Nursing Care for Recumbent Patients
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Questions and Answers

What is the main goal of bowel care for patients?

  • Increase fluid intake
  • Prevent constipation (correct)
  • Promote weight gain
  • Reduce appetite

Which method is recommended for ensuring catheter lines remain functional?

  • Leave catheter lines exposed to air
  • Keep catheter lines wrapped tightly
  • Regularly switch out catheter lines
  • Flush for patency as needed (correct)

What should be used on skin areas to prevent moisture-related issues?

  • Baby oil
  • Barrier cream (zinc oxide, Vaseline) (correct)
  • Water-based gel
  • Perfumed lotion

What is one benefit of performing Passive Range-of-Motion (PROM) exercises?

<p>Stimulates muscle contracture and decreases wasting (D)</p> Signup and view all the answers

When wrapping tails, which layer should be applied directly onto the skin for moisture wicking?

<p>Cotton fabric (A)</p> Signup and view all the answers

What defines a recumbent patient?

<p>A patient who cannot stand (A)</p> Signup and view all the answers

Which of the following is NOT a common predisposition for a recumbent patient?

<p>Increased physical activity (C)</p> Signup and view all the answers

What is a key nursing concern for recumbent patients regarding their bedding?

<p>It should reduce risk of decubitus ulcers (D)</p> Signup and view all the answers

Which complication is associated with recumbent patients?

<p>Pressure sores (B)</p> Signup and view all the answers

What is the primary cause of decubital ulcers?

<p>Continuous pressure on bony prominences (B)</p> Signup and view all the answers

Which of the following is NOT a recommended method for preventing pressure sores?

<p>Limiting patient hygiene to avoid discomfort (B)</p> Signup and view all the answers

Which practice helps in the prevention of infections in recumbent patients?

<p>Using clean techniques for all procedures (D)</p> Signup and view all the answers

How can nursing care address bladder and bowel elimination for recumbent patients?

<p>Maintaining regular monitoring and care (C)</p> Signup and view all the answers

Which treatment is suggested for small ulcers?

<p>Astringents like zinc oxide (A)</p> Signup and view all the answers

For optimal pain management in recumbent patients, what should be avoided?

<p>Giving overly sedating medications (B)</p> Signup and view all the answers

What is the role of passive range of motion (PROM) in caring for recumbent patients?

<p>To prevent muscle stiffness and maintain mobility (C)</p> Signup and view all the answers

What nursing consideration involves providing appropriate sized spaces and reducing noise for recumbent patients?

<p>Bedding and comfort (B)</p> Signup and view all the answers

What is the goal of good hygiene in preventing infections related to pressure sores?

<p>Minimize organic debris (B)</p> Signup and view all the answers

What is the main purpose of cold therapy in physiotherapy?

<p>Decrease pain and inflammation (D)</p> Signup and view all the answers

Which of these is a sign that IV catheter care is needed?

<p>Increasing peripheral edema (B)</p> Signup and view all the answers

What is the preferred method of nutrition for improving GI motility in recumbent patients?

<p>Increased activity and enteral feeding (A)</p> Signup and view all the answers

When is it most appropriate to use heat therapy post-injury?

<p>48 – 72 hours after the injury (B)</p> Signup and view all the answers

What is a common complication for recumbent patients?

<p>Pressure sore ulcers (B)</p> Signup and view all the answers

What type of bandage should be used for protecting pressure points?

<p>Donut bandages (A)</p> Signup and view all the answers

How frequently should a heat source be applied for effective therapy?

<p>q6–12 hours (A)</p> Signup and view all the answers

What is the correct action for passive range of motion exercises?

<p>Beneficial in various conditions (B)</p> Signup and view all the answers

What should the skin temperature be monitored for during heat therapy?

<p>To prevent burns and discomfort (D)</p> Signup and view all the answers

How often should the ET tube be changed for a patient on mechanical ventilation?

<p>Every 24 hours (A)</p> Signup and view all the answers

What is the primary mechanism by which cold therapy reduces swelling?

<p>Vasoconstriction (C)</p> Signup and view all the answers

What is the recommended frequency for lubricating the eyes of a recumbent patient?

