Term
|
Definition
1. address client by name and introduce self
2. turns on water at sink
3. wets hands and wrists thoroughly
4. applies soap to hands
5. lather all surfaces, wrists, hands, and fingers, for at least 25 seconds
6. KEEP HANDS LOWER THAN ELBOWS AND THE FINGERTIPS DOWN
7. rinse all surfaces of wrists, hands, and fingers, KEEPING HANDS LOWER THAN ELBOWS AND FINGERTIPS DOWN
8. use clean, dry paper towel to dry all surfaces of hands, wrists, and fingers and dispose of paper in trash
9. use clean paper towel to turn off faucet then dispose into trash (or use knee/foot control for faucet)
10. DONT TOUCH INSIDE OF SINK AT ALL |
|
|
Term
| applies one knee-high elastic stocking |
|
Definition
1. adress client by name and introduce self, explain procedure.
2. PROVIDE PRIVACY (close curtain, say giving you privacy)
3.make sure client is in supine position laying down on bed
4. turn stocking inside out- at least to the heel
5. place foot of stocking over toes, foot, and heel
6. pull top of stocking over foot, heel, and leg
7. moves foot and leg gently and naturally, avoiding force and over-extension of limb and joints
8.finishes procedure with no twists or wrinkles, and heel is in right position with toe opening under toes
9. PUT CALL BELL IN REACH
10. MAKE SURE BED IS LOCKED AND LOW
11. GIVE PRIVACY, CLOSE CURTAIN
12. say GOING TO WASH HANDS |
|
|
Term
| assists to ambulate using a transfer belt |
|
Definition
supplies: belt
1. knock, introduce yourself, address client by name and explain procedure, assemble equipment
2. before assisting to stand, MAKE SURE CLIENT IS WEARING SHOES and that you have gait belt
3. "wash hands" check BED IS AT SAFE LEVEL, LOCKED AND LOW, PULL CURTAINS CLOSED FOR PRIVACY
4. CLIENT ASSISTED INTO SITTING POSITION WITH FEET FLAT ON FLOOR and wearing proper non skid footwear (give them a second to situate) "SAY THIS OUTLOUD"
5.PUT BELT SECURELY AT THE WAIST OVER GOWN/CLOTHING, CHECK TO MAKE SURE ITS ON RIGHT BY SLIDING 2 SINGERS UNDER BELT
6. TELL PATIENT THEY WILL ROCK 3 TIME AND ON COUNT OF 3 THEY WILL BEGIN STANDING AND GIVE INSTRUCTION TO PLCE HANDS ON BED TO HELP STAND
7. STAND FACING CLIENT AND POSITION IN SAFE PLACE TO HELP
8.COUNT TO THREE and ON THREE, gradually assist client to stand by grasping transfer belt ON BOTH SIDES with an *upward grasp*, candidates hands are in upward position
*** ASK IF THEY ARE DIZZY OR OKAY***
9. WALK SLIGHTLY BEHIND AND TO ONE SIDE OF CLIENT FOR A DISTANCE OF 10 FEET, WHILE HOLDING ONTO BELT AND PUTTING SAME LEG AS CLIENT FIRST WHEN WALKING
10. ASSIST CLIENT TO BED AND REMOVE BELT
11.PLACE CALL BELL WITHIN REACH
12. BED IS LOCKED AND LOW
13. OPEN PRIVACY CURTAIN, IM GOING TO WASH MY HANDS, CLOSE DRAPE |
|
|
Term
| assists with use of bedpan |
|
Definition
**toilet tissue**hand wipes **2 towels **2 gloves
1. place tissue and hand wipes where they can be reached by client
2. introduce self address client by name, EXPLAIN PROCEDURE
2. PROVIDE PRIVACY, CHECK BED IS LOCKED AND LOW AND GO WASH HANDS
3.come back and LOWER HEAD OF BED AND PUT ON BATH BLANKET AND REMOVE TOP SHEET TO FEET
