Basic Nursing Care And Practice

The Laboratory Equipment And Rubber Articles

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Laboratory Equipment And Articles Made Of Rubber

Rubber Sheet – This is to protect the linen or bed mattress from getting soiled; used in post-operation beds, when giving shampoo or enema. The Method of Cleansing: wash with soap and water; hang to dry and air to remove odor.
Kelly Pad – This is to direct the flow of water to a pail as in rendering hair shampoo; also used in gynecologic and obstetrical procedures. Wash with soap and water; rinse and hang to dry; inflate with small amount of air.

The Laboratory Equipment And Glass Articles

2012-08-11T23:31:00.000-07:00

Laboratory Equipment And Articles Made From Glass

Here is the list of laboratory equipments and articles made out of glass:

Clinical Thermometers: a) Oral Thermometer – This is to determine body temperature through the mouth. The method of cleaning is washing with soap and water, dry with tissue paper, and keep inside the container. b) Rectal Thermometer - This is to determine body temperature through the rectum. The method of cleaning is washing with soap and water, dry with tissue paper, and keep inside the container.

The Laboratory Equipment And Enamel Ware Articles

2012-08-11T23:29:00.000-07:00

Laboratory Equipment And Articles Made Of Enamel Wares

Here is the list of laboratory equipments and articles made of enamel wares:

Pitcher – This is receptacle for water and large amount of solution. The method of cleaning is washing with soap and water.
Flushing Cup – This is receptacle of warm water for perennial hygiene. The method of cleaning is washing with soap and water.
Irrigation Can – This is receptacle of solutions as in enemas. The method of cleaning is washing with soap and water.

The Miscellaneous Laboratory Equipment and Articles

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Miscellaneous Laboratory Equipment And Articles

Here is the list of other laboratory equipments and articles:

Bedpan Brush – This is used for cleaning bedpans and should be cleaned by washing soap and water, then hang dry.
Bottle Brush – This is a type of brush used for cleaning tall slender bottles, e.g. feeding bottles. The method of cleaning is washing with soap and water, then hand dry.

The Hand Washing Technique

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Hand Washing

Hand-washing is an important measure in preventing the spread of microorganisms. Good aseptic technique involves limiting the transfer of organisms from one person to another. By washing her hands after contact with a patient, the nurse can limit the spread of microorganisms to other people, particularly other patients.

The Physical Examination

2012-08-11T21:56:00.000-07:00

Physical Examination

A physical examination is generally carried out by the doctor in an office, clinic or hospital. Although most people have had a physical examination at some time, it should not be assured that patients do not require any explanation from the nurse. If a patient does not know the physical, he may be unduly fearful; in such instances the nurse can introduce the doctor and the patient and perhaps explain why the patient requires an examination at this time.

The Preparation And Administration Of Medicines

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Preparation And Administration Of Medicines

General Rules in Ordering and Checking of drugs in the unit

1. Ordering of drugs from the hospital

Only the head nurse and the charge-nurse are authorized to order drugs. All drugs that come up from the pharmacy are to be checked against the drug order notebook or the medication for initial orders. Only the medication-nurse does the receiving, checking and storing the medicines.
The amount of all medicines ordered or received initially should be indicated at the lower left and corner of the medicine card.

The Temperature

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Temperature

Body temperature is the balance between heat produced and heat lost from the body. It is affected largely by centers located in the hypothalamus.

Heat Production and Heat Loss

Heat is produced chemically through food metabolism and the activity of hormones secreted by the endocrine glands specifically, thyroxine, epinephrine, and norepinephrine.

The Pulse

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Pulse

The pulse is the wave of blood in an arterial wall created by the contraction of the left ventricle of the heart. By slight pressure on an artery, the pulse wave can be felt as the blood is pumped around the body. When the ventricle contracts, it forces about 70 ml of the blood into the already filled aorta causing increased pressure within the artery. The walls of the artery expand as blood passes through.

The Respiration

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Respiration

Respiration is the act of breathing. It includes the intake of oxygen and the output of carbon dioxide. External respiration refers to the interchange of oxygen and carbon dioxide between the alveoli of the lungs and pulmonary blood. There are two phases of external respiration namely:

The Principles Underlying Body Mechanics

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Principles Underlying Body Mechanics

Muscles tend to act in groups rat her than singly. For example, breathing requires the coordinated activity of a number of muscles including the intercostals, the diaphragm and the sternocleidomastoid muscles, the scalenes, the thoracohumeral and the thoracoscapular muscles. To move the thigh alone involves all the gluteus muscles as well as the adductor muscles.

