Exam 2 CH 31/33

Question 1

Factors the affect Personal Hygiene

Answer 1

• Culture -Socioeconomic Class
• Spiritual Practices - Developmental Level
• Health State - Personal Preferences

Question 2

Questions to ask during Nursing Assessment

/ Skin Alterations

Answer 2

• How long have you had this problem
• Does it bother you?
• How does it bother you (itching)?
• Have you found anything helpful in relieving these symptoms?

Question 3

Guidelines for assessing the skin

Answer 3

• use a good light source
• compare bilateral parts for symmetry
• Use standard terminology to report and record findings
• allow data obtained in the nursing history to direct the skin assessment
• Identify any variables known to cause skin problems.

Question 4

Oral Cavity Assessment

Answer 4

A physical assessment involves inspection of the oral cavity and surrounding structures with attention to any unusual odors. Examine the following

• Lips: color, moisture, lumps, ulcers, lesions, and edema
• Buccal mucosa: color, moisture, lesions, nodules, and bleeding
• Color of the gums and surface of the gums: lesions, bleeding, and edema
• Teeth: any loose, missing, or carious (decayed) teeth. Note the presence and condition of dentures or other orthodontic devices
• Tongue: color, symmetry, movement, texture, and lesions
• Hard and soft palates: intactness, color, patches, lesions, and petechiae (pinpoint round, red, purple, or brown spots that result from bleeding)
• Oropharynx: movement of the uvula and condition of tonsils, if present

Question 5

Define: Pediculosis

What are the three types of lice?

Answer 5

Infestation of Lice

• Pediculus Humanus Capitis: Lice infests hair and scalp
• Pediculus Humanus Poris: Lice infests the body
• Phthirus Pubis: Lice infests shorter hairs. Pubic and Auxillary

Question 6

Signs and symptoms of head lice

Answer 6

• Tickling feeling on scalp; itching; sores on the head caused by scratching.
• Irritability and difficulty sleeping (head lice are most active in the dark).
• Lice may be seen especially behind the ears and near the neckline at the back of the neck.

Question 7

Treatment of head lice

Answer 7

• Apply a pediculicidea according to the manufacturer’s directions.
• Hats, scarves, pillowcases, bedding, clothing, and towels worn or used by the infested person in the 2-day period just before treatment is started can be machine washed and dried using the hot water and hot air cycles (lice and eggs are killed by 5 minutes of exposure to temperatures greater than 130°F)
• Items that cannot be laundered may be dry-cleaned or sealed in a plastic bag for 2 weeks.
• Soak combs and brushes in hot water (at least 130°F) for 5 to 10 minutes

Question 8

Early Morning/ Morning Care (After Breakfast)

Answer 8

• Washing up/ Personal Hygiene
• Assist with using the bathroom
• Oral Care
• Hair Care/ Cosmetics
• Dressing
• Changing bed linens
• Repositioning body to be more comfortable
• Tidying up room

Question 9

Afternoon Care PM care (After Lunch)

Answer 9

• Offer assistance toileting, handwashing, oral care
• straighten bed linens
• reposition body if needed.

Question 10

Night Care (Before patient retires)

Answer 10

• offer assistance with toileting, washing, and oral care
• offer back massage
• change soiled linens or clothing
• reposition body for patient to be comfortable
• ensure call light and other items patient needs are within reach.

Question 11

As Needed Care

Answer 11

• offer individual hygiene measures as needed
• change clothes and bed linens of diaphoretic (sweating Heavily) patients
• Provide oral care every 2 hours if indicated.

