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Download Small Animal Medical Nursing Grooming/Bathing/Etc.
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SMALL ANIMAL MEDICAL NURSING GROOMING/BATHING Grooming and medicated bathing are recommended for the treatment and prevention of many dermatologic problems. Control and treatment of ectoparasites. Cleanliness of the patient at the time of discharge is an indication to the owner of the overall quality of health care provided. Grooming and Bathing Every animal hospital should have adequate collection of grooming and bathing equipment and supplies. Supplies include: Combs Brushes Scissors Towels for drying Electrical dryers Selection of shampoos Dryers Grooming Considerations Care must be taken to prevent the spread of infections from one animal to another via grooming instruments. Instruments should be thoroughly cleaned in an appropriate disinfectant solution after each use. Things to Remember When clipping or removing hair from an animal for medical reasons, it is important to obtain the owner’s permission, whenever possible. Certain breeds , regrowth is slow. Bathing Basic technique for bathing dogs and cats is to thoroughly wet the coat and then apply small amounts of shampoo starting at the head and working back to the tail. Rub shampoo into a lather, starting at head and working back to tail. Bathing Considerations Eyes should be protected by mineral oil, or ophthalmic ointment. Care should be taken to prevent water from entering the ears by placing a small amount cotton in each ear. (Remember to remove once bath is complete). Bathing Continued Thermal injury can be caused by excessively hot water. Constantly monitor water temperature. Thoroughly rinse shampoo residue to prevent skin irritation. Axillary and scrotal regions of long-haired dogs are particularly vulnerable to residual shampoo irritation. Bathing continued Shampoos containing insecticides should be used only with approval of the attending veterinarian because of possible cumulative toxicity or drug interactions with medications or other topically applied insecticides. Insecticidal dips should be used with correct dilutions to avoid toxic reactions. If complete immersion bath is contraindicated, can sponge bath dirty areas. Orthopedic and neurological patients may not be able to stand steady in the bath tub, so may need to use rubber mat to help reduce injury. Ringworm Treatment Lime Sulfur Dip Needs to be diluted Always wear gloves! READ the directions Do not dry Do not ingest Do not rinse CAUTION!!!! Close your mouth!!!! Do not peer in “line of fire” Very unpleasant odor, can be messy, be sure to clean up afterwards. FYI: Fatty acid supplements have been shown to help reduce the inflammation associated with Anal Sac disease. Anal Sac Tumors Sometimes present in pets Generally require surgery Anal Sac Abscess Occur when sac ruptures out to the skin. Usually provide relief to patient. Must be kept clean and use appropriate meds. Impacted Anal Sacs Exercise Moderate exercise is beneficial for the general care of the animal patient. Exercise should take place in a secure, controlled, and safe environment so that injury or loss of the animal does not occur. Decision to restrict exercise should be made after consultation with the attending veterinarian. Moderate exercise consists of taking the patient for a walk and can be considered the simplest and most basic form of physical therapy. Moderate exercise may be useful means of reducing peripheral edema and improving muscle tone and strength. Contraindications to exercise Respiratory issues Cardiovascular issues Musculoskeletal issues Exercise Feeding Technician plays important role in ensuring that each patient remains in a positive energy balance. Technician will notice subtle changes in appetite or eating behaviors. Familiarity with the home feeding regimen will aid in selection of palatable alternative diets. Owner may need to bring home diet to clinic in order to get patient to eat in the hospital setting. Feeding Continued Personal attention at feeding time such as talking to the patient or hand feeding may be needed to stimulate eating. Cats must smell food in order to eat. Force feeding may be necessary in some cases. Feeding tubes may be needed in some cases. May use caloric pastes if needed. May need to stimulate appetite. Bedding Keeping a dog clean is to appropriately use bedding and exercise runs. Several types of bedding are routinely used and may include: Newpaper Paper products Blankets Towels Lamb’s wool products “cots” Bedding Continued Bedding material used should be disposable or readily and effectively cleaned between uses. Dogs will eat their bedding so should be digestible and non-toxic. Dogs do not like to urinate and defecate where they sleep so regular exercise is recommended. Cat Bedding Generally easier to keep clean. Usually will use litter pans and groom and clean themselves unless seriously ill. Litter pans should be changed daily, preferably when dirty. Pans should be disposable or able to be completely cleaned between uses. Newspaper may be used in place of gravel litter to keep from getting into wounds or surgical incisions. Cat Bedding Continued “Yesterday’s News” is sometimes used after surgeries and especially some de-claws. Usually walking cats is not necessary, can have exercise time for the cat. Decubital Ulcers (Bedsores) Decubital Sores (Bedsores) and urine scald are extremely important aspects of the care of recumbent patients. Animals that can be recumbent for long periods of time require special care. Urine and fecal soiling can cause serious problems that can complicate recovery. Best treatment is prevention- Cleaning bedding and turning patient. Bedsores can cause sepsis which can lead to death. Pressure sore from cast Pressure sore’s from slings Pressure Sore Prevention of Bedsores Adequate padding. Air or water mattresses. Grids, grates and straw. Material needs to be able to be cleaned or disposed of. Needs to be impermeable to urine or moisture, or allow microorganisms in. Keep skin