Nursing Care and Procedures
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Transcript of Nursing Care and Procedures
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Nursing Care and ProceduresMichael Lavoie, B.S.
Middlesex Community CollegeVeterinary Assistant Program
March 2012
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Common Abbreviations in the Vet FieldAb antibody AD right earAS left earAU both earsACL anterior cruciate ligament ad lib as much as desired ag antigen ant. anterior AP anterior posterior bid twice a day (can also be written q12hrs)
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Continued…
BP blood pressure BW body weight ºC degree Celsius (centigrade) Ca calcium cal calorie(s) cc cubic centimeter CDC Centers for Disease Control and Prevention CF cardiac failure
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Continued…
CHF congestive heart failureCNS central nervous system CPR cardiopulmonary resuscitation CSF cerebrospinal fluid DEA Drug Enforcement Agency DJD degenerative joint disease dL deciliter(s) DM diabetes mellitus
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Continued…
dx diagnosis ECG electrocardiogram EFA essential fatty acids eg for example EKG electrocardiogram ºF degree Fahrenheit FDA Food and Drug Administration
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Continued…
FeLV feline leukemia virus FIP feline infectious peritonitis FIV feline immunodeficiency virus FLUTD feline lower urinary tract disease FUO fever of undetermined origin fx fracture g gram(s) GDV gastric dilatation and volvulus GI gastrointestinal gr grain(s)
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Continued…
hr hour(s) IBD inflammatory bowel disease IC intracardiac IM intramuscular(ly) IN intranasal IV intravenous(ly) IVD intervertebral disc
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Continued…
kg kilogram(s) L liter(s) lat. Laterallb pounds (may be written #)LPF low-power field m meter(s) mEq milliequivalent(s) µg microgram mg milligram(s)
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Continued
min minute(s) mL milliliter(s) MLV modified live virus mm millimeter(s) mo month(s) MRI magnetic resonance imaging NAF no abnormalities found NSAIDS non-steroidal anti-inflammatories O2 oxygen
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Continued
OD right eye OS left eye OU both eyesOTC over the counter oz ounce(s) PCV packed cell volume PE physical exam plt platelet PO per osPRN as required qid four times daily q4h every 4 hours
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qod every other day RBC red blood cell(s) rx treatment, prescription SC subcutaneous(ly) Sub Q subcutaneous(ly) sx surgery tid three times daily, q8hrs UTI urinary tract infection VD ventral dorsal WBC white blood cell wk week(s) wt weight yr year(s)
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Sterilization
Process of killing all living organisms on a surface
Treatment areaExam roomsSurgical suites
Several classifications
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Cold Sterilization
Process of soaking items in a disinfectant chemical until they are cleansed for reuse
Cold trays hold a chemical that acts as a sterilizing agent
Items that are used often and require a simple and quick sanitation method
Brushes, nail clippers, some instruments Endotracheal tubes
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Dry heat or incineration
Use of flame by exposing an item to extreme heat or through incineration
Incinerator- used to burn the remains of items that have the potential to spread disease
Incineration- necessary with biological hazards, medical wastes, and animal remains
Requires the items to be burned to ashes to prevent the spread of disease
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Autoclave
Sterilizes items, especially surgical equipmentAutoclave- piece of equipment in the form of a
sealed chamberObjects are exposed to heat and steam under pressure
at extremely hot temperatures to kill living organisms
Special preparation of instruments requires- different layers to protect instruments and self life
Indicator tape.
