Soiled patient + Supporting patient elimination Flashcards
Describe a wire coat, on the dog
- Wire-like feel
- Top coat is harsh
- Thick, softer undercoat
- Coarse
(To keep in mind how to nurse them, by caring for their coat)
What breeds might have a wire coat?
- Border Terriers
- WHWT
- Wire-haired Dacshund
Describe a smooth coat, on the dog
- Smooth feel
- Short length
- Close to body
(To keep in mind how to nurse them, by caring for their coat)
What breeds might have a wire coat?
- Doberman Pinschers
- Boxers
- Staffordshire Bull Terrier
Pinschers = The Pinscher is a group of German dog breeds, developed originally as ratters on farms or as guard dogs. In the twenty-first century they are commonly kept as companion animals.
Describe a silky coat, on the dog
- Silky feel
- Varies in length
- Medium > Long
- Fine texture
(To keep in mind how to nurse them, by caring for their coat)
What breeds might have a silky coat?
- Afghan Hound
- Setters
- Most Spaniels
- Yorkshire Terriers
- Terriers
Setters = A setter silently searches for game by scent; hunting is done systematically and methodically. When prey is encountered, the dog becomes motionless rather than chasing after the game. Setters get their name from their distinctive stance; a sort of crouch or “set” upon finding their quarry.
Describe a double coat, on the dog
- Long top-coat (guard hairs)
- Thick, dense but soft under-coat
(To keep in mind how to nurse them, by caring for their coat)
What breeds might have a double coat?
- GSDs
- Old English Sheepdog (OES)
- Lhasa Apso
- Rough Collies
- Spitz breeds (Pomeranians, Chow Chows, Siberian Huskies)
Spitz = Any of a group of northern dogs, characterized by dense, long coats, erect pointed ears, and tails that curve over their back
Other Spitz breeds are:
* Samoyed
* Finnish Spitz
* Shiba Inu
* Samoyed
* Alaskan Malamute
* American Eskimo Dog
* Keeshond
* Icelandic Sheepdog
* Finnish Lapphund
* Norwegian Elkhound
* Japanese Spitz
* Norwegian Lundehund
* Akita Inu
* Basenji
What’s’ the difference between a Setter and a Pinscher?
Setter
* Sporting breed
* Used for pointing + hunting game birds
* Medium length coat
* Medium size
* Higher energy requirements than Pinscher
Pinscher
* Working breed
* Used for ratting + guard dogs
* Short length coat
* Larger size
* Lower energy requirements than Setter
Describe a wool coat, on the dog
- Curly coated
- Wool-like texture (Wooly)
- Dense
- Frizzy
(To keep in mind how to nurse them, by caring for their coat)
What breeds might have a wool coat?
- Poodles
- Bichon Frise
- Bedlington Terrier
What 4 things do you need to assess when considering the care for a dog’s coat?
- Coat type (Short or Long)
- Normal grooming routine
- Normal skin appearance
- Condition/Procedure/Treatment that may cause soiling
When reducing the risk of the patient’s coat from being soiled, what can you do to protect the patient’s skin + fur?
- Regular opportunities to allow elimination
- Protect the tail - bandaging etc
- Appropriate type of cat litter - for cats
- Absorbent bedding
- Regular checking to remove soiling from patient + kennel
- Regular removal of excess saliva + mucus
- Bed baths
- Consider an Indwelling catheter for urinary or fecal matter
- Regular monitoring of any wounds
When the patient’s coat is soiled, what can you do to prevent and further protect the patient’s skin + fur?
- Protect the tail - bandaging etc
- Absorbent bedding
- More regular cleaning of soiled areas, including bed baths
- Keep skin + fur dry
- Regular checking to remove soiling from patient + kennel
- Regular removal of excess saliva + mucus
- Indwelling catheter for urinary or fecal matter
- Regular monitoring of any wounds
How should you clean a soiled patient?
