Subject: Medicine

Module 1

The Nurse’s Role in Medical Clinics 

Why set up a monitoring clinic?

How to set up a monitoring clinic

Equipment needed for a monitoring clinic

Learning objectives
After completion of this module, participants should be able to:

Understand the importance of nurses being involved in the long term monitoring of cats with medical diseases

Visualise how they would be able to set up this type of clinic in their own practice

Feel ready to learn and revise common chronic feline disease and become up to date with the latest evidence

Module 2

Chronic Kidney Disease

What is CKD?

What effects does CKD have on the body?

How to monitor CKD

Treatment aims for CKD

IRIS staging

Learning objectives
After completion of this module, participants should be able to:

Understand the pathophysiology of CKD

Identify parameters used to monitor the CKD patient

Understand the IRIS staging scheme

Understand what treatments are appropriate at which stage of disease

Use evidence based medicine to help educate your clients

Module 3

Diabetes Mellitus

What is diabetes mellitus?

How to monitor diabetes mellitus

Treatment aims for diabetes mellitus

Owner support for cats with diabetes mellitus

Learning objectives
After completion of this module, participants should be able to:

Understand the pathophysiology of diabetes mellitus

Understand the difference between cats and dogs with diabetes mellitus

Understand how to monitor diabetes mellitus and the importance of blood glucose curves

Understand what treatments are available for diabetes mellitus

Counsel owners of cats with diabetes mellitus

Module 4

Degenerative Joint Disease

How prevalent is DJD in cats?

How to assess cats for DJD

Treatments for DJD

How to engage owners in the treatment and monitoring of DJD

Learning objectives
After completion of this module, participants should be able to:

Understand the prevalence of DJD in cats and use that information in the nursing treatment and handling of the cat

Assess cats using a variety of methods both in the clinic and at home for DJD

Understand the different treatments available for DJD

Educate owners about the treatments and how the owner can assess the cat to

improve compliance

Week 1

From Conception to Weaning

Parent health prior to conception and how this may affect pregnancy, parturition, and offspring

Nutritional requirements during pregnancy

Nutritional adaptations required during lactation

Neonate nutritional requirements, including how to hand feed effectively

Weaning

Learning objectives
After completion of this week, participants should be able to:

Discuss how nutrition affects reproduction and key adaptations that are required

Have a clear understanding of how to promote health through nutrition during lactation

Identify the essential nutritional requirements for neonates

Understand how to hand feed neonates correctly

Week 2

Growth

Optimal growth

Effects of neutering

Nutritional considerations for large breed puppies

Learning objectives
After completion of this week, participants should be able to:

Correctly use growth charts to map growth

Identify when growth is not ideal and the necessary changes that are required to maintain a healthy weight to adulthood

Have a good understanding of the nutritional adaptations that will be required at the point of neutering

Week 3

Adult Maintenance

Promoting health in adults

Maintaining a stable weight

Treat management

Recognise key aspects of feeding working dogs

Learning objectives
After completion of this week, participants should be able to:

Understand nutritional requirements for adults and how these must be adapted for each pet’s circumstance

Identify points of concern and to make appropriate recommendations

Reflect on how nutritional requirement for working dog may differ from pet dogs

Week 4

Golden Oldies – Senior Pets

Defining ‘senior’ age as an individual process

Understanding age related changes and how these require nutritional adaptation

Environmental considerations for pets in their senior years

Learning objectives
After completion of this week, participants should be able to:

Confidently assess the needs of a senior pet

Identify environmental changes that may be required

Understanding of the dynamic changes to nutrition that are required for seniors to better support the pet and pet owner

Week 5

Diet Choices

Examination of the pet food label

Introduction to alternative diet types and how to have conversations with pet owners

How to manage pets fed an alternative diet within a hospital environment

Learning objectives
After completion of this week, participants should be able to:

Identify all key information on a pet food label and how this is used to determine a feeding amount

Have a broad understanding of the pros and cons associated with alternative diets that are now commonly fed

Appreciate methods for assessing the suitability of alternative diets and how to improve safety

Confidently talk to the pet owner who wish to feed an alternative diet type

Week 6

Maintaining an Ideal Weight

Assess ideal weight through body condition scoring and muscle condition scoring

Simple steps to ensure obesity does not occur, and what can help if it does

How to calculate a feeding quantity of dry, wet or mixed diet types

Learning objectives
After completion of this week, participants should be able to:

Confidently be able to body condition score and muscle condition score to identify an ideal weight and good health

Understand how simple food management in the home can prevent obesity occurring

Thoroughly understand calculations for determining a feeding amount to prevent over, or under feeding

Week 1

From Conception to Weaning

Parent health prior to conception and how this may affect pregnancy, parturition, and offspring

