Assisting in thoracentesis

Guide in assisting in thoracentesis:

1. Ascertain in advance if chest Roentgenograms and or other test has been prescribed or completed for accuracy and guides the physician the extent of injury of the lungs. This should be available at the bedside.

2. See if consent from has been explained and signed.

3. Determine if the client is allergic to the ideal anesthetic agent to be used. Give sedation if prescribed.

4. Explain the procedure to client and indicated how he can be helpful. Discuss the following:
         a. Nature of the procedure
         b. Importance of remaining immobile/ refraining from coughing.
         c. Pressure sensation to be experienced.
         d. No discomfort is anticipated after the procedure.
         e. Readjust gown if needed; put lining (draw sheet/ draw sheet).
         f. Ask permission from client to arrange for the procedure.

Wound Dressing

A guide to wound dressing.

1. For proper identification of the patient, check the chart for doctor's order, name of patient, dressings, solutions and ointment to be used.

2. Explain to the patient the following: procedure, purpose and use of overbed table and garbage can.

3. Clean overbed table.

4. Put garbage can near to the patient's bedside (remove cover).

5. Leave patient to prepare things for dressing.

Urine Testing for Sugar and Ketone

Urine Testing is a test to determine the amount of sugar and ketone in the urine.


Materials:

1. Fresh Urine from patients in a clean container.
2. Clinitest reagent tablet as indicated, acetest tablet as indicated, Benedict's solution as indicated.
3. Test tube, clean and dry
4. Index card
5. Medicine Dropper
6. Alcohol lamp


Procedure:


Urine Collection

Hot and Cold Application

Hot and Cold application is the application of dry, moist or wet form to the body; either hot or cold.






Indications:

a.) Hot application
   1. Relief of swelling.
   2. Relief of pain caused by deep congestion.
   3. Healing of wounds, removal of toxin.
   4. Reduction of muscle spasm.
   5. Relief of fatigue.
   6. Elimination.
   7. Warmth, comfort.

Cardiopulmonary Resuscitation (CPR)

Cardiopulmonary Resuscitation (CPR) is the combination of artificial respiration and manual artificial circulation that is recommended for the use in cases of cardiac arrest. It requires special supplemental training in the recognition of cardiac arrest and the performance of CPR.

CPR is the combination of mouth to mouth breathing which supplies oxygen to the lungs and chest compression which circulates blood.


Purpose of Cardiopulmonary Resuscitation:

To provide oxygen to the brain, heart and to vital organs until appropriate definite medical treatment can restore the heart and ventilatory function.

Catheterization

Catheterization is the emptying the bladder with the use of a sterile catheter.

Indications:

1. Urinary retention due to surgery, childbirth or trauma of the urinary tract.
2. Pre-operative measure as a precaution to prevent possible surgical error in identifying abdominal organs.
3. Collection of urine specimen for diagnosis.
4. Adjust for bladder irrigation and instillation.
5. Other urinary disturbances: Incontinence, polyuria, dysuria, oliguria and enuresis.

Procedure:
1. Secure doctor's order for catheterization to make sure that drug being administered and the patient being attended is the right one.

Perilite Exposure

Perilite Exposure is the application of dry heat to the perineal area to provide comfort. It increases blood circulation and hasten wound healing.

Materials Used:

1. Perilite or heat lamp
2. Blanket
3. Perineal flushing set

Procedure:

1. Review physician's order.

2. Gather equipments and check it for safety factors i.e. frayed cords, bulb in place.

3. Bring lamp to patient's room.

Perineal Flushing

Perineal Flushing for Female

Materials:

1. 1 flushing can with warm water
2. 1 pick-up forceps sealed with antiseptic solution
3. 1 flushing forceps sealed with antiseptic solution
4. 1 bottle with dry sterile cotton ball
5. 1 waste receptacle

Procedure:

1. Explain the procedure to the patient. Screen the bed. Lock the door if in private room. This provide privacy to clients and minimizes anxiety during procedure that is often embarrassing to nurses and clients.

TPR

Temperature is the balance between heat produced and heat lost is measured by a clinical thermometer (mercury, glass, electronic or tape thermometer)

Pulse is the force of blood from the left ventricle as it flows into the arterial circulation.

Respiration is the continued process of drawing in and expelling of air from the lungs; taking of O2 and elimination of CO2, H2O and other products of oxidation.



Equipments to be Used:

1. Oral Thermometer
2. A box of tissue wipes
3. Wastes receptacle
4. Medicine tray
5. Watch with a second hand

Taking Blood Pressure

Blood Pressure is the force exerted by the blood against a vessel wall.


Equipments:

1. sphygmomanometer
2. stethoscope
3. jot down pad and pen

Procedure:

1. Inspect equipment for defects to avoid stopping n the middle of the procedure or cause any delays.

2. Wash hands.

3. Explain the procedure including the discomfort of a tightening cuff, the importance of relaxing the patient's arm and why silence during reading is preferred to the client.

4. Have client sit or lie down as preferred. Give her 15 minutes rest if client came in from the long walk under the heat of the sun or from exercise.

5. Position arm at heart level with palm up exposing patient's forearm.

Breast Care

Care rendered in preparation for breast feeding.

Materials Used:

A lined tray containing:
1. a jar/ bottle of clean cotton balls
2. lukewarm water in a container
3. kidney basin/ small bowl
4. waste container

Procedure:

1. Explain the procedure to the patient.

2. Prepare the necessary materials and perform medical handwashing.

3. Bring materials to the bedside and screen the patient.

Medical Handwashing Technique

Medical Hand washing is the mechanical removal of microorganisms from the hands and forearm with the use of soap and water.
 



Equipments Used:

1. bath soap in a soap dish
2. nail stick
3. hand towel

Points To Remember:

1. Jewelries must not be worn except for plain wedding rings for married individuals.
2. Fingernails should be short trimmed.
3. Fold sleeves approximately 2-3 inches from the elbows before starting the procedure.