Large muscles fatigue less quickly than small muscles.

The Hair Shampooing In Bed

2012-08-11T08:03:00.000-07:00

Hair Shampoo in Bed

This is the process of washing of the patient’s hair while in bed. This is done to cleanse hair and scalp of patient.

The Positioning

2012-08-11T07:27:00.000-07:00

Positioning

Positioning is the art of putting the patient in proper body alignment to expose the operative site or area.

Positioning the patient properly does not only make the patient comfortable but also prevents various complications that may result from improper positioning. Restraints, on the other hand, are intended to protect the patient from self-injury or injuring others.

The Cleansing Bed Bath

2012-08-10T05:02:00.000-07:00

Cleansing Bed Bath

This kind of bath is to cleanse and refresh the patient. It also aid to stimulate circulation for increase of elimination through the skin.

Equipment used for Cleansing Bed Bath

The Tub Bathing

2012-08-10T04:24:00.000-07:00

Patient’s Tub Bathing

Tab Bathing is the process of cleaning the patient using bath tab which not only cleanses but refreshes the patient when able to get out of the bed.

The Subcutaneous Injection

2012-08-10T03:39:00.000-07:00

Subcutaneous Injection

Advantages and Disadvantages of subcutaneous injection

Some medications are best administered into the subcutaneous tissue by a needle. R is route has the advantage of almost complete absorption, providing the patient’s circulation is good; therefore an accurate measur e of the amount of the drug absorption is possible. Medicines administered in this manner are not affected by gastric disturbances (although it should be remembered that the medicines may themselves cause gastrointestinal disturbances), nor is their administration dependent upon the consciousness or rationality of the patient.

The Intramascular Injection

2012-08-10T02:51:00.000-07:00

Intramuscular Injection

Advantages and Disadvantages of intramuscular injection

Intramuscular injection is the method of choice for the administration of medication. Drug which are irritating of subcutaneous tissue are often given by this route. In addition, a larger amount of fluid can be given into muscle tissue than into subcutaneous tissue. Absorption through a muscle is fas ter than through subcutaneous tissue because of the vascularity of the muscle area. The danger of damaging nerves and blood vessels, however is greater.

The Intradermal Injection

2012-08-10T02:36:00.000-07:00

Intradermal Injection

When some medications are taken over a long period of time, the affect of the drug diminishes and the patient requires continually larger doses. This reaction to a medicine is called tolerance. Narcotics are among the drugs for which patients frequently develop such a tolerance.

The Sponge Bath

2012-08-10T02:23:00.000-07:00

Sponge Bath

The purpose of sponge bath is to assist in lowering body temperature and promote relaxation.

The two kinds of Sponge Bath

A. Tepid Sponge Bath

B. Alcohol Sponge Bath

The Cold Packs

2012-08-10T02:11:00.000-07:00

Cold Packs

There are two kinds of Cold Packs:

A. Cold Pack No. 1 - this is used for reducing temperature (duration is 30 minutes).

B. Cold Pack No. 2 – this is used for its sedative effect (duration is 1 hour or longer).

The equipment used for Cold Packs

The Hot Water Bags

2012-08-10T02:07:00.000-07:00

Hot Water Bags

The purpose of hot water bag is to provide warm to the patient. It also helps lessen pain felt in any part of the body. The heat aid the muscles to relax and ease muscle stiffness, thus provides immediate relief for pain by applying dry heat with safety to the affected area.

The Care of Rooms, Wards and Furnishings

2012-08-05T01:33:00.000-07:00

It is very important to provide clean, attractive and hygienic surroundings for patient to promote a healthy life environment.

The equipment used for Taking Care of Rooms, Wards and Furnishings

Scrubbing Basin or Pail with warm water
Soap
Cleaning and Dusting Cloths
Cleanser
Newspaper to clean mirrors
Brush

Procedure in Daily Care of Room or Bed Unit and Bathroom

Maintain proper lighting and ventilation.
Clean articles not in use and put away in proper place.
Instruct and supervise orderly in cleaning the room (walls and floor). Dust furniture, window ledges, and walls of room using soap and warm water.
Keep drawers clean. See that articles there are in order.
Check all equipment, report those that are missing or out of order.
Keep mirrors clean and free from stains. Use cleaner and newspapers.
Take all flowers to utility room, clean, arrange and return to bedside.
Empty and clean garbage can.
Toilet bowl and lavatory should be cleaned with cleanser and soap daily. Floor mopped with Roccal 1,2500.