4. BEFORE HANDING BED PAN PUT ON GLOVES
5.PLACE BEDPAN UNDER CLIENTS BUTT
6. REMOVE AND DISPOSE OF GLOVES WITHOUT CONTAMINATING SELF, throw in trash
7.SAY "WASH HANDS"
8.RAISE HEAD OF BED to 30 degree (AFTER HANDS ARE WASHED)
9. "TOILET TISSUE AND HAND WIPES FOR CLEANING YOUR HANDS AFTER ARE IN REACH HERE"
10. "HERES YOUR CALL BELL IN REACH SIGNAL WHEN YOU ARE DONE"
11. I WILL GIVE YOU SOME PRIVACY, BE RIGHT BACK, close drapes
12. PUT ON CLEAN GLOVES
13. LOWER HEAD OF BED
14. REMOVE BED PAN
15. AVOID OVER EXPOSURE OF CLIENT
16. EMPTY AND RINSE BEDPAN, POUR RINSE INTO TOILET
17. PLACE BEDPAN IN DIRTY AREA
18.REMOVE AND DISPOSE OF GLOVES, WASH HANDS
19. COVER CLIENT WITH TOP SHEET AND REMOVE BATH BLANKET
20. HERE IS YOUR CALL BELL, . BED IS LOCKED A LOW
21. GIVE PRIVACY AND CLOSE DRAPE |
|
|
Term
| Transfer from Bed to wheelchair using transfer belt |
|
Definition
supplies: BELT, WHEELCHAIR, FOOTWEAR
1. knock on door, enter, introduce, address by name, explain procedure
2. PROVIDE PRIVACY BY PULLING CURTAINS
3.CHECK BED IS LOCKED AND LOW
4. "WASH HANDS"
5. if client is in bed, lower to a position where feet will be flat on floor
6. help client to sitting position, give some time to sit on edge of bed
7. make sure shoes are fastened and safe "say out loud"
8. apply transfer belt around client's waste over clothing and hold belt using underhand grip
9. say "we are going to rock three times and stand on three" tell patient to position hands on bed to help them up
10. ONCE STANDING, MOVE CLIENT TO END OF BED AND HAVE THEM SIT BACK DOWN
11.POSITION WHEELCHAIR ALONGSIDE OF BED AND THE SEAT OF THE WHEELCHAIR FACING THE FOOT OF THE BED
12. FOLD FOOTRESTS OF WHEELCHAIR BACK
13.LOCK WHEELS ON WHEELCHAIR BEFORE ASSISTING PATIENT TO STAND
14." I SEE YOU HAVE SHOES ON AND YOUR FEET ARE FLAT ON THE FLOOR WE WILL ROCK THREE TIMES AND GET UP ON THREE"
15. ASSIST CLIENT TO PIVOT TO WHEEL CHAIR WITH LEGS AGAINST WHEELCHAIR SEAT
16. HAVE CLIENT REACH BACK AND HOLD ARM RESTS AS YOU ASSIST AND LOWER THEM INTO WHEELCHAIR
17.ASK THEM TO BEND AT WASTE AND LEAN FORWARD AS THEY ARE LOWERED INTO THE WHEELCHAIR
18. POSITION THE CLIENT WITH HIPS TOUCHING BACK OF WHEELCHAIR
19. REMOVE TRANSFER BELT
20. POSITION CLIENTS FEET ON FOOT REST
21.UNLOCK WHEELCHAIR BRAKES
22. HERES YOUR CALL BELL, BED LOCKED AND LOW,
23. OPEN PRIVACY CURTAINS
24"wash hands" |
|
|
Term
| RANGE OF MOTION (ROM) ARM AND SHOULDER |
|
Definition
1. knock on door
2.introduce self, address patient by name
3. explain procedure to client
4. provide privacy by pulling curtains
5. bed is locked and low
6. "wash hands"
7. raise the bed to a comfortable working height and lower the head of the bed
8. position the client in supine
9. ARM: provide support for each individual joint while ROM is being performed. support arm at elbow by placing one hand under the elbow and by placing one hand under the wrist
10. instruct client "IF THIS HURTS LET ME KNOW"
11.raise the straightened arm up past patients ear and return arm down to side. move joint gently, slowly, and smoothly to point of resistance.
