medical nursing note book

7/28/2019 Medical Nursing Note Book

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Medical Nursing Note Book

Sara von Kriegenbergh

Mon 9-3:30

Dr. Uyeno

Due: 11/23/09


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Lab Number One

Date: 8/31/09

Objective: Do a venipuncture in the leg and jugular, IV injection of .5cc saline in 1cc

syringe, IV cath. Placement, IV fluid bag set up & IV machine and heart auscultation.

Overview: Learn to collect blood from the leg and jugular vein, learn to place an IV cath.,

inject .5cc of saline, listen for different heart murmurs and learn how to set up an IV bad

and place one in a machine.

Materials: manikin leg, manikin head, stuffed animal dog with auscultation, IV bags, IV

machine, 1 cc syringes, catheters, medical tape, and saline.

Procedures: First my group and I got a quick demonstration of how to prepare an IV bag,then Katie (group member) followed the demo. And get up a bag for our group by taking

the IV bag then taking the cap off the bottom of the bag and sticking the adaptor into theproper tube, pushing it all the way in (be careful not to poke through the bag or yourself).

Once the line is all the way in, you can squeeze the tube that the fluids drip into and get

that filled to your desire. Once the line is complete in, we purged the line and to do thatwe just opened up the line (pushing it up) and then take off the cap on the end of the line

and let the fluid come out. This helps to get rid of all of the air pockets in the line; once

the line is clear (dont worry about the tiny bubbles) close off the line (push it down).

Once we set up a bag, we got a manikin dog leg and three 1cc syringes so our groupcould practice drawing blood from the cephalic vein. Once we all got blood from that

vein, we moved on to placing a IV Catheter in the cephalic vein. So we got three

catheters, two 1 inch strips of medical tape and two inch strips on medical tape. Firstwe removed the male part of the catheter from the rest of the catheter. Then carefully

holding both the needle and the catheter together, as to not let them separate when we

break the skin, and then place the needle into the vein. Once the needle and catheter is inthe vein, using the same hand we pushed the catheter into the vein completely and then

pulling the needle out once the whole catheter is in the vein. This processes has to happen

fairly fast because blood will start coming out of the needle while you are pushing the

catheter in the vein. You also want to get the needle out quickly and replace the end ofthe catheter with the male part and then keep light pressure on the end of the catheter to

make sure that it doesnt bend or come out. After that whole processes is done, we got

one of the 1/2 inch tape and placed it sticky side up, underneath the catheter and fold itaround the catheter and crimped it. At this point you can finally let go of the catheter with

your thump. Then using the rest of that same piece of tape, wrap it around the base of the

catheter and the leg. Next take the 1 inch tape and put it sticky side down and wrap itpartly around the base of the catheter and the leg, then take another of the 1 inch tape and

put it underneath the catheter with the sticky side down and this is to keep the area

around the catheter clean from anything going into it. Finally taking the other inch


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tape, putting it sticky side up and under the catheter and criss-crossing the tapes aroundthe leg to made sure they are secured.

The next procedure we decided to do was to inject .5cc of saline into the manikin legusing the 1cc syringes again. First we draw up .5cc of the saline and then with some one

else holding the leg, we held the vein in place and place the needle in the vein. To check

if you actually hit the vein, all you have to do is aspirate and you should get blood and atthat point you can inject the saline. Then we pulled the needle out and the holder covered

up the punch mark with a finger to stop the bleeding.

Collecting blood from the leg vein was basically the same process as injecting, exceptthat we are trying to get blood this time. So once again we took a 1cc syringe, found the

vein and held it in place with our thumps, then placing the needle into the vein and

aspirating to get blood out. After we collected enough blood, we pulled the needle out

and placed a finger over the puncture mark to stop the bleeding.

After being completely done with the manikin leg, my group moved on to the manikinhead to practice getting blood from the jugular vein. We each got a 1cc syringe, dammed

the jugular vein and placed the needle in the vein. Once the needle is in you draw the

blood then pull it out and undam the vein and put a finger over the puncture.

Lastly, I went to a stuffed animal dog that had a machine in it where you could use a

stethoscope to listen to the different sounds of heart murmurs and regular heart beats.

