Unit 11-Resident Care Procedures

Unit 11
Resident Care Procedures

Nurse Aide I Course
DHSR Approved Curriculum-Unit 11 1

Introduction
Residents frequently require assistance

to meet their normal elimination needs.
They may also require special
procedures that the nurse aide will
perform.

Introduction
(continued)
This unit explores:
• helping the resident to the bathroom;
• assisting with use of the bedside
commode, bedpan and urinal;
• providing catheter care and emptying a
urinary drainage bag;
• collecting a routine urine specimen;
• applying and caring for condom
catheters;
Introduction
(continued)
In addition, this unit explores:
• collecting a stool specimen;
• administering cleansing enemas;
• applying warm or cold applications,
elastic bandages, elastic stockings
(TED hose) and non-sterile dressing;
• and assisting with coughing and deep
breathing exercises.
11.0 Describe what is meant by
elimination needs.

Elimination of Waste Products
• Natural process
• Healthy individuals
have regular
elimination habits

(continued)
• Equipment needed
– Bedpan
• regular size - used by female for
urination and both men and
women for defecation
• fracture pan - smaller and flatter
and usually used with fracture of
vertebrae, pelvis or leg
(continued)
– Urinal
• used by men
• used for urination

(continued)
– Bedside commode
• portable chair brought to bedside
• contains opening for a bedpan or
similar type container
• used for residents unable to walk
to bathroom
11.1 Review the guidelines to follow
when assisting the resident with
elimination needs.

Guideline To Assist With Elimination
• Assist to as close to a
sitting position as
possible

(continued)
• Provide privacy and warmth

– close doors, curtains, and drapes
– assist with robe and footwear
– cover with cotton blanket or lap
robe when using bedside
commode
– leave area if safe to leave alone

(continued)
• Provide toilet paper and
place call signal within
the resident’s reach
• Offer bedpan
periodically as residents
may be uncomfortable
requesting its use

(continued)
• Do not leave on bedpan

for long periods of time
• Cover and empty
bedpan immediately.

(continued)
• Put on glove and assist
resident to clean genital
area as necessary
• Assist with handwashing
– at the sink
– by providing soap and
basin of warm water
11.2 Demonstrate the procedure to
follow when assisting the resident
to use the bathroom.

follow when helping the resident
to use a bedside commode.

follow when assisting the resident
to use a bedpan.

follow when assisting a resident
to use a urinal.

11.6 Discuss indwelling catheters and
catheter care.

Indwelling Catheters
• Used to continuously drain
urine from bladder
• Inserted by licensed nurse
or NA II after being
ordered by physician
• Attached to tubing that
connects to urinary
drainage bag
(continued)
• Use
– Residents with nerve injury:
• following spinal cord injury
• after stroke
– After surgery
– Some incontinent residents

(continued)
• Increased Risk of Urinary Tract
Infections
– Urinary meatus and
surrounding area must
be kept clean
– Catheter care given at
least daily and PRN

11.6.1 Identify guidelines to follow
when caring for residents with
indwelling catheters (Foley).

Guidelines To Follow When
Caring For Residents With
• Never pull on catheter and keep
catheter tubing and drainage tubing
free of kinks, so that urine can flow
freely
• Report any leakage, complaints of
pain, burning, or need to urinate
(continued)
• Observe and report any
swelling, skin irritation, or
discoloration
• Measure and record urinary
output accurately, noting color,
odor and appearance of urine
(continued)
• Keep collection bag below bladder
• Attach collection bags to bed frame,
never to side rail
• Never leave on floor
• Follow facility policy for securing
catheter to resident’s leg without
tension on catheter
(continued)
• Never disconnect catheter
from tubing to drainage
bag
• When emptying urinary
drainage bag, never touch
drain with measuring
container or graduate
11.7 Demonstrate the procedure for
providing catheter care.

emptying a urinary drainage bag.