Nutritional requirements during pregnancy

Nutritional adaptations required during lactation

Neonate nutritional requirements, including how to hand feed effectively

Weaning

Learning objectives
After completion of this week, participants should be able to:

Discuss how nutrition affects reproduction and key adaptations that are required

Have a clear understanding of how to promote health through nutrition during lactation

Identify the essential nutritional requirements for neonates

Understand how to hand feed neonates correctly

Week 2

Growth

Optimal growth

Effects of neutering

Nutritional considerations for large breed puppies

Learning objectives
After completion of this week, participants should be able to:

Correctly use growth charts to map growth

Identify when growth is not ideal and the necessary changes that are required to maintain a healthy weight to adulthood

Have a good understanding of the nutritional adaptations that will be required at the point of neutering

Week 3

Adult Maintenance

Promoting health in adults

Maintaining a stable weight

Treat management

Recognise key aspects of feeding working dogs

Learning objectives
After completion of this week, participants should be able to:

Understand nutritional requirements for adults and how these must be adapted for each pet’s circumstance

Identify points of concern and to make appropriate recommendations

Reflect on how nutritional requirement for working dog may differ from pet dogs

Week 4

Golden Oldies – Senior Pets

Defining ‘senior’ age as an individual process

Understanding age related changes and how these require nutritional adaptation

Environmental considerations for pets in their senior years

Learning objectives
After completion of this week, participants should be able to:

Confidently assess the needs of a senior pet

Identify environmental changes that may be required

Understanding of the dynamic changes to nutrition that are required for seniors to better support the pet and pet owner

Week 5

Diet Choices

Examination of the pet food label

Introduction to alternative diet types and how to have conversations with pet owners

How to manage pets fed an alternative diet within a hospital environment

Learning objectives
After completion of this week, participants should be able to:

Identify all key information on a pet food label and how this is used to determine a feeding amount

Have a broad understanding of the pros and cons associated with alternative diets that are now commonly fed

Appreciate methods for assessing the suitability of alternative diets and how to improve safety

Confidently talk to the pet owner who wish to feed an alternative diet type

Week 6

Maintaining an Ideal Weight

Assess ideal weight through body condition scoring and muscle condition scoring

Simple steps to ensure obesity does not occur, and what can help if it does

How to calculate a feeding quantity of dry, wet or mixed diet types

Learning objectives
After completion of this week, participants should be able to:

Confidently be able to body condition score and muscle condition score to identify an ideal weight and good health

Understand how simple food management in the home can prevent obesity occurring

Thoroughly understand calculations for determining a feeding amount to prevent over, or under feeding

Week 1

The Immune System

Learning objectives
After completion of this week, participants should be able to:

Understand the specialised cells and molecules of the immune system

Recognise which organs are involved in the immune system and their function

Identify physical barriers that play a role in a patient’s immune system

Explain the difference between innate and adaptive immune responses

Explain the difference between humoral and cell mediated immunity

Understand the laboratory diagnostics in immunology

Understand thermoregulation in veterinary patients and differentiate hyperthermia vs pyrexia

Differentiate different types of immune system disorders

Week 2

Immune-Mediated Haemolytic Anaemia (IMHA)

Learning objectives
After completion of this week, participants should be able to:

Understand the pathophysiology of immune mediated haemolytic anaemia (IMHA)

Recognise the common clinical signs associated with IMHA

Understand the diagnostic tests performed during the diagnosis of IMHA

Perform in-house cytology as part of the diagnosis of IMHA

Understand the treatment options available for veterinary patients including long-term monitoring

Recognise the prognosis of the disease and negative prognostic factors

Consider the nursing considerations for these patients and the role of the RVN

Week 3

Immune-Mediated Thrombocytopenia (IMTP)

Learning objectives
After completion of this week, participants should be able to:

Understand the pathophysiology of immune mediated thrombocytopaenia (IMTP)

Define thrombocytopaenia and recognise what our platelets are

Recognise the common clinical signs associated with this condition

Understand the laboratory tests performed during the diagnosis of ITP

Review the manual platelet count

Understand the diagnostic tests performed during the diagnosis of ITP

Understand the treatment options available for veterinary patients including long term monitoring

Recognise the prognosis of this disease and negative prognostic factors

Consider the nursing considerations for these patients

Week 4

Immune-Mediated Polyarthritis (IMPA)

Learning objectives
After completion of this week, participants should be able to:

Understand the pathophysiology of IMPA

Differential erosive vs non-erosive forms of IMPA

Recognise the classification system of IMPA

Recognise the most common clinical signs associated with this disease

Understand the diagnostic tests performed in these patients (including infectious disease screening)