Result: The results from todays lab ended with all of us learning to draw blood, inject

saline, placing a catheter and putting an IV bag and machine together. We learned that

there are a lot of different things to keep in mind about placing a catheter. This lab issomething that all of us students need to truly master because these procedures are going

to be happening a lot in the vet. office. For the most part every one had at least an idea of

how to do everything except for the catheter, which as I stated earlier has a lot of thingswe need to remember how to do and Ill be the first to admit that I was a little nervous

about placing it (even though it was a fake dog leg) but Im still excited to place a

catheter in a real dog.

I think that most people really enjoyed what we did today, it was weird using the fake

dog legs and head but it was really effective. I personally havent drawn blood in months

and it was nice to practice without having a stressed out dog to deal with. Plus I havenever been given the chance to set up an IV bag and it wasnt really what I thought it

would be, but setting up the machine was actually easier than I thought which was cool.

Today was a great practice day and got me remembering how to do what I already knowand teaching me to do new skills.


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Lab Number Two

Date: 9/14/09

Objective: Learn to do a proper physical exam, veinipuncture and place an IV catheter

Overview: The purpose of this lab is to learn to do the most common of exams onanimals which is a physical exam and to actually put to practice doing a veiniuncture to a

live animal and placing a common catheter which will be done regularly as well.

Materials: 25 gage needle, alcohol, catheter, saline, surgical prep cleaners, tape, gaze, vetwrap, clippers, lubrication and a thermometer. The dog we used was Kelvin.

Procedures: We started out by helping Darlene get all the dogs out of the truck and into

the class. After giving each dog to a group (and keeping the door close for safety reasons)my group got together and got Kelvin ready for our first physical exam. The first thing

we did was what we considered would be the hardest to get, a rectal temperature. In thisclass we used a mercury thermometer. So Linda decided that she would take it, she got

the lubrication and placed a little on the tip of the thermometer and then slowly placed it

into the anus of Kelvin. I took the time and Katie made sure that Kelvin didnt go anywhere so nothing got lost and we got a chance to look at the rectum and make sure there

was a wink. After we got through that small process, Katie and Linda walked Kelvin

over to the scale and weighed him. Once every one was back together we took a starting

heart rate, which we got from where the elbow touches the chest, then went through a listthat we had. The next step we looked at his teeth and guns and evaluated them by looking

at the color and the condition they are in. Along with checking the mouth, we looked at

the capillary refill and to do that all we had to do was take one finger and put pressureagainst the gums of the dog making them white and see how quickly or slowly the gums

go back to color. Then we moved on to the eyes where we looked for gunk, color and

making sure that both pupils are the same size. The next on the list was to check thelymph nodes on Kelvin which we just had to feel for and make sure they werent

enlarged. The lymph nodes are submandibular, prescapular, axillary, inguinal and

popliteal. After letting the dog calm down we took the pulse to get a better and more

accurate reading and while doing that the rest of the group looked at Kelvins body to geta body score condition. For the body score we had to look at the coat condition, the fat on

the body, the muscle and also take into consideration that we are working with

greyhounds and that they thinner in general. For the final exam we did the neurologicaltest. This test only require us to take one of Kelvins paws and placing the dorsal side of

it on the ground, the dog should automatically fix its foot which would show some sort of

neurological disorder. After performing all the physical exams needed, we moved on togiving SQ injections along with IM injections.

No one in my group needed to do the SQ because every one was comfortable with giving

the most basics of injections. Linda did give an IM injection of saline solution in the


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lower back where the soft spot is. Finally we went on to placing catheters, which only 2of our group members did for today because we didnt want to stress out the dog too

much and because this was our first time and blowing the vein was and is a good

possibility. First we got all the supplies needed for placing the catheter which included:tape, surgical prep cleaners, clippers, gaze, vet wrap and of course the catheter itself.

