Veterinary Client Education For Post-Operative Patient (VETC 2016) PDF

CLIENT EDUCATION FOR THE POST OPERATIVE PATIENT Lecture 2 VETC 2016 Postoperative Client Education Provide instructions to the owner describing the proper care of a patient after general anesthesia. Provide...

CLIENT EDUCATION FOR THE POST OPERATIVE PATIENT Lecture 2 VETC 2016 Postoperative Client Education Provide instructions to the owner describing the proper care of a patient after general anesthesia. Provide instructions to the owner describing proper care following surgical procedures. Copyright © 2022, Elsevier Inc. All Rights Reserved. 2  Who is responsible to go over the surgical discharge instructions and educate the client about homecare? Copyright © 2022, Elsevier Inc. All Rights Reserved. 3 Copyright © 2022, Elsevier Inc. All Rights Reserved. 4 POST OPERATIVE PATIENT - DISCHARGING  Book an appointment slot (in a private room)  Complete the entire discharge appointment BEFORE bringing the patient into the room  Client education and what the client can expect should start prior to the discharge appointment Post operative patient - discharging appointment slot (in a private room) to provide the client with uninterrupted instructions for post-surgical care. avoid distraction while discussing discharge statement with owner by not bringing the pet to the owners until finished with discharge and invoice. They should be provided with information regarding what to expect for post-operative care during the surgical procedure initial booking. This information should be reiterated during admission for the procedure and be fully understood by the time of discharge. Copyright © 2022, Elsevier Inc. All Rights Reserved. 6 POST OPERATIVE PATIENT – WRITTEN AND ORAL COMMUNICATION  Discharge summary:  Exercise  Feeding  Grooming/bathing  Medications  Checking the surgical site  Questions  Don’t rush, be pleasant, using layman terms and welcome questions Discharge Instructions At-home care Written and oral instructions Open-ended questions Individualize instructions Copyright © 2022, Elsevier Inc. All Rights Reserved. 8 POST OPERATIVE PATIENT – BRING IN THE PATIENT  Inspect the site with the owner  Show them what is normal and what to look for  Following up with the client the very next morning/day is essential. POST OPERATIVE PATIENT – FOLLOW UP  Recheck/suture removal appointment booked  Following up with the client the very next morning/day is essential  This allows the client to express their concerns and gives the technician an understanding of the patient’s recovery process at home.  General Post anesthesia Instructions Instruction sheet for at least first 24 hours  Confinement  Feeding  Meds  Adverse reactions  Hospital or emergency contact  Others specific to patient’s situation Copyright © 2022, Elsevier Inc. All Rights Reserved. 11 Post operative patient - homecare Help the client to know what to look for when they observe the surgical site. Discuss what the visual contrast between normal and abnormal is. Encourage the client to call if they have any questions. Support the client and the family, caring for a patient at home may cause significant disruption. Give the client information regarding tracking their pets condition. The concern for self-mutilation prevention cannot be overemphasized. Schedule a follow-up Copyright © 2022, Elsevier Inc. All Rights Reserved. 12 Post-operative Surgical Complications Copyright © 2022, Elsevier Inc. All Rights Reserved. 13 Complications Related to Surgery: Hemorrhage Bleeding at surgical site Copyright © 2022, Elsevier Inc. All Rights Reserved. 14  Hemorrhage Monitor for excessive bleeding If direct pressure 5-10 minutes doesn’t stop it Bandage Notify surgeon Signs of internal bleeding Pale mucous membranes Slowed capillary refill time Rapid respiratory rate Abdominal bloating Swelling at/around surgical site Hypotension Copyright © 2022, Elsevier Inc. All Rights Reserved. 15  Hemorrhage Diagnosis Abdominocentesis, thoracentesis Causes Coagulation disorder Certain breeds Chronic liver disease Dislodged ligature Post-surgical perfusion Treatment Reoperate Transfusion or autotransfusion (who knew??!) Copyright © 2022, Elsevier Inc. All Rights Reserved. 16  What tests are included in the preanesthetic assessment of animals with chronic liver disease? Copyright © 2022, Elsevier Inc. All Rights Reserved. 17  Answer Coagulation profile: including complete platelet count prothrombin time and activated partial thromboplastin time Copyright © 2022, Elsevier Inc. All Rights Reserved. 18  Hematoma Postoperative scrotal hematoma Copyright © 2022, Elsevier Inc. All Rights Reserved. 19  Hematoma Hematoma: Excessive bleeding at incision site Manifests as soft, fluctuant swelling Treatment Warm, moist compresses Suction and pressure bandage Drain Copyright © 2022, Elsevier Inc. All Rights Reserved. 20 Seroma Seroma at surgical site Copyright © 2022, Elsevier Inc. All Rights Reserved. 21  Seroma Seroma Serum collects between skin and muscle Typically, due to excessive movement Potential abscess formation Diagnosis Aspiration Differential via Diff-Quik-type stain Treatment Warm, moist compresses Suction and pressure bandage Possibly surgical drainage Copyright © 2022, Elsevier Inc. All Rights Reserved. 22  Seroma Seroma drainage Copyright © 2022, Elsevier Inc. All Rights Reserved. 23  Dehiscence Copyright © 2022, Elsevier Inc. All Rights Reserved. 24  Dehiscence Postoperative dehiscence: Loss of sutures allowing surgical site to open Risks: Contamination Serious, potentially fatal Causes: Excessive licking and chewing at site (self-trauma) Infection Blunt trauma Copyright © 2022, Elsevier Inc. All Rights Reserved. 25  Self-trauma Application of “BiteNot” collar Copyright © 2022, Elsevier Inc. All Rights Reserved. 26  Self-trauma Preventative measures: Elizabethan collar “BiteNot” collar Bandaging Basket muzzle Hobbles Foul-tasting product Sedation (“chemical restraint”) Stainless steel suture or staples Adequate pain management Copyright © 2022, Elsevier Inc. All Rights Reserved. 27  Self-trauma Application of hobbles Copyright © 2022, Elsevier Inc. All Rights Reserved. 28  Infection Copyright © 2022, Elsevier Inc. All Rights Reserved. 29  Swollen, red, draining surgical site Infection Delays healing Treatment Possible surgical debridement and re- suturing Systemic antibiotics Warm, moist compresses Dilute antiseptic solution at site Allergic reaction to suture material may mimic infection Copyright © 2022, Elsevier Inc. All Rights Reserved. 30