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Radiation and ultrasound
Another method of sterilizationRadiation- use of ultraviolet or gamma rays that
radiate and kill living organismsUltrasound- passage of high frequency sound
waves through a solution to create a vibration that scrubs an item to remove debrisUltrasonic cleaner- machine where items soak in a
solution that vibrates and remove dirt and debrisUsed primarily for surgical instruments/equipmentDone prior to packing instruments for autoclavingPart of the cleaning process
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Filtration
Method of sanitationRemove particles from the air using a physical
barrierCommon in lab areas, research facilitiesUsually entails a separate room that is entered
prior to entering the area where animals are housed or contained
Pressurized room that prevents organisms from entering a facility
Sterile clothing and personal protective equipment (PPE)
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Sanitation
Involves cleaning and disinfecting the veterinary facility
Controls the direct spread of organisms on surfaces, in the air and on other objects within the facility
Employees must follow standard sanitation procedures and policies
Failure- harm to patients, loss of clients, decrease in revenue, loss of jobs
Awareness of potential transmission of diseases from patient to patient and patient to people
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Sanitation chemicals and cleaners
Handle with careSome have harmful vaporsCan cause burnsAlways read the label or MSDS (material
safety data sheet)Proper dilutionWear gloves, gogglesSpecific chemicals for specific areas
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Remember…
1 teaspoon= 5 mL
1 tablespoon= 15 mL
1 ounce= 30 mL
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Antiseptics
Solutions that destroy microorganisms or inhibit their growth on living tissue
Effective disinfecting agentsVariety of properties that alter their uses and
effectivenessSpectrum of activity- what the agent will killConcentration of the solution- strength of the solutionContact time- how long the disinfectant should sitAppropriate surface uses Inhibiting factors- uses that should be avoidedToxic effects- hazardous effects the agent may have to
humans or animals
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Types/names
Chlorhexidine solution- disinfectantChlorhexidine scrub- disinfectant and antisepticBleach- cleaner and disinfectantAlcohol- disinfectant and antisepticHydrogen peroxide- antisepticBetadine/iodine- disinfectant and antisepticFormaldehyde- disinfectant
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Hand Hygiene
HandwashingMost common method of spreading disease- direct hand
contactSneezingCoughingRestroomsTouching or handling each animalMoney Direct contact with peoplePhonesDoor handles
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Proper hand washing
Antibacterial soap and use water or hand sanitizer
Avoid wearing jewelry, fake nails, long nails
Post reminder signsMoisturizers at wash stations
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Exam Room Santiation
Important part of safety and disease control Include rooms, tools, equipment and suppliesAll staff members understand and practiceClean after every patientClean from top to bottom, dry to wet areas, sweep up
hair and debrisUse up and down and side to side motionsEmpty trashPlace items in sharps containersCold trayMop bucket- change water and mop head often
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Antiseptic techniques
Most important principle in veterinary hospitalPractice of keeping a sterile environment and
keeping the environment disease and contaminant free
Especially vital in the surgical suitesGoverns how the facility is cleaned, how
equipment and instruments are cleaned, and how sugical and medical procedures are preformed
A break in technique leads to possible infection, disease, and potential patient death
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Sterile techniques
Changing of all surfaces with disinfectants to prevent spread of disease
Glove wearing- animals and possible contaminants
Frequent hand washing
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Nosocomial infections
A human causes disease and or contamination of an animal
Unsterile surgical practicesAllowing contagious animals to contact
healthy animalsContamination of a health animal due to
unsafe sterile practices with hands or equipment not being cleansed
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QUESTIONS?
