Nursing Skills: Bedmaking, Bathing, Infection Control & Safety

When is the ideal time to change linens?

When the patient is out of bed (after bath, shower, procedure).

What should you do if the patient has pain before a linen change?

Give PRN analgesic 30-60 minutes before.

Which linens are changed daily?

Bottom sheet, top sheet, pillowcase.

What should you do if clean linens touch the floor?

Discard them.

Why avoid shaking linens?

It spreads microorganisms.

What is an open bed?

Top linens folded back for easy entry.

What is a closed bed?

Top linens pulled to top under pillow for new admission.

What is a post-op bed?

Linens folded to bottom third for stretcher transfer.

Why raise the bed during bedmaking?

Prevent nurse injury; proper body mechanics.

Why keep side rails up during occupied bedmaking?

Prevent falls and assist patient in turning.

What is the purpose of bathing?

Remove microorganisms, stimulate circulation, assess skin.

What is included in a partial bath?

Face, hands, axillae, back, perineum.

What is a therapeutic bath?

Bath with additives (oatmeal, sitz bath) for treatment.

What patients require sitz baths?

Rectal/perineal surgery patients.

Why avoid excessive bathing in older adults?

Causes dry, cracked skin.

What is the female perineal cleaning direction?

Front to back.

What is the male perineal cleaning order?

Meatus → shaft → scrotum → buttocks.

What to apply after incontinence care?

Barrier cream.

When is oral care performed?

Before breakfast, after meals, bedtime.

Who is at highest risk for dry mouth?

NPO, oxygen therapy, NG tube patients.

What is the best position for unconscious oral care?

Side-lying with suction ready.

What is sordes?

Buildup of bacteria/mucus on teeth/lips/tongue.

Which denture is removed first?

Upper denture.

How to prevent denture breakage?

Clean over lined sink.

How to store dentures?

In water, labeled cup.

What are the 6 links in the chain of infection?

Agent, reservoir, exit, transmission, entry, host.

What breaks the chain most effectively?

Hand hygiene.

What is contact PPE?

Gown + gloves.

What is droplet PPE?

Surgical mask.

What is airborne PPE?

N95 + negative pressure room.

What are examples of contact infections?

MRSA, VRE, C. diff, RSV.

What are examples of droplet infections?

Influenza, pertussis.

What are examples of airborne infections?

TB, measles, varicella.

What is the most contagious stage of infection?

Prodromal.

What stage has specific symptoms?

Acute.

What is the donning order for PPE?

Gown → mask → goggles → gloves.

What is the doffing order for PPE?

Gloves → goggles → gown → mask.

What is the first action after a needlestick?

Wash area.

What is the second action after a needlestick?

Report immediately.

What is the third action after a needlestick?

Seek medical evaluation; ask about PEP.

What are universal fall precautions?

Non-skid footwear, bed low/locked, call light in reach, clutter-free room.

What are high-risk fall factors?

Age, weakness, meds (antihypertensives, antidepressants), poor vision.

When are restraints used?

Last resort.

What must be done before using restraints?

Try alternatives (sitter, reorientation, diversional activities).

How often must restraints be assessed?

Per facility policy; circulation/skin checks frequently.

What type of restraint is all 4 side rails up?

Barrier restraint.

What does RACE stand for in fire safety?

Rescue, Alarm, Contain, Extinguish.

What does PASS stand for in fire safety?

Pull, Aim, Squeeze, Sweep.

What is the best way to lift?

Bend knees, keep back straight, hold object close.

What movement should be avoided when lifting?

Twisting.

Why do older adults have unsteady gait?

Poor balance, joint stiffness, decreased muscle mass, vision changes.

What is the purpose of dangling?

Prevent orthostatic hypotension.

On which side does the cane go?

Strong side.

What is the cane walking sequence?

Cane → weak leg → strong leg.

What is the walker sequence?

Walker → weak leg → strong leg.

What is the crutch gait for non-weight bearing?

Three-point gait.

What is the max assist device?

Mechanical lift.

What is the moderate assist device?

Sit-to-stand lift.

What is the minimal assist device?

Gait belt.

What is the best DVT prevention?

Early ambulation.

What is the purpose of TED hose?

Prevent venous pooling.

What is a contraindication for SCD?

Severe arterial disease.

What is the most accurate indicator of fluid balance?

Daily weight.

What does intake include?

Oral fluids, IV fluids, tube feedings, irrigations.

What does output include?

Urine, liquid stool, emesis, drainage.

How often is intake and output recorded?

At least every 8 hours.

What does negative fluid balance mean?

Fluid deficit.

What does positive fluid balance mean?

Fluid retention.

Why is a patient NPO before surgery?

Prevent aspiration.

What should the nurse clarify regarding NPO?

Whether meds are allowed.

What are the restrictions for a regular diet?

None.

Who needs a soft diet?

Jaw/mouth surgery, dysphagia, GI issues.

Who needs a pureed diet?

No chewing ability.

What are examples of a full liquid diet?

Pudding, ice cream, milkshakes, strained soups.

What are examples of a clear liquid diet?

Broth, gelatin, tea, clear juice.

What should be avoided before colon procedures?

Red dye.

What is the sodium limit for a cardiac diet?

<2300 mg/day.

What foods should be avoided on a cardiac diet?

Processed foods, high-fat foods.

What minerals should be limited on a renal diet?

Sodium, potassium, phosphorus.

What are high-potassium foods to avoid?

Bananas, oranges, tomatoes, potatoes, spinach.

What are high-phosphorus foods to avoid?

Dairy, beans, mushrooms, colas.