Provision of Comfort Measures - 1 Flashcards
is the science of health and its maintenance
Hygiene
is provided to clients as they awaken in the morning. It is serving a urinal or bedpan to the confined-to-bed clients, washing the face and hands, and giving oral care.
Early morning care
is the provision of breakfast, elimination needs, bath/shower, perineal care, back massages, oral, nail, and hair care, and making the client’s bed.
Morning care
is care provision before patients retire at night. It involves the provision of elimination needs, washing face, and hands, giving oral care, and giving back rub/ massage.
Hours of sleep or PM care
is required as needed by the patient
As needed or PRN care
Factors influencing individual hygienic purposes
Culture
Religion
Environment
Developmental level
Health and energy
Personal preferences
Bedmaking
It is the technique of preparing different types of beds to make a patient/client comfortable or his/her position suitable for a particular condition.
PURPOSE OF BEDMAKING
▸ To provide the client with a safe & comfortable bed to rest & sleep.
▸ To keep the ward neat and tidy.
▸ To prevent Bedsores
It is a bed, made when it is about to be occupied by either a new patient or an ambulatory patient.
OPEN BED
It is an unoccupied or empty bed made to receive the patient and is fully covered with counterpane to protect it from dust and dirt. On admission of the patient, the closed bed is converted into an open bed.
CLOSED BED
PURPOSES OF OPEN AND CLOSED BEDS:
To keep the bed ready for occupancy.
To provide a neat and tidy appearance to the unit
This bed is made with the patient in it.
OCCUPIED BED
PURPOSES OF OCCUPIED BED:
To make a bed with the least possible discomfort to the patient.
To handle the bedclothes skillfully while the patient is in bed, giving the least disturbance to the occupant.
To provide a neat, clean, and tidy appearance.
It is a bed prepared for a patient who is recovering from the effects of anesthesia following surgery.
POST-OPERATIVE BED
PURPOSES POST-OPERATIVE BED:
To receive the patient conveniently
To provide warmth and comfort
To prevent shock
To prevent injury
To prevent soiling of the bed
To meet any emergency
PRINCIPLE 1:
*Microorganisms are found everywhere on the skin, on the articles used by the client, and in the environment. The nurse takes care to prevent the transference of microorganisms from the source to the new host by direct or indirect contact or to prevent the multiplication of the microorganisms.
- The nurse washes her hands before and after bedmaking to protect the client and herself from cross-infection.
*When changing bed linen, follow the principles of medical asepsis by keeping soiled linen away from the uniform.
*Place soiled linen in special linen bags before placing it in a hamper.
*To avoid air currents that spread microorganisms, never shake the linen.
*To avoid transmitting infection, do not place soiled linen on the floor. If clean linen touches the floor or any unclean surface, immediately place it in the dirty linen container.
PRINCIPLE 2:
A safe and comfortable bed will ensure rest, and sleep and prevent several complications in bedridden patients. E.g. bedsores, foot drop etc.
*The body exerts uneven pressure against the mattress, the pressure is greatest over the bony prominences. Lumps and creases in the bed can cause bedsores due to friction between the bed and mattress or wrinkled sheets. Therefore the nurses should take care to make the bed smooth and unwrinkled.
*Pull the bottom sheet tightly so that there are no wrinkles.
INABILITY TO LIFT THE FRONT PART OF THE FOOT
OFF THE GROUND
DROP FOOT
PRINCIPLE 3
Systematic ways of functioning save time, energy, and materials.
When patients are confined to bed, organize bed-making activities to conserve time and energy.
Assemble all articles and arrange them conveniently before starting the bed-making.
Arrange the linen in the reverse order of use.
Finish on one side of the bed before going to the opposite side
When tucking the sheets under the mattress, flexing is done by the knees and hips. This position shifts the work to the long and strong muscles of the thighs and keeps the back in good alignment. This reduces strain on the back.
When placing the linen on the bed and tucking it under the mattress face the direction of work and move with the work rather than twisting the body and overreaching.
___ is the coordinated effort of the musculoskeletal and nervous systems to maintain balance, posture, and body alignment during lifting, moving, positioning, and performing activities of daily living.
Body mechanics
PRINCIPLE 4:
Good body mechanisms maintain body alignment and prevent fatigue.
*During bedmaking use safe patient handling procedures and proper body mechanics.
Body mechanics and safe handling are important when turning or repositioning the patient in bed.
