Theme: Basics of care for the elderly and seriously ill
Task № 1. List the features of the elderly and senile age
Answer-
- Involutional functional and morphological changes in the various organs and systems. Back development and aging come with age.
- Several
- Mostly chronic diseases.
- Atypical clinical course of the disease.
- The presence of «senile diseases» (osteoporosis, benign prostatic hyperplasia, prostate cancer, Alzheimer’s disease and others).
- Disorder protective, immune responses.
- Disorder of the social and psychological status. The main causes of social disadaptation. Anxiety, depression, hypochondriac syndrome often develop against this background.
Task № 2. Fill in the tablePrinciples of care for the older patient
| Principle | Activities carried out by the staff |
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Injuryprevention
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Bruise and fracture bones are the most common injury in the elderly patient.
Bruise and fracture bones (especially fracture of neck of femur) violate movement of patients, inevitably lead to complications, such as pneumonia, pulmonary thromboembolism, lead to death.
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Control pharmacotherapy
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1. Dosage of medication
2. Frequency of intake drugs 3. Regular intake of medicinal preparation 4. Features pharmacokinetics (some drugs are taken before a meal, the other drugs after eating) 5. Optimal combination drugs with food, the other drugs
The Nurse should Monitor these Moments.
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Diet nutrition
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Characteristic of diet for elderly patient:
1. Low content of calories 2. Reduced fat 3. A small volume of food 4. Nutrition should be divided (4 – 5 times a day), 5. High content of fruit and vegetables. |
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Prevention of chronic constipation
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The nurse should provide (monitor):
1. Regulation of defecation by diet 2. Regular intake of purgative preparation 3. Cleansing enema or oily enema (for chronic constipation)
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Prevention of cold
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Duties of a Nurse:
1. The ward should be empty during the ventilation. 2. Patients should be dressed in accordance with the temperature of environment. 3. Infectious patients should be isolated. Elderly and old people are more sensitive to cold drafts.
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Control of physical inactivity
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1. Medical gymnastics if there are no contraindications
2. Keep the individual motor mode
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Prevention of insomnia
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1. Walk before bedtime
2. Limit fluid intake before bedtime 3. Empty the bladder before going to sleep 4. A warm shower before bedtime 5. Intake of hypnotics if necessary
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Providing personal hygiene of the patient
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Patients who need help the nurses to provide personal care:
1. Seriously ill clients. 2. Paralysed clients. 3. Unconscious patient. 4. Malnourished patients.
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Task № 3. What patients need the help of Junior medical staff in the implementation of personal hygiene?
Answer– Seriously ill clients, Paralysed clients, Unconscious patient, Malnourished Patients need the help of Junior medical staff in the implementation of personal hygiene.
Task № 4. Fill in the table Personal Hygiene of the Bed ridden Patient
| Hygiene measures | Execution frequency |
|
Eyes Care |
Daily |
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Ears Care |
Daily |
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Nose Care |
Daily |
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Care of the oral Cavity |
Daily |
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Hair Care |
1 Time Per Seven Days |
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Skin Care |
1 Time Per Seven Days |
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Care of the Perineum |
Daily and after each Defecation |
Task № 5. Fill out the scheme
Task № 6. Fill in the table Providing of personal hygiene of a seriously ill person
| Manipulation | Equipment | What problems can lead to neglect of hygiene rules |
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Nose hygiene
|
Sterile: Pipette, cotton turundas, tray, oil (vaseline, sea buckthorn and more). Gloves, container for disinfection (tray). | To Prevent Violation of Nasal Breathing. |
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Oral hygiene
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Sterile: Gauze Napkin, Medical tray, Spatula, Dressing forceps, Antiseptic Solution in Measuring Glass (0,02% aqueous Solution Furacin or 0,9% Physiological Solution of Sodium Chloride), Petrolatum. Towel, Gloves, a container for Disinfection (Tray). | Wiping of the mouth is conducted to a Seriously ill patient or unconscious.
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Eyes hygiene
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Sterile: Tray, Gauze Napkins, Tweezers, Antiseptic Solution in Measuring glass (0.02% aqueous Solution Furacin). Unsterile: Gloves, a container for Disinfection (tray). | Prevention of Inflammatory Eye Diseases. |
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Care of Ears
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Sterile: Pipette, Cotton Turundas, Tray, Warm ear drops. Gloves, Container for Disinfection (tray). | Preventive, Curative. |
Task № 7. Solve a Clinical Task
You are on duty in the intensive care unit as a nurse. There is a patient on artificial ventilation in your room. He needs a change of bed linen.
Determine how to change (what’s the method) the bed linen and justify your answer
Answer:
Longitudinal Way of Changing Bed linen
- Clean sheet Roll Roll down the length of 2/3.
- Remove the blanket, gently lift the Patient’s head and Remove the Pillows.
- Turn the Patient on its side.
- On the vacated half of the bed, roll the dirty sheet with a roller to the middle of the bed (under the patient).
- Roll the prepared clean sheet onto the vacant part of the bed with a roller to the patient.
- Turn the patient to the other side facing him.
- Clean the dirty sheet from the vacant part of the bed, straighten the clean, pull and fill in from all sides under the mattress.
- Lay the patient on his back, put pillows in clean pillowcases.
- Replace the duvet cover, cover the patient with a blanket.
Task № 8. Solve a Clinical Task
There is an elderly patient in your ward who is bed ridden. His position in bed is passive due to severe weakness (the patient can not change his position without assistance).
List the most common complications of prolonged bed rest
Answer: Most common Complications of Prolonged bed Rest
- Urologic problems
- Gastrointestinal issues
- Pulmonary problems
- Endocrine system
- Cardiovascular system
Task № 9. Solve a Clinical Task
During the morning examination, a seriously ill patient showed signs of conjunctivitis and glued eyelashes.
Your tactics?
Describe the direction of your movements when cleaning your eyes and applying ointment to your eyes.
Answer- Equipment- Sterile: gauze napkins, tray tube of ointment. Gloves, tray, container for disinfection (tray).
- Explain to the patient the purpose and procedure course. Obtain patient’s consent.
- Conduct hygienic washing hand and processing hand. Put the gloves on.
- Seat the patient face to light. Gently tilt the head back or lay patient on his back without a pillow. Offer the patient to look up.
- Take the gauze napkin in the left hand. Attach the gauze napkin to the inferior Eyelid . Pull the lower eyelid down.
- Use your right hand to squeeze the ointment from the tube on the conjunctiva of the lower eyelid. From the internal to the external corner of the eye.
- Release the lower eyelid and ointment is pressed against the eyeball.
- Put in the other eye ointment. Use a new gauze napkin .
- Conduct disinfection used material.
- Take the gloves off and put them in the container for disinfection.
- Wash hands hygienic way.
- Make a record of results in a medical documentation.
Task № 10.Arrange pictures showing the algorithm of putting on diapers in the correct sequence
Answer : Putting on Diapers in the Correct Sequence
Serial No. Correct Sequence
« 1 » 4
« 2 » 6
« 3 » 8
« 4 » 1
« 5 » 7
« 6 » 2
«7 » 3
« 8 » 5
