POST-MORTEM CARE: ROLE OF THE NURSE

I. Purpose:
To clean the patient's body and prepare it for removal from the hospital after death.

II. Responsibilities of the Nurse

1. Care of the Valuables

a) Valuable with the patient at the time of death should be identified, accounted for and sent to the proper department of the institution for safe keeping until family claims for it.
b) Valuables taken or given to the patient's family should be voted on the form sheet specified by the institution.


2. Care of the body

a) Post mortem care of the body is not rendered unless the physician has pronounced the patient to be dead
b) Indicate the chart time the patient was pronounced dead and the physician pronouncing
c) Have the body cleaned and properly identified
d) If the patient is communicable the water used in cleaning must be medicated
e) Inform medico legal Officer if accident, suicide, homicide, or illegal therapeutic practices causes death
f) Prevent all means of distortion, discoloration or scarring of the body as it is distressed to the family.

3. Accomplishment of necessary papers related to death. Death certificate is sent to the local health Department. It is accomplished by the physician and signed by him and by pathologist if autopsy has been performed.

4. Attitude towards the family. Provide all means to comfort the family and relatives who may be around.

BED SHAMPOO: PERFORMANCE CHECK LIST

I. Purpose of bed shampoo

1. To cleanse the hair
2. To eliminate the oil glands
3. To stimulate circulation in the scalp
4. To remove excess oil
5. To remove dandruff

II. Preparation for bed shampoo

1. Kelly pad
2. Rubber sheet
3. Pitchers for water (2 Quarts capacity)
4. Shampoo
5. Three bath towels
6. Face towel
7. Washcloth
8. Rubber pillowcase
9. Cotton balls
10. Hair brush or comb
11. Large pail
12. Bath blanket
13. Lemon juice or vinegar
14. Sponge bowl
15. Bath thermometer

III. Procedure/Check list

1. Check the chart for a written order
2. Wash your hands
3. Explain the procedure and offer the bedpan or urinal
4. If able, assist the patient to sitting position. Arrange pillor and line with rubber sheet
5. Line with a (first) towel the rubber sheet
6. Place kelly pad or rolled rubber sheet and line it with the second towel
7. Assist patient to recumbent position with the kelly pad under the patient's shoulders
8. Brush the hair thoroughly
9. Place one cotton ball to each ear.
10. Place the third towel over the chest
11. Place damp wash cloth over eyes
12. Test the temperature of the water
13. Wet the hair and apply shampoo. Rinse well
14. Wet the hair again and apply shampoo. Rinse well
15. Apply the lemon juice. Rinse with water
16. Remove the kelly pad or rolled rubber sheet and place it in the pail
17. Return pillo to its proper postion under the head
18. Remove earplugs and damp wash cloth.
19. Dry and comb the hair
20. Tidy up the place
21. Return articles to their proper places clean and dry
    

TEMPERATURE, PULSE RATE AND RESPIRATORY RATE: PERFORMANCE CHECK LIST

I. Definitions

1. Temperature - is the degree of heat maintained by the body as measured by a predetermined scale. It is the balance between the heat production and heat loss of the body
2. Pulse - the rhythmic expansion of an artery produced by increased volume of blood forced into by contraction of the left ventricle at each heart beat
3. Respiration - the exhange of gases between an organism and its environment

II. Preparations
A tray lining containing:

1. A wide mouth container containing cotton balls soaked on soap solution
2. A wide mouth container with plain water
3. A wide mouth container with clean oral thermometer in disinfectant solution
4. A wide mouth container with clean dry cotton balls
5. A wide mouth container for soiled cotton balls
6. A watch with swift second hand
7. Paper and pencil
8. Hand towel

III. Procedure/Check list

ORAL TEMPERATURE

1. Wash hands
2. Explain procedure to patient
3. Obtain proper thermometer
4. Wipe thermometer bulb to stem
5. Check for proper lighting
6. Shake the thermometer down to 35 degrees
7. Place the thermometer under the tongue
8. Instruct to gently close the mouth
9. Leave in place for eight minutes
10. Remove thermometer
11. Wipe thermometer from stem to bulb
12. Read thermometer at eye level
13. Place thermometer in container
14. Record finding

