Plus-Hex CLINICAL
and to check that the pleural space had not filled with fluid. A few B-lines, which can indicate fluid and air in close proximity to one another in the lung field, were visible, but these were not deemed significant [ 12 ].
The mobility status of this patient was assessed at the initial triage appointment at the primary care practice and then again by the veterinary surgeon( VS) at the OOH clinic. The patient was able to move around, although he was graded 10 / 10 lame on his right forelimb. The patient was hospitalised overnight to be monitored before surgical repair of the fracture.
The patient ' s respiratory effort and rate were monitored throughout the night; increased respiratory effort could indicate free fluid in the body, such as blood from a slow haemorrhage or urine from a ruptured bladder, but these were ruled out.
Nursing care
The aim of the initial nursing care for this patient when he was presented at the OOH clinic was to stabilise the fracture and administer analgesia to keep him comfortable.
When considering nursing interventions and patient care, it is important to encompass different nursing methods to ensure that patient comfort remains the priority. The Orpet and Jeffrey Ability Model [ 13 ]( Figure 4) enables veterinary nurses( VNs) to help the patient maintain a status of homeostasis that is as close to normal for them as possible. However, certain criteria in this model cannot be simulated in a hospital environment, such as the ability to‘ express normal behaviour’, due to the patient being kennelled and on medications that could diminish or alter their mentation, or to‘ mobilise adequately’, as they may be restricted due to the risk of hurting themselves.
The patient ' s hydration status was monitored by the VS. The patient was placed on intravenous fluid therapy at a maintenance rate to support his body throughout the recovery process and to encourage metabolisation of the drugs used during his general anaesthetic. His maintenance fluid rate was calculated at 2.5 ml / kg / hour( 28.75 ml / hour), and his surgical fluid rate was 5 ml / kg / hour( 57.5 ml / hour) [ 14 ].
It is important to secure venous access in all trauma cases, as intravenous catheterisation provides immediate access for the administration of medications and supportive interventions such as fluids. In this instance, a cephalic vein catheter was successfully placed and maintained without difficulty, although the saphenous vein would have provided an alternative site if required.
While in the hospital, this patient was regularly taken to the toilet area, a grassy area outside the clinic. A sling was used, usually by two VNs, to support him when he was taken outside. He produced normal amounts of urine and normal faeces. The patient ' s urination was monitored closely throughout his hospital stay to ensure there was no injury to his bladder. Inability to urinate could increase the risk of damage to the kidneys, due to the increase of creatinine and urea in the bloodstream when they are not excreted.
Supportive measures, such as pheromone diffusers and minimisation of unnecessary handling, were implemented to promote rest and recovery.
The patient was offered small meals throughout the day, rather than one large meal. This reduced the risk of gastrointestinal discomfort and upset, and allowed medications to be given with food when required.
Hospitalised patients are weighed a minimum of once daily and their daily resting energy requirement( RER) is calculated to ensure they are getting the appropriate nutrition. Adequate nutrition allows the body to maintain optimal immune function and normal cellular structure, and assists with the metabolism of drugs [ 15 ].
The RER is recorded on the hospital sheets, together with details of the meals given throughout the day, and the nursing team regularly communicates with the VSs in relation to the patient ' s ongoing nutritional requirements and intake.
Postoperative care
Figure 4. Orpet and Jeffrey Ability Model [ 13 ].
Immediately following the surgery to stabilise the fracture, a large bandage was placed( modified Robert Jones style) for the initial 12 – 24 hours [ 16 ]. The bandage was placed to immobilise the leg after surgery, to prevent pain, discomfort, damage or movement of the pins caused by the patient trying to move the newly stabilised leg.
Volume 41( 1) • February 2026
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