nutrition terminology #1

NutritionNutritionTerminology #1Terminology #1

NutritionNutritionFatsFatsHyperalimentationHyperalimentationMineralsMineralsGastrostomy tubeGastrostomy tubeFluidsFluidsFull liquid dietFull liquid diet

Terminology #2Terminology #2Mechanical soft dietMechanical soft dietADA (American Diet Association) dietADA (American Diet Association) dietPureed diet Pureed diet Clothes protector (i.e., towel, bib)Clothes protector (i.e., towel, bib)Cellulose or fiberCellulose or fiberDiaphoresisDiaphoresisDiuresisDiuresis

Terminology #3Terminology #3EmesisEmesisEssential nutrientsEssential nutrientsExpectorate Expectorate Forcing fluidsForcing fluidsIntake and output (I & O)Intake and output (I & O)Therapeutic dietsTherapeutic diets

Terminology #4Terminology #4CarbohydratesCarbohydratesProteinsProteinsIntravenous infusionIntravenous infusionVitamins Vitamins Nasogastric tubeNasogastric tubeClear liquid dietClear liquid dietSoft dietSoft diet

Terminology #5Terminology #5Low sodium dietLow sodium dietLow fat dietLow fat dietBland dietBland dietAmino acidsAmino acidsDehydrationDehydrationDigestion Digestion EdemaEdema

Terminology #6Terminology #6Enteral feedingEnteral feedingExchange listExchange listFatsFatsGavageGavageNutrientsNutrientsTotal parenteral nutrition (TPN)Total parenteral nutrition (TPN)

Body’s need for food and fluidsBody’s need for food and fluidsProvide energy for daily livingProvide energy for daily livingPromote growth and repair of tissuePromote growth and repair of tissueProvide the necessary substances for Provide the necessary substances for regulation of bodily functionsregulation of bodily functionsA balanced diet is essential to good A balanced diet is essential to good healthhealthA balanced diet is composed of A balanced diet is composed of sufficient nutrientssufficient nutrients

Common nutrients and their food Common nutrients and their food sourcessources

CarbohydratesCarbohydratesProteins Proteins FatsFatsVitaminsVitaminsMineralsMineralsDietary fiberDietary fiberWater Water

Basic four food groupsBasic four food groupsMeat groupMeat group

Dairy groupDairy group

Vegetable and fruit groupVegetable and fruit group

Bread and cereal groupBread and cereal group

Vegan basic four food groupsVegan basic four food groupsWhole grainsWhole grains

VegetablesVegetables

FruitsFruits

legumeslegumes

Special nutritional needs of the Special nutritional needs of the elderlyelderly

Fewer calories if they are less activeFewer calories if they are less activeAdditional vitamins and minerals due Additional vitamins and minerals due to digestive disturbancesto digestive disturbancesMedications may interfere with Medications may interfere with digestion and nutrient usedigestion and nutrient usePoor oral hygiene or ill-fitting Poor oral hygiene or ill-fitting dentures dentures

Special nutritional needs of the Special nutritional needs of the elderly #2elderly #2

Ability to taste foods could be Ability to taste foods could be diminisheddiminishedMany common diseases interfere Many common diseases interfere with eatingwith eatingSocial isolation may interfere with Social isolation may interfere with appetiteappetite

Diets commonly ordered in diet Diets commonly ordered in diet therapy for residentstherapy for residents

Low sodiumLow sodiumDiabetic (ADA) Diabetic (ADA) Low fatLow fatBlandBlandMechanical softMechanical softPureed Pureed

Diets commonly ordered in diet Diets commonly ordered in diet therapy for residents #2therapy for residents #2

Full liquid dietFull liquid diet

Clear liquidClear liquid

SoftSoft

Liquids and foods allowed for the Liquids and foods allowed for the “special” hospital diets-Role of NA“special” hospital diets-Role of NASee that the residents received the See that the residents received the diets ordereddiets orderedReport any problemsReport any problemsAssist the doctors and nurses in Assist the doctors and nurses in evaluating a resident’s fluid balanceevaluating a resident’s fluid balanceCalculate and record resident’s food Calculate and record resident’s food intakeintake

Proper technique for feeding Proper technique for feeding residentsresidents

Provide a comfortable and enjoyable Provide a comfortable and enjoyable atmosphereatmosphereProviding feeding assistanceProviding feeding assistanceServing resident’s in their roomServing resident’s in their roomServing resident’s in dining roomServing resident’s in dining room