12. REPEAT FULL ROM 3 TIMES
13. SHOULDER:provide arm support for the shoulder joint. grasp wrist with one hand and the elbow with the other
14. instruct client, "IF THIS HURTS LET ME KNOW"
15. while supporting limbs straighten arm from one side position outward to shoulder level and return arm to side of body, moving joint gently, slowly, and smoothly through range of motion to the point of resistance REPEAT THREE TIMES. stop if patient is in pain
16. HERES CALL BELL, BED LOCKED AND LOW, OPEN PRIVACY CURTAINS, "wash hands", call me if you need me |
|
|
Term
| RANGE OFM OTION ONE KNEE AND ONE ANKLE |
|
Definition
1. kock, enter, introduce, address by name, explain procedure
2. PROVIDE PRIVACY
3. BED IS LOCKED AND LOW
4. "wash hands"
5. raise the bed to a comfortable working height and LOWER HEAD OF BED
6. position client supine
7. KNEE: provide support for each individual joint while range of motion is being performed. support client leg by placing one hand UNDER THE KNEE, one hand UNDER ANKLE
8. IF THIS HURTS LET ME KNOW
9 FLEXION/EXTENSION OF KNEE: raise the leg by bending 90 degrees and moving the leg towards head and then straighten the leg, REPEAT THREE TIMES
10.ANKLE: IF THIS HURTS LET ME KNOW, provide support to ankle joint, keep foot close to bed. put one hand under the client's ankle and grasp his/her foot with other hand.
11. IF THIS HURTS LET ME KNOW
12. DORSIFLEXION/PLANTAR FLEXION: push the foot toward the clients head, then pull foot downward away from client's head
13. REPEAT 3 times
14. HERES CALL BELL IF YOU NEED ME
15. PULL CURTAINS (OPEN PRIVACY CURTAINS)
16. "WASH HANDS" |
|
|
Term
| COUNTS AND RECORDS RADIAL PULSE |
|
Definition
supplies: second hand watch, paper, pen
1. knock on door and enter, introduce self by name and title, identify and address client by name, explain procedure to client
2. PROVIDE PRIVACY
3.CHECK BED IS LOCKED AND LOW
4.WASH HANDS
5. locate radial pulse by placing tips of fingers on thumb side of clients wrist, press lightly until you hear beat
6. count pulse beats for one full minute
7.HERES CALL BELL IF YOU NEED ME
8. BED IS LOCKED AND LOW
9.OPEN CURTAINS
10. WASH HANDS
11. RECORD PULSE |
|
|
Term
| COUNTS AND RECORDS RESPIRATIONS |
|
Definition
supplies: second hand watch, paper, pen
1. knock on door, enter, introduce self by name and title, IDENTIFY and address patient by name, explain procedure
2. PROVIDE PRIVACY
3. BED IS LOCKED AND LOW
4. "WASH HANDS"
5. count respirations for one full minute, count "one" when you see the client's chest is rising as he/she breathes in.
6. HERES YOUR CALL BELL IF YOU NEED ME
7. OPEN PRIVACY CURTAINS
8. "WASH HANDS"
9. RECORD RESPIRATIONS |
|
|
Term
| MEASURES AND RECORDS BLOOD PRESSURE |
|
Definition
supplies: stethoscope, BP cuff, paper and pen, 2 antiseptic pads.
