FUNDAMENTALS OF NURSING CARE

The Hospital Experience

Responsible,

efficient and emphathetic nursing intervention is required to assure that the hospital milieu becomes an environment in which the patient feels as comfortable as possible and over which he feels he has some degree of control.

Empathy-

is identifying with way another person feels.

Common Anxiety Producing Factors in the Hospital Milieu

Regimentation-

to many patients, the schedules and rules of agency appear to be more important than the patient. The nursing aid should be careful to allow the patient to make decisions regarding his care to the extent that he can.

Dehumanization

the hospital can be a depersonalizing experience for the patient unless health workers take time to consider each patient as an individual person with his own unique needs. When the patient is not involved in decisions about his care or when health-care personnel discuss the patient in his presence without talking to him.

Separation from significant others

at

a time when support from significant other is so essential, separation contributes to the patients anxiety.

Lack of privacy
the

patient may be confronted with an almost entire lack of privacy after admission to the hospital. Conversations can be overheard.

 Functions

ordinarily carried out in private, such as elimination, may require assistance from others.

People

come and go from the patients room at any time. The lack of privacy is the most frequent heard complaint about the hospital setting.

Lack of understanding of the hospital language

it

has been well established that the health-care milieu has a language that is not understood by outsiders.

 When

the patient enters the hospital, he may feel that he is entering a foreign country where people speak a language he cannot understand.

Strange sights and sounds

a

walk down in a hospital corridor is a unique education to even the casual observer concerning unusual sights and sounds.

 In

one room, the steady pulsating of a cardiac monitor can be heard, in another room, the bubbling of an oxygen humidifier, while in still another, a patient may be heard to moan.

Personal Care
Equipments:

A basin,

a soap dish, mouthwash cup, an emesis basin, a bedpan, a urinal for the male patient, a water container and a drinking glass.

SAFETY MEASURES
Restraining

Patients Preventing the Spread of Microorganisms Preventing Falls Side Rails

 Falls

account for nearly half of the accidental deaths that occur in the health agency. Causes of Falls Slippery floors Poor lighting Worn rugs Misplace furniture Objects littered

Susceptible to Falls
Young Old Physically

handicapped

Measures to Decrease Falls

Hand

rails in bathrooms and on stairs Good lighting Discarding and repairing broken equipment

GUIDELINES TO HELP DECREASE EQUIPMENTRELATED ACCIDENTS

Use

equipment only for the use for which it was intended. Do not operate equipment with which you are unfamiliar.

 Handle

equipment with care to prevent damaging it. Use three-prong electrical plugs whenever possible. Do not twist or bend electrical cords. The wires inside the cord may break.

 Be

alert to signs that indicate equipment is faulty, such as breaks in electrical cords, sparks, smoke, electrical shocks, loose or missing parts, and unusual noises or odors. signs of trouble immediately.

Report

Hospital Bed
Bed

making is a fundamental part of the training of the nursing aid. A skillfully made bed gives comfort and pleasure to the patient who may be required to spend many days or weeks in it.

 A gatch

bed is generally in use. The stationary one is about 26 inches high. Modern hospitals are equipped with beds, which may be operated manually or electrically. These beds maybe lowered to 13 inches to accommodate the out of bed patient.

Types of Unoccupied Bed

Closed

Bed- is made when a patient gets out of bed for the day. The spread is pulled over the pillow.

Open

Bed- is made for the patient who is getting out of bed for a short time. The top linens are fan folded so the patient can safely get into bed.

Bed Making
You

may have a patient who spends part of the day in bed. Some of your patients are unable or not permitted to get out of bed.

DEFINITION OF TERMS

1.1 Bed making the ability of the nurse to keep the bed clean and comfortable the technique of preparing different types of bed in making patients/clients comfortable in his/her suitable position for a particular condition it requires keen inspection to be sure that the linens are clean, dry and wrinkle-free

1.2 Fanfold is done by grasping the upper edge of the linen with both hands specifically folding the edge of the sheet used in the bed 6-8 inches outward

1.3 Mitered corner a means of anchoring sheets on mattresses method of folding the bed clothes at the corners to secure them in place while the bed is occupied it is accomplished on the bottom sheet by placing the end of the sheet evenly under the mattress 1.4 Toe pleat a fold made in the top bed clothes to provide additional space for patients toes

1.5 Foot drop dropping of the foot from paralysis of the anterior muscle of the leg plantar flexion of the foot with permanent contracture of the gastrocnemius (calf) muscle and tendon

1.6 Bed cradle is a curved, semi-circular device made of metal that can be placed over a portion of the patients body is sometimes called an Anderson frame, is a device designed to keep the top bedclothes off the feet, legs, and even abdomen of a client

1.7 Magic corner corners of a folded linen when upon opening it automatically positions the sheets the way it is placed on the bed

1.

