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What do we need to monitor and watch for with a recumbent patient?
- monitor breathing and temperature
- watch for vomiting, aspiration
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Should we use heating pads under a recumbent patient?
no because it can easily cause thermal burns due to the patient not being able to move
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How often should we turn a patient who is in a recumbent position for a short period of time? Why do we turn them?
- turn every 10 - 15 minutes
- to prevent hypostatic congestion, atelectasis
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Why do we turn a patient feet under instead of feet over?
to prevent gastric torsion
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What would cause a patient to be recumbent for a long period of time?
- ill
- injured
- debilitated
- paralysis
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Besides treatment of original condition, we need to prevent new problems due to lack of ability to move. What new problems could occur?
decubital ulcers, bladder, and bowel problems
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How do we keep a recumbent patient clean? Why do we need to keep them clean?
- bathe frequently, dry completely
- if patient has urinary or fecal incontinence, clip or shave perineal area
- helps prevent decubital ulcers and skin infections
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What are decubital ulcers?
pressure sores, bed sores
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Where and how do decubital ulcers develop?
develop over bony prominences due to continuous pressure and local ischemia - lack of blood flow
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Which areas of the body are most likely affected by decubital ulcers?
- sternum
- shoulders
- lateral sides of 5th digits
- stifles
- hips
- elbows
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How quickly can decubital ulcers develop?
within 2 or 3 days
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How can we manage small decubital ulcers?
- donut bandages
- topical antibiotics - water based cream not oil based oinment which can harbor bacteria
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How can we manage deep, serious decubital ulcers?
- surgery
- debride, may place drains, closure
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How can we prevent decubital ulcers?
- turning
- padding
- bladder and bowel maintenance
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How frequently should we turn a long term recumbent patient?
every 2 - 4 hours
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What kind of padding can we use for long term recumbent patients?
- fleece pads
- egg crate type foam
- waterbeds
- towels
- blankets
- diapers
- can place absorbent items in plastic bags to use as padding
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How long can a urinary catheter be left in at a time?
no more than 3 - 4 days - risk of infection
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What can using a urinary catheter help prevent?
urine scalding
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How can we prevent urine scalding?
- clip
- keep clean and dry
- apply desitin ointment or powder
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