1. knock on door and enter, introduce self by name and title, identify and address the client by name, explain procedure
2. assemble equipment
3. PROVIDE PRIVACY
4. BED IS LOCKED AND LOW
5. WASH HANDS
6. make sure client is in a comfortable relaxed position
7. CLEAN diaphragm and earpieces of stethoscope with alcohol wipe before using
8. expose clients upper arm
9. position clients forearm relaxed, as fully extended as possible, and supported in a palm up position approximately at the level of the client's heart
10. before putting cuff on arm, open the valve and squeeze all the air out of the cuff. make sure needle is on zero
11. locate brachial pulse with fingertips
12. apply blood pressure cuff to bare upper arm approximately two inches above the elbow. wrap the cuff around the arm snuggly and smoothly to that the bladder presses evenly against the arm. make sure the sensor arrow is placed over the brachial artery
13. be sure the manometer is at the level of the heart and in a position so that you can read the numbers easily
14. place diaphragm of stethoscope over brachial artery and hold snuggly in place
15. place stethoscope earpieces in your ears in proper position with earpieces forward
16. inflate cuff to 160-180 mm hg. (deflate cuff slowly and steadily while listening to palpitations. the first sound heard is SYSTOLIC pressure, remember this number. the last sound heard is the DIASTOLIC pressure. remember number and let air out of cuff. IF reading is not noted first time, wait one minute before trying again and never try more than twice on one arm. if beat heard immediately upon cuff deflation, completely deflate cuff and re inflate to no more than 200 mm hg.
17. REMOVE CUFF
18.clean stethoscope with alcohol pad and replace equipment
19. HERES YOUR CALL BELL,
20. OPEN PRIVACY CURTAINS
21. WASH HANDS
22. RECORD bp |
|
|
Term
| MEASURE AND RECORD WEIGHT ON AN AMBULATORY CIENT |
|
Definition
supplies: PEN AND PAPER
1.knock and enter, introduce by name and title, identify patient and address by name, explain procedure
2. assemble equipment
3. PROVIDE PRIVACY
4.BED IS LOCKED AND LOW
5. WASH HANDS
6. MAKE SURE THEY HAVE SHOES ON
7.CHECK BALANCE OF SCALE BEFORE WEIGHING CLIENT AND BALANCE SCALE TO ZERO
8. help client step up onto center of the scale platform
9. check that client is balanced and centered on scale with arms at side and holding on to nothing.
10. weigh client
11.assist client off scale
12. recalibrate scale to zero
13. HERES YOUR CALL BELL IF YOU NEED ME
14.OPEN PRIVACY CURTAIN
15.WASH HANDS
16. RECORD WEIGHT TO NEAREST POUND (first two small notches- round down, second two notches- round up) |
|
|
Term
| MEASURE AND RECORD WEIGHT ON AN AMBULATORY CIENT |
|
Definition
supplies: PEN AND PAPER
1.knock and enter, introduce by name and title, identify patient and address by name, explain procedure
2. assemble equipment
3. PROVIDE PRIVACY
4.BED IS LOCKED AND LOW
5. WASH HANDS
6. MAKE SURE THEY HAVE SHOES ON
7.CHECK BALANCE OF SCALE BEFORE WEIGHING CLIENT AND BALANCE SCALE TO ZERO
8. help client step up onto center of the scale platform
9. check that client is balanced and centered on scale with arms at side and holding on to nothing.
10. weigh client
11.assist client off scale
12. recalibrate scale to zero
13. HERES YOUR CALL BELL IF YOU NEED ME
14.OPEN PRIVACY CURTAIN
15.WASH HANDS
16. RECORD WEIGHT TO NEAREST POUND (first two small notches- round down, second two notches- round up) |
|
|
Term
| MEASURES AND RECORDS URINARY OUTPUT |
|
Definition
supplies: gloves, paper and pen, graduated container, paper towel, bed pan.
1. don't need to introduce yourself, just get supplies and go to the sink and begin
1. wash hands
2. put on clean gloves
3. place a paper towel on the counter and put graduated container on top of the paper towel
4.pour contents of bedpan into container without spilling or splashing urine outside of container.
5. measure output accurately by reading the measurement at eye level
6.after measuring urine, empty the graduate into the toilet.
7. rinse measuring container and pour contents into toilet
8. rinse bedpan and pour rinse into the toilet
9. after rinsing container and before recording output, remove and dispose of gloves into trash.
