Clinical Small Animal Care E-Book

Kimm Wuestenberg

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 273

Veröffentlichungsjahr: 2012

Beschreibung

Clinical Small Animal Care: Promoting Patient Health through Preventative Nursing is an introduction to the principles of day-to-day veterinary practice, with coverage ranging from the initial assessment, fluid therapy monitoring, and perioperative management to care of animals with specific diseases. The book offers concrete guidance on best practices for promoting patient health in veterinary care, emphasizing specific techniques to prevent complications before they happen. A practical, clinically relevant resource for veterinary technicians, Clinical Small Animal Care provides step-by-step descriptions of the core tasks associated with examining, nursing, and monitoring small animal patients.

Taking a hands-on approach to the fundamentals of clinical practice, the book gives specific advice for how to perform tasks associated with patient care. Chapters begin with basic information on topics such as husbandry and nutrition, then move into more specialized information on applied nursing and the care of tubes and catheters. The final section presents information on caring for animals with a variety of conditions organized by body system. Clinical Small Animal Care: Promoting Patient Health through Preventative Nursing offers veterinary technicians and nurses with achievable steps for improving health in their small animal patients.

Leseprobe

Table of Contents

Cover

Companion website

Title page

Copyright page

Preface

Acknowledgments

Section 1: Clinical Fundamentals in Promoting Good Health

Chapter 1 The Elements of Environmental Husbandry

Nosocomial infections

Bedding and dish rotation

Noise and air quality

Circadian rhythm

Infectious disease protocols

Chapter 2 Considerations in Patient Management

Hygiene and grooming

Exercise and walks

Routine assessment and treatments

Pain assessment

Psychological health

Care for the recumbent patient

Detecting abnormalities

Chapter 3 Patient Exam and Assessments

Obtaining and interpreting vital signs

Patient monitoring equipment

Chapter 4 Nutritional Notability

Energy-producing nutrients: Proteins, carbohydrates, and fats

Non-energy-producing nutrients: Vitamins, minerals, and water

Nutritional differences between dogs and cats

Section 2: Applied Nursing of the Veterinary Patient

Chapter 5 Monitoring the Fluid Therapy Patient

Mechanisms of fluid therapy

Fluid selections for the veterinary patient

Fluid administration routes

Fluid therapy calculations

Fluid additives

Monitoring the patient

Chapter 6 Physical Therapy Applications

Chapter 7 Perioperative Patient Management

Perioperative nursing

Preoperative patient nursing

Intraoperative patient nursing

Postoperative patient nursing

Chapter 8 Executing Emergency Care

Initial assessments of the emergent patient

Emergency medications

Chapter 9 Harmonizing Hospice Needs

Section 3: Proper Care of Tubes and Catheters

Chapter 10 Venous and Arterial Catheter Care

Maintaining the central venous catheter

Intraosseous catheter care and maintenance

Venous access ports

Maintaining the arterial catheter

Chapter 11 Indwelling Urinary Catheter Care and Maintenance

Daily catheter care

Daily collection set care

Patient nursing

Chapter 12 Feeding Tube Care

NG and NE tubes

EG tube care

Gastrostomy tubes

Miscellaneous tubes

Chapter 13 Nasal Oxygen Catheter Care

Chapter 14 Tracheostomy Tube Care

Chapter 15 Chest Tube Care

Section 4: Comprehensive Areas of Focus

Chapter 16 Cardiovascular Nursing

Basic anatomy and physiology overview

Assessing the cardiovascular patient

Common cardiovascular diseases and conditions

Chapter 17 Regard for the Respiratory Patient

The respiratory system overview

Oxygen delivery techniques

Chapter 18 Grasping Gastrointestinal Nursing Care

Digestive system

Liver and gall bladder

Gastric conditions

Enteric: intestinal disorders

Colonic

Pancreatic

Hepatic

Chapter 19 Rendering Renal Care

The excretory system

Urogenital conditions

Nursing interventions

Chapter 20 Endocrine Nursing Encounters

The endocrine system

Chapter 21 Nursing Care of the Neurological Patient

Nervous system

Chapter 22 Musculoskeletal Minding

Overview of anatomy and physiology

Traumatic muscle injuries

Infectious muscle disease

Immune-mediated diseases

Metabolic disorders affecting muscle

Orthopedic

Wounds and fractures

Chapter 23 Tending to the Skin and Special Senses

Special senses

Integumentary system conditions

Eye

Nursing interventions

Appendix 1 Formulas

Fluid therapy

Nutrition

Manual hemogram

Measurement conversions

Body surface conversion

Cytotoxic clearing times

Arterial blood gas

Emergency drug doses

Appendix 2 Anatomy Illustrations

Appendix 3 Clinical Quick Reference Guides

Abbreviations

Vital signs

Emergency assessment

Stages of shock

Types of shock

Electrolyte disorders

Anesthesia (Ax) monitoring and troubleshooting

Transfusions

Pearls of wisdom

Appendix 4 General Forms

Sample treatment flow sheet

ICU monitoring flow sheet