<p>Every 4-6 hours (C)</p> Signup and view all the answers

What should be done to prevent atelectasis in a recumbent patient?

<p>Change patient positions every 2-4 hours (A)</p> Signup and view all the answers

Which of the following is true regarding oral care for a recumbent patient?

<p>Moistened lips, tongue, and gingiva can help prevent ulcers. (A)</p> Signup and view all the answers

What is a major risk associated with bladder care in completely recumbent patients?

<p>Urinary obstruction (D)</p> Signup and view all the answers

What should be done with the endotrachial (ET) tube to ensure proper care?

<p>Change the ET tube daily for sterile ventilation. (B)</p> Signup and view all the answers

How can you decrease the risk of aspiration pneumonia in recumbent patients?

<p>Clean the oropharynx regularly. (D)</p> Signup and view all the answers

What is a key aspect of caring for a recumbent patient's bladder?

<p>Monitor bladder size routinely. (D)</p> Signup and view all the answers

What should be used to clean the prepuce and vulva in recumbent patients?

<p>Dilute chlorhexidine three times daily (B)</p> Signup and view all the answers

What is a primary benefit of using Passive Range-of-Motion (PROM) techniques for recumbent patients?

<p>Reduces muscle wasting (A)</p> Signup and view all the answers

Which of these actions is crucial for preventing scalding when caring for a patient's tail?

<p>Using moisture wicking cotton before wrapping (B)</p> Signup and view all the answers

In bowel care for recumbent patients, which stool softener is commonly recommended?

<p>PEG 3350 (B)</p> Signup and view all the answers

Which purpose does applying barrier cream, such as zinc oxide or Vaseline, serve in patient care?

<p>To prevent moisture-related skin damage (C)</p> Signup and view all the answers

What is an important consideration when managing catheter lines for recumbent patients?

<p>Ensure no kinks and maintain patency (A)</p> Signup and view all the answers

What is one of the key nursing concerns related to nutrition for a recumbent patient?

<p>Prevent aspiration during feeding (B)</p> Signup and view all the answers

Which of the following complications is not commonly associated with recumbent patients?

<p>Hypoglycemia (D)</p> Signup and view all the answers

What aspect of bedding and comfort is important for preventing complications in a recumbent patient?

<p>Using soft, padded surfaces to reduce pressure (C)</p> Signup and view all the answers

How can a veterinary nurse contribute to the prevention of infections in recumbent patients?

<p>By ensuring cleanliness of fluid and catheter lines (C)</p> Signup and view all the answers

What nursing intervention can help reduce the risk of impaired ventilation and perfusion in a recumbent patient?

<p>Encouraging frequent turning and repositioning (D)</p> Signup and view all the answers

Which position should be carefully managed to avoid complications such as pressure sores in a recumbent patient?

<p>Securing with appropriate padding (D)</p> Signup and view all the answers

What is a recommended practice for ocular care in recumbent patients?

<p>Applying lubricants regularly to prevent drying (A)</p> Signup and view all the answers

What is a primary purpose of cold therapy in physiotherapy?

<p>Reduce pain and inflammation (A)</p> Signup and view all the answers

What is a common reason for impaired gut motility in recumbent patients?

<p>Lack of movement and activity (B)</p> Signup and view all the answers

Which condition is NOT an indication for using heat therapy?

<p>Acute swelling phase (B)</p> Signup and view all the answers

In which time frame should cold therapy ideally be applied to an acute injury?

<p>Immediately after injury (C)</p> Signup and view all the answers

Which of the following is a complication associated with improper application of cold therapy?

<p>Temperature burns (A)</p> Signup and view all the answers

What is a key consideration for monitoring during heat therapy application?

<p>Skin temperature (C)</p> Signup and view all the answers

What type of therapy is appropriate for managing a muscle strain 48-72 hours after injury?

<p>Heat therapy (B)</p> Signup and view all the answers

Which statement about passive range of motion exercises is accurate?