AXILLARY TEMPERATURE

1. Wash hands
2. Explain procedure and elicit cooperation
3. Pat the axilla dry
4. Obtain proper thermometer
5. Wipe thermometer from bulb to stem
6. Shake the thermometer down to 35 degrees
7. Place the thermometer in the axilla directed upward. Place arm across the chest
8. Leave thermometer in place for ten minutes
9. Remove and wipe the thermometer from stem to bulb
10. Read at eye level
11. Place the thermometer in the container
12. Record on a paper
13. Fix the sleeves of the client
14. Wash hands

RADIAL PULSE

1. Wear watch with swift second hand
2. Explain procedure to patient
3. Place patient's arm across the chest
4. With gentle pressure, place first three fingers against the radial artery
5. Feel for pulsation
6. Count for one full minute
7. Record on a paper

RESPIRATION

1. With fingers still in place, after taking pulse rate, note the rise and fall of the pateint's chest
2. Count for one full minute
3. Record for one full minute
4. Transfer the readings in the patient's chart
   

BLOOD PRESSURE TAKING: PERFORMANCE CHECK LIST

I. Definition
Blood Pressure - the force exerted by the blood against the walls of the blood vessels as it flows through them.

II. Preparation
A tray with the lining containing the following:

1. Sphygmomanometer
2. Stethoscope
3. Cotton balls soaked in alcohol
4. Wash cloth or hand towel
5. Waste container
6. Tissue paper to line the BP cuff

III. Performance check list

1. Wash hands and gather equipment
2. Wipe the earpieces of the stethoscope with cotton balls
3. Explain the procedure to the patient
4. Apply blood pressure cuff on arm
5. Locate patient's brachial artery.
6. Place earpieces of stethoscope into the ears
7. Close valve on hand bulb.
8. Place diaphragm of the stethoscope over the brachial artery
9. Pump hand bulb to 30 mmHG. Above last beat heard.
10. Note first sound, muffling and last sound heard.
11. Remove cuff from patient's arm and earpieces of the stethoscope from own ears.
12. Wipe earpieces with cotton balls soaked in alcohol
13. Record appropriately, including narrative if necessary.
14. Return the apparatus to its proper place.
15. Wash hands.
    

ROUTINE DAILY CARE FOR THE PATIENT: BED BATH

Purpose:

1. To clean the skin thus eliminate waste products
2. To stimulate circulation through slightly active or entirely passive exercises
3. To refresh the patient by relieving fatigue and discomfort

I. Preparation
Equipments: A tray containing the following:

1. Basin with warm water of 105-110 degrees Fahrenheit
2. Two (2) bath towels
3. Two (2) wash cloth
4. Drinking glass
5. Toilet articles
6. Hair brush
7. Comb
8. Tooth brush and tooth paste
9. Scissors
10. Powder
11. Toilet Soap
12. Deodorant
13. Bath blanket
14. Two (2) pitchers
15. Bath thermometer

II. Procedure

1. Wash your hands (as always.. hmm..)
2. Screen the bed
3. Replace top sheet with bath blanket
4. Remove gown
5. Put one towel under patient's head and one on the chest
6. Test temperature of water
7. Dip washcloth in warm water. Sponge face, ears, neck. Rinse and dry.
8. Place bath towel under arm and shoulder from you. Sponge axilla. Rinse and dry.
9. Soak hands in basin of water. Soap and rinse.
10. Drape chest and abdomen with bath towel. Sponge, rinse and dry.
11. Turn patient towards you. Cover back after sponge. Massage. Use firm long strokes.
12. Place towel under leg. Drape well. Sponge, soap, rinse and dry.
13. "FINISH THE BATH" (you may be asking what "finish the bath means", i'll post it next.^_^)
14. Apply deodorant. Remake bed. Comb patient's hair, clean nails.
15. Leave until unit is neat, order and clean.

I'll post some pictures too.. I have no more time now. Gotta go to sleep! hehe! Hope this can help! ^_^

BEDMAKING

I. Definition

1. Bed making - is the art of arranging linens
2. Closed Bed - is used to designate the hospital bed which remains empty after admission of another patient.
3. Open bed - used to designate the hospital bed when it is occupied or about to be occupied by a patient.
4. Ether bed or anesthetic bed - is one which it is made ready to receive a patient who has undergone anesthesia.

