10 - 14 days old
  6. When do the puppies eyes changef rom a blue-gray color to their adult color?
    4 - 6 weeks old
  7. When do puppies get their canine teeth?
    most get canines by 3 weeks old
  8. What do we need to exam on a physical exam of a puppy?
    • weight
    • gross abnormalities
    • mouth
    • skin
    • breathing
    • heart
    • muscle tone
    • limbs
    • abdomen
    • umbilicus
    • tail, anus, genitals
    • anus
    • check urine and feces
  9. What about the mouth should we check on a physical exam of a puppy?
    • mucous membrane color
    • cleft palate
    • sucking reflex
  10. What about the skin should we check on a physical exam of a puppy?
    • dehydration
    • wounds
    • hair cover
  11. What about the breathing should we check on a physcial exam of a puppy?
    should be regular and unlabored
  12. What about the heart should we check on a physical exam of a puppy?
    • auscultation is difficult due to high rate
    • should be over 200 bpm
  13. What about the limbs do we need to check on a physical exam of a puppy?
    • deformities
    • joint mobility
    • tendon contracture
    • wrapped cord that could have caused atrophy
  14. What about the abdomen should we check on a physcial exam of a puppy?
    • normally enlarged after nursing
    • if enlarged and puppy is restless, weak, and crying - could be ill or have gas
  15. What about the umbilicus should we check on a physical exam of a puppy?
    • infection
    • hernia
    • muscle wall abnormality
  16. What about the anus should we check on a physical exam of a puppy?
    patent, swollen, red
  17. How do we do a neurological evaulation?
    • mental status
    • reflexes, gait, posture
    • cranial nerves
    • motor system
  18. How do we check the mental status of a puppy?
    • gauge by response to external stimuli - touch, sound, quality of cry
    • gauge by how puppies sleep - normally sleepin a pile, usually don't sleep alone for 5 - 6 weeks
  19. What type of reflexs do we need to check?
    • anogenital reflex
    • respiration reflex
    • pain perception
    • righting reflex
    • rooting reflex
  20. What is the anogenital reflex?  How do we check it?  When is this reflex present?
    • reflex for urination and defectation
    • gently rub rear end with warm damp cotton ball
    • present until about 18 - 28 days old
  21. How do we check the respiration reflex?  When is this present?
    • stimulate abdominal or genital area - puppy should inhale
    • present for the first 3 days
  22. How do we check the pain perception?  When is this present?
    • pinch toes and puppy should cry
    • present at birth
  23. How do we check the righting reflex?  When is this present?
    • place puppy on his side - will flip onto his sternum
    • test both sides
    • present soon after birth
  24. How do we check the rooting reflex?  When does this reflex go away?
    • cup hand around muzzle, puppy should root or push forward
    • gone by 25 days old
  25. What are the reflexes we check for the cranial nerves?
    • blink reflex
    • withdrawal reflex
    • sucking reflex
    • tongue evaulation
    • gag reflex
    • startle reflex
  26. How do we do the blink reflex and when is it present?
    • touch face between nose and eye - puppy should blink
    • present even before eyes are open
  27. How do we check the withdrawal reflex?
    • touch nostrils
    • puppy should pull back
  28. How do we check the sucking reflex?
    • put your finger in puppy's mouth, puppy should try to suckle
    • reflex lasts for 4 weeks
  29. How do we do the tongue evaluation?
    put your finger in puppy's mouth - tongue should move when touched
  30. How do we do the gag reflex?  When is this reflex present?
    • put object in back of puppy's throat - this should cause the puppy to gag
    • present by 10 days old
  31. How do we check the startle reflex? When do we check this reflex?
    • drop something or make a loud noise
    • no good until about 3 weeks old because they do not open their ears for 10 - 14 days after birth
  32. How do we check the motor system?
    • wheelbarrow reflex
    • hopping reflex
    • placing reflex, visual placing
    • weight support
    • walking
    • tone - flexor tone, extensor tone
    • flexor reflex
  33. How do we check the wheelbarrow reflex?  When do we check this?
    • make puppy walk on front legs
    • should hold up head and use both front legs
    • can do this at 4 - 5 days old
  34. How do we check the hopping reflex?  When can they do this?
    • make puppy support weight on one limb, then make him hop on that limb - forward and laterally
