Resident Care Procedures Terminology

1. Resident Care Procedures Terminology • Admission • Anti-embolic stockings • Bandage • Binders • Clean catch • Closed bed • Defecate • Discharge

2. Terminology #2 • Drawsheet • Edematous • Elastic bandage • Electric bed • Evacuation • Excoriated • Expectorate • Fan fold

3. Terminology #3 • Fluid • Gastrostomy • Gatch • Hives • Intake • Integumentary system • Intravenous • Lesions

4. Terminology #4 • Manual bed • Mitered corner • Mucus • Nasogastric • Non-prescription • Occupied bed • Ointment • Open Bed

5. Terminology #5 • Output • Pruritus • Reverse Trendlenberg • Scaling • Semi-Fowler’s position • Side rails • Specimen

6. Terminology #6 • Suppository • T.E.D. hose • Transfer • Trendlenberg • Unoccupied bed

7. Collecting sputum specimens • Reason for study sputum • Blood • Microorganisms • Abnormal cells

8. Collecting sputum specimens – Role of NA • Usually coughed up in early AM • Allow resident to rinse mouth with water • Do not use mouthwash • May be embarrassing to the resident • Specimen may be perceived as unpleasant

9. Collecting urine specimens – Methods of collection • Mid-stream • Clean catheter urine specimen • 24-hour urine specimen • Fresh-fractional urine (second void)

10. Collecting urine specimens – Role of NA • Wash hands before and after • Use Standard Precautions • Use correct and clean container • Label the container accurately

11. Collecting urine specimens – Role of NA #2 • Do not touch inside the container • Ask resident not to have a BM while specimen is being collected • Take specimen and requisition slip to the designated lab pick-up station • Document that specimen was obtained

12. Collecting stool specimens – Purpose • Blood • Fat • Micro-organisms • Worms • Any abnormal contents

13. Collecting stool specimens – Role of NA • Maintain privacy • Use Standard Precautions • Give clear instruction • Label container accurately • Clarify if specimen must be kept warm or at room temperature • Take specimen and requisition slip to the designated lab pick-up station

14. Bed making - Role of NA • Linen must be wrinkle-free • Keep call bell clipped to linen • Keep resident reality-oriented by use of resident’s personal pillow, afghan, etc.

15. Bed making - Role of NA #2 • Wash hands before and after • Hold and carry linen away from uniform • Do not shake linens • Keep linens off the floor or bedside table • Soiled linen hampers kept covered

16. Hospital Bed – Functions and structures • Manually operated beds • Electric beds • Side rails

17. Bed Positions • High positions • Low positions • Fowler’s position • Semi-Fowler’s position

18. Bed making – Body Mechanics • Know your limitations • Get close to sides of bed • Keep back straight and knees bent • Keep feet apart • Move feet to turn • Face in the direction you are working

19. Maintaining Environment – Role of NA • Rooms should be comfortable • Rooms should be safe

20. Maintaining Environment – Role of NA #2 • Make sure resident can reach bedside stand • Arrange personal belongings as per resident’s preference • Keep call bell within reach • Make sure resident can reach equip. • Provide tissues and toilet paper

21. Enemas - Purpose • Stimulate a bowel movement • Cleanse bowel prior to surgery • Remove flatus (gas)

22. Enemas - Types • Cleansing enemas • Oil retention enemas • Commercial mixtures (i.e. Fleet’s)

23. Enemas – Role of NA • Temperature of solution • Amount of solution • Resident position • Height of enema bag • Depth of tube insertion

24. Enemas – Role of NA #2 • Administer solution slowly • Hold enema tube in place • Make sure toilet facility is nearby and available • Observe the results of the enema • Use Standard Precautions

25. Rectal Tube • Inserted into rectum to relieve flatulence and intestinal distention • Equipment: • Tube and flatus bag or folded waterproof pad • Method: See book

26. Suppository - Purpose • Stimulate one to empty the bowel • Lubricate the stool to ease evacuation

27. Suppository – Role of NA • Identify the resident • Remove wrapper from suppository • Place suppository • Instruct resident to hold the suppository in the rectum as long as possible • Observe results • Report results