Importance of Body mechanics
1.Proper body alignment and posture prevent fatigue and deformities.
2.Poor posture causes Deformities.
3.Good posture promotes the physiologic functions of the body.
4.Reduces the expenditure of energy.
5.Helps to maintain the balance of the body without undue strain on the body parts.
6.To prevent strain and injury to the patient/nurse.
It is an ulceration in the skin that is caused by prolonged pressure on a bony or weight
bearing part of the body.
Bedsore
Three Primary Causes of Bedsores
Sustained
Friction
Shear
When your skin and the underlying tissues are trapped between bone and a surface such as a wheelchair or bed.
Sustained pressure.
is the resistance to motion. When a person changes position or is handled by care providers, friction may occur when the skin is dragged across a surface
Friction
occurs when two surfaces move in the opposite direction. For example, when a hospital bed is elevated at the head, a person can slide down in bed.
Shear
.
This might be due to poor health, spinal cord injury, and other causes.
Immobility
Spinal cord injuries, neurological disorders, and other conditions can result in a loss of sensation. An inability to feel pain or discomfort can result in not being aware of warning signs and the need to change position.
Lack of sensory perception.
People need enough fluids, calories, protein, vitamins, and minerals in their daily diet to maintain healthy skin and prevent the breakdown of tissues.
Medical conditions affecting blood flow. Health problems that can affect blood flow, such as diabetes and vascular disease, increase the risk of tissue damage.
Poor nutrition and hydration.
4 Stages of Bedsores
The area looks red and feels warm to the touch. With darker skin, the area may have a blue or purple tint. You may feel that it burns, hurts, or itches.
Stage 1.
4 Stages of Bedsores
The area looks more damaged and may have an open sore, scrape, or blister. You have a lot of pain, and the skin around the wound may be discolored.
Stage 2.
4 Stages of Bedsores
The area has a crater-like appearance because of damage below the skin’s surface.
Stage 3.
4 Stages of Bedsores
The area is severely damaged and a large wound is present. Muscles, tendons, bones, and joints can be affected. Infection is a large risk at this stage.
Stage 4.
How often should you change your patient’s positioning?
Every 2 hours
Best positions for reducing bedsores
Supine
Lateral
Sim’s
The first step in treating a bedsore is ___
reducing the pressure and friction that caused it.
Strategies for addressing bedsores include:
Repositioning
Using support surfaces
Cleaning
Putting on a bandage
Removing damaged tissue
it is a bed made for patients suffering from rheumatism or renal disease.
THERAPEUTIC BEDS
includes oral hygiene, bathing, eliminating, shaving, brushing, and styling hair.
Personal Hygiene
- skin is relatively immature. The epidermis and dermis are bound together loosely, and the skin is very thin. Friction against the skin layers causes bruising.
Neonate
- skin layers become more tightly bound together. The child has greater resistance to infection and skin irritation. Parents need to provide thorough hygiene and teach good hygiene habits
Toddler
- maturation of the integument increases. Girls: estrogen secretion causes the skin to become soft, smooth, and thicker with increased vascularity. Boys: male hormones produce an increased thickness of the skin with some darkening in color. Sweat glands become fully functional during puberty.
Adolescence
- Skin is elastic, well hydrated, firm, and smooth. With aging, the rate of epidermal cell replacement slows, and the skin thins and loses resiliency. As the production of lubrication substances from the skin glands decreases, the skin becomes dry and itchy. These changes warrant caution when bathing, turning, and repositioning older adults.
Adult
Nurse baths an entire body of dependent patients in bed
Complete Bed Bath
Patients confined to bed are able to bathe themselves with some help
Self-Help Bath
Parts of the body are washed by the patient and some by the nurse
Partial Bath
Much easier for bathing and rinsing than in a bed
Varies in style
Medicated solutions may be used in bathing
Range from warm water baths, cool water baths, cornstarch, oatmeal
Tub Bath
Cleanses and aids in reducing inflammation of the perineal and anal areas of the patient who has undergone rectal or vaginal surgery or childbirth
Hot Sitz bath:
to reduce the body temperature to normal
Tepid Sponge Bath:
A complete bed bath is a bath provided to weak, dependent clients who are confined to bed
CLEANSING BED BATH
It is a sustained core temperature beyond the normal variance, usually greater than 39° C (102.2° F).
Hyperthermia
occurs as the body temperature falls lower than normal; usually below 35 °C (95 °F).
Hypothermia