Once everything is together, Katie and I lifted Kelvin properly on the table with Katie

taking the end and me taking the head and carefully laying him on the table. Then Katieand I went into position to restrain and held out the left front leg for on of our group

members to start clipping the area of the vein, meaning the cephalic vein area. We

clipped above and below where the catheter will be place that way you have a wider

range of areas to put the catheter and just incase you need to reinsert the catheter. Aftereverything was clipped we cleaned the area three times to make sure that everything was

sanitary and nothing would get into the dog while placing the catheter. We opened up the

catheter and took the male adaptor and left it in the container for now. Then the restrainer

took the leg and closed off the vein and twisted a little to make the vein pop more. Finallyone of the girls used her thumb to keep the vein in place and then went in to insert the

catheter into the cephalic vein. Once blood appears in the female part of the adaptor, youpush the rest of the catheter in leaving the needle where it is. The catheter needs to go all

the way in and once it is in, you take the needle all the way out and as quickly and

carefully as possible, insert the male adaptor to the catheter. That will keep the bloodfrom coming out. This whole time you had your thumb at the end of the catheter to keep

it in place, giving just enough pressure to make sure you dont push too hard and crimp

the catheter or let it come out. Now we clean up the area around the catheter because

there was blood on the dog and the tape wont stick with blood around. All we had to dowas get clean gaze and wipe up the area. After the area is clean we took our first half

piece of tape and places in under the end on the catheter itself (not the male adaptor) with

the sticky side up. Then we folded it over to crimp the tape to the catheter and wrappedthe rest of the tape around the leg and base of catheter. With this piece of tape on we

didnt have to hold on to the catheter because it is now secured. The next piece of tape

was a full size piece that we placed sticky side down against the skin and that piece goesunder the catheter. It needs to do directly under the catheter; this keeps that area clean

from hair getting in or anything. When we wrapped that piece of tape we made sure that

it didnt go over the male adaptor and only on the catheter and the dogs leg. The last

piece of tape was another half size tape that we placed sticky side up under the catheterand then criss crossed the tape and wrapped it around the dogs leg again. With all the

different pieces of tape, we would fold in the ends that way we would have something to

grab onto when taping the tape all.

With the catheter in, we could technically hook up and IV line or inject the dog with

something. Once we were done with the catheter, we carefully took all the tape offleaving the very first piece on because that is the one that is holding the catheter in place.

Until we were ready with gaze and vet wrap, with finally got the last piece of tape off and

slowly pulled the catheter out. Right as the catheter comes out we pressed a finger to the

wound and kept pressure to make sure he doesnt hemorrhage. After we are sure the


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bleeding is under control/stopped we up gaze to it and wrapped vet wrap around his leg toact as a bandage. The last thing that we did was cleaned everything up with triple two and

got the dog back to Darlene.

Results: The results that we got today were as follows: Weight = 73.6 pounds (fairly good considering everything)

Temp. = 100 degrees F ( the average temp. of a dog is 101 degress)

Heart Rate = 76 BPM

Pulse = 84

Respiratory = 72

Body Score = 4 (out of a scale of 9 our dog was actually in very goodshape)

Skin = dry

Teeth = rotting (the dogs were fed a raw meat diet and had no real care)

Cap. Refill = good, about one second

Gums = Very red

Eyes = good (no discharge and pupils the same size)

Lymph Nodes = good

Neurological test = good (flip foot right away again)

Rectum = good *wink*

IM = done

Cephalic = Linda

IV Catheter = Tracy and Katie was the restainer

Personally I havent actually put a lot of this to practice in awhile, but for the most part

every one felt very comfortable with what they were doing. By doing a standard physicalexam, we get to look for the problems that could be right in your face. If the dog had

nasal or ocular discharge we could have thought that there was a problem. Just like the

neurological test will tell you right away that if the dog does not fix its foot and right it

again, then there is a problem with the dogs brain. The physically exam is the best way tolook for symptoms that we can easily feel for or even just look at rather than running

unnecessary test. Placing a catheter is something that will be done all the time and

knowing how to place it and clean the area and what to expect is exactly what we allneed. We also learned that we need to be fairly coordinated to place a catheter because

we are basically down to one hand to do things. Good lab to really see what needs to be

done and what goes into everything that we do but also why we do it. One of the main

reasons why we do a physical is because a lot of the time you can easily figure out whatis wrong with the animal but a lot of people over look these easy things.


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Lab Number Three

Date: 9/21/09

Objective: Learn to do a proper physical exam and place an IV catheter

Overview: The purpose of this lab is to learn to do the most common of exams on

animals which is a physical exam and to actually put to practice doing a veiniuncture to a

live animal and placing a common catheter which will be done regularly as well.

Materials: 25 gage needle, alcohol, catheter, saline, surgical prep cleaners, tape, gaze, vet

wrap, clippers, lubrication and a thermometer. The dog we used was Kelvin.

