Bag Technique

Name: Joan Glezelle M. Babiera Grade:

Year and
Section: BSN2-B Date: 12/10/21
DEFINITION:
Bag Technique is a tool making use of a public health bag through which the nurse, during
his/her home visit, can perform nursing procedures with ease and deftness, saving time and effort with
the end in view of rendering effective care.
PURPOSE:
To render effective nursing care to clients and/or members of the family during home visit.
EQUIPMENT NEEDED:

Paper lining Sterile cord tie

Extra paper for making bag for waste materials (paper bag) Adhesive plaster
Plastic/linen lining Dressing (OS, Cotton ball)
Apron Alcohol lamp
Hand towel in plastic bag Tape measure
Soap in a soap dish Baby’s scale
Thermometers in case 1 pair of rubber gloves
(one oral and rectal) 2 test tubes
Test tube holder
Pairs of scissors Syringes (5m and 2ml)
(1 surgical and 1 bandage) Hypodermic needles G19, 22, 23, and 25
Sterile dressings (OS and cotton balls)
2 pairs of forceps (curved and straight)
Medicines: Legend:
• Betadine - 70 Alcohol 1- Excellent
• Zephiran solution - hydrogen peroxide 2- Very Satisfactory
• Spirit of ammonia - acetic acid 3- Satisfactory
• Benedict’s solution - ophthalmic ointment 4- Needs improvement
(antibiotic) 5- Poor

Note: Blood pressure apparatus and stethoscope are carried separately.

PROCEDURE RATIONALE 1 2 3 4 5
1. Upon arriving at the client’s home, place the bag on the This is done to keep the
table or any flat surface lined with paper lining, clean side bag from becoming
out (folded part touching compromised. To
maintain sterility and to
the table). Put bag’s handles or strap beneath the bag. prevent in cross
contamination that
might jeopardized the
patients’ health and also
the health worker.
2. Ask for a basin of water if faucet is not available. Place This is intended to be
these outside the work area. used for handwashing
and to keep the work
area dry. Preventing the
area from getting wet
might attract vectors.
This too will also foster
efficiency.
3. Open the bag, take the linen/plastic lining and spread over The plastic lining
work field or area. The paper lining, clean side out (folder part facilitates in making the
out). instruments as well as
the bag from
contamination. This is
done in order to provide
such a clean work
environment.
4. Take out hand towel, soap dish and apron and place them To make supplies
at one corner of the work area (withing the confines of the readily available and to
prepare for
linen/plastic lining.)
handwashing. To
preserve sterility and
prevent cross
contamination, always
retain the linens or used
tools during the process
between the
confinement of the
plastic lining.
5. Do handwashing. Wipe and dry with towel. Leave the plastic To keep germs from
wrappers of the towel in in soap dish in the bag. spreading. After
washing, wipe damp
hands with a dry towel
to prevent germs or
infections from growing,
since these
microorganisms thrive in
humid environments.
6. Put on apron right side out and wrong side with cease To protect the nurses’
touching the body, sliding the head into the neck strap. uniform from any
exterior bodily fluids. It’s
Neatly tie the straps at the back.
important to tie the
straps at the back neatly
to maintain the
attachment of apron
tight and to make ones’
appearance presentable
to the patients.
7. Put out things most needed for the specific case (e.g. In order to make them
thermometer, more accessible. To
kidney basin, cotton ball, waste paper bag) and place at increase productivity
and save time and
