BEDMAKING

Fundamentals of Nursing (NCMA113 LAB)

BS Nursing | PROF. | (PRELIM) SUMMER 2024

BEDMAKING PARTS OF THE BED

Bedmaking is a technique in preparing MATTRESSES

different type of beds for patient’s comfort.
Mattresses used for the client should be firm,
• Ability of the nurse to keep the bed clean. thick and smooth

• It gives support to the client

IMPORTANCE OF BED MAKING
• All should have a washable cover
• Clean, order, comfortable room • The size is 190cm width
• Secure proper rest, comfort that is essential
for health SIDE RAILS

• Prevents microorganism to come in contact

Side rails serve as a safe and effective means
with patient
of preventing clients from falling out of bed.
• Minimize source of infection

FOOT BOARD/FOOT BOOT

PURPOSE OF BED MAKING
• To provide the client with a safe and
comfortable bed to take rest and sleep
• To keep the ward neat and tidy
• To adapt to the needs of the client and to
be ready for any emergency or critical
condition of illness
• To economize time, material and effort
• To accommodate the patient’s needs.
• To prevent bed sores
• To observe the client
• For patient comfort
• To prevent cross infection
• For treatment of certain conditions
REMEMBER DURING BED MAKING
• During bed-making, we should remember
some knowledge that is useful for us and
Foot board also known as foot boot or foot drop
• Used to support the immobilized client's
foot in a normal right angle to the legs to
prevent plantar flexion contractures.
BED CRADLE (ANDERSON FRAME)
Bed cradle (Anderson frame) are curved,
semi-circular device made of metal.
• Keep top bed linen OFF the patient feet,
legs, abdomen
• Bed cradle is a device designed to keep the
top bedclothes off the feet, legs, and even
abdomen of a client
INTRAVENOUS RODS/IV POLE
Intravenous rods also known as IV pole are

also to the patient. usually made of metal, support intravenous

• During bed-making, bed position keep infusion containers while fluid is being

elevated and ensures nursing staff’s good administered to a client.

body alignments
• During the procedure, the nurse should
study her movements to avoid waste of
time and energy.
• After completing, the bed should be in a
lower position.
• During occupied bed making, confirm
patient safety and comfort.
• Wash hands before and after bed making
and use gloves during bed-making.
• Maintain privacy while making the bed.
• Keep soiled linen away from uniform which
may have germs.
• Do not shake dirty linen to prevent germs
spread around the room.
• Do not mix soiled and clean linen during
bed-making.
• For the bedridden patient, the mattress
must be turned the air and ensure free of
lumps and fold.

stethoscat
 TYPES OF BEDMAKING PATIENT’S POSITIONING

UNOCCUPIED BED 1. Flat / Supine

2. Semi-fowler’s position
Unoccupied bed is made when there is NO 3. Fowler’s position
patient confined in bed. 4. Trendelenburg’s position
5. Reverse trendelenburg’s position
OPEN BED

Fanfold top sheet to foot of bed to convert

closed bed to open bed

• Fanfold means to fold sheets in accordian

pleats
• Done to welcome a new patient or for
patients who are ambulatory or out of bed.

CLOSED BED

In closed bed, top sheet blanket is drawn up to

the head of mattress.

• Made following discharge of patient

• To keep the bed clean until new patient is
admitted.

OCCUPIED BED

Occupied bed is made while patient is in it.

Usually done after the morning bath. TYPES OF BLANKET / LINEN

BED WITH CRADLE
Cradle placed on bed under the top sheet.
• Prevents top sheets from touching parts of
the patients body.
• Used for burns, skin ulcers, lesions, blood
clots, fracture or surgery
• Some cradles have light bulbs to provide
BOTTOM SHEET
Bottom sheet covers the bed/mattress
RUBBER SHEET
Rubber sheet protects bottom sheet from
secretions. Placed at the center of bottom sheet
• Red: when patient is NOT bleeding; for

heat for special treatment waste management

• Green: when pt is bleeding

SURGICAL BED DRAW SHEET

Surgical bed also known as Postoperative bed Draw sheet is placed on top of rubber sheet.
• For the patient who is coming from the • Cotton
operating room or from another procedure • Absorbs moisture
that requires anesthesia. • Helps nurse in moving pt.
• Pleats are located at the side of bed
• Made in such a way for easy transfer of TOP SHEET

unconscious or weak patient from a

Top sheet is used to cover patient.
stretcher to the bed.
• Provides warmth
TYPES OF PLEAT
BLANKET
VERTICAL PLEAT
• Blankets are optional
Vertical toe pleat is used for large patients • Large, soft woolen
• Provides warmth
HORIZONTAL PLEAT
PILLOW AND PILLOWCASE
Horizontal toe pleat is used for tall patients
• Opening of pillowcase should NOT be facing
MITERED CORNER
door.

