Nurseinfo.in provides free Nursing Notes, Nursing Procedures, Medical MCQs, Nursing Calculators, Care Plans and exam preparation resources for BSc Nursing, GNM, P.B. BSc and MSc Nursing students. Browse subject-wise notes, previous year questions and study materials based on the latest nursing syllabus.
Nurseinfo.in provides free Nursing Notes, Nursing Procedures, Medical MCQs, Nursing Calculators, Care Plans and exam preparation resources for BSc Nursing, GNM, P.B. BSc and MSc Nursing students. Browse subject-wise notes, previous year questions and study materials based on the latest nursing syllabus.
Nursing Procedure – COLD APPLICATION (Definition, Purpose, Classification, Physiological Effects, Principle, Contraindications, Complication and General Instructions)
UPDATED 2024
Cold
application is more effective than heat for sprains or other soft tissue
injuries and is the preferred treatment within the first 48 hours after injury.
Cold is applied to prevent swelling (edema); however, cold application usually
will not reduce edema that is already present. Methods of cold application
include the use of a compress, icecap, ice collar, ice pack, sponge bath, and
hypothermia (cooling) blanket.
DEFINITION
Cold
application means the application of an agent cooler than the skin. Cold
application is also either moist or dry.
Moist cold: applications are ice to
suck, cold compress and evaporating lotion
General Cold
Applications
Moist cold: cold sponging, cold bath,
cold packs
Dry cold: hypothermia
PHYSIOLOGICAL EFFECTS
Cold
Application: Primary Effects
Peripheral vasoconstriction
Decreased capillary permeability
Decreased local metabolism
Decreased oxygen consumption
Blood flow is decreased
Blood viscosity is increased
Lymph flow is decreased
Motility of leukocytes is decreased
Muscle tone is decreased
Secondary
Effects
The primary effect of cold application may last only for 30 minutes to one hour, after this time, a recovery time of one hour must be allowed or secondary effects (vasodilatation) will take place.
CONTRAINDICATIONS
Cold should not be applied on
patients who are in a state of shock and collapse
Cold should not be applied when there
is edema
Cold should not be applied when there
is muscle spasm
Cold should not be applied in
diseases or disorders associated with impaired circulation
Cold should not be applied when there
is decreased sensation
Cold should not be applied when there
is infected wound
Cold should not be applied when the
patient is having shivering or having a very low temperature
PRINCIPLES INVOLVED
Cold causes construction of blood
vessels and decrease the blood supply to the area
Cold decreases metabolism and the
cell activity or growth
The end organs of the sensory nerves
in the skin convey the sensation of cold; the sensations are interpreted in the
brain
Woolen materials absorb moisture
slowly, but hold moisture longer and colds off less quickly than the cotton
materials
Moisture left on the skin causes
rapid cooling due to evaporation of the moisture
Prolonged exposure to moisture
increases the skins susceptibility to maceration and skin breakdown
COMPLICATIONS
Pain
Blisters and skin breakdown
Maceration (with moist cold)
Gray-bluish discoloration
Thrombus formation
Hypothermia
GENERAL INSTRUCTIONS
In hyperpyrexia, the temperature of the body should be bought gradually and steadily. Sudden cooling is dangerous to the patient
Protect the patient from getting chills, a shivering can raise the temperature, it also allows a patient to catch a cold
After the procedure, dry the part gently by patting and not by rubbing by removing the moisture, thereby, in prevent maceration of the skin and further cooling by evaporation
Maintain the correct temperature for the entire duration of the application
Never ignore the complaints of a patient, however, small they appear to be.
