Care of the stoma site is very simple. Warm water is all that is necessary to keep the skin clean. If you are using soap, be sure it is mild, without fragrance or addititives. Wash the stoma site and dry well before putting on the new pouch.
If a patient begins to fall while walking or standing, do not try to catch them or prevent the fall. Control the fall by easing them to the floor. This prevents injury to both the patient and the CNA. It also allows you to protect the patient's head from hitting the floor or an object. Stay with the patient until help arrives.
Pressure sores (also called bedsores and decubitus ulscers) develop when there is prolonged pressure on a part of the body that has little padding. Common areas are elbows, shoulders. Hips, tailbone, and heels. Because the skin is delicate, it should never be rubbed or massaged vigorously, espcecially if it is reddened. This damages the tissue under the skin and can contribute to the development of a pressure sore.
When a client is incontinent of urine, the nurse aide should clean the client as soon as possible. Urine contains ammonia, which is a harsh chemical that can cause skin irritation and breakdown. Ammonia promotes bacteria growth in a warm, moist environment. Bacteria can double every 20 minutes.
A sitz bath is warm bath that covers the client's buttocks and hips. Some reasons for taking a sitz bath include post-rectal surgery, to soothe hemorrhoids, following childbirth, and to clean the perineum. With a sitz tub or the bathtub, use about 3-4 inches of warm water. Depending on the reason, medications may be added. A sitz bath lasts 15-20 minutes. After the bath, dry the perineum well.
Each resident has an individualized care plan that covers all aspects of their treatment and needs. It includes the type of services needed, who can provide the services, special equipment needed, and diet. If the resident is new, or has a new diagnosis or situation, always refer to the care plan before giving care. Ask the nurse if you have questions or need more information about how to proceed.
The best way to clean eyeglasses is with warm water and a drop of liquid dish soap on each lens. Don't use soap that contains lotion. Gently rub both sides of each lens, as well as the nose piece and frame. Rinse with warm water. Dry carefully with a microfiber towel or a soft, clean cloth.
A contracture is a deformity that develops when muscles, joints, and connective tissue become stiff from lack of active exercise. It prevents the normal movement of the joints. The muscles get shorter, so arms or legs are unable to straighten. Some causes are paralysis, from stroke or injury, cerebral palsy, or muscular dystrophy. Range of motion exercises are essential to prevent contractures.
Female perineal care is always done front-to-back. Begin by washing the inner thigh and outer labia. When washing the inner labia, use gentle downward strokes. Use a different part of the washcloth for each area. Rinse and dry well. For the buttocks, position the client on their side. Spread the buttocks apart and gently wash the anal area from front to back. Rinse and dry well.
Never let a client enter a bath or shower without checking the temperature of the water. The water should be warm, 95-105 degrees F (35-40 degrees C). Test the water against your inner forearm. The flow or spray should be gentle and directed at the client's body to keep them warm.
When dressing a client with left-sided weakness, teach the client to use their unaffected (right) side to dress the affected (left) side first. When getting undressed, take the right side out of the sleeve first, Clothing should be loose fitting and comfortable.
When helping a resident with one-sided weakness transfer or ambulate, support the weak side. The resident may not have feeling on the affected side or be aware of where their leg is. The nurse aide should stand on the resident's weak side to be ready to assist or prevent a fall.
Dentures are important for the client's nutrition, as well as for their appearance and self-esteem. Handle dentures carefully, because they are expensive to replace. After cleaning, place the dentures into a clean denture cup filled with cold water and labeled with the client's name. Do not place dentures in a tissue; they could be accidentally thrown away.
A nasogastric (NG) tube is a tube that is passed through the nose into the stomach. One of the uses of an NG tube is feeding on a short-term basis. When a patient is receiving nourishment via the NG tube, the head of the bed is raised to reduce the chance of choking or aspiration. The patient must be observed for signs of choking, nausea, vomiting, and regurgitation of the liquid food. Excellent oral care is necessary for the patient during the time that the tube is in place.
A diet that is low sodium cannot have added table salt. Foods that are processed, such as hot dogs, sausage, and luncheon meat are not allowed because of their high salt level. Other foods that have surprisingly high sodium levels include cheese , soup, and salad dressing. Mechanical soft diets are easy to chew and swallow. The client may be too ill, have a swallowing disorder, or no teeth to properly chew the food.
When giving a bath or shower, always check the temperature before assisting the resident into the water. The ideal temperature is about two degrees more than the resident's body temperature. Test the water on the inside of your arm to ensure it is comfortable. It is also helpful to warm the room before starting a bath.
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