In basic terms, from start > finish
No matter what, always clean the patient ASAP
1. Wash hands + apply PPE
2. Remove excess soiling w/paper towel
3. Dispose of excess waste appropriately
4. Ensure water of bath or shower is warm (not too hot, not too cold)
5. Rinse thoroughly
6. Dry thoroughly
7. Remove matts w/appropriate brush
8. Check for scalding + sores
(May require bathing pre + post procedures)
If the patient repeatedly soils itself:
1. Clip fur
2. Dry fur
3. Apply barrier creaam (Often vaseline - make sure appropriate) cream chosen)
Name 3 types of shampoo that can be used in practice
- Virbac EPI-Soothe
(Colloidal oatmeal Glycerin) - Coatex medicated Shampoo for Dogs
- HiBiScrub Antimicrobial Skin Cleanser
(Chlorhexidine Gluconatee 4%)
Name 8 potential considerations that need to be taken into account when bed bathing or showering patients
- Allergies
- Existing skin conditions
- Tolerance/Behaviour/Temperament
- Wounds + dressings
- Intravenous catheters
- Indwelling drains or catheters
- Aural infections
- Infectious diseases
Name 3 methods of drying a patient
- Blow-drying (often using hair dryers)
= Common in groomers + hydrotherapy centres
= Rarely used in practice
= Hair-dryers, most commonly used in practice - Towel drying
= Simple
= Inexpensive
= Less likely to cause fear or stress in patients
= Use a shammy cloth to help eliminate moisture before using a towel - Talc power
= Great for damp patients
Name the method of drying which carry higher risks of causing thermal burns, if not used correctly
Blow-drying/Hair dryers
What method of drying would contraindicated if the patient has a skin disease or wounds?
Both:
* Blow-drying
= As can cause further damage to vulnerabale skin, using heat + could cause burns
* Talc powder
= Can delay wound healing + cause skin infections
Name the 5 main areas of patient hygiene that hospitilised patients require to be maintained, by nurses
- Oral care
- Aural care
- Ocular care
- Grooming
- Nail clipping
(Focusing mainly on cats + dogs)
Name ways of maintaining a patient’s oral care
- Regular tooth brushing w/toothbrush or finger brush
- Providing Antos tooth brush chews (Dogs)
- Dried kibbled diet
- Appropriate species chewing materials (remove tartar)
- Using damp swabs to remove sticky secretions + provide comfort
- Providing an Oral rinse
Name ways of maintaining a patient’s aural care
- Montoring ear health/cleanliness
- Check for:
= Irritation
= Odour
= Self trauma
= Excessive wax
= Dirt - If the patient tolerates it + is clinically indicated (breed specific) gently remove any wax or dirt
- Always use caution with ear cleaners
Name ways of maintaining a patient’s ocular care
- Remove any discharge or secretions w/ damp swabs
- If infection is present = always clean un-infected eye 1st
- Use fresh swabs per wipe
- Use PPE
- Never share eye drops between patients
- Always provide eye lube for patients who:
= Requiring Oxygen
= In a dry or hot enviornment
= When a fan is being used
What are 7 common types of grooming equipment that can be used in the VP
- Soft-bristled brush
- Pin brush
- Slicker brush
- Comb
- Rubber brush/Hound glove
- Clippers
- Nail clippers
When should you use a soft-bristled brush?
For removing dried material from a topcoat
When should you use a pin brush?
For removing dead hair from thick coats
When should you use a slicker brush?
For removing loose hair in all coat types - except smooth
When should you use a comb?
For removing matts from smooth coats
When should you use a rubber brush/hound glove?
For removing loose hair from smooth coats
When should you use clippers?
To shave (remove) hair + matts
When should you use nail clippers?
To cut nails to an appropriate length
Should you cut above or below the quick?
Below
What colour is the quick in the majority of animals or dogs?
+
What colour nail is the hardest to define the quick?
- Usually the quick is = Pink
- Harder to define in = Black
Name potential reasons to why a patient may require nursing support in elimination
- Recumbency
- Concurrent medical problems
- Drug side-effects
- Monitoring flud input + output
- Samples for diagnostic tests (If cystocentesis is not clinically possible)
- Pre + post procedure
- Post surgery - some surgical cases require post-op catheterisation for prolonged periods
- Admin of drugs
Name 3 side affects of drugs that can affect fluid inputs + outputs
- Diarrhoea
- Polydipsia
- Polyuria
What causes diarrhoea?
Inflammation of the colon
What drug that is commonly used for heart conditions, such as congestive heart faliure, lung fluid retention or kidney disease, cause polyuria?
Furosemide
How can you measure out fluid ins + outs?
Ins
* Measure out water given
* Measure IVFT provided
Outs
* Weigh or measure water bowl once removed from the kennel
* Weight the soiled vetbed
Typically, how much water content is within a wet food diet?
80%
Is it normal for cats to drink less?
Yes
What is a method of administering anti-epileptic drugs, such as Diazepam?
