basic nursing care

1. Fundamentals of nursing
M.S Yosra Raziani
M.Sc. pediatric nursing
KUST
Spring-2020
session 5
Basic nursing care-I

2. objectives
◈ After this session you should be able to:
✓ Describe hygienic care that nurses provide to clients
✓ Identify the purposes of bathing.
✓ Describe various types of baths
✓ Apply the nursing process to common problems related to hygienic
care of the: Mouth AND Hair
✓ Name the electrolytes in the body and define role of all
✓ Describe different type of fluid movement in the body 2

3. Hygiene
▪ The science of health and its maintenance.
▪ It involves care of the skin, feet, nails, oral and nasal cavities, teeth,
hair, eyes, ears, and perineal-genital areas.

4. Hygienic Care
Nurses commonly use the following terms to describe
types of hygienic care
Early morning care
Morning care
Hour of sleep care /PM

5. Factors influencing hygienic practice
➢General condition of the patient
➢Self care ability
➢Age of the patient
➢Educational status
➢Socioeconomic status

6. Assisting in oral hygiene
• Assisting the weak or debilitated patient for cleansing mouth

7. Indications
✓Mouth breathers
✓Patient on NPO
✓Oral surgery patients
✓Patient on oxygen inhalation
✓Children under three years
✓Debilitated patient

8. Purposes
• To maintain a healthy state of mouth,teeth,gum and lips
• To clean the mouth off food particles ,plaque and bacteria
• To relieve discomfort resulting from unpleasant odors and tastes
• To enhance the well-being and comfort
• To stimulate the appetite
• To prevent sores , caries and infection to oral tissue
• Plaque is an invisible soft film that adheres to the enamel surface of teeth;
it consists of bacteria, molecules of saliva, and remnants of epithelial cells
and leukocytes

9. Tooth parts

10. Equipment
1. Face towel
2. Tumbler/ cup containing water
3. Soft-bristled toothbrush
4. Toothpaste/tooth powder/available dentifrice
5. cotton balls
6. Clean gloves
7. Small mackintosh
8. Emesis basin

11. Procedures
1. Asses the condition of patient
2. Inspect the integrity of lips , teeth ,gums and tongue
3. Asses the patient ability to collaboration
4. Explain the procedures to patient
5. Pull the screen
6. Perform hand washing and don gloves
7. Position patient in high fowlers/semi fowlers position
8. Place the small mackintosh with the face towel on the chest
9. Brush the teeth
10. Floss the teeth
11. Remove and dispose of equipment appropriately
12. Document assessment of the teeth, tongue, gums, and oral mucosa.

12. Brushing & flossing
• The sulcular technique: Place the bristles at a 45-degree angle with
the tips of the outer bristles under the gingival margins.
• Brushing from the sulcus to the crown of the teeth
• Brushing the biting surfaces.

14. ARTIFICIAL DENTURES
• Remove the dentures
• Clean the dentures
• Inspect the dentures and the mouth
• Return the dentures to the mouth.
• Assist the client as needed
• Remove and discard gloves.
• Perform hand hygiene
• Document all assessments

15. Hair care
• The appearance of the hair often reflects a person’s feelings of self-
concept and sociocultural well-being.
• Each person has particular ways of caring for hair

16. Purpose
• To keep hair clean and healthy
• To promote growth of hair
• To prevent loss of hair
• To prevent itching and infection
• To prevent accumulation of dirt ,dandruff and oil
• To prevent tangles
• To stimulate circulation
• To enhance personal appearance and self-esteem
• To provide a sense of well-being

17. contraindication
• Head and neck injuries
• Spinal cord injuries
• Surgeries on back and neck

18. Equipment
1. Clean brush and comb
2. Towel
3. Hair oil preparation, if appropriate
4. Gloves

19. Procedure
• introduce self and verify the client’s identity using agency protocol.
• Explain to the client what you are going to do, why it is necessary
• Perform hand hygiene
• Provide for client privacy
• Position and prepare the client appropriately.
• Remove any mats or tangles gradually.
• Brush and comb the hair
• Arrange the hair as neatly and attractively
• Document assessments and special nursing interventions

20. BED BATH PROCEDURE
What is it?
A bed bath cleans the skin and helps keep the
skin free of infection. It helps to relax the
person being bathed and help him feel better.
Let the person wash himself as much as
possible. You may only need to get the bath
supplies ready and wash the person’s back. Or
you may need to do most or all of the bath

21. PURPOSE
➢ Bathing is an important part of personal hygiene
➢ Bathing cleanses the skin makes the patient more comfortable
➢ It stimulates the circulation and relaxes the patient.
➢ It’s a good opportunity to serve the observe the client body and as well as communicate with the patient.

22. INDICATIONS
• Bed ridden patients
• Coma patients
• Major surgery
• Orthopedic patients with surgery
• Mentally ill patients
• Certain infections
• Patients with amputation surgery

23. Two categories of baths are given to clients
Cleaning
• Complete bed bath
• Self-help bed bath
• Partial bath (abbreviated bath)
• Bag bath
• Towel bath
• Tub bath
• Shower
Therapeutic
➢Therapeutic baths are given for physical effects, such as to
soothe irritated skin or to treat an area (e.g., the
perineum).
➢Medications may be placed in the water.
➢temperature is generally included in the order; 37.7°C to
46°C (100°F to 115°F) may be ordered for adults and 40.5°C
(105°F) is usually ordered for infants.