    • present in forelimbs at 2 - 4 days old
    • present in rear limbs at 6 - 8 days old
  35. How do we do the placing reflex?  When can they do this?
    • hold puppy beside table, blindfolded, facing, it, lower than the top
    • bring him up and twards the table so his feet hit the edge
    • he should put his feet on the top of the table
    • present in forelimbs at 2 - 4 days old
    • present in rear limbs at 5 - 9 days old
  36. When can a puppy support their own weight?
    • forelimbs:  7 - 10 days old
    • rear limbs:  10 - 24 days old
    • support own weight at about 16 days old
  37. When can a puppy walk?
    • jerky walking at 18 - 21 days old
    • coordinated walking betwen 3 and 4 weeks old
  38. What is the flexor tone?
    • puppy flexes spine, limps and curls up into a ball
    • dominates in first 4 days
    • crossed extensor reflex present up to 3 weeks old - pinch left leg, and puppy will extend right leg
  39. What are some common medical problems we see with neonatals?
    • hypoglycemia
    • hypothermia
    • internal parasitism (diarrhea, hookworm anemia)
    • external parasitism (flea anemia)
  40. What are some common birth defects we see with neonatals?
    • cleft palate
    • cerebellar hypoplasia
    • hernias
    • PDA
    • hydrocephalus
  41. When should a puppy's weight double birth weight?
    should double birth weight in 8 - 10 days
  42. What should a neonatal puppy's respiratory and heart rate be?  What should their urine specific gravity by?
    • respiratory rate:  15 - 35 bpm
    • heart rate:  about 220 bpm
    • urine specific gravity:  1.006 - 1.017
  43. Do neonatal puppies have a shivering reflex?
    no
  44. What should a puppies temperature be in the first week?  Second week?  Third week?
    • first week:  94 - 97
    • second week:  97 - 99
    • third week:  101.5 - normal adult temperature
  45. When do we use pediatric anesthesia?
    under 6 weeks old
  46. What procedures would require pediatric anesthesia?
    • trauma - lacerations, fractures
    • correct congenital problems - cleft palate
    • cosmetic - ear crop
  47. What is the problem with using injectable anesthesia drugs with neonatals?
    • neonates have greater body water volume which results in faster distribution of drug throughout body
    • smaller fat stores to take up and slowly redistribute drug
    • slower liver metabolism due to undeveloped enzyme systems
    • less developed renal function
    • drugs hit them harder, faster, and effects last longer
  48. Do neonatals take up inhalation anesthetics quickly?
    • yes due to higher respiratory rate
    • may go down faster
  49. What is the choice of anesthetic agents for neonatals?
    • local analgesics
    • atropine
    • sedatives
    • inhalants
  50. When should we avoid using atropine and why?
    animals under 8 weeks old because it could decrease heart rate
  51. Which sedatives should we use and which ones should we avoid?
    • avoid:  phenothiazines (acepromazine), xylazine, ketamine
    • use:  opioids
  52. Why should we avoid using phenothiazines (acepromazine)?
    causes hypotension and prolonged depression of neonates
  53. Why should we avoid using xylazine?
    causes cardiovascular depression and prolonged sedation
  54. Why should we avoid using ketamine?
    causes muscular rigidity, delirium - may cause convulsions
  55. Why are opioids okay to use?  What side effects do they have?
    • okay to use because they have a reverser agent
    • can cause apnea, respiratory depression
  56. If we have to use a mask to induce our patient with inhalants, which kind of mask should we use?  Why?
    a clear one to watch for vomiting or excess salivation
  57. Which type of endotracheal tube is best?
    uncuffed tube
  58. Which type of anesthetic circuit is best?
    • non-rebreathing
    • Ayre's T-piece
    • avoid circle system - causes lots of resistance to gas flow and makes it harder for the puppy to breathe
  59. How do we keep the puppy's body temperature up during anesthesia?
    • towels, hot water bottles, warm IV fluids
    • can submerge puppy in warm water in plastic bag after surgery
  60. How can we administer fluids to a neonatal puppy since their veins are so small?
    • jugular vein can be used
    • intraosseous catheter is possible
  61. What kind of fluids can we use to avoid a neonateal becoming hypoglycemic?
    5% dextrose
  62. Should we turn on the fluids to a large bag and leave the puppy hooked up to it?
    • no, don't want to over load the puppy with fluids, calculate and measure fluids out
    • can use a burette to measure
  63. A puppy without access to water for 24 hours can become ____ dehydrated.
    10%
  64. Offer puppies and kitten water up to _____ before anesthesia and as soon as possible afterwards.
    1 hour
  65. What life threatening things do we need to watch for in a puppy after anesthesia?
    • respiratory depression
    • hypoglycemia
    • hypothermia

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