Prevention of choking Prevention of choking Close supervision when eatingClose supervision when eatingFollow resident’s individual feeding Follow resident’s individual feeding planplanCut food into small piecesCut food into small piecesProceed at the resident’s paceProceed at the resident’s paceSit down while feeding the helpless Sit down while feeding the helpless residentresident

Recognition of signs of chokingRecognition of signs of chokingInability to speakInability to speak

coughingcoughing

Dietary modifications affiliated with Dietary modifications affiliated with religious culturesreligious cultures

No pork-JewsNo pork-JewsNo coffee, tea, alcohol-Mormon, No coffee, tea, alcohol-Mormon, Seventh Day AdventistSeventh Day AdventistNo milk products-AsianNo milk products-AsianNo beef-East IndianNo beef-East IndianNo alcohol, pork-MuslimNo alcohol, pork-Muslim

Alternative ways to administer Alternative ways to administer nutritionnutrition

Tube feedingsTube feedings

Intravenous infusionIntravenous infusion

Terminology #2Terminology #2IntegumentaryIntegumentaryDermisDermisEpidermisEpidermisAbrasionAbrasionCyanosisCyanosisExcoriationExcoriationDecubitus ulcerDecubitus ulcer

Terminology #3Terminology #3NecrosisNecrosisUrineUrineProsthesisProsthesisUrinalUrinalUrinationUrinationCatheterCatheter

Terminology #4Terminology #4FecesFecesEliminationEliminationFecal impactionFecal impactionAnal incontinenceAnal incontinenceFlatulenceFlatulenceConstipationConstipationDiarrhea Diarrhea

Terminology #5Terminology #5OstomyOstomyColostomyColostomyileostomyileostomyStoolStoolStomaStomaDefecationDefecation

Daily routine care/Early MorningDaily routine care/Early MorningOffer bedpan/urinal or assist to Offer bedpan/urinal or assist to bathroombathroomWash face and handsWash face and handsOffer oral hygieneOffer oral hygieneStraighten bed and unitStraighten bed and unitPosition resident for breakfastPosition resident for breakfast

Morning care after breakfastMorning care after breakfastOral hygieneOral hygieneOffer bedpan/urinal or assist to Offer bedpan/urinal or assist to bathroombathroomBathingBathingShavingShavingSkin careSkin careDressingDressingHair careHair careChange bed linensChange bed linens

Prepare for mealsPrepare for mealsLunch and dinnerLunch and dinner

Offer bedpan/urinal or assist to Offer bedpan/urinal or assist to bathroombathroomWash hands/faceWash hands/faceStraighten bed/unitStraighten bed/unitPosition for mealPosition for meal

Afternoon careAfternoon careOffer bedpan/urinal or assist to Offer bedpan/urinal or assist to bathroombathroomWash face and handsWash face and handsOral hygieneOral hygieneGrooming as necessaryGrooming as necessaryChange soiled linenChange soiled linenStraighten unitStraighten unit

Evening (HS) careEvening (HS) careOffer bedpan/urinal or assist to Offer bedpan/urinal or assist to bathroombathroomWash face and handsWash face and handsOral hygieneOral hygieneChange soiled linenChange soiled linenDress for bedDress for bedBack massageBack massageStraighten unitStraighten unit

Benefits of bathingBenefits of bathingCleanlinessCleanlinessReduce bacteria and germsReduce bacteria and germsPromote skin integrityPromote skin integrityStimulate circulationStimulate circulationProvide movement and exerciseProvide movement and exerciseRelaxationRelaxationSense of well-beingSense of well-beingOpportunity for communication and Opportunity for communication and observationobservation

Body areas that require bathingBody areas that require bathingFaceFaceUnderarms (axilla)Underarms (axilla)HandsHandsPerineal areaPerineal areaAny area where skin folds or creasesAny area where skin folds or creases

Types of bathsTypes of bathsShowerShowerTub/whirlpool, medicinalTub/whirlpool, medicinalComplete bed bathComplete bed bathPartial bed bathPartial bed bath

General guidelines for bathing General guidelines for bathing residentsresidents

Check with nurse regarding type of Check with nurse regarding type of bathbathRefer to procedure manual for special Refer to procedure manual for special bathsbathsIdentify skin care products to be usedIdentify skin care products to be usedCheck resident’s personal choicesCheck resident’s personal choicesCollect necessary equipmentCollect necessary equipmentProvide privacyProvide privacy