Anesthetic record

Patient order sheet

Case transfer form for opposing shifts

ABC animal hospital

Appendix 5 Employee Skill and Knowledge Advancement Plans

Assistant level skills mastery form

Technician level 1 skills mastery form

Technician level 2 skills mastery form

Technician level 3 skills mastery form

Ten qualities of highly effective veterinary staff

Index

Companion website

This book is accompanied by a companion website:

www.wiley.com/go/wuestenberg

The website includes:

• Powerpoints of all figures from the book for downloading

• Editable Word files containing the general forms found in Appendix 4

• Powerpoint files containing the employee skill and knowledge advancement plans found in Appendix 5

This edition first published 2012 © 2012 by John Wiley & Sons, Inc.

Wiley-Blackwell is an imprint of John Wiley & Sons, formed by the merger of Wiley’s global Scientific, Technical and Medical business with Blackwell Publishing.

Registered office: John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

Editorial offices: 2121 State Avenue, Ames, Iowa 50014–8300, USA

The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

9600 Garsington Road, Oxford, OX4 2DQ, UK

For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell.

Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by Blackwell Publishing, provided that the base fee is paid directly to the Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923. For those organizations that have been granted a photocopy license by CCC, a separate system of payments has been arranged. The fee codes for users of the Transactional Reporting Service are ISBN-13: 978-0-8138-0514-6/2012.

Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought.

Library of Congress Cataloging-in-Publication Data

Wuestenberg, Kimm.

 Clinical small animal care : promoting patient health through preventative nursing / Kimm Wuestenberg.

p. ; cm.

 Includes bibliographical references and index.

 ISBN 978-0-8138-0514-6 (pbk. : alk. paper)

 ISBN 978-1-1182-3314-6 (epdf)

 ISBN 978-1-1182-3316-0 (epub)

 ISBN 978-1-1182-3318-4 (mobi)

 I. Title.

 [DNLM: 1. Animal Diseases–nursing. 2. Patient Care–veterinary. 3. Veterinary Medicine–methods. SF 774.5]

 636.089'073–dc23

2011037206

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Disclaimer

The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation warranties of fitness for a particular purpose. No warranty may be created or extended by sales or promotional materials. The advice and strategies contained herein may not be suitable for every situation. This work is sold with the understanding that the publisher is not engaged in rendering legal, accounting, or other professional services. If professional assistance is required, the services of a competent professional person should be sought. Neither the publisher nor the author shall be liable for damages arising herefrom. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read.

Preface

I will always remember my very first patient suffering from multiple organ dysfunction syndrome (MODS), Angel. Looking back, I’m sure I had actually observed MODS dozens of times before Angel, but I remember her because I learned an invaluable lesson from her that night. In that 13-hour shift, I was given the opportunity to take patient care to the next level. As I cared for her, I also learned what her body was doing physically, from the sequence of dysfunctional microvascular blood flow to internal organ deterioration. I learned the common pathway of the disease process and more importantly, what measures we could take in attempts to stop the process. That night I learned that critical thinking skills, anticipation of ensuing body processes, and hands-on nursing were the true skill and talent of a veterinary technician.

Patient care and husbandry is one of the noblest nursing tasks that we have; however, it is often underrated or overlooked. Veterinary support staff members have numerous resources to use in educating themselves on particular body systems and diseases, diagnostics, therapeutics, and even performing procedures. Unfortunately, there are few resources that focus on the crucial standards of hands-on patient care. The veterinary profession as a whole has not developed a set standard of care as the human nursing field has; knowledge in this area is typically gained through experience, at the troubled expense of the patient. I recall seeing red rings of bacteria in food and water dishes when I was new to the field in 1993. I remember midcareer the patients who had lost toes and limbs due to improper bandaging techniques. More recently, in 2009, I saw a patient with an intravenous catheter site abscess and another patient with excrement scald. In essence, this equates to nearly two decades of observing a challenging enigma in this profession—the inability for veterinary practices and personnel to uphold fundamental hygiene, patient care, and nursing standards. A clean pet is a happy pet. A veterinary patient receiving proper nursing care has a better chance at recovery because of those nursing interventions.

