Assisting Ill and Disabled Patients in Daily Activities

Flashcards about assisting ill and disabled patients in daily activities, covering oral hygiene, perineal care, bathing, bedpan and urinal assistance, enema administration, bed making, patient positioning, ambulatory devices and wheelchair assistance.

Oral Hygiene

Brush all tooth surfaces thoroughly with a fluoride toothpaste.

Perineal Hygiene for Male Patients

Wash the head of the penis first using an outward circular motion; If uncircumcised, retract the foreskin. Wash, rinse, and dry.

Perineal Hygiene for Female Patients

Wash from front to back, rinse, and pat dry; If a catheter is in place, carefully wash around it with soap and water. Rinse and dry carefully.

Purposes of Bathing

Three main purposes are for cleansing the skin, stimulating circulation, and providing relaxation.

Preparing for a Bed Bath

Place soiled linen in laundry bag; Remove patient's gown or pajamas; Raise side rail and fill clean washbasin two-thirds full with warm water. Check water temperature.

Washing Patient's Face

Wash patient's eyes using a different section of mitt for each eye. Move mitt from inner to outer canthus. Dry thoroughly but gently.

Washing Arms

Bathe arm with soap and water using long, firm strokes from distal to proximal areas. Thoroughly wash axilla. Rinse and dry.

Washing Feet

Cleanse foot, making sure to bathe between toes.

Washing Patient's Back

Wash, rinse and dry back from neck to buttocks using long, firm strokes; Pay special attention to folds of buttocks and anus.

Factors Influencing Hygiene Practices

Social groups influence hygiene preferences and practices; Motivation is a key factor in the importance of hygiene; People from diverse cultural backgrounds follow different self-care practices.

Factors influencing hygiene

Social practices, personal preferences, body image, socioeconomic status, health belief and motivation, cultural variables, and physical condition.

Types of Bedpans

Regular pan (metal or hard plastic) and fracture pan (for patients with lower extremity fractures).

Enema

An Enema is the introduction of fluid into the rectum and colon by means of a tube to stimulate peristalsis and the urge to defecate or to wash out waste products or feces.

Purpose of Cleansing Enemas

Given to stimulate peristalsis and the urge to defecate or to wash out the waste products or feces

Principles of Medical Asepsis when Changing Bed Linen

Keep soiled linen away from the uniform. Place soiled linen in special linen bags. Never shake the linen or place soiled linen on the floor.

Procedure for making a surgical bed (recovery bed)

Raise bed to highest position, place bottom sheet, place draw sheet, lap top sheet and blanket, then fan fold linen to side or bottom of bed;Used for post-operative patients

Uses of Assistive Devices

Redistribute and unload a weight-bearing lower limb, improve balance, reduce lower limb pain, and provide sensory feedback.

Canes

Are often used to widen the base of support and decrease stress on the opposite lower extremity

Cane Fitting

Instruct patient to hold cane on the stronger side of the body, and the cane should extend from the greater trochanter to floor with a 15 to 30 degrees for elbow flexion.

Cane Technique for Use

Cane should support 15-25% of patient's body weight; Place cane about 12 inches in front of the foot and slightly to the outside; Move cane four inches in front of patient and then move affected leg forward.

Crutches

Provide better stability than do canes and have 2 points of contact with the body.

Axillary Crutches

Wooden or aluminum models that can be adjusted easily to the overall height and hand height; For temporary use (acute injuries); Requires significant upper body strength.

Forearm Crutches

Crutches where increased flexion allows the arm to bear greater weight; For active patients with severe leg weakness; Offers easier mobility than with axillary crutches.

Crutch Fitting - Axillary

Ask the patient to stand against the wall with the feet slightly apart and slightly away from the wall; Measure with the crutch tips flat on the ground and approximately 6 inches lateral to and 6 inches in front of the foot.

Three-Point Gait

A type of gait that provides a slow, stable gait as three points of floor contact are maintained. Weight is borne on both lower extremities and typically is used with bilateral involvement due to poor balance, in coordination, or muscle weakness.

Walkers

When patients require maximum stability and support from an ambulation device. Very durable, light weight, typically made of aluminum, for ambulation the user must lift the device and move it forward and it also requires a degree of upper extremity strength and coordination

Walker Fitting

Place the front of the walker 12 inches in front of the patient. The walker should partially surround the patient. The hand grip of the walker should sit at the wrist crease, (ulnar styloid process), or greater trochanter of the patient standing erect with hands down at the side.

Techniques for walker use

Place the front of the walker 12 inches in front of the patient, Walker hand grip at patients wrist crease, hands at the side. Confirm the rear feet of the walker are set at about the midpoint of the patient's shoes

Manual Wheelchairs

Operated by using hands and arms. Patient needs to have good upper body strength to use one of these.