General guidelines for bathing General guidelines for bathing residents #2residents #2

Assure adequate comfortAssure adequate comfortUse comfortably warm water, change Use comfortably warm water, change it when it becomes soapy, dirty or it when it becomes soapy, dirty or coldcoldBathe areas soiled by fecal material Bathe areas soiled by fecal material or urine or urine Wash from cleanest to dirtiest areaWash from cleanest to dirtiest areaRinse off all soapRinse off all soapPat skin dryPat skin dry

Safety Guidelines for bathingSafety Guidelines for bathingMonitor correct water temperatureMonitor correct water temperatureUse safety equipmentUse safety equipmentStay with residentStay with residentUse correct body mechanicsUse correct body mechanics

Privacy during bathingPrivacy during bathingClose door Close door

Pull curtain around residentPull curtain around resident

Only uncover area being washedOnly uncover area being washed

Observations to be made during Observations to be made during bathing/skinbathing/skin

ColorColorRashesRashesDrynessDrynessBruisesBruisesOdorsOdorsSwellingSwelling

Observations/Fingernails,toenails,Observations/Fingernails,toenails,hair,eyes and Mental Status #2hair,eyes and Mental Status #2

Presence of nitsPresence of nitsColor of scleraColor of scleraOrientation/alertnessOrientation/alertnessMoodMoodAttitudeAttitude

Observations that require reportingObservations that require reportingskinskin

ColorColorNew rashesNew rashesNew bruises, broken skin, bleedingNew bruises, broken skin, bleedingUnusual odorsUnusual odorsComplaints of painComplaints of pain

Observations that required Observations that required reporting/ Fingernails, hairreporting/ Fingernails, hair

New Yellow, thickened nailsNew Yellow, thickened nailsNew significant hair lossNew significant hair lossFlakingFlakingSore scalpSore scalpNitsNits

Observations that require reportingObservations that require reportingEyes and Mental statusEyes and Mental status

RednessRednessYellowing of scleraYellowing of scleraDisorientationDisorientationDepressionDepressionDevelopment of unresponsivenessDevelopment of unresponsiveness

Types of medicinal bathsTypes of medicinal bathsBranBranOatmealOatmealStarchStarchSodium bicarbonateSodium bicarbonateEpsom saltsEpsom saltsPine productsPine productsSulfurSulfurSaltSalt

Purposes of medicinal bathsPurposes of medicinal bathsSoothing sedationSoothing sedation

Relief of pruritisRelief of pruritis

Relief of skin disorder (dry skin, Relief of skin disorder (dry skin, irritation, rash)irritation, rash)

Oral hygiene / PurposeOral hygiene / PurposeCleanliness of mouth and teethCleanliness of mouth and teethPrevent mouth odor and infectionPrevent mouth odor and infectionPrevent tooth lossPrevent tooth lossComfortComfortPleasant tastePleasant tasteImprove taste of foodImprove taste of food

Oral hygiene / When to performOral hygiene / When to performOn awakeningOn awakening

After each mealAfter each meal

Bed timeBed time

Oral hygiene / Special Oral hygiene / Special circumstancescircumstances

UnconsciousUnconsciousMouth breatherMouth breatherO2O2NG tubeNG tubeElevated temperatureElevated temperature

Steps of oral hygieneSteps of oral hygieneCarry out procedure using standard Carry out procedure using standard precautionsprecautions

Examine oral cavity and report Examine oral cavity and report findingsfindings

Steps in cleaning and care of Steps in cleaning and care of denturesdentures

Use standard precautionsUse standard precautions

Examine oral cavity and report Examine oral cavity and report findingsfindings

Nurse assistant role for resident Nurse assistant role for resident nail carenail care

Easier to clean after soaking in Easier to clean after soaking in warm, soapy waterwarm, soapy waterBe cautious to prevent damage to Be cautious to prevent damage to tissuestissuesReport unusual conditions to nurseReport unusual conditions to nurseFollow facility procedureFollow facility procedure

Nurse assistant role / caring for hairNurse assistant role / caring for hairPart of daily carePart of daily care

Important for identity and self-Important for identity and self-esteemesteem

Accommodate resident preferences Accommodate resident preferences for style, hair productsfor style, hair products

