what types of patients are at high risk for impaired skin breakdown? - answer a pt who
is bed bound or immobile
who is at high risk for safety issues? - answer nurses are at high risk for work related
injuries due to lifting, transferring and repositioning pt's
what is the importance of good body mechanics for the nurse and the pt? - answer to
prevent injury during activity
key terms of body mechanical and patient positions - answer base of support
center of gravity
dorsal/surpine
dorsal recument
fowlers
semi fowlers
semi fowlers
orthopneic
sims
prone
knee-chest
lithotomy
trendelenburg
turning a pt - answerside lying, dangling, log roll
transferring the pt - answerbed to chair, bed to gurney, mechanical lift
cool water bath - answerWater is tepid 98.6 F; relieves tension or lowers body
temperature.
warm water bath - answerWater is 109.4 F; Primarily to reduce muscle tension.
hot water bath - answerused to relieve muscle soreness or spasms; 113-115 F
medicated bath - answerMay include agents such as oatmeal, cornstarch, Burow's
solution, and soda bicarbonate
•To relieve symptoms or treat conditions of the skin
sitz bath - answera warm soak of the perineal area to clean perineal wounds and
reduce inflammation and pain; 98-110 F; takes 20-30 minutes
, why is it important for a nurse to take part in a pt's personal hygiene - answerto exam
the skin and evaluate the pt
what factors can influence the pt's personal hygiene? - answersocial practices
body image
socioeconomic status
knowledge
personal preference
physical conditions
cultural variables
what are some complicators of a Sitz bath? - answerwatch for signs of weakness
rapid/weak pulse
rapid breathing
dizziness
partial bath - answerbath that includes washing the face, underarms, hands, and
perineal area
complete bath - answerTotal body area washed. Usually refers to bed bath.
self care bath - answerpt baths self
is a nurse allowed to cur fingernails? - answera nurse is never allowed to cut fingernails.
if needed an order needs to be put in
oral care - answermaintaining healthy state of the mouth, teeth, gums, lips, dentures
hair care - answercombing, brushing, shampooing
Shaving care - answerusing an electric razor on pt's with a bleeding disorder
eye care - answerplain, clear water; cleanse from inner to outer eye using a separate
washcloth for each eye
ear care - answercleanse outside only with washcloth of cotton swab
nose care - answeruse tissues, clean washcloth, cotton swab, or suction when required
hand, foot and nail care - answer-Hands and feet often require special attention to
prevent infection, odors and injury
Assessment:
-Examine all skin surfaces
-Carefully assess between toes
-Observe for adequate circulation
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