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Foundations of Nursing
SN Nanjunde Gowda
1:
Introduction to Nursing
OBJECTIVES
WHAT IS NURSING?
WHAT IS NURSING SCIENCE?
DEFINITION OF NURSING
EARLY DEFINITIONS OF NURSING
Florence Nightingale's (Founder of Modern Nursing) Definition of Nursing
Virginia Henderson's (American Nurse Educator) Definition of Nursing
American Nurses' Association's Definition (1980)
World Health Organization's Definition (WHO)
SCOPE OF NURSING
1. Educational Opportunities at Present
2. Service Opportunities
EDUCATIONAL JOB OPPORTUNITIES IN INSTITUTES
PRINCIPLES OF NURSING
HISTORY OF NURSING
Nursing in Ancient Times
Nursing History
Care of Sick among Primitive People
Nursing and Medicine
Medical Science
Sickness and Sin
The First Hospitals
Egypt and Babylon
India
China
Greece
Hippocrates Oaths
Rome
Early Christianity and its Influence on Nursing
Important Dates
Modern Medicine and Hospitals
Nursing Brotherhoods
Related Orders
Influence of the Crusades on Nursing
Early American Hospitals
The Renaissance
Beginning of Modern Science
The Reformation
Industrial Revolution (1700–1800)
Emancipation of Women
Education
Florence Nightingale
Early Life and Education
Experience at Kaiserswerth (Institute at Germany)
Crimean War
DEFINITION OF NURSE
The Professional Nurse
Preparation of a Nurse
Philosophy
Questions of Philosophical Inquiry
Philosophy of Nursing
CORE VALUES IN NURSING
Qualities and Characteristics of a Professional Nurse
Nursing as a Profession
Criteria for a Profession
Ethics in Nursing
Code of Professional Conduct
Background
Nurses and Practice
Maintaining Standards of Practice
Delegating and Accepting Responsibilities
Nurses and Co-workers
Cooperative Relationship
Implications for Nurses
Nurses and the Profession
Implications for Nurses
Respect for Life
Implication for Nurses
Conflict Related to Malformed Infants
Nurses and People
Values, Customs and Beliefs
Implications for Nurses
Personal Information Held in Confidence
Implication for Nurses
Informing the Patient
Meeting Nursing Needs of People
NURSES RESPONSIBILITIES FOR IMPROVING THEIR OWN IMAGE
ROLE OF THE PROFESSIONAL NURSE
Care Giver
Communicator
Teacher
Counselor
Client Advocate
Change Agent
Leader
Manager
Researcher
Building a Nursing Team
NURSING CARE DELIVERY MODELS
Total Patient Care
Functional Nursing
Team Nursing
Primary Nursing
Case Management
School Health Nursing
Occupational Health Settings
Home Health Care Agencies
Progressive Patient Care (PPC)
Total Patient Care
Nurse-Patient Relationship
Therapeutic Relationship
The Nurses Role
Steps of Nurse Patient Relationship
Steps of Nurse Patient Relationship
Factors that Help to Promote Successful Therapeutic Nurse-Patient Relationship
Barrier to Therapeutic Nurse-Patient Relationship
THE HOSPITAL
Introduction
Definition
Functions of the Hospital (four categories)
CLASSIFICATION OF HOSPITAL
According to the Type of Service
According to Administration, Ownership, Control or Financial Income
ORGANIZATION OF THE HOSPITAL
MAJOR HOSPITAL HEALTH SERVICES DEPARTMENTS
Professional Health Service Departments
B. Non-Professional Health Service Departments
NURSING SERVICE DEPARTMENT
Functions of the Nursing Service Department
THE NURSING UNIT
Introduction
Functions of the Nursing Unit
Types of Nursing Units
SOCIAL AND PSYCHOLOGICAL EFFECT OF HOSPITALIZATION
Introduction
Common Anxiety Producing Factors in the Hospital Environment
EMOTIONAL NEEDS OF PATIENTS
Introduction
Definition—Emotion
Types of Emotion
Ways of Expressing Emotion
Physiological Effects of Emotions
Common Emotional Responses to llness and Nursing mplications
2:
Safety Guidelines in Nursing Unit
OBJECTIVES
SAFETY GUIDELINES IN NURSING UNIT
Objectives
ENVIRONMENTAL SAFETY
Lighting
Beds
Sleep
Noises
Exposure to Microorganisms
Electrical Safety
OXYGEN SAFETY
Prevention of Electrical Hazards
Incidents Involving Patients, Visitors, and Employees
Safety in Moving Patients and Equipment
Safety in Transporting Patients
Safety from Insect
Preventing Falls in the Hospital
TIPS
Preventing Falls in the Hospital
Safety for Preventing Cross Infection in the Hospital
Patient's and Visitor's Information
SAFETY PRECAUTION IN THE HOSPITAL
3:
Basic Human Needs
OBJECTIVES
INTRODUCTION
DEFINITION
1. Basic Human Needs
2. Hierarchy
MASLOW'S HIERARCHY OF HUMAN NEEDS
BASIC HUMAN NEEDS AND RELATED NURSING ACTIONS
Physiological Needs
Safety and Security Needs
Love and Belonging Needs
Selfesteem Needs
Selfactualization Needs
ACTIVITIES OF DAILY LIVING
Introduction
Factors Influencing the Activities of Daily Living
Implication of Human Needs in Nursing Practice
4:
Communication
OBJECTIVES
INTRODUCTION
DEFINITION
KINDS OF COMMUNICATION
THE COMMUNICATION PROCESS
THE BASIC ELEMENTS OF COMMUNICATION PROCESS
The Sender
The Message
The Channel
The Receiver
The Response/Feedback
MODES OR FORMS OF COMMUNICATION
Verbal Communication
Nonverbal Communication
THE MEANS OF NONVERBAL COMMUNICATION
Physical Appearance Including Adornment
Posture and Gait
Facial Expressions
Eye Contact
Body Movements and Gestures
Touch
Tone of Voice
Symbols
Signals
GUIDELINES FOR EFFECTIVE COMMUNICATION
Communication Model
Sender and Receiver
Message
Endocing
Transmitting
Decoding
Action
Feedback
Barriers to Effective Communication
Physical Barriers
Socio-psychological Barriers
Semantics
MANAGEMENT FUNCTIONS AND COMMUNICATIONS
Factors Influencing the Communication Process
1. Ability of the Sender and Receiver
2. Personal Space
3. Roles and Relationships
4. Time
5. Environment
6. Attitudes
7. Sociocultural Background
8. Education or Knowledge
9. Language
10. Emotions and Selfesteem
THERAPEUTIC COMMUNICATION
EFFECTIVE METHODS
COMMUNICATION WITH THE CHILD AND ADOLESCENT
PRESCHOOL OR SCHOOL-AGE CHILD
PREADOLESCENT AND ADOLESCENT
PARENTS
COMMUNICATING WITH THE CLIENT WHO HAS COMMUNICATION DIFFICULTIES
COMMUNICATION WITH THE HEARING IMPAIRED CLIENT
COMMUNICATION WITH THE VISUALLY IMPAIRED CLIENT
COMMUNICATION WITH THE APHASIC OR MUTE CLIENT
COMMUNICATION APPROACHES FOR SPECIFIC BEHAVIORS
Over Talkativeness
Fear of Helplessness
Fear of Dependency
IMPLICATIONS FOR HEALTH PROMOTION
Application to Nursing
5:
Nursing Process
OBJECTIVES
DEFINITION AND GOAL OF NURSING PROCESS
HISTORICAL PERSPECTIVE OF THE NURSING PROCESS
STEPS IN THE NURSING PROCESS
BENEFITS OF THE NURSING PROCESS
BENEFITS FOR THE CLIENT
BENEFITS FOR THE NURSE
A FRAMEWORK FOR ACCOUNTABILITY
PROCESS OF ASSESSMENT
TYPES OF DATA
SOURCES OF DATA
Client
Significant Others
Significant Others
Health Personnel
Medical Records
Other Records and Reports
Literature
METHODS OF DATA COLLECTION
Observing
Interviewing
Examining
The Diagnostic Process
THE STEPS OF DIAGNOSTIC PROCESS
1. Data Processing
