2. PPAATTIIEENNTT CCRRIITTEERRIIAA
Recovering from non-elective surgery
Recovering from an orthopaedic procedure
Hospitalized for 48 hours in intensive care
Complex non-routine wound care
3. PPAATTIIEENNTT DDEETTAAIILLSS
Georgie: Female Fox
Terrier x Jack Russell
Age: 4 yrs 1 month
Weight: 7.5 kg
Body Condition 6/10
Hit by car in Feb’ 2014,
resulting in dislocation of
left femoral head. After
relocation, the joint
remained unstable. In May,
the decision was made to
perform an excisional
arthroplasty of femoral neck
and head.
Surgery performed on 20th
May.
4. KEY POINTS FOR NURSING
CARE – POTENTIAL PROBLEMS
Pain Control: Monitor well – look for signs of pain.
Inform vet immediately if any seen and treat.
Care of Wound: Monitor frequently for redness,
swelling, haemorrhage, patient interference,
infection. Keep clean.
Reduced Mobility: Make sure bedding is adequately
cushioned; get Georgie moving – use affected limb;
physiotherapy; ensure she is warm enough –
(extra blankets, heat pad, ambient temperature?)
5. Key Points For Nursing Care –
Potential Problems (cont.)
Nutrition: Calculate energy requirements
(keeping in mind little activity but energy
required for healing), as well as fluids. Get
her to eat and drink!
Psychological: Monitor demeanour. Organize
visits from family. Spend time with her – lots of
TLC! Walk her outside for toileting, stimulation,
“normality “(and exercise limb!). Groom her.
6. WHY GEORGIE
IS SPECIAL
I have a soft spot for Georgie. She is a such
a quiet, gentle girl.
I happened to be on duty when she was
originally brought into the clinic after being
hit by the car, so I was pleased to be the
nurse designated to take care of her, both
during and after surgery.
She had been through a lot and I really
wanted to see her being well nursed, well
pampered, and to recover well.
7. My Approach to Her Care
Apart from nursing her well in the
clinical sense, I wanted to ensure
my care of her was holistic and to
give her lots of TLC, pamper her,
get her owners in to visit and – in
general – treat her like she was
my own dog.
9. NURSING OBSERVATONS
Immediately Post Surgery
Problem: Hypothermic (37.5 deg)
Action: Heated room, heat pad, extra
blankets, kept rechecking
Later
Problem: Restless, whimpering, restless,
increase in HR and RR – signs of pain
Action: Informed vet. Administered pain
relief. Kept pain monitored and under
control.
10. Nursing Observations (cont.)
Problem: Initially no interest in food or water.
Action: Heated food slightly, hand-fed until
eating willingly, syringed water until drinking.
Removed E-collar for meals (only!)
Problem: Decreased mobility (needed to use
leg, toileting, hygiene)
Action: Got her to move – lead walked outside
for toileting. Gentle massage. Made sure
kennel floor was well cushioned.
11. Nursing Observations (cont.)
Problem: Appeared depressed.
Action: Organized family visit. Took her outside
for some “normal behaviour “. Spent lots of
time with her and gave her lots of TLC.
Problem: Keep wound healthy.
Action: Kept checking for signs of infection,
Interference (E-collar), haemorrhage – all good.
12. CASE
OUTCOME
Georgie made a very good recovery.
After two and a half days in our care,
she went home. She was re-checked after
two days and her sutures removed after
ten days. The affected joint has remained
stable and she is leading a happy, active
life again! A great result!