10. WASH HANDS
11. record contents of container within plus or minutes 25 ml/cc of evaluators reading. |
|
|
Term
|
Definition
supplies: 3 towels, 2 wash clothes, basin, soap, protective pad, bath blanket, gloves
1. knock on door and enter, introduce self by name and title, identify and address patient by name and explain procedure
2. assemble equipment
3.PROVIDE PRIVACY
4. BED IS LOCKED AND LOW
5. WASH HANDS
6. raise bed to working height
7. fill washbasin with comfortable warm water. Test water temperature and have client test the water to ensure it is safe and comfortable, adjust if necessary
8. place washbasin on over-bed table on top of the protective barrier
9. put on clean gloves before contact with linen, bed protector, and or client.
10, position client in supine position
11. cover client with a bath blanket to maintain privacy
12. remove top sheet and blanket to foot of bed
13. raise bed rail on side of bed client will be rolled to
14. turn client to side and place bed protector under buttocks
15. check to make sure that urine can flow, unrestricted into the drainage bag.
16. fold back the bath blanket expose the genital area only
17. separate labia, check for crusts, abnormal drainage, or secretions REPORT TO NURSE
18. apply soap to wash cloth and clean area as you do for perineal care. "4 corners" 1st washcloth (only use two corners here)
19. hold catheter near meatus to avoid tugging on catheter
20. clean at least 4 inches of catheter nearest to meatus, moving only in one direction (away from meatus) use a clean area of the wash cloth (next two areas) for each stroke. use a clean wash cloth (2nd wash cloth) to RINSE USING SAME PROCEDURE
21. pat dry with a clean towel and dry catheter
22. make sure there are no kinks and tube hangs straight into catheter bag
23. replace bath blanket back over client
24.remove bed protector and dispose in soiled linen
25.empty, rinse, and wipe basin and put in dirty area.
26.remove and dispose of gloves and WASH HANDS
27. cover the client with top sheet and blanket and removed the bath blanket and put in dirty linen
28. LOWER BED RAIL
29.BED IS LOCKED AND LOW
30. HERES YOUR CALL BELL
31. OPEN PRIVACY CURTAINS
32. WASH HANDS |
|
|
Term
|
Definition
supplies: 4 washcloths, 3 big towels, soap, gloves, bath blanket, protective pad
1. knock and enter, introduce self by name and title, identify and address patient by name
2. explain procedure to client
3. GIVE PRIVACY
4. BED LOCKED AND LOW
5. WASH HANDS
6. Raise bed to comfortable working height
7. arrange items on over bed table on PROTECTIVE BARIER/ 1st TOWEL
8. cover client with bath blanket, to maintain client privacy
9. remove top sheet and blanket/bedspread to foot of bed keeping privacy
10. fill washbasin with comfortably warm water. test water temperature and ask client to test the water and ensure it is a good temp.
11. place the filled washbasin on the over-bed table on top of protective barrier (1st big towel)
12. raise side rail on opposite side of bed for safety
13. PUT ON GLOVES
14. place protective pad under residents perineal area
15. help the client flex knees and spread legs, if client cannot flex knees help the client spread legs as much as possible with knees straight
16. expose perineum only to maintain client privacy
17. wet and apply soap to 1st washcloth, squeeze excess water out
18. separate labia with one hand
19. clean one side of outer labia from top to bottom
20. clean other side of labia from top to bottom with new surface
21.clean one side at a time of inner labia from top to bottom with new surfaces
22. place dirty rag on towel on table
23. use a new 2nd wet washcloth to rinse entire perineal area like way we cleaned (four corners)
24. pat perineal area dry with 2nd big towel (front to back)
25.cover client with bed blanket
26. assist client to turn onto side away from you
27. Use a clean 3rd wet washcloth with soap to clean perineal area (front to back)
28. use another part of this wet washcloth with soap to clean area and wipe buttocks without contaminating perineal area
29. Rinse using 4th washcloth
30. dry buttocks with 3rd big towel
31. remove incontinence pad after drying buttocks
32. position client supine maintaining privacy
33. place dirty linen in soiled linen avoiding contact with your clothing the whole time
34.empty, rinse, and wipe basin and place in designated dirty area.
