Nursing Interventions Flashcards
What would you do to heat a patient before actively heating them?
Insulate the patient.
- blankets under to prevent heat loss to kennel
- blankets over patient - layers are better as trap a layer of warm air between
- tinfoil reflects heat back to patient (place between the blankets)
Describe the methods of actively heating the patients
- Wheat Bags - microwave and store heat
+ mouldable to patient
- Need to monitor heat levels - Hot water bottles
+ easy to use
- can chew / burst/ leak
- can scold patient - Infrared light (heat-producing bulb)
+powerful hotspot (ideal for mothers and pups)
- not ideal for recumbent patients
- bulb can explode if comes into contact with fluid - Heat Mat
+Warm ambience created in that kennel
+Can control to maintain a specific temperature
- can chew wires
- fans just blow air around. Hot hand can burst*
Describe the methods used to cool a patient
- A/C
+ very effective in creating a cool environment
- non-specific - Fan
- kicks up dust and can affect other patients - Ice packs or ‘cool hands’
+ effective and reuseable
- small. Have to use multiple
- chewable - Cool mat
+ can lie on it and is effective
What can be done to reduce barking and stress in patients?
Exercise dogs regularly
Environmental Enrichment
Owner Visits
What should you do during the physical examination of the patient?
Examine from head to tail to avoid missing anything
Conduct more thorough exam of problem area
Auscultate heart and lungs
Measure vital signs
observe gait and mobility
Test reflexes
Describe some differences between dogs and cats you would find during a physical exam
Cat nose a little dryer than dogs
Cats MM are paler than dogs
Cat claws are retractable
Cat penis has barbs but appears smooth after castration
State the 5 vital signs
- Temperature
- Pulse rate and Heart Rate
- Respiration Rate and Effort
- MM and CRT
- Blood Pressure
State the normal temperature range for dogs, cats and rabbits
Dog: 38.3 - 38.7
Cat: 38.0 - 38.5
Rabbit: 38.5 - 40
State the normal temperature range of guinea pigs, hamsters, rats and horses
Guinea Pigs: 39-40
Hamsters: 37-38
Rats: 37.5-38
Horse: 37-38
What is the difference between hyperthermia and pyrexia?
Hyperthermia - increased body temp usually due to environmental conditions
Pyrexia (fever) - increased body temp usually due to infection
What term describes a fluctuating body temperature? What can cause it?
Diphasic
Canine Distemper Virus
State the normal pulse rate ranges for dogs, cats, rabbits and horses
Dog: 60 - 140 bpm
Cat: 110 - 180 bpm
Rabbit: 205 - 235 bpm
Horses: 36 - 42 bpm
State the 3 variation in pulse rate?
Tachycardia - increased HR
Bradycardia - decreased HR
Dysrhythmia - abnormal HR
State the normal ranges for RR for dogs, cat, rabbits ad horses?
Dog: 10 - 30 breaths/min
Cat: 20 - 30 breaths/min
Rabbits: 35-60 breaths/min
Horse: 8-12 breaths/min
Describe the 5 variations in RR
Tachypnoea - increased RR Bradypnoea - decreased RR Dyspnoea - difficulty breathing Apnoea - Stopped/Not breathing Cheyne-Stokes Respiration - abnormal rhythm and rate of breathing (often last gasp)
Describe the variation in MM colour
Pale - reduced tissue perfusion ( delivery of RBC) or anaemia (not enough RBC)
Cyanotic - hypoxia (not enough O2 in blood)
Icteric/ jaundiced - bilirubin accumulation
Brick Red - vasodilation
What is the normal CRT ?
1-2 seconds
What does an increased and decreased CRT mean?
increased (prolonged) = poor circulation
decreased (faster) = increased blood pressure
What are the normal average BP values for dogs and cats?
Dog = 133mmHg Cat = 124mmHg
Describe how to use a doppler?
