Basic Patient Care Flashcards
Bathing
Bathing is essential for maintaining personal hygiene. The activity can also provide a chance to observe any skin breakdown or ROM difficulty and communicate this to the nurse. The nurse will also delegate the type of bath that is appropriate for the patient. This depends on the provider’s prescriptions, the patient’s mobility status, the patient’s overall health, and the amount of hygiene care the patient needs.
Bathing
First, gather all the supplies necessary for the bath. These can include a bath towel, washcloth, skin cleanser, gown, body lotion, powder, and deodorant. For a bed bath, you will need a bath blanket, wash basin, clean bed linen, and laundry bag. If the patient is mobile, you will assist them to the shower or tub. Depending on your facility, a shower chair might be available and can be helpful if the patient becomes fatigued or unsteady.
Water Temperature
The bath water should be 37 to 47 degrees Celsius (98.6 to 115 degrees Fahrenheit). Depending on the purpose and desired temperature of the bath, most routine baths should be 40.5 to 43.3 degrees Celsius ( 105 to 110 degrees Fahrenheit) Water that is too hot or too cold can be uncomfortable and cause injury. Always ask the patient to feel the water to determine if the temperature is appropriate. Observe that patients’ reactions to the bathing process and report any issues to the nurse.
Privacy
Always take steps to ensure patients’ privacy. Close the door to the patient’s room or pull the curtains in a shared space. When possible, keep the patient’s body covered with a bath blanket.
Safety
Assist the patient in and out of the tub or shower, as the floor might be slippery. Use nonskid mats and socks if available. Never leave a patient alone unless you are sure they are safe. A call light should be in close reach, especially if a patient is alone in the shower. During bed baths, keep the bed rail up on the opposite side to ensure the patient doesn’t roll off the bed. Ensure IV sites and surgical incisions are protected from moisture, which could lead to infection
Technique
Wash the patient from the cleanest to dirtiest areas to prevent contamination, using long, firm strokes to stimulate circulation. Rinse the skin, because the residual cleanser can irritate the skin. When drying, do not rub the skin vigorously with the towel. Skin can be fragile, especially for older adult patients. A gentle patting motion with the towel will suffice and prevent skin breakdown or injury. When performing a bed bath, adjust the height of the bed to a comfortable position to prevent back strain.
Oral Care
Oral hygiene is an important part of overall health, but easy to overlook. Offer oral care when patients awaken, after meals, and before bedtime. Some conditions-such as NPO status or medications that can make the mouth dry- warrant more frequent oral care. Check with the nurse before initiating oral care, as some patients have difficulty swallowing. Patients who have natural teeth. Many patients can perform their own goal care with assistance with set-up and supplies. However, if a patient is unable, you must provide this care.
Oral Care
If the patient has natural teeth, a soft-bristle toothbrush, and toothpaste are adequate. Raise the head of the bed as much as the patient can tolerate. If the patient can brush their teeth, provide the supplies they need, such as a toothbrush, toothpaste, water, emesis basin, dental floss, washcloth, and towel. If the patient is unable, gently cleanse each tooth in a circular motion at a 45-degree angle to the gums from the back of the mouth toward the front. Provide water for patients to rinse their mouth and spit into an emesis basin. After brushing teeth, flooding is essential.
Oral Care
Patients who wear dentures might prefer to clean them on their own. Dentures are expensive, fragile, and custom-made, which makes them difficult to replace. Ask the patient for their preferred cleansing and soaking technique. If they can remove their dentures, have them do so and place them in a washbasin containing lukewarm water; hot water might damage them. If the patient requires your assistance removing dentures, first apply gloves. Then break the suction on the upper denture with your thumb and forefinger. Using gauze and gentle pressure, slightly tug downward twisting it sideways. Use denture cleaner–not toothpaste, which can scratch the surfaces of the dentures. place a washcloth in the sink, holding the denture in one hand, and gently brush all the surfaces until they are clean. Rinse thoroughly with lukewarm water. the patient still requires oral care with a soft bristle toothbrush, foam-tipped applicator, or mouthwash on the gums, tongue, and inside of the cheeks with a thorough rinsing afterwards.
Bed Making
First, gather all necessary bed-making equipment before entering the patient’s room. This can include a fitted sheet, mattress pad, flat sheet, pillowcases, lift(draw)sheet, absorbent pads, and linen bag.
Bed Making
- Roll the patient to one side of the bed
- Tuck the sheets to be removed under the patient
- Replace the sheets on the unoccupied side
- Tuck the fresh sheets under the patient
- Roll the patient to the fresh side
- Remove the old linens
- Complete the linen change
Dressing
Patient care technicians assist with routine dressing in the morning, before bed, and when clothes become soiled throughout the day. In a hospital setting, patients usually wear hospital gowns, but they can have intravenous lines or weaknesses that might make dressing challenging.
Dressing
When assisting a patient in or out of a hospital gown, be aware of any IV lines or dressings so as not to snag them and cause the patient any discomfort. If the patient has an IV line connected to an IV bag, take the arm without the IV line out of the gown first, then gently remove the gown over the IV site and the tubing. Once the gown is off of the patient, thread the tubing and bag through the sleeve. When putting the clean gown on, place the IV bag and tubing through the appropriate arm sleeve, hanging the bag on the IV pole. Then you can assist the patient by gently guiding the arm with the IV line through the other sleeve. Make sure the gown is tied at the neck and the waist, and that the patient is comfortable. Ask the RN to disconnect the patient from the infusion pump to help them dress or undress. Improper technique can introduce bacteria into a sterile environment and put the patient at risk for a bloodstream infection.
Grooming
Hair care is a part of overall hygiene. Some patients can brush their hair but need assistance with washing it. Check with the patient and nurse to determine your level of assistance and patient preference. You can wash the patient’s hair during a shower or tub bath, at the sink, or in bed. Some facilities have shower caps that contain a no-rinse shampoo inside. You can also use a shampoo tray or trough that allows patients to rest their heads comfortably. It either collects water or allows it to run down into a wash basin. Use pillows and towels to ensure that the patient is comfortable and dry. Make sure the water is between 40.5 and 43.3 degrees Celsius (105 and 110 degrees Fahrenheit). Comb hair before washing to remove any tangles. Dry and style hair according to their preference. Assist patients in changing any clothing or linens that might have gotten wet.
Toileting
Many patients need assistance using the bathroom. You might assist them to the restroom or help them use equipment for elimination such as a bedpan, urinal, or bedside commode. Be aware of any activity restrictions before assisting patients out of bed. If a patient is ambulating to the bathroom, make sure they have a call light within reach to alert you when they are finished. Never leave confused or unstable patients alone. Assist patients with any perineal care if needed, and remind them to wash their hands afterward.
