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TRANS-NCM103RLE Module3
TRANS-NCM103RLE Module3
1
Ncm 103 rle
FUNDAMENTALS OF NURSING PRACTICE
MODULE 3 | FINALS
E. Document the procedure, the length of time the compress GIVING A SITZ BATH:
was applied, including use of an Aquathermia pad. Record
the temperature of the Aquathermia pad and length of Q. To give a sitz bath, a patient is placed in a shallow tub or
application time. Include a description of the application basin containing enough warm water so that only the
area noting any edema, redness, or ecchymosis. Document pelvic area is submerged. The nurse should implement the
the patient’s reaction to the procedure, including pain plans for the care of the assigned patient so as to allow
assessment. Record any patient and family education that approximately 15 to 30 minutes for the sitz bath. Although
was provided. intended to cause vasodilation, prolonged heat may cause
the reverse effect if the warm temperature is sustained. By
GENERAL CONSIDERATIONS coordinating the preparation of the equipment with the
o Patients with diabetes, stroke, spinal cord injury, patient’s readiness, the maximum effects of the procedure
and peripheral neuropathy are at risk for thermal are likely to be achieved.
injury, as are patients with very thin or damaged
skin.
PURPOSES:
o Be extremely careful when applying to heat-
o 1. To increase local circulation.
sensitive areas, such as scar tissue and stomas o 2. To reduce swelling.
o 3. To promote healing.
o 4. To help relax local muscles.
COLD OR TEPID SPONGE BATH
ASSESSMENT:
F. DEFINITION: Consist of the general application of cold or o 1. Read the physician’s order.
tepid water to a patient’s body by means of a sponge bath. o 2. Consult the agency’s policy for the amount of
time and temperature recommended for sitz
PURPOSE: bath.
o 1. To relieve discomfort o 3. Read the patient’s record to determine the
o 2. To stimulate circulation reason for the sitz bath such as promoting
o 3. To reduce temperature healing of perineal incision.
o 4. Assess the patient’s mental status and any
GENERAL CONSIDERATIONS: evidence of sensory or cardiovascular diseases.
o 1. Do not allow the water to drip from the sponge o 5. Inspect the perineal area for color, swelling,
cloth sponging and keep friction. discharge, and integrity, evidence of external
o 2. Keep the patient’s arm away from the sides and hemorrhoids, drains, packing or dressing material.
sponge the axilla to get a thorough cooling in the o 6. Observe the patient’s ability to sit directly on
axilla, the inside surfaces of the arms and legs the buttocks, note signs of discomfort.
where the large blood vessels lie. o 7. Take the patient’s vital signs and compare them
o 3. Watch the pulse and color of the patient with the recommended range for the patient’s
constantly. If the patient chills, discontinue the age, determine the pattern of the vital sign
treatment. recordings.
o 8. Ask the patient to describe the sensations
EQUIPMENT: experienced in the perineum and rectum
o 1. Tray with the following especially with sitting, walking, and when
eliminating urine or stool.
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Ncm 103 rle
FUNDAMENTALS OF NURSING PRACTICE
MODULE 3 | FINALS
3
Ncm 103 rle
FUNDAMENTALS OF NURSING PRACTICE
MODULE 3 | FINALS
o Work on one side of the bed at a time to FF. It is a narrow rectangular table designed
complete removal of soiled linen and placement especially for hospital patients that
of clean linen. spans the bed and is typically fitted with
casters and a crank for adjusting the
DEXTERITY AND CARE IN HANDLING MATERIALS height and tilting the top
o Never shake bed linens, because microbes will be o Closets and dressers
released into the air. GG. Closet is a cabinet or recess for
o As soiled linen is removed from the bed, keep the especially china, household utensils,
soiled areas on the inside and fold or roll the linen HH. Drawer is a piece of furniture that has
toward the center. drawers for storing clothes and that
sometimes has a mirror.
EQUIPMENT o Privacy curtains and room dividers
o LINENS II. A hospital curtain is also known as a
o FURNITURE cubicle curtain and is a method of giving
o Chairs and table privacy to a patient in a hospital.
o Over-bed tables o Bedside tables
o Closets and dressers JJ. It is a table used to store patient’s
o Privacy curtains and room dividers things.
o Bedside tables ADDITIONAL EQUIPMENT
o OTHER EQUIPMENT o Call light and intercom system / Call Button
(signal device)
KK. A nurse call button is a button or cord
LINEN
found in hospitals and nursing homes, at
o Cloth made of flax used to make sheets
places where patients are at their most
o Linen is famous because of its strength and
vulnerable, such as beside their bed and
durability hence it is known as versatile fabric.
in the bathroom.. It allows patients in
o It is highly absorbent and can absorb up to 20% of
health care settings to alert a nurse or
its own weight.
other health care staff member
o Linen is 100% natural and oldest fabric used by
remotely of their need for help.
ancient Mesopotamia,
o Oxygen tank and accessories
LL. Oxygen tanks are filled with pressurized
TYPES OF LINENS oxygen and can help people with health
o 1. Bottom Sheet
problems breath.
