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Nursing tomtom

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Carina Waldron
Carina Waldron

Tomtom, a 2 year old domestic short haired cat, was hospitalized for a blocked bladder. He underwent catheterization and was given fluids and medications. However, he later showed signs of incontinence, vomiting, and lethargy and was readmitted. His condition deteriorated further and he developed liver failure. Despite intensive nursing care and support, Tomtom had to be euthanized after nearly three weeks of treatment for his worsening illness.

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Care of a Hospitalised Patient
Patient Criteria Covered ï‚— Tomtom was an example of an intensive care hospitalized case. He also underwent non-elective surgery when a catheter was placed and he was a non-infectious medical case both for the blocked bladder and later for his liver failure. ï‚— He was a male domestic short haired cat 2 years and 9 months old. ï‚— His body score condition was 3-4/5 on the hills scale. He was slightly overweight.
Medical history ï‚— Tomtom was a young male cat who had been straining to urinate and being quiet vocal at home causing his owners to become worried. He was taken to the after hours emergency care where he was diagnosed with a blocked bladder. He was brought to us the following morning for further treatment and monitoring. A blood test and urine sample taken and the results analysed in order to determine the appropriate care.
Treatment Plan  Our plan of treatment was to provide fluid therapy in order to flush out the bladder, Monitor urination and patient comfort, provide nutritional support and medication. It was important to monitor urination both while his catheter was in place and once it was removed to ensure he didn’t re-block. This did occur so the vets attention was called to this and he was unblocked. We insured his comfort by providing comfortable bedding that was warm and drew moisture away as well as monitoring for pain and ease in urinating all of which was to help Tomtom recover. Tomtom’s diet was important in supporting the diuresis provided by fluid therapy in flushing the bladder and dissolving the struvite crystals seen in a urinalysis this is why he was placed on Hills s/d dry and c/d wet as a urinary diet.  Emotional support was provided by the owner when they came to visit.
Complications  Tomtom was discharged after 8 days in hospital as we were confident he would not block again.  Two days later his owner came to us worried about his incontinence and he was licking himself and growling and he had vomited.  We admitted him for monitoring. His bladder was painful to palpate but he was not blocked. He was prescribed some medication and closely monitored through the day.  The following day Tomtom was lethargic and inappetant with a low blood pressure. Atropine was administered and this improved but his demeanour did not. Attempts at hand feeding were made and they day was spent encouraging him to walk and providing emotional support. Most medication was stopped as there was some concern that the multiple medications had caused him harm.  The following day Tomtom’s mucous membranes had an icteric tinge and he was diagnosed with liver failure.
Care Plan – Problem List  Prevention – diet and medication  Hygiene– clean cage frequently, incontinence sheets, change of bedding  Urine scalding – patient hygiene and protection  Patient discomfort – monitor pain and provide pain relief  Patient interference – buster collar, bandaging site, stop chew spray  Catheter patency – check for inflammation at site, occlusion of catheter  Limb swelling – check limbs, bandaging, and catheter patency  Hydration Level – Over or under Hydrated  Recumbent patient– encourage movement, physiotherapy regime, massage  Temperature regulation – heaters set to right temp, heat pads, blankets  Circulation – frequent repositioning, encourage to walk and remain motile  Toileting –ensure waste dealt with  Depression – environmental enrichment, Owner visits
Special Considerations ï‚— Because Tomtom was going to be spending a lot of time hospitalised it was important we continue to support him beyond just medicating him for his illness. Tomtom required emotional support as he was normally an active guy and had suddenly been confined to a cage. This was provided by owner visits and the nurses taking time to give hi cuddles. ï‚— He was given physical support in order to keep his joints flexible and muscles toned we was given time throughout the day to wander around and stretch his legs. When recumbent in his last days we made sure that he was made to stand and walk back to his cage hourly in order to help circulation, muscle tone and joint flexibility. ï‚— Tomtom was also provided with nutritional support for his condition using the Hills prescription diet urinary range. This was to supplement the medication and provide a foundation for how the owner was to care for him long term after he cam off the medication.
Nursing Considerations ï‚— Tomtom was often incontinent so he required mutliple bedding changes and cage cleans through out the day. ï‚— The most important things we were monitoring was his urination, Pain and demeanour all of which would indicate how he was recovering. ï‚— When he began to spend more time in his litter tray, became epresse and grumpy and seemed hunched in a corner we realised he was uncomfortable and liekly had blocked again. This turned out to be a correct observation when we asked the vet to look at him and a plan of action to unblock him was made. ï‚— When Tomtom beccame lethargic and inappetant we chose other signs to monitor. These were his vital signs for example: respiration, heart rate, blood pressure, mucous membrane colour and CRT as well as monitoring his food intake and demeanour. ï‚— It became important at this point to make sure more hands on physiotherapy tok place as Tomtom was not very active and pressure points were of concern.
Case Outcome ï‚— Unfortunately once Tomtom started exhibiting signs of liver failure it was decided that the kindest thing to do was to euthanize. ï‚— Tomtom was put to sleep on the 4th of September after battling for nearly three weeks.

