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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