2. Determining the Client's Health Problems, Health Risks, and Strengths
3. Formulating Nursing Diagnoses
NURSING DIAGNOSIS FORMAT
Characteristics of a Diagnostic Statement
PLANNING
Components of Planning
Nursing Diagnosis:
Setting Priorities
Factors for Setting Priorities
Establishing Client Goals and Outcome Criteria
GUIDELINES FOR WRITING GOALS AND OUTCOME CRITERIA
Planning Nursing Strategies
Generating Alternative Nursing Strategies
Writing Nursing Orders
Writing the Nursing Care Plan
Guidelines for Writing Nursing Care Plans
Implementing
TYPES OF NURSING ACTIONS
Process of Implementing
Implementing Skills
Implementing Activities
Process of Evaluating
Evaluating the Quality of Nursing Care
Guidelines for Implementing Nursing Strategies
Patient Identification Date
Health History of the Family
Socioeconomic Data
Personal History
Physical Assessment
Skin
Head
Face
Eyes
Ear
Nose
Throat and Mouth
Neck
Respiratory System
Abdomen
Liver
Cardiovascular System
Nutrition
Hygiene
Elimination (bowel)
Elimination (Urine)
Reproduction
Neurological
Musculoskeletal
Investigation
Medical Diagnosis: (Final Diagnosis) ________________________________________________________
Drug Management
Diet Plan
Nursing Care Plan
Student Nursing Care Plan
6:
Physical Examination and its Assessment
OBJECTIVES
INTRODUCTION
DEFINITION
PURPOSES
TYPES OF NURSING ASSESSMENT
BASIC SKILLS FOR ASSESSMENT
TECHNIQUES OF PHYSICAL EXAMINATION
Inspection
Palpation
Percussion
Purposes
Types of Percussion
Auscultation
Olfaction
PREPARING TO PERFORM THE PHYSICAL EXAMINATION
Preparing the Environment
Preparing Equipment
Equipment and Supplies Needed for Performing the Physical Examination
Preparing the Patient
POSITION USED IN NURSING
Introduction
PERFORMING THE PHYSICAL EXAMINATION
General Survey
Physical Appearance
Body Structure
Behavior
Vital Signs
Detailed Physical Examination
Specific Areas of Examination
Assessment
Implementation
Psychological Preparation
Mental Status and Speech
Nutritional Status
Judgment
Orientation
Memory
Affect
Consciousness
Speech
INTEGUMENTARY SYSTEM (SKIN)
Color
Moisture
Temperature
Texture
Turgor
Edema
HAIR AND SCALP
NAILS
HEAD AND NECK
Head
Eyes
Visual Acuity
Extraocular Movement
External Eye Structure
Position and Alignment
Eye Brow
Eyelids
Ears
Auricle
OTOSCOPIC EXAMINATION
Acoustic Nerve
Webber Lateralization
Rinne Air Condition and Bone Conduction Test
Nose and Sinuses
Frontal and Maxillary Sinuses
OLFACTORY NERVE
MOUTH AND PHARYNX
Lips
Gums and Teeth
Tongue
NECK
THYROID
Trachea
Carotid Arteries
Spinal Accessory Nerve (CN XI)
External Jugular Veins
Chest
Lung Assessment
Inspect Lungs
Palpation
Vocal Fremitus
Percussion
Auscultation
Normal Breath Sounds
Adventitious Breath Sounds
Anterior Chest
Heart
Examination of Breast
Female Breast
History
Inspection
Palpation
Breast and Auxillae Examination
Inspect the Breast
Male Breast
Abdominal Examination
Previous Abdominal Surgery or Trauma
Land Mark for Abdominal Examination
Auscultation
Percussion
Palpation
Abdominal Reflex Assessment
Reflex Assessment
Genitalia and Rectum
Female Genitalia
External Inspection
Internal Inspection
Male Genitalia
Palpation
Rectum and Anus
Musculoskeletal Assessment
Assessment Guidelines
Inspection of Gait and Stance
Muscle Tone and Strength
Maneuvers to Assess Muscle Strength
Balance of Gross Motor Function
Peripheral Vascular Assessment Subjective Data
Objective Data
Guidelines to perform Alien's Test
Measuring Jugular Venous Pressure
Circulation of Lower Extremity
NEUROLOGICAL ASSESSMENT
Definition
Indication
Neurological Observations and Assessment
Special Consideration
PROCEDURE
Preparation
Assessment
Assessment of Common Reflexes
Cutaneous Reflexes
Reflexes
Assessment of Sensory Nerve Function
Assessment of Sensory Nerve Function
Intellectual Function
Cranial Nerve Function and Assessment
Mental and Emotional Status
Glasgow Coma Scale
Level of Consciousness and Responsiveness
Post Examination Activities
Documentation
7:
Recording and Reporting
OBJECTIVES
DOCUMENTATION
Importance of Communication among Health Team Members
Discussion
Report
Record
Purposes of Records
Communication
Legal Documentation
Reseach
Statistics
Education
Audit
Planning Care
Types of Records
Special Records and Reports
Kardex and Nursing Care Plan
Types of Progress Records
Formats for Writing Progress Notes
Good Charting Costs Your Time and Effort in Return it Protects You and the Patient
REPORTING
Definition
Purpose
Reporting
Kinds of Reports
Oral
Communication–Nurses and Physician
Characteristics of a Good Record (or) Report
Guidelines for Giving Report of Patients
8:
Diagnostic Tests and Procedures
OBJECTIVES
Nursing Standards and Protocols for Specimen Collection for Laboratory Investigation
Nursing Responsibilities
Specific Guidelines for the Nursing Role Assess for Interfering Factors
Prepare the Patient Properly
Be aware of Legal Implication
Consider Ethical Implications
Use Safety Measures
Observe Infection Control and Universal Precautions
Store and Transport Specimens
Nursing Protocol for Blood Specimen
Nursing Role
Skin Puncture (Capillary Blood)
Pre-test Care
Intratest Care
Past-test Care
Veinpuncture (Venous blood)
Clinical Alert
Post-test Care
Arterial Puncture (Arterial blood)
Common Investigation Arterial Blood Gas
Pulse Oximetry
Complete Blood Count (CBC)
Hemoglobin (Hgb)
Culture and Sensitivity (C and S)
Electrolytes
Erythrocyte Sedimentation Rate (ESR)
Enzyme-linked Immunosorbent Assay (ELISA)
Western Blot
Polymerase Chain Reaction (PCR)
CD4 Cell Count
Partial Thromboplastin Time (PTT) also called Activated Partial Thromboplastin Time
Activated Partial Thromboplastin Time (APTT)
Bleeding Times
Coombs' Test (Direct Antiglobulin Test)
Folic Acid (Folate Level)
Hematocrit
Schilling Test
Sickle Cell Test
White Blood Cells (WBCs)
Differential Count
Blood Urea Nitrogen Test (BUN)
Serum Creatinine
Rheumatoid Factor (RF)
Uric Aid
Blood Glucose, Fasting Blood, Sugar
Two hours Post-prandial Glucose (2 h PPG) or 2 hour Post-prandial Blood Sugar (2h PPBS)
Glucose Tolerance Test (GTI)
VDRL
Thyroid Stimulating Hormone (TSH), Thyrotropin
Thyroid Stimulating Hormone Stimulating Test (TSH, Stimulating Test)
Serum Free Tri-iodothyronine (T3)
Calcitonin, HCT, Thyrocalcitonin
Radioactive Iodine Uptake (RAIU) > Iodine Uptake Test
Parathyroid Hormone (PTH), Parathormone
Adrenocorticotropic Hormone Stimulation Test
Urine Tests
Creatinine Clearance
Stool for Occult Blood
Computerized Axial Tomography (CT Scan or CAT Scan)
Pulmonary Function Tests (PFTs)
Pulmonary Angiography
Bronchoscopy
Sputum Analysis
Thoracentesis
Cardiac Biopsy
Cardiac Catheterization (Cardiac Angiogram, Coronary Arteriogram)
Cardiac Position Emission Tomography Scan (Cardiac PET Scan)