one corner of the work area. energy.
8. Place waste paper bag outside of work area. Because waste paper
bags contain harmful
germs, it is best to store
them outside or far
away from the working
area. This, too, will aid
in the prevention of
infestation in a clean
environment.
9. Close the bag. To keep the bag and its
contents clean.
10. Proceed to the specific nursing care or treatment (e.g., TPR Proceed immediately in
taking, providing nursing care
Urinalysis, or wound dressing). to the client to serve
your purpose upon
going to the community.
11. After completing nursing care or treatment, clean and To keep the nurse safe
alcoholize the things used. and the following user
from being infected.
Sanitizing is done to
prevent illness from
spreading to others.
12. Do hand washing again. To keep germs from
spreading. Because you
are exposed to various
bodily fluids and
different persons who
may have harmful
germs on their bodies, it
is critical to wash your
hands often.
13. Open the bag and put back all articles in their proper Put back all the
places. materials after usage to
prevent it from losing
and to prevent from
buying the lost items
again.
14. Remove apron folding away from the body, with soiled To avoid the spread of
side folded germs. When the apron
inwards, and the clean side out. Place it in the bag. is removed, it is critical
not to touch the
exposed region, since
this area is likely to
have been exposed to a
variety of dangerous
pathogenic germs.
15. Fold the linen/plastic lining. If clean, place it in the bag and To avoid the spread of
close the germs. If the plastic
bag. linen is still clean,
reusing it will be of good
investment.
16. Make post-visit conference on matters relevant to To be used as a point of
health care, taking anecdotal notes preparatory to final reference in the future.
Post-visit conferences
reporting.
must be maintained and
followed because they
allow clients and health
care providers to meet
and learn about and
discuss topics, ideas,
and work that are of
mutual importance,
such as the health of
the individuals in the
home or in the
community.
17. Make appointment for the next visit (either home or For follow-up treatment
clinic). and to advise those at
the clinic or in the
 household to be present
on the specified day for
additional examination
and assessments. This
will also assist in
determining whether
there are any positive or
negative changes that
require quick treatment
or care.
POST-PROCEDURE ACTIVITY
18. After care of materials. To distinguish between
the clean and the
unclean.
19. Get the bag from the table, fold the paper lining and place To protect sterile and
in clean contents against
between the flaps of the bag. Close bag. contamination.
20. Record all relevant findings about client and family. To serve as a reminder
Take note of environmental factors which affect their for a future visit or
health. Include quality of follow-up.
nurse-patient relationship and nursing care provided.
ATTIDUE OF THE STUDENT:
21. Accept constructive suggestions and criticisms. To promote
improvement and
proper execution of
procedure.
22. Assumes accountability. Accountability ensures
that nurses are aware of
the responsibilities and
liabilities that come with
their decisions, actions,
and expertise.
Mastering the
fundamentals enhances
skills and confidence,
resulting in improved
performance and
healthcare service.
Source:
Pañares-Reyala, Jean, Community Health Nursing Services in
the
Philippines, 9 edition. Manila: Community Health Nursing
th