Understand the method of arthrocentesis and how to assist the veterinary surgeon

Understand the treatment options available to these patients

Recognise the differences in polyarthritis in feline patients

Understand the role of the RVN when caring for these patients

Week 1

Dentistry Analgesia

Different analgesia drugs available

Dose selection

Routes of administration

Drug combinations

Local nerve blocks

Sides effects of drugs

Learning objectives
After completion of this week, participants should be able to:

Assist the veterinary surgeon in selecting appropriate analgesic drugs for different oral surgeries

Be aware of potential side effects of these drugs

Alongside the veterinary surgeon, create a tailored drug protocol for each patient to go home with

Comfortably calculate analgesic drugs at low doses

Be aware of what drugs are suitable as a combination

Understand the exclusion or reduced dose of some drugs, regarding co-morbidities

Use pain scoring methods and understand what analgesia the patient may need

Week 2

Anaesthesia – Airway Security and Hypothermia

How to maintain a patent airway

Patient positioning

To cuff or not to cuff?

Causes of hypothermia

Negative effects of hypothermia

Preventing and treating hypothermia

Learning objectives
After completion of this week, participants should be able to:

Understand different styles of ET tubes and their benefits and potential negatives

Understand appropriate ET tube cuff pressures and why this is so integral to protecting the airway

Appreciate techniques to protect the airway

Know the gold standard method to move patients under anaesthesia, whilst protecting their airway

List the common causes of hypothermia

Understand the negative effects of hypothermia

Have practical knowledge on how to prevent and treat hypothermia

Understand the risk of using some heating devices

Week 3

Anaesthesia – Managing Hypotension

Causes of hypotension

Negative side effects of hypotension

How to obtain accurate blood pressure reading

How to prevent hypotension

Fluid therapy

Anaesthesia drug choices

The use of vasopressors and anticholinergics

Learning objectives
After completion of this week, participants should be able to:

Obtain accurate blood pressure readings for cats and dogs under general anaesthesia for dentistry

Understand the limitations of blood pressure measurements and trouble shoot potential problems

Know what is deemed as an appropriate blood pressure reading under general anaesthetic

Know which drugs may interfere with maintaining blood pressure

Understand what could happen to our patients if left hypotensive

Feel more confident, alongside the veterinary surgeon, in making a treatment plan tailored to each individual patient, to treat any hypotensive episodes

Week 4

Post-operative Care

Immediate post op care once extubated

Care for patients in the recovery ward

Discharge instructions

Post op care at home

Post op checks

Learning objectives
After completion of this week, participants should be able to:

Maintain and monitor a patent airway in the immediate post-operative period

Understand the importance of close monitoring in recovery

Create a post-operative plan tailored to each individual patient

Feel confident to create discharge instructions for your patient

Confidently communicate with the owner about the anaesthesia and surgery the patient has received

Perform a thorough physical post-operative check, including the whole patient

Understand the best dental care an owner can provide at home, along with alternative options if these goals cannot be met

Week 1

Canine Hypothyroidism

Learning objectives
After completion of this week, participants should be able to:

Identify the clinical signs of canine hypothyroidism

Explain the role of hormones in the body

Explain the relationship between TSH and thyroid hormones

Describe what canine hypothyroidism is and why it occurs

Describe ways to support the client owning a canine with hypothyroidism

Week 2

Canine and Feline Diabetes

Learning objectives
After completion of this week, participants should be able to:

Name the 3 types of cell that contribute to the endocrine function of the pancreas

Name the two main types of insulin used in cats and dogs

Describe the reason dogs become diabetic

Describe the reason cats become diabetic

Explain some differences in the nursing considerations you would give cats compared to dogs and why

Week 3

Feline Acromegaly

Learning objectives
After completion of this week, participants should be able to:

Identify 3 major hormones that are lost when you remove the anterior pituitary gland

Explain how feline hypersomatotropism occurs

Discuss how excess growth hormone results in acromegaly

Explain the nursing considerations for a hypophysectomy patient

Explain the support that a client might need for a cat with FeHS

Week 4

Feline Hyperthyroidism

Learning objectives
After completion of this week, participants should be able to:

Discuss the clinical signs that a hyperthyroid cat might present with

Explain the effects of too much thyroid hormone on the body

Demonstrate an understanding of the treatment options available for the disease in order to support the client with the hyperthyroid cat

Describe the most commonly used test to diagnose feline hyperthyroidism and what that test is measuring

Explain the difference between free T4 and total T4

Week 5

Canine Hyperadrenocorticism (Cushing’s Disease)

Learning objectives
After completion of this week, participants should be able to:

Explain the reasons why canine hyperadrenocorticism (HAC) occur

Identify the clinical signs associated with a canine HAC patient

Discuss some of the common tests available for HAC and the reasons for their use

Identify 3 main forms of treatment for the canine HAC patient

Demonstrate an understanding of the nursing considerations for the patient with HAC

Week 6

Canine Hypoadrenocorticism (Addison’s Disease)

Learning objectives
After completion of this week, participants should be able to:

Explain the causes of canine hypoadrenocorticism

Identify some of the clinical signs that a patient may present with and why

Discuss the treatment options available to the client with the hypoadrenocorticism pet

Demonstrate an understanding of the nursing considerations for a canine with hypoadrenocorticism

Name some of the tests that a vet may ask you to carry out on the suspected hypoadrenocorticism patient and discuss why they may be required

Week 1

What is Cancer?

