Nursing Fundamentals Review

Bedmaking and Bed Baths

  • Introduction to Bedmaking and Bed Baths
      - Important nursing tasks involving cleaning and patient comfort.

  • Step-by-Step Process for Bed Baths
      - First Step: Wash Eyes First
        - Use no soap to prevent bringing bacteria toward the eyes, avoiding infections.
      - Next Steps: Wash Other Body Parts
        - Order of washing:
          1. Face
          2. Chest
          3. Arms
          4. Abdomen
          5. Legs
          6. Feet
          7. Back
        - Last Step: Wash Perineum
          - Wash patient's genitals and rectum last.
          - Change Water before washing the perineum to maintain hygiene.
          - If patient has a vulva, remember to wipe from front to back to prevent fecal bacteria moving toward the urethra, reducing the risk of urinary tract infections.

  • Key Points on Bed Making
      - Raise Bed to Waist Height
        - Ensures safe ergonomics for the nurse, preventing injury.
      - Do Not Shake Linen
        - Avoids dispersing skin cells or pathogens in a hospital setting.
      - Dispose of Soiled Linens Properly
        - Place immediately in a soiled linen bag, not on the floor.

Oral and Denture Care

  • Basic Care and Comfort for Oral Care
      - For an alert and oriented patient:
        - Place a basin beneath the mouth for rinsing and spitting.
      - For an unconscious patient or one unable to protect their airway:
        - Angle their head 45 degrees and turn them to the side to prevent aspiration.
        - Have suction equipment readily available.
      - Avoid Placing Fingers in Patient's Mouth
        - Whether alert or unconscious, this poses a high risk of injury.

  • Denture Care
      - Handle dentures with care due to their cost.
      - Prevent Damage:
        - Place towels in the sink basin to cushion any drops.
      - Cleaning Options:
        - Brush with a toothbrush and toothpaste or use dedicated denture cleanser.
      - Storing Dentures:
        - Must be stored in a labeled denture cup (includes patient's name and date of birth).
        - Store in denture solution or water to prevent drying out.

Seizure Precautions

  • Introduction to Seizure Precautions
      - Essential understanding for nursing care and patient safety.

  • Preparation for a Patient on Seizure Precautions
      - Pad Side Rails of the Bed
        - This helps prevent head injuries during a seizure.
        - Use specialized pads or blankets taped around side rails.
      - Ensure Equipment Readiness:
        - Oxygen with a delivery device, suction equipment, and vital signs monitoring equipment should be ready in the room.

  • Actions During a Seizure
      - If patient is standing:
        - Carefully lower them to the floor using the leg as a slide if possible.
      - After they are on the floor or in bed:
        - Turn them to their left side for safety.
        - Ensure that secretions can exit the mouth to prevent choking.
        - Loosen restrictive clothing to ease breathing and airway access.
      - Protecting the Patient:
        - Clear the area of objects that may cause harm.
      - Important Safety Guidelines:
        - Do not restrain patients during seizures. Evidence shows this can cause harm as patients may push against constraints.
        - Do not place anything in the patient’s mouth, including fingers, to avoid the risk of injury (biting, choking).
      - Documentation:
        - Note the start and stop time of the seizure for medical records.

  • Postictal Phase
      - After the seizure, patients may experience confusion, disorientation, and potentially combative behavior.
        - Calmly reassure and reorient the patient.
        - Record vital signs and perform a brief neurological examination.

  • Conclusion of Review
      - Importance of understanding nursing roles in managing patients effectively.
      - Encouragement to subscribe for more nursing content and skills.

Personal Anecdote on Seizures

  • Meris’s Experience:
      - Describes first seizure experience at a friend’s house during a movie.
      - Confused postictal phase: covered with food, unclear about what transpired.
      - The importance of awareness of the patient's condition and compassionate care post-seizure.

  • Final Note:
      - Promotes sharing content that is helpful for nursing students.