NHA CPCT

ADLs

activities of daily living

for a bed bath, you will need:

bath blanket, wash basin, clean bed linen, and laundry bag

bathing is an activity that can also provide a chance to observe any skin breakdown such as

tenderness, redness, warm in any area of bony prominence

supplies necessary for a bath

bath towel, washcloth, skin cleanser, gown, body lotion, powder, and deodorant

for a bed bath the supplies needed

a bath blanket, wash basin, clean bed linen, and laundry bag

a ____________________ can be helpful if a patient becomes fatigued or unsteady

shower chair

when bathing patients

a complete bed bath is not done everyday

how does a patient check the water temperature?

use back of hand

the bath water should be at for a warm temperature

37 to 46 C (98.6 to 115 F)

most routine baths are at what temperature?

40.5 to 43.3 C (105 to 110 F)

for privacy for a bath keep

the patient's room door closes, pull curtain in a shared space, and keep the patient's body covered with a bath blanket

a ______________ should be in close reach, especially if patient is alone in the shower

call light

during bed baths, keep the bed rail on the _____________ side to ensure the patient does not roll off the bed.

opposite

Ensure ____ sites and ___________________ are protected from moisture, which could lead to infection.

IV; surgical incisions

wash the patient from

cleanest to dirtiest areas to prevent contamination

when washing patient use

long firm strokes to stimulate circulation

do not rub the skin vigorously with the towel when drying patient, instead

pat dry

a partial bath consists of cleansing the patient's

face, neck, hands, back, armpits, buttocks, and perineal area

perineal

genital and anal areas

for perineal care was from

anterior to posterior (front to back)

never raise the drainage bag higher than the

patient's bladder

lifting the patients drainage bag higher than the patient's bladder can cause

contaminated urine to drain back into the bladder, leading to infection

when cleaning a perineal area with a catheter, cleanse the area with

soap and water or prescribed microbicidal ointment at the catheter insertion site

catheter care is done

2x daily

if a patient has a catheter in, ensure that there is enough slack in the catheter tubing and that the bag is

secured to the side of the bed; not the bed rail

why should the catheter bag be secured to the side of the bed?

to prevent the catheter from being pulled out during repositioning

a sitz bath is how long?

20-30 minutes

what does a sitz bath do?

the warm water bathes and soothes the perineal and anal areas

A sitz bath is useful after

childbirth, vaginal or rectal surgery, or hemorrhoids

dyshasia

difficulty swallowing

NPO

nothing by mouth

oral care offered when

patient is awake, after meals, and bed time

for a patient with natural teeth use,

a soft bristle toothbrush and toothpaste

If patient is unable, gently cleanse each tooth in a circular motion at a 45* angle to the gums from the

back of the mouth toward the front

when washing dentures, they are placed in a washbasin containing

lukewarm water (hot water can damage them)

to break the suction on the upper denture..

use your thumb and forefinger

when removing the upper denture with thumb and forefinger use

gauze and gentle pressure, slightly tug downward and remove the denture from the patient's mouth

remove the lower denture by

lifting it up and twisting it sideways

when inserting dentures

moisten them to make it easier to create suction

when dentures are not being used

place them into a denture cup with the patient's name and room number

fill the denture cup with

lukewarm water or denture solution so they do not dry out

unconscious patients have some level of awareness

and talking to them can reassure them that they are safe and being cared for

when performing oral hygiene care for a patient who is unable to do it, which of the following actions should you take?

brush from the back of the mouth to the front

what three things are important for having a clean bed?