Pathophysiology of neoplasia

Common causes of cancer in animals

Classifications of cancer types

The difference between benign and malignant disease

Learning objectives
After completion of this week, participants should be able to:

Understand the alterations in the cell cycle that results in neoplastic disease

List the different types of cancer based on tissue origin

Describe the different causes of cancer in small animals

Explain how benign disease is different to malignant disease and the risks associated with both conditions

Identify higher risk categories of patients and analyse the research available in line with evidence-based medicine

Week 2

Diagnosis and Prognosis

Fine needle aspirates

Cancer cytology

Cancer staging

Specialist tests for cancer

Learning objectives
After completion of this week, participants should be able to:

List fine needle aspirate methods to optimise cytological yield

Evaluate a cytology sample in-house to ensure sample is of diagnostic quality

Understand the commonly preferred methods for staging patients with neoplasia

Describe the types of specialist tests required to further categorise cancer

Analyse personal skill set and determine if any modifications to current practice would be beneficial

Week 3

Common Chemotherapy Agents

Overview of common chemotherapy drugs

Administering chemotherapy

Chemotherapy safety

Adverse effects with administering chemotherapy

Learning objectives
After completion of this week, participants should be able to:

Understand how chemotherapy agents work

Explain how to correctly administer chemotherapy agents

List what safety factors should be observed when administering chemotherapy in practice

Describe how to manage an extravasation injury and reduce risk of chemotherapy associated nausea and vomiting

Evaluate practice protocols to standardise and promote best practice in line with most current information

Week 4

Client and Patient Support

Introduction to oncology clinics

Nadir checks

Managing adverse effects following chemotherapy administration

The Cancer Journey

Learning objectives
After completion of this week, participants should be able to:

Describe how and why a nadir check is performed

Identify common adverse effects associated with chemotherapy

Understand preventive and interventional treatment protocols for chemotherapy associated adverse effects

Explain the causes for likely outcome of treatment failure and the physiology behind this

Reflect over professional skill set and evaluate how you can further enhance your personal development to support clients of patients with cancer

Week 1

Canine Hypothyroidism

Learning objectives
After completion of this week, participants should be able to:

Identify the clinical signs of canine hypothyroidism

Explain the role of hormones in the body

Explain the relationship between TSH and thyroid hormones

Describe what canine hypothyroidism is and why it occurs

Describe ways to support the client owning a canine with hypothyroidism

Week 2

Canine and Feline Diabetes

Learning objectives
After completion of this week, participants should be able to:

Name the 3 types of cell that contribute to the endocrine function of the pancreas

Name the two main types of insulin used in cats and dogs

Describe the reason dogs become diabetic

Describe the reason cats become diabetic

Explain some differences in the nursing considerations you would give cats compared to dogs and why

Week 3

Feline Acromegaly

Learning objectives
After completion of this week, participants should be able to:

Identify 3 major hormones that are lost when you remove the anterior pituitary gland

Explain how feline hypersomatotropism occurs

Discuss how excess growth hormone results in acromegaly

Explain the nursing considerations for a hypophysectomy patient

Explain the support that a client might need for a cat with FeHS

Week 4

Feline Hyperthyroidism

Learning objectives
After completion of this week, participants should be able to:

Discuss the clinical signs that a hyperthyroid cat might present with

Explain the effects of too much thyroid hormone on the body

Demonstrate an understanding of the treatment options available for the disease in order to support the client with the hyperthyroid cat

Describe the most commonly used test to diagnose feline hyperthyroidism and what that test is measuring

Explain the difference between free T4 and total T4

Week 5

Canine Hyperadrenocorticism (Cushing’s Disease)

Learning objectives
After completion of this week, participants should be able to:

Explain the reasons why canine hyperadrenocorticism (HAC) occur

Identify the clinical signs associated with a canine HAC patient

Discuss some of the common tests available for HAC and the reasons for their use

Identify 3 main forms of treatment for the canine HAC patient

Demonstrate an understanding of the nursing considerations for the patient with HAC

Week 6

Canine Hypoadrenocorticism (Addison’s Disease)

Learning objectives
After completion of this week, participants should be able to:

Explain the causes of canine hypoadrenocorticism

Identify some of the clinical signs that a patient may present with and why

Discuss the treatment options available to the client with the hypoadrenocorticism pet

Demonstrate an understanding of the nursing considerations for a canine with hypoadrenocorticism

Name some of the tests that a vet may ask you to carry out on the suspected hypoadrenocorticism patient and discuss why they may be required

Week 1

What is Cancer?