35. WASH HANDS
36. lower side rail on bed
37.replace top cover and remove bath blanket
38. BED IS LOCKED AND LOW
39.HERES YOUR CALL BELL
40. OPEN PRIVACY CURTAINS
41. WASH HANDS |
|
|
Term
| modified bed bath (FACE, one ARM, hand and underarm) |
|
Definition
supplies: 3 towels, 2 washcloths, basin, soap, 1 gown, gloves, bath blanket
1.knock, enter, introduce self by name and title, identify and address patient by name, explain procedure, assemble equipment
2. YOUR BED IS LOCKED AND LOW IM GOING TO GIVE YOU SOME PRIVACY AND WASH MY HANDS AND GET WATER, CALL BELL IS HERE BRB
3. WASH HANDS/ get water and equip
4. wet 2 washcloths and place them on edge of bin, one towel under bin, 2 more towels for drying, soap, 1 gown, bath blanket, and gloves
5. raise bed to comfortable working height.
6. cover client with blath blanket and remove other blankets.
7.remove clients gown making sure not to expose client
8. fill basin 2/3 full with WARM water
9. test water and ask client to ensure it is safe
10. put on CLEAN GLOVES
11. wash clients eyes and face with WATER ONLY. clean far eye first by gently wiping from the inner part of the eye to the outer corner of eye with a corner of wash cloth. then turn to clean area to wipe other eye
12. one side for one eye, one side for other eye, another side for rest of face (FIRST WASH CLOTH, no soap)
13.dry clients eyes and face same way as washing.
14. expose only part of body being bathed
15. WASH ARM- place bath towel used for face underneath arm, support the arm with your palm under clients elbow, his/her forearm rests on your forearm. apply SOAP to 2nd wet washcloth. wash the arm, hand, and in-between fingers, shoulder, and underarm with long, firm stroked using soap.
16. ONLY WASH DOWNWARDS NOT UPWARDS
17. move clients body gently and naturally, avoid force and over extension of limbs and supporting joints throughout the procedure.
18. rinse and dry arm, hand, shoulder, back of arm, and armpit
19.place dirty towels and washcloths and gown in dirty laundry area
20. empty rinse, dry basin and place in designated dirty area
21. removed gloves and WASH HANDS
22. return to client and put on clean gown
23. cover client with sheet and blanket/ bedspread
24. remove bath blanket
25. place bath blanket in dirty area
26. HERES YOUR CALL BELL, BED LOCKED AND LOW,
27. OPEN CURTAINS
28. WASH HANDS |
|
|
Term
| provide foot care on one foot |
|
Definition
supplies: basin, soap, 3 towels (1 towel as barrier), 1 wash cloth, lotion, gloves
1. knock on door and enter
2. introduce self by name and title, identify patient and address by name
3. explain procedure to client
4. assemble equipment
5. PROVIDE PRIVACY
6. check bed is locked and low
7. WASH HANDS
8. if client is able to be out of bed, assist client to chair
9.place protective barrier on floor in front of the lint
10. fill basin with comfortable warm water and place on protective barrier
11. test water temp, ask client
12. remove shoes
13. put on clean gloves before completely submerging foot
14. apply soap to washcloth
15. lift foot from water and wash foot (and between toes)
16.rinse entire foot, and in-between toes
17. dry foot including between toes
18. put lotion in hand and apply onto foot (top and bottom and ball of foot NOT INBETWEEN TOES) REMOVE EXCESS WITH A TOWEL
19. support foot and ankle properly
20. empty, rinse, dry basin and place in designated dirty area
21. dispose of soiled linen in laundry receptacle
22. remove and dispose of gloves
23. WASH HANDS
24. HERES CALL BELL, PRIVACY, WASH HANDS |
|
|
Term
| apply one knee high anti embolism elastic stocking |
|
Definition
supploes: stocking, 1 pillow
1. knock, enter, introduce, identify, address, tell procedure
2. PROVIDE PRIVACY
3 WASH HANDS
4. position client in a supine (laying down) position
5. raise the bed to a comfortable working height
6. expose only the leg to which stocking is being applied
7. place pillow under foot
8. face heel away from you and roll stocking unto heel area. put left index finger to thumb and push finger up. grab the ginger with the right hand and hold finger while pulling down the sock with left hand.