Procedure in Cleaning a Room or Bed Unit after the discharge of a patient

Strip bed, pillows, screens, etc. Take all used linen to utility room and empty in laundry bag.
Air room or bed unit well.
Take bath basin, emesis basin, soap dish, to the utility room. Wash well with cleanser, then soap and water. Rinse and dry. Return to proper places.
Remove all unnecessary articles from room or unit.
Mattress: Brush entire mattress, pillows and springs. If it is possible, the mattress is placed under the sun for a few hours.
Dust bed frame, bedside table, cabinet, dressers and drawers, chairs, etc. Leave drawers open for airing for a few hours. Wash bowl and lavatory, etc. thoroughly.
Clean mirrors with cleanser and newspaper.
After cleaning is done, and room has been aired sufficiently, the room is put in order.

Procedure in Cleaning a Room Used by Infectious Cases

Mattress and pillows are brushed and placed under the sun all day.
Care of rubber goods
Enamel wares
The entire room or bed unit including furniture and fixtures are entirely cleaned with soap and water.
The room is aired for twenty-four hours.
The floor is mopped with Roccal 1,2500.

Procedure in Taking Care and Arrangement of Flowers

Take vases of flowers to utility room. Line work table with newspaper.
Wash vase wit soap and water, rinse thoroughly and dry. Fill vase with fresh water.
Wash stems of the flowers, remove wilted leaves and flowers and rearrange in vase.
Clip a little from the stems everyday to prolong the life of the flowers.
Avoid crowding the stems in the vases. You should give them enough space or room.
Keep flowers in a cool place and out of drafts.
Water potted plants daily. See that an old saucer, plate or small tray is kept under a potted plant.
Arrange vases of flowers and plants attractively in the patient’s room.
Flowers from the florist are received at the Information Desk. Then they are delivered to the specified department by the Information Clerk. The nurse receiving the flowers from the clerk signs a slip which is returned by the clerk to the person who delivered the flowers. The nurse is responsible for delivering them to the patient.
Flowers are to be taken directly to the patient before being opened, so that the patient may see contents of box or package. Give the card to the patient, then, arrange flowers in vase or bowl or jar in utility room. If flowers are already arranged in a vase or pot, water if necessary.

Taking Blood Pressure

2012-08-05T01:24:00.000-07:00

Blood pressure or commonly known as (BP) is one of the principal vital signs of human being. The word pressure itself means the pressure brought about by the circulating blood towards the wall of the blood vessels. When the heart is beating, the blood pressure (BP) depends on each heartbeat. The maximum pressure is called the “systolic” while the minimum pressure is the “diastolic”.

Equipment used in taking manually blood pressure

a. Sphygmomanometer (aneroid or mercurial)

b. Stethoscope

c. Jot down pad and pen/pencil

Important Note:

The interpretation and meaning of the blood pressure can only be made by a qualified physician. Most people’s blood pressure varies a great deal during each day; checking the pressures a number of times during the day give a better representation of your blood pressure range.

Steps on how to measure blood pressure:

