Nursing Care for Recumbent Patients

A patient unable to stand.

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

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

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

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

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

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

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

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

Actions taken to stop pressure sores from developing.

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

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

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

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

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

Managing pain effectively while avoiding oversedation.

To prevent constipation in a recumbent patient.

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

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

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

Maintaining patency and cleanliness of catheters to prevent infections.

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.

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.

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

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

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

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.

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.

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.

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.

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

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

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

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

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).

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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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.

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.

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

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

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

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

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.

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

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

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

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

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

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