NURSING PROCEDURE – DIET FOR PATIENTS (Gastrojejunostomy Feeding, Breastfeeding and Artificial Feeding)
Purpose, General Instructions, Preliminary Assessment, Preparation of Patient and Environment, Equipment, Procedure and After Care
UPDATED 2024
GASTROJEJUNOSTOMY FEEDING
Gastrojejunostomy
feeding is defined as enteral nutrition is a liquid food preparation directly
into the stomach or small intestine via a tube
It is an
ideal method of providing nutrition for the person who is unable to swallow
food and drink normally but has intact gastrointestinal function
It is the
introduction of liquid good through a tube or catheter which the surgeon has
already introduced into the stomach through the abdominal wall
Indications
Tumors or operations on the upper
gastrointestinal tract
Cancer of the esophagus
Stricture of the esophagus caused by
poisoning in case of fistula
General Instructions
It is essential that the area of the
skin around the tube be kept clean and dry
A water proof ointment such as zinc
oxide may be applied around the tube to protect the skin from the irritation of
the hydrochloric acid
Foods given through the gastrostomy
tube are some as those given by nasogastric tube and the same amounts are given
at the same intervals
Methods of Administration
Intermittent feeding: given four to
six times a day rather the continuously is delivered as a bolus through a
longer lumen tube. Volume for formula usually 250-450 ml is placed in a large
syringe and inserted into the proximal end of the tube
Intermittent gravity drip:
administration delivers a similar volume 250-450 ml of feeding over 20-30 ml a
minute, four to six times a day
Continuous administration: delivers
fluid through a small lumen tube at a constant rate via orogastric and
nasogastric routes. The rate of flow is carefully regulated. The nurse should
calculate the amount of fluid to be infused during an hour and regulates the
infusion pump accordingly
Preliminary Assessment
Check
The doctors order for specific
instruction
Level of consciousness of the patient
Self-care ability of the patient
Mental status to follow instructions
Articles available in the unit
Operation of
the Patient and Environment
Explain the sequence of the procedure
Provide privacy
Arrange the articles at the bedside
Place the patient in a comfortable
position
Keep the environment clean and tidy
Keep ready with feed to be given
Equipment
A clean tray
containing
A funnel, rubber tubing, glass
connection screw and a clamp
A glass of drinking water
Required amount of fed, temperature
100 degree F
Sterile lubricant to protect
surrounding area
Sterile dressing and forceps in a
dressing tray
Medicine as per odor
Kidney tray
Many tailed binder if required
Mackintosh and towel
Stethoscope
Syringe
Procedure
Wash hands thoroughly
Place the mackintosh or towel; clean
the surrounding area of the opening. Cover the wound with sterile piece of gauze
Unscrew the clamp from the
gastrostomy tube and attach the funnel and rubber tubing; keep the tube pinched
to prevent air from setting in
Aspirate the gastric contents by
attaching a syringe
Pour some clean water into the funnel
and lower a little to let our air
Then pour the feed before the funnel
is empty
If any medicines are ordered, these
are given after feed
Give water after giving medicines
Disconnect the tabbling and funnel
Clean and apply sterile instrument
around the wound, dress it with sterile dressing and apply the binder
After Care
Remove the Mackintosh and towel
Position the patient comfortable
Secure the tube with plaster
Replace the articles to utility room
Hand wash
Record the procedure in nurse record
sheet
BREASTFEEDING
Breastfeeding
is the best food for the baby. It’s not only gives nourishment but also suffice
the baby’s emotional needs.
Advantages
It is the best natural food for the
baby
It fully meets the nutritional
requirement of the infant and promotes optimal growth
It protects the baby from the
infections
It satisfies the sucking reflex of
the child
It is always clean and sterile
It is available at the correct
temperature and requires no preparation
Lactoferrin present in the breast
milk inhibits the growth of bacteria
Gastrointestinal disturbances are
less in breast fed, children, due to presence of lactobacillus fibrous
It creates bonding between the mother
and child
It helps parents to space their
children
It reduces infant mortality rate
It helps in involution of the uterus
It gives baby a sense of security
Contraindication for Breastfeeding
Mother
Breast diseases e.g., mastitis,
breast abscess
Cardiac diseases and active
tuberculosis
Infectious diseases
Mental illness of mother
Unconscious mother
Baby
Babies with cleft lip and cleft
palate
Premature and sick babies who have
poor sucking reflex
Oral thrush
Breastfeeding Methods
General Instructions
Mother should keep her body clean and
wear clean cloths
Before each feed, clean the breasts
and hands of the mother
Mother should be in comfortable
position during feeding
Hold the nipple between index and
middle finger
Feed the baby on demand; it helps the
baby to gain weight
Feed the baby for minimum 10 minutes
on each breast
Instruct the mother to feed the baby
even when the child is ill
Burping should be done after each
feed to expel the air from the baby’s stomach
When the baby is 4 to 6 months old start
weaning, because, mother’s milk is not sufficient to sustain growth after 6
months of age
If the baby’s napkin is wet, dirty,
change the napkins and cloths before each feeding
Weigh the child every month and
record it
Teach the mother to have adequate rest to avoid tension, fatigue and stress
ARTIFICIAL FEEDING
Artificial
feeding is given to infants instead to the breast milk. Breast milk is often
substituted by cow’s milk. The cow’s milk is substituted by dried milk,
evaporated milk, etc.