Section, national League of Philippine Government Nurses,

Inc., 2000, pp.54-58).
 Scoring:
1x =
2x =
3x =
4x =
5x =
Total divided by no. of items =

Comments:

Clinical Instructor’s Signature and Date over

 Wound Care
Name: Joan Glezelle M. Babiera ____________________________Grade: ________________________
Year
Section: BSN2-B Date: 12/10/21
DEFINITION:
The application of dry material such as absorbent gauze to protect or cover the wound or lesions.
PURPOSE:
To protect the healing wound from trauma or bacterial invasion.
EQUIPMENT NEEDED: Legend:
1- Excellent
Clean examination gloves 2- Very Satisfactory
Container for proper disposal of soiled dressing 3- Satisfactory
Sterile 4x4 gauze pads 4- Needs Improvement
Betadine paint and cleanser 5- Poor
plaster

PROCEDURE RATIONALE 1 2 3 4 5

1. Wash hands. To reduce transmission of

microorganisms.

2. Prepare materials. To be efficient in doing the

procedure. This also saves
time, effort and energy. This
also enables productivity in
doing the said procedure.
3. Provide privacy To maintain client’s comfort and
privacy while body is exposed during
the procedure. Maintains things
confidential and safe for the patient
to cooperate.
4. Explain procedure to the client. This would make the client be more
comfortable. Reduces the client’s
anxiety and enables the client to
cooperate.
5. Wash hands. To reduce transmission of
microorganisms. To mitigate cross
contamination against exposure, od
organic matter and bodily fluids.
6. Apply clean gloves. To promote infection control and
protection from bodily fluids.
7. remove old, soiled dressing
and place in appropriate
receptacle.
8. Apply new set of gloves.
9. Assess the appearance of the
undressed wound bed for healing.
10. Cleanse the wound with normal saline
solution.
11. Cleanse the wound with betadine
cleanser.
12. Cleanse the wound with betadine
paint.
13. Remove used gloves.
14. Wash hands.
15. Apply new pair of gloves.
16. Grasping the edges, apply the new
dressing on the wound.
Dressings and gloves contaminated with
bodily fluids should be disposed of in a
biohazard container.
To provide cleanliness, infection control
and protection from body fluids. To provide
and maintain sterility especially that the
nurse is going to have in contact with the
client’s body.
To assess appearance of redness, foul
odor, swelling, irritation, drainage,
bleeding or skin breakdown. Also, this
enables to have a proper diagnosing,
planning, implementation, and evaluation
of the patient’s condition.
To cleanse the wound from bacteria.
Saline is the preferred cleanser for most
wounds because it is physiologic and will
always be safe.
To cleanse the wound from bacteria.
Betadine is also used in a medical setting
to help prevent infection and promote
healing in skin wounds, pressure sores, or
surgical incisions.
To cleanse the wound from bacteria. To
help prevent infections, supporting the
healing process. Infections can cause
delays and prevent healing, or even
worsen the wound condition.
Used gloves should be disposed of
properly since they are contaminated.
Hands should be washed prior to setting up
the dressing to reduce transfer of
microorganisms.
To provide cleanliness, infection control
and protection from body fluids. Fosters
sterility and prevents cross contamination
from pathogens.
To protect the incision from floating and
provide healing. To maintain it sterile and
to prevent the wound from developing
undesired infection.
 17. Approximate, cut, and apply plaster on To promote healing for the damaged tissues.
dressing. Plasters give wound healing assistance from
the time of damage until the wound has
healed completely. They shield the skin from
external factors including pressure, moisture,
filth, and infection.
18. Remove gloves and dispose properly. To reduce transmission of microorganisms.

19. Conduct client and family education To inform about the wound dressing and
about the dressing. prepare for discharge. To teach the client the
do’s and dont’s upon the wound dressing. To
educate clients of the appropriate measures
that needs to be done to mitigate infection.
20. Do after care. To leave the area clean and organized.

21. Wash hands. To reduce transmission of microorganisms.

22. Do proper documentation To record all the data gathered during

assessment period.

Scoring:
1x =
2x =
3x =
4x =
5x =
Total divided by no. of items =

Comments:

Clinical Instructor’s Signature and Date

 TESTING URINE FOR SUGAR
Name: BABIERA, Joan Glezelle M. Grade:
Year
Section: BSN2-B Date: 11/10/2021
PURPOSE:
1. To check urine for presence of sugar, acetone, bacteria, and other urinary products.
2. To aid in diagnosis
3. To determine the condition of the patient.
4. To determine effectiveness of therapy.
EQUIPMENT NEEDED:

2 test tubes Clean gloves Test tube holder Legend:

Alcohol lamp Denatured alcohol Match or lighter 1- Excellent
Benedict’s solution Acetic acid Small glass 2- Very Satisfactory
Container of urine Colored chart 3 droppers 3- Satisfactory
Tissue Waste receptacle 4- Needs improvement

PROCEDURE RATIONALE 1 2 3 4 5
1. Assemble all equipment. Organization of materials facilitates
accurate skills and performance.
This too will help save time and
energy.