Question 12

Benefit for providing back massages

Answer 12

• Acts as a general body conditioner
• Relieves muscle tension and promotes relaxation
• Provides opportunity to perform a skin assessment
• Improves Circulation
• May decrease pain, distress, and anxiety
• improve sleep quality
• means of communication through touch

Question 13

Providing Oral Care Skills (11 Steps

Answer 13

1. Perform hand hygiene and put on gloves if assisting with oral care, and/or other PPE, if indicated.
2. Identify the patient. Explain the procedure to the patient.
3. Assemble equipment on overbed table or other surface within patient’s reach.
4. Close the room door or curtains. Place the bed at an appropriate and comfortable working height; usually elbow height of the caregiver (VHACEOSH, 2016).
5. Lower side rail and assist the patient to a sitting position, if permitted, or turn the patient onto side. Place towel across the patient’s chest.
6. Encourage the patient to brush own teeth according to the following guidelines. Assist, if necessary.
   a. Moisten toothbrush and apply toothpaste to bristles.
   b. Place brush at a 45-degree angle to gum line and brush from gum line to crown of each tooth. Brush outer and inner surfaces. Brush back and forth across biting surface of each tooth.
   c. Brush tongue gently with toothbrush.
   d. Have patient rinse vigorously with water and spit into emesis basin. Repeat until clear. Suction may be used as an alternative for removal of fluid and secretions from the mouth.
7. Assist patient to floss teeth, if appropriate:
   a. Remove approximately 18 in of dental floss from container or use a plastic floss holder. Wrap most of the floss around one of the middle fingers. Wind the remaining floss around the same finger of the opposite hand, keeping about 1 to 1.5 in of floss taut between the fingers.
   b. Insert floss gently between teeth, moving it back and forth downward to the gums.
   c. Move the floss up and down, first on one side of a tooth and then on the side of the other tooth, until the surfaces are clean. Repeat in the spaces between all teeth and the backside of the last teeth.
   d. Instruct patient to rinse mouth well with water after flossing.
8. Offer a mouth rinse if patient prefers or if use has been recommended.
9. Offer lip balm or petroleum jelly.
10. Remove equipment. Remove gloves and discard. Raise side rail and lower bed. Assist patient to a position of comfort.
11. Remove any other PPE, if used. Perform hand hygiene.

Question 14

Making an Unoccupied Bed

SKILL 31-4 pg. 1029

Answer 14

1. Perform hand hygiene. Put on PPE, as indicated.
2. Explain to the patient what you are going to do and the reason for doing it, if the patient is present in room.
3. Assemble necessary equipment on the bedside stand, overbed table, or other surface within reach.
4. Adjust the bed to a comfortable working height, usually elbow height of the caregiver (VHACEOSH, 2016). Drop the side rails.
5. Disconnect call bell or any tubes from bed linens.
6. Put on gloves. Loosen all linen as you move around the bed, from the head of the bed on the far side to the head of the bed on the near side.
7. Fold reusable linens, such as sheets, blankets, or spread, in place on the bed in fourths and hang them over a clean chair.
8. Snugly roll all the soiled linen inside the bottom sheet. Hold linen away from your body and place directly into the laundry hamper. Do not place on floor or furniture. Do not hold soiled linens against your clothing.
9. If possible, shift mattress up to head of bed. If mattress is soiled, clean and dry according to facility policy before applying new sheets.
10. Remove your gloves, unless indicated for transmission-based precautions. Place the bottom sheet on the mattress and secure the bottom sheet over the corners at the head and foot of the mattress.
11. Push the sheet open to the center of the mattress, pulling the sheet taut from the secured corners.
12. If using, place the drawsheet with its centerfold in the center of the bed and positioned so it will be located under the patient’s midsection. Open the drawsheet and fan-fold to the center of the mattress. If a protective pad is used, place it over the drawsheet in the proper area and open to the centerfold. Not all facilities use drawsheets routinely. The nurse may decide to use one. In some institutions, the protective pad doubles as a drawsheet. Tuck the drawsheet securely under the mattress.
13. Move to the other side of the bed to secure bottom linens. Pull the bottom sheet tightly and secure over the corners at the head and foot of the mattress. Pull the drawsheet tightly and tuck it securely under the mattress.
14. Place the top sheet on the bed with its centerfold in the center of the bed and with the hem even with the head of the mattress. Unfold the top sheet. Follow same procedure with top blanket or spread, placing the upper edge about 6 in below the top of the sheet.
15. Tuck the top sheet and blanket under the foot of the bed on the near side. Miter the corners.
16. Fold the upper 6 in of the top sheet down over the spread and make a cuff.
17. Move to the other side of the bed and follow the same procedure for securing top sheets under the foot of the bed and making a cuff.
18. Place the pillows on the bed. Open each pillowcase in the same manner as you opened other linens. Gather the pillowcase over one hand toward the closed end. Grasp the pillow with the hand inside the pillowcase. Keep a firm hold on the top of the pillow and pull the cover onto the pillow. Place the pillow at the head of the bed.
19. Fan-fold or pie-fold the top linens.
20. Secure the signal device on the bed, according to facility policy.
21. Raise the side rail and lower the bed.
22. Dispose of soiled linen according to facility policy.
23. Remove any other PPE, if used. Perform hand hygiene.