- comfort

- healing

- infection control

the best time to perform bed making

when patient is:

- out of bed

- ambulating

- showering

- having a procedure

when transporting clean linens to the patient's room...

hold them away from your body so that any pathogens on your uniform do not transfer to the clean supplies

8 item for bed making

- a fitted sheet

- mattress pad

- flat sheet

- pillowcases

- lift (draw sheet)

- absorbent pads

- blankets

- linen bag

before changing linens, complete any tasks that could soil the bed sheets such as:

use bathroom, bathe patient

7 step process for occupied bed:

1. roll the patient to one side of the bed

2. tuck the sheets to be removed under the patient

3. replace the sheets on the unoccupied side

4. tuck the fresh sheets under the patient

5. roll the patient to the fresh side

6. remove the old linens

7. complete the linen change

what gives the patient a sense of control and independence

allow the patients to choose their clothes and complete as much of their dressing as they can

if a patient has a weak side- for example, from a stroke or surgery-

work with that side first

If the patient has an IV line connected to an IV bag, you must do what?

take the arm without the IV line out of the gown FIRST

Once the gown is off of the patient, thread the tubing and bag...

through the sleeve

Assist the patient by gently guiding the arm with the IV line

through the arm sleeve

only a __________ can disconnect the patient from the infusion pump to help them dress or undress

RN

For hair care:

- comb downwards

- do small sections at a time

- start combing from the scalp

You are taking the hospital gown off a patient who has an IV line in the right arm. Which arm should you take out of the gown first?

Left Arm

Be aware of any activity restrictions...

before assisting the patients out of the bed

__________ leave confuses or unstable patients alone

Never

If the patient is unable to get out of the bed for toileting, you will provide a

bedpan or urinal

a bedpan is for

females

a urinal is for

males

Ensure that patients have _____________ and a ______________________ within reach to notify you when they have finished using the restroom.

privacy; call light

Clean and dry the perineal area after bedpan use to avoid

skin breakdown or irritation

Check with the nurse about any

- dietary restrictions (or precautions)

- NPO status

- if patient has diabetes

- if patient has dysphagia

- if patient has liquid diet

As a PCT offer to assist the patient with ____________ prior to mealtime.

toileting

Raise the head of the bed or have patients sit in a chair during meals to prevent

choking

Standing over patients while they eat can make them feel

rushed

It might be difficult for patients who have had a stroke to chew on the affected. When feeding the patient, what should PCT do?

Direct the food toward the non affected side of the mouth

Using a __________ is safer than a _________ when assisting with feeding

spoon; fork

It is important to weigh patients accurately because weight determines many

treatments and medication dosages

Types of scales

- upright (electronic or mechanical)

- bed scale

- chair scale

- sling scale

Make sure the scale is set to zero..

prior to use

when weighing a patient using an in-bed scale,

subtract the weight of bedding and equipment

ensure that all connections are secure before

raising the patient for the weight measure

accepting

hearing what a patient says and following the thoughts they express

Clarifying

Asking for a clearer explanation when what a patient says is vague

encouraging communication

Asking a patient to share what they are feeling

Exploring

gently persuading a patient to express their thoughts in a little more detail, but avoiding an probing or prying

focusing

keeping a patient's attention on the important topic or information they need to understand

example of accepting

"I get what you're saying."

Example of clarifying

"I'm not sure I'm following that."

example of encouraging communication

"Tell me if you start feeling anxious."

example of exploring

"Would you tell me a little more about that."

example of focusing

"I'm enjoying hearing your thoughts about your upcoming vacation, bit let's get back to what to do if this keeps bleeding after you leave."

giving a broad opening

allowing patient to direct the discussion

example of giving a broad opening

"What do we need to know about what we're doing today?"

giving recognition

showing a patient recognition as an individual, including addressing them by name

example of giving recognition

"Let's get started as soon as you're ready, Mr. Ellis"

Making observations

sharing your perceptions with a patient

example of making observations

"You seem a bit nervous today"

mirroring

restating the patient's statement to show understanding

Example of mirroring

Patient: "I can't always understand what the doctor is telling me.:

PCT: "You're having difficulty understanding your doctor?"

offering self

conveying your availability to listen and help

example of offering self

"I'm here for you. Tell me what you need."

Offering general leads

encouraging a patient to keep expressing their thoughts

Example of Offering general leads

"Please continue."

Remaining silent

conveying that a patient can continue formulating the thoughts they want to express without any pressure to converse

summarizing

demonstrating an understanding of the important parts of the conversation

reflecting

repeating a patient's statement or question back to them to encourage them to value or accept their own opinions