Recumbent patient care Flashcards
recumbent patient
ant patient with limited mobility
how should we house recumbent patients?
non-skid surface, good padding, soft and absorbent for eliminations (can put pee pads right under them if they can’t move around), consider thickness (too thin= ulcers, too thick= injury if patient tries to dig out), things that can be easily cleaned/disinfected, add a personal touch
what are other things with housing recumbent patients that should be considered?
elevate their head, do they have light/sound sensitivities?, do they have anxiety? (don’t walk in and out of their kennel more than needed)
why do we turn recumbent patients?
so they don’t develop pressure sores or pulmonary atelectasis (partial or complete lung collapse due to pressure)
how often should recumbent patients be turned?
every 2-4 hours
how do you rotate a recumbent patient?
rotate with legs under to avoid turning the stomach and causing gastric dilation and volvulus
check skin for redness every time you turn
massage and flex/extend limbs
how much should a recumbent patient’s head be elevated?
~30% to help passively decrease intracranial pressure
put a folded towel under their head
when changing out the towel that is elevating a recumbent patient’s head, what should you do before putting down a new towel?
lower the head briefly to allow for the patient to expel mucus or fluids (use a smooth and gentle movement)
what should you check with bandages on recumbent patients?
check for strike through and ensure it is clean
avoid using red or black vetwrap so you can see if there is strike through
nursing care for recumbent patients
keep them clean and dry (baby wipes, waterless shampoo, butt paste, bathe and dry patients PRN)
replace soiled bedding right away
keep in mind their mental state (speak calmly and quiet, move smoothly and gently when handling, fluff pillows, straighten blankets, pet them, facilitate owner visits)
what is a good rule to follow for bedding?
the heavier the patient, the thicker the padding
bladder monitoring
monitor bladder size, amount, color, odor, and act of urination (straining, incontinence)
how should a recumbent patient eliminate?
on their own if they can
or can express: only express ~50%, 4-6x a day
catheterize: only 3-4 days then change, record collected amount
can use drugs to help relax too: Diazepam (relaxes urethra), Bethanechol (relaxes contraction of bladder)
recumbent patient defecation
record
enema or digital removal may be necessary
laxatives can be used
consider clipping hair of long-haired patients to keep clean
recumbent patient body temperature
have trouble regulating
hypothermia can be corrected with warming cages, heating pads, forced air devices, or heating blankets
check temp regularly to monitor for hyperthermia
check skin for thermal burns
recumbent patients: eating
many patients won’t want to eat or have the energy to eat
enteral route preferred
can hand feed, use appetite stimulants, feeding tubes, or total parenteral nutrition
what are some important things about feeding recumbent patients?
never feed in lateral recumbency, only sternal
never force feed
don’t leave right under patient’s nose if they don’t want to eat right away when offered
recumbent patient mobility
if able to walk, allow assisted opportunities to walk
it will improve patient’s muscles, respirations, circulation, and mental health
if assisting with a sling, be sure rear feet aren’t dragging
recumbent patients muscles and joints
unused muscles quickly atrophy abd joints will become stiff and painful
consider physical therapy
recumbent patients respirations
prolonged lateral recumbency can cause atelectasis of the down lung (auscultate lungs every time you flip)
sternal recumbency preferred
coupage can be performed to help clean airways
consider checking oxygen saturation (SPO2)
recumbent patients circulation
measure BP every 4-6 hours
strive for: systolic= 100 mmHg
diastolic= 40 mmHg
mean= 60 mmHg
physical therapy helps increase circulation and lympathic drainage
edematous limbs can be massaged to facilitate lympathic drainage
cold therapy
most effective in the 1st 24-48 hours after injury
helps decrease pain perception, decrease nerve conduction, decrease muscle spasms, causes local vasoconstriction, and decreases edema
ice pack or cold compress for 5-10 minutes 2-4x a day
heat therapy
apply 48-72 hours after injury
caution in patients with sensory nerve damage or recovering from anesthesia
always have a barrier between pack and skin
104-113 F for 10 min 2-4x a day
helps with muscle relaxation, pain relief, local vasodilation, not for acute wounds= causes edema
passive exercise: massage
helps enhance muscle tone, decreases stress, promotes relaxation, stimulates lymph flow and immunity
can start within a few days after surgery
state law regulates who can perform certain massages and under what level of supervision