You have to choice comfortable and quiet place.
Let the patient sit in a comfortable way in place. Explain to him/her what is to be done, the discomfort of a tightening cuff, the importance of relaxing his/her arms and why silence during the procedure must be observed. In this manner, you will gain cooperation with the patient, diminish the anxiety and would allow you to take the blood pressure accurately.
Prepare and bring the needed equipment with you, then have the patient sit or lie down depending on his/her condition and preference.
Position left palm upward exposing the patient’s forearm. This position places the branchial artery so that the stethoscope can rest on it conveniently on the antecubital fossa.
Extend your arm. Using your other hand find the mid-arm (brachial) pulse in it. This pulse is just to the inner side of the arm, on the front of the arm, at a level a bit higher than the elbow. (It is just to the inner side of where the biceps muscle starts). Always remember where the pulse is located.
Wind the self-adhering hook-and loop-cloth cuff snugly over the upper arm, leaving the pulse uncovered. The rubber tube should come of the cuff near the pulse. Your arm must be supported and resting at about the level of your heart.
Place the stethoscope ear set on.
Place the stethoscope chest piece (diaphragm) over the pulse. When checking your own pressure for the first few times, it is probably easier to tape the chest-piece to your arm.
Tighten the screw over the rubber bulb (which closes the air valve).
Inflate the cuff by squeezing the rubber bulb repeatedly; listen through the stethoscope while doing this. If you are checking your own pressure, squeeze the bulb with your free hand, not with the hand on the same arm as you are checking the pressure on.
As the pressure in the arm cuff rises you will hear a beating sound at some point. Rapidly raise the pressure until the beating sound disappears; then raise it another 20 to 25 points higher (check gauge). Alternatively, you can raise the pressure to a level about 25 points higher than the point at which you can no longer feel the mid-arm pulse. If you still have difficulty with these two procedures, you can try just raising the pressure to about 230 points.
Open the screw for the valve over the rubber bulb, to decrease the pressure about 2 to 4 points per second, listening all the time.
Note the gauge reading when the beating sound first appear as the pressure falls. This is the “systolic” pressure.
As the pressure continues falling, note the point at which the beating stops. This is a measure of the “diastolic” pressure.
Record the systolic and diastolic pressures with date and time, for the medical physician to see. It is often handy to use lined paper with one line for each pressure-reading session

Assisting the Patient with a Bedpan or Urinal

2012-08-05T01:18:00.000-07:00

The equipment used in assisting patient with bedpan or urinal

Bedpan or Urinal with cover
Rubber protector and cover
Toilet Paper
Douche Pitcher with warm water (un-sterile)
Basin of warm water
Soap
Hand Towel (bath towel may also be used)

Procedure in assisting patient with Bedpan or Urinal

Prepare all equipment and bring to bedside and them place bedpan or chair.
Provide privacy to the patient.
Fold diagonally upper flap of top sheet near you. Ask the patient to flex the legs. Lift the buttocks slightly and simultaneously slip the rubber protector and cover under the buttocks.
Remove bedpan cover, Fold and tuck under mattress at the foot of the bed then place bedpan along side of patient. The patient is placed in a comfortable position to facilitate elimination.
Help patient lift under the lower lumbar region. With the free hand slip bedpan under buttocks. Make sure the patient the patient is comfortable and is in such a position where she will be able to void and/or defecate, without wetting herself or the bed.
Place call bell within patient’s reach with instructions to call when through. Weak patients are not left alone when on the bedpan.
Assist patient to clean herself. This is done to insure thorough cleaning of patient.
Assists patient to lift herself as you remove the bedpan, rubber protector and cover. Place bedpan on chair and cover with bedpan cover immediately. Assisting will avoid too much strain on the part of the patient. Covering the bedpan will eliminate embarrassment.
Assist patient to wash her hands and then make her comfortable. Washing of the hands is a good health habit.
Take all used equipment to the utility room.
Observe contents of bedpan before emptying into the aeroflush. Accurate observation is of utmost importance and helpful in the diagnostic of the patient’s illness.
Take back equipment to the bedside. All equipment is kept in the table for neatness and facility for next use.

Important Points to Remember in Giving and Removing Bedpan

Insure privacy so that tension is relieved and patient’s sphincters are relaxed.
Bedpan should be warmed to help the patient to relax.
Bedpan should never be left on the floor and should be emptied and cleaned immediately.

Procedure in Giving Bedpan to the Patient

Warm the bedpan in the utility room by pouring warm inside and rotating the water around the sides of the bedpan.
Cover the bedpan and bring to the patient’s bedside. Screen the patient.
Place the bedpan on the chair at the side of the bed.
Hang cover on the foot of the bed or over the back of the chair.
Turn back the top sheet without exposing the patient.
Flex the patient’s knees and see that the gown or pajama is out of the way.
With the other hand, slide the bedpan under the buttocks.
Place one hand under the buttocks and help the patient raise his buttocks.
Unless contraindicated, raise the patient to the backrest position. Put the patient in a favorable position for elimination by either elevating head of bed or by placing a small pillow rolled towel under the lumbar region.
Place the toilet paper and the call light within easy reach of the patient.
Leave the room or unit unless the patient is too weak to be left alone.

Procedure in Removing Bedpan from the Patient

Give the toilet paper to the patient. If the patient is too ill, the nurse is responsible for cleaning the patient.