as dry as possible. Prevention of Bedsores Continued Frequently move or turn the patient. May use slings from time to time as well. If develop, should be cleaned thoroughly with a surgical scrub. Should be thoroughly dried after cleaning. Soaking with a mild astringent solution may be made. Afterwards, pad area but allow air in (donut shaped padding). Surgical debridement may be necessary. TPR Vital Signs- include a temperature (T), pulse (P) and respiration (R) count. Changes with every species of animal an varies due to size, age, environment, stress, activity level, and health. Signs of a Healthy Animal Clear, bright eyes with pink mucous membranes (mm). Appearance of contentment. Alert attitude and interest in surroundings. Good appetite. Sleek, shiny coat with fur that is pliable; not dry and brittle. Feces and urine that are easily passed and have normal appearance. TPR is in normal range. The normal Temp for dogs: 101.0 to 102.5 Cats normal Temp 100.5 to 102.5 Temperature (T) The range of body heat in an animal. Can predict: Infection Overheating Hypothermia Stress Excitement Environment etc. Ways to take Temperatures Thermometer- gauge used to measure body temperature. Various types of thermometers available for animal use. Can use human thermometers on animals. If measuring in Celsius degrees, can convert to Fahrenheit by using formula: C= (degrees F – 32) x 5/9 Types of thermometers Regular human mercury thermometer. Veterinary mercury thermometer (storage reservoir is short and spherical rather than elongated). Digital thermometers. Infrared thermometers-infrared beam is focused on the tympanic membrane. External ear thermometers. Mercury Thermometer We have these at VTI.. Digital Thermometer Where temperatures are taken Generally will take a rectal temperature. In some cases may use an ear thermometer or axillary reading but these instances are very rare. If temperature is taken from alternate location, then 1 degree F should be added to the reading. How to take a Temperature 1. Clean the thermometer (not just with alcohol, make sure is disinfected). 2. If using a mercury thermometer, make sure the thermometer has been shaken so that the mercury is below the constriction in the glass tube. 3. Lubricate the tip of the thermometer with petroleum jelly. Taking Temperature Continued 4. Restrain the animal so that the thermometer will stay in place. 5. Hold mercury thermometer in place for 3 minutes, digital thermometers should be held in place until an auditory beep is heard. 6. Remove thermometer, observe reading and record. 7. Clean off thermometer appropriately. 8. Store thermometer appropriately. Normal temperatures Cat- 100.5-102.5 Dog-101-102.5 Cattle- 101.0 Chicken- 107.0 Goat- 102.5 Horse- 100.0 Rabbit- 103.0 Sheep-102.0 Snake- room temperature Special Considerations Smaller animals and puppies tend to have/require higher body temperatures. Certain diseases may show fluctuations in body temperatures so any animal that is sick should have temperature taken throughout day. This can be referred to diurnal fluctuations. Pulse (P) The heartbeat of an animal. Rate and character of the pulse are valuable means of assessing the cardiovascular status of the patient. Range and rate can also indicate: Anxiety Exercise Pain Disease Shock Areas to locate pulse Can be palpated in any artery located close to the body surface. Index finger is best to use for sensitivity to pulse, while thumb is least sensitive. Locations include: Femoral artery (inside rear leg). Palmar aspect of the carpus Ventral aspect of base of tail Pedal artery Through auscultation of the heart itself. Listen with stethoscope at PMI (point of maximum intensity) which is located at the costochondral junction between the fourth and sixth intercostal spaces. Femoral Pulse Procedure for taking a pulse 1. Gently roll your index finger and middle fingers over the artery. 2. Count number of pulses for 15 or 30 seconds and then multiply by 4 or 2 respectively. Notes of Consideration If you are listening to heart rate and feeling pulse at the same time and the pulse rate is less than the heart rate, then this is a Pulse deficit. Dogs can have regularly irregular pulse rates. Sinus arrhythmia- heart and pulse rates increase with inspiration and decrease with expiration. Pulse Characteristics Pulse Pressure- how hard or strong the pulse is. May hear terms such as thready, weak, etc. Decreased pulse pressure can indicate systemic hypotension or drops in the blood pressure. Normal Pulse Parameters Dog- 60-160 beats per minute (bpm) Cat- 110-240 bpm Cattle- 60-70 bpm Chicken- 200-400 bpm Goat- 40-60 bpm Horse- 30-60 bpm Rabbit- 123- 304 bpm Sheep- 60-90 bpm Snake- 12 bpm Special Considerations Puppies and small breed dogs will have higher pulse rates. 220 bpm Cats will have higher heart rates than dogs. 240 bpm Cold blooded animals will have lower heart rates. Example: Snake – 26 bpm Respiration (R) The breathing rate of an animal. Should be counted when animal is at rest but not sleeping. Respiration includes both inspiratory and expiratory pause. Can count inspirations or expirations but not both. Respiration continued Respiration is evaluated by the depth and character of breathing. Depth- degree of chest effort that is needed to take a breath. The volume of air inspired in each breath. Increased depth indicates a greater demand for oxygen. Character- whether or not animal is breathing slow, normal, or rapid. Procedure for counting Respirations 1. Observe the rise and fall of the chest. 2. Count the number of breaths for 15 or 30 seconds. 3. Multiply by 4 or 2 respectively to get number of breaths per minute. 4. Record in patient record. Normal Respiration Rates Dogs- 15-30 breaths per minute Cats- 20-30 Cattle- 10-30 Chicken- 15-30 Goat- 12-20 Horse- 8-16 Rabbit- 30-45 Sheep- 12-20 Snake- 1-2 TPR’s continued TPR exams should be conducted on every animal that enters the hospital or clinic. Should also be done on a daily basis and after surgery. TPR’s are a very good indicator of sickness if the animal is not in the normal range for their species.