Procedures: First we walked Kelvin over to the scales and weighed him, and right after

we got the temperature. Again we used a lubricant at the tip of the thermometer and held

it in the rectum. While doing that we noted the dogs attitude and at the same time we tookthe heart rate at the point where the elbow touches the chest and took the respiration.

Multitasking is the best and most efficient way to get things done and that is what we did,

every one having there own job and every one concurring with the results. We lookedover Kelvins body to get a body score, looking at how much the ribs and spin show

(being aware that he is a greyhound). We felt the skin, opened up the mouth to check to

see the teeth, gums and apply the cap. refill test by pressing a finger to the gums. Thenwe looked at the eyes and felt the different lymph nodes to make sure nothing was too

large or abnormal. The last things we did was check the rectum to make sure there was a

wink and the neurological test where we flipped the dogs paw and he had to fix it. Finally

we went to do the catheters once again.

We clipped both legs around the cephalic vein going up and down and side to side. Using

the surgical prep cleaners we cleaned the area three times and the restrainer got the leginto place closing off the cephalic vein off and giving us and area to work with. I used my

thump to keep the vein in place and then with the bevel up, I placed the catheter into the

vein. Once there was a stead blood flow into the base of the catheter, I used my one handto push the rest of the catheter itself into the vein leaving the needle where it was at. After

I got the catheter all the way in I got my male adaptor ready and pulled the needle out and

placed the male adaptor into the catheter. Keeping my thumb on the tip of the catheter to


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keep it in place, I got my different pieces of tape and secured my first piece of tape to the

catheter and in doing so securing the catheter itself. I got to let go of the catheter and then

finished up my taping. Once I was finish I started to take the tape off and pressed thewound off to make sure the bleeding stopped. After the bleeding stopped I took the clean

gaze and vet wrap and wrapped Kelvins leg and he was ready to go.

Results: Todays results are as follows:

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Attitude = BAR then went to QAR (Kelvin was one of the dogs that

wasnt feeling well/doing well)

Weight = 71.1 pounds (this shows that Kelvin really is sick because he isnow losing weight instead of gaining weight as the other dogs are doing)

Temp. = 102.2 (a little above the average, once again showing he isnt

feeling well)

HR/Pulse = panting; 60 (because he was panting almost of whole time we

knew something was wrong) Resp. = panting then it went to 62

Body Score = 4 (even though Kelvin isnt feeling well his body score isstill good, for now)

Skin = a little dry

Teeth = brown and still rotten

Cap. refill = normal

Gums = very red

Eyes = normal (pupils are the same size and no discharge)

Lymph Nodes = normal

Neuro. = normal

Rectum = good *wink*

IV Catheter = Katie and Me

Based on the physical exam, we realized that something was wrong with Kelvin becausenot only was he losing weight and his temperature was up but also because he was at an

almost constant pant and went very quiet and didnt want to move around at all. With

these results we asked Darlene is something was wrong with him and it turns out that hewasnt doing well and had a couple of problems. What happened with our group and dog

goes to prove that a physical exam is very important because you recognize the slight

differences. We did have some issues with the catheter because it isnt as easy as it seems

but we learned that we just needed to remain calm and focus on who we were working onand where the vein was.


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Lab Number Four

Date: 9/28/09

Objective: Do a physical exam and do a Robert Jones bandage properly

Overview: The main purpose of this lab is to learn how to properly put on a standard

Robert Jones bandage and the different materials used.

Materials: Thermometer, lubricant, tongue depressors, absorbent cotton roll, tape, stretchgaze and vet wrap.

Procedures: We went through the standard physical exam of looking at the teeth, eyes,

lymph nodes, temperature and weighing Brewster (dog). Then we went onto the new item

on the list, apply the Robert Jones bandage.

First we took on piece of tape and placed it against the middle top portion of the dogs leg

and letting enough slack to drop off the edge of the dogs foot. Using the tonguedepressor, we put the rest of the slack flat of the tongue depressor so that the tape wont

stick anywhere else. Then we took another piece of tape and did the same thing on the

opposite side of the leg and placing the slack on the tongue depressor as well. Doing thiswill keep the tape from sticking together or moving around too much. The next step was

to take the roll of cotton and starting distally and going proximally up until the elbow.