Question 15

Making an Occupied Bed

SKILL 31-5 pg. 1032

Answer 15

1. Check health care record for limitations on patient’s physical activity.
2. Perform hand hygiene. Put on PPE, as indicated.
3. Identify the patient. Explain what you are going to do.
4. Assemble equipment on overbed table or other surface within reach.
5. Close the curtains around the bed and close the door to the room, if possible.
6. Adjust the bed to a comfortable working height, usually elbow height of the caregiver (VHACEOSH, 2016).
7. Lower side rail nearest you, leaving the opposite side rail up. Place bed in flat position unless contraindicated.
8. Put on gloves. Check bed linens for patient’s personal items. Disconnect the call bell or any tubes/drains from bed linens.
9. Place a bath blanket over the patient. Have the patient hold on to bath blanket while you reach under it and remove top linens. Leave top sheet in place if a bath blanket is not used. Fold linen that is to be reused over the back of a chair. Discard soiled linen in laundry bag or hamper. Do not place on floor or furniture. Do not hold soiled linens against your clothing.
10. If possible, and another person is available to assist, grasp mattress securely and shift it up to head of bed.
11. Assist patient to turn toward opposite side of the bed, and reposition pillow under patient’s head.
12. Loosen all bottom linens from head, foot, and side of bed.
13. Fan-fold or roll soiled linens as close to the patient as possible.
14. Use clean linen and make the near side of the bed. Place the bottom sheet in the center of the bed. Open the sheet and pull the bottom sheet over the corners at the head and foot of the mattress. Push the sheet toward the center of the bed, pulling it taut and positioning it under the old linens.
15. If using, place the drawsheet with its centerfold in the center of the bed and positioned so it will be located under the patient’s midsection. Open the drawsheet and fan-fold it to the center of the mattress. Tuck the drawsheet securely under the mattress. If a protective pad is used, place it over the drawsheet in the proper area and open to the centerfold. Not all facilities use drawsheets routinely. The nurse may decide to use one.
16. Raise side rail. Assist patient to roll over the folded linen in the middle of the bed toward you. Reposition pillow and bath blanket or top sheet. Move to other side of the bed and lower side rail.
17. Loosen and remove all bottom linen. Discard soiled linen in laundry bag or hamper. Do not place on floor or furniture. Do not hold soiled linens against your clothing.
18. Ease clean linen from under the patient. Pull the bottom sheet taut and secure at the corners at the head and foot of the mattress. Pull the drawsheet tight and smooth. Tuck the drawsheet securely under the mattress.

Question 16

Gait Belt

Answer 16

Device used for transferring patients and assisting with ambulation (an act or action like walking).

Question 17

Three Types of Joints

Answer 17

• Fibrous
• Cartilaginous
• Synovial

Question 18

Fibrous Joint Characteristics

Answer 18

• Synarthrosis (immovable)
• No joint cavity. Fibrous connective tissue between bones
• Example: Sutures between bones of the skull

Question 19

Cartilaginous Joint Characteristics

Answer 19

• Amphiarthrosis ( Slightly Moveable)
• No joint Cavity. Cartilage between bones.
• Example: Pubic symphysis; joints between bodies of vertebrae.

