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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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