The tip of the toes should be showing a little, because at the end of this the dog will still

have to be able to walk. As you go up the leg, the wrap should be firm but not tight andthe wrap should be covering at least half itself each time. This wrap should be done a

couple of times to make it half as thick as the dogs leg. The cotton wrap is for cushion so

it needs to be on the thicker side and because later the wrap will get tighter. After the


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cotton wrap is set we move on to the brown stretch gaze, which only needed to go around

twice. But for the brown stretch gaze, this is when you make the wrap tight. We had to

pull has hard as we could to compress the cotton wrap and this brown wrap is going to bewhat keeps the leg from moving and in place. After going up and down at least twice and

pulling tight, we took the tongue depressor which still had the tape on it and pulled the

two pieces on tape off. Taking the two pieces of tape, you twist them around and thenstick them to the brown stretch gaze. By doing this, the tape helps to make sure that the

bandage doesnt fall down or completely off. Finally we took the vet wrap and wrapped

from distal to proximal and then back to distal. We didnt have to make it tight becausethe vet wrap is used for protection more than anything else.

Results: Todays physical exam results are as follows:

Attitude = BAR

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Weight = 82.1 (Brewster is one of the bigger dogs and also in good shapecompared to others)

Body Score = 5 (out of a scale of 9 so he is in great shape)

Skin = fairly good but a little dry

Gums = pink (this could indicate that he was a winning race dog so he

possibly got better treatment than the others)

Teeth = good, not rotting or too brown (again this dog was probably a

winner so got better treatment to keep him a winner)

Cap. Refill = good

Temp = 101.2 (Brewster showed to be one of the dogs that was doing

pretty well health wise)

HR/Pulse = panting (we got this when he was still very excited to be outof the car)

Eyes = slightly red (the pupils where the same but there was a little bit of

red in them, which could show an infection)

Lymph Nodes = good

Neuro. = good

Rectum = good *wink*While doing the physical exam we were able to really see the difference between this dog

and some of the other dogs. Brewster is in great shape and the evidence in that is very

obvious in not only the obvious weight difference but in the coat condition and the teeth.

This again goes to show again that a physical exam can give you a lot with just doingsimple tasks. Then with the Robert Jones bandage, it is the most common wraps to do and

it is just nice to do for not just a break but also a bad gash to the leg or anything of the

sort. For the different wraps, the cotton wrap is a thicker material in general and we laythat wrap on thick because the cotton wrap is the cushion for the leg to make sure

everything is comfortable underneath and to not let anything else rub. Then the brown

stretch gaze is what is used for security, it is the actual brace itself. But the importantthing to remember is to pull tight or else this wrap isnt going to help or do its job. Lastly


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the vet wrap which is used for protection, plain and simple. It is a sturdy material and can

help to give some support but it is used to protect the bandages under it.

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Lab Number Five

Date: 10/5/09

Objective: Learn to exam the ears, eyes and to express anal sacs

Overview: The Purpose of the lab is to learn to use the older tools and newer tools for the

eyes and ears and how to read the outcomes. Also to learn how to properly express anal

sacs.

Materials: mercury thermometer, ear thermometer, chlorhexadine, animax ointment,

otoscope, ophthalmoscope, tonopen, schiotz, shirmer tear test, cornea stain, gloves and

lubricant.

Procedures: First we expressed the anal sacs and to do that we got out gloves and

lubricant. We inserted our index finger into the rectum and had our thumb opposite of theindex finger. Then we felt for a little bulge around the perianal region and then squeeze,

but not too hard and squeeze a couple of times to make sure you get everything out. Once

everything was out, we took gaze and cleaned the area.

Then we moved on to checking the dogs temperature both rectally and auditory.

For the rectal temperature all we had to do was put some lubricant on the tip of the

thermometer and insert into the rectum then read the outcome. The ear thermometer is alittle different besides from the inserting location. With the ear, you usually have a

disposable tip at the end of the thermometer but for the class purpose we just used one.

Then there is a button and the press it to set the thermometer and then you insert it intothe dogs ear. To do this, you first going into the ear parallel and then you push it


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downwards. Once the thermometer is in place, you hold down the button until you hear it

beep and that indicates that you have gotten a proper reading.