Mitered corner is used to secure bottom and

top sheet in place underneath the mattress.
BED BATH & BACK RUB
Fundamentals of Nursing (NCMA113 LAB)
BS Nursing | PROF. | (PRELIM) SUMMER 2024

BED BATH AFTERNOON CARE

• Hospitalized patients often undergo many

PURPOSES OF BED BATH
exhausting diagnostic test or procedures in
• Cleans the skin the morning.
• Stimulates circulation • Afternoon hygiene care includes washing
• Provides mild exercise the hands and face, helping with oral care,
• Promotes comfort offering a bedpan or urinal, and
• Allows assessment of skin condition, joint straightening bed linen.
mobility, and muscle strength.
EVENING OR HOUR-BEFORE-SLEEP CARE
MATERIALS USED (PM CARE)

A. Basin or sink with warm water • Evening care is done before bedtime; offer
B. Soap and soap dish or liquid chlorhexidine personal hygiene care that helps patients
gluconate (CHG) (CHG cloths optional) relax and promotes sleep.
C. Linens; bath blanket; two bath towels; • Includes changing soiled linens, gowns.
washcloth; clean gown, pajamas, or • Helping patients wash the face and hands,
clothes, as needed; and additional bed providing oral hygiene and giving a back
linen and towels, if required massage.
D. Gloves, if appropriate
E. Personal hygiene articles
CATEGORIES OF BATH
F. Shaving equipment if needed
G. Table for bathing equipment
Cleansing/Cleaning Therapeutic bath is
H. Laundry hamper
bath is given chiefly for given for physical
hygiene purposes effects
HYGIENE CARE SCHEDULE IN ACUTE AND
LONG-TERM CARE SETTINGS Soothe irritated skin or
to treat an area (e.g.,
the perineum).
EARLY MORNING CARE

Types: Medications may be

• For early morning care, nursing personnel
1. Complete bed bath placed in the water.
on the night shift provide basic hygiene to
2. Partial bath
patients getting ready for breakfast, Generally taken in a tub
3. Bag bath
scheduled tests, or early morning surgery. 4. Towel bath one-third or one-half
• ’AM Care’ includes offering a bedpan or 5. Tub bath full

urinal if the patient is not ambulatory, 6. Shower

The client remains in
washing the patient’s hands and face, and
the bath for a
helping with oral care.
designated time, often
20 to 30 minutes.
ROUTINE MORNING CARE

• Routine morning care is done after COMPLETE BED BATH

breakfast; help by offering bedpan or urinal
to patients confined to bed.
• Provide a full or partial bath or shower,
including perineal care and oral, foot, nail,
and hair care
• Change a patient’s gown, bed linens
• Often referred to “Complete AM Care”
Complete bed bath administered to totally
dependent patient in bed.
PARTIAL BED BATH
Partial bed bath consists of bathing only body
parts that would cause discomfort if left
unbathed such as the hands, face, axillae and
perineal care.

• May also include washing back and

providing back rub.
• Provide a partial bath to dependent
patients in need of partial hygiene or self-
sufficient bedridden patients who are
unable to reach all body parts.