9. place foot of stocking over tows and pull over foot and heel
10. check to see if heel is where it is supposed to be
11. pull top of stocking over for, heel, and leg
12. move clients foot and leg gently and naturally to remove ANY WRINLES, avoid force and over extension of limbs
13. check toes for possible pressure from stocking, adjust as needed
14. finish with NO WRINKLES<
15. return bed linens to cover client
16. HERES YOUR CALL BELL
17. BED LOCKED AND LOW
18. OPEN CURTAIN
19. PLACE PILLOW IN DIRTY AREA
20. WASH HANDS |
|
|
Term
|
Definition
supplies: toothbrush, tooth paste, 1 cup of water, spit basin, paper towel, clothing protector, gloves
1. knock, enter, introduce by name and title, identify and address patient, explain procedure
2. PROVIDE PRIVACY
3. BED IS LOCKED AND LOW
4. WASH HANDS
5. if on bed, lock bed wheels and raise to comfortable height
6. ensure client is in an upright sitting position (75-90 deg)
7. position the over bed table so you can reach it with ease. place protective barrier on table such as PAPER TOWEL
8. PUT ON GLOVES
9. place towel across clients chest before providing mouth care
10. moisten toothbrush with water
11. apply toothpaste on toothbrush and brush teeth
12. hold emesis basin under chin
13. clean entire mouth thoroughly including tongue, and all surface of teeth including inner, outer, and chewing surfaces of all upper and lower teeth, roof of mouth, and gums using gentle rolling motions.
14. assist client in rinsing mouth, offer mouthwash solution if available
15. hold emesis basin to clients chin
16. dry around clients mouth and remove towel
17. maintain clean technique with placement of toothbrush throughout procedure
18. place toothbrush in basin
19. dispose of soiled linen in laundry
20. rinse basin and dry. rinse toothbrush and place toothbrush and toothpaste in basin. place in designated dirty area.
21. remove gloves
22. WASH HANDS
23. HERES CALL BELL BED IS LOVCKED AND LOW
24. OPEN CURTAINS
25 WASH HANDS |
|
|
Term
|
Definition
supplies: tooth brush and paste in spit basin, dentures, washcloth, paper towel, gloves
1. wash hands and put gloves on
2. before handling dentures, protect dentures from possible breakage by lining sink with WASHCLOTH.
3. take dentures out of cup and place on a paper towel on sink. maintain a clean technique with placement of dentures and toothbrush always
14.handle dentures carefully
15. rinse dentures using tepid water before brushing them, RINSE DENTURE CUP BEFORE PLACING CLEAN DENTURES IN IT, FILL DENTURE CUP WITH WATER AND SET BACK ON PAPER TOWEL
16. apply toothpaste to toothbrush and thoroughly brush all surfaces of dentures.
17. rinse dentures using cool running water
18. place dentures in clean denture cup
19. return denture cup to proper storage or designated clean area
20. rinse toothbrush and place in a spit basin with toothpaste and place in a designated dirty area.
21. dispose of sink liner in dirty area
22. remove gloves
23. wash hands |
|
|
Term
| dressing a client with a weak right side |
|
Definition
supplies: 2 shirts, hospital gown
1. knock, introduce by name and title, identify and address patient, explain procedure
2. provide privacy
3. bed locked and low
4. WASH HANDS
5. ask client which outfit they want to wear and position client for dressing
6. keep client covered as needed
7. remove gown from STRONG (left) side first, then right side (weak arm) second,
8. while putting on items, move patient gently
9. put on shirt: dress client's weak side first. insert hand through back of sleeve of garment and grasp clients hand, drawing sleeve over your hand and clients arm and shoulder, assist client to move forward, placing shirt over back to left side. hold gown for privacy and have client put left arm into shirt sleeve. button, zip or snap garment and smooth back of garment to remove any wrinkles.