Y. Placed over the mattress pad
o Suction apparatus and catheter
o 2. Bed protector/ Water proof Underpad/ Rubber
MM.In medicine, devices are sometimes
sheet necessary to create suction. Suction
Z. Used for people who are incontinent may be used to clear the airway of
and for people with draining wounds; blood, saliva, vomit, or other secretions
protects the linens. so that a patient may breathe.
o 3. Top Sheet o Goose neck lamp
AA. Is a flat sheet that covers the person
NN. A gooseneck lamp is a type of light
o 4. Bath blanket
fixture in which a lamp or light bulb is
BB. Used during bed baths and linen attached to a flexible, adjustable shaft
changes to allow the user to position the light
o 5. Pillowcase source without moving the fixture or
CC. Used to cover pillow and protect it from item to be illuminated.
moisture and soiling o Kidney / EMESIS basin
OO. It is a shallow basin with a kidney-
FURNITURE shaped base and sloping walls used in
o Ward furniture is ideally used in various hospitals, medical and surgical wards to receive
medical centres and such other places. soiled dressings and other medical
o Ward plain bed, IV stand, bedside screen, bedside waste.
locker deluxe, hospital washbasin stand, hospital o Padded tongue depressor
basin stand and other furniture comes in the PP. It is used to moisten the lips of the
category of ward furniture. patient by soaking the pad with water.
DIFFERENT FURNITURE
o Chairs and tables TYPES OF BEDS
DD. A table is an item of furniture with a flat o Bed Making
top and one or more legs, used as a QQ. Unoccupied Bed
surface for working at, eating from or RR. Open
on which to place things. SS. Close
EE. A chair is a type of seat. Its primary o Obstetrical Bed
features are two pieces of a durable o Surgical Bed
material, attached as back and seat to o Occupied Bed
one another at a 90° or slightly greater
angle
TERMS TO REMEMBER:
o Overbed tables
o 1. Hem – the edge or border of a garment
4
Ncm 103 rle
FUNDAMENTALS OF NURSING PRACTICE
MODULE 3 | FINALS
UNOCCUPIED BED
ZZ. BED MAKING PROCEDURE
WW. A method of bed making for a patient who has gave TYPES:
birth. o a. Close Bed - is made following discharge of a
EQUIPMENT: patient and after the unit is cleaned (terminal
o Waterproof under pad\ cleaning). It remains closed until a new patient is
o Cotton draw sheet to be admitted. (The top sheet is drawn up to the
o Top Sheet (Pink) top of the bed over the pillows).
o Pillow case o b. Open Bed - is like a sign saying “welcome” to
o Pillow the new patient. It indicates that the patient’s
o Bath towel arrival has been made. (The top covers are folded
back for the patient to get in).
SURGICAL BED
PURPOSES:
XX. A method of bed making for a patient who underwent a o 1. To provide a comfortable bed for the patient.
surgical operation. o 2. For cleanliness.
EQUIPMENT: o 3. To maintain good appearance.
o Bottom Sheet (Green)
o Waterproof under pad OPEN BED
o Cotton draw sheet
o Bath towel
DEFINITION:
o Top Sheet (Pink) o An open bed in one that is originally made as a
o Pillow case close bed with the top sheet rearranged in such a
o Pillow way that is ready for use.
PURPOSE:
ADDITIONAL EQUIPMENT: o To provide a comfortable and neatly prepared
o I.V. pole bed for a patient to get into at his convenience.
o Suction apparatus MATERIALS:
o Suction catheter (fr.12-14 for adults; fr. 8-10 for o Same as in close bed
children)\
o Oxygen tank prepared with necessary
OBSTETRICAL BED
connections
o Goose neck lamp (optional)
o Kidney basin lined with tissue paper DEFINITION:
o Padded tongue depressor o A method of bed making for a patient who has
o Tissue wipes/ wash cloth gave birth.
EQUIPMENT:
o 1 bottom sheet
OCCUPIED BED o 2 cotton draw sheets (any clean cotton sheet)
o 1 waterproof under pad
o 1 top sheet
YY. It is a method of bed making with a patient in bed.
o 2 pillow cases
INDICATION: o 2 pillows
o This is commonly suggested for patients who are
unconscious, critically ill and in continuous SURGICAL OR POST OPERATIVE BED
traction. o A method of bed making for a patient who
underwent a surgical operation.
EQUIPMENTS:
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Ncm 103 rle
FUNDAMENTALS OF NURSING PRACTICE
MODULE 3 | FINALS
GENERAL CONSIDERATION:
o See to it that all the needed set of equipment are
assembled and ready for use before the patient
arrives from the Operating Room.
EQUIPMENT:
o Same as the unoccupied bed with the addition of
the following:
AAA. bed protector
BBB. bath towel
CCC. Gown
DDD. Blanket
EEE. Padded tongue depressor
FFF. Tissue wipes/ wash cloth
GGG. I.V. pole
HHH. Suction apparatus
III. Suction catheter (fr.12-14 for adults; fr.
8-10 for children)
JJJ. Oxygen tank prepared with necessary
connections
KKK. Goose neck lamp (optional)
LLL. Waterproof underpad (optional)
MMM. On the bedside are:
NNN. Kidney basin lined with tissue paper
OCCUPIED BED
DEFINITION:
PURPOSES:
o 1. To make a bed with least possible discomfort to
patient.
o 2. To provide exercise for the patient and help
stipulate circulation.
o 3. To observe patient’s condition.
EQUIPMENT:
o 1 bottom sheet
o 1 pillow case
o 1 pair of working gloves, face mask (PPE)
o 1 top sheet
o 1 bath blanket (optional)
o gown (optional)
GENERAL CONSIDERATIONS:
o 1. Avoid jarring the bed.
o 2. Avoid unnecessary exposure of patient.
o 3. Avoid having the top sheet uncomfortably
tight.
SUMMARY: