LESSON PLAN 3rd MEETING

Duration : 90 minutes

Goals :

1. Nurses are able to understand about medical tools instruction.

2. Nurses are able to understand about medical symbols.

3. Nurses are able to know how to use the medical tools.

Learning method: Individual

Materials

Nurses in puskesmas must know about the medicals symbol. Nurses also
must understand how to use the medicals tools.

Medical symbols:
Medical tools:

The sphygmomanometer

How to use sphygmomanometer

To begin blood pressure measurement, use a properly sized blood

pressure cuff. The length of the cuff's bladder should be at least
equal to 80% of the circumference of the upper arm.
 Wrap the cuff around the upper arm with the cuff's lower edge one
inch above the antecubital fossa.

Lightly press the stethoscope's bell over the brachial artery just
below the cuff's edge. Some health care workers have difficulty
using the bell in the antecubital fossa, so we suggest using the bell
or the diaphragm to measure the blood pressure.

Rapidly inflate the cuff to 180mmHg. Release air from the cuff at a
moderate rate (3mm/sec).

Listen with the stethoscope and simultaneously observe the dial or

mercury gauge. The first knocking sound (Korotkoff) is the subject's
systolic pressure. When the knocking sound disappears, that is the
diastolic pressure (such as 120/80).

Record the pressure in both arms and note the difference; also
record the subject's position (supine), which arm was used, and the
cuff size (small, standard or large adult cuff).

If the subject's pressure is elevated, measure blood pressure two

additional times, waiting a few minutes between measurements.

A BLOOD PRESSURE OF 180/120mmHg OR MORE REQUIRES

IMMEDIATE ATTENTION!

Stethoscope

How to use stethoscope

 Starting from the top of the stethoscope, the ear pieces should be
inserted so that they point towards the bridge of your nose. A good
stethoscope is designed with binaurals (the two tubes that end with
the ear pieces) that point slightly forwards.
This is because your ear canals are angled slightly forwards. Youll
know that you have a good fit because all the noise around you
becomes very faint when the ear pieces are inserted, allowing you
to concentrate on the sounds coming through the stethoscope.
If youre not sure whether youve got the stethoscope the right way
round, put the two ear pieces together and youll see that they form
the point of a shallow V. If the V is directed towards you, its the
wrong way around.
Another useful guide is to hold the stethoscope headset in front of
your face and see whether you can see the holes in the earpieces. If
you can, again its the wrong way around. Because the earpieces
should face slightly away from you, the holes will be out of sight.
Choose ear pieces that fit snugly and comfortably, based on their
size, design and material.
Getting the fit right is important for both acoustic performance of
the stethoscope and your comfort. Discomfort could be a distraction
that prevents you from using your stethoscope effectively.
Ear pieces are replaceable.

Thermometer

How to use thermometer

Do not drink or eat 1 minute prior to taking a temperature
reading. As mentioned before, food and drinks change oral
temperature significantly, thus affecting accuracy.
 Do not breathe heavily through the mouth prior to taking
temperature. Breathing through the mouth may lower the
temperature of the mouth tissue, resulting in inaccurate readings.
Position the thermometer in the correct area, as close to the center
as possible, under the tongue. The areas of the lower jaw next to
the lower molars are heat pockets. Sticking the sensor or probe into
this area is essential to getting the closest oral temp measurement.
Ensure there is no air left in the mouth while keeping the
thermometer in place. Air in the mouth will cause temperature
differences in the mouth tissue, making readings inaccurate.
Wait at least 20 seconds even if the thermometer indicates it is
already ready. You may also measure twice. The metal probe or
sensors temperature will first cool down the mouth tissue, so the
tissue will need more time to go back up to body temperature.
Add several tenths of degrees to the temperature. When on a
threshold of a fever, it is better to confirm the temperature by doing
a rectal measurement just to be sure.

Oxygen/oxygen tank

How to use Oxygen/oxygen tank

Learn the parts of an oxygen tank. There is a pressure gauge, which

indicates how much oxygen is left in the tank. The tank also has a
regulator, where you can adjust the flow, which means how much
oxygen comes out of the tank.

Crack the regulator on the tank to open the valve, which allows the
flow to come out. Many regulators for home use have a dial
regulator, which is turned to crack the tank. Check the pressure
gauge to determine if there is still oxygen in the tank. The gauge
reads full on one end and empty on the other and in between there
 are numbers that indicate the amount of oxygen in the tank. Talk
with your doctor about how to calculate how long the oxygen in the
tank will last. There are different calculations based on the size of
the tank and flow of oxygen.

Hook the oxygen device you are using to the flow meter. Oxygen
devices commonly used include an oxygen mask and nasal cannula.
Whichever device you use, it will have oxygen tubing connected to
it and one end will fit onto the oxygen flow meter.

Turn the flow on. Your doctor will prescribe a certain liter flow of
oxygen. Tanks usually go from 1 liter per minute to fifteen. Several
types of flow meters attach to oxygen tanks. One of the most
common is a simple dial meter. The dial is turned and the number
appears in a small window on the meter.

Keep safety in mind. Oxygen is a gas and the tank is under

pressure. Keep the tank in an upright position. Consider using a
storage device, which secures the tank and prevents it from falling
over. Oxygen is also flammable, therefore you should never smoke
around an oxygen tank or expose it to any type of flames

Learning Activities:

Duration Activity
10 minutes Opening :
- Praying.
- Greeting
- Prepare the instrument that will be used in learning
activity
60 minutes Main Activity :
- Give feedback about the materials in 2nd meeting.
- Give each student task in the form fill in the blank.
- Students answer the question in different paper.
.
20 minutes Closing :
- Teacher collects the students answer sheets.
- Teacher apologizes and say see you next meeting
- Teacher inform about next plan meeting

Task

Symbols Meaning
 1. 1.

2.
2.

3.
3.

4.
4.

5.

5.

Medical tools How to use it?

1. Thermometer 1.
2. Oxygen/oxygen tank 2.
3. Stethoscope 3.
4. Sphygmomanometer 4.