Nurse assistant role / types Nurse assistant role / types shampooshampoo

Shower / tubShower / tub

SinkSink

BedBed

Nurse assistant role / purpose of Nurse assistant role / purpose of Medicinal ShampooMedicinal Shampoo

Eradicate liceEradicate lice

ScabiesScabies

Soothe / heal irritated skinSoothe / heal irritated skin

Shaving a resident / GuidelinesShaving a resident / GuidelinesUse either electric or safety razorUse either electric or safety razorUse appropriate safety precautions Use appropriate safety precautions for electrical equipmentfor electrical equipmentSafety razors can cause nicks or cutsSafety razors can cause nicks or cutsUse standard precautions to prevent Use standard precautions to prevent contact with bloodcontact with blood

Functions of the integumentary Functions of the integumentary systemsystem

Provides protective barrier against Provides protective barrier against microorganismsmicroorganismsEnables the body to feel pain, Enables the body to feel pain, pressure, and temperaturepressure, and temperatureShields body tissue from injuryShields body tissue from injuryInsulates against heat and coldInsulates against heat and coldEliminates waste productsEliminates waste productsProduces Vitamin D for body useProduces Vitamin D for body use

How to maintain healthy skinHow to maintain healthy skinEncourage well-balanced diet and Encourage well-balanced diet and fluidsfluidsMaintain skin careMaintain skin careObserve color and temperatureObserve color and temperatureGive special attention to bony Give special attention to bony prominencesprominences

Age –related changes affecting the Age –related changes affecting the skinskin

Excessively dry areasExcessively dry areas

Elasticity decreased, causing Elasticity decreased, causing wrinkleswrinkles

Thinner layersThinner layers

Residents at risk for skin Residents at risk for skin breakdownbreakdown

Elderly residentsElderly residentsResidents who have no sensation of Residents who have no sensation of painpainParalyzed residentsParalyzed residentsResidents with edemaResidents with edemaThin residentsThin residentsDiabetic, Overweight, in castsDiabetic, Overweight, in castsUnconscious, sedated residentsUnconscious, sedated residents

Conditions which cause decubitus Conditions which cause decubitus ulcersulcers

PressurePressureDecreased blood flow to an areaDecreased blood flow to an areaWet skinWet skinScratches from fingernailsScratches from fingernailsDry skinDry skin

Decubitus ulcers #2 / Signs and Decubitus ulcers #2 / Signs and symptoms or stagessymptoms or stages

Stage oneStage one

Stage twoStage two

Stage threeStage three

Decubitus ulcers #3 / Bony Decubitus ulcers #3 / Bony prominencesprominences

SacrumSacrumHeelsHeelsKneesKneesShouldersShouldersBack of headBack of headHipsHipsAnkles, Elbows and EarsAnkles, Elbows and Ears

Decubitus ulcers / Preventive Decubitus ulcers / Preventive nursing care measuresnursing care measures

Keep skin clean and dryKeep skin clean and dryUse only small amounts of powder Use only small amounts of powder and lotionand lotionWash after each incontinent episodeWash after each incontinent episodeKeep safety devices, clothing, and Keep safety devices, clothing, and bedding from being too tightbedding from being too tightKeep edges of casts and braces from Keep edges of casts and braces from pressing against the skinpressing against the skin

Decubitus ulcers / Preventive Decubitus ulcers / Preventive nursing care measures #2nursing care measures #2

Remove crumbsRemove crumbsAvoid wrinkles in beddingAvoid wrinkles in beddingKeep tubes from pressing on the skinKeep tubes from pressing on the skinRemove residents from toilets and Remove residents from toilets and bedpans promptlybedpans promptlyKeep your nails short and smoothKeep your nails short and smooth

Decubitus ulcers / Use of pressure-Decubitus ulcers / Use of pressure-reducing devices # 3reducing devices # 3

Bed cradleBed cradleSheepskinSheepskinHeel and elbow protectorsHeel and elbow protectorsEgg crate mattressEgg crate mattressAlternating pressure matressAlternating pressure matressClinitron bedClinitron bedTrochanter rollsTrochanter rollsFlotation pads or cushionsFlotation pads or cushions

Decubitus ulcers # 4Decubitus ulcers # 4Turn or change resident’s position Turn or change resident’s position every two hoursevery two hoursEncourage circulation by gentle Encourage circulation by gentle massage around areamassage around areaTeach resident to change position Teach resident to change position frequentlyfrequentlyAssist with range of motion exercisesAssist with range of motion exercisesApply lotion to dry skin areasApply lotion to dry skin areas

Dressing Residents / Types of Dressing Residents / Types of ClothingClothing

CardiganCardiganPulloverPulloverPantsPantsDisposable briefDisposable briefShoes and stockingsShoes and stockingsAccessories Accessories

Physical factors that limit a Physical factors that limit a resident’s ability to dressresident’s ability to dress

Lack of maturationLack of maturationBrain impairmentBrain impairmentWeaknessWeaknessPainPainFracturesFracturesContracturesContracturesParalysisParalysisLack of visionLack of visionPsychological factorsPsychological factors

Caring for resident clothingCaring for resident clothingLabel garmentsLabel garmentsAvoid cuttingAvoid cuttingDo not discardDo not discardStore in the resident’s unitStore in the resident’s unitFold neatly or hang in closetFold neatly or hang in closetAssist resident or family to choose Assist resident or family to choose clothing that meets physical needsclothing that meets physical needs

Purposes for dressing a residentPurposes for dressing a residentHow we look influences the way we How we look influences the way we feel about ourselvesfeel about ourselvesIt encourages resident to be It encourages resident to be independentindependentIt discourages incontinenceIt discourages incontinence

Guidelines for dressing and Guidelines for dressing and undressing a residentundressing a resident

Provide for privacyProvide for privacyEncourage the resident to do as Encourage the resident to do as much as possiblemuch as possibleAllow residents to choose what to Allow residents to choose what to wearwearRemove clothing from the strong or Remove clothing from the strong or good side firstgood side firstPut clothing on weak side firstPut clothing on weak side first

Ways the body eliminates wasteWays the body eliminates wasteUrinary elimination (Urine)Urinary elimination (Urine)

Bowel elimination (Feces)Bowel elimination (Feces)

Urinary EliminationUrinary EliminationThe body excretes 1000 to 1500 ml The body excretes 1000 to 1500 ml of urine / dayof urine / dayUrine consists of the wastes and Urine consists of the wastes and excess fluidsexcess fluidsResidents have different urination Residents have different urination needsneedsKeep resident’s routine as normal as Keep resident’s routine as normal as possiblepossible

Characteristics of normal urineCharacteristics of normal urineClearClear

Amber ( Medium Yellow) colorAmber ( Medium Yellow) color

Mild odorMild odor

Frequency of urinationFrequency of urinationAmount of fluid ingestedAmount of fluid ingestedPersonal habitsPersonal habitsAvailability of toilet facilitiesAvailability of toilet facilitiesPhysical activitiesPhysical activitiesIllnessIllnessRanges from every 2-3 hours to Ranges from every 2-3 hours to every 8-12 hoursevery 8-12 hours

Observations to be made about Observations to be made about urineurine

ColorColor

ClarityClarity

OdorOdor

AmountAmount

Information to report about urineInformation to report about urineCloudyCloudyPinkish or reddish tintPinkish or reddish tintResident complaints burning on Resident complaints burning on urinationurinationDifficulty in urinationDifficulty in urinationFeeling of pressureFeeling of pressureFrequencyFrequencyStrong OdorStrong Odor

Urinary incontinenceUrinary incontinenceInability to control the passage of Inability to control the passage of urine from the bladderurine from the bladder

Constant dribbleConstant dribbleOccasional dribble when laugh, Occasional dribble when laugh, cough or sneezecough or sneezeNo controlNo control

Urinary incontinence / CausesUrinary incontinence / CausesCentral nervous systemCentral nervous systemSpinal cord injurySpinal cord injuryAging and confusionAging and confusionMedicationsMedicationsWeak pelvic musclesWeak pelvic musclesUrinary tract infectionUrinary tract infectionProstate problemsProstate problemsProlapse of uterus and bladderProlapse of uterus and bladder

Catheter / DefinitionCatheter / Definition

Plastic or rubber tube used to drain Plastic or rubber tube used to drain or inject fluid through a body or inject fluid through a body opening, most commonly used to opening, most commonly used to drain the bladder.drain the bladder.

Catheter TypesCatheter Types

Indwelling CathetersIndwelling Catheters– FoleyFoley– RetentionRetention

Straight CathetersStraight Catheters

Catheter PurposeCatheter Purpose

Complete loss of bladder controlComplete loss of bladder control

Urinary retentionUrinary retention

Before, during and after surgical Before, during and after surgical proceduresprocedures

Catheter CareCatheter CareTubing should not be kinkedTubing should not be kinked

Bag placed below level of the bladderBag placed below level of the bladder

Bag should be attached to the bed Bag should be attached to the bed frame NOT the side table or side railframe NOT the side table or side rail

Should be secured to the inner thighShould be secured to the inner thigh

Catheter Care #2Catheter Care #2Clean the perineal area and around Clean the perineal area and around the catheterthe catheterBag should be emptied and Bag should be emptied and measured each shift ( or more often measured each shift ( or more often if ordered )if ordered )Report complaints promptly to the Report complaints promptly to the nursenurseFollow the rules of asepsis at all Follow the rules of asepsis at all timestimes

Bladder TrainingBladder TrainingGoal is voluntary control of bladderGoal is voluntary control of bladder

Two basic methods:Two basic methods:Scheduled use of bedpan, urinal or Scheduled use of bedpan, urinal or toilettoiletClamping of catheter on a schedule Clamping of catheter on a schedule basisbasis

Bowel EliminationBowel Elimination

The excretion of wastes from the gastro-The excretion of wastes from the gastro-intestinal systemintestinal system

Normal StoolNormal StoolBrownBrownSoftSoftFormedFormedCharacteristic odorCharacteristic odor

Bowel Elimination #2Bowel Elimination #2

Pattern: each person is differentPattern: each person is different

Frequency – daily to every 2-3 daysFrequency – daily to every 2-3 days

Time of day – morning or eveningTime of day – morning or evening

Factors influencing bowel Factors influencing bowel movementmovement

PrivacyPrivacyAgeAgeDietDietFluidsFluidsActivityActivityMedicationsMedications

Common Problems in eliminationCommon Problems in eliminationConstipationConstipation

Hard, dry stoolHard, dry stoolFeces that moves too slowly through Feces that moves too slowly through the bodythe bodyCaused by decreased fluids, diet, Caused by decreased fluids, diet, inactivity, ignoring the urge to inactivity, ignoring the urge to defecatedefecate

Common Problems in elimination Common Problems in elimination #2#2

Fecal ImpactionFecal Impaction

Stool is unable to pass from the Stool is unable to pass from the rectumrectumResults from unrelieved constipationResults from unrelieved constipation

Common Problems in elimination Common Problems in elimination #3#3

DiarrheaDiarrhea

Liquid or unformed stoolLiquid or unformed stoolFeces that moves rapidly through the Feces that moves rapidly through the intestinesintestinesCaused by infection, medications, Caused by infection, medications, irritating foodsirritating foods

Common Problems in elimination Common Problems in elimination #4#4

Anal IncontinenceAnal Incontinence

Inability to control the passage of Inability to control the passage of feces and gasfeces and gasPossible cause due to injury or Possible cause due to injury or diseases of the nervous systemdiseases of the nervous systemMay result when residents do not May result when residents do not receive the assistance they need in a receive the assistance they need in a timely mannertimely manner

Common Problems in elimination Common Problems in elimination #5#5

Flatulence ( gas )Flatulence ( gas )

Excessive formation of gas in the Excessive formation of gas in the stomach and intestinesstomach and intestinesCaused by foods, medications, or air-Caused by foods, medications, or air-swallowingswallowing

Maintaining Normal Elimination Maintaining Normal Elimination PatternPattern

Provide the bedpan, urinal or Provide the bedpan, urinal or commodecommodeAssist to get into normal positionAssist to get into normal positionCover the resident for privacyCover the resident for privacyRemain nearby if the person is weak Remain nearby if the person is weak or frailor frailPlace signal light and toilet tissue Place signal light and toilet tissue nearbynearby

Maintaining Normal Elimination Maintaining Normal Elimination Pattern #2Pattern #2

Allow the resident enough timeAllow the resident enough timeIf resident has difficulty, ask them If resident has difficulty, ask them what kinds of things they did at what kinds of things they did at homehomeProvide perineal care if neededProvide perineal care if neededOffer opportunity to eliminate at Offer opportunity to eliminate at regular intervalsregular intervals