II. Preparation

1. 2 white sheets
2. 1 draw sheet
3. 1 rubber sheet
4. 1 bath towel
5. 1 hand towel
6. 1 face towel
7. 1 pillow
8. 1 pillow case
9. 1 bedspread
10. 1 blanket

III. Procedure

CLOSED BED

1. Arrange the linens in order as they are needed
2. Bring the preparation to the bedside of the patient
3. Take the bottom sheet; spread it on the mattress, placing the smaller hem at the foot part. Place it lengthwise on the middle of the mattress with the side equidistant from the center
4. Tuck the sheet under the head of the mattress. Miter the corner along the near side.
5. Place the rubber sheet 18 inches from the head part of the mattress. Place the draw sheet.
6. Spread top sheet on the mattress with wrong side up, making even the edges of the bed. Draw all linens tight and tuck under the mattress.
7. Fold top sheet back to 18 inches
8. Place the pillow case and put it at the head part of the bed. Cover with top sheet.
9. Fold the towel into three sections and fold into two.
10. Hang over at the top of the bed with free or loose ends out of sight

OPEN BED

1. Prepare the materials needed (same as closed bed)
2. Replace the top sheet with bath blanket. Loosen all the bed linens from all sides of bed. Go to opposite side of bed and draw the patient towards you. Return to the work side of the bed.
3. Fanfold the bottom sheet, rubber and draw sheets in irregular folds to the center of the bed.
4. Place a clean bottom sheet, the rubber sheet and the draw sheet on the bed in the position described for closed bed.
5. Tuck the top sheet, miter the corner then pull the loose ends on the bed and the draw sheet. Tuck in together with the bottom sheet.
6. Fanfold the halt of the clean sheet close to the patient along with the half of the rubber sheet and the draw sheet.
7. Roll the patient gently over the folded sheets to the near side of the bed.
8. Go around to the other side of the bed, remove the soiled bottom sheet and pull the fan folded sheet at the side and make bed as it was done on the opposite side. Fold the soiled linens and place it at the foot part of the bed.
9. Remove the bath blanket and put on the top sheet. Miter the corner as in the closed bed but care is taken that they are loose enough at the foot top to prevent pressure on the patient's feet.
10. Straighten the upper edge of the cover, fold neatly and put clean pillow
11. Change the soiled wash cloth, bath and hand towels with fresh ones.
12. Rerturn chair and bedside table to proper place
13. Place all soiled linens in the linen hamper.
    

THE EVER BELOVED,EVER FAMOUS, HANDWASHING!

HANDWASHING
- is the single most important, least expensive method in preventing and controlling transmission of infections

PURPOSE:

1. Reduce number of resident and transient bacteria from the hands
2. Prevent transfer of microorganisms from hospital environment to patient and from patient to hospital personnel

Handwashing was our 2nd exposure to RLE.

MISSION 2:
HANDWASHING:
MISSION ACCOMPLISHED

weee! congratz! hehe! ^_^

DUSTING: OUR VERY FIRST EXPOSURE TO RLE!! WAAA!

DUSTING

PRINCIPLES:

1. HAVE EVERYTHING READY BEFORE STARTING TO WORK
2. BEGIN WORKING FROM TOP TO BOTTOM

PROCEDURE:

1. FILL BASIN HALF FULL OF WATER. BRING PREPARATION TO THE UNIT. PLACE TRAY ON TABLE NEVER ON FLOOR
2. DUST UPPER PART GRADUALLY TO BOTTOM PART
3. FORM THE HABIT OF ONE STROKE
4. DUST IN ONLY ONE DIRECTION
5. WRAP THE CLOTH AROUND YOUR HAND & GRASP THE BAR. DRAG YOUR HAND ALONG SURFACES
6. REMOVE DUST FROM CREVICES BY PROVIDING A STICK WITH ONE END ROUND WITH CLOTH
7. NEVER FORGET TO DUST THE PART OF THE BED & ARTICLES THAT ARE OUT OF SIGHT.

MISSION 1:
DUSTING:
MISSION ACCOMPLISHED!
WOHOOO! HEHEHE! ^_^