<p>They can benefit all patients, including those with neurological conditions. (A)</p> Signup and view all the answers

What is the typical recommendation for frequency of monitoring a recumbent patient for potential complications?

<p>Every 4 hours (B)</p> Signup and view all the answers

What is a critical factor in the prevention of decubital ulcers?

<p>Frequent patient turning and repositioning (B)</p> Signup and view all the answers

What should be prioritized to prevent infection in relation to pressure sores?

<p>Emphasizing good hygiene practices (B)</p> Signup and view all the answers

Which of the following is commonly used to treat small ulcers?

<p>Calamine lotion (A)</p> Signup and view all the answers

What is the main goal of pain medication for recumbent patients?

<p>To maintain comfort without excessive sedation (A)</p> Signup and view all the answers

What option is essential for managing large ulcers effectively?

<p>Surgical treatment (B)</p> Signup and view all the answers

What is one method to evaluate catheter care in a recumbent patient?

<p>Palpate and visualize the skin and insertion site (D)</p> Signup and view all the answers

Which of the following practices helps increase GI motility in recumbent patients?

<p>Increasing patient activity levels (A)</p> Signup and view all the answers

Which condition is associated with a recumbent patient's inability to respond to vascular volume changes?

<p>Ineffective blood circulation (A)</p> Signup and view all the answers

What is the recommended interval for repositioning a recumbent patient?

<p>Every 2-4 hours (C)</p> Signup and view all the answers

Which method is recommended for cleaning the oral cavity of a recumbent patient?

<p>Wiping with water or chlorhexidine and gauze (C)</p> Signup and view all the answers

What type of catheter system should be used for a completely recumbent patient?

<p>Closed collection system (C)</p> Signup and view all the answers

What is a key risk associated with bladder management for recumbent patients?

<p>Urinary obstruction (B)</p> Signup and view all the answers

How often should the eyes of a recumbent patient be lubricated?

<p>Every 4-6 hours (D)</p> Signup and view all the answers

What is the purpose of performing a fluorescein dye test on a recumbent patient?

<p>To detect corneal ulcers (D)</p> Signup and view all the answers

What should be done to the ET tube in ventilated recumbent patients to prevent complications?

<p>Deflate the cuff regularly (C)</p> Signup and view all the answers

What is the primary benefit of moistening the lips and tongue of a recumbent patient?

<p>To prevent oral ulcers (D)</p> Signup and view all the answers

Flashcards

Recumbent Patient

A patient unable to stand.

Recumbent Patient Complications

Potential problems for recumbent patients including impaired breathing, dehydration, pressure sores, and infections

Impaired Ventilation/Perfusion

Problems with the flow of air into and out of the lungs and flow of blood.

Decubital Ulcers

Pressure sores that develop on the skin due to prolonged pressure on a bed.

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Nursing Concerns (Recumbent Patient)

Important care points for a recumbent patient include bedding, pain management, IV care, nutrition, ocular health, positioning, elimination, mouth care, therapy, and heat/cold.

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Bedding & Comfort (Recumbent)

Prevention of reduced circulation, decubitus ulcers, nerve damage via proper padding and a good resting surface.

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Fluid & Catheter Care

Keeping fluid lines and catheters clean to minimize infection risk for a recumbent patient.

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Nutrition & Elimination

Ensuring the patient's nutritional needs are met, and addressing potential bladder/bowel problems in a recumbent pet.

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Pressure sores (decubitus ulcers)

Skin damage caused by prolonged pressure on the skin, often over bony areas.

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Prevention of pressure sores

Actions taken to stop pressure sores from developing.

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Appropriate bedding (pressure sores)

Using padded blankets, pillows, or specialized supports to reduce pressure on vulnerable areas.

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Patient turning/repositioning

Regularly shifting a patient's position to relieve pressure on different body parts.

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Hygiene goals (pressure sores)

Maintaining cleanliness to prevent infection and encourage healing of pressure sores; managing organic debris

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Treatment of small pressure sores

Using topical astringents, antiseptics, and potentially antibiotics and pain medications.

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Treatment of large pressure sores

Often requiring surgical intervention in addition to other treatments like topical medications.

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Pain management (recumbent patients)

Managing pain effectively while avoiding oversedation.

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Bowel Care Goal

To prevent constipation in a recumbent patient.

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Preventing Scalding

Protecting the skin of a recumbent patient from moisture damage, especially in tail areas.

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PROM Techniques

Passive range of motion exercises to maintain mobility and prevent complications in a recumbent patient.

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PROM Benefits

Improves circulation, prevents muscle wasting, decreases edema, relaxes the patient, and strengthens the human-animal bond.

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Catheter Care

Maintaining patency and cleanliness of catheters to prevent infections.

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Lubricating Recumbent Eyes

Keeping the eyes of a recumbent patient moist to prevent corneal ulcers. This is done with eye ointments or solutions applied every 4-6 hours.

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Corneal Ulcer Risk

Recumbent patients are at an increased risk of corneal ulcers because their eyelids cannot blink normally to spread tears across the eye surface, leading to dryness and potential damage.

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Fluorescein Dye Test

A test used to diagnose a corneal ulcer by staining the eye with fluorescent dye. The dye highlights any imperfections on the cornea.

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Recumbent Patient Positioning

Changing the position of a recumbent patient every 2-4 hours to prevent pressure ulcers, improve lung volume, and reduce hypoxia.

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Positioning Benefits

Regularly changing a recumbent animal's position improves ventilation and perfusion by expanding lung capacity, minimizing atelectasis (collapsed lung), and reducing breathing effort.

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Mouth Care for Recumbent Patients

Keeping the mouth moist to prevent ulcers and aspiration pneumonia. This includes wiping the lips, tongue, and gums with water or chlorhexidine and cleaning the oropharynx.

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Ventilated Patient Mouth Care

Maintaining a clean airway for a ventilated patient involves humidifying the air, suctioning the airway, adjusting the tube location, and changing the endotracheal tube regularly.

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Coupage for Ventilated Patients

A technique used to mobilize lung secretions in ventilated patients. Gentle percussion of the chest wall helps to loosen mucus, making it easier to cough up.

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Cold Therapy Indication: Acute Injury

Cold therapy is used to decrease pain, inflammation, and discomfort in the first 24-48 hours of an acute injury. This is particularly helpful during the acute swelling phase.

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Cold Therapy Mechanism

Cold therapy works by decreasing tissue temperature and inflammation, reducing pain perception and muscle spasms. Vasoconstriction, the narrowing of blood vessels, reduces edema (swelling).

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Cold Therapy Duration

Cold therapy should be applied for 5-10 minutes at a time. Applying cold for longer than 30 minutes can actually cause edema.

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Heat Therapy Indication: Muscle Sprains/Strains

Heat therapy is used to relieve pain and promote muscle relaxation 48-72 hours after an injury, after the acute swelling phase has subsided.

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Heat Therapy Mechanism

Heat therapy works via localized vasodilation, expanding blood vessels and improving circulation. It can be used to reduce pain and relax muscles.

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Recumbent Patient Risks

Recumbent patients (unable to stand) are at risk for a variety of complications, including pressure sore ulcers, oral ulcers, corneal ulcers, and atelectasis (lung collapse).

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Passive ROM Importance

Passive Range of Motion (ROM) exercises are important not just for musculoskeletal rehabilitation, but also for preventing complications in recumbent patients, promoting blood flow, and maintaining joint mobility.

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ET Tube Change Frequency

A patient on mechanical ventilation should have their ET (endotracheal) tube changed every 24 hours to minimize infection risk and maintain airway patency.

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What is a recumbent patient?

A patient who is unable to stand and remains lying down.

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What are the main risks for recumbent patients?

They are at risk for things like pressure sores, aspiration pneumonia, infections, and reduced mobility.

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How can we prevent pressure sores?

By frequently repositioning the patient, using padded bedding, and keeping the skin clean and dry.

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Why is mouth care important?

To prevent ulcers, keep the airway clear, and reduce the risk of aspiration pneumonia.

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What is PROM and why is it useful?

Passive range of motion exercises, which helps maintain joint flexibility and prevent muscle atrophy.