Electrocardiogram (EKG or ECG)
Holter Monitor
Magnetic Resonance Imaging (MRI)
Pericardiocenthesis
Thallium Scan (Myocardial Perfusion Scan)
Gastric Analysis, Tube and Tubeless Test
Biopsy
Patch Testing
Woods Light Examination
Skin Scrapings
Weber Test (Tuning Fork)
Rinne's Test (Tuning Fork)
Audiometric Testing
Speech Audiometry (Spondee Threshold)
Tympanometry
Romberg Test
Otoscopic Exam
Tonometry
Slit-Lamp Examination
Perimetry
Ophthalmoscopic Examination
Pap Smear (Papanicolaou)
Endometrial Biopsy
Mammography
Breast Biopsy
Dilatation and Curettage (D and C)
Laparoscopy
Hanging Drop Slide Urine Specimen
Liver Biopsy
Cardiac Enzymes and Isoenzymes
Blood Chemistries
Exercise Stress Testing
Echocardiography
Phonocardiography
Doppler Ultrasonography
Pulmonary Wedge Pressure Monitoring
Cardiac Catheterization
Angiography
Bone Marrow Aspiration
Equipment
Reagent Tablet Testing
Reagent Strip Testing
Fallow-up Activity
Definition
Indications
Cervical Scrape
Equipment
Procedure
EAR SWAB
Definition
Purpose
Equipment
Procedure
EYE SWAB
Definition
Purpose
Equipment
Procedure
COLLECTING A STOOL SPECIMEN
Equipments
NASAL SWAB
Definition
Purpose
Equipment
Procedure
PENILE SWAB
Definition
Purpose
Equipment
Procedure
RECTAL SWAB
Definition
Purpose
Equipment
Procedure
SEMEN
Definition
Purpose
Equipment
Procedure
THROAT SWAB
Definition
Purpose
Equipment
Procedure
URINE
Definition
Purpose
Equipment
Procedure
VAGINAL SWAB
Definition
Purpose
Equipment
Procedure
WOUND SWAB
Definition
Purpose
Equipment
Procedure
9:
Admission of Patient
OBJECTIVES
DEFINITION
TYPES
Purpose
Common Procedures for Admission
The First steps in Admitting Clients
Admission of the client to a Nursing Unit
Room Preparation
Procedure
RECEPTION AND ASSESSMENT OF PATIENT TO AN ACCIDENT AND EMERGENCY DEPARTMENT
Admission of Patient to an Emergency Department
Introduction
Purpose
Readiness of the A and E Department
Equipment and Materials Required for Meeting the Emergency
Equipment kept in the Ambulance Bag
Priorities of the A and E Unit
Functions of the Nursing Staff in the A and E Department
Initial Assessment of A and E Patient by the Nurse
Lifting the Patient
Removal of Clothing
Patients Property and Valuables
The Doctor's Examination
Head
Limbs
Chest
Abdomen
Baseline Vital Signs
Meeting Patient Social and Spiritual Needs
Documents
Final Checklist Before Transferring the Patient to Ward
Internal Transfer of Patients
Procedures
Discharge from the Hospital
Definition
Purpose
Last Office/Care of Death
Purpose
Policy
Equipment
Procedure
10:
Rest and Sleep
OBJECTIVES
INTRODUCTION
Conditions that Promote Rest
Freedom from Irritation and Discomfort
Having Satisfying Amount of Purposeful Activity
FACTORS AFFECTING NORMAL SLEEP
Common Sleep Disorders
Assessing
Sleep History
Sleep Diary
Physical Examination
NURSING RESPONSIBILITIES
Implementing
Evaluating
11:
Bed Making
OBJECTIVES
INTRODUCTION
Clinical Guidelines for Bed Making
Making an Unoccupied Bed
Purposes
Equipment
Procedure
MAKING AN OCCUPIED BED
Purposes
Procedure
Different kinds of beds to meet the special needs of clients
12:
Hygienic Needs
HAND WASHING
OBJECTIVES
Definition
Purpose
Types of Hand Washing
ANTISEPTIC HAND WASHING
Equipment/Requirements
Procedure
BED BATH
Definition
Purpose
Equipment
Procedure
ASSISTING A HELPLESS PATIENT IN BRUSHING TEETH
Introduction
Purposes
Requirements/Equipment
Procedure
SHAMPOOING THE HAIR OF A BEDRIDDEN CLIENT
Contra Indications for Hair Shampooing
Equipment
Implementation
Evaluation
Recording and Reporting
BACK CARE/BACK RUB
Introduction
Purposes
Equipment
Procedure
PERFORMING MOUTH CARE FOR AN UNCONSCIOUS PATIENT
Introduction
Purposes
Requirements/Equipment
Procedure
MENSTRUAL HYGIENE
Introduction
Anatomy and Physiology of Female Reproductive System
External Genitalia
Internal Genitalia
Menarche
Secondary Sexual Characteristic in Girls
Menstrual Cycle
Phases of Menstrual Cycle
Length of Menstrual Cycle
Length of Periods
Cessation of Menstruation or Menopause
Symptoms During Normal Menstruation
Before menstruation
During Menstruation
Menstrual Hygiene
Care of Genital Area
Care of Sanitary Napkins
PADS
Types of Pad
Options
Care of Pads
Cotton Clothes
Care of Clothes
TAMPONS
Care of Tampons
Douches
Vaginal Spray
Personal Hygiene
Bathing
Diet
Exercise
General Measures During Menstruation
Herbs and Natural Remedies
Stress Reduction Techniques
Social and Therapeutic Supports
Menstrual Disorders
Dysfunctional Uterine Bleeding
• Amenorrhea
• Menorrhagia
Treatment for Dysfunctional Uterine Bleeding
Dysmenorrhea
Disorders with Poor Menstrual Hygiene
Toxic Shock Syndrome and Infections
Symptoms
Treatment
Vaginitis
Sign and Symptoms
Treatment
Urinary Tract Infection
Treatment
Pelvic Infection
Management
Prevention
Conclusion
CARE OF EYES, NOSE, EAR, TEETH AND ORAL CAVITY, FEET, NAILS AND PERINEAL CARE
Care of Eyes
Eye Glasses
Contact Lenses
Care of Nose
Care of Ears
Care of Teeth and Oral Cavity
Measures to Prevent Tooth Decay
Care of Feet
COMMON FOOT PROBLEMS
Callus
Corn
Unpleasant Odors
Plantar Warts
Fissures
Athlete's Foot
Ingrown Toe Nails
Hallux Valgus
Hammer Toe
Care of Nails
Perineal Care
13:
Mobility and Immobility
OBJECTIVES
INTRODUCTION
Structure and Functions of Musculoskeletal System
Joint Mobility
Range of Motion
Degrees of Immobility
Benefits of Bed Rest
ASSESSING MOBILITY
Range of Motion
Gait
Exercise and Activity Tolerance
Factors Affecting Mobility
ASSESSING MOBILITY AND IMMOBILITY
ASSESSING IMMOBILITY
Identifying Patients at Risk if Immobility Complications
Problems of Immobility (Complications)
Ability to Perform Activities of Daily Living
Self-care Deficit: Toileting
PRESSURE SORES
Definition
Causes of Pressure Sores
Categories of Pressure Sores
Stages in the Development of Superficial Pressure Sores
Factors Affecting the Formatting of Pressure Sores
ASSESSING PRESSURE AREAS
ASSESSING PATIENTS AT RISK
Potential Pressure Sore Sites
Assessing Patients with Pressure Sores
Guidelines for Assessing Pressure Areas and Pressure Sores
NURSING INTERVENTIONS
Musculoskeletal Problems
General Guidelines for Providing Exercises
PREVENTING PRESSURE SORES
1. Manipulation of the Environment
2. Ongoing Assessment
3. Proper Positioning
4. Good Nutrition
5. Meticulous Hygiene
6. Patient Teaching in Preventing Pressure Sores
BODY MECHANICS
RANGE OF MOTIONS
Definition
Purposes
Types
Passive Movement
Ambulation
MAINTAINING BODY ALIGNMENT
Key Points
LIFTING AND MOVING TECHNIQUES
CHANGING POSITION
Definition
Purposes
Equipment
Procedure
TRANSFER FROM BED TO CHAIR AND VICE VERSA
Definition
Purposes
Equipment
Procedure
CARE OF THE PATIENT IN TRACTION
Definition
Purposes of Traction
Classification of Traction
Principles of Effective Traction and the Role of the Nurse
