Funda-NA 1
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Transcript of Funda-NA 1
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FUNDAMENTALSOF NURSING
CARE
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The Hospital Experience
Responsible, efficient andemphathetic nursing intervention is
required to assure that the hospitalmilieu becomes an environment inwhich the patient feels as comfortable
as possible and over which he feels hehas some degree of control.
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Empathy- is identifyingwith way another personfeels.
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Common Anxiety ProducingFactors in the Hospital Milieu
Regimentation- to many patients,the schedules and rules of agency
appear to be more important than thepatient. The nursing aid should becareful to allow the patient to make
decisions regarding his care to theextent that he can.
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Dehumanization
the hospital can be a depersonalizingexperience for the patient unlesshealth workers take time to consider
each patient as an individual personwith his own unique needs. When thepatient is not involved in decisions
about his care or when health-carepersonnel discuss the patient in hispresence without talking to him.
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Separation fromsignificant others
at a time when support fromsignificant other is so essential,
separation contributes to thepatients anxiety.
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Lack of privacy
the patient may be confrontedwith an almost entire lack of
privacy after admission to thehospital.
Conversations can be overheard.
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Functions ordinarily carried out in
private, such as elimination, mayrequire assistance from others.
People come and go from thepatients room at any time. The lack
of privacy is the most frequent heardcomplaint about the hospital setting.
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Lack of understanding ofthe hospital language
it has been well established that
the health-care milieu has alanguage that is not understoodby outsiders.
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When the patient enters the
hospital, he may feel that he is
entering a foreign country wherepeople speak a language hecannot understand.
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Strange sights andsounds
a walk down in a hospital
corridor is a unique education to
even the casual observerconcerning unusual sights andsounds.
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In one room, the steady
pulsating of a cardiac monitor
can be heard, in another room,the bubbling of an oxygenhumidifier, while in still another,
a patient may be heard to moan.
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Personal Care
Equipments:A basin, a soap dish, mouthwash
cup, an emesis basin, a bedpan,a urinal for the male patient, awater container and a drinking
glass.
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SAFETY MEASURES
Restraining Patients
Preventing the Spread of
MicroorganismsPreventing Falls
Side Rails
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Falls account for nearly half of the
accidental deaths that occur in thehealth agency.
Causes of Falls
Slippery floors
Poor lighting
Worn rugsMisplace furniture
Objects littered
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Susceptible to Falls
Young
Old
Physically handicapped
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easures o ecreaseFalls
Hand rails in bathrooms and
on stairs
Good lightingDiscarding and repairing
broken equipment
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DECREASE EQUIPMENT-RELATED ACCIDENTS
Use equipment only for the use
for which it was intended.Do not operate equipment with
which you are unfamiliar.
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Handle equipment with care to
prevent damaging it.
Use three-prong electrical plugswhenever possible.
Do not twist or bend electricalcords. The wires inside the cordmay break.
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Be alert to signs that indicateequipment is faulty, such as breaks
in electrical cords, sparks, smoke,
electrical shocks, loose or missingparts, and unusual noises or odors.
Report signs of trouble immediately.
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Hospital Bed
Bed making is a fundamental part of
the training of the nursing aid.
A skillfully made bed gives comfortand pleasure to the patient who maybe required to spend many days or
weeks in it.
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A gatch bed is generally in use. Thestationary one is about 26 incheshigh. Modern hospitals are equipped
with beds, which may be operatedmanually or electrically.
These beds maybe lowered to 13
inches to accommodate the out ofbed patient.
ypes o noccup e
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ypes o noccup eBed
Closed Bed- is made when apatient gets out of bed for the
day. The spread is pulled overthe pillow.
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Open Bed- is made for thepatient who is getting out ofbed for a short time. The toplinens are fan folded so thepatient can safely get into
bed.
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Bed Making
You may have a patient who
spends part of the day in bed.
Some of your patients areunable or not permitted to getout of bed.
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DEFINITION OF TERMS
1.1 Bed making
the ability of the nurse to keep the bedclean and comfortable
the technique of preparing different
types of bed in making patients/clientscomfortable in his/her suitable positionfor a particular condition it requires keen inspection to be sure
that the linens are clean, dry andwrinkle-free
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1.2 Fanfold is done by grasping the upper edge
of the linen with both hands specifically folding the edge of the
sheet used in the bed 6-8 inchesoutward
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1.3 Mitered corner a means of anchoring sheets on
mattressesmethod of folding the bed clothes at
the corners to secure them in placewhile the bed is occupied
it is accomplished on the bottom sheetby placing the end of the sheet evenlyunder the mattress
1.4 Toe pleat a fold made in the top bed clothes to
provide additional space for patientstoes
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1.5 Foot dropdropping of the foot from
paralysis of the anterior muscle of
the legplantar flexion of the foot with
permanent contracture of the
gastrocnemius (calf) muscle andtendon
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1.6 Bed cradle is a curved, semi-circular device
made of metal that can be placed
over a portion of the patientsbody is sometimes called an Anderson
frame, is a device designed tokeep the top bedclothes off thefeet, legs, and even abdomen ofa client
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1.7 Magic cornercorners of a folded linen whenupon opening it automaticallypositions the sheets the way itis placed on the bed
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1. It helps maintain a clean, orderlyand comfortable room whichcontributes to the patients sense ofwell-being.
