basic patient care Flashcards
what is basic patient care?
- making beds
- ADLs (bathing, eating , restroom, oral care)
- vital signs
- transferring patients
- assistive devices
- Report changes
goals of patient care
- promoting independence
- collaborate
- involve family
Before providing patient care…
introduce yourself
ID patient using 2 proper identifiers
hand hygiene
ensure patient is verbally understanding
while bathing patients you are…
observing skin breakdown or difficult ROM
bathing is…
essential to maintaining personal hygiene
bath water temp
37- 46 C (98.6-115 F)
routine bath temps should be…
40.5-43.3 C (105-110 F)
You are giving a patient a bath, you have gathered all your supplies and turned on the shower, before bathing the patient you should ask…
the patient to feel the water
ensure privacy by…
- closing door
- closing curtains
- keep body parts covered with bath blanket
when assisting with bathing, how can you ensure safety for your patient?
- check for wet floors
- assist patient in & out of shower/tub
- use nonskid mats/socks
- never leave patient alone
- call light is within reach
- protect IV/surgical sites form moisture (infection control)
to ensure safety during bed baths…
keep bed rails up on the opposite side you are working on
what technique do you use to wash a patient?
- wash from cleanest to dirtiest areas
- long, firm strokes
- rinse well
how do you dry a patient after bathing?
gently pat the patients skin to prevent skin breakdown/injury
partial bath includes…
face, neck, hands, back, armpits, buttock, perineal area
perineal care technique…
wash anterior to posterior (front to back)
If your patient has a catheter never…
- raise drainage bag higher than patient’s bladder (can cause infection)
when doing peri care with a catheter…
- ensure slack in tubing
- secure bag on side of bed (never bed rail)
- clean w/ soap & water at insertion site
catheter care should be done…
twice daily
after removing a patient’s dentures…
place in wash basin containing lukewarm water (hot water can damage them)
how do you remove upper denture?
break suction using thumb & forefinger
use gauze, gentle pressure, & tug downwards
how do you remove lower denture?
break suction by lifting it up & twisting sideways
what do you use to clean dentures?
denture cleaner (NOT tooth paste, can scratch them)
to make reinsertion of dentures easier, what do you do?
moisten dentures proir
when dentures are not being used…
place in a cup w/ lukewarm water or denture solution with patient’s name & room number
sitz baths are used for…
- childbirth
- vaginal/rectal surgery
- hemorrhoids
the nurse delegates you to giving a patient a sitz bath. how long does a patient sit in the bath for?
20-30 mins
what is a sitz bath?
appliance filled with warm water placed on the toilet to sooth perineal/rectal areas
when should oral care take place?
- when awaken
- after meals
- prior to bedtime
what can cause your patient to need more frequent oral care?
- if they are NPO (nothing by mouth)
- medications (can make mouth dry)
How do you assist a patient with oral care…
- brush each tooth gently in a circular motion
- 45 degrees to the gum
- back to front of mouth
after oral care what is most important?
flossing
how should you position an unconscious patient during oral care?
on their side facing you
Where should you place a towel and emesis basin during oral care on an unconscious patient?
towel under head and emesis basin under chin
what do you NEVER do during oral care on an unconscious patient?
place you fingers in their mouth
throughout oral care…
explain the procedure (even to unconscious patient)
when providing oral care check for…
- red/irritated gums
- bleeding
-canker sores
-pus - infection
- foul smell or fruity breath
bed making aids with…
comfort, healing, & infection control
when is the best time to change the bedding?
when the patient is OOB (unoccupied)
- ambulation
- showing
- procedure
supplies for bed making…
fitted sheet, mattress pad, flat sheet, pillow case, draw sheet, absorbent pad, blankets, linen bags
when transporting clean linens…
hold away from your body (prevents pathogens on uniform from transferring to patient)
before changing linens…
check for patients personal belongs in the bed
if substances have leaked through the bed…
wipe mattress down, then place linens on the bed
turning, boosting, repositioning improperly can lead to….
excessive workload on your spine and injury to patient’s skin
before you change linens on an occupied bed…
complete any task that could soil the sheets (bathing or lab draw)
steps to making occupied bed
- ROLL patient to one side of bed
- TUCK sheets to be removed under patient
- REPLACE sheets on unoccupied side
- TUCK fresh sheets under the patient
- ROLL patient to fresh side
- REMOVE old linens
- COMPLETE the linen change
when making an occupied bed make sure…
- bed rails are up and locked when you roll the patient
- explain procedure throughout
- provide patient w/ reassurance
when do patients usually need assistance with dressing?
in morning, prior to bed, when clothes become soiled
when assisting with dressing watch for
- IV lines/drains/ tubes
- weakness that could make dressing difficult
allowing the patient to wear and choose their own clothes and dress themselves as much as the can, provides what?
a sense of independence/ control
you patient with a weak side needs assistance with dressing, how do you dress/undress them?
