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