The next exam we did was the eyes, we started out using the schiotz to check the

pressure of the eyes. We had some one restrain the dogs head and then we took the

schiotz and used one of our hands to hold open the left or right eye lids. Then we presseddown the middle pendulum on the center of the eye. For this to work properly, when we

press down you really have to press down and then match sure you watch the

measurements move right above it. When you press down, pay attention to the scale andonce you get the number you look at a chart that goes along with the schiotz. With that

number we moved on to the tonopen which is the new tool. The tonopen has a small

plastic stick with a larger ball at the end and this is the sensor that reports back to the

hand held machine. First you set the machine by pressing the starting button and then youpress the trigger button and aim for the pupil. You pull the trigger 5 times and you do this

consecutively getting a reading each time and not pulling out any zeroes because that

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means you didnt get a reading. Finally the machine comes out with an average for you

and there is no need for a chart any more.

While holding the dogs head, we took the ophthalmoscope to look for the optic

disk. For the ophthalmoscope, you need to twist the top making sure everything isattached and then you push the red button which turns on the light. Then you once again

use one hand to keep the eye lids open and then use the ophthalmoscope to look into the

eye and find the optic disk.

We went to the ears and the first thing we did was use the otoscope to look into

the ear and see what was inside. For this we took the otoscope and put it into the ear then

moved it downwards to look all the way in. After looking in the ear we had to clean them.First we had to flush the ear out and for that we used chlorhexadine and then used gaze to

clean the rest of the flushed out ear. Then when the eye was cleaned we put animax

ointment in the ear to treat it and for that we just put a little bit of the ointment on somegaze and rubbed it in.

Then we went back to the eyes to perform a Shirmer tear test and for that we

needed the Shirmer tear strip. The strip are just paper just at the same as a pH stickwould. First you bend the paper strip at the indentation and then put it in the eye and

keeping the eyelids closed. The paper needs to be held ventrally and should be under the

eye as well. Leave there for five minutes and there should be wetness showing in theform of blue being drawn up. Measure the length of the blue on the mm table that comes

with the Shirmer tear test. Afterwards we went to the cornea stain. For the cornea stain

we took a cornea strip and then used sterile water to flush the stain off into the eye. Oncethe dye is in the eye (it should be a bright green color) wash the eye out. If there is stain

still on the eye then there would be a problem.

Results: The results for the different temperature are as follows:


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Ear Temp. = 100.1

Rectal Temp. = 101

The results are very close but both have there advantages and disadvantages.One would be that for the rectal temperature it is hard to proper read and get

the correct number right away but for the ear temperature the problem is that

dogs do not like their eyes being messed with.Results for the eyes are as follows:

Schiotz = 26

Tononet = 17For the different tools that we used the older one, Schiotz, proved to be much

harder to use and takes a lot more effort on all participants of this task. While

the newer machine is more costly and takes a little more aiming skill, it is a lotmore effective and accurate.

Tear Test (left eye) = 5

Tear Test (right eye) = 8Page 12

Cornea Stain = both eyes clearFrom these results we learned that this particular dog wasnt producing a

lot/enough tears and this was something that we took in mind and

mentioned just for others to beware and know. Because the eyes arentproducing enough tears this dog could be a candidate for dry eye. Also

both eyes are clear after giving the cornea stain both eyes turned out clear.

If there was any stain left in the eye it would show positive for ulcers.

Results for the ears are as follows:

Dirty

Because of where these dogs have come from, having dirty ears is expectedbut still we need to clean them to make sure nothing builds up because the

ears could always get a lot worse.


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Lab Number Six

Date: 10/19/09

Objective: Learn to place a male urinary catheter

Overview: The purpose is to learn how to properly place a standard male urinary catheter

Materials: Plunger, lubricant, urinary catheter and gloves.

Procedures: First you get the dog on the table and lay the dog on his side. Then you puton your gloves and get your urinary catheter out. Using regular lubricant, you put some at

the tip on the catheter (this makes it a little more comfortable for insertion). After, you

take one of your hands and use it to block the os penis bone from going back. Then use

your free hand and use two fingers to form a V and push back where the skin attaches.Doing this will expose the penis, so you take the hand that was blocking off the os penis

bone and now pinch off the penis from going back in. Now take the lubricated catheter

and find the small hole at the tip of the penis. Slowly start pushing the catheter into thetip of the penis and the hole will open up and the catheter will go in. Taking our time and

slowly feed the catheter until you think you reach the bladder. Connect the plunger to theend of the catheter and pull back to see if you have hit the bladder. Once we got urine, weslowly started to pull the catheter back out and keeping a little suction on to make sure

urine doesnt come out of the catheter.