11.9 Discuss the collection of urine
specimens.

Collecting Routine Urine Specimen
• Collected for laboratory study

– Aids physician in diagnosis
– Evaluates effectiveness of
treatment
• Laboratory requisition slip completed
and sent to laboratory with each
specimen
General Rules To Follow When
Collecting Urine Specimens
• Wash hands carefully before and

after collection of urine specimens
• Wear gloves
• Collect specimen at appropriate time
• Use proper container and do not
touch inside of lid or container

General Rules To Follow When
Collecting Urine Specimens
(continued)
• Label container accurately
and transport to laboratory as
soon as possible
• Tell resident not to have
bowel movement or discard
tissue in bedpan when
collecting urine specimen
collecting a routine urine
specimen.

11.11 Discuss the collection of two
more types of urine sample
collections: the clean catch and
the 24-hour specimen.

Clean Catch Urine Specimen
(mid-stream)
• Cleaning of perineum prior to
collection reduces number of
microbes that may contaminate
specimen

Clean Catch Urine Specimen
(mid-stream)
(continued)
• Procedure
– resident begins voiding into
appropriate receptacle and
stops midstream; then container
is placed and urine specimen is
collected.
– follow above general rules
when collecting urine specimen
– follow Standard Precautions
24-Hour Urine Specimen
• All urine voided in 24-hour
period collected
– urine chilled on ice to prevent
growth of microorganisms
– some tests may require
preservative
– sample usually collected in
dark colored gallon jug
(continued)
• Procedure
– the resident voids to begin
test with empty bladder
– first voiding is discarded
– all voidings for next 24 hours
collected
– if test interrupted, it must be
restarted with new gallon jug
(continued)
• Imperative that
resident and staff
understand procedure
and exact time period
for sample collection
• Follow Standard
Precautions
11.12 Discuss guidelines to follow
when caring for a resident with a
condom catheter.

Applying And Caring For
Condom Catheters
• Description and Use
– External catheter used for
incontinent men
– Made of soft rubber sheath that fits
over penis with tubing connected to
urinary drainage bag
– Ambulatory residents may prefer
leg bags during day
Applying And Caring For
Condom Catheters
(continued)
• Description and Use
– New condom catheter is applied
daily
– Penis observed for reddened or
open areas and reported to
supervisor prior to new being
applied
11.12.1 Demonstrate the procedure
for applying a condom
catheter.

11.13 Discuss the collection of stool
specimens.

Guidelines For Collecting Stool
Specimen
• Ordered by physician
• Studied by laboratory to identify:
– Blood in stool
– Parasites
– Fat
– Microorganisms
– Other abnormalities
Guidelines For Collecting Stool
Specimen
• Specimen should not be mixed with
urine
• Use tongue blades to handle
specimen
• Prevent contaminating outside of
specimen container
• Properly label and transport
specimen promptly
collecting a stool specimen.

11.15 Define the term enema and
identify some of the most
common solutions.

Cleansing Enemas
• Definition - the introduction of fluid

into the rectum and colon to remove
feces
• Physician orders:
– Solution to be used
– Amount of fluid to be used

Cleansing Enemas
(continued)
• Common solutions
– Tap water
– Saline solution
– Soap suds
– Oil retention
– Prepackaged disposable,
hypertonic solution
11.15.1 Discuss the guidelines for
giving an enema.

Cleansing Enemas:
Guidelines For Administration
• Check temperature of enema
solution with thermometer
• Temperature no greater than
105° F
• Container should not be higher
than 12 inches above anus.
Solution must run in slowly to
avoid serious side effects
Cleansing Enemas:
(continued)
• Resident should be positioned on
left side with knees slightly flexed
• If possible, enemas should be given
before bath and before breakfast;
otherwise, wait at least one hour
after meals before giving

Cleansing Enemas:
(continued)
• Be sure bathroom is
available for use

administering a cleansing
enema.

