nursing care part ii eva rivero

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Nursing Care Part II: Geriatrics

Eva Rivero, RVT

Geriatric Patients Recumbent and Neurological Patients Post Operative Orthopedic patients

Amputations Surgical repairs or fixations

Post Operative Tumor Excisions Lumpectomy Mammary Neoplasia

Post Operative Urogenital patients Urethrostomy Cystotomy

{Outline of Presentation

Animals needing hospice care have normal mental faculties with physical disabilities

Severe orthopedic or spinal cord disease

Important to keep the patients with good appetite and ambulatory

Should keep temperatures warm Decubital ulcer, bladder

expressions, urine scalding, feeding tubes, carts and slings, appetite stimulants

Geriatric Patients

Increased veterinary care Diet and nutrition Weight control Parasite control Maintaining mobility Vaccination Mental health Environmental considerations

Reproductive diseases

Geriatric Patient Considerations

Increased reaction to sounds Increased vocalization Confusion Disorientation Decreased interaction w/humans Increased irritability Decreased response to commands Increased aggressive/protective behavior Increased anxiety House soiling Decreased self-hygiene/grooming Repetitive activity Increased wandering Change in sleep cycles

Behavior Changes to Expect

platinumprimetimers.wordpress.com

Pain Score charts for Canine Patients

Pain Score charts for Feline Patients

Padding in kennels Flooring with good traction to reduce

stress while walking or inflicted trauma Constant supervision Signs to remind co-workers of specific

needs Long hospitalizations can cause lethargy

and depression Range of motion (ROM) Assisted Standing, weight shifting, and

transitions Yoga mats or runners can help with slippery floors

Recumbent and Neurological Patients

Example of Slings and Harnesses to Assist in Increasing Mobility

Decubital Ulcers and Urine Scald Rotations every 4 hours Bladder should be checked for

possible expression to prevent overflow

Cleanliness is key with avoiding excessive moisture

Pain management is very important Seroma formation is common Cold compresses and warm compresses Exercise restriction if seroma is formed Anemia can occur if there was a great amount

of blood loss intra op. Sling support, well padded cage Tension on incision line may cause dehiscence Animals with neoplasia can develop metastatic

disease or have the tumor recur at surgery site

Post Operative Orthopedic Patients: Amputations

External coaptation (bandages, casts)

Passive Range of Motion Encouraging use of limb

(esp. with FHO) Floor surfaces Cold compresses and

warm compresses

Post-Op Orthopedic Patients: Repairs or Fixations

Post op complications are generally related to skin tension

Seroma formation is common Drain care and monitoring is important Bruising, hemorrhaging Exercise restriction Dehiscence

Post Operative Tumor Excisions: Lumpectomy or Mastectomy

Anonymous feline patient that received a mastectomy.

IV fluid therapy Urine production carefully monitored, post

op swelling and irritation can cause straining

First 48-72 hours hematuria can be expected

Complications to look out for: uroabdomen, urinary obstruction, celiotomy (or laparotomy) incision complications

Possible catheter placement if animal is unable to urinate

Post Operative Cystotomy Patients

http://www.vet.purdue.edu/pcop/urinary-bladder-cancer-research.php

Radiograph of bladder stones in an anonymous dog.

Ultrasound image of a bladder tumor.

Make sure purse-string suture has been removed

Mild hemorrhage during urination is expected post 24-72 hours

Post pot IV fluids at least 24 hours after surgery

Post op catheters discouraged (incr. stricture incidence)

Shredded paper in litter box for feline patients

Post Operative Urethrostomy Patients

Image to show where the urethral opening is created in a dog patient.

McCurnin’s Clinical textbook for Veterinary Technicians

The NAVTA Journal June/July edition 2014 https://

www.purdue.edu/research/vpr/rschadmin/rschoversight/animals/forms/pacuc_pain_recog.pdf

https://www.avma.org/public/PetCare/Pages/Caring-for-an-Older-Pet-FAQs.aspx

http://www.vet.purdue.edu/pcop/urinary-bladder-cancer-research.php

References