SKIN TRACTION
Definition
Purposes
Equipment
Procedure
Follow-up Care
Application of Skin Traction—Nonadhesive Type
Follow-up Care
General, Nursing Care of the Patient with Traction
Special, Nursing Care of Patient with Different Types of Traction
CARE OF PATIENT IN A CAST
Definition
Purposes
Types of Casts
Chemistry of Plaster of Paris
Casting Materials
Assisting with Cast Application
Assisting with the Application of a Cast
Documentation
Patient Education and Home Health Care
Cast Removal
Evaluation
14:
Assessing Vital Signs
OBJECTIVES
INTRODUCTION
Times to Assess Vital Signs
Physiological Basis of Body Temperature
Factors Affecting Body Heat Production and Heat Loss
Heat Loss
Factors Affecting Body Temperature
Factors that Affecting Body Temperature
Alterations in Body Temperature
Common Types of Fevers
Clinical Signs of Fever
Nursing Interventions for Patients with Fever
Assessing Body Temperature
Advantages and Disadvantages of three sites for body Temperature Measurement
Hypothermia
People at Risk for Hypothermia
Types of Thermometers
Guidelines For Taking Vital Signs
TAKING THE ORAL TEMPERATURE
Definition
Purpose
Equipment
TAKING THE RECTAL TEMPERATURE
Purposes
Equipment
Procedure
TAKING AXILLARY TEMPERATURE
Purpose
Equipment
Procedure
Follow-up Activities
Special Consideration
PULSE
• Pulse
Physiological Basis of Pulse
Factors Affecting Pulse Rate
Pulse Sites
Characteristics of the Pulse
Pulse Technique: Peripheral Pulse Assessment
Apical Pulse Assessment
Procedure
Special Considerations
RESPIRATION
Physiological Basis for Respiration
Definition
Assessing Respiration
Equipment
Procedure
BLOOD PRESSURE
Definition
Physiology of Arterial Blood Pressure
Peripheral Resistance
Blood Volume
Factors affecting Blood Pressure
Assessing Blood Pressure
The Sphygmomanometer
Manometer
Cuff
Inflable Bladder
Control Valve, Pump and Rubber Tubing
Korotkoff's Sounds
Systolic Pressure
Diastolic Pressure
Common Errors in Assessing Blood Pressure
Sources of Error in Blood Pressure Assessment
Indication for Blood Pressure Measurement
Equipment
Procedure: Measuring Blood Pressure
Palpation Method
15:
Medication Administration
OBJECTIVES
KNOWLEDGE BASE FOR THE NURSES
PHARMACOLOGICAL CONCEPTS
Drug Names
DRUG INTERACTION
Definition
Pharmacokinetics
Principles of Pharmacokinetics
Absorption
Distribution
Metabolism
Excretion
Types of Medication Action
Therapeutic Effects
Side Effect
Adverse Effect
Anaphylaxis
Effect on Urinary System
Effect on Cardiovascular System
Blood Dispraises
Effects on Nervous Systems
Toxic Effect
Idiosyncratic Reaction
Allergic Reaction
Effects on the Gastrointestinal System
Factors Influencing Drug Actions
A. Genetic Differences
B. Physiological Variables
C. Environmental Conditions
D. Psychological Factors
E. Diet
Routes of Drug Administration
Drug Administration
Sublingual Administration
Buccal Administration
Potential Routes
Topical Administration
Inhalation
Classification of Drugs
Systems of Drug Measurement
A. Metric System
B. Apothecary System (Customary English System)
C. Household System
D. International Unit System (SI)
Calculation of Drug Dosages
Guidelines for Drug Administration
Physician's Role
Standing Order
PRN Order
Single (one time) Orders
State Orders
Nurse's Role
History of Allergies
Drug Data
Medication Delivery
The “Right” of Drug Administration
Right Drug
Right Dose
Right Client
Right Route
Right Time
Medication Error
Oral Drug Administration
Forms of Medication
Oral Drug Administration
Storing of Medications
Care of Medicine Cabinet and Drugs
Administering Oral Medications
Administration of Injection
Preventing Infection during an Injection
Equipment
Types of Syringes
Needles
Disposable Injection Units
Administering Injections
Subcutaneous Injection
Intramuscular Injection
Sites
Vastus Lateralis Muscle
Ventrogluteal Muscle
Dorsogluteal Muscle
Deltoid Muscle
Intradermal Injection
Procedure
EAR IRRIGATION AND INSTILLATION OF EAR DROPS
Irrigation the External Auditory Canal
Purposes
Nursing Alert
Equipment and Solutions
Procedure Preparatory
INSTILLATION OF EAR DROPS
Definition
Purposes
Equipment and Solutions
Procedure
APPLICATION OF DRUGS IN OTHER FORMS TROPICAL DRUGS
Equipment
Procedure
INSULIN ADMINISTRATION
Purpose
Equipment
Types of Insulin
Procedure
MIXING MEDICATION FROM TWO VIALS
Definition
Purposes
Nursing Alert
Equipment
Procedure
A. Medications from vials
B. Mixing Insulin
Nursing Alert
THROAT PAINTING
Purpose
Equipment
Procedure
THROAT GARGLING
Purpose
Equipment
Procedure
HEPARIN LOCK
Definition
Equipment
Administration of Medication
Follow-up
Discontinuance of Heparin Lock
WING TIPPED CANNULA INSERTION
Equipment
16:
Nutritional Needs
OBJECTIVES
INTRODUCTION TO THE SCIENCE OF NUTRITION
DEFINITION
Importance of Diet in Health
Factors Influencing Food Habits and Food Selection
Physical Factors
Psychological Factors
Sociocultural Factors
Environmental Factors
Economical Factors
Individuality in Eating and Drinking
Lifespan effect on eating and drinking
Summary of Factors Influencing Food Habits and Selection
CLASSIFICATION OF NUTRIENTS
Macronutrients and Micronutrients
Proteins
SOURCES
Animal Sources
Plant Sources
Function
Requirements
IMPORTANCE OF DIET IN HEALTH AND DISEASE
Deficiency
Carbohydrates
Sources
Plant Sources
Animal Sources
Functions
Requirements
Deficiencies
Fats
Sources
Animal Sources
Plant Sources
Functions
Requirements
Deficiencies
VITAMINS
Factors Affecting Quality and Quantity
Favorable Food Handling Practices
Deficiencies
MINERALS
Deficiencies
Water
Functions
Sources
Requirements
Deficiency
SUMMARY
Essential Body Nutrients:
Major Physiological Functions of Nutrition
Important Sources of Nutrients
NUTRITION IN HEALTH
Balanced Diet
Ideal Nutrition
Clinical Signs of Good Nutritional Status
Basic Food Groups Guides
Dietary Guidelines
1. Eat a variety of foods
2. Maintain Ideal weight
3. Avoid too much fats and cholesterol
4. Eat foods with adequate starch and fiber
5. Avoid too much sugar
6. Avoid too much sodium
UTILIZATION OF NUTRIENTS
Digestion
Absorption
Metabolism
Organs of Digestion
Large Intestine
Digestibility of Food
Therapeutic Nutrition
Basic Hospital Diet
Modification of hospital diet for therapeutic purpose
Prescription of therapeutic diet
Examples of therapeutic diets and indications
Modifications in carbohydrate, protein and fat
Modification in fat
Modification in protein
Modification in carbohydrate, minerals and vitamins
Important consideration in meal service
General consideration in meal service
Suggestion for assisting patient
ASSESSING NUTRITIONAL STATUS
Purpose
Equipments Required
Procedure
ASSISTING ADULT PATIENT WITH ORAL NUTRITION
Introduction
Purpose
Equipments / Requirements
Procedure
NASOGASTRIC INTUBATION
