Recumbent patient Flashcards
Define what is meant when a patient is ‘recumbent’
- Recumbency = Lying down
- A recumbent animal may be unable to rise, turn or lie in any other direction, requiring to be regularly turned
Can get different degrees
Define Ventral recumbency
Lying on its belly
Define Dorsal recumbency
Lying on its back
In surgery, patient’s are unlikely to stay, when they are concious
Define Sternal recumbency
Lying on its sternum (chest) or propped up
Define Lateral recumbency
Lying on its side
Why might a patient become recumbent?
- Injuries
- CCL surgery
- Neurological disease
- Recovering from anaesthesia
(temporarily) - Multiple fractures
- Amputations
- Severe surgery
(Spinal, Orthopaedic) - High dose, long term analgesic or pain meds
- Severe ear infections
(Especially middle ear)
Middle ear infections - secondary to Labrinthitis, due to inflammation + meningitis (can go on for 3 weeks, requiring 24/7 care)
How can you assess a patient’s ability to mobilise adequately?
- Questionnaries
- Visual examination
- Question the client - Is it acute? Chronic?
When assessing the patient’s ability to mobilise, what must you take into consideration?
- What is normal for the species
- What is normal fot the patient (Exercise routine + what their potential limitations are)
- Observations
- Examinations
- What is the patient’s score on the mobility assessment scale?
- Evaluate the patients:
= Gait
= Posture
= Weight distrubtion - Evaluate movement
= Is it fully or partially recumbent?
= Weakness?
= Paresis?
= Stiffness?
= Unwilling to move?
- Mobility scale = Assess gait, easier to use for partial recumbency
- Gait = Contorted posture = pain or neurological
- Weight distribution = May guard abdomen or painful
- Is it fully or partially recumbent? = Could be due to spinal trauma or paralysis
- Unwilling to move? = Can be confused with:
= Weakness
= Dehydration
= Too painful
= Too stresssed
= Scared
As a veterinary nurse, you need to consider the behaviours the animal will or may find it difficult to perform themselves.
What 10 natural behaviours can nurses help with nursing interventions?
- Eating
- Drinking
- Urinating
- Defecating
- Thermoregulating
- Turning
- Mobilising
- Exercising
- Grooming
- Washing
What nursing interventions can be used for patients that require help with eating?
- Tube feeding
- Syringe feeding
- Feeding tubes
- Encouragement/tempt
- Adjust contistany of food
- Heat food for palatability
- Change foods
What nursing interventions can be used for patients that require help with drinking?
- IVFT
- Encouragement
- Moistien mucous membranes
- Subcut fluids
What nursing interventions can be used for patients that require help with urinating + defecating?
- Provide absorbant bedding
- Inco pads
- Urinary catheters
- Regular checks
- Spot cleaning
- Laxatives
- Enema
- Remove soiled urine from kennel + bedding
- Provide regular opportunities to urinate (even if w/use of moving aids)
- Remember = urine contains ammonia = burns/scalds the skin
- Urinary catheters = cause significant irritation to the urethra = why the procedure should be as sterile as possible
What nursing interventions can be used for patients that require help with thermoregulation?
- Vetbeds
- Cold washes = cool down
- Bear huggers = heat up
- Heat pads
- Hot hands
- Adjust environmental temperature
- Fans
- Warm subcut fluids
- Warm IVFT
What nursing interventions can be used for patients that require help with turning?
- Turn every 1hr
- Turn to prevent pressure sores
- Prevent hypostatic pneumonia
What nursing interventions can be used for patients that require help with mobilising?
- Provide assistance aids
- Strechers
- Slings
- Towels
- Regular movements to keep blood circulating
What nursing interventions can be used for patients that require help with exercising?
- Important to prevent sarcopenia or muscle atrophy = hard to build, easy to loose
- Mobility aids
- Regular mvoements to encourage circulation
What nursing interventions can be used for patients that require help with grooming?
- Brushing
- Wiping
- De-matting
What nursing interventions can be used for patients that require help with washing?
- Baths
- Remove soiled matter
- Drying
- Shampoo (medicated, allergy-specific, skin disease, antibacterial etc)
In simple terms, how can you manually express the patient’s bladder?
- Palpate the bladder
- Caudal of the abdomen
- If its full, will feel like a small fluid sac
- Squeeze in a caudal motion, to express + stimulate urination
What are the actual or potential problems that can be associated with recumbency?
- Pressure sores
- Urine scalding
- Lack of lymph drainage = due to fluid build up in irregular places, within the thoracic cavity - pools in the lungs, on the side the patient is recumbent on
- Problems eating + drinking normally
- Problems w/ urinating + defecation
- Soiling of skin + fur
- Hypostatic pneumonia
- Hypothermia
- Hyperthermia
(unable to move from heat source) - Decubitus ulcers
What species that presents with a blocked bladder, is considered an emergency?
Cats!
What is the name given to the condtion when cats get a blocked bladder?
Feline Urethral Obstruction
Why is Feline Urethral Obstruction (FUO) lethal?
The pressure build up toxins or can burst the bladder and can die within 24hrs, without prompt treatment + extreamly painful
When the cat is unable to pass urine, the kidneys are no longer able to remove toxins out of the body + or maintain the body’s electrolytes.
As it will eventually lead to:
* Inflammation of the urinary tract
* Kidney damage
* Heart arrhythmias
* Peritonitis
* Cystisis
* Death
Peritonitis = inflammation of the mm that lines the peritoneum (abdominal cavity) = fatal
What causes FUO?
- Urolithiasis
- Strictures
- Tumors
- Urethral plugs
- Mechanical blockages, secondary to urethral spasms or swelling, due to inflammation in the lower urinary tract
- Dehydration
Urethral plugs = blockage made from mucus, protein + cells
True or False.
Females are of greater risk of developing FUO than males.
False, males are more susceptible to this, due to their length + narrowing urethra
What increases the risk of Cats developing FUO?
- Obesity
- Multi-cat households (stress)
- All-dry food diet
- Dehydration
- Restricted access to outdoors
- History of UTIs
- Males, 1 - 10 y/o
- Stress
What does “turgid” mean?
Swollen
Why does pressure on the bladder cause kidney damage?
Because the swollen bladder puts pressure on the kidneys, which causes damage
What is a behaviour that can lead to a blocked bladder, associated with husbandry?
- Stress + retention of elimination.
- This can be caused by providing more than 1 litter tray and/or spot cleaning this regularly.
- This can cause discomfort + stress, as the cat will refuse to eliminate, leading to holding it in, building up toxins, leading to constipation
- Which will lead to impaction of GI tract + retention of urine, leading to build up of toxins + ruptured bladder - if continues