2. Wash hands. Prevent the transmission of microbes

3. Explain procedure to the patient and
explain proper collection of urine.
4. Explain procedure to the client.
5. Don clean gloves.
and illness and prevent cross-
contamination among patients and
healthcare workers.
Protects you from contamination by
bodily fluids. Certain procedures may
require the patient to stop eating,
drinking, or taking specific
medication, so they must be
informed of this upon the collection
of urine. If there are many details for
the patient to remember then writing
it down for them or advising them to
take notes may make things easier.
To encourage individuals to actively
participate in this procedure.
Establishes rapport and makes the
client feel comfortable and at ease
upon the procedure. Also, to reduce
anxiety.
Donning clean gloves helps prevent
the developing site for infections and
reduce the risk of exposure to blood
and body fluid pathogens for the
health care worker.
6. Apply clean gloves. It is important to wear gloves when
working with bodily fluids and other
materials because they protect our
hands from infection and
contamination. Wear gloves every
time you touch blood, bodily fluids,
bodily tissues, mucous membranes,
or broken skin to reduce the risk of
germ dissemination to the
environment and of transmission
from the health-care worker to the
patient and vice versa, as well as
from one patient to another.
Benedict’s Test
1. Place 5 cc of Benedict’s solution in a test Benedict’s solution is used to detect
tube. if there is a glucose present in the
urine. To get the desired result, use
the exact amount of Benedict's
solution in the test tube. If you use
too little or too much solution, you
might not obtain the desired
outcome, or you might not get a
satisfactory result.
2. Add 8 drops of urine. Bodily fluid specimen is used in
glucose test, particularly urine is
used for this test. Apply only the
desired or expected bodily fluid
because excessive amounts body
fluid might have detrimental
ramifications.
3.Heat the button of the test tube until boiling Heat is added when using Benedicts
point reagent in order to add more energy
to the solution and in order to get the
result of the test, to provide energy
needed to cause the chemical
reaction.
4. Read the result and compare with the color Read the result to the client so that
chart. they may be aware of the outcome
and compare it to the color chart for
correlation. Also, to interpret the
conclusions drawn of the Benedicts
solution and urine sample reaction.
B. Acetic Acid Test
1. Place 5 cc of the urine Fill the test tube halfway with 5 cc of urine.
and place it on a test tube. Simply apply the recommended amount of urine
sample to achieve the desired outcome. This
also the initial test for acetic acid test. A test
used for albumin determination of the patient
2. Heat the test tube on the This process is used to determine presence of
upper half. albumin. The upper section of the tube is boiled
over the flame, which is tilted at an angle. Only
the upper section is heated, so that heat-
induced convection currents do not disrupt the
precipitate, and the upper portion may be
compared to the clear bottom portion.
3. Add 3 drops of acetic Add the desired and instructed 3 drops of acetic
acid once it boils. acid once it boils. Excess of Acetic acid may
dissolve traces of proteins giving false negative
reaction that is why it is very vital to follow the
desired quantity.
4. Heat again until boiling Heat once again to see if there are any
point. changes. Acetic acid decomposes to produce
carbon dioxide and methane, or to produce
ketene and water. If the coagulum persists, then
it is due to proteins and if it disappears it is due
to phosphates. Excess of Acetic acid may
dissolve traces of proteins giving false negative
reaction)
5. Read and compare the Read the result to the client so that they may be
result with the color chart. aware of the outcome and compare it to the
color chart for correlation. Also, to interpret the
conclusions drawn of the Acetic Acid test.
Check if turbidity is still present, protein is
present in urine. If turbidity disappears, that is
due to phosphates or carbonates present in
urine.
AFTER CARE
1. Explain result to the To make the patient aware of the situation and
patient. to schedule any necessary follow-up
appointments. Positive Benedict’s Test:
Formation of a
reddish precipitate within three
minutes.Indicates presence of Glucose
Negative Benedict’s Test: No color change
(Remains Blue).
Result: If urine contains sugar, it is most
frequently glucose, which is indicative of
diabetes or other disorder in
blood glucose level regulation.
Acetic acid test
If the turbidity persists it confirms the presence
of albumin in
the urine sample (disappearance of turbidity,
confirms the
presence of phosphates). Appearance of
turbidity which persists after heating indicate
proteins. The test is graded depending on the
traces or amount of proteins.
Result:
A small amount of protein in the urine is
normally not a problem. However, larger levels
of protein in the urine may be caused by kidney
problems.
2. Place used instrument in Placing used instruments ensures that non-
the pouch for soiled sterile items won’t contaminate the unused and
clean ones. Placing them in one bag facilitates
instruments, place
prevention against cross contamination and
soiled articles outside the
maintenance of sterility.
bag.
3. Return clean equipment Returning clean equipment to the bag allows for
inside the bag. simple item access and identification of sterile
items, since they are segregated from non-
sterile items.
4.Wash hands. Hands should be washed with soap to eliminate
germs. Because you recently came into touch
with someone's body fluids, this helps avoid
illnesses. This is a criterion that must be
followed in order to eliminate transitory
microorganisms from the surface of the hands
that have been acquired via routine tasks in the
clinical setting. Both patients and staff benefit
from good hand hygiene.
5. Return clean equipment Returning clean equipment to the bag allows for
inside the bag. simple item access and identification of sterile
items, since they are segregated from non-
sterile items.
6. Document findings. Document findings for reference and for future
use. Documentation helps assure continuity of
care. Documenting will help in mitigating
malpractice risks, and helping healthcare
providers evaluate and plan the patient's
treatment and maintain the continuum of care.
 Scoring:
1x =
2x =
3x =
4x =
5x =
Total divided by no. of items =
Comments:

Clinical Instructor’s Signature and Date

 LEOPOLD’S MANEUVER

Name:__Joan Glezelle M. Babiera Grade:__________________

Year and Section:__BSN 2- B Date: 11/10/2021

Legend:
1- Excellent
2- Very Satisfactory
3- Satisfactory
4- Needs Improvement
5- Poor

PROCEDURE RATIONALE 1 2 3 4 5
PREPARATION
1. Wash hands. Prevents
transmission of
microorganisms.
2. Encourage the patient to empty the bladder The patient should be
advised to void, as an
empty bladder
promotes comfort and
allows for more
productive palpation
because fetal contour
will not be obscured
by a distended
bladder.

3. Compute the following: Determine if fetal

a. OB Score growth corresponds
b. EDC to gestational period
c AOG by identifying the
fundus.
4. Physical Assessment Assessment aids in
determining the
client's and fetus'
general health, as
well as ensuring that
there are no
problems.
First Maneuver .
1.Position the patient Assist the woman into
a comfortable position
with her shoulders up
and knees bent. The
process is less painful
if you bend your
knees.

2. Stand at the side of the bed, facing the mother. During abdominal
palpation, you can
detect any discomfort
or pain the lady is
experiencing.
Determine the height
of the fundal height.
3 Palpate the uterine fundus with warm hands. To figure out where
the fetus is in the
fundus.
Cold hands can
trigger uterine
contractions, which
can be
uncomfortable.
4. Determine which part of the baby’s body lies on The goal is to figure
the upper fundus out where the fetus is
according to its: in the fundus. Breech
a. Relative consistency feels big, nodular,
and softer, whereas
b. Shape
head feels round and
c. Mobility firm, freely moveable
and ballotable.
Second Maneuver
1. Place the palmar surface of both hands on Accurate results are
either side of the abdomen. ensured by proper
hand placement.
2. Apply gently but deep pressure in one side of Gentle yet deep
the abdomen. pressure that is not
damaging to the client
or the fetus is
necessary for proper
palpation.
3. Palpate the opposite side from the top to the To figure out which
lower segment of the uterus in a slightly circular way the fetal head is
motion. oriented.
4. Determine which side of the uterus is the long Fetal back is defined
axis of the fetus located. as a robust convex,
constantly smooth,
and unyielding mass
stretching from
breech to neck. The
fetal tiny parts/limbs
are identified by little
knobs, uneven
masses, and
movement when
pushed.
5. Check the fetal heart rate The best fetal heart
rate is generally
obtained by placing a
transducer or
ultrasonography over
the fetal back.

Third Maneuver
1. Grasp the lower uterine segment with thumb The presenting
and fingers section and its motion
are determined. The
presenting part is
engaged when it
moves high enough
for an examiner's
hands to be pushed
together (not firmly
settled into the pelvis)
2. Identify the presenting part. If the presenting
 portion is not
moveable, it is not
engaged. If it is still
moveable, it is not yet
engaged.
3. Determine the mobility of the presenting part. If the fetal head is
above the pelvic brim,
it will be easily
movable and
ballotable.
Fourth Maneuver
1. Stand to the side facing the patient’s feet. Proper positioning
ensures accurate
outcomes.
2. Place the tips of the first three fingers on both Only utilize this
sides of the midline about two inches from the method to evaluate
inguinal ligament. fetal attitude and
degree of fetal
extension into the
pelvis if the fetus is in
cephalic position. The
infant's anterior-
posterior position can
be determined by this
last movement.
3. Apply pressure downward and in the direction of The fetal head is
the birth canal. stretched if it is
dragged out. The fetal
head is flexed when
it's along the anterior
side.
4. Confirm the presenting part. The head is not
engaged when the
hands converge
around the presenting
portion. There will be
no movement if the
presenting section is
activated. This is the
sign of an engaged
head.
ATTITUDE
1. Accepts constructive suggestions and criticisms To promote
improvement and
proper execution of
procedure.
2. Assume responsibility of his or her actions. To take accountability
of the actions
committed.
Scoring:
1x ____________ = __________
2x ____________ = __________
3x ____________ = __________
4x ____________ = __________
5x ____________ = __________
Total divided by no. of items = __________
Comments:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
______________________________