Bowel TrainingBowel TrainingSuppository at a regular timeSuppository at a regular time

Increase fluidsIncrease fluids

DietDiet

ActivityActivity

PrivacyPrivacy

Purpose of an OstomyPurpose of an Ostomy

Artificial opening most commonly Artificial opening most commonly into colon or small intestineinto colon or small intestine

Allow healing of intestine after Allow healing of intestine after surgery or diseasesurgery or disease

Can be temporary or permanentCan be temporary or permanent

Types of OstomiesTypes of OstomiesCecostomyCecostomyColostomyColostomyIleostomyIleostomyJejunostomyJejunostomyDuodenostomyDuodenostomy

Location depends on the disease or injuryLocation depends on the disease or injuryCharacteristics of stool from different Characteristics of stool from different ostomiesostomies

Ostomy CareOstomy Care

EquipmentEquipmentEmptying the bagEmptying the bagSkin careSkin careOdor managementOdor management

Ostomy Care – Role of NAOstomy Care – Role of NA

Assist with personal hygieneAssist with personal hygieneProvide for privacyProvide for privacyChanging appliancesChanging appliancesEmptying ostomy bagEmptying ostomy bagProvide skin careProvide skin careUse Standard PrecautionsUse Standard Precautions

Measuring weight and heightMeasuring weight and heightOn admission and as orderedOn admission and as orderedWears gown or pajamasWears gown or pajamasUrinate before being weighedUrinate before being weighedDo routine weights at the same time Do routine weights at the same time each dayeach day

Types of prosthetic devices / Types of prosthetic devices / Artificial limbsArtificial limbs

Nursing considerationsNursing considerations

Ask charge nurse for guidelinesAsk charge nurse for guidelinesObserve ability to participate in ADL’sObserve ability to participate in ADL’sAssist resident to apply brace Assist resident to apply brace Maintain body alignmentMaintain body alignmentKeep call bell within reachKeep call bell within reachROM to affected musclesROM to affected muscles

Nursing considerations #2Nursing considerations #2Pad bracePad braceGive constant praise for Give constant praise for rehabilitative effortsrehabilitative effortsProvide skin careProvide skin careObserve for complaint of Observe for complaint of pain,numbness, or weaknesspain,numbness, or weakness

Artificial eyesArtificial eyesDaily removal are not necessaryDaily removal are not necessarySpecial concern to prevent infection Special concern to prevent infection of the eye socketof the eye socketReport redness, drainage, or crusting Report redness, drainage, or crusting of eyelashesof eyelashesStore the artificial eye in a container Store the artificial eye in a container labeled with the resident’s namelabeled with the resident’s name

Hearing aidsHearing aidsCheck the batteryCheck the batteryDo not drop or try to repair the Do not drop or try to repair the devicedeviceApply to the ear it is designed forApply to the ear it is designed forDo not allow thr device to get wetDo not allow thr device to get wet

Purposes of a hearing aidPurposes of a hearing aidRestore hearingRestore hearing

Always face the resident when Always face the resident when talkingtalkingSpeak clearlySpeak clearly

Parts of a hearing aidParts of a hearing aidMicrophoneMicrophoneAmplifierAmplifierEarmoldEarmoldCordCordOn / off switchOn / off switch

Placement of the hearing aidPlacement of the hearing aidTurn down the volumeTurn down the volumeIt should fit tightly but comfortablyIt should fit tightly but comfortablyTurn it on and adjust volumeTurn it on and adjust volumeCheck the placement if the resident Check the placement if the resident complains of an unpleasant whistlecomplains of an unpleasant whistleCheck the batteriesCheck the batteries

Caring for the hearing aidCaring for the hearing aidNever wash a hearing aidNever wash a hearing aidNever drop the hearing aidNever drop the hearing aidDo not expose to heatDo not expose to heatDo not let moisture get into the Do not let moisture get into the hearing aidhearing aidDo not use any kind of hair sprayDo not use any kind of hair spray

Talking to a partially deaf personTalking to a partially deaf personFace the residentFace the residentSpeak slowly and clearlySpeak slowly and clearlyDon’t cover your mouth or chew gumDon’t cover your mouth or chew gumSit on the side of the better earSit on the side of the better earUse short sentencesUse short sentencesRepeat and rephrase statementsRepeat and rephrase statementsFacial expressions and body languageFacial expressions and body languageReduce background noiseReduce background noise