Rectally
Why is it common to give Diazepam rectally to epileptic patients?
- Its safer, quicker + non-invasive for person administering
- Prevents triggering further seizures
What will regular enemas prevent, post-surgery of the abdominal + urogenital tract?
Post-op infections
Anal glands may require:
* Removal
* Flushed
* Investigation to check for perianal adenoma (not cancerous)
Name as many questions as possible that an RVN may ask a client, for their patient
- What are their usual routine?
- Normal diet?
- How often do they pass faeces p/day?
- Do they have any issues or abdominalties with their faeces?
- Where do they usually toilet?
- What do they toilet on? (Grass, concrete)
- What commands do they use?
- Do they go to the toilet on or off their lead?
- Have they got any on-going medical issues, related to elimination?
- What litter do they use?
- Are they litter trained? (Rabbits etc)
- Indoor or outdoor cats?
- Do they have any issues w/ ongoing regurgitation?
Why are commands so important when it comes to patient elimination, when within the VP?
Because some patients will refuse or hold in their urine or faeces as they are not used to or are not comfortable eliminating on a particular surface
What type of dogs are particularly sensitive to commands?
Assistant dogs!
As they are trained to eliminate on command and will not, without permission.
What happens if a cat is either too stressed to eliminate at the VP?
May have to discharge them, to eliminate at home, to prevent FUO
A cat is refusing to eliminate despite many nursing interventions.
What is a nursing intervention which may be required to use on felines, before discharging them home, in order to eliminate?
Temporary urinary catheter
Remember - they are contraindications!
What substrate can you use to replace litter if a cat or other species develops or has litter aversion?
Soil
(Filter, clean + make it safe 1st, obv)
In what circumstance would using the substrate of soil be applicable, for cats?
Outdoor cats may prefer soil over commerical litter as they are not used to soiling inside the house or litter tray, especially if stray
When assessing faeces, what must you determine?
Whether it is diarrhoea + constipation
When assessing urine, what must you determine?
Whether it is:
* Polyuria
* Incontienence
* Oliguria
* Anuria
* Blockage
- Oliguria = less than normal urine output
- Anuria = Absence of urine output
What 3 potential clinical signs will be found with diarrhoea?
- Mucus consistency in stools
- Blood in stools
- Ineffective straining
What 2 potential clinical signs will be found with constipation?
- Mucus or jelly-like consistency
- Straining
With constipation, what happens to the colon?
Faces are impacted within the colon
When physically palpating a patient, what can indicate the patient is may be suffering from constipation?
The colon will feel full when palpated
What is the name given to the state when a patient’s urinary tract is blocked + not producing any urine?
Anuria
What 4 essential things should you look for when assessing the patient’s urine, when they have polyuria?
- Colour
- Volume
- Consistency
- Dilution
What common condition do cats often present with the following symptoms:
- Stops using the litter tray
- Urinates in the bath or shower
Stres cystitis
If a patient is suffering from incontinence, will they cease all production of urine completely, or may they still drip urine?
They may still drip urine, if they were not producing urine, they would be presenting with anuria
Why is it more important to be aware of urine issues with cats?
- They are very secretive, especially when toileting
- Will hide symptoms of pain etc
Do female and/or male cats spray?
Both!
Just males are more known for it, especially toms.
What can client’s often mistake incontinence for in cats?
Spray or marking their territory
What 4 infectious diseases can cause diarrhoea?
- Parvo Virus
- Lishmaniasis
- Giardia
- Gastroenteritis
What should you do if a patient presents with infectious diarrhoea?
- Isolate the patient in isolation
- Remove soiled matter into clincial waste
- Great hygiene + disinfection of all areas
- Barrier nurse
What 4 main patient’s are most susceptible to the parvo virus?
- Young/neonatal
- Geriatric
- Immunocompromised
- Unvaccinated
What are 2 characteristic signs of parvo virus that can be seen in the infected patient’s faeces?
- Melena
- Metallic (blood) + sickly-sweet scent (bacteria)
- Hematochezia = passage of fresh blood in the anus or within the stools
- Melena = passage of black, tarry stools, blood-stained causes black colour
What 2 types of parasites can cause Giardia?
- Endoparasites
- Protozoans
What is Leishmaniasis?
A zoonotic protozoal parasite, transmitted by small biting sand-flies.
Presents w/ enlarged lymph nodes + spleen, letharfgy, epitasis, skin problems around head + pressure points etc.