24. ARTICLES
• Disposable gloves.
• Water basin (bowl) to hold the water for the bed bath.
• Soft, lightweight cotton or flannel blanket.
• Bath towel and washcloth.
• Soap, powder, lotion, deodorant, comb
• Clothing, such as underwear and clean bedclothes or robe.

25. BEFORE A BED BATH
• Explain what you are about to do, even if the patient is unconscious.
• Clear the area of any obstacles so that you can move around freely.
• Ensure the ward is warm.
• Have all the equipment to hand so that you do not have to leave the patient during the procedure.
• The use of toiletries such as deodorants, cosmetics and perfume should be determined by the patient.

26. PROCEDURE
1.Gather necessary equipment.
2.Wash your hands. Put on gloves.
4. Provide privacy.
5. Place client in supine position near the side of the bed nearest you.
6. Un-tuck bed linens.
7. Remove bedspread and blanket; fold and place on chair if reusing; otherwise, place in laundry basket.
8. Remove client's gown or pajamas.
9. Fill bath basin 2/3 full of warm water (115o F). Check temperature with inner aspect of arm.
10. Wet washcloth and squeeze out excess water. Make a washcloth mitt.

27. Washing order

28. After washing
1. Place dirty linen in appropriate container.
2. Remove and dispose of gloves. Wash hands.
3. If client did own peri care, provide fresh water for client to wash hands
4. Apply warmed lotion and deodorant as needed.
5. Put clean clothing on client without exposing him.
6. Remove, clean, and store equipment.
7. Wash your hands.
8. Make the client comfortable.
9. Record observations and report anything unusual to nurse/supervisor.

29. Fluids, Electrolytes Balance

34. Movement of BODY FLUIDS
1. Diffusion
2. Osmosis
3. Active Transport
4. Filtration

35. Diffusion
• the natural tendency of a substance to move from an area of higher
concentration to one of lower concentration.

36. Osmosis
• fluid shift to the membrane from the region of low concentration to
the region of high concentration

37. Active Transport
• movement of molecules against a concentration as they move from an area of
lower concentration to an area of higher concentration and requires an energy.

38. Filtration
• movement of water & solutes occurs from an area of high hydrostatic
pressure to an area of low.

39. the solute concentrations inside and outside are the same
(iso means equal in Latin). In this state there is no concentration gradient
no large movement of water in or out.

40. Outside solute concentration is higher than inside
. The difference in concentration between the compartments causes water to enter the cell.

41. Salute concentration inside is higher than outside
. This causes water to rush out making the cell wrinkle or shrivel.

42. Factors affecting fluid-Electrolyte
• Age
• Acute illness
• surgery
• Burns
• Diet
• Life style
• Medications
• environmental factors

43. Electrolytes
substances that become ions in solution & acquire the capacity to conduct
electricity.
▪ Regulation of water distribution
▪ Contraction of muscle
▪ Enzyme reaction
▪ Clotting of blood

44. Sodium
• (Na)
• 135 to 145 mEq/L (135-145 mmol/L)
• Major positive ion in fluid outside the cells.
• Regulates the total amount of water in the
body & the transmission of into & out of cells.
• sodium is regulated by Salt intake ,
Aldosterone and Urinary output

45. potassium
• Potassium (K+)
• 3.5 to 5.0 mEq/L (3.5 to 5.0
mmol/L)
• Major positive ion found inside the
cells.
• Regulation of the heartbeat &
function of the muscles.
• Potassium is regulated by kidney

46. Calcium
Normal concentration :4 to 5 mEq/L
• Calcium is the most abundant element
in the body
• Calcium is extracellular fluid
• Regulated by the action of Thyroid gland
parathyroid gland
✓Maintenance of cell membrane, its integrity
and structure
✓Conduction of nerve impulses in the skeletal
muscle
✓contraction of cardiac muscles

47. Magnesium
• Magnesium is the second most important cation in the intracellular fluid
✓Precipitation of metabolic activities of cells
✓Enzyme activity
✓Neuro chemical activity
✓Muscular excitability
✓Normal concentration of magnesium 1.5 to 2.4 mEq/L

48. Chloride
• Chloride (Cl-)
• 98 to 108 mmol/L
• Helping the body maintain a normal balance of fluids
• Chlorides are found in extracellular and intracellular fluids
• Chloride is regulated through kidneys

49. bicarbonate
• Bicarbonate (HCO3)
• 22 to 30 mmol/L
• Measured to monitor the acidity of the blood & body fluids.
• Bicarbonate is found in extracellular and intracellular fluids
• Regulation is through kidneys

50. Phosphate
• PO4
• Important for cell division
• Involved in important chemical
reactions
• It helps maintain acid-base balance
• Serum phosphate is regulated by
kidneys Parathyroid hormone
• Normal concentration of phosphate
2.5 to 4.5 mEq/L

51. 51

52. 52
THANKS!
You can find me at
Yosra.anvar@komar.edu.iq