stethoscat
 SELF-HELP BED BATH
In self-help bed bath, clients confined to bed
are able to bathe themselves with help from
the nurse for washing the back and perhaps the
feet.
BAG BATH
Bag bath is a commercially prepared product
that contains 10 to 12 presoaked disposable
washcloths that contain norinse cleanser
solution.
TOWEL BATH
Towel bath is similar to a bag bath but uses
regular towels. It is useful for clients who are
bedridden and clients with dementia
TUB BATH
Tub bath involves immersion in a tub of water
that allows more thorough washing and rinsing
than a bed bath.
• Often preferred to bed baths because it is
easier to wash and rinse in a tub.
SHOWER
Patient sits or stands under a continuous
stream of water. The shower provides more
thorough cleaning than a bed bath but can
cause fatigue.
• Many ambulatory clients are able to use
shower facilities and require only minimal
assistance from the nurse.
CHLORHEXIDINE GLUCONATE (CHG) BATH
This antimicrobial bath wipe with
chlorhexidine gluconate is used to decrease
the frequency of hospital-acquired infections
on skin, invasive lines, and catheters.
Another type of bath is,
Sponge bath which involves bathing from a
bath basin or sink with patient sitting in a chair.
Patient is able to perform part of the bath
independently. Assistance is needed for hard-
to-reach areas.
STEPS FOR BEDBATH
1. Assess the client’s ability for self-care and
check for doctor’s order if there’s any
2. Perform hand washing
3. Gather the necessary materials needed
4. Identify the client and explain the
procedure
5. Provide clients’ privacy
6. Obtain water for the bath
7. Wear clean gloves
8. Remove the top linen, placing a bath
blanket over the client before removing the
top sheet
9. Position the client in supine if tolerated.
Move client to your side of the bed. Bathe
the client in the following order
10. Spread the towel across the client’s chest
tucking it under the chin
11. Make a mitt out of the wash cloth
12. Wash face with or without soap as client
wishes. Rinse and pat dry
13. Loosen/remove the client’s gown
METHOD OF FOLDING
14. Placed a towel lengthwise under the far
arm. Do the far arm first using a long
strokes towards the center of the body
including the axilla of the client. Pat dry
15. Replace the water in the basin and wash
the hand of the client thoroughly. Use
orange wood stick to clean the nails if
needed. Rinse and pat dry.
16. Repeat the procedure for the hand and arm
nearest you.
17. Fold the bath blanket down to the waist,
leaving the towel over the chest
18. Wash the chest, for female, clean the breast
starting from the nipple out in circular
motion under and include the breast. For
male, start from the farthest towards you.
Rinse and pat dry
19. Assess for any skin irritation
20. Fold the bath blanket down to the pubic
bone. Leaving the towel over the chest.
21. Change the water in the basin and wash,
rinse, and pat dry the abdomen especially
the umbilicus. Remove the towel.
22. Change the water in the basin and lift the
leg and place a bath blanket lengthwise
over the far leg of the client. Keeping the
perineum covered
23. Wash, rinse and pat dry the leg using long,
smooth, firm strokes from the ankle up to
the thigh
24. Change the water in the basin and reverse
the coverings and repeat for the other leg.
25. Bending the leg, slide the basin onto the
bed and place the foot carefully and wash.
Pat dry giving special attention to areas in
between toes. Then repeat the procedure
for the other foot.
BED BATH & BACK RUB
Fundamentals of Nursing (NCMA113 LAB)
BS Nursing | PROF. | (PRELIM) SUMMER 2024
26. Change gloves and water and wash the
genital area
27. Take off the gloves and wear a new one.
28. Assist the client in prone or side lying
position facing away from you. Drape
properly.
29. Wash, rinse, and dry the back using long
firm strokes.
30. Change the water in the basin. Wash , rinse
and dry the buttocks
31. Remove gloves. Help the client put on clean
gown or pajamas
32. Perform back massage after the
completion of bed bath
33. Assist the client in combing the hair
34. File or cut finger nails and toe nails short
35. Place the client in comfortable position
36. After care of the materials used
37. Perform hand washing
38. Document the procedure done.
SHAMPOOING
1. Assess the client’s need for
shampooing/verify the doctor’s order.
2. Gather the materials needed and perform
hand washing.
3. Greet and identify the client and explain the
procedure.
4. Provide clients privacy during the entire
procedure.
5. Assess any scalp problems and activity
tolerance.
6. Loosen the gown of the client.
7. Fold top sheet down to the middle and
replace with bath blanket and cover the
client’s chest using bath towel.
8. Remove pillow and bring client’s head close
to the edge of the bed by placing the client
diagonally across the bed.
9. Place the rubber sheet under the client’s
