Nurse Assistant SkillsNurse assistants are important members of the health care team
Measuring and RecordingIntake and Output
Measuring and RecordingIntake and Output(continued)
Intake: fluids taken in by patientWhat is included in intakeOutput: fluids eliminated by patientWhat is included in outputRecords must be accurateFluids usually measured by metric system
Measuring and RecordingIntake and Output(continued)
Agencies follow different policies for recording I&O
Careful instructions should be given to patients on I&O
Standard precautions
Feeding a Patient
Good nutrition is an important part of a patient’s treatment
Make mealtimes as pleasant as possibleMealtimes are regarded as social time Proper preparation for mealtimeDelay of mealsCheck food tray
Feeding a Patient
Allow patient to feed themselves whenever possible
Test temperature of foodPrinciples to follow while feedingRelaxed, unhurried atmosphereObserve amount eaten Observe for any signs of choking
Assisting with a Bedpan/Urinal
Elimination of body waste is essentialTerminologyMany patients sensitive about using
bedpan/urinalAccurate observations importantStandard precautionsUse of gloves important
Providing Catheter andUrinary-Drainage Unit Care
Catheters: hollow tubes usually made of rubber or plastic
French or straight catheterFoley catheterExternal condom catheterUrinary-drainage unitsLeg bags for ambulation
Providing Catheter and Urinary-Drainage Unit Care
Careful observation of catheter and drainage unit
When catheter and urinary-drainage unit in place, preferable never to disconnect unit
If necessary to disconnect catheter, follow agency policy
Catheter care
Providing Catheter andUrinary-Drainage Unit Care
Observation of urineFollow correct procedure to empty
drainage unit to prevent contamination and infection
Bladder training programKeep records
Summary
Assisting patient with intake and output important part of care
Provide privacy and respect patient’s rights at all times
Observe standard precautionsFollow correct procedures
Collecting Stool/Urine Specimens
Laboratory tests are performed on specimens to detect disease
Specimens must be collected correctly for tests to be accurate
Routine urine specimenClean-catch or midstream-voided urine
Collecting Stool/Urine Specimens
Sterile catheterized urine specimen24-hour urine specimenRoutine stool (feces) specimenStool for occult bloodLabel all specimens correctlyUse standard precautions
Enemas and Rectal Treatments
Enemas◦Retention enemas◦Nonretention enemas
Types of enemas◦Cleansing◦Disposable◦Oil retention
Enemas and Rectal Treatments(continued)
Impactions—removed by licensed or advanced care provider
Rectal tubeSuppositories
Summary
Enemas and rectal treatments cannot be administered without a doctor’s order
Follow correct procedures at all timesObserve standard precautions to prevent
spread of infection
Applying Restraints
Chemical restraints—medicationsPhysical restraints—protective devicesConditions that may require restraintsTypes of physical restraintsPoints to remember when using restraintsComplications of restraints
Applying Restraints
Most health care facilities have specific rules and policies regarding the use of restraints
Be aware of legal responsibilities
Administering Oxygen
Blood must have oxygenSigns of oxygen shortageDeficiency of oxygen (hypoxia)Methods of administration of oxygenWays of providing oxygen to the patient Humidifier
Administering Oxygen(continued)
Safety precautionsPulse oximetersPoints to check while oxygen in useLegal considerations
Giving Postmortem Care
Care given to the body immediately following death
Begins when a doctor has pronounced the patient dead
Difficult but essential part of patient care
Giving Postmortem Care
Dealing with death and dyingPatient’s rights apply after deathFamily member may want to view bodyProcedure for postmortem care will vary
with different facilities
Giving Postmortem Care
Morgue kitsCare of valuables and belongingsTwo people often work together to
complete careObserve agency policy
Summary
The nursing assistant provides quality personal care for patients
Many skills are required to perform approved procedures
Standard precautions must be observedRecord observations carefullyKnow your legal responsibilities
Measuring and RecordingIntake and Output
A large part of the body is fluid, so there must be a balance between the amount of fluid taken into the body and the amount lost from the body
Swelling and edema DehydrationIntake and output (I&O) forms vary
between facilities