Definition
Purpose
Equipments/Requirements
Procedure
NASOGASTRIC TUBE FEEDING
Introduction
Purpose
Requirements/Equipments
Procedure
17:
Bowel Elimination
OBJECTIVES
INTRODUCTION
DEFECATION
Normal Defecation
The Defecation Reflex
FACTORS AFFECTING BOWEL ELIMINATION
Age and Development
Daily Patterns
Lifestyles
Diet
Fluids
Activity and Muscle Tone
Psychological Factors
Pathological Conditions
Medications
Diagnostic Procedures
Surgery and Anesthesia
Irritants
Pain
COMMON PROBLEMS IN BOWEL ELIMINATION
1. Constipation
2. Fecal Impaction
3. Diarrhea
4. Fecal Incontinence
5. Flatulence
ROLE OF THE NURSE IN BOWEL ELIMINATION
Assessing Bowel Elimination
Nursing History
Planning
Implementation
Evaluation
Toilet Utensils
The Bedpans
The Commode
The Toilet Chair
Special Considerations Related to Provision of Toilet Utensils
COLLECTING A STOOL SPECIMEN
Equipments
Follow-up Activities
ADMINISTERING AN ENEMA
Types of Solutions Used for Enemas
Equipments
Prepackaged Enema
INSERTING A RECTAL TUBE
Equipment
18:
Urinary Elimination
OBJECTIVES
Introduction
Definition
Anatomy and Physiology (Review)
Urination
Frequency of Urination
Normal Urination Process (Act of Urination)
Urinary Elimination
Factors Influencing Urinary Elimination
Developmental Considerations
Lifestyle
Fluid and Food Intake
Environment
Psychological Factors
Medications
Muscle Tone and Activity
Pathological Conditions
Surgical and Diagnostic Procedures
Common Alterations in Urinary Elimination
a. Altered Urine Production
b. Altered Voiding Pattern
Hesitancy
Urinary Incontinence
Urinary Retention
Assessing Urinary Elimination
Nursing History
Examples of Interview Questions
Voiding Pattern
Description of Urine and Any Changes
Urinary Elimination Problems
Physical Examination
Examination of Urine
Maintaining Normal Voiding Habits
Relaxation
Implementing
Promoting Fluid Intake
ASSISTING A CLIENT TO USE A URINAL
Equipment
Home Care Considerations
Development Considerations
COLLECTING A RANDOM URINE SPECIMEN
Equipment
COLLECTING A MIDSTREAM (CLEAN-VOIDED) URINE SPECIMEN
Equipment
COLLECTING A STERILE URINE SPECIMEN FROM AN INDWELLING CATHETER
Equipment
Follow-Up Activities
MEASURING SPECIFIC GRAVITY OF URINE
Equipment
Follow-up Activity
Special Consideration
URINARY CATHETERIZATION
Definition
Purpose
Equipment
Procedure
19:
Oxygenation
OBJECTIVES
Introduction
Factors Affecting Oxygenation
Alterations in Respiratory Function
1. Hypoxia
Causes of Hypoxia
Clinical Signs of Acute Hypoxia
Clinical Signs of Chronic Hypoxia
2. Altered Breathing Patterns
Terms describing Abnormal Breathing Patterns
3. Obstructed Airway
Types and Causes of Airway Obstruction
Clinical Signs
Abnormal Breath Sounds—Definitions
Secretion and Coughing
Assessing
Nursing History
ASSESSMENT OF OXYGENATION
Current Respiratory Problems
History of Respiratory Disease
Current or Past Cardiovascular Problems
Lifestyle
Presence of Cough
Description of Sputum
Presence of Chest Pain
Presence of Risk Factors
Medication History
Implementing
Positioning
Positioning the Patient to Allow for Maximum Chest Expansion
Deep Breathing and Coughing Exercise
Patient Teaching – Deep Breathing and Coughing
Abdominal and Pursed-lip Breathing
OXYGEN THERAPY
OXYGEN THERAPY SAFETY PRECAUTIONS
Evaluating
OXYGENATION
Skills of Learning
Applying a Nasal Cannula
Equipment
Procedure: Oxygen Therapy
APPLYING AN OXYGEN MASK
Equipment
SUCTIONNING THE NOSE AND MOUTH OF CHILD
Suctioning
Preparing the Supplies
Clean Jars and Containers
Sterile Saline
Equipment
Instructions
TRACHEOSTOMY CARE
Definition
Purposes
Equipment
Procedure
Preparatory Phase
Performance Phase
TRACHEOSTOMY SUCTIONING PATIENT ON MECHANICAL VENTILATION
Definition
Purposes
Equipment
Procedure
Performance Phase
NEBULIZATION THERAPY
Definition
Purposes
Types
JET MEDICATION NEBULIZER
Definition
Equipment
Procedure
Nursing Alert
ULTRASONIC NEBULIZER
Definition
Equipment
Procedure
STEAM - INHALATION
Purposes
Equipment
Procedure
20:
Heat and Cold Application
OBJECTIVES
Introduction
Principles Related to Heat and Cold
Methods of Heat and Cold Applications
GUIDELINES FOR HEAT AND COLD APPLICATIONS
EXAMPLES OF HOT AND COLD APPLICATIONS
Hot Applications
Temperature For Heat and Cold Applications
General Nursing Measures of Heat and Cold Applications
During Procedure
After the Procedure
Cold Applications
Assessment
Follow-up Activities
Special Considerations
APPLYING AN ICE PACK, BAG, OR COLLAR
Equipment
Follow-Up Activities
Both Heat and Cold Applications can be used Effectively in Various Clinical Conditions
21:
Fluid and Electrolyte Balance
OBJECTIVES
Water Balance
Disorders of Water Balance
Hypotonic Dehydration
Isotonic Dehydration
Hypertonic Dehydration
Hypotonic Overhydration
Isotonic Overhydration
Hypertonic Overhydration
ELECTROLYTE BALANCE
SODIUM
Hypo and Hypernatremia
Hypernatremia
Nursing Intervention
Monitor
Monitor Response
Hypernatremia
Nursing Intervention
Monitor
POTASSIUM
Hypo- and Hyperkalemia
Hypokalemia
Nursing Intervention
Hyperkalemia
Nursing Intervention
CALCIUM
Hypo- and Hypercalcemia
Hypocalcemia
MAGNESIUM
Hypo- and Hypermagnesemia
Hypermagnesemia
PHOSPHATE
Hypophosphatemia
Hyperphosphatemia
CHLORIDE
Water and Electrolyte Balance in Children
Identify Clients at Risk for Fluid and Electrolyte Imbalance
Measuring and Recording the Intake and the Output
Equipment
Follow-up Activities
Special Considerations
INTRAVENOUS THERAPY
Psychological Consideration
Intravenous Drug Policy
Prescribing Information
Administration of Drug into Containers of Intravenous Fluids
Vein Puncture Technique
General Rule
Selecting the Cannula/Vein
Skin Preparation
Palpating the Vein
Methods Used to Distend Vein
Tourniquet
Blood Pressure Cuff
Steps in the Vein Puncture Process
Teaching Consideration
Special Consideration
Professional Practice
Confirming the Correctness of the Prescription
Responsibility
Accountability
Important Highlights
Monitoring Intravenous Therapy
Factors Affecting Rate of Flow
Nurses Responsibility as Regards the Intravenous Therapy
Methods of Administering Intravenous Drugs
Three Recommended Methods
INITIATING INTRAVENOUS THERAPY
Caution
Teaching
Equipment
Assessment
Preparation of Person
VEIN PUNCTURE AND STARTING INTRAVENOUS INFUSION
Procedure
FURTHER STEPS
Parenteral Replacement of Fluids
Common Complication in Intravenous Therapy
Common Complications
1. Infiltration
Signs and Symptoms of Infiltration
Preventive Measure for Infiltration
2. Infusion Phlebitis
Predisposition
Preventive Measures for Phlebitis
3. Thrombosis
Predisposition
Preventive Measures
4. Thrombophlebitis
Nursing Implication for Thrombophlebitis
5. Pyrogenic Reaction
Preventive Measures
6. Air Embolism
Preventive Measures
7. Blood Embolism
Preventive Measures