28. Gastrointestinal tubes • Nasogastric tubes ( inserted through nose ) • Gastrostomy tubes ( inserted through abdominal wall )

29. Gastrointestinal tubes – Nursing Care • Frequent oral hygiene • Securing tubing with clamp or tape to clothing • Tubing free of kinks • Checking if suction machine operating satisfactorily • Position head of bed elevated at all times to prevent reflux

30. Gastrointestinal tubes – Nursing Care #2 • Keep environment clean • Answer call lights promptly • Give emotional support • Giving an extra back rub • Straightening or changing bed linen • Asking resident to express concerns • Encourage resident to be up, dress in day clothes and join in activities

31. Intravenous (I.V.) Therapy • Provides the body with needed elements that cannot be given rapidly or efficiently by other means. • Blood, plasma • Nutritional – water, salt, sugar, etc. • Medications

32. Intravenous (I.V.) Therapy – Role of NA • Keep tubing free of kinks • Observe tube and condition of injection site for any infiltration • Wash gently around the area • Assist resident with ADLs • Assist resident to ambulate

33. Maintaining fluid body balance • Death can result from taking inadequate fluids or loosing too much fluids • Amount of fluid taken in and amount lost must be equal • Edema • Dehydration • An adult needs 2000 ml of fluids/day

34. Force fluids • Resident drink an increased amount of fluids • May order specific amount of fluid for 24-hour period • Maintains fluid balance • May be for general or specific amount of fluid

35. Nurse assistant responsibility • Keep record of amount taken in • Provide variety of fluids • Place within resident’s reach • Offer fluids frequently to residents who cannot feed themselves

36. Restrict fluids • Sign posted above bed • Water is offered in small amounts • Keep accurate intake and output record • Provide resident with frequent oral hygiene • Explain to resident and family the reason for limiting fluid

37. Nothing by mouth (NPO) • Reasons-before and after surgery, before certain lab tests and x-rays, and in the treatment of some illnesses

38. Nurse assistant responsibilities • NPO sign above bed • Remove water pitcher and glass • Offer frequent oral hygiene; no swallowing of any fluid

39. “Intake and Output” • The doctor or nurse may want to keep track of a resident’s fluid intake and output • To evaluate fluid balance and kidney function, or medical treatment

40. Measuring the amount of fluid taken in by the resident • Measurement of resident’s intake is done in milliliters (ml) or cubic centimeters (cc) • Determine the fluid capacity • A conversion table is on the intake and output record used to chart intake • A graduated cylinder is used to measure fluid

41. Measuring the amount of fluids excreted by the resident • Measurement of resident’s output is also done in ml or cc • Plastic urinals and emesis basins may be calibrated • Use universal precautions when measuring output

42. Recording intake and output • Document amounts when fluid is taken or excreted • Amounts are totaled at end of shift and entered in the patient’s record • Other special forms may be required by facility • Report any unusual occurences

43. Reasons for using bandages and binders • To apply pressure • To provide for immobilization • To hold dressings in place • To protect open wounds from contaminants • To apply warmth • To provide support and aid in venous circulation

44. Materials used for dressings and bandages • Gauze • Bandages • Binders

45. Principles of bandaging • Apply bandage so pressure is evenly distributed to area • Support joint in a comfortable position with a slight flexion • Attach bandage securely to avoid friction of underlying tissue

46. Observations that should be reported • Swelling • Pain • Change in color • Decreased temperature

47. Use and method of applying antiembolic hose (T.E.D. hose) • Anti-embolic hose/stockings are used to increase circulation by improving venous return from the legs to the heart

48. Things to remember when applying elastic stockings • Always apply before resident gets out of bed • Check frequently for wrinkles • Check circulation in feet frequently • Check popliteal pulse

49. Integumentary System • Largest organ of the body • Forms water proof, protective covering for the body • Helps regulate the body temperature

50. Anatomy of the skin • Epidermis • Dermis