2. Helps the patient secure proper rest
and comfort which are essential forhealth and refresh him/her byproviding cleanliness
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3. It helps prevent or avoidmicroorganisms to come incontact with the patient which
could cause tribulations.
4. It minimizes the sources of skinirritation by providing smooth,wrinkle-free bed foundation.
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Guidelines of Bed Making
Try to make the bed accordingto the policy of the health
agency. If you must change thepolicy, explain your reasons to
the patient and superior.
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Do not use a torn piece of linen.
It may tear even more and
could be dangerous.Never use a pin on any item of
linen.
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Do not shake the bed linen.Shaking spreads harmfulmicroorganisms to everything
and everyone in the room,including you.
Never allow any linen to touchyour uniform.
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Dirty used linen should never be
put on the floor.
Put dirty linen in prescribed/designated place.
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The bottom sheet must be form,smooth, and wrinkle free. This isvery important for the patients
comfort.
By fan folding the top of the bed,
you make it easy for the patientto get in and out of his bed.
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The draw sheet is about half the sizeof a regular sheet. When drawsheets are not available, a large
sheet can be folded in half widthwiseand used. The fold must always be
placed toward the head of the bed
and the hems toward the foot of thebed.
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The plastic draw sheet anddisposable bed protectorsprotect the mattress. Plastics
should never touch a patients
skin. When using a plastic draw
sheet, be sure to cover it entirelywith a cloth draw sheet.
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To save linen and washing, a
used clean top sheet may be
used as a draw sheet orbottom sheet.
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A patient who does not use his
bed a great deal may not have to
have the linen changed everyday. Evaluate the linen, theroom, the patient, and the entire
situation before you change thebed.
OBJECTIVES
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OBJECTIVES
To learn how to make a clean,comfortable and safe bed forpatients.
To aid in the orderly appearanceof the unit.
To learn how to conserve energy
by making the bed completely onone side before proceeding to the
other side.
R B d
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Recovery Bed
To learn how to make a
comfortable, safe bed for the
patient recovering fromanesthesia.
Prepared only in recovery
room.
S i l F
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Special Features
The head and foot ends areremovable.
The bed is narrow enough to permitready passage through doors and
corridors of the hospital.
Overhead or lateral fractureequipment may be mounted on bed.
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The intravenous (IV) rod may
be used in six different locations
(two at the head, two at the footof the bed and two at the centersection of the spring).
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The rod is special designed so that
the solution bottles hang securely in
place. It is square in contour toprevent turning around in thereceptacle.
A plunge type catch automaticallylocks the inner rod into position.
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The outer tube (the lower end of this
tube contains a slot) can be locked
into position in the receptacle withone slight turn. This fixes the hooksin a parallel position with the head
or foot of the bed, making itimpossible for the hooks to damagethe walls.
U f St d d E i t
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Use of Standard Equipment
Over Bed Table
Standard equipment in hospital
units
Used as means of support when
patient wishes to lean forward
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Wheels should be locked when
it is being used
Adjustable heightUseful for patients with dyspnea
or orthopnea
Sid R il
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Side Rails
Safety measure to prevent
patient from falling out of bed
Attached to modern hospitalbed and extends to just below
the patients hips
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Useful for patients who are
restless, aged, anesthetized,
heavily sedated or irrational.
Maintaining the Proper
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Maintaining the ProperEnvironment
Ventilation
To ventilate means to allowfresh air to circulate through a
room and replace foul air.
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Opening windows and doors
provides natural ventilation.
Two openings are necessary-warm air go out of upper opening
and cool air will enter through
the lower.
Temperature
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Temperature
Sufficient heat should be
provided
Certain conditions willnecessitate various deviations
in temperature and humidity.
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Room should be 70 degrees
F, especially in ward with
several patients.In Private room temperature
nay be regulated according to
patients needs.
Lighting
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Lighting
Hospital units are usually
fitted with adjustable lights.
Insufficient lights may causedfatigue if patients attempts to
read.
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Glare is a source of annoyance.
Nightlights may also cause
patients to have difficulty insleeping.
Sufficient light is needed toprotect patient from falling.
Noise
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Noise
Produces most tension
among the environmental
conditions.
Ways to Eliminate Noise
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Ways to Eliminate Noise
1. Soundproofing
2. Improvising door silencer3. Seeing that movable
equipment is kept well oiled
4. Cultivating a quiet mannerand soft speech
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