Question 20

Synovial Joint Characteristics

Answer 20

• Diarthrosis ( Freely Movable)
• Joint cavity containing synovial fluid
• Gliding (carpal bones of wrist) , hinge (elbow), pivot (radius and ulna at the wrist), condyloid (joint connecting fingers to palms), saddle (metacarpal of thumb), ball-and-socket joints (hip joints).

Question 21

Abduction

Answer 21

• Away from the midline.

- A person’s arm is abducted when it is moved away from the body.

Question 22

Adduction

Answer 22

• Toward the midline

- A person’s arm is adducted when it is moved from an outstretched position to a position alongside the body

Question 23

Circumduction

Answer 23

• Turning in circular motion

- Circling the arm at the shoulder, as in bowling or a serve in tennis

Question 24

Flexion

Answer 24

• state of being bent.

- A person’s cervical spine is flexed when the head is bent forward, chin to chest

Question 25

Extension

Answer 25

• State of being in a straight line

- A person’s cervical spine is extended when the head is held straight on the spinal column

Question 26

Hyperextension

Answer 26

• exaggerated extension

- A person’s cervical spine is hyperextended when looking overhead, toward the ceiling.

Question 27

Dorsiflexion

Answer 27

• backward bending of the hand or foot

- A person’s foot is in dorsiflexion when the toes are brought up as though to point them at the knee.

Question 28

Plantar Flexion

Answer 28

• Flexion of the foot

- A person’s foot is in plantar flexion in the footdrop position.

Question 29

Rotation

Answer 29

• Turning on an axis

- A thumb is rotated when it is moved to make a circle.

Question 30

Internal Rotation

Answer 30

• Turning on axis toward the midline of the body

- A leg is rotated internally when it turns inward at the hip and the toes point toward the midline of the body

Question 31

External Rotation

Answer 31

• turning on axis away from midline of body

- A leg is rotated externally when it turns outward at the hip and the toes point away from the midline of the body.

Question 32

Pronation

Answer 32

• Prone Position
• A person is in the prone position when lying on the abdomen; a person’s palm is prone when the forearm is turned so that the palm faces downward.

Question 33

Supination

Answer 33

• Supine Position
• A person is in the supine position when lying on the back; a person’s palm is supine when the forearm is turned so that the palm faces upward.

Question 34

Inversion

Answer 34

Movement of the sole of the foot inward (occurs at the ankle)

Question 35

Eversion

Answer 35

Movement of the sole of the food outward (occurs at the ankle)

Question 36

Opposition

Answer 36

Rotation of the thumb around its long access (movement of the thumb across the palm to touch each fingertip of the same hand).

Question 37

Three Types of MUSCLES

Answer 37

• Skeletal
• Cardiac
• Smooth or Viseral

Question 38

Skeletal Muscle Purpose

Answer 38

Skeletal muscle works with tendons and bones to move the body

Question 39

Cardiac Muscle Purpose

Answer 39

Cardiac muscle forms the bulk of the heart and produces the contractions that create the heartbeat.

Question 40

Smooth Muscle Purpose

Answer 40

Smooth muscle forms the walls of the hollow organs (such as the stomach and intestines) and is in the walls of blood vessels and other hollow tubes (such as ureters) that connect internal organs.

Question 41

5 Common Bed Positions

TABLE 33-6

Answer 41

• FOWLER’S Position: seated in a semi-sitting position (45-60 degrees) and may have knees either bent or straight.
• SUPINE Position: Lying on back
• Side- Lying or LATERAL Position
• SIMS’ Position: person lying on the left side, left hip and lower extremity straight, and right hip and knee bent.
• PRONE Position: Lying on Front

Question 42

Cane Use

Answer 42

• The patient stands with weight evenly distributed between the feet and the cane.
• The cane is held on the patient’s stronger side and is advanced one small stride ahead.
• Supporting weight on the stronger leg and the cane, the patient advances the weaker foot forward, parallel with the cane.
• Supporting weight on the weaker leg and the cane, the patient brings the stronger leg forward to finish the step.
• Teach patients to position their canes within easy reach when they sit down so that they can rise easily.

