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Nursing hospitalized patients

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Abstract

This chapter is designed to give information on administration of fluids, nutrition and medication to exotic patients. It also looks at nursing care plans and their application to exotic patients. Includes self-assessment questions.

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Figures

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6.1 Fluid administration via a pharyngostomy tube in a ‘dry-docked’ pond terrapin. (© Emma Whitlock)
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6.2 Use of a metal mouth gag to facilitate fluid administration via gavage in a snake. (Courtesy of Elisabetta Mancinelli)
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6.3 Subcutaneous fluid administration in an albino Burmese python. (Reproduced from the )
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6.4 intravenous catheter taped in place in the cephalic vein of a ferret. (Courtesy of Richard Saunders)
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6.5 Bolus intravenous administration of the authors’ suggested fluid mix via needle and syringe into the right jugular vein of a kestrel. (Courtesy of Richard Saunders)
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6.6 An intravenous catheter for fluid administration via the brachial vein of a barn owl. (Courtesy of Richard Saunders)
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6.7 Catheterization of the jugular vein in a Solomon Island ground boa. Sedation or anaesthesia (e.g. intravenous propofol and/or isoflurane via facemask) is required; in severely debilitated reptiles a local anaesthetic may suffice. In snakes the jugular vein is exposed by making a longitudinal incision at the junction of the lateral and ventral scales, approximately 5–8 scales cranial to the heart. (In chelonians and lizards (except chameleons) a transverse incision is made at about half the distance between the tympanum and shoulder joint.) A small retractor aids in placement of the pre-heparinized catheter, which is then sutured to the skin. Control of flow rate and volume requires the use of a syringe pump. (Reproduced from the )
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6.8 intravenous catheter for fluid administration in the marginal ear vein of a rabbit. Note that the catheter has been attached to the rolled-up swab within the pinna using adhesive tape. (Courtesy of Molly Varga)
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6.9 Common sites for intraosseous catheter placement in the rodent include the femur through the trochanteric fossa, or the tibia (as shown here) through the tibial crest. Placement is similar to normograde insertion of an intramedullary pin and requires strict aseptic technique during placement and maintenance. (Reproduced from the )
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6.10 Intraosseous administration in the proximal cranial tibiotarsus of a common buzzard. (Courtesy of Elisabetta Mancinelli)
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6.11 Intraosseous needle inserted into the plastrocarapacial junction. (Courtesy of Ron Rees Davis)
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6.12 Intracoelomic fluid administration in a Horsfield’s tortoise. (© Emma Whitlock)
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6.13 Epicoelomic fluid administration in a Horsfield’s tortoise. (© Emma Whitlock)
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6.14 Intraperitoneal injection into the lower right quadrant of a rat. (Courtesy of Richard Saunders)
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6.15 Harrison’s ‘Recovery Balls’ mixed in with seed and pelleted diets for encouraging self-feeding in hospitalized psittacine birds. (© Emma Whitlock)
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6.16 Abundance feeding of leafy greens to a previously inappetent rabbit. (© Emma Whitlock) Abundance feeding of good quality fresh forage to an inappetent wild rabbit. (Courtesy of Richard Saunders)
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6.17 Assisted hand-feeding of a chinchilla using a herbivore convalescence formula. (Courtesy of Terri Pettis)
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6.18 Assisted hand-feeding of a juvenile red squirrel using a syringe. (Courtesy of Richard Saunders)
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6.19 Syringe-feeding a rabbit with a convalescent herbivore formula in a wide-bore feeding syringe. (© Emma Whitlock)
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6.20 Use of a metal mouth gag to facilitate gavage for assisted nutrition in a semi-aquatic red-eared terrapin. (© Elisabetta Mancinelli)
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6.21 An pharyngostomy tube in a Mediterranean tortoise. (Courtesy of Elisabetta Manicinelli)
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6.22 A naso-oesophageal feeding tube may be useful for delivering enteral fluid and nutritional support. (Reproduced from the )
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6.23 A very thin rabbit: body condition score 0–1/5. An obese rabbit: body condition score 5/5. (Courtesy of Richard Saunders)
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6.24 Morbid obesity in a budgerigar. It is very unusual to be able to assess body condition visually without palpation of the keel. (© John Chitty)
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6.25 Body condition scoring in leopard geckos. Condition score 1/5: emaciated; almost no fat store in the tail. Condition score 3/5: normal; tail rounded with reasonable amount of stored fat. Condition score 5/5: obese; note the increased girth of the legs as well as the tail. (Reproduced from the )
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6.26 Intravenous drug administration in the marginal ear vein of a rabbit. (Courtesy of the University of Bristol)
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6.27 The Roper, Logan and Tierney Model for living. The Roper, Logan and Tierney Model for nursing. (Reproduced from the )
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6.28 An example of a nursing care plan template (Roper, Logan and Tierney Model).
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6.29 An example of a nursing care plan (Roper, Logan and Tierney Model).

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