head and shoulder. Support the shoulder
with the pillow(unless contraindicated).
10. Place a towel around the client’s neck and
shoulder. Hold towel in place by using
safety pins.
11. Arrange a Kelly pad under the client’s head
so that when you pour the water, it will go
through and empties into the pail.
12. Cover the eyes of the client by placing a
folded face towel.
13. Plug ears using cotton balls.
14. Check the water temperature before
pouring to client’s head.
15. Put on clean gloves.
16. Advise the client that you are about to pour
water and wet the hair thoroughly.
stethoscat
17. Put a small amount of shampoo in your
palm and make a lather and start
shampooing the client’s head while
massaging the client scalp using finger
pads.
18. Rinse the hair thoroughly.
19. Squeeze as much water as possible out of
the hair using your hand.
20. Put the towel that is in client’s neck and
cover the hair.
21. Remove the kelly pad and drop it into the
pail.
22. Remove the face towel over eyes and the
cotton balls from ears and the pillow under
shoulder.
23. Dry the client’s hair, ears and neck.
24. Assist the client in combing the hair.
25. Remove gloves and the blanket on client’s
chest and pull the top sheet up.
26. Place the client in comfortable position and
allow the client to rest.
27. Wash all the materials used and perform
hand washing.
28. Document the procedure done
ORAL CARE
PARTS OF THE TOOTH
• Crown is the exposed part of the tooth,
which is outside the gum.
• Root of a tooth is embedded in the jaw and
covered by a bony tissue called cementum.
• Pulp cavity in the center of the tooth
contains the blood vessels and nerves.
s
*Adult: 32
teeths
ORAL HYGIENE
Oral hygiene is maintaining cleanliness of the
oral cavity.
SIGNS THAT CAN BE SEEN IN THE MOUTH
A. Systemic disease – chronic renal failure
(CRF), systemic lupus erythematosus (SLE)
B. Bacterial and Fungal – mouth thrush
C. Infections - tonsillitis
D. Nutritional deficiencies – kwashiorkor or
edematous malnutrition
 Terminologies:
• Dental caries - tooth cavities
• Periodontal disease - (gum disease,
pyorrhea) is an inflammation of tissues
around the teeth
• Plaque - thin film that sticks to teeth. It
contains saliva, microbes and other
substances. Plaque causes tooth decay
(cavities)
• Tartar - hardened plaque
• Flossing - removes plaque and tartar
PURPOSE OF ORAL HYGIENE
1. Maintains the healthy states of the mouth
2. Cleanses teeth of food particles, plaque,
and bacteria
3. Massages the gums
4. Relieves discomfort from unpleasant odors
and tastes
5. Refreshes the mouth and gives a sense of
well being and thus can stimulate appetite
6. Reduces the risk for cavities (dental caries
and periodontal disease)
DAILY MOUTH CARE BENEFITS TO OLDER ADULTS
• Minimize medical problems
• Enhance quality of life
• Enhance cooperation
• Enhance nursing care delivery
ASSESSMENT: ORAL HYGIENE
FREQUENCY
• Depends on the condition of the patient's
mouth
• Some patient's with dry mouth or lips need
care every 2 hours
• Usually done twice a day or after each meal
ASSISTANCE NEEDED
• Does the patient need assistance to do oral
care
• The nurse can help patients maintain good
oral hygiene by:
a. teaching them correct techniques
b. actual performing for weakened or
disabled patients
ABNORMALITIES
• Loose or missing teeth
• Swelling and bleeding of gums
• Unusual mouth odor (Halitosis)
• Pain or stinging in mouth structures
BRUSHING
Major concerns are:
• Thoroughness in cleansing
• Maintaining of the oral mucosa
POSITIONING
• Conscious: upright position
• Unconscious: sidelying position
MATERIALS
Water, Toothbrush, Toothpaste, Sink or small
basin, Floss, Mouthwash, Gloves, Towel
FOR DENTURES:
a. Denture cup
b. Small basin
c. Tissues
d. Denture toothpaste
e. Towel
f. Mouthwash
g. Denture solution or tablets
h. Hand gloves
DENTURE CARE
• Clean dentures as frequently as natural
teeth
• Dentures are the patients personal property
and should be handled with care because
they can be easily broken
• Remove before going to bed - allows gums
to rest and prevents buildup of bacteria
• Store in a labeled container covered with
water or denture cleaner if available
BRUSHING: UNCONSCIOUS PATIENT
PREVENT ASPIRATION
• Positioning - Lateral position with head
turned to the side or side lying.
o Position back of the head on a pillow so that
the face tips forward and fluid/secretions
will flow out of the mouth, not back into the
throat
• Place a bulb syringe or suction machine
with suction equipment nearby.
KEEPING THE MOUTH OPEN
• Never place your hand in the patient's
mouth or open with your fingers.
o Oral stimulation often causes the biting
down reflex and serious injuries can occur
• Use a padded tongue blade to open the
patients mouth and separate the upper
and lower teeth.
BED BATH & BACK RUB
Fundamentals of Nursing (NCMA113 LAB)
BS Nursing | PROF. | (PRELIM) SUMMER 2024

