Nursing The Recumbent Patient & Physiotherapy Flashcards

1
Q

What does recumbent mean?

A

It describes a patient that is in lying position
(lateral, sternal, dorsal)

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2
Q

How is mobility assessed?

A
  • must understand normal for the animal
  • normal exercise routine, timing, frequency, limitations, concurrent conditions and life stage
  • must observe and evaluate movement, weakness, stiffness, gait, posture, weight distribution, and if fully or partially recumbent
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3
Q

What can be impacted in recumbent patients?

A
  • exercise
  • urination
  • defecation
  • drinking or eating normally
  • breathe normally
  • maintain body temperature
  • grooming
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4
Q

Potential problems caused by recumbency?

A
  • unable to eat leading to weight loss
  • unable to drink leading to dehydration
  • difficulty urinating and defacating leading to accidents
  • breathlessness or panting
  • hyperthermia or hypothermia
  • can’t groom themselves
  • unable to move
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5
Q

What nursing intervention can be provided for recumbent patients?

A
  • supported sitting
  • supported standing and walking
    (lifting, slings, harnesses, patient trolley)
  • physiotherapy
    (massage, passive exercise)
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6
Q

Interventions for patients with difficulty eating and drinking?

A
  • ensure they have access to bowls
  • supported sitting and assisted feeding
  • easy to swallow food
  • pain and nausea management
  • saliva or pinch skin to manage hydration levels
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7
Q

Interventions for patients with difficulty urinating and defacating?

A
  • assisted walking techniques
  • provide absorbent bedding
  • manual expression or laxatives
  • urinary catheterisation
  • monitor frequency, consistency, colour, volume
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8
Q

What can cause soiling of skin/fur and what can it lead to?

A
  • caused by urine, faeces, blood, saliva, vomit or pus
  • can cause infection or disease of skin
  • can be uncomfortable
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9
Q

Intervention for patients with soiled skin/fur?

A
  • provide absorbent bedding
  • bed baths (however risk of hyperthermia)
  • assisted walking
  • clipping hair/application of barrier creams
  • tail bandaging
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10
Q

What is Hypostatic Pneumonia?

A

Where lack of movement results in pooling of blood within the lungs
This causes fluid to accumulate in the tissues, atelectasis, decreased oxygenation, and increasing risk of infection

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11
Q

What are signs of hypostatic pneumonia?

A
  • rapid, shallow breathing
  • dyspnoea
  • moist breath sounds
  • coughing
  • depression
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12
Q

Treating hypostatic pneumonia?

A
  • turn patients every 4 hours (3 - 6 hours)
  • encourage supported sitting
  • physiotherapy (massage, active exercise)
  • refer to vet for pain management plan
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13
Q

What is Hypothermia?

A
  • when the core body temperature is less than 37*
  • seen in neonates, geriatrics, small patients, slim breeds, recumbent/low mobility, after anaesthetic or sedation
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14
Q

How can Hypothermia be treated?

A
  • blankets, vet beds, socks (passive)
  • heat mat, increased room temperature, hot hands (active-external)
  • warmed IV fluids, warm water enema (active-internal)
  • keep animal dry and warm gradually
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15
Q

What can cause Hyperthermia?

A
  • if patient is unable to move away from the heat source causing overheating
  • if room temperature is too high
  • most common in stressed patients
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16
Q

What are Decubitus Ulcers and where are they seen?

A
  • ‘bed sores’
  • spine of scapula, elbow, sternum, pelvic pin bones, stifle
17
Q

How can decubitus ulcers be prevented?

A
  • soft bedding
  • dry bedding
  • regular turning
  • padding bony prominences
  • physiotherapy or assisted walking
  • monitor skin circulation
18
Q

How to treat decubitus ulcers?

A
  • apply water soluble jelly to ulcer, clip hair then wash out
  • dry and apply dressing, foam ring and bandage
  • monitor and change dressings regularly
19
Q

What is physiotherapy?

A

The treatment of disease or injury by physical means

20
Q

What are the aims of physiotherapy?

A
  • reduction of pain
  • promote healing
  • improvement of mobility
  • return to pre-injury strength and flexibility
  • prevention of recurrence of injury
  • cardiovascular fitness and respiratory function
21
Q

What conditions can use physio?

A
  • musculoskeletal injury or disease
  • pain
  • respiratory disease
  • neurological conditions
22
Q

What are the 4 physiotherapy techniques?

A
  • massage
  • passive movements
  • therapeutic exercise
  • hot & cold therapies
23
Q

Why is a massage technique used?

A
  • mobilisation of skin
  • management of scar tissue
  • loosening secretions
  • drainage of venous blood
  • pain control
  • reduction of tension/anxiety
  • improved relaxation
24
Q

Why may massage be unsuitable for use?

A

Not used where there is acute inflammation, pyrexia, unstable fractures, open wounds, or infectious skin diseases

25
Q

Massage Techniques - effleurage

A

Hands passed up limb alternately stroking in smooth movements towards the body

Encourages venous return

26
Q

Massage Techniques - petrissage

A

Pressure on muscles and sub-cut tissues, hands move in circular motion proximal up limb/trunk

Encourages blood flow/re muscle spasms

27
Q

Massage Techniques - frictions

A

Using thumbs to make circular movements, towards heart

28
Q

Massage Technique - coupage

A

Cupped hands clapping against chest, from diaphragm towards head

Encourages loosening secretions

29
Q

What are passive movements?

A

Range of movement exercises are carried out to reduce the effect to immobilised joints, or to increase the suppleness of affected joints

30
Q

How is passive movement massage carried out?

A

Supporting above and below the joint, gently flex and then extend the hip

31
Q

What are therapeutic exercises?

A

A system of programmed exercise used to rehabilitate patients

32
Q

Describe the different types of therapeutic exercises?

A

Active - passive movements

Active-assisted - supported standing and walking

Free Active - walking, flat to slopes and obstacles

Resisted - weight to increase strength or hydrotherapy

33
Q

What are hot therapies and why are they used?

A
  • heat applied using heat packs, baths and laser therapy
  • assists in pain reduction, blood pressure reduction, increase of circulation, and tissue elasticity
34
Q

What are cold therapies and why are they used?

A
  • cold using ice or cold packs
  • reduces pain, causes vasoconstriction, and reduces inflammation
35
Q

What is hydrotherapy?

A

Any healing in water

Is controlled exercise

36
Q

What are the benefits of hydrotherapy?

A
  • relieves pain
  • reduced swelling and stiffness
  • circulatory benefits
  • muscle strength
  • joint mobilisation
  • increased mental stimulation
37
Q

What conditions are suitable for hydrotherapy?

A
  • pre and post orthopaedic and spinal surgery
  • orthopaedic conditions
  • neurological conditions
  • muscle atrophy
  • obesity management
  • behavioural issues (relieves energy)
38
Q

What conditions are not suitable for hydrotherapy?

A
  • sickness
  • diarrhoea
  • infections
  • aural haematoma
  • external fixators
  • unstable fractures
  • fleas and parasites
  • severely obese
39
Q

What are water treadmills?

A

Low water levels are harder for patients to manoeuvre as it provides less balance