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recumbent patient

Principles of VN W24

QuestionAnswer
meaning of recumbent lying down and unable to rise
causes of recumbency Fractures Spinal trauma Weakness (associated with medical disease) Electrolyte imbalance Head trauma Shock Neurological injury and disease Anaesthesia
consequences of recumbency Hypostatic pneumonia Musculoskeletal problems Coat and skin problems Soiling Hypothermia Physical difficulties with normal activities Depression and poor mental wellbeing Hypostatic Pneumonia
hypostatic pneumonia is caused by the pooling of blood in the lower lung and a decrease in the lung viability
what can a SVN/RVN do to prevent Hypostatic Pneumonia Turning the patient every 2 to 4 hours, 24 hours a day Alternate lateral recumbency with sternal recumbency Encourage active assisted or supported exercise Respiratory physiotherapy techniques Good record keeping
cause of Decubitus Ulcers pressure on an area resulting in a local ischaemia of tissue
where do Decubitus Ulcers occur in areas where there is little fat present and over bony prominences
what can a SVN/RVN do to prevent Decubitus Ulcers Turn/reposition the patient every 2 to 4 hours, 24 hours a day Provide thick, comfortable and supportive bedding Pad and bandage high risk areas Physiotherapy Excellent hygiene standards Close monitoring of high risk areas
different types of soiling Urination and defecation (including diarrhoea) Vomit Blood Salivation Wound exudates Discharges Food and water
general reduction of soiling Provide a large enough kennel so the patient is able to move away from the soiled area (not always possible for recumbent patients) Absorbent bedding Regular patient assessments Remove soiled materials immediately Kennel hygiene Patient hygiene
how musculoskeletal problems occur - muscle tone + joint movement are maintained during normal exercise - due to lack of exercise recumbent patients lose muscle tone + muscle mass, joint movement can be compromised + limb oedema may occur - result may be long term reduction + mobility
physiotherapy techniques should be performed to help prevent musculoskeletal problems and to support recovering patients
how do recumbent patients experience hypothermia recumbent patients expend little energy meaning heat production is lowered - predisposes them to hypothermia
methods to prevent hypothermia Accommodate away from draughts Provide warm and insulative bedding Maintain the ward temperature Provide a safe heat source Physiotherapy Close patient monitoring
methods to promote wellbeing Grooming Physiotherapy Fresh air Exercise Toys (where safe) Client visitation Varied environment Music/radio Hand feeding
Physical Difficulties with Normal Activities, urination Supported towel or harness walking Shallow litter trays for cats Urinary catheterisation Manual bladder expression (video) Cystocentesis Monitor urine output Assess for scalding Apply a barrier cream Good record keeping
Physical Difficulties with Normal Activities, Defecation Bowel movements may be affected in the recumbent patient due to the inability to move. Problems include constipation, impaction and soiling
faeces should be passes at least once every 48 hours
Physical Difficulties with Normal Activities, eating and drinking Physical barriers may prevent normal eating and drinking (for example, a fractured mandible) patient may be inappetant or anorexic
Physical Difficulties with Normal Activities, eating and drinking The patient may be unable to reach their food and water if recumbent Spillage may occur if unassisted Offer water little + often
coat and skin problems recumbent patient will be unable or unwilling to groom matting may occur and skin lesions may go unnoticed
methods to prevent coat and skin conditions Groom regularly (if tolerated) Look for discharges and bathe eyes, ears, prepuce and vulva (orifices) Check nail length Look for skin lesions and parasites
Created by: lucy.fox
 

 



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