It helps maintain a clean, orderly and comfortable room which contributes to the patients sense of well-being. Helps the patient secure proper rest and comfort which are essential for health and refresh him/her by providing cleanliness

2.

3. It helps prevent or avoid microorganisms to come in contact with the patient which could cause tribulations. 4. It minimizes the sources of skin irritation by providing smooth, wrinkle-free bed foundation.

Guidelines of Bed Making

Try

to make the bed according to the policy of the health agency. If you must change the policy, explain your reasons to the patient and superior.

 Do

not use a torn piece of linen. It may tear even more and could be dangerous. Never use a pin on any item of linen.

 Do

not shake the bed linen. Shaking spreads harmful microorganisms to everything and everyone in the room, including you. Never allow any linen to touch your uniform.

 Dirty

used linen should never be put on the floor. Put dirty linen in prescribed/ designated place.

 The

bottom sheet must be form, smooth, and wrinkle free. This is very important for the patients comfort. By fan folding the top of the bed, you make it easy for the patient to get in and out of his bed.

 The

draw sheet is about half the size of a regular sheet. When draw sheets are not available, a large sheet can be folded in half widthwise and used. The fold must always be placed toward the head of the bed and the hems toward the foot of the bed.

 The

plastic draw sheet and disposable bed protectors protect the mattress. Plastics should never touch a patients skin. When using a plastic draw sheet, be sure to cover it entirely with a cloth draw sheet.

 To

save linen and washing, a used clean top sheet may be used as a draw sheet or bottom sheet.

 A patient

who does not use his bed a great deal may not have to have the linen changed every day. Evaluate the linen, the room, the patient, and the entire situation before you change the bed.

OBJECTIVES
To

learn how to make a clean, comfortable and safe bed for patients. To aid in the orderly appearance of the unit. To learn how to conserve energy by making the bed completely on one side before proceeding to the other side.

Recovery Bed
To

learn how to make a comfortable, safe bed for the patient recovering from anesthesia. Prepared only in recovery room.

Special Features
The

head and foot ends are removable. The bed is narrow enough to permit ready passage through doors and corridors of the hospital. Overhead or lateral fracture equipment may be mounted on bed.

 The

intravenous (IV) rod may be used in six different locations (two at the head, two at the foot of the bed and two at the center section of the spring).

 The

rod is special designed so that the solution bottles hang securely in place. It is square in contour to prevent turning around in the receptacle. A plunge type catch automatically locks the inner rod into position.

 The

outer tube (the lower end of this tube contains a slot) can be locked into position in the receptacle with one slight turn. This fixes the hooks in a parallel position with the head or foot of the bed, making it impossible for the hooks to damage the walls.

Use of Standard Equipment

Over

Bed Table Standard equipment in hospital units Used as means of support when patient wishes to lean forward

 Wheels

should be locked when it is being used Adjustable height Useful for patients with dyspnea or orthopnea

Side Rails
Safety

measure to prevent patient from falling out of bed Attached to modern hospital bed and extends to just below the patients hips

 Useful

for patients who are restless, aged, anesthetized, heavily sedated or irrational.

Maintaining the Proper Environment

Ventilation To

ventilate means to allow fresh air to circulate through a room and replace foul air.

 Opening

windows and doors provides natural ventilation. Two openings are necessarywarm air go out of upper opening and cool air will enter through the lower.

Temperature
Sufficient

heat should be

provided Certain conditions will necessitate various deviations in temperature and humidity.

 Room

should be 70 degrees F, especially in ward with several patients. In Private room temperature nay be regulated according to patients needs.

Lighting
Hospital

units are usually fitted with adjustable lights. Insufficient lights may caused fatigue if patients attempts to read.

 Glare

is a source of annoyance. Nightlights may also cause patients to have difficulty in sleeping. Sufficient light is needed to protect patient from falling.

Noise
Produces

most tension among the environmental conditions.

Ways to Eliminate Noise

1.

Soundproofing 2. Improvising door silencer 3. Seeing that movable equipment is kept well oiled 4. Cultivating a quiet manner and soft speech