11.17 Discuss the purposes and
effects of warm and cold
therapy.

Warm And Cold Therapy
• Requires physician’s
order for type of therapy
and length of time for
application

(continued)
• Purposes and Effects
– WARMTH: dilates blood vessels
• increased blood supply to area
• blood brings oxygen & nutrients
for healing
• fluids are absorbed
• muscles relax
• pain relieved
(continued)
• Purposes and Effects
– COLD: constricts blood vessels
• decreased blood supply to area
• prevents swelling
• controls bleeding
• numbs skin, reducing pain
• reduces body temperature
11.17.1 Discuss the three types of
warm and cold applications.

Types Of Warmth And Cold
• Dry cold - water does not touch

skin
– ice bags
– ice caps
– ice collars
– disposable cold pack

(continued)
• Moist cold - water touches
skin
– compresses – localized
application
– soaks - body part
immersed in water
– cool sponge bath
(continued)
• Dry warmth – pads
with circulating
warm water
• Moist warmth
– compresses
– soaks
– sitz bath
11.17.2 Discuss the guidelines for
warm and cold applications.

Guidelines For Warm Applications
• Guidelines for Applications
– Use bath thermometer to measure
the temperature of moist heat
solutions.
– Do not operate equipment you have
not been trained to use.
– Temperature never over 105° F.
Check skin frequently and report
any signs of complications.
Guidelines For Cold Applications
• Guidelines for Applications
– Apply ice caps with metal or
plastic lids away from skin
– Cover ice caps/bags/collars prior
to application
– Check skin frequently and report
any signs of complications
– Never leave in place longer than
directed by supervisor
applying warm or cold
applications.

11.19 Discuss the application of
nonsterile bandages.

Bandages
• Purposes
– hold dressing in place
– secure splints
– support and protect body parts
• Materials in various types and sizes
– roller gauze
– elastic bandages
– triangular
11.19.1 Review the guidelines to be
considered with the use of
bandages.

Guidelines For Use Of Bandages
• Applied snug enough to

control bleeding and prevent
movement of dressings
• Should not be so tight that
they interfere with circulation
• Circulation of extremity
checked below bandage
(continued)
• Signs/symptoms that indicate poor
circulation should be reported
immediately to supervisor such as:
– swelling
– cyanotic skin
– numbness
– tingling
– skin cold to touch
– pain or discomfort
(continued)
• Loosen bandages if any signs of
impaired circulation noted and report
to supervisor immediately.

for applying elastic bandages.

11.20 Discuss reasons for coughing
and deep breathing exercises.

Coughing And Deep Breathing
• Purposes
– To prevent respiratory
complications in certain at-risk
residents
• persons on bed rest or reduced
activity
• following surgery
• person with respiratory disorders
(continued)
• Purposes
– Two major complications prevented
by coughing and deep breathing:
• pneumonia - inflammation of lung
• atelectasis - collapse of portion of
lung

(continued)
• Physiology
– Deep Breathing
• increases level of
oxygen in blood
• increases lung
expansion

(continued)
• Physiology
– Coughing
• removes mucus from
airways and lungs
• may cause collapse of
lung if congestion not
present

(continued)
• Considerations with deep

breathing and coughing
– Doctors order exercises
– Frequency of
performing exercise
varies per doctor’s
order
(continued)
• Considerations with deep
breathing and coughing
– Nurse aides receive
instructions from
supervisor
– Coughing may cause pain
and be difficult to perform

for assisting with coughing
and deep breathing exercises.

11.21 Discuss the purpose of elastic
stockings.

Elastic Stockings
(Anti-embolitic Hose)
• Purpose
– Provide support
– Provide comfort
– Promote circulation by
providing pressure
– Reduce risk of thrombus
formation
11.21.1 Discuss indications for use of
elastic stockings.