Difference
between human’s milk and cow’s milk
Human –
carbohydrate (7%), protein (1.5%) and fat (3.5%)
Cow –
carbohydrate (4%), protein (4%) and fat (4%)
Preparation of formula
The milk
formula should be planned to meet the nutritional requirement of the infant
which is based on his age and weight
Caloric
requirement: 110 calories per kg of baby weight
Fluid
requirement: 165 ml per kg of baby weight
Milk
requirement: 100 to 130 ml per kg of body weight
Number of
feeds in 24 hours: 7 feeds
Time
interval between each feed: 2-3 hours
Preparation
of Milk Formula for a Day
Take 460 ml
of milk, 140 ml of water and add 9 teaspoonful of sugar and boil it and keep it
in the refrigerator, for each feed, take 85 ml of milk, ward it and feed the
baby
Different Ways of Feeding in Infant
By using the feeding bottle and teat
By nasal tubes
By belcroy feeder
By dropper
By using spoon
General Instructions
Plan the formula according to the
nutritional requirement of the baby
The feeding bottle, teat and other
articles used for the feeding should be sterile
The milk feed should be warm
The mother and the child should be in
a comfortable position
Ensure a slow and steady flow of milk
by making a hold in the teat neither too big nor too small
Change the napkin before the feed, if
it is wet or soiled
The feeds should be given at regular
intervals
The mother should wash her hands
thoroughly before preparing the feed and feeding the child
Offer a small quantity of water at
the end of each feed
Never pinch the baby’s nose to make
him to open his mouth instead press his cheeks
Preliminary Assessment
Check
The doctors order for any specific
instructions
Plan the formula according to the
nutritional needs of the infant
Time at which the last feed was given
General condition of the baby
Baby’s ability for sucking
Articles available in the unit
Preparation of the Infant and the Environment
Arrange the articles at the bedside
Provide privacy
Change the napkin if it is wet
Bath the baby in necessary
Keep the feeding bottle ready
Equipment
A tray
containing
Mackintosh and towel
Baby dress and napkin
Feeding bottle and teat in a sterile
container
Required amount of feed (sterile)
Sterile water in a bottle
A piece of clean towel or flannel
Gown and mask for the nurse
Procedure
Wash hands thoroughly
Hold the baby in a position similar
to one used for breastfeeding
Check the temperature of the feed by
dropping few drops on the inner aspect of the wrist joint
Hold the bottle in an angle of 45
degree and bring the teat to the lips and then into the mouth of the baby
Take care to keep the teat filled
with milk throughout the feeding
Break the wind (burping) in between
the feeds
When the feed is finished, give
sterile water to the baby
After Care
Keep the baby on the shoulders and
pat over his back
Wipe the face
Remove the towel and lay the baby in
the cradle
Replace the articles in the proper
place after cleaning
CARE OF UNDER FIVE’S – Under Five’s Clinic, Aims of Under Five Clinics, Objectives of Under Five Clinics, Role of a Nurse in Under Five’s Clinic and Physical Facilities for a Children’s Clinic (CHILD HEALTH NURSING)
UPDATED 2026
THE RIGHTS OF THE CHILD
To meet the special
need of the child, the general assembly of the United Nations adopted on 20th
November 1959, and the declaration of the Rights of the child. India was a
signatory to this declaration
Right to develop in an atmosphere of
affection and security and whenever possible in the care and under the
responsibility of his/her parents
Right to enjoy the benefits of social
security including nutrition, housing and medical care
Right to free education
Right to full opportunity for play
and recreation
Right to a name and nationality
Right to special care if handicapped
Right to be among the first to
receive protection and relief in times of disaster
Right to learn to be a useful member
of society and to develop in a healthy and normal manner and in conditions of
freedom and dignity
Right to bring up in a spirit of
understanding of brotherhood
Right to enjoy these rights,
regardless of race, color, sex, religion, social and national origin
UNDER FIVE’S CLINIC
The under five’s clinic or well baby clinic’s combines the concepts of prevention, treatment, health supervision, nutritional surveillance, and education into a system of comprehensive health care within the resources available in the country, making use of nonprofessional auxiliaries, thus making the service not only economical but also available to a larger proportion of children in the community. Under five clinics must provide for courteous reception of mother and children, with enthusiasm and zeal on the part of each member of the team
AIMS OF UNDER
FIVE CLINICS
Care in
illness: the basic philosophy of the under five’s clinic to give nurses
effective training and responsibility for handling the child healthcare
service. The illness care for children will comprise of diagnosis and
treatment, X-ray and laboratory services and referral services
Preventive
care: the preventive care given on the basis of immunization, nutritional
surveillance, health checkups, oral rehydration, family planning and health
education
Growth
monitoring: for under five clinic to weigh the child periodically at monthly
intervals during the first year, every 2 months during the second year and
every 3 months thereafter up to a age of 5 to 6 years. The growth curve will
help the health worker to detect early onset of growth failure
OBJECTIVES OF UNDER FIVE CLINICS’
The prevention of malnutrition,
pertussis, tuberculosis, poliomyelitis, diphtheria, tetanus and measles
The supervision of the health of all
children upon the age of five
The education of parents to promote
health and family planning
The provision of simple treatment for
diarrhea, with or without dehydration, pneumonia, skin conditions and other
common disorders
ROLE OF A NURSE IN UNDER FIVE’