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