Dress them starting with the weak side, and undress them ending with the weak side
if a patient is connect to an IV line and needs assistance with taking off a gown…
take arm without the IV first, then gently remove gown over the IV site/tubing
How should you put a clean gown on a patient with a IV line
thread the IV bag through the sleeve, hang the bag on the IV pole, then assist putting the arm gently through the gown
if IV tubing is connected to an infusion pump…
ask RN to disconnect
before preforming grooming…
check with patient & nurse to see what is needed & level of assistance
hair washing can be done…
during shower/bath, at sink, in bed
water temp for hair washing….
40.5-43.3 C
prior to hair care…
comb hair to remove all tangles
to ensure patient comfort during grooming
use towels and pillow cases to make sure patient is dry and comfortable
when assisting with toileting…
be aware of any restrictions the patient may have
When the patient is in the restroom make sure…
call light is within reach
when assisting with toileting NEVER….
leave a confused/ unstable patient alone
what can you do to make a bed pan more comfortable for the patient?
run warm water over the pan & place baby powder on the rim
after the patient uses the restroom in the bedpan/urinal….
- measure intake/output
- empty pan/urinal, then clean
- clean & dry peri area
when assisting with toileting you are reporting what kind of finding to the nurse?
diarrhea, constipation, blood in stool/urine, mucous in stool, burning/pain during urination, frequent urination, incontinence
before assisting a patient with eating…
check with nurse about dietary restrictions/precautions
before assisting with eating…
assist with toileting
to avoid chocking while assisting with eating…
raise HOB or have patient sit up in chair
Where should sit when assisting with eating
across from patient
when assisting with eating you should…
monitor proper swallowing
what should you do if you are assisting a stroke patient with eating?
Direct food towards unaffected side of the mouth
what is the safest utensil to use when assisting with eating?
a spoon
before weighing your patient…
- zero the scale prior to use
- clear the area of tripping
types of scales
- mechanical
- chair scale
- bed & sling scales
chair scale
subtract the weight of the wheelchair
bed & sling scale
Subtract weight of bedding/equipment
active listening
mindfully hearing & attempting to comprehend the meaning of words
patients have the right…
to full disclosure about their care
smile, eye contact, erect posture, & giving the speaker attention, giving feedback by paraphrasing is examples of….
effective communication
verbal communication
sharing information between individuals using spoken words
nonverbal communication
behavior that complements, negates, or substitutes for spoken words
gestures, mannerism, facial expressions, body posture, eye contact, stance, and movements such as touch, personal space, & overall appearance is examples of…
nonverbal communication
an interaction between a health care professional & a patient that aims to enhance the patient comfort, safety, trust , health, & well being
therapeutic communication
therapeutic communication includes
strategies that convey understanding & respect, with the intention of encouraging patients to express their feeling and ideas
how can you help with pain when assisting a postoperative patient that has had abdominal surgery with turn, cough, and deep breathing?
hold a pillow to the incision site while coughing
how many second should you instruct your patient to hold their breath for when using a incentive spirometer?
3 seconds
normal BP for an adult?
120/80
what do you do if your patient gets a cut that is bleeding?
get a gauze & hold for 2 mins with pressure, then check
epistaxis
nose bleed
what do you do if your patient if your patient is having a seizure?
- clear the area to prevent patient injury
- stay with your patient
what do you do if your patient say they feel dizzy and they feel like they’re going to pass out?
place head between their knees
ABCs
- airway
- breathing
- circulation
1 oz. is equal to?
30mLs
signs of infection
- redness
- swelling
- fever
- warmth around wound
- foul odor or drainage
anything sterile is out of your scope of practice as a PCT. True or False?
true
a patient’s dressing is soaking through, loose, and nonadherent. what do you do?
notify the nurse
drains that exit surgical wounds help?….
drain the fluid that would otherwise pool around the inside of the wound
fluid & other material can leak around the wound
drainage
pool in the wound
exudate
What is purulent
Drainage that contains pus
- sign of infection
- white, yellow, green
5 rights of delegation
right
- task
- circumstance
- person
- direction
- supervision
what is most important about Maslow’s hierarchy of need?
physiologic
your patient is saying they are having trouble going to the restroom (pooping), what should you looking out for?
- no stool for 3 days or more
- stool that is hard & pebble like (sign of dehydration)