Results: The urine that we got from the dogs bladder came out clean, this shows thatthere isnt any infection or at possible trauma because there wasnt blood in the urine as

well. I learned that placing a male urinary catheter is fairly easy and that the tip on the


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penis where the hole is, is very small but the catheter will go in. Also I learned that you

need to feed the catheter in slowly because it is an uncomfortable thing to happen and

that you some times need to check a couple of time to see if you hit the bladder. Allcatheters that were places were done successfully and properly without causing any pain

or much discomfort to the dog.

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Lab Number Seven

Date: 10/26/09

Objective: Learn to take blood pressure and how to do an ECG

Overview: The purpose of the lab is to learn how to properly take blood pressure and how

to set a dog up for an ECG and how to read the results.

Materials: ECG machine, alcohol, ultrasound jelly, clippers, inflatable cuff and Doppler.Dog used was Babe

Procedures: For the ECG the dog needs to be placed in right lateral recumbency on topof the table. Then you take the different lead clips and place then in the correct positions,

which are: black goes to left arm, white goes to right arm, red goes to left leg and green

goes to right leg. Each lead is placed on either the elbow or the knee of the dog, and thensome alcohol is placed under each lead clip. Then turn the ECG machine on set

everything up on the machine and then have the lead on 2. When you start to get a

reading, wait until you get a straight line and then press the print button to get a print outof the dogs ECG to do further evaluation.

First for blood pressure, you need to clip the hair from on of the dogs pastern.

Then you place the inflatable cuff around the forearm making sure it isnt too loose. Nextyou place some gel on the Doppler and turn it on. Place the Doppler on the clipped

pastern and find a pulse, you might need to go side to side a little to find it so move the

Doppler slowly. After, take the cuff and start to inflate it until you no longer hear a pulsefrom the Doppler. Once the pulse is gone slowly start to release the pressure and pay


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attention to the numbers because the minute you hear the pulse return you need to know

which number this happened at.

Results: The results for the ECG are as follows:

Babe (the dog) had a normal ECG at the Lead 2 this is the most common

lead used. The alcohol is used to prevent any interference

The straight line results should have a constant P Q R S T, if

any of those were absent or looked too long or too short, a problem wouldbe indicated.

Taking an ECG is actually fairly easy and so is getting a straight line, what

is hard though is making sure that everything is normal and nothing out ofplace.

The results for Blood pressure are as follows:

Page 15

Find the actual pulse turned out to be harder than most of us thought and

once we found it, it was hard to not move or keep the same amount of

pressure on,

The dogs pulse turned out to be very steady and it sounded normal with noabnormalities.


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Page 16

Lab Number Eight

Date: 11/9/09

Objective: Review any thing we need to.

Overview: The purpose of this lab was to allow us to review anything that we felt the

need to review.

Materials: IV line, IV bag, IV machine, IV catheter, tape, surgical scrub, clippers,Doppler and ultrasound jelly.

Procedures: First we went over how to set up an IV bag. Take the IV line and slide the

roller downwards to close off the line. Then take the IV bag and pull of the tap from theneck of the IV bag and then carefully stick the piercing pin straight into the neck, make

sure to go straight down or else you can poke through the bag or poke yourself. Now that

the line is in, squeeze the tube coming off of the IV bag and let some fluid go into it.


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Take the end of the line and take off the cap thats on the end and aim the end into a sink

or trash can. Release the clamp by moving the roller upwards and purge the line to get all

the air pockets out. Go ahead and close off the cline again and now we can put the lineinto a catheter or place the line into an IV machine.

Next we laid the dog on the table and clipped the area around the cephalic veinwhere the catheter will be placed. Then prep the clipped area with surgical scrub at least

3 times. Next, open up the catheter and take off the male adaptor and with the bevel up,

stick the catheter into the vein. Once there is blood flow into the catheter, start pushingthe catheter itself into the vein leaving the needle where it is. After the catheter is all the

way in, take the needle all the way out and stick the male adaptor into the catheter. Now,

keeping your thumb on the end of the catheter, take a half width piece of tape and crimp

the tape to the catheter and then wrap it around the leg. With this first piece of tape on,we didnt have to hold the catheter any more. Then take a full piece of tape and wrap it

around the base of the catheter and around the leg as well. Finally take another half width

piece of tape and place it underneath the catheter sticky side up and criss-cross it over the

catheter.