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Nursing tomtom

  • 1. Care of a Hospitalised Patient
  • 2. Patient Criteria Covered ï‚— Tomtom was an example of an intensive care hospitalized case. He also underwent non-elective surgery when a catheter was placed and he was a non-infectious medical case both for the blocked bladder and later for his liver failure. ï‚— He was a male domestic short haired cat 2 years and 9 months old. ï‚— His body score condition was 3-4/5 on the hills scale. He was slightly overweight.
  • 3. Medical history ï‚— Tomtom was a young male cat who had been straining to urinate and being quiet vocal at home causing his owners to become worried. He was taken to the after hours emergency care where he was diagnosed with a blocked bladder. He was brought to us the following morning for further treatment and monitoring. A blood test and urine sample taken and the results analysed in order to determine the appropriate care.
  • 4. Treatment Plan ï‚— Our plan of treatment was to provide fluid therapy in order to flush out the bladder, Monitor urination and patient comfort, provide nutritional support and medication. It was important to monitor urination both while his catheter was in place and once it was removed to ensure he didn’t re-block. This did occur so the vets attention was called to this and he was unblocked. We insured his comfort by providing comfortable bedding that was warm and drew moisture away as well as monitoring for pain and ease in urinating all of which was to help Tomtom recover. Tomtom’s diet was important in supporting the diuresis provided by fluid therapy in flushing the bladder and dissolving the struvite crystals seen in a urinalysis this is why he was placed on Hills s/d dry and c/d wet as a urinary diet. ï‚— Emotional support was provided by the owner when they came to visit.
  • 5. Complications ï‚— Tomtom was discharged after 8 days in hospital as we were confident he would not block again. ï‚— Two days later his owner came to us worried about his incontinence and he was licking himself and growling and he had vomited. ï‚— We admitted him for monitoring. His bladder was painful to palpate but he was not blocked. He was prescribed some medication and closely monitored through the day. ï‚— The following day Tomtom was lethargic and inappetant with a low blood pressure. Atropine was administered and this improved but his demeanour did not. Attempts at hand feeding were made and they day was spent encouraging him to walk and providing emotional support. Most medication was stopped as there was some concern that the multiple medications had caused him harm. ï‚— The following day Tomtom’s mucous membranes had an icteric tinge and he was diagnosed with liver failure.
  • 6. Care Plan – Problem List ï‚— Prevention – diet and medication ï‚— Hygiene– clean cage frequently, incontinence sheets, change of bedding ï‚— Urine scalding – patient hygiene and protection ï‚— Patient discomfort – monitor pain and provide pain relief ï‚— Patient interference – buster collar, bandaging site, stop chew spray ï‚— Catheter patency – check for inflammation at site, occlusion of catheter ï‚— Limb swelling – check limbs, bandaging, and catheter patency ï‚— Hydration Level – Over or under Hydrated ï‚— Recumbent patient– encourage movement, physiotherapy regime, massage ï‚— Temperature regulation – heaters set to right temp, heat pads, blankets ï‚— Circulation – frequent repositioning, encourage to walk and remain motile ï‚— Toileting –ensure waste dealt with ï‚— Depression – environmental enrichment, Owner visits
  • 7. Special Considerations ï‚— Because Tomtom was going to be spending a lot of time hospitalised it was important we continue to support him beyond just medicating him for his illness. Tomtom required emotional support as he was normally an active guy and had suddenly been confined to a cage. This was provided by owner visits and the nurses taking time to give hi cuddles. ï‚— He was given physical support in order to keep his joints flexible and muscles toned we was given time throughout the day to wander around and stretch his legs. When recumbent in his last days we made sure that he was made to stand and walk back to his cage hourly in order to help circulation, muscle tone and joint flexibility. ï‚— Tomtom was also provided with nutritional support for his condition using the Hills prescription diet urinary range. This was to supplement the medication and provide a foundation for how the owner was to care for him long term after he cam off the medication.
  • 8. Nursing Considerations ï‚— Tomtom was often incontinent so he required mutliple bedding changes and cage cleans through out the day. ï‚— The most important things we were monitoring was his urination, Pain and demeanour all of which would indicate how he was recovering. ï‚— When he began to spend more time in his litter tray, became epresse and grumpy and seemed hunched in a corner we realised he was uncomfortable and liekly had blocked again. This turned out to be a correct observation when we asked the vet to look at him and a plan of action to unblock him was made. ï‚— When Tomtom beccame lethargic and inappetant we chose other signs to monitor. These were his vital signs for example: respiration, heart rate, blood pressure, mucous membrane colour and CRT as well as monitoring his food intake and demeanour. ï‚— It became important at this point to make sure more hands on physiotherapy tok place as Tomtom was not very active and pressure points were of concern.
  • 9. Case Outcome ï‚— Unfortunately once Tomtom started exhibiting signs of liver failure it was decided that the kindest thing to do was to euthanize. ï‚— Tomtom was put to sleep on the 4th of September after battling for nearly three weeks.