8. Circulatory Over Load
Nursing Implication
Speed Shock
Nursing Implication
Golden Rule of IV Therapy
Types of Fluids Replacement
Intravenous Solutions
TOTAL PARENTAL NUTRITION
Introduction
Definition
Daily Requirements in Parental Nutrition
Energy
Precaution to be taken while Administering TPN
Complication of Parental Nutrition
Nursing and Documentation
Administration
Precaution
BLOOD TRANSFUSION
Introduction
Purposes
Blood Products—Blood Group Systems and Classification
Selection of Blood Points to be Remember while Selecting Blood
Test on Donor Blood
Blood Components and its Products
Preservation and Storage of Blood
Blood Transfusion as a Component Therapy
Nursing Intervention on Blood Transfusion
Transfusion Reaction
Nursing Interventions
Blood Transfusion Procedures
Procedure
22:
Infection Control
OBJECTIVES
Definition
Mode of Spreading of Infection
Agent
Disease Agents
Mechanical Agents
Social Agents
Host factors
Environment
Chain of Infection
Elements of Infection
Classification of Infection
Microorganism Ability to Cause Disease
Factors that Predispose a Person to an Infection
Dynamics of Disease Transmission
Factors Affecting the Severity of Infection
Three Blood Borne Pathogens that Nurses could Acquire Through Hospital Acquired Infection
HOSPITAL ACQUIRED INFECTION
Equipment
Environment
Respiratory Droplet
Air Borne Spread
Hospital Acquired Infection
Factors Responsible for Hospital Acquired Infection
How Disease Spread Indirectly in the Hospital
Cross Infection Occurs in the Hospital due to
Source of Hospital Acquired Infection
Who is a Case
Who is a Carrier
Carrier has Three Elements
How a Carrier can Spread Disease
Mode of Entry of Organisms into Human Body
Route of Exit or Mode of Exit of Infection
Mode of Transmission of Disease
Direct Transmission
Indirect Transmission
Blood Stream
Wound Infection
Urinary Tract Infection
Chest Infection
Potential for Hospital Acquired Infection
Aims of Standard Precautions against Hospital Acquired Infection
Universal Precaution
Aims
Elements of Universal Precautions
Hand Washing
Objective
Principle: Hands must be Washed Thoroughly
Methods
Protective Clothing
Purpose
Sharp
Precautions
Sharp Disposal Bin Can be Used For
Clinical Waste
Principles to be Followed during Collection of Waste
Collection of Waste
Transportation of Waste
Spillage
Linen
Categories of Linen
Principles
Specific Protection
The Personnel to be protected
Immunization
Protection Against Infected Materials
Principles
Disinfection of Infected Linen
Disinfection of Bedpans/Urinals
Disinfection of Equipment
Action after Accidental Injury
Isolation Precautions
Essentials of Isolation Precautions
Routine and Terminal Cleaning
MEDICAL ASEPSIS
Definition
Medical Aseptic Practices
SURGICAL ASEPSIS OR STERILE TECHNIQUE
Definition
General Principles of Surgical Asepsis
Principles of surgical asepsis in relation to handling to transfer forceps/Cheatle forceps
Principles of Surgical asepsis in relation to handling of a sterile container
Principles of Surgical Asepsis in Relation to Pouring of Sterile Solutions
CARE OF WOUNDS
Definition
Purpose
Equipment
For Wound Irrigation Add
DRESSING OF WOUND
Procedure
Guidelines to use Sterile Package
Irrigating a Wound
STERILIZATION AND DISINFECTION TECHNIQUES
Definitions of the Terms Used in Sterilization
Methods of Sterilization
A. Sterilization by Heat
1. Dry Heat Sterilization
Definition
Types
Uses
Disadvantages
2. Moist Heat Sterilization
Definition
A. Autoclaving or Steam under Pressure
Precautions to be taken while using steam under pressure
Steam Sterilization, Temperature, Pressure and Time Requirements for different Items
B. Fumigation or Gas Sterilization
Definition
Uses
Disadvantages
C. Radiation
Definition
Uses
D. Filtration
Uses
Factors determining the effectiveness of chemical method
DISINFECTION
Definition
Types
Methods of Disinfection
A. Moist Heat
1. Boiling
Introduction
Advantages
Disadvantages
Points to remember, when boiling is used for disinfection
2. Pasteurization
Definition
Methods
3. Low temperature (Sub-atmospheric) steam
B. Gases
C. Chemical Disinfection
Introduction
Uses
Advantages
Disadvantages
Rules to be followed when chemicals are used to disinfection
23:
Perioperative Nursing
OBJECTIVES
Introduction
Concept and Phases of Perioperative Patient Care
CONDITIONS REQUIRING SURGERY
Obstruction or Blockage
TYPES OF SURGERY
Ambulator Surgery
Extent of Surgery
CATEGORIES OF SURGERY BASED ON URGENCY
TYPES OF SURGERY ACCORDING TO PURPOSE
PREOPERATIVE NURSING CARE
Introduction
Age
Presence of Pain
Nutritional Status
Fluid and Electrolyte Balance
Infection
Cardiovascular Function
Pulmonary Function
Renal Function
Gastrointestinal Function
Liver Function
Neurological Function
Hematological Function
Use of Medications
Habits
Social History
Hematological Function
Nursing Interventions
Preoperative Assessment
General Guideline History
Physical Examination
Risk Factors for any Surgical Procedures
PHYSIOLOGICAL PREPARATION, DAY BEFORE SURGERY
SKIN PREPARATION FOR SURGERY
PHYSICAL PREPARATION
Preparation Involves
Preparation on the Day of Surgery
Legal Preparation—Informed Consent
Preoperative Teaching
Expected outcome
Prepares for Surgical Intervention
Check
Operative Consent
Drugs Commonly used as Pre-medication
Guidelines for Administration of Premedication
Preoperative Visit by Perioperative Nurse
Preoperative Visits
Preoperative Visit by Anesthesiologist
Before Meeting the Patient
Immediate Preoperative Preparation
Remove
THE PREOPERATIVE CHECKLIST
Preoperative Nursing Checklist
Transporting Patient to Operating Room
INTRAOPERATIVE NURSING CARE
Introduction
The Operating Room Team
Introduction
Daily Cleaning Schedule
Walls
Furniture
Lights
Operation Table
Diathermy Apparatus
Suction Apparatus
Anesthtic Machine
Cleaning the Operation Room
Floors
Cleaning in between the Cases
Collection and Disposal of used and Left over Items from Operation Room
Cleaning the Operation Room
Cleaning the Operation Room
Equipment
Re-Setting the Room
Contract Cleaning of Walls and Ceilings
Presterilized Basic Packs, Sterile Instrument Trays and Supplementary Packs
Swab Chart
Anesthesia Room
PRINCIPLES OF ASEPSIS IN OT
Introduction
BASIC RULES OF SURGICAL ASEPSIS
General
Handling of Transfer Forceps/Cheat Forceps
Draping
Guidelines for Nursing Action in Surgical Draping:
Delivery of Sterile Supply
Solutions
Putting a Sterile Cap
Putting on a Face Mask
Donning Cop and Mask
MASKS
Surgical Hand Scrub
GUIDELINES: SCRUBBING FOR AN OPERATION
Procedure for Timed Scrub (10 minutes)
Procedure for Stroke Count Method
GOWNING AND GLOVING
METHODS
Gowning
Putting on Sterile Gloves: Closed Method
Putting on Sterile Gloves: Open Method
Another Method
