1. Nurse Assistant Skills Nurse assistants are important members of the health care team

2. Measuring and Recording Intake and Output

3. Measuring and Recording Intake and Output (continued) Intake: fluids taken in by patient What is included in intake Output: fluids eliminated by patient What is included in output Records must be accurate Fluids usually measured by metric system

4. Measuring and Recording Intake and Output (continued) Agencies follow different policies for recording I&O Careful instructions should be given to patients on I&O Standard precautions

5. Feeding a Patient Good nutrition is an important part of a patient’s treatment Make mealtimes as pleasant as possible Mealtimes are regarded as social time Proper preparation for mealtime Delay of meals Check food tray

6. Feeding a Patient Allow patient to feed themselves whenever possible Test temperature of food Principles to follow while feeding Relaxed, unhurried atmosphere Observe amount eaten Observe for any signs of choking

7. Assisting with a Bedpan/Urinal Elimination of body waste is essential Terminology Many patients sensitive about using bedpan/urinal Accurate observations important Standard precautions Use of gloves important

8. Providing Catheter and Urinary-Drainage Unit Care Catheters: hollow tubes usually made of rubber or plastic French or straight catheter Foley catheter External condom catheter Urinary-drainage units Leg bags for ambulation

9. 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

10. Providing Catheter and Urinary-Drainage Unit Care Observation of urine Follow correct procedure to empty drainage unit to prevent contamination and infection Bladder training program Keep records

11. Summary Assisting patient with intake and output important part of care Provide privacy and respect patient’s rights at all times Observe standard precautions Follow correct procedures

12. 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 specimen Clean-catch or midstream-voided urine

13. Collecting Stool/Urine Specimens Sterile catheterized urine specimen 24-hour urine specimen Routine stool (feces) specimen Stool for occult blood Label all specimens correctly Use standard precautions

14. Enemas and Rectal Treatments Enemas ◦Retention enemas ◦Nonretention enemas Types of enemas ◦Cleansing ◦Disposable ◦Oil retention

15. Enemas and Rectal Treatments (continued) Impactions—removed by licensed or advanced care provider Rectal tube Suppositories

16. Summary Enemas and rectal treatments cannot be administered without a doctor’s order Follow correct procedures at all times Observe standard precautions to prevent spread of infection

17. Applying Restraints Chemical restraints—medications Physical restraints—protective devices Conditions that may require restraints Types of physical restraints Points to remember when using restraints Complications of restraints

18. Applying Restraints Most health care facilities have specific rules and policies regarding the use of restraints Be aware of legal responsibilities

19. Administering Oxygen Blood must have oxygen Signs of oxygen shortage Deficiency of oxygen (hypoxia) Methods of administration of oxygen Ways of providing oxygen to the patient Humidifier

20. Administering Oxygen (continued) Safety precautions Pulse oximeters Points to check while oxygen in use Legal considerations

21. 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

22. Giving Postmortem Care Dealing with death and dying Patient’s rights apply after death Family member may want to view body Procedure for postmortem care will vary with different facilities

23. Giving Postmortem Care Morgue kits Care of valuables and belongings Two people often work together to complete care Observe agency policy

24. Summary The nursing assistant provides quality personal care for patients Many skills are required to perform approved procedures Standard precautions must be observed Record observations carefully Know your legal responsibilities

25. Measuring and Recording Intake 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 Dehydration Intake and output (I&O) forms vary between facilities