Select correct cuff
Keep cuff level with heart
Apply spirit and small amount of gel to fur over pulse site
apply gel to doppler transducer and inflate cuff slowly until pulse disappears
inflate another 20mmHg over and then slowly release the pressure in the cuff
Take the reading when the pulse returns - systolic pressure
Repeat and take average
Name some problems a recumbent patient may face?
Problems eating and drinking properly Problems with natural elimination Soiling of the skin and fur Hypostatic pneumonia Hypothermia Decubitus ulcers
What intervention are there to assist patient mobility?
Supported sitting
Supported standing and walking
Physiotherapy
(massage improves circulation and maintains muscle tone; passive exercise maintains and improves, muscle tone and joint suppleness)
What is hypostatic pneumonia?
Lack of movement results in pooling of blood within the lungs, accumulation of blood within the tissues, collapse of lung, decreased oxygenation and increased risk of infection.
How can you treat a decubitus ulcer?
Apply water-soluble jelly to ulcer, clip hair and then wash up. Dry thoroughly, apply a dressing, a foam ring and a bandage. Monitor and change dressings regularly.
What are the aims of physiotherapy?
Reduce pain Promote Healing Improve mobility Regain strength and flexibility Prevent recurrence of injury CV fitness and Respiratory function
When is massage contraindicated?
When there is acute inflammation, pyrexia, unstable fractures, open wounds, infectious skin diseases
What is effleurage used for?
Stroking, smooth movements encourages venous return and reduces oedema
What massage technique is used to loosen secretion?
Coupage
What does passive range of movement involve?
Gently flexing and extending the joint whilst supporting it.
What does heat help?
pain reduction
reduces blood pressure
increases circulation
What does cold help?
Reduces pain
Vasoconstriction
Reduces inflammation
When will a patient require assisted feeding?
- If they have been anorexic/unable to eat/inappetant for more than 3 days ( including time at home)
- If Body condition score is less than 3/9
- Recent weight loss is more than 10% body weight
- Severe Cachexia (severe breakdown of fat and muscle stores- can use muscle condition score to measure)
Describe the process when starting to initiate feeding support in a patient (i.e. first step to last step)
Want to work from least invasive first!
- Tempt/ encourage
- syringe feeding
- Tube feeding
- Parenteral Feeding
What do we have to be careful of when feeding an anorexic patient?
Re-feeding syndrome.
potentially fatal shift in fluids and electrolytes e.g. can cause hypophosphataemia
What must the animal be/have to be syringe fed?
Must be conscious
Have normal GI function and ability to swallow
Name and describe the 4 types of feeding tube
- Naso-oesophageal (NO) or Naso-gastric (NG)
- NO doesn’t interfere with cardiac sphincter so not as many problems with acid reflux
- These a shorter term -several days.
- stomach and intestines must be functioning
- use liquid food and flush before and after - Oesophagostomy tube (O tube)
- tube placed through lateral neck by vet under GA
- sutured in place and stoma site dressed.
- can get more volume and slightly more solid food in
- also needs to be flushed before and after
- slightly longer term - PEG tube
(percutaneous endoscopically-placed gastrostomy tube)
- placed through surgical opening in lateral abdominal wall under GA by vet. Endoscope pulls feeding tube down oesophagus into stomach.
- Longer term (minimum 7-10 days)
- Higher liquid volumes as food administered directly into stomach
-mushroom head prevents it coming back out stomach. - Stomach tube
- good for reptiles, birds etc
- passes from mouth to stomach
- good to ‘kick-start’
What is parenteral feeding?
Feeding of nutritional components intra-venously using central vein.
Used when GI tract is not functioning
No room for error! Expensive
What should be done to avoid re-feeding syndrome?
Feeding little and often - 4-6 meals/day
Introducing food back gradually
e.g. Day 1 = 1/3 RER, Day 2 = 2/3 RER, Day 3 =RER
Can introduce over 4 days if want!
Feed slowly!
Observe animal when feeding for signs of aspiration, discomfort, nausea.