Clinical Procedures and Nursing Skills
Overview
Clinical Procedures and Nursing Skills is the largest practical domain: obtaining and recording vital signs, preparing for venipuncture and catheter placement, carrying out treatments the veterinarian orders, and keeping the patient clean, warm, and monitored. Expect questions on normal parameters, exam order, and checking your own math.
Vitals and exam order
Normal adult dog: 60–160 beats/min, 10–30 breaths/min, 37.5–39.2 °C (99.5–102.5 °F). Cat: 140–220 beats/min, 20–30 breaths/min, same temperature range. The full exam is nose-to-tail, but a sick patient gets the problems first: airway, breathing, circulation, then the complete exam. Record TPR, weight, mucous membrane color, capillary refill time (under 2 seconds), hydration, and a pain score.
Procedures
- Venipuncture sites: cephalic, lateral saphenous, and jugular in the dog; medial saphenous in the cat; ear vein or jugular in the rabbit.
- Clip and aseptically prep for a catheter, flush and cap it, and check the site each shift for swelling or pain.
- Fluid bags get labeled with date opened, rate, and initials; use a pump when one is available.
- Bandages have three layers: primary contact, secondary padding applied with 50% overlap, and tertiary outer. Check the toes for swelling, coldness, or discharge.
Worked example
Order: 500 mL LRS over 8 hours by gravity with a 20 gtt/mL set. Reasoning: 8 hours is 480 minutes, so 500 ÷ 480 = 1.04 mL/min. Multiply by 20 drops per mL: 20.8, so set 21 gtt/min. Count drops for 30 seconds and double it to confirm, then recheck the rate hourly because patient position changes flow.
Traps
Reading a thermometer in Fahrenheit when the chart is Celsius, forgetting to subtract the towel when weighing, hand-squeezing a fluid bag to speed it up, and walking away with the tourniquet still on.