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What are some signs of a recumbent patient's distress?

Difficulty breathing, vomiting, changes in defecation, and signs of pain.

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How often should we reposition a recumbent patient?

Ideally every 2-4 hours to prevent pressure sores and improve circulation.

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What is the role of veterinary nurses for recumbent patients?

Veterinary nurses provide hands-on care, monitor their condition, and implement treatment plans to ensure their well-being.

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Preventing Decubital Ulcers

Taking steps to prevent pressure sores by minimizing pressure on vulnerable areas. This includes appropriate bedding, frequent repositioning, and good hygiene.

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Hygiene for Decubital Ulcer Prevention

Maintaining cleanliness to prevent infection and encourage healing of pressure sores. This includes handwashing, clean bedding, and regular cleaning of the affected area.

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Treatment for Small Decubital Ulcers

Typically involves topical treatments like astringents, antiseptics, and potentially antibiotics. Pain medications may be used to manage discomfort.

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Treatment for Large Decubital Ulcers

Often requires surgical intervention to promote healing and address extensive tissue damage. Topical medications are also commonly used.

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Pain Management for Recumbent Patients

Providing pain relief to keep the patient comfortable without excessive sedation. This is crucial for maintaining mobility and overall well-being.

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IV Hydration for Recumbent Patients

Assessing hydration levels and ensuring adequate fluid intake through intravenous therapy. Monitoring for signs of dehydration and complications like phlebitis.

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Nutrition for Recumbent Patients

Providing adequate nutrition to support healing and strength. This can be achieved through enteral or parenteral feeding depending on the patient's needs.

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Urine Characteristics

Evaluating urine color, specific gravity, and any sediment (particles) can provide valuable clues about a patient's health, including dehydration, infection, or organ function.

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Scalding Prevention

Scalding is a serious risk for recumbent patients, especially in the tail area. Keeping the fur/skin dry, using absorbent bedding, and applying barrier cream can help prevent moisture damage.

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Passive Range of Motion (PROM)

PROM exercises involve gently moving the patient's joints through their full range of motion. This helps maintain mobility, prevent contractures, stimulate muscles, reduce edema, and promote relaxation.

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Eye Care for Recumbent Patients

Frequent lubrication with eye ointments or solutions is crucial to prevent dry eyes and corneal ulcers due to lack of blinking.

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Bladder Care for Recumbent Patients

Monitoring bladder size and preventing scalding is important to avoid urinary issues and infections.

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Coupage

Gentle chest percussion that helps mobilize lung secretions in ventilated patients, making it easier to cough up mucus.

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Risks for Recumbent Patients

These patients face a multitude of complications such as pressure sores, aspiration pneumonia, infections, and reduced mobility.

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Cold Therapy: When to Use?

Cold therapy is used to decrease swelling and pain in the first 24-48 hours after an acute injury, especially during the initial 'swelling' phase.

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Cold Therapy: How it Works?

Cold constricts blood vessels, reducing inflammation and pain. It also decreases muscle spasms.

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Heat Therapy: When to Use?

Heat therapy is used to relieve pain and relax muscles 48-72 hours after an injury, once the swelling has gone down.

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Heat Therapy: How it Works?

Heat dilates blood vessels, increasing circulation and reducing pain. It also relaxes muscles.

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Recumbent Patient: What is it?

A recumbent patient is one who is unable to stand and remains lying down.

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Recumbent Patient: Main Risks?

They are at risk for pressure sores, aspiration pneumonia, infections, and reduced mobility.

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Preventing Pressure Sores: How?

Frequent repositioning, padded bedding, and keeping the skin clean and dry help prevent pressure sores in recumbent patients.

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Study Notes

Recumbent Patient Nursing Considerations

  • A recumbent patient is unable to stand
  • Recumbent patients can be any age, and have various conditions (e.g., geriatric, respiratory, trauma, musculoskeletal, metabolic diseases, toxicities, neurological, coma)
  • The length of time a patient remains recumbent varies depending on the condition.

