COLLEGE OF MEDICINE AND ALLIED HEALTH SCIENCE (COMAHS)

(UNIVERSITY OF SIERRA LEONE)

Course: DIPLOMA IN NURSING (SRN)

ASSIGNMENTS
  Three disease conditions in each position use in nursing and the nurses care for
these diseases?

Three bed positions and three disease conditions in each bed position and the nursing care for
those diseases are as follows:

1. FOWLER'S POSITION: Fowler's position is when the head of the bed is elevated
between 45 and 60 degrees, with the knees slightly elevated. This position is used to
promote respiratory function by allowing for maximum chest expansion and facilitating
breathing. It is also helpful for patients with cardiovascular conditions as it promotes
venous return and reduces the risk of orthostatic hypotension.

Here are three disease conditions where Fowler's position is often indicated, along with the
corresponding nursing care:

i. Congestive Heart Failure (CHF): Fowler's position helps reduce the workload on
the heart and improves lung expansion, facilitating breathing.

Nursing care:

 Assist the patient in assuming and maintaining Fowler's position.

 Monitor vital signs, including heart rate, blood pressure, and oxygen
saturation.
 Administer medications as prescribed, such as diuretics or vasodilators, to
manage fluid overload.
 Monitor intake and output closely.
 Educate the patient on a low-sodium diet and the importance of fluid
restriction.
 Promote activity within the patient's tolerance level.
ii. Pulmonary Edema: Fowler's position aids in reducing fluid accumulation in the
lungs, allowing for improved oxygenation and breathing.
 Nursing care:

 Help the patient achieve Fowler's position and provide appropriate pillows or
supports for comfort.
 Administer supplemental oxygen as prescribed to improve oxygen saturation.
 Monitor respiratory status, including auscultation of lung sounds and oxygen
saturation levels.
 Assist with prescribed diuretic medications to reduce fluid overload.
 Assess and document the amount, color, and consistency of sputum.
 Encourage deep breathing and coughing exercises.
iii. Gastroesophageal Reflux Disease (GERD): Fowler's position helps reduce the risk
of acid reflux by promoting the flow of gastric contents away from the esophagus.

Nursing care:

 Help the patient assume a comfortable Fowler's position.

 Encourage the patient to have small, frequent meals and avoid lying down
after meals.
 Provide antacids or prescribed medications for acid suppression.
 Educate the patient about dietary modifications, such as avoiding spicy foods,
fatty foods, and caffeine.
 Assist with elevation of the head of the bed using foam wedges or raising the
entire bed at the head end.
 Monitor the patient for symptoms of reflux, such as heartburn or regurgitation,
and document their frequency and severity.
 2. TRENDELENBURG POSITION: Trendelenburg position is when the entire bed is
tilted with the head down and the feet elevated. This position is used in specific medical
situations such as hypotension or shock. It helps to improve blood flow to vital organs
and increase venous return.

Three disease conditions that may require the Trendelenburg position are:

i. Hypotension: Trendelenburg position is commonly used to treat hypotension, which

is low blood pressure. This position helps increase venous return to the heart and
improves cardiac output.

Nursing care:

 For a patient in Trendelenburg position due to hypotension includes

monitoring vital signs regularly, ensuring the patient's safety, providing
supplemental oxygen if necessary, and assessing for any signs of
complications such as impaired circulation or pressure ulcers.
ii. Shock: Shock is a life-threatening condition that occurs when there is an inadequate
supply of blood and oxygen to the body's organs and tissues. In certain cases of
shock, the Trendelenburg position may be employed to improve venous return and
cardiac output.

Nursing care:

 For a patient in Trendelenburg position due to shock involves continuous

monitoring of vital signs, administration of intravenous fluids and medications
as prescribed, frequent assessments of the patient's mental status and
perfusion, and providing emotional support to the patient.
iii. Peritonitis: Peritonitis refers to inflammation of the peritoneum, the thin tissue lining
the abdominal cavity. In some cases of peritonitis, placing the patient in the
Trendelenburg position may help reduce pain and alleviate symptoms.

