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Rationale for Interventions

Summary:

The intention of this section is to provide veterinary technicians with guidelines for writing the patient care plan portion of the veterinary medical record. As there is no standardized format for writing a veterinary care plan, the following principles are only one example of how a care plan may be formulated.

Note: Giving the rationale for each intervention is not always required as part of a patient care plan. This section is included primarily for educational purposes.

Objective

To highlight the knowledge of why you are carrying out an intervention and how the patient is expected to respond.

What to Include

The rationale for an intervention is the medical, nursing, husbandry, physiological, or pathophysiological reason why the intervention is carried out.

In academic contexts, give references for the rationale.

List and number the rationale according to the corresponding problem and intervention.

Sample “Rationale for Interventions” List

The following list is a continuation of the mastitis cow care plan above, and the numbered rationale corresponds with the interventions listed in the previous section.

Interventions

Rationale for Interventions

1, 2

Conduct culture and sensitivity test (DVM)
Sanitize teat ends (VT)
Collect 4 quarter milk samples using accepted procedures (VT)
Administer prescribed medication based on test results and subsequent DVM Rx (DVM)
Warm pack and massage udder every six hours (VT)

Teat ends are sanitized to prevent iatrogenic infections and contamination of the milk samples with environmental organisms. Teats are sanitized from the farthest to nearest teat to limit the possibility of contamination while sanitizing. Individual quarter samples are collected to identify the causative organism in each quarter. Samples are collected from the nearest to farthest teat to limit the possibility of contamination in the collection process.

Reference: “Procedures for Collecting Milk Samples” (2004). Microbiological Procedures for the Diagnosis of Bovine Udder Infection (3rd ed.). National Mastitis Council. Retrieved from: www.nmconline.org/sampling.htm

Warmth and massage help increase circulation to the udder, thereby mitigating congestion.

Reference: Bassert, J.M. & McCurnin, D. M. (2002) Clinical Textbook for Veterinary Technicians (5th ed.). Philadelphia: Saunders.

Milk patient last (every 12 hours) (VT)
Sanitize udder and teats (VT)
Hand strip quarters (VT)
Dip teats (VT)
Inspect milking machines and evaluate practices (VT)

Milking cows with mastitis last in order helps prevent the spread of mastitis to other cows. Proper vacuum and sequencing of the milking machine, as well as fit and sanitation of teat cups, limits irritation and contamination of the teats.

Reference: Schroeder, J.W. (2010) Mastitis Control Programs: Bovine Mastitis and Milking Management. Retrieved from: http://www.ag.ndsu.edu/pubs/ansci/dairy/as1129w.htm