Clinical Instructor’s Signature and Date over

Printed name
 NGT FEEDING

Name: Joan Glezelle M. Babiera Grade:__________________

Year and Section: BSN-2B Date: 10/12/2021
DEFINITION:
Enteral feeding is a method of supplying nutrients directly into the gastrointestinal tract.
EQUIPMENT NEEDED:

NGT Medicine Cup Legend:

Asepto Syringe Tissue/Towel 1- Excellent
Stethoscope Kidney Basin 2- Very Satisfactory
Clean Gloves Plaster 3- Satisfactory
Glass of Warm Water Prepared Formula 4- Needs Improvement
Calibrated Glass 5- Poor

PROCEDURE RATIONALE 1 2 3 4 5
ASSESSMENT: It's important to check
Prior to NGT feeding ensure that the tube is located in the the tube's position in
stomach. Coughing, vomiting and movement can move the the stomach before the
tube out of the correct position. The position of the tube surgery to make sure
must be checked: it's in the right place.
This will also guarantee
• Prior to each feed that enteral feeding is
• Before each medication done appropriately,
• Before putting anything down the tube with nutrients reaching
• If the patient has vomited the gastrointestinal
Perform the following observations and obtain a tract immediately.
gastric aspirate to establish tube position.

• Ensure taping is secure

• Observe and document the position marker
on NGT/OGT – compare to initial
measurements.
• Observe Patient for any signs of respiratory
distress
Procedure:
1. Wash hands. This reduces the
danger of cross-
contamination and
transfer of infectious
agents to clients and
oneself by minimizing
the buildup of germs on
the hands.
2. Prepare materials. The gathering of all
resources required for
the operation
necessitates the
preparation of
materials. This will help
you save time, energy,
and effort as well.
3. Provide privacy. It is important to
maintain the patient's
privacy in order to offer
a private place for the
client, to provide
maximum comfort and
to develop a strong
rapport and trust.
4. Explain procedure to the client. It is critical to inform the
customer of what will
be done to them before
to the operation so that
they are prepared and
informed of the
procedure.
5. Wash hands. To prevent the
transmission of germs
and illness and
the cross-
contamination among
patients and other
healthcare personnel.
6. Apply clean gloves. To reduce the danger
of infection, since some
elements in the
environment, such as
health-care
professionals, clients,
and items, may be
susceptible to germ
dispersion or transfer.
This is also important
for your personal
safety, since it lowers
your risk of contracting
a disease.
8. Measure the correct amount of formula and warm it to the To guarantee that the
desired temperature. client is drinking a
warm and appropriate
amount of formula
while maintaining a
healthy diet.
9. Elevate the patient’s bed to a high- or semi-Fowler’s The danger of
position aspiration is reduced by
elevating the bed. This
is required in order for
the nutrients to enter
the digestive tract
directly.
10. Place protective sheet under tubing to protect bedding To minimize spilling on
and clothes. beds and clothing,
place a cover under the
tube.
11. Remove cap or plug from the feeding tube. To examine the tube's
patency and location,
remove the cap from
 the feeding tube.
12. Check tube patency and placement To verify that the tube
is in the right and
• observing mark on NG tube correct position before
• pH testing giving the formula,
• use the asepto syringe to inject 10-15 mL of air check its patency and
while auscultating with stethoscope listen for placement first.
bubbling or gurgling sound.
• Aspirate stomach contents. Note amount of
residual withdrawn and inject gastric fluid back
into tube. DO NOT discard this fluid. If residual
is greater than 100 mL or twice the hourly rate
of feeding, call physician. DO NOT administer
feeding.
13. Clamp the tube and attach the tube to the asepto This is necessary to
syringe. keep the tube securely
in place and avoid
leakage.
14. Flush with 50 ml - 60 ml water or as recommended. Prior to delivering the
formula, this will assist
in clearing the passage
in the tube to prevent
obstruction.
15. Pour the formula into the asepto syringe and unclamp This will allow the
the tube. formula from the asepto
syringe to enter the
tube on its journey to
the gastrointestinal
system.
16. Allow the formula to flow in by gravity. Let the force of gravity
lead the formula to flow
out from the asepto