Pathophysiology of neoplasia

Common causes of cancer in animals

Classifications of cancer types

The difference between benign and malignant disease

Learning objectives
After completion of this week, participants should be able to:

Understand the alterations in the cell cycle that results in neoplastic disease

List the different types of cancer based on tissue origin

Describe the different causes of cancer in small animals

Explain how benign disease is different to malignant disease and the risks associated with both conditions

Identify higher risk categories of patients and analyse the research available in line with evidence-based medicine

Week 2

Diagnosis and Prognosis

Fine needle aspirates

Cancer cytology

Cancer staging

Specialist tests for cancer

Learning objectives
After completion of this week, participants should be able to:

List fine needle aspirate methods to optimise cytological yield

Evaluate a cytology sample in-house to ensure sample is of diagnostic quality

Understand the commonly preferred methods for staging patients with neoplasia

Describe the types of specialist tests required to further categorise cancer

Analyse personal skill set and determine if any modifications to current practice would be beneficial

Week 3

Common Chemotherapy Agents

Overview of common chemotherapy drugs

Administering chemotherapy

Chemotherapy safety

Adverse effects with administering chemotherapy

Learning objectives
After completion of this week, participants should be able to:

Understand how chemotherapy agents work

Explain how to correctly administer chemotherapy agents

List what safety factors should be observed when administering chemotherapy in practice

Describe how to manage an extravasation injury and reduce risk of chemotherapy associated nausea and vomiting

Evaluate practice protocols to standardise and promote best practice in line with most current information

Week 4

Client and Patient Support

Introduction to oncology clinics

Nadir checks

Managing adverse effects following chemotherapy administration

The Cancer Journey

Learning objectives
After completion of this week, participants should be able to:

Describe how and why a nadir check is performed

Identify common adverse effects associated with chemotherapy

Understand preventive and interventional treatment protocols for chemotherapy associated adverse effects

Explain the causes for likely outcome of treatment failure and the physiology behind this

Reflect over professional skill set and evaluate how you can further enhance your personal development to support clients of patients with cancer

Week 1

The Neurological Exam

Mentation

Posture and gait

Postural reactions

Cranial nerve evaluation

Spinal reflexes

Palpation

Localisation

Learning objectives
After completion of this week, participants should be able to:

Recognise the rationale for performing a neurological examination

Accurately perform a detailed neurological examination and determine if the case is neurological

Understand the findings of the neurological examination and how that leads to the localisation of the lesions

Week 2

Emergency Triage

Initial patient triage

Head trauma management

Acute spinal cord injury management

Emergency seizure management

Learning objectives
After completion of this week, participants should be able to:

Understand how to triage and assess neurological emergency patients

Recognise abnormalities and signs of raised intracranial pressure Assess and manage spinal trauma patients

Know what to prepare and how to manage an emergency seizure patient

Week 3

Intracranial Disease

Pathophysiology

Intracranial pressure

Meningoencephalitis of unknown origin (MUO)

Hydrocephalus

Vestibular disease

Neoplasia

Learning objectives
After completion of this week, participants should be able to:

Describe how to recognise and manage raised intracranial pressure

Discuss the clinical signs of hydrocephalus and be able to manage patients with this presentation

Know the presentation, diagnosis, management and outcome of patients with meningoencephalitis of unknown origin

Week 4

Spinal Cord Injury

Intervertebral disc disease

Fibrocartilaginous embolism (FCE)

Surgical vs medical management

Vertebral abnormalities

Nursing management

Learning objectives
After completion of this week, participants should be able to:

Know and understand the common causes of spinal cord injury and demonstrate an awareness of diagnostic and management options

Discuss the surgical options available to spinal patients Understand why medial management is an option for some patients

Know the nursing management required for spinal patients

Week 5

Neuromuscular Disease

Myasthenia Gravis

Polyradiculoneuritis

Myositis

Complications and risks

Nursing care

Learning objectives
After completion of this week, participants should be able to:

Understand the cause, presentation, diagnostics and treatment for the most common neuromuscular presentations

Describe the complications and risks associated with each of the diseases

Know the nursing care required for each of the discussed neuromuscular diseases

Week 6

Nursing Care for Neurological Patients

Bladder and faecal management

Skin care

Exercise considerations

Handling techniques

Physiotherapy

General nursing care for hospitalised patients

Learning objectives
After completion of this week, participants should be able to:

Describe bladder management techniques and how to manage overflow incontinence and faecal incontinence

Appropriately handle and move neurological patients with a range of conditions

Understand the most appropriate exercise techniques and aids to use with different patients

Discuss physiotherapy techniques and when one may be used over another

Advise and help owners with long term home care plans

Combine knowledge from each of the previous lectures to be able to successfully create care plans for a variety of neurological conditions

Week 1

The Neurological Exam

Mentation

Posture and gait

Postural reactions

Cranial nerve evaluation

Spinal reflexes

Palpation

Localisation

Learning objectives
After completion of this week, participants should be able to:

Recognise the rationale for performing a neurological examination

Accurately perform a detailed neurological examination and determine if the case is neurological

Understand the findings of the neurological examination and how that leads to the localisation of the lesions

Week 2

Emergency Triage

Initial patient triage

Head trauma management

Acute spinal cord injury management

Emergency seizure management

Learning objectives
After completion of this week, participants should be able to:

Understand how to triage and assess neurological emergency patients

Recognise abnormalities and signs of raised intracranial pressure Assess and manage spinal trauma patients

Know what to prepare and how to manage an emergency seizure patient

Week 3

Intracranial Disease

Pathophysiology

Intracranial pressure

Meningoencephalitis of unknown origin (MUO)

Hydrocephalus

Vestibular disease

Neoplasia

Learning objectives
After completion of this week, participants should be able to:

Describe how to recognise and manage raised intracranial pressure

Discuss the clinical signs of hydrocephalus and be able to manage patients with this presentation

Know the presentation, diagnosis, management and outcome of patients with meningoencephalitis of unknown origin

Week 4

Spinal Cord Injury

Intervertebral disc disease

Fibrocartilaginous embolism (FCE)

Surgical vs medical management

Vertebral abnormalities

Nursing management

Learning objectives
After completion of this week, participants should be able to:

Know and understand the common causes of spinal cord injury and demonstrate an awareness of diagnostic and management options

Discuss the surgical options available to spinal patients Understand why medial management is an option for some patients

Know the nursing management required for spinal patients

Week 5

Neuromuscular Disease

Myasthenia Gravis

Polyradiculoneuritis

Myositis

Complications and risks

Nursing care

Learning objectives
After completion of this week, participants should be able to:

Understand the cause, presentation, diagnostics and treatment for the most common neuromuscular presentations

Describe the complications and risks associated with each of the diseases

Know the nursing care required for each of the discussed neuromuscular diseases

Week 6

Nursing Care for Neurological Patients

Bladder and faecal management

Skin care

Exercise considerations

Handling techniques

Physiotherapy

General nursing care for hospitalised patients

Learning objectives
After completion of this week, participants should be able to:

Describe bladder management techniques and how to manage overflow incontinence and faecal incontinence

Appropriately handle and move neurological patients with a range of conditions

Understand the most appropriate exercise techniques and aids to use with different patients

Discuss physiotherapy techniques and when one may be used over another

Advise and help owners with long term home care plans

Combine knowledge from each of the previous lectures to be able to successfully create care plans for a variety of neurological conditions

Week 1

Aetiology and Pathogenesis

Anatomy of the head

Tooth and periodontal anatomy, and oral soft tissues

Oral nomenclature

Tooth types, nomenclature and formulae

Eruption times

Occlusion

Learning objectives
After completion of this week, participants should be able to:

Identify tooth and periodontal structures

Explain the Modified Triadan System of numbering teeth in the dog and cat

Recognise normal occlusion

Week 2

Periodontology

Aetiology and pathogenesis of dental disease

Gingivitis

Periodontitis

Gingivostomatitis

Periodontal therapy

Scaling and polishing

Pocket control and therapy

Medications, homecare (brief), dental clinics (brief)

Learning objectives
After completion of this week, participants should be able to:

Describe how gingivitis develops and its progression to periodontal disease

Explain what gingivostomatitis is

Outline the process of safe ultrasonic tooth scaling and its purpose

Week 3

Oral Pathology and Treatment

Trauma and treatment options

Tooth fracture / discolouration / (sub) luxation

Dental diseases and treatment options

Tooth resorption / caries / periodontal disease

Malocclusion and treatment options

Traumatic / dental / skeletal malocclusions

Other conditions and treatment options

Enamel defects / dentigerous cysts / persistent deciduous / root dilacerations and abnormal morphology / tumours

Learning objectives
After completion of this week, participants should be able to:

Identify common pathologies associated with the teeth and oral cavity

Describe some potential treatment options for common pathologies

Week 4

Oral Examination and Charting

History taking and clinical examination – conscious oral examination

Pre-operative tests

Assessment under general anaesthesia – including anaesthesia induction, intubation, oral preparation, probing

Charting – what to fill in, disease scoring and making your chart work

Imaging and other investigations

Radiography – parallel and bisecting angle techniques

Biopsy

Learning objectives
After completion of this week, participants should be able to:

Confidently undertake a thorough conscious examination of a patient’s teeth
and oral cavity

Set up for and assist with assessment of the teeth and oral cavity in an anaesthetised patient

Accurately complete a dental chart which documents all pathology discovered upon examination

Week 5

Instrumentation and Dental Surgery

Instruments – use, care and maintenance

Dental machine and other powered equipment – use, care and maintenance

Ancillary equipment – use, care and maintenance

Preparation for and veterinary nursing assistance with surgery

Pre-, intra- and post-operatively, including analgesia

The role of intraoperative radiography

Learning objectives
After completion of this week, participants should be able to:

Differentiate between different instruments used for dental and oral procedures, and state what they are used for

Describe the proper use, care and maintenance of a range of dental instruments and equipment

Explain the benefits of oral radiography in veterinary patients and outline the basic, fundamental principles of the parallel and bisecting angle techniques

Week 6

Dental Clinics, Products and Homecare

What is an effective dental clinic

Types of patients attending dental clinics

Resources for dental clinic consultations

Products and interventions available to help with maintaining oral health

Oral homecare regimes

Effective dissemination of theoretical and practical oral hygiene advice

Client concordance and follow-up

Learning objectives
After completion of this week, participants should be able to:

Debate what makes a dental clinic effective

Explain the range of resources required to run an effective dental clinic, and the purpose of these resources

Describe how a range of products and interventions used to maintain optimal oral health work

Outline how to achieve and maintain client compliance with recommended oral homecare regimes

Week 1

Nutritional Assessment and Calculations

How to perform a nutritional assessment

Calculate energy requirements and how much to feed

Treatment regimens for inappetence

Instigating nutritional support

Learning objectives
After completion of this week, participants should be able to:

Perform a nutritional history and assessment of the animal

Calculate BER and RERs and apply this to how much to feed

Identify when nutritional support is required and how to do this

Week 2

Clinical Nutrition – Renal, Urinary, Liver and Cardiac

Clinical nutrition for renal, urinary, liver and cardiac disease

Look at each of the nutrient requirements for each of these management regimes

Learning objectives
After completion of this week, participants should be able to:

Make recommendations for clinical diets for renal, urinary, liver and cardiac disease

Understand the nutrient specifications for these diets

Discuss the benefits of these diets

Week 3

Clinical Nutrition – Gastrointestinal and Pancreatic

Clinical nutrition for gastrointestinal and pancreatitis

Look at each of the nutrient requirements for each of these management regimes

Learning objectives
After completion of this week, participants should be able to:

Make recommendations for clinical diets for range of gastrointestinal and pancreatitis

Understand the nutrient specifications for these diets

Discuss the benefits of these diets

Week 4

Nutritional Supplements and Trends

Supplements

Nutritional trends (including raw and homecooked diets)

Learning objectives
After completion of this week, participants should be able to:

Make recommendations for supplements for the diseases discussed in weeks 3 and 4

Look at the nutritional evidence behind nutritional fashions

Discuss raw and home cooked feeding with clients

Week 1

Mammary Tumours

Mammary tumours are a common tumour in cats which are often malignant, yet a small percentage are benign. Early detection and intervention can have a positive outcome and some patients go on to live disease-free lives, others require continuous treatment and monitoring.

Presentation and behaviour of mammary tumours

Diagnosis and staging

Treatment modalities and monitoring considerations

Learning objectives
After completion of this week, participants should be able to:

Explain the potential causes of mammary tumours in cats

List what investigative procedures may be necessary to secure a diagnosis and what safety factors should be observed when sampling masses

Understand which treatment modalities are most useful for which form of the disease

Describe the patient and client care considerations when managing cases of feline mammary tumours

Week 2

Lymphoma

Lymphoma is a cancer of the lymphocytes and/or lymphoid tissue, which is present in many locations within the body; presentation and treatment of these cases is dependant on location. This week we will cover:

Manifestation of feline lymphoma and categories of disease

Diagnosis, staging and prognostic indicators

Treatment options for feline lymphoma

Chemotherapy protocols, client expectations and how to create a feline friendly environment

Learning objectives
After completion of this week, participants should be able to:

List the common manifestations of feline lymphoma and the patient groups most affected

Understand the value of staging and monitoring the disease

Describe the subtypes of feline lymphoma and the difference in treatment approaches

Explain the rationale of a multimodal chemotherapy protocol and how it may impact on prognosis

Analyse personal skill set and determine how you could support feline patients with lymphoma using your practice facilities

Week 3

Squamous Cell Carcinoma

Squamous cell carcinoma is the most common form of head and mouth cancer in cats; the behaviour of this neoplasm is sometimes unpredictable and can be very invasive. On week three we discuss the presentation, investigation and treatment options available for these patients and look at some practices which are novel to veterinary medicine.

