Chapter 2

Foundations of CareChapter 2

Communication:Verbal Written, verbal

Non-Verbal Body Language

Speak in simple terms, not medical language

Be respectful when speaking and giving care: a. Do not speak in another language with another caregiver when helping a resident.

Collecting and Reporting InformationAsk open vs closed questionsCollect accurate information, using sensesa. smell, vision, touchingWhen reporting info to the nurse:1. Use objective info, not subjective.Examples of objective info: a. measurements: vs, weightb. Color? Temperature/skin? c. Odors (incontinence, food hoarding, UTI)

Collecting and Reporting (contin)Answering phone:1. State facility name, your name and title.2. If not for you, ask if you may place on hold.Call lights:1. Always answer if you are nearby2. Find out need. If you cant help, get the person who can.3. Check careplan in closet

Barriers to CommunicationUsing slangHearing levelUsing cliches canned responsesEverything will be okWeve all been there beforeIt could be worseVision impairmentMental issues:Mental illnessDementiaAlzheimers

Things that affect CommunicationCulture languageBody language gesturesTouchLearning levelHearing aids

Guidelines for Hearing ImpairedMake sure hearing aids are in (theirs and yours!)Face directly, talk slowlyTouch lightly, get their attentionDo not shoutRepeat, if neededUse gestures, writing, white boards, if neededGive and request feedback

Guidelings for Visually ImpairedIdentify self when entering roomTouch lightly after introductionExplain fully what you are doingDescribe anything that resident needs to know aboutUse imaginary clock face

Mental Health and IllnessSigns of mental health:A. Gets along with othersCan give and accept loveAdaptable to changeTakes responsibility for own actions and decisionsImpulse control

Defense MechanismsUnconscious behaviors to relieve stress or cope with a situationCan be another barrier to communicationSome common ones:DenialProjectionDisplacementRationalizationRepressionRegression

Guidelines for CareAlways treat with dignity and respectListen!Never talk down to anyoneBe honest and directAvoid argumentsBe sensitive with touch

Combative BehaviorGuidelines:Never approach from behindBlock any attempts to hit, etcKeep safe distanceGet help if needed

May say unkind things, its the disease talkingAnger always report, leave and reapproach later

Inappropriate Behavior

Try distraction and redirection first

Take to private area if redirection not working

Always report

SafetyAccident prevention important for both staff and residentsBody mechanicsMaintain good postureLegs shoulder width apartBend at knees, not waistKeep package close to your body when liftingNo twisting, instead pivot

Accident prevention in residentsFalls can cause fracturesRisks for falls are throw rugs, slippery floors, clutter, poor lighting, and call lights that are not close by.Guidelines for prevention:Answer call lights promptlyLock wheelchairs, bedsClean up spills right awayGet help if needed for moving someone

Burns or scaldsRemove resident from heat sourceRun under cool water for 5 minutesPoor hot liquids away from residentAlways test water first, then resident

Resident IDMake sure you know who you are caring for.Very important for meals. Must identify first.

ChokingResidents must be up at least 90 degrees before eating.Place food in unaffected side, if feeding.Make sure you know what they should have:Thickened liquidsType of food texture

Bruising/AbrasionsBe gentle with residentsMany are on blood thinnersVery fragile skinBe careful when transferring residents from bed to wheelchair and backand to toilet, then back to WC.Watch out for feet and hands when transferring.

MSDSBinder in every facility that gives information on chemicals that are used.Contains info on how to clean up, etcEmployers must keep one of these in a location that you can find.Workers Right to Know

FireRACERemove residentsActivate 911Contain fireExtinguishPASSPull the pinAim at base of fireSqueeze handleSweep back and forth

Medical EmergenciesCPR neededFirst aidBleedingChokingAbdominal thrustsHeimlich ManueverShock organs not receiving enough bloodLife threatening and dangerouspale skin, increased HR, low BPElevate legs, if able, Call for help (nurse)

Bleeding, FaintingPut on gloves.Apply Pressure

Lower person to floor or have him/her sit down

Insulin reaction, Seizures & vomiting

Cause: Either too much insulin or too little foodWeakness, confusion give food, report to nurseIf seizure occurs, safety is priority.Move objects awayPlace pillowsKeep your hands away from their mouthEmesis give resident basin, help with washcloth, report

Chain of infectionLets look on pg 44.Causative agentReservoirPortal of ExitMode of transmissionPortal of EntrySusceptible Host

Prevent Infection and TransmissionMedical Asepsis washing handsSurgical Asepsis Sterilization for procedures, etcUse of standard precautions everyone is infected!Protect self when touching body fluids, genital area, nose, mouth, eyesStandard precautions must be used on every person you care for.

Transmisson-Based precautionsGownGlovesGogglesMaskCDC

Handling equipmentCleanDirtyContaminatedDisposable or notIf not, chemical disinfection

Transmission based PrecautionContact MRSA, Scabies, Lice, pinkeye, C-Diff, Norovirus, EColiDroplet - TBAirborn Colds, fluBloodborne- Hepatitis, HIV

Handwashing is the #1 way to prevent infection!!!!