syringe to the tube,
pulling the formula in a
downward direction.
17. During the feeding, keep the bottom of the syringe no The speed with which
higher than 6 inches above the patient’s stomach. the formula is injected
is affected by the
syringe's height.
Holding it higher than 6
inches may cause the
client's stomach to
inflate out and cause
them to vomit.
18. Continue adding formula into the syringe until the To ensure that the
prescribed amount is given. correct amount of
formula is injected into
the syringe and to
ensure that the
customer consumes
the recommended
amount.
19. If there are medications to be given, do not mix the Because certain drugs
medication into the feeding, take note if the medication is to are incompatible with
be given before or after the feeding, crushed the the client's feeding
medication and mix it with water in the medicine cup, pour formula, it's best not to
the medication into the asepto syringe. add any medications to
the client's food to
avoid indigestion. To
act in the client's body
and prevent unforeseen
events, it is important to
know when the
medicine should be
delivered. Crushing the
medicine allows it to
dissolve more easily in
water, allowing for
better flow into the
asepto syringe and
down to the tube.
20. When the syringe is empty, flush the tube with the This will guarantee that
prescribed amount of warm water. all of the feeding
formula is delivered
straight to the
gastrointestinal system
through the tube.
21. Clamp the tube. This will keep the
formula in the tube and
prevent it from leaking.
22. Leave patient in high- or semi-Fowler's position for at This position will aid in
least 30 minutes and observe after for vomiting or any other the emptying of the
unusualities. stomach following a
meal and will prevent
aspiration. After giving
the formula, keep the
client's body raised for
at least 30 minutes to
allow the nutrients to
enter the
gastrointestinal tract
directly.
23. Discard soiled supplies in appropriate containers. Disposing of dirty
materials in their proper
containers helps to
avoid
microorganism, cross-
contamination and
promotes a clean
environment.
POST-PROCEDURE ACTIVITY
24. After care of materials. Cleanse reusable equipment and Promoting or
rinse. Allow to airdry and wrap in clean towel to be used at supporting a clean
next feeding. place or environment
sets an example or
raises awareness for
others, as well as
ensuring your own and
others' safety,
particularly in terms of
cleanliness. It's also a
personal hygiene issue.
25. Proper Documentation: To keep track of all
information acquired
a. Verification of proper tube placement. between interactions
b. Amount of aspirated stomach content. and during the
c. Feeding solution and amount. proceedings so that
d. Medications administered. any discrepancies or
e. Amount of water administered. difficulties with the
f. Patient's response to procedure. nursing plan or
g. Instructions given to patient/caregiver. healthcare procedures
h. Communication with physician, when necessary. may be addressed and
the patient's well-being
can be maximized. It
also facilitates efficient
client care by
promoting good
communication among
peers or professionals
in interdisciplinary
health departments.
Finally, any occurrence
of a lapse in operation
or misconduct involving
conditions or legal
boundaries should be
recorded so that future
issues between the
facility and the
customer may be
handled.
ATTITUDE OF THE STUDENT
26. Accept constructive suggestions and criticisms. Constructive criticism
promotes personal
development and
success in the nursing
industry. It also fosters
healthy relationships
via effective
communication and
eliminates future flaws
with the help of
professional experts.
27. Assumes accountability. Nurses who are held
accountable are aware
of the obligations and
liabilities that come with
their decisions, actions,
and skills. Mastering
the fundamentals
improves abilities and
confidence, which
leads to better
performance and
service in the
healthcare industry.
Reference:
https://www.vnhcsb.org/media/data/papers/pdf/031_2.12.3.pdf
Scoring:
1x ____________ = __________
2x ____________ = __________
3x ____________ = __________
4x ____________ = __________
5x ____________ = __________

Total divided by no. of items = __________

Comments:
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Clinical Instructor’s Signature and Date over Printed name