Predispositions and Complications

  • Recumbent patients (aka cage rest complications) are prone to impaired ventilation and perfusion, desaturation (low oxygen levels), vomiting/regurgitation, aspiration pneumonia, and reduced gut motility.
  • Pressure sores (decubital ulcers) frequently occur due to continuous pressure over bony prominences. This leads to necrosis of tissue. Organic debris further increases infection risk.

Nursing Concerns

  • Bedding and comfort: Reduce risk of decreased circulation, blood flow problems (edema), decubital ulcers, and muscle/nerve damage by using appropriate padding, space, and reducing noise. Provide bedding that allows the patient to watch videos if possible. Daily light cycles and TLC can also help provide comfort to the patients.

  • Pain medications/Anesthesia: Keep patients comfortable without over-sedation. Pain control is vital for function. Often needed even if the cause of hospitalization is not painful, since immobility can cause pain from stiffness and pressure sores. Anesthesia may be necessary if mechanical ventilation or extreme pain is needed.

  • IV fluid and catheter care: Palpate and visualize the insertion site regularly to monitor for catheter patency, infection (phlebitis), and bandage wetness. Monitor hydration levels, blood pressure, peripheral edema, and urination. Remove and replace catheters if there is redness, swelling, odor, discomfort, or oozing in the original insertion site.

  • Nutrition: Increase activity to improve GI motility to prevent ileus, stomach acid pooling, regurgitation, aspiration pneumonia. Provide enteral or parenteral nutrition, and position the patient to assist drainage and digestion.

  • Ocular care: Lubricate eyes frequently, using appropriate ointments/lubricants. Assess if eye care is needed every 4-6 hours. Have dedicated tubes for recumbent pets. Flush eye/conjunctival sac, as needed, if there is any eye discomfort. Assess for corneal ulcer risk, as needed.

  • Posture and positioning: Routinely change patient positions every 2-4 hours (or as needed). Positioning aids in ventilation and perfusion by increasing lung volume (placing in sternal recumbency). This helps prevent atelectasis, reduce work of breathing, and decreases hypoxia, especially in obese patients.

  • Mouth/airway care: Keep the tongue inside the mouth, moisturize lips, tongue, and gingiva. Clean oropharynx to reduce aspiration pneumonia risk. If intubated, provide humidification, sterile suctioning, cuff deflation/repositioning, and regular ET tube care. Coughing/nebulizing can help mobilize secretions.

  • Bladder and bowel elimination: Monitor for infections, urine/fecal scalding, urinary obstructions, and constipation. Provide appropriate bedding to prevent scalding. Catheter care for recumbent patients should include closed systems (to reduce infection), and careful expression of the bladder with dilute chlorhexidine solution cleaning.

  • PROM/Physiotherapy: Maintain mobility, prevent soft tissue and joint contractures, stimulate muscle contraction to decrease wasting, and reduce peripheral edema. This can involve passive range of motion exercises.

  • Ice or heat packs: Use cold therapy for the first 24-48 hours after injury during acute swelling. Use heat therapy after the acute swelling phase for muscle strains/sprains to help with relaxation and pain relief.

  • Hygiene Prevent organic debris and infection by ensuring good hygiene (handwashing, bedding cleaning, patient hygiene)

Treatment

  • Small ulcers: Use astringents (calamine lotion, burrow's solution, zinc oxide), antiseptics (povidone-iodine, hydrogen peroxide), and +/- topical/systemic antibiotics, pain medications. Apply donut bandages.

  • Large ulcers: Surgical treatment.

Quizzes

  • Recumbent patients are at risk for pressure sores, oral ulcers, corneal ulcers, and atelectasis. Thorough pain assessment and control is vital to recumbent patient care. Passive range of motion exercises are important for all recumbent patients, regardless of the reason for recumbency. A patient on mechanical ventilation should not have their ET tube changed every 24, 48, or 72 hours.

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Nursing Recumbent Patients PDF

Description

This quiz focuses on essential nursing practices and considerations for caring for recumbent patients. It covers bowel care, skin management, pressure sore prevention, and overall patient comfort. Test your knowledge on the techniques and benefits that ensure the well-being of those unable to move independently.

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