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Hospitalized and Recumbent Patient Care, General Nursing Care, Special Patient Care With Complete Solutions Latest Update

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Hospitalized and Recumbent Patient Care, General Nursing Care, Special Patient Care With Complete Solutions Latest Update...

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Hospitalized and Recumbent Patient Care, General Nursing Care, Special
Patient Care With Complete Solutions Latest Update



Care for the hospitalised patients - ANSWER -Care for patient's Physical, Medical and
Mental needs

-Plan care w.r.t. patient's routine-type of food, time of feeding, bathroom habits

-Cats-Feeding with a bowl/plate from home, Bedding/litter preference, Kennel setup

-Always inform the patients, Approach the patients slowly, Kennel vs floor space



Patient's hygiene and exercise - ANSWER -Keep them clean, Avoid urine infection,
scalding, Groom/wash as needed

exercise May be contraindicated for respiratory, cardiovascular and musculoskeletal
conditions

Vet will decide the level of exercise that is required

Routine Inpatient Care - Nutrition - ANSWER -Obese patients: does not mean that we
should starve them

Thin patients: during hospitalization may not be a good thing

Concern with obese patients continue to show decreased weight during hospitalization.

Prolonged anorexia may result in compromised immune system→ infection, delayed
healing

Daily Resting Energy Requirement

Address why a patient would refuse to eat: Pain, Nauseous, Differences in diet

If they are not eating we can try: Warming and/or wetting of food, Hand feeding, Type of
food-dry vs wet



Daily Resting Energy Requirement - ANSWER Patients over 2Kg but less than 30kg

(30 x Body Weight in Kg) + 70

~ 670 Kilocalories per day for a 20Kg dog

,Patients over 2Kg and patients over 30 kg

70 x (Body Weight in Kg) 0.75

~ 117 Kilocalories per day for a 2 Kg cat



Appetite Stimulant - ANSWER -AFTER other things have been tried:

-Mirtazapine, Cyproheptadine, Clonazepam



Feeding tube - ANSWER -often last resort

-Clinicare - liquid diet

-2 Types - Stomach tubing (gastric gavage) and nasoesophageal tubes (via the nose)

-Gastric tube - surgically inserted. Animal is fed directly into the stomach



Nasoesophageal - ANSWER -Contraindicated in patients that are vomiting or that do not
have a gag reflex. We want them to be able to swallow and gag. Can end up with
aspiration pneumonia if fluid enters the lungs.

-Uses a 5 to 8 Fr pediatric feeding tube

-Nares and the distal esophagus (8-9th rib) is measured and marked on tube

-Patient is in sternal recumbancy

-Local anesthetic is given into the nose given (e.g. lidocaine for dogs)

-End of tube is lubed

-Tube is inserted and directed ventrally

-Animal swallows when tube enters pharynx

-X-rays used to test tube placement



Mirtazapine - ANSWER Appetite Stimulant

-has anti-emetic properties (acts on neurotransmitters in the intestine and stomach that
communicates with the vomit center in the brain).

-Is a potent appetite stimulant.

, -In humans is given as an anti-depressant



Cyproheptadine - ANSWER Appetite Stimulant

-is an antihistamine, used in cats (not as good in dogs)

-Inhibits serotonin receptor which controls satiety

-Side effects include excitement and aggression

-May take a few days to reach full effect.



Clonazepam-ANSWER Appetite Stimulant

-anticonvulsant

-similar class of drugs to diazepam, "valium munchies"

-treatment of seizures, quick response if given IV



non-ambulatory patients-ANSWER things that cause problems

-Orthopedic/spinal injuries

-Traumatic injuries - i.e., hit by car

Critically ill - e.g., severe heart disease, anemia Sedation - e.g., for procedures,
seizures, animals that are sedated on arrival for seizure control. Bedding - ANSWER
-Prevention of decubital ulcers: bed sore caused from lying down. -Found on skin of
bony prominence-Due to compromised circulation -Prevented by regular ROM
exercise/position change/dense bedding -Padding

Padded grates: above grate, Urine flows through padding and under grate. Animal will
be wet but not swimming in urine.

Clean and dry at all times



Positioning - ANSWER -Sternal recumbancy: as much as possible to allow lungs to
expand on either side

-Turn every 2-4 hours if they cannot be in sternal recombancy

-Decubital ulcers and Atelectasis: partial or complete lung collapse

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