In my own personal experiences, I have learned that turning away from a patient receiving a blood transfusion is not a good idea. I have learned that a medication dose you’ve asked for may not necessarily be the dose you’re actually giving, so it is best to use the check system. I have underestimated the temperature of a heat source; conversely, I have underestimated the physiological effects of hypothermia. I have learned, and I will continue to learn. We all must continue to build our talents, recognize the powerful skill in our thinking and with ambition, dedication, and a true love for animals, and with this profession, be the best that we can possibly be for these precious patients we are fortunate enough to care for.

I would like to thank you, the reader, for your contribution to this profession, your devotion, and your passion for veterinary nursing.

Kimm Wuestenberg

Acknowledgments

First and foremost, I would like to thank the person who introduced me to veterinary medicine, Pam Gardner. My wonderful instructor who was faced with the challenge of teaching veterinary nursing to a 17-year-old high school student in 1993 and not only succeeded, but became one of the most influential people in my career.

I would like to thank Margaret Mills for taking me under her wing and setting the stage for future accomplishments; Jim Minnick for not only teaching me how to perform a thoracocentesis 6 months out of school, but for telling me that I should be performing advanced procedures as a technician; Raegan Wells, Rich Fisher, and Bill Gooldy for setting an example of how to be an all-around better person and professional; Amy Felock for sharing my passion for veterinary nursing, encouraging me, supporting me, and being the best friend a girl could have; Linda Merrill, you are an absolute inspiration and I’m honored to know you. Thanks to the Academy of Veterinary Emergency & Critical Care Technicians (AVECCT) and the Academy of Internal Medicine for Veterinary Technicians (AIMVT) for bringing so much to my life, my career, and this fantastic profession.

Lastly, I would like to thank my family whom I love dearly with all my heart: my beloved father, Richard, whose words to me throughout his life were “You can do anything, Kimberly!” and so I did; my supportive mother, Gale, who recognized my full potential before I did; my brother, Jason, for the sibling rivalry that encouraged me to always go one step further; my sister-in-law, Melissa, whose compassion and love for animals has inspired me. Most of all, I would like to thank my beautiful sons, Imre Albrecht and Kayden Avery, for all the joy, love, laughter, challenges, adventures, and growth you bring to my life … you are both so very special, I love you and I thank you for enriching my life.

K.W.

Section 1: Clinical Fundamentals in Promoting Good Health

Chapter 1

The Elements of Environmental Husbandry

Nursing care of the veterinary patient involves astute knowledge of normal anatomy and physiology, a clear understanding of disease pathology, and practical critical thinking skills. However, a key nursing aspect often overlooked is basic nursing care of the patient and the patients’ environment. Influences such as noise, temperature, hygiene, and surface area cleaning protocols can influence the heath of the patient. For example, a postoperative patient experiencing hypothermia is at risk for delayed healing, pain, surgical site infection, and a longer hospital stay, which means a possibility of developing a nosocomial infection. This section will cover basic nursing skills which have a profound affect on the patients’ ability to recover from illness.

Nosocomial Infections

Nosocomial infections are those that occur within the hospital setting, often referred to as “hospital-acquired” infections. They are also known as “super infections” or “super bugs,” since nosocomial infections pose a great threat to the debilitated and immunocompromised veterinary patient. Microorganisms such as bacteria take Darwin’s “survival of the fittest” theory to the next level when it comes to multiple antibiotic resistances in a hospital setting. They not only survive, they thrive, and veterinary patients can fatally fall victim to these “super bugs.” Human medicine hospital rates for nosocomial infections tend to be higher in intensive or critical care settings; however, incidence is not limited to these areas. In addition, human nosocomial infections tend to be one of the leading causes of death in the intensive care unit (ICU) due to causing septic shock and subsequent multiple organ failure. Surprisingly, sources of nosocomial infections are the patient and the healthcare worker.