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Nursing Careers

Nursing Careers. RN, LPN, CNA 18.3 557-662. Nursing Responsibilities. Spend more time with pt that any other member of healthcare team. AM & PM Care Oral hygiene Offer bedpan/urinal Monitor elimination Assist with dressing/undressing Bathe pt Skin care Follow pt care plan

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Nursing Careers

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  1. Nursing Careers RN, LPN, CNA 18.3 557-662

  2. Nursing Responsibilities Spend more time with pt that any other member of healthcare team • AM & PM Care • Oral hygiene • Offer bedpan/urinal • Monitor elimination • Assist with dressing/undressing • Bathe pt • Skin care • Follow pt care plan • Perform ROM Provide body alignment/positioning Care for hair and nails Shave pt Apply hot cold Make bed Ambulate Feed pt Record I &O

  3. AM & PM Care Read 18-11 & 18-12

  4. Skin Management • Skin is first line of defense • Observe/Assess for • Appearance • Pale, flushed, bruising, open areas, rashes cyanotic, jaundice, diaphoresis • Skin turgor – good, tented • Temperature • Dry, hot, warm, cold • Pain- if yes rate on scale

  5. Pressure Sores, Bed Sores, Decubiti • Areas sensitive (as risk) • Shoulders, elbows, hips, sacrum, Heels, Ankles, Ears, Toes • How to prevent • Change position at least every 2 hours • Keep skin clean • Massage reddened areas to increase circulation • Keep linen free of wrinkles • Specialized beds

  6. DocumentingPressure Sores Stage of breakdown Size of breakdown in centimeters Steps taken to care for breakdown

  7. Oral care Reduces odor Helps prevent tooth decay Is refreshing Relieves dry lips 18.14-18.19

  8. Offering a Bedpan/Urinal • Urinary check off • Solid waste- bowel movement, feces, stool • Liquid waste- urinating, voiding • Liquid bowel movement – diarrhea • Impaction- if solid waste is not eliminated (N,V) • Laxative- a medicine for relieving constipation • Suppository- a solid medical substance that melts upon insertion into the rectum

  9. Ambulation- Walking Maintains stamina Increases joint mobility Improves muscle tone Helps prevent lung congestion Improves circulation Helps prevent blood clots Helps maintain independence Provides sense of accomplishment

  10. Bathing a Pt – 18.43-18.53 Removes perspiration and dirt Removes odor Increases circulation Allows for exercise Gives opportunity to observe skin Provides relaxation Bed bath, partial/complete Tub, shower, whirlpool

  11. Hair and Nail Care • Keep hair clean • Keep nails trimmed and clean • Do not cut nails of a diabetic pt • Shave your male pt daily • Dressing/undressing • Dress weak or most involved side first • Undress weak or most involved side last • Terminal/Postmortem Care

  12. Prosthetic Devices Dentures Glasses Hearing Aids Artificial limbs Artificial eyes Artificial breast Place these items in a safe place so they are not lost

  13. Bed making 18.55-18.58 Making a closed bed Making an occupied bed Making an opened bed

  14. Preparing the Pt for a meal Assist pt to wash hands Remove unpleasant items Offer opportunity to use restroom Raise HOB / position in chair/transport to dining area Check to be certain right tray for that patient and correct diet Place food within reach • Check the tray to make sure everything is there • Prepare any item pt cannot manage- open containers • Butter bread, cut meat, open milk, season food • Tell pt where each item is using face of clock if pt is blind

  15. Fluid Imbalance –dehydration vs edema • Dehydration is caused by • Diarrhea • Vomitting • Bleeding • Excessive perspiration (diaphoresis) • Poor fluid intake • Symptoms of dehydration • Fever • Decreased urine • Urine is concentrated • Wt loss • Membranes are dry • Tongue is coated and thick • Skin hard and cracks

  16. Edema • Edema is caused by: • High salt intake • Infections • Injuries or burns • Certain kidney diseases • Certain heart diseases or heart inefficiencies • Sitting too long in one position • Infiltration of IV fluid • Symptoms of Edema: • Decrease in urine output • Gain in weight • Puffiness/Swelling • Sometimes shortness of breath

  17. Measuring I & O • Intake • All liquid taken by mouth • Any food item that turns to liquid at room temp • All IV intake • All tube feeding • 1cc = 1ml • 30 cc = 1 oz • 30 x (number of ounces) = cc • 30 x 8 = 240cc • Output • Urine • Liquid stool • Emesis (vomit) • Suctioned secretion • Drainage • Excessive perspiration

  18. Enemas

  19. Urinary Output

  20. Incontinent Pt

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