Unit 7

Question 1

Guidelines for Personal Care

Answer 1

Safety
Medical Asepsis
Body Mechanics
Resident Rights
Communication

Question 2

AM Care

Answer 2

before Breakfast

Question 3

Morning Care

Answer 3

after Breakfast

Question 4

Afternoon Care

Answer 4

after Lunch/before Supper

Question 5

PM Care

Answer 5

Evening/bedtime

Question 6

Observations

Answer 6

ability to respond
movement
pain/discomfort
skin
Ear, Nose, Throat & Mouth
Respiration
Bowel & Bladder
Appetite & ADL's

Question 7

Hygiene

Answer 7

keeping body clean

Question 8

ADL’s

Answer 8

grooming
dressing
bathing
eating & drinking
transferring
bathroom

Question 9

Bedpans

Answer 9

bedrest

Question 10

Urinals

Answer 10

for men urinating

Question 11

Bedside Commodes

Answer 11

able to get out of bed but not walk far

Question 12

Fracture pan

Answer 12

Residents cannot roll onto regular bedpan

handle towards foot of bed

Question 13

Cleaning bedpan

Answer 13

rinse with water in bathroom
wash with soap & dry
put back in place

Question 14

Observations

Answer 14

color, clarity, odor
amount
complaints
color & consistency of stool
blood

Question 15

Oral hygiene

Answer 15

Increases comfort
keeps mouth & teeth clean
provide tid
offer lip moisture after

Question 16

Oral care is given to

Answer 16

unresponsive
Oxygen 
NPO
Nasogastric tube
Don't have teeth

Question 17

Foot Care

Answer 17

report breaks or redness of skin

DON’T ever cut toe or finger nails

Question 18

Shaving

Answer 18

Shave direction of hair growth
Use electric razor on those who take anticoagulants
dispose of razors in sharps container

Question 19

Pediculosis

Answer 19

Head lice

don’t share personal items

Question 20

S/S of pediculosis

Answer 20

itching of scalp
scratch marks on scalp
visible eggs on hair, behind ears

Question 21

Dressing and Undressing

Answer 21

Assist as needed
dress weak side first
undress weak side last

Question 22

Decubitus Ulcers

Answer 22

localized injury to skin and/or underlying tissue

S/S- pale or reddened skin

Question 23

Patients who are at risk for Ulcers

Answer 23

anemia
obesity
undernourished
paralysis
chronic illness (diabetes)

Question 24

Causes of Ulcers

Answer 24

Pressure
Shearing
Friction
Moisture

Question 25

Pressure

Answer 25

over body prominence ischemia- obstructed blood flow oxygen & nutrients don't reach tissue tissue death- necrosis

Question 26

Moisture

Answer 26

Urine Feces Wound drainage Perspiration

Question 27

Stage I

Answer 27

Intact skin | pale or red not relieved by change of position

Question 28

Stage II

Answer 28

Partial skin loss | Blister or shallow ulcer

Question 29

Stage III

Answer 29

Full skin loss | fat exposed

Question 30

Stave IV

Answer 30

Full tissue loss | muscle/tendon/bone exposed

Question 31

Prevention

Answer 31

``` Skin care Pressure relief Friction relief Nutritional Support Preventing Contractures ```

Question 32

Factors affecting pain

Answer 32

1. past experience 2. anxiety 3. rest & sleep 4. Attention 5. personal & family duties 6. meaning of pain 7. support from others 8. culture 9. illness 10. age

Question 33

Pain scale rating

Answer 33

0-10

Question 34

Measures to promote comfort

Answer 34

good alignment -> straighten blankets -> assist with bathroom -> give blankets -> calm environment -> gentle handling -> no sudden movements

Question 35

Benefits of Bathing

Answer 35

``` cleans skin relaxing stimulates circulation exercise observations communication ```

Question 36

Frequency

Answer 36

personal choice weather activity ability health

Question 37

Types of bathing

Answer 37

partial (face, pits, hands, pari) shower tub bath bed bath

Question 38

Steps before bathing

Answer 38

``` identify patient introduce self inform patient of what doing offer bedpan or toilet gather supplies ```

Question 39

Order of bathing

Answer 39

``` eyes face ears neck farthest then nearest arm chest farthest then nearest leg back peri butt ```

Question 40

temperature of water

Answer 40

105

Question 41

Back of massage

Answer 41

``` relaxes muscles stimulates circulation keep hands of their skin 3-5 minutes rub lotion between hands ```

Question 42

Don't give back rub to patients with

Answer 42

``` certain heart diseases back injuries back surgery some lung d/o skin disease ```