Flex the patient’s knees. With one hand, raise the buttocks of the patient and remove the bedpan with the other hand.

Place the bedpan cover at once and place on the chair.

Straighten the top sheet and adjust the back and knee rest.

Wash the patient’s hands with soap and water. Rinse and dry with hand towel.

Carry the covered bedpan to the utility room.

Empty contents into toilet bowl. Rinse thoroughly in cold water with bedpan brush. Scald with hot water afterwards.

Place in rack to drain.

Wash your hands thoroughly.

Procedure with the Bedpan if the Patient does not need Assistance

Cover the urinal with a urinal cover and take to the bedside.
Place the urinal on the other side of the bed without removing the cover. If the patient does not need assistance, leave the unit.
Be sure that the light is within easy reach.
Return to bedside when the patient turns on the signal light.
Take the covered urinal to the utility room.
Measure urine if an output order is required.
Empty and rinse the urinal. Wash and return to its proper place.

Procedure with the Bedpan if the Patient needs Assistance

Fold back the top sheet and bring down the pajamas taking care not to expose the patient.
Separate the legs slightly so that the urinal can be placed between them.
With one hand holding the urinal, raise the penis the other hand and direct it to the opening of the urinal.
After the patient has finished, slowly remove the urinal by withdrawing it from the patient’s legs.
Cover with urinal cover and place on the chair. Make the patient comfortable.
Measure the urine if an output record is required.
Empty the urinal, rinse and place it in the proper place.

The Anatomy And Physiology Of Body Movement

2012-08-05T01:03:00.000-07:00

The knowledge of anatomy and physiology is an essential basis for healthful living. It is equally essential in understanding the pathological state of the body. Before one can bring sick individuals back to normal anatomically, and physically, this subject is very important. Anatomy and Physiology is also one of the basic subjects in medicine and allied courses: like nursing, medical-technology, midwifery, etc.

Anatomy is the study of different structures of the plants and its parts. The two principal methods of this science are:

Gross Anatomy – the dissected body and its parts are seen by the naked eye (i.e. without the aid of the microscope.
Minute Anatomy or Histology – the tissues and organs are examined with the aid of the microscope.

Posture is “the relationship of the various parts of the body at rest or in any phase of activity.” Posture is considered to be good when proper placed upon the muscles, ligaments, and joints in maintaining balance.

Body movements are made principally by means of the skeleton, the muscles and the nervous system. The skeleton is made up of bones, two of the functions of which are to provide an attachment for muscles and ligaments and to act as levers. The proximal end of a skeletal muscle is attached to the less movable bone; this point of attachment is called the origin of the muscle. The distal end of the muscle is attached to a freely movable bone; this point is called the insertion of the muscle.

The muscles, which are composed of fibers, contract to produce motion. Skeletal muscles are continuously in slight contraction, or tonus. General good health, good nutrition, alternate rest and activity help to maintain the extensibility of muscle without stretching and thus affect muscle tone favorably.

The bones of the body also act as levers, and in body mechanics the principle of leverage is frequently used. A lever is “a rigid bar which revolves about a fixed point, the fulcrum of the lever is a fixed point. The resistance arm is the area between the resistance or weight and the fulcrum. The effort arm is the area between the point at which the energy is applied and the fulcrum. The levers of the body vary in shape and even in rigidity. The principles of leverage are applied in the procedures described.

The spinal nerves are directly involved in trunk and limb movements. Each spinal nerve has an anterior and a posterior root. The anterior root constructs impulses to the muscles from the central nervous system; the posterior root conducts impulses from the sensory receptors to the central nervous system.

Body movement is also affected by gravity, the force which pulls all objects toward the center of the earth. Most movement, then, involves pulling to at least some extent against the force of gravity. To describe the movement of the body parts, term such as abduction, adduction, flexion, and extension are used. Abduction refers to movement away from the central axis of the body. Adduction refers to movement toward the axis of the body. Flexion is the act of bending; extension can be described as the act of straightening. Illustrations of abduction, adduction, flexion and extension are given later in the chapter.

Body movements can be described relative to three planes; the sagittal, frontal and transverse. When the body is in the anatomical position, the sagittal plane divides in into right and left sections, the frontal plane into dorsal and ventral sections and the transverse plane into upper and lower sections.

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