Clinical Procedures and Nursing Care
This domain tests aseptic technique, venipuncture and catheter care, fluid therapy, medication administration, bandaging, and patient monitoring. Expect calculation and complication questions.
Vascular access and sampling
Common venipuncture sites are the cephalic and lateral saphenous veins in dogs, the medial saphenous in cats, and the jugular vein when larger volumes are needed. Clip, scrub, and allow contact time for antiseptic. Secure catheters with tape or a suture and a light bandage; flush with saline and check patency.
Fluid therapy
Maintenance is roughly 50 to 60 mL/kg/day for adult dogs and cats, adjusted for losses, cardiac disease, and renal status. Shock boluses are given by the veterinarian's protocol and reassessed after each bolus. Record the rate in mL/hr, not drops/min, unless the pump requires drops.
Worked example
A 20 kg dog needs a 5 mL/kg/hr constant-rate infusion for 6 hours. Reasoning: 20 kg × 5 mL/kg/hr = 100 mL/hr; 100 mL/hr × 6 hr = 600 mL total. Set the pump at 100 mL/hr and confirm the bag contains at least 600 mL plus flush volume.
Monitoring and charting
Track mentation, heart rate, respiratory rate, mucous membrane color, capillary refill time, temperature, urine output, and pain score. Report trends, not just single values.
Traps
Confusing mL/hr with drops/min; adding drugs to a bag without labeling; using a peripheral catheter for a hypertonic or irritant solution; ignoring catheter-site swelling; failing to document a missed fluid rate.