RECEPTION OF THE PATIENT IN OT
Introduction
On Arrival of the Patient at the Theater
Check and Record the following to Ensure Patient's Safety
Preanesthesia Preparation
In the Anesthesis Room
Before Induction
During Anesthesia
After Anesthesia
Guidelines for Nursing Actions in Positioning Patients
Commonly Used Operative Patient Position
SAFETY PRECAUTIONS IN OT
Introduction
Safety Precautions
Prevention of Accidents
2. Prevention of Fire (anti-static precautions)
Precautions
The Role of Circulating Nurse
Definition
The Role of the Circulating Nurse before Surgery
Role of the Circulating Nurse During Surgery
Role of Circulating Nurse before end of Surgery (i.e. Before Surgeon Sutures the Cavity)
Role of Circulating Nurse on Completion of Surgery
Role of Scrub Nurse
Definition
Role of Scrub Nurse Before Surgery
Role of Scrub Nurse at the commencement of Surgery
Role of Scrub Nurse Before Surgeon Sutures the Cavity
Counting Swabs, Instruments and Needles in OT
General Rules to be followed for Counting Swabs in OT
COUNTING INSTRUMENTS
Introduction
General Rule to be followed in Counting Instruments in OT
Counting of Needles
Rules to be followed in counting needles in OT
Collection and Preservation of Specimens in QT
Introduction
Equipment Required
Nursing Measures
POSTOPERATIVE NURSING CARE
Immediate Postoperative Care in Recovery Room (RR) or Postanesthesia Care Unit (PACU)
Personnel in Postanesthesia Care Unit
Admission to Postanesthesia Care Unit
Postoperative Report and General Nursing Care for All patients in Recovery Room
Assessment Parameters
Postanesthesia Assessment
NURSING INTERVENTION
Maintaining Pulmonary Ventilation
Promoting Normal Temperature
Maintaining Fluid Balance
Preventing Injury
Relieving Pain
Observe
Discharge from Recovery Room
Transfer of Patient to Clinical Unit/Ward
Preparing Room for Patient's Return from Surgery
Patient Assessment on Return from Recovery Room
Guidelines for Postoperative Nursing Care
Ensure Circulation
Maintain Fluid and Electrolytes
Maintain Nutrition
Sputum Observation
Hygiene
Pressure Area Care
Record Urine Output
Encourage Micturition
Postoperative Evaluation
24:
Bandaging
OBJECTIVES
TYPES OF BANDAGES
According to Material Used
Types of Bandages According to Shape
General Purposes of Bandages
General Rules for Applying Bandages
Applying Roller Bandage
Basic Terms for Roller Bandages
Abdominal Binders
APPLICATION OF ELASTICATED TUBULAR BANDAGE (TUBIGRIP)
Definition
Purpose
Equipment
Procedure
BANDAGING
Spiral Bandaging
Figure of Eight Bandaging
Recurrent Bandaging
Spica Bandaging
BINDERS
Scultetus Binder
T-Binders
SPLINTING
a. Indications
Contraindications
b. Materials
c. Patient Education
d. Procedure/Technique
e. Complications
Compartment Syndrome
Prevention
Management
Pressure Sores
Heat Injury
Infection
Joint Stiffness
Documentation
25:
Managing Some Common Problems in Illness
OBJECTIVES
SUPRA PUBIC CYSTOSTOMY (SPC) DRAINAGE
Definition
Purposes
Equipment
Performance Phase (By Physician)
BLADDER IRRIGATION (BLADDER WASH)
Purpose
Equipment
Procedures
CONTINUOUS BLADDER IRRIGATION
Purpose
Irrigating Solution Used
Equipment
Procedures
SITZ BATH (HIP BATH)
Definition
Purposes
Solutions Used
Equipment
Procedure
COLOSTOMY AND ILEOSTOMY
Introduction
Definition of Colostomy
Definition of lleostomy
Classification
Indications for Colostomy and lleostomy
Nursing Care Management of Colostomy and lleostomy
STOMA CARE
Ostomy Sites
Purpose
Equipment
Procedure
Irrigation of Stoma
COLOSTOMY IRRIGATION
Definition
Purpose
Equipment
Procedure
INTRAPLEURAL DRAINAGE
Intrapleural Drainage Insertion of Under Water Seal Chest Drain
Definition
Purpose
Equipment
Procedure
Outline of Procedure
Observation and Post-procedural Care
SPECIFIC NURSING ALERT
CHEST DRAINAGE
Chest Drainage System Changing Drainage Tubing Bottles
Definition
Indication
Equipment
Procedure
REMOVAL OF AN INTRAPLEURAL DRAIN
Equipment
Procedure
DRAIN DRESSING REDIVAC- CLOSED DRAINAGE SYSTEMS
Equipment
Procedure
CHANGING VACUUM BOTTLE
Equipment
Procedure
REMOVAL OF DRAIN, REDIVAC-CLOSED DRAINAGE SYSTEMS AND PENROSE ETC-OPEN DRAINAGE SYSTEMS
Equipment
Procedure
DRAINAGE DRESSING CORRUGATED AND NAUNTON MORGAN DRAINAGE ENROSE, PAUL'S TUBING SYSTEMS
Equipment
Procedure
Minimum Drainage
Copious Drainage
Nursing Care Plan
26:
Assisting Diagnostic Measures
OBJECTIVES
PLEURAL ASPIRATION
Definition
Purpose
Equipment
Procedure
Preparatory Phase
Performance Phase
LIVER BIOPSY
Assisting in Liver Biopsy
Definition
Indication
Contraindications
Equipment
Procedure
Procedure Phase
Follow-up Phase
ASSISTING IN ANTRUM PUNCTURE AND ANTRAL WASHOUT
Introduction
Purpose
Indication
Equipment
Procedure
GASTRIC LAVAGE
Definition
Purpose
Equipment
PARACENTESIS
Definition
Purposes
Equipments
LUMBAR PUNCTURE
Definition
Purpose
Equipment
Procedure
Preliminary Assessment / Preparation of Patient
Performance Phase (By the Physician)
Follow up Phase
BONE MARROW ASPIRATION AND BIOPSY
Definition
Purposes
Equipment
Procedure
Preliminary Assessment
Doctor
Procedure
Nurse Responsibility
ASSISTING WITH ESOPHAGO-GASTRO-DUODENOSCOPY
Definition
Purpose
Equipment
Procedure
27:
Managing Emergency
OBJECTIVES
MANAGEMENT OF PATIENT WITH CARDIAC MONITOR
Cardiac Monitor
Purposes of a Cardiac Monitor
BASIC COMPONENTS OF A CARDIAC MONITOR
1. Oscilloscope
2. Rate Indicator
3. Alarm
4. Sweep Speed
5. Central Console
Problems
OPERATION OF CARDIAC MONITORS
Electrodes
EGG Electrode Placement
Reasons for Using Chest for Placement of the Electrodes
Procedure for Attachment of Electrodes
A few General Rules are Suggested
Major Responsibilities of the Nurse
Cardiac Arrhythmias
Disturbance in Impulse Formation
Site of Origin
Mechanism
Disturbance in Impulse Conduction
ECG Interpretation
Ventricular (QRS) Rate
QRS Rhythm
P Waves
QRS Width
Sinus Rhythm, Tachycardia and Bradycardia
Sinus Bradycardia
Going off the Monitor
CENTRAL VENOUS PRESSURE (CVP) MONITORING
Indications
Purpose
Description
Insertion and Position of the Patient
Anatomy
Preparation of the Patient
Inserting the Catheter
CVP MONITORING WITH WATER MANOMETER
Articles Required
Procedure
Measurement of CVP
Data Interpretation
Complication
Care and Maintenance
Dressing Change
Removal
INTRAVENOUS CUT DOWN
Definition
Purposes
Equipment
Principles to be Applied through the Preparation and Procedure
NURSING MANAGEMENT OF UNCONSCIOUS PATIENT
Unconsciousness
Coma
Conscious
Clinical Manifestation of Unconsciousness
Diagnostic Procedures
Laboratory Tests
Etiology and Risk Factors
Pathophysiology
Emergency Care
Nursing Intervention
Procedure
NURSING CARE PLAN
Special Consideration
CARDIOPULMONARY RESUSCITATION
Objectives
HEART ATTACK
What is Heart Attack
YOU AND YOUR CHOLESTEROL
Why is my cholesterol important ?