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Veterinary Assisting
Similar to nursing care in human patientsA service and trained area essential to caring for
and preventing illness and disease in hospitalized patients
Essential to the health of the patientsTeam effortDental care, monitoring IV fluids and catheters,
providing injections for the health of the patient, understand the needs and process of euthanasia
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Dental Care
Essential part of veterinary medicine and patient care
Small animals, large animals and pocket pets teeth brushingPreventative dental careClient educationMonitoring young animals for proper tooth
eruptionShould be part of a yearly exam
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Daily dental care
Feed a hard, dry dietHard treatsDental toys or bonesTeeth brushing- proper method and
necessary toold and suppliesNo human toothpaste- non-digestible
enzymes
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Daily dental care- continued
Dentifrices- toothpasteVariety of flavorsSafe, digestible enzymes that can easily be
broken down in the animal’s bodyFish, malt, beef, poultryHumans vs. pet toothbrushes
Needs to fit the size and shape of the animalPet toothbrushes- small round head, soft bristles, short
narrow handle- fits comfortable into the mouth of an animal
Fingerbrush- small tool that fits on the end of the finger, thimble-like device
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The brushing procedure
Similar to brushing one’s own teethOnly the buccal, labial, and occlusion
surfaces in animalsBuccal- the surface of the teeth, located
on the outer area near the cheekLabial- surface of the teeth in the front
covered by the lipsOcclusal- top of the teeth
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Some things to consider
It is not safe to open an animal’s mouth to brush the inside surfaces of the teeth
Injuries may be causedMost areas are easily accessed by lifting the lips
to expose the outer tooth surfaceBe patient- takes time and consistency for an
animal to acceptBegin with small amounts of toothpaste on the
tip of your finger; allow animal to smell +/- taste
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Other considerations
Start with your finger and then work your way up to the tooth brush
Hold the tooth brush at a 45 degree angle over the tooth
Brush in a circular patternBrush all teethIntroduce at a young ageSample kits, models, encouragement to ownersWant a pleasurable experience!
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Dental prophylaxis
Professional cleaning by a scaling and polishing the teeth
May need to be done once a year or moreConsiderations- health, age, and breed of
patientsLarge animals- floating
Prevents sharp edges from forming- difficulty eatingAdvanced technique that requires training and
experience
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Dental prophylaxis- continued
Provided by the technicianSome participation by assistance Involves general anesthesiaTechnician scales all surfaces of the upper and lower
dental arcade; polishes all tooth surfacesVeterinarian checks any diseased areas or extracts teethComplete dental exam performed
Damaged teeth Broken teeth Gingivitis Missing teeth Excessive plaque
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QUESTIONS?
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Socialization of patients
Provide positive social interaction to all hospitalized patients during treatments, cage cleaning, and/or exercise
Talk to the animalsPet the animalsHold themUse a gentle and soothing voiceMost patients are accustomed to human
interactionPut patients at ease
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Exercise of patients
Provided to hospitalized patients if ableImportant part of their recovery and treatmentImportant for eliminationWalk outside in a designated and safe areaUse appropriate leashesProper sanitation methodsTime outside varies from patient to patient
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Humane euthanasia
Euthanasia is the process of putting an animal to sleep using humane methods by means of a painless death
Way to end an animals sufferingDecision based on personal beliefs, religious
beliefs, and previous experiencesVeterinarian guidance and recommendationsDifficult for owners as well as the veterinary staff
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Process of euthanasia
As pain free and stress free as possibleStaff should be supportive and
sympathetic to owner’s needs and valuesMaintain client confidentialityClients signs a waiverDiscuss the procedure and process of
events with clientsDetermine what the owner would like done
with the remains
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Process- continued
Will the client be present?Would the client like to pay before?Complete all the necessary paperwork before
the procedure is doneInform a client of any legal restrictions for
private/home burialDetermine how the client would like to care for
the animal’s remainsPet cemetery for burialPrivate cremationGroup cremation
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Things to consider
A warm exam room or garden
Tissues
Keep things out of sight
+/- use of sedatives, IV catheters
Label remains accurately!
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After the euthanasia
Patient’s body will relax completelyMay have agonal response
Gasps of breath while the respiratory system shuts down
May be cyanoticLose control of bladder and bowelsOwners may want time alone after the process-
keep privateOwner may want the pets collar, hair or paw
printsReactions are variable
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After the euthanasia
Be respectful of the remainsTreat professionallyPlace in a cadaver bagLabel the bag with an ID tag- “be accurate”Place in appropriate area of facility or package
for ownerCardboard coffins, sheets, waterproofClean or disinfect exam room or area as neededEnsure all controlled drugs and substances are
recorded
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QUESTIONS?