10. remove fown and place in soiled linen container
11. HERES CALL BELL, BED LOCKED AND LOW
12. OPEN CURTAINS
13. wash hands |
|
|
Term
|
Definition
supplies: 4 bed pillows, if one on bed only 3 needed
1. kock/enter, introduce by name and title, address and identify patient, explain procedure
2. PROVIDE PRIVACY, CHECK BED IS LOCKED AND LOW, WASH HANDS
3. raise the bed to a comfortable working height
4 make the bed flat, lower the head of the bed before turning client, reposition pillow under clients head
5. ensure clients face does not become obstructed by the pillow
6.fanfold linens to bottom of bed. maintain privacy by only exposing body parts as necessary
7. raise bed rail on side patient is being rolled to
8. move upper body towards you (place your arm under the clients shoulders then place other arm under mid back, move the upper part of the clients body towards you using proper mechanics
9.move hips towards you (place one arm under client's waist and one under clients thighs
10. move legs towards you (place one arm under client's thighs and one under client's calves)
11. slowly roll client onto side while supporting the clients body
12. assure good body alignment of client in center of bed
13. use pillows/support devices to maintain body alignment and protect bony protuberances
a. head: under neck
b. back-place pillow lengthwise behind clients back
c. leg- position the top leg with knee flexed in front of the bottom leg with hip in proper alignment and support the upper led and ankle with a pillow
d. arm- place arm at 90 degress angle toward head
14. cover client with bed covers or blanket
15. HERES CALL BELL, OPEN CURTAINS
16. wash hands |
|
|
Term
| what are the 3 skills you put up rail for |
|
Definition
1. peri care (up and down)
2. catheter care (up and down)
3. positioning on side (up and leave there) |
|
|
Term
| when do you use blue pad? |
|
Definition
|
|
Term
| when do you have to crank the bed |
|
Definition
1. bath (up and down)
2. peri (up and down)
3. catheter (up and down) |
|
|
Term
| three times you don't have to intro |
|
Definition
1. dentures
2. urine output
3. ppe |
|
|
Term
which arm is strong?
do you dress first or second |
|
Definition
LEFT IS STRONG
REMOVE STRONG/ LEFT FIRST
DRESS WEAK FIRST/ right |
|
|
Term
do you dress weak or strong side first?
do you remove gown from weak or strong side first? |
|
Definition
DRESS weak side first (weak- right)
REMOVE strong side first (strong-left) |
|
|
Term
| the left arm is considered |
|
Definition
|
|
Term
| feeding a client who cannot feed self |
|
Definition
supplies: tray with food, 2 handy wipes, clothing protector.
1. knock, enter, introduce, identify and address client., explain procedure, assemble equipment, check bed is locked and low, give privacy and wash hands
2. position 75-90 degrees
3. place door tray where it can be easily seen by client
4. clean clients hand with handy wipes
5. VERIFY FOOD TRAY WITH PATIENT BRACELET
6. assist client with putting on clothing protector
7. sit down in a chair at eye level facing the patent
8. identify and list food on plate for client
9. using spoon, ask client which they would like a bite of first
10. offer clinet bite of each type of food telling them the contents of spoonful of each food
11. allow time to chew and swallow
12. make sure clients mouth is empty before next bite of food or drink beverage
13. offer beverage at least one time during meal
14. ask if finished, then use handy wipe for MOUTH then hands
15. carry on pleasant conversation
16. remove clothing protector and food tray and then places tray in designated dirty area
17. place clothing protector in dirty laundry area
18. place call bell in reach
19. bed locked and low
20. open curtains
21. wash hands |
|
|