Elastic Stockings
(continued)
• Indications for use
– Residents with heart disease and
circulatory disorders
– Residents on bed rest
– Residents who recently had
surgery

11.21.2 Discuss action of elastic
stockings in the prevention of
blood clots.

Elastic Stockings
(continued)
• Prevention of blood clots (thrombi)
– blood clots form (blood flow is
sluggish)
– usually develop in deep leg
veins
– can break loose and travel
though blood stream (then
known as embolus)
Elastic Stockings
(continued)
• Prevention of blood clots (thrombi)
– embolus can travel to the lungs
and possibly cause death
– elastic stockings exert pressure
on veins, promoting venous blood
flow to heart
– also known as anti-embolitic
stockings or TED hose
Elastic Stockings
(continued)
• Fitting of stockings
– Come in thigh
high or knee high
lengths
– Resident must be
measured to
ensure proper fit
for applying and removing
elastic stockings or TED hose.

11.22 Discuss purpose of applying a
nonsterile dressing.

Applying Nonsterile Dressing
• Covering applied to wound or
injured body part where slight risk
of infection or re-injury
• Materials come in various types
and sizes:
– Gauze pads
– Band-aids
– Thick compresses
for applying a nonsterile
dressing.


Unit 11-Resident Care Procedures

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Unit 11-Resident Care Procedures

Uploaded by

Copyright:

Available Formats

Unit 11

Resident Care Procedures

DHSR Approved Curriculum-Unit 11 1

Residents frequently require assistance

DHSR Approved Curriculum-Unit 11 2

DHSR Approved Curriculum-Unit 11 6

DHSR Approved Curriculum-Unit 11 7

DHSR Approved Curriculum-Unit 11 9

DHSR Approved Curriculum-Unit 11 11

DHSR Approved Curriculum-Unit 11 12

• Provide privacy and warmth

DHSR Approved Curriculum-Unit 11 13

DHSR Approved Curriculum-Unit 11 14

• Do not leave on bedpan

DHSR Approved Curriculum-Unit 11 15

DHSR Approved Curriculum-Unit 11 18

DHSR Approved Curriculum-Unit 11 19

DHSR Approved Curriculum-Unit 11 20

DHSR Approved Curriculum-Unit 11 21

DHSR Approved Curriculum-Unit 11 23

DHSR Approved Curriculum-Unit 11 25

DHSR Approved Curriculum-Unit 11 26

DHSR Approved Curriculum-Unit 11 27

DHSR Approved Curriculum-Unit 11 33

DHSR Approved Curriculum-Unit 11 34

DHSR Approved Curriculum-Unit 11 36

• Collected for laboratory study

• Wash hands carefully before and

DHSR Approved Curriculum-Unit 11 38

DHSR Approved Curriculum-Unit 11 41

DHSR Approved Curriculum-Unit 11 43

DHSR Approved Curriculum-Unit 11 44

DHSR Approved Curriculum-Unit 11 50

DHSR Approved Curriculum-Unit 11 54

DHSR Approved Curriculum-Unit 11 56

DHSR Approved Curriculum-Unit 11 60

DHSR Approved Curriculum-Unit 11 62

• Definition - the introduction of fluid

DHSR Approved Curriculum-Unit 11 63

DHSR Approved Curriculum-Unit 11 65

DHSR Approved Curriculum-Unit 11 67

DHSR Approved Curriculum-Unit 11 68

DHSR Approved Curriculum-Unit 11 70

DHSR Approved Curriculum-Unit 11 72

DHSR Approved Curriculum-Unit 11 73

DHSR Approved Curriculum-Unit 11 76

• Dry cold - water does not touch

DHSR Approved Curriculum-Unit 11 77

DHSR Approved Curriculum-Unit 11 80

DHSR Approved Curriculum-Unit 11 84

DHSR Approved Curriculum-Unit 11 86

DHSR Approved Curriculum-Unit 11 88

• Applied snug enough to

DHSR Approved Curriculum-Unit 11 91

DHSR Approved Curriculum-Unit 11 93

DHSR Approved Curriculum-Unit 11 95

DHSR Approved Curriculum-Unit 11 97

DHSR Approved Curriculum-Unit 11 98

DHSR Approved Curriculum-Unit 11 99

• Considerations with deep

DHSR Approved Curriculum-Unit 11 101

DHSR Approved Curriculum-Unit 11 103

DHSR Approved Curriculum-Unit 11 105