Final Exam - The Recumbent Patient

Question 1

how can you prevent injuries from occurring in laterally recumbent large animals?

Answer 1

turn the patient every 2 hours

deep bedding that is clean & dry

prevent any sores, crush injuries - use a sling

prevent ophthalmic injury

Question 2

what are 3 organ systems that if dysfunction, could lead to recumbency in large animals?

Answer 2

1. neurologic disease
2. musculoskeletal injury/trauma
3. cardiovascular compromise

Question 3

what components of patient care must be managed in a recumbent large animal patient?

Answer 3

1. water
2. nutrition
3. manure
4. urine
5. preventing injuries

Question 4

how is water managed for recumbent large animal patients?

Answer 4

maintenance fluid requirements must be met

method of delivery is dependent on the patient - IV if laterally recumbent (don’t want to tube a down animals & risk aspiration)

use of isotonic fluids

consider electrolyte support

Question 5

T/F: colic is a risk factor for recumbent horses

Answer 5

true

Question 6

how is nutrition managed for recumbent large animal patients?

Answer 6

consider the patient’s forage requirements

consider the neuro status - can the patient eat

delivery method - bring it to them!!!

Question 7

how is manure/feces managed for recumbent large animal patients?

Answer 7

need to evacuate the rectum daily - prevent impaction, constipation, & rumen bloat

Question 8

how is urine managed for recumbent large animal patients?

Answer 8

avoid urine scalding

may consider a urinary catheter

Question 9

what is the basic amount of urine produced in large animals daily?

Answer 9

~1 ml/kg/hr

Question 10

before beginning any recumbent exam, what should you do? why?

Answer 10

PUT ON GLOVES!!! rabies is real!!!

Question 11

why are urinary catheter bags not great for horses?

Answer 11

they only hold 1 L of fluid - guess they have a lot of piss

Question 12

what do you have to worry about with electrolytes in anorexic large animals?

Answer 12

they get calcium & potassium from their diet - if they aren’t eating, may have to supplement

Question 13

what may clue you in to a muscular injury in a recumbent large animal patient?

Answer 13

tachycardia, tachypnea, pyrexia, myoglobinuria, & increased AST/CK

Question 14

what ophthalmic injury are you worried about in recumbent large animal patients?

Answer 14

corneal ulcers

Question 15

T/F: colic is always a risk factor in recumbent large animals

Answer 15

true

Question 16

what is the shock fluid dose for recumbent small animals?

Answer 16

90 ml/kg - divide this by 4 (essentially, 20 ml/kg)

Question 17

T/F: hyperkalemia in a recumbent patient is an emergency & must be addressed ASAP!!!

Answer 17

true