REMINDER FOR MOUTHCARE BACK RUBBING

A. Mouth care should be given before and/or
after meals, in the morning and at night
before the person goes to sleep.
- When a person is unconscious, they
may need oral care every two hours
B. Oral care keeps the mouth and teeth clean
and without odors. It prevents cavities,
infection, gum disease and bad breath. It is
a very important part of care.
Back Rub also known as back massage means
massaging patient’s back, while paying
attention to pressure points.
• It promotes relaxation, relieves muscular
tension, and decreases perception of pain.
TYPES OF MASSAGE
EFFLEURAGE (STROKING)

C. If you notice any of the things below during
oral care, they must be reported and
documented:
o Sores, redness or bleeding in the mouth on
the gums, cheeks or lips
o Pain during mouth care
o Coating of the tongue or cheeks
o Broken teeth or dentures
o Bad breath
STEPS FOR ORAL CARE
Effleurage (Stroking) is a long sweeping
movement with palm of the hand, conforming
to the contour of the surface treated, over small
surface (on the neck).
• The thumb and fingers are used.
• Strokes are long, slow, gliding motion.
• The effleurage is associated with reduced
measured anxiety, heart rate and
respiratory rate.

1. Assess the client’s need for self-care

2. Gather the materials needed and perform
hand washing
3. Identify the client and explain the
procedure. Provide privacy if necessary. PETRISSAGE (KNEADING)
4. Place the client in appropriate position.
5. Wear clean gloves Petrissage (Kneading) is performed using the
6. Place a towel on the client’s chest ulnar side of the palm resting on the surface,
7. Prepare a tissue paper if needed while the fingers and thumb grasping the skin
8. Offer a glass of water and allow the client to and subcutaneous tissues of the patient’s
gurgle and offer the basin body.
9. Assist the client to brush his or her own
• It is used to improve blood
teeth if the client can, if not, brush the teeth
circulation, increase
of the client make sure that his head is
recovery, stretch and
facing you.
loosen muscle fibers and
10. Assess for any soreness in oral mucosa,
increase range of
bleeding gums, broken teeth and bad
movement.
breath
11. Allow the client to gurgle to rinse the mouth
and offer the basin to receive the fluid from TAPOTEMENT (FRICTION)
the mouth (offer mouth wash if needed)
Tapoment (Friction) is a rapid, percussive
12. Use towel to pat dry the lips of the client.
tapping, slapping and cupping of the patient’s
Remove the towel
back.
13. Place the client in comfortable position
14. Discard and wash the materials used • It is used to strengthen deep tissue
15. Remove the gloves muscles.
16. Perform hand washing
17. Document the assessment of the teeth,
tongue, gums, and oral mucosa.

stethoscat
 PURPOSE OF BACK RUB

• To promote circulation to the back

• To reduce anxiety
• To relieve from fatigue, pain and stress
• To help induce sleep
• To prevent bedsore
• To provide comfort

MATERIALS USED

A. Face Towel
B. Drapes
C. Bath Towel
D. Oil/Lotion

NURSING CONSIDERATIONS:

• Do not massage patient’s legs or calf

muscle to avoid the risk of dislodging a
vascular clot.
• Have the patient relax, by instructing to take
slow deep breaths
• Ask patient to rate level of pain
• Note any areas of muscle pain or tension
• Note any areas of redness or impairment
• Report any areas of skin breakdown to the
health care team.

STEPS FOR BACK RUB

1. Gather the materials needed and perform

hand washing
2. Greet and identify the client and explain the
procedure
3. Provide clients privacy during the entire
procedure
4. Move client close to the side of the bed
5. Position the client in prone position if
possible
6. Loosen the gown of the client.
7. Pull top covers down below buttocks
8. Assess the back of the client for skin
redness and areas of decreased circulation
9. Pour a small amount of lotion into your
hands and rub palms together
10. Start to massage the client’s back using
effleurage, petrissage, tapotement.
11. Replace the top cover and place the client
in comfortable position
12. After care of the materials used
13. Wash hands and document that a back rub
was performed and the clients response.
14. Record any unusual findings.