Nursing care:
  For a patient in Trendelenburg position due to peritonitis includes
administering prescribed antibiotics, monitoring vital signs and pain levels,
providing frequent oral hygiene and skin care, assisting with activities of daily
living, and closely observing for signs of complications such as infection or
fluid imbalance.
3. SUPINE POSITION: The supine position, also known as the dorsal recumbent position,
is when the patient lies flat on their back with the head and shoulders slightly elevated.
This position is commonly used for routine nursing care, assessments, and procedures. It
allows for easy access to the patient's body for examinations, wound care, and
venipuncture.

Three disease conditions that may require a supine position are:

i. Congestive Heart Failure (CHF):

Nursing care:

 Elevate the head of the bed to reduce venous return and preload.
 Monitor vital signs, oxygen saturation, and cardiac rhythm regularly.
 Administer medications as prescribed, such as diuretics to reduce fluid
overload.
 Provide oxygen therapy if necessary.
 Assess lung sounds for crackles or signs of fluid accumulation.
 Encourage fluid and sodium restrictions as advised by the healthcare provider.
 Monitor and manage edema by measuring daily weights and assessing
peripheral edema.
 Provide emotional support and education to the patient and family regarding
lifestyle modifications, medication adherence, and recognizing signs of
worsening symptoms.

ii. Acute Respiratory Distress Syndrome (ARDS):

 Nursing care:

 Position the patient in a supine position with the head of the bed elevated at a
30–45-degree angle to optimize oxygenation.
 Administer oxygen therapy and monitor oxygen saturation closely.
 Maintain a strict aseptic technique to prevent infections.
 Assist with frequent turning and repositioning to prevent pressure ulcers and
improve lung expansion.
 Administer medications as prescribed, such as bronchodilators or surfactant
replacement therapy.
 Monitor and manage fluid balance carefully to prevent fluid overload.
 Collaborate with the interdisciplinary team to provide respiratory therapies
such as mechanical ventilation or prone positioning.
 Provide emotional support to the patient and their family members during the
critical illness.
iii. Stroke (Cerebrovascular Accident):

Nursing care:

 Position the patient in a supine position with head and neck support to
maintain proper alignment and reduce the risk of aspiration.
 Assess neurologic status frequently, including level of consciousness,
pupillary response, and motor function.
 Monitor vital signs regularly, including blood pressure, heart rate, and oxygen
saturation.
 Implement measures to prevent complications such as deep vein thrombosis,
pressure ulcers, and pneumonia.
 Collaborate with the rehabilitation team to initiate early mobilization and
physical therapy as appropriate.
 Assist with activities of daily living (ADLs) such as feeding, grooming, and
toileting.
  Provide emotional support and education to the patient and their family
regarding stroke recovery, medications, and lifestyle modifications.
 List and explain 5 nursing accessories?

Here are five nursing accessories commonly used by nurses:

1. Stethoscope: A stethoscope is an essential tool for nurses to listen to the sounds

produced by the body, such as heartbeats, lung sounds, and bowel sounds. It consists
of a chest piece, tubing, and earpieces. Nurses use the stethoscope to assess and
monitor a patient's health.
2. Pulse Oximeter: A pulse oximeter is a small device that measures the oxygen
saturation level and pulse rate of a patient's blood. It is commonly used to assess a
patient's respiratory status and to monitor oxygen levels during procedures or in
critical care settings.
3. Penlight: A penlight is a small, portable flashlight that nurses use for various
purposes. It is commonly used to assess pupillary responses, examine the throat or
oral cavity, and perform neurologic assessments. The penlight helps nurses illuminate
specific areas during examinations.
4. Nursing Clipboard: A nursing clipboard is a handy accessory that helps nurses keep
important patient information organized and accessible. It usually includes a storage
compartment for patient documents, a notepad for taking notes, and various reference
materials, such as medical abbreviations and vital sign ranges.
5. Badge Holder: A badge holder is a practical accessory for nurses to display their
identification badges. It typically consists of a retractable reel attached to a clip or
lanyard. Nurses wear their identification badges at all times to maintain security,
identify themselves to patients and colleagues, and access restricted areas.

These nursing accessories play a crucial role in the daily work of nurses, enabling them to
provide effective care, document patient information, and maintain safety and professionalism in
healthcare settings.