Basics of care for the elderly and seriously ill-Answer

Theme: Basics of care for the elderly and seriously ill

Task № 1. List the features of the elderly and senile age

Answer-

  1. Involutional functional and morphological changes in the various organs and systems. Back development and aging come with age.
  2. Several
  3. Mostly chronic diseases.
  4. Atypical clinical course of the disease.
  5. The presence of «senile diseases» (osteoporosis, benign prostatic hyperplasia, prostate cancer, Alzheimer’s disease and others).
  6. Disorder protective, immune responses.
  7. 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

PrincipleActivities carried out by the staff
 

 

 

Injuryprevention

 

 

 

 

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.

 

 

Control pharmacotherapy

 

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.

 

 

Diet nutrition

 

 

    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.

 

 

Prevention of chronic constipation

 

 

     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)

 

 

Prevention of cold

 

 

      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.

 

 

Control of physical inactivity

 

 

1.     Medical gymnastics if there are no contraindications

2.     Keep the individual motor mode

 

 

Prevention of  insomnia

 

 

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

 

 

Providing personal hygiene of the patient

 

 

Patients who need help the nurses to provide personal care:

1.     Seriously ill clients.

2.     Paralysed clients.

3.     Unconscious patient.

4.     Malnourished patients.

 

 

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 measuresExecution frequency
 

Eyes  Care

Daily
 

Ears  Care

Daily
 

Nose  Care

Daily
 

Care of the oral Cavity

Daily
 

Hair Care

1 Time Per Seven Days
 

Skin Care

1 Time Per Seven Days
 

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 EquipmentWhat problems can lead to neglect of hygiene rules
 

Nose hygiene

 

 

 

 

Sterile: Pipette, cotton turundas, tray, oil (vaseline, sea buckthorn and more). Gloves, container for disinfection (tray).To Prevent Violation of  Nasal Breathing.
 

Oral hygiene

 

 

 

 

 

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.

 

 

 

Eyes hygiene

 

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.
 

Care of  Ears

 

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

  1. Clean sheet Roll Roll down the length of 2/3.
  2. Remove the blanket, gently lift the Patient’s head and Remove the Pillows.
  3. Turn the Patient on its side.
  4. On the vacated half of the bed, roll the dirty sheet with a roller to the middle of the bed (under the patient).
  5. Roll the prepared clean sheet onto the vacant part of the bed with a roller to the patient.
  6. Turn the patient to the other side facing him.
  7. Clean the dirty sheet from the vacant part of the bed, straighten the clean, pull and fill in from all sides under the mattress.
  8. Lay the patient on his back, put pillows in clean pillowcases.
  9. 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

  1. Urologic problems
  2. Gastrointestinal issues
  3. Pulmonary problems
  4. Endocrine system
  5. 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).

  1. Explain to the patient the purpose and procedure course. Obtain patient’s consent.
  2. Conduct hygienic washing hand and processing hand. Put the gloves on.
  3. 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.
  4. Take the gauze napkin in the left hand. Attach the gauze napkin to the inferior Eyelid . Pull the lower eyelid down.
  5. 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.
  6. Release the lower eyelid and ointment is pressed against the eyeball.
  7. Put in the other eye ointment. Use a new gauze napkin .
  8. Conduct disinfection used material.
  9. Take the gloves off and put  them in the container for disinfection.
  10. Wash hands hygienic way.
  11. 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

 

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