Finally with the blood pressure, place the inflatable cuff on the forearm not tooloosely. Then clip the pastern area of the dogs paw and put gel on the Doppler and look

for the pulse. Once the pulse is found, inflate the cuff until you no longer hear the pulse

coming from the Doppler. Next, slowly release the pressure from the cuff and wait untilyou start to hear the pulse again and then record the number that came with that.

Results: Today was just a day to review anything that any of us felt unsure about or

needed some more practice on. Setting up an IV bag is something that is very easy to doPage 17

but I didnt get a chance last time to actually do hands on work with it. There are a lot ofsmall tasks that needed to be remembered but it is over all an easy item to set up. The

most important part of an IV bag is to remember to purge of air pockets. Then for the

catheter, it was good for us to remember how to tape because that is what most of usseem to forget. What was also good for us though, is that we need to be careful when

placing a catheter because we can easily blow a vein which could lead to hemorrhaging.

Also with blowing a vein, if you do it to both legs you might lose the veins in both the

legs and have to go to the back legs or even the neck.


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Page 18

Lab Number Nine

Date: 11/16/09

Objective: Learn to place a catheter in a sheep and draw blood from the jugular vein

Overview: The purpose is to learn to place a catheter in the jugular vein of a sheep and to

draw blood from the jugular vein.

Materials: Clippers, sheep halter, catheter, syringe, paper towels, disinfectant and sheep.


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Procedures: The first thing that needs to be done is get your group into the sheep pen and

get a sheep. Once you have gotten your self, get the sheep halter around the sheeps headand lead her to an open area to get started. Make sure you have some one that knows how

to retrain a sheep because they are strong and move around a lot First we tried to take

blood from the jugular vein, which didnt go well, so instead we too the clippers andclipped both sides of the neck. After the area was clipped with took a piece of paper

towel with disinfectant on it and cleaned off the neck. Then we damned the vein off to get

the vein to pop more and taking the needle with the bevel up we stuck the needle all theway into the vein. There is a little more force needed to get the needle into the jugular

vein because the sheeps skin is so thick. Once the needle is in, pull back on the plunger

and draw the blood out. When you are ready to pull the needle out, the restrainer will

place a finger over the injection site to keep the bleeding under control.

Then we moved on to place a catheter in the jugular vein. The first thing that we

did was damn off the vein again and had the vein pop out. Then open up the catheter, take

the male adaptor off and with the bevel up place the catheter into the vein but this timegoing downwards. Once you get blood in the base of the catheter, push the rest of the

catheter into the vein and then pull the needle out and place the male adaptor into thecatheter. Normally there is a slight surgical way to keep the catheter in place but my

group decided against it because we only wanted to practice placing a catheter and didnt

find the need to do an unnecessary suture.

Results: The results of this lab was that we all learned how to take blood from the

sheeps jugular vein and how to properly place a catheter. The biggest two differences of

placing a catheter into the jugular was that the catheter goes downwards and that insteadof using tape, you actually sutured the catheter to the neck of the sheep. Also, I think that

a lot of people got to remember how to actually move a sheep or restrain a sheep as well.

When it comes down to cleaning the area that we are working in, there is anotherdifference because we dont actually use a nice surgical scrub. We clean as well as we

can with what we have because usually this is on a working farm so you use what you

got. Then with the jugular vein, when you are in the process of taking the needle out andPage 19

replacing it with the male adaptor, there is a lot more of a blood flow coming out than

with the catheter in the cephalic vein. Finally sheep move a lot more and both the sheepand the restrainer have to remain standing so the sheep will move its head and legs and

body so there is a lot more that you need to keep in mind while doing everything. Overall

I do think that a lot of the students realized that doing catheters and blood draws on sheepis a lot more difficult and different from a dog. There is more than we need to take

control of and need to keep under control. At the same time though, we need to think how

realistic this lab is. Yes taking blood is something that we would do, but placing acatheter isnt something too realistic unless maybe you are talking about a prize winning

sheep that is worth a lot. Again though, we need to keep in mind how realistic doing

certain procedures on livestock is.

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