NURSING “GEORGIE”NURSING “GEORGIE”

PATIENT CRITERIAPATIENT CRITERIA

Recovering from non-elective surgery Recovering from an orthopaedic

procedure Hospitalized for 48 hours in intensive

care Complex non-routine wound care

CASE SUMMARYCASE SUMMARY

PATIENT DETAILSPATIENT DETAILS

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.

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?)

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.

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.

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.

CARE / INTERVENTION PLAN

NURSING OBSERVATONSImmediately 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.

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.

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.

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!