Presentation, diagnosis and staging of squamous cell carcinoma, including lymph node mapping

Treatment options and impact on prognosis

Surgical interventions, nursing support and rehabilitation

Introduction to electrochemotherapy and photodynamic therapy

Learning objectives
After completion of this week, participants should be able to:

Describe the different imaging techniques used to evaluate feline squamous cell carcinoma

List treatment options and prognostic indicators for feline squamous cell carcinoma

Understand the mechanism of action behind novel techniques for feline squamous cell carcinoma

Describe the common surgical interventions and post-operative patient considerations

Week 4

Soft Tissue Sarcoma

Feline injection site sarcoma (FISS) is one of the most common soft tissue sarcomas of cats. The disease may present as a minor mass to the owner but often this is just the tip of the iceberg. Week 4 looks at FISS in more detail and brings the courses learning materials all together in this last week

Soft tissue sarcoma pathophysiology overview

Diagnostic and staging processes

Treatment options, radiation and surgical management

Adjuvant (post-operative) chemotherapy and restaging

Learning objectives
After completion of this week, participants should be able to:

Describe the diagnostic approach to determining cancer diagnosis and tumour burden

Explain typical neoplastic behaviour of FISS and the impact of intervention on survival time

Understand the fundamental reasoning for adjuvant chemotherapy and the options for post-operative care

Week 1

Physiotherapy Toolkit (Modalities)

Electrotherapies

Therapeutic hot/cold packs

Manual therapies

Applied exercise therapies

Learning objectives
After completion of this week, participants should be able to:

Understand the principles and application of electrotherapy including:

K-laser

Transcutaneous electrical nerve stimulation (TENS)

Neuromuscular electrical stimulation (NMES)

Pulsed magnetic therapy (Biomag)

Therapeutic ultrasound

Understand the use of therapeutic hot/ cold packs

Understand manual therapy and its application including:

Massage

Effleurage

Coupage

Joint mobilisations

Graded stretches

Understand applied exercise therapy including:

Strengthening and stabilising exercises

Balance and proprioceptive exercises

Functional exercises

Hydrotherapy

Week 2

Patient Assessment

Musculoskeletal patient assessment

Neurological patient assessment

Respiratory / critical care patient assessment

Learning objectives
After completion of this week, participants should be able to:

Carry out a basic musculoskeletal, neurological, and respiratory physiotherapy assessment

Understand valid outcome measures to guide patient treatment

How to write SOAP (subjective, objective, analysis, plan) notes to progress patient treatment

Week 3

Physiotherapy and Hydrotherapy Treatment Techniques

Early phase rehabilitation 0-2 weeks

Mid phase rehabilitation 2-6 weeks

Late phase rehabilitation 6-12 weeks

Patient discharge or maintenance physiotherapy programme

Learning objectives
After completion of this week, participants should be able to:

Carry out early physiotherapy treatment including:

Early manual therapy techniques

Early phase hot and cold pack treatment

Early electrotherapies to improve healing and for pain relief

Mid phase gentle exercise programmes including hydrotherapy

Late phase exercise therapy to include advanced strengthening, proprioceptive, balance and functional exercises

Late phase electrotherapies for pain relief, soft tissue injuries and muscle strengthening

Week 4

Physiotherapy Progression Plans and Home Exercise Programmes

Patient rehabilitation plans

Discharge and maintenance programmes

Home exercise plans

Learning objectives
After completion of this week, participants should be able to:

Learn how and when to progress patient plans from early to mid through to late stage rehabilitation to optimise patient outcomes

Understand when to discharge a patient, or to continue with a maintenance programme for chronic cases or surgical complications

Design home exercise programmes for owners to carry out

Week 5

Musculoskeletal Case Studies

CCL reconstruction – TPLO or lateral suture

Soft tissue injuries (tendinopathies, iliopsoas strains)

Fracture repair

Conservative management of chronic conditions, including hip dysplasia and elbow dysplasia

Learning objectives
After completion of this week, participants should be able to:

Consider appropriate assessment, treatment plan and progression of a musculoskeletal case study

Consider appropriate assessment, treatment plan and progression of a soft tissue case study

Consider appropriate assessment, treatment plan and progression of a fracture repair case study

Consider appropriate assessment, treatment plan and progression of a chronic condition case study

Week 6

Neurological and Respiratory (Intensive Care) Case Studies

Hemi- laminectomy (HLE)

Fibrocartilage embolism (FCE)

Pneumonia

Learning objectives
After completion of this week, participants should be able to:

Consider appropriate assessment, treatment plan and progression of a surgical neurological case study

Consider appropriate assessment, treatment plan and progression of a non-surgical case study

Consider appropriate assessment, treatment plan and progression of a respiratory (critical care) case study