What is Cholesterol
Why Does High Cholesterol Occur
How do I find out Whether I Have a Cholesterol Problem
What are Saturated Fats
What are Unsaturated Fats
What are Lipoproteins
What is the Normal Blood Cholesterol Level
What can I do if I Need Treatment
Can cholesterol be reduced with medicines
What's the bottom line on cholesterol
EMERGENCY CARDIAC CARE
Definition
Cardiac Arrest
Resuscitation
Clinical Death
Biological Death
BCLS (Basic Cardiac Life Support)
What is CPR
Why CPR training is needed
Chain of Survival
For Your Health
How your body works
Did You Know
Cardiovascular Disease
Warning Signs for Heart Attack and Stroke
Risk Factors for Cardiovascular Disease
Indication for BCLS (Basic Cardiac Life Support)
Performing CPR on the adult victim by two rescuers (Two Men) CPR
Monitoring the Victim
About Disease Transmission
Precaution for Health Professionals
Barrier Devices
FOREIGN BODY AIRWAY OBSTRUCTION (CHOKING)
Cause of Upper Airway Obstruction
Tongue
Vomit
Foreign Body
Swelling
Spasm
Degree of Airway Obstruction
Partial Airway Obstruction
Complete Airway Obstruction
Self Choking
28:
Quality Management
OBJECTIVES
DEFINITION OF QUALITY
DEFINITION OF QUALITY MANAGEMENT
HISTORY OF QUALITY MANAGEMENT
GOALS OF QUALITY MANAGEMENT
IMPLICATIONS FOR NURSING PRACTICE
IMPLICATION FOR NURSING ADMINISTRATION
COMPONENTS OF QUALITY MANAGEMENT
QUALITY ASSESSMENT AND IMPROVEMENT
Risk Management and Safety
Health Care Risks
Risks to the Individual Nurse Professional
Risks to the Health Care Employer
Risks to the Patients, Client, or Visitors
Risks to the General Public
Safety
Safety in Health Care
Infection Control
Epidemiology
The Scientific Basis for Infection Control
Nosocomial Infection Rates and Types
Infection Control and Nursing
Utilization Management
29:
First Aid
OBJECTIVES
DISCUSS TYPE OF BANDAGES
WHAT IS FIRST AID?
AIMS OF FIRST AID
PRINCIPLES OF FIRST AID
Keep Calm
Identify Yourself
Evaluate the Situation
Protect the Accident Scene
Keep Bystanders Away
Be Aware of Common Responses at an Accident Scene
Make the Victim Comfortable
Keep the Victim Lying Down (if possible)
Check the Victim for ID
Examine the Victim
Never Permit the Victim to Know the Extent of Injury
Prepare for the Worst
Rules of First Aid
FIRST AID FOR FIRE AND BURNS
Introduction
Causes
Types of Burns
First-Degree Burns
Second-degree (partial thickness) Burns
Third-degree (full thickness) Burns
Immediate Treatment for Burn Victims
Prevention
Burn Prevention
Fire Work Safety
Health Education
FRACTURES
Type of Fractures
Causes
Effect
First Aid Tips—Fractures
Look out for/Indication
Signs and Symptoms of a Fracture
Management of Fractures
A. Using Bandages
B. Using Splints
MANAGEMENT OF FRACTURES WITH DIFFERENT AREAS
Fracture Collar Bone
Symptoms and Signs
Management
FRACTURE UPPER ARM
Symptoms and signs
Management
FRACTURE FOREARM
Symptoms and signs
Management
FRACTURE OF THE HANDS AND THE FINGERS
Symptoms and Signs
Management
FRACTURE THIGH
Symptoms and Signs
Management
FRACTURE NECK OF THE THIGH BONE
Symptoms and Signs
Management
FRACTURE HIP
Symptoms and Signs
Management
FRACTURE KNEECAP
Symptoms and Signs
Management
FRACTURE LOWER LEG
Symptoms and Signs
Management
FRACTURE FEET AND TOES
Symptoms and Signs
Management
FRACTURE ANKLE
Symptoms and Signs
Management
FIRST AID FOR ACCIDENT
Road Traffic Accidents
Approaching the Scene
Examine the Scene
Control the Scene
Assess the Scene
Attending the Casualties
Treatment of Casualties
FIRST AID FOR POISONING
What is a Poison?
Causes
Symptoms
First Aid
Call Immediately for Emergency Medical Assistance
Prevention
FIRST AID FOR FOOD POISONING AND POISONOUS PLANTS
Prevention of Food Poisoning
Treatment of Food Poisoning
Poisonous Plants
Treatment of Ingestion of Poisonous Plants
DO NOT Attempt to Induce Vomiting
Poison in Eye
Poison on Skin
DROWNING
To Prevent Drowning
What to Check
First Aid for Drowning
Important
First Aid for Drowning Victims
Immediate Treatment
FIRST AID FOR BLEEDING
Causes, Prevalence and Risk Factors
Types of Bleeding
Hemorrhage in the Brain
First Aid
Minor Traumatic Bleeding
Severe Traumatic Bleeding
Immediate First Aid
Severe Bleeding
Externalized Bleeding
Internal Bleeding
RISK OF BLOOD CONTAMINATION
FIRST AID FOR AN INSECT BITE
Home Treatment
First Aid for Insect Bites
Signs of an Allergic Reaction to Insect Bite
Prevention
FOREIGN BODIES
Free Floating Foreign Bodies
Adherent or Embedded Foreign Bodies
Penetrating Foreign Bodies
Nose
Ears
Splinters
Stab Wounds (knives, sharpnel, or other weapons)
Transportation of the Injured
Emergency Vehicles, Equipment, and Supplies
30:
Rehabilitation Aspects of Nursing Care
OBJECTIVES
DEFINITION
PHILOSOPHY OF REHABILITATION
PRINCIPLES OF REHABILITATION
BASIC PRINCIPLES OF REHABILITATION
DEVELOPMENT OF REHABILITATION TO MOVEMENT
ASSISSTIVE DEVICES
OTHER REHABILITATION TECHNIQUES
ELECTRICAL STIMULATION
THERMAL APPROACHES
REHABILITATION OF WALKING PROBLEMS
CANES
WALKERS
ORTHOTICS OR BRACES
Important Principles to follow when using Neck Supports
Amputations and Prostheses
The use of Prostheses is Governed by the following Principles
The Use of Wheel Chairs
Transferring from one Place to Another
Stroke Rehabilitation
Hip Fracture Rehabilitation
Rehabilitation if You Need an Amputation
Common Medical Problems during Rehabilitation
Rehabilitation Process
1. Referral
2. Assessment
3. Treatment
4. Discharge
5. Follow-up
Rehabilitation Team
Role of a Nurse in Rehabilitation
Practitioner
Care Coordinator
Advocate
Educator
Consultant
Researcher
Functions of the Home Care Rehabilitation Nurse
Assessment
Data Analysis and Formulation of a Nursing Diagnosis
Establishment of Goals and Plan of Care
Implementation
Collaboration
References
INDEX
TOC
Index
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