Question 43

4 types of Bone Classifications

Answer 43

• Long Bones: Upper and lower extremities
• Short Bones: Wrist and Ankle
• Flat Bones: Ribs and skull bones
• Irregular Bones: Spinal Column and Jaw

Question 44

Neurons

Answer 44

Conduct impulses from one part of the body to another.

Question 45

Afferent Nervous System

Answer 45

Conveys information to the Central Nervous System (CNS)

- Info is processed by the CNS.

Question 46

Efferent Neurons

Answer 46

Convey the response from the CNS to skeletal muscles by way of the somatic nervous system

Question 47

Assisting a Patient with Turning in Bed

SKILL 33-2 pg. 1181

Answer 47

1. Review the medical orders and nursing care plan for patient activity. Identify any movement limitations and the ability of the patient to assist with turning. Consult patient handling algorithm, if available, to plan appropriate approach to moving the patient.
2. Gather any positioning aids or supports, if necessary.
3. Perform hand hygiene. Put on PPE, as indicated.
4. Identify the patient. Explain the procedure to the patient.
5. Close the curtains around the bed and close the door to the room, if possible. Position at least one nurse on either side of the bed. Place pillows, wedges, or any other support to be used for positioning within easy reach. Place the bed at an appropriate and comfortable working height, usually elbow height of the caregiver (VHACEOSH, 2016). Lower both side rails.
6. If not already in place, position a friction-reducing sheet under the patient.
7. Using the friction-reducing sheet, move the patient to the edge of the bed, opposite the side to which he or she will be turned. Raise the side rails.
8. If the patient is able, have the patient grasp the side rail on the side of the bed toward which he or she is turning. Alternately, place the patient’s arms across his or her chest and cross his or her far leg over the leg toward which they are turning.
9. If available, activate the bed-turn mechanism to inflate the side of the bed behind the patient’s back.
10. The nurse on the side of the bed toward which the patient is turning should stand opposite the patient’s center with his or her feet spread about shoulder width and with one foot ahead of the other. Tighten your gluteal and abdominal muscles and flex your knees. Use your leg muscles to do the pulling. The other nurse should position his or her hands on the patient’s shoulder and hip, assisting to roll the patient to the side. Instruct the patient to pull on the bed rail at the same time. Use the friction-reducing sheet to gently pull the patient over on his or her side.
11. Use a pillow or other support behind the patient’s back. Pull the shoulder blade forward and out from under the patient.
12. Make the patient comfortable and position in proper alignment, using pillows or other supports under the leg and arm, as needed. Readjust the pillow under the patient’s head. Elevate the head of the bed as needed for comfort.
13. Place the bed in the lowest position, with the side rails up, as indicated. Make sure the call bell and other necessary items are within easy reach.
14. Clean transfer aids, per facility policy, if not indicated for single patient use. Remove gloves and other PPE, if used. Perform hand hygiene.

Question 48

Moving a patient up in bed with the assistance of another caregiver
SKILL 33-3 pg. 1183

