EXERCISE 25.15 CASE STUDY: MANAGEMENT OF RECUMBENT PATIENTS
Leslie, a 10-year-old, spayed female Shepherd mix is presented for management of recumbency caused by paralysis sec-ondary to a rupture of an intervertebral disc. She has not been eating well and has disturbed fluid balance. She is also in pain secondary to the disc rupture and has developed several open ulcers over her elbows and other bony prominences. Because she is panting a lot, she has dry oral mucous membranes, and she also has red and irritated skin around her rear quarters because she is often lying in a pool of her own urine. In addition to these problems, if her recumbency is pro-longed, she will be prone to loss of muscle mass, and contracture and edema of her limbs. Recumbent patients may also require placement of an endotracheal tube or tracheostomy tube and/or may be on me-chanical ventilation. For the problems Leslie is facing, as well as the additional problems common to recumbent patients, indicate the reasons that each occurs and then summarize the care that must be provided to manage each problem appro-priately and effectively