Answer 48

1. Review the medical record and nursing care plan for conditions that may influence the patient’s ability to move or to be positioned. Assess for tubes, IV lines, incisions, or equipment that may alter the positioning procedure. Identify any movement limitations. Consult patient handling algorithm, if available, to plan appropriate approach to moving the patient.
2. Perform hand hygiene and put on PPE, if indicated.
3. Identify the patient. Explain the procedure to the patient.
4. Close the curtains around the bed and close the door to the room, if possible. Place the bed at an appropriate and comfortable working height, usually elbow height of the caregiver (VHACEOSH, 2016). Adjust the head of the bed to a flat position or as low as the patient can tolerate. Place the bed in slight Trendelenburg position, if the patient is able to tolerate it.
5. Remove all pillows from under the patient. Leave one at the head of the bed, leaning upright against the headboard.
6. Position at least one nurse on either side of the bed, and lower both side rails.
7. If a friction-reducing sheet (or device) is not in place under the patient, place one under the patient’s midsection.
8. Ask the patient (if able) to bend his or her legs and put his or her feet flat on the bed to assist with the movement.
9. Have the patient fold the arms across the chest. Have the patient (if able) lift the head with chin on chest.
10. One nurse should be positioned on each side of the bed, at the patient’s midsection, with feet spread shoulder width apart and one foot slightly in front of the other.
11. If available on bed, engage mechanism to make the bed surface firmer for repositioning.
12. Grasp the friction-reducing sheet securely, close to the patient’s body.
13. Flex your knees and hips. Tighten your abdominal and gluteal muscles and keep your back straight.
14. If possible, the patient can assist with the move by pushing with the legs. Shift your weight back and forth from your back leg to your front leg and count to three. On the count of three, move the patient up in bed. Repeat the process, if necessary, to get the patient to the right position.
15. Assist the patient to a comfortable position and readjust the pillows and supports, as needed. Take bed out of Trendelenburg position and return bed surface to normal setting, if necessary. Raise the side rails. Place the bed in the lowest position. Make sure the call bell and other necessary items are within easy reach.
16. Clean transfer aids, per facility policy, if not indicated for single patient use. Remove gloves or other PPE, if used. Perform hand hygiene.

Question 49

Transferring a patient from the bed to a stretcher

SKILL 33-4 pg. 1186

Answer 49

1. Review the medical record and nursing care plan for any conditions that may influence the patient’s ability to move or to be positioned. Assess for tubes, IV lines, incisions, or equipment that may alter the positioning procedure. Identify any movement limitations. Consult patient handling algorithm, if available, to plan appropriate approach to moving the patient.
2. Perform hand hygiene and put on PPE, if indicated.
3. Identify the patient. Explain the procedure to the patient.
4. Close the curtains around the bed and close the door to the room, if possible. Adjust the head of the bed to a flat position or as low as the patient can tolerate. Raise the bed to a height that is even with the transport stretcher (VHACEOSH, 2016). Lower the side rails, if in place.
5. Place the bath blanket over the patient and remove the top covers from underneath.
6. If a friction-reducing transfer sheet is not in place under the patient, place one under the patient’s midsection. Have patient fold arms against chest and move chin to chest. Use the friction-reducing sheet to move the patient to the side of the bed where the stretcher will be placed. Alternately, place a lateral-assist device under the patient. Follow manufacturer’s directions for use.
7. Position the stretcher next (and parallel) to the bed. Lock the wheels on the stretcher and the bed.
8. Two nurses should stand on the stretcher side of the bed. A third nurse should stand on the side of the bed without the stretcher.
9. Use the friction-reducing sheet to roll the patient away from the stretcher. Place the transfer board across the space between the stretcher and the bed, partially under the patient. Roll the patient onto his or her back, so that the patient is partially on the transfer board.
10. The nurse on the side of the bed without the stretcher should grasp the friction-reducing sheet at the head and chest areas of the patient. The nurse on the stretcher side of the bed should grasp the friction-reducing sheet at the head and chest, and the other nurse on that side should grasp the friction-reducing sheet at the chest and leg areas of the patient.
11. At a signal given by one of the nurses, have the nurses standing on the stretcher side of the bed pull the friction-reducing sheet. At the same time, the nurse (or nurses) on the other side push, transferring the patient’s weight toward the transfer board, and pushing the patient from the bed to the stretcher.
12. Once the patient is transferred to the stretcher, remove the transfer board, and secure the patient until the side rails are raised. Raise the side rails. To ensure the patient’s comfort, cover the patient with blanket and remove the bath blanket from underneath. Leave the friction-reducing sheet in place for the return transfer. Make sure the call bell and other necessary items are within easy reach.
13. Clean transfer aids, per facility policy, if not indicated for single patient use. Remove gloves and any other PPE, if used. Perform hand hygiene

Question 50

Transferring a patient from the bed to a chair

SKILL 33-5 pg. 1189

Answer 50

1. Review the medical record and nursing care plan for conditions that may influence the patient’s ability to move or to be positioned. Assess for tubes, IV lines, incisions, or equipment that may alter the positioning procedure. Identify any movement limitations. Consult patient handling algorithm, if available, to plan appropriate approach to moving the patient.
2. Perform hand hygiene and put on PPE, as indicated.
3. Identify the patient. Explain the procedure to the patient.
4. If needed, move equipment to make room for the chair. Close the curtains around the bed and close the door to the room, if possible.
5. Place the bed in the lowest position. Raise the head of the bed to a sitting position or as high as the patient can tolerate.
6. Make sure the bed brakes are locked. Put the chair next to the bed. If available, lock the brakes of the chair. If the chair does not have brakes, brace the chair against a secure object.
7. Encourage the patient to make use of a stand-assist aid, either freestanding or attached to the side of the bed, if available, to move to the side of the bed and to a side-lying position, facing the side of the bed on which the patient will sit.
8. Lower the side rail, if necessary, and stand near the patient’s hips. Stand with your legs shoulder width apart with one foot near the head of the bed, slightly in front of the other foot.
9. Encourage the patient to make use of the stand-assist device. Assist the patient to sit up on the side of the bed; ask the patient to swing his or her legs over the side of the bed. At the same time, pivot on your back leg to lift the patient’s trunk and shoulders. Keep your back straight; avoid twisting.
10. Stand in front of the patient and assess for any balance problems or complaints of dizziness. Allow the patient’s legs to dangle a few minutes before continuing.
11. Assist the patient to put on a robe, as necessary, and nonskid footwear.
12. Wrap the gait belt around the patient’s waist, based on assessed need and facility policy.
13. Stand facing the patient. Spread your feet about shoulder width apart and flex your hips and knees.
14. Ask the patient to slide his or her buttocks to the edge of the bed until the feet touch the floor. Position yourself as close as possible to the patient, with your foot positioned on the outside of the patient’s foot. If a second staff person is assisting, have him or her assume a similar position. Grasp the gait belt.
15. Encourage the patient to make use of the stand-assist device. If necessary, have second staff person grasp the gait belt on opposite side. Rock back and forth while counting to three. On the count of three, using the gait belt and your legs (not your back), assist the patient to a standing position. If indicated, brace your front knee against the patient’s weak extremity as he or she stands. Assess the patient’s balance and leg strength. If the patient is weak or unsteady, return the patient to bed.

Question 51

Denture Care pg. 1005.

Answer 51

Dentures should be cleaned daily to reduce plaque and potentially harmful microorganisms (Felton et al., 2011). Daily cleaning includes soaking in and brushing with a nonabrasive denture cleanser (Felton et al.). When cleaning dentures, put on gloves and hold them over a basin of water or a sink lined with a washcloth or soft towel (Fig. 31-3) so that if they slip from your grasp, they will not fall onto a hard surface and break. If necessary, grasp the dentures with a 4” × 4” piece of gauze to help prevent them from slipping out of your gloved hands. Use cool or lukewarm water to cleanse them. Hot water may warp the plastic material of which most dentures are made. Use a soft toothbrush and dental cleanser. Do not use toothpaste as it can be too harsh for denture surfaces. Rinse dentures thoroughly after soaking and brushing, prior to reinsertion into the mouth (Felton et al.). Give the patient the opportunity to brush the gums and tongue and rinse the mouth before the dentures are replaced. Assist the patient with care as necessary.

Question 52

Back injuries for health care workers. common reasons

Answer 52

• Uncoordinated lifts
• Manual lifting and transferring of patients without assistive devices
• Lifting when fatigued or after recent back injury recovery
• Repetitive movements such as lifting, transferring, and repositioning patients
• Standing for long periods of time
• Transferring/repositioning uncooperative or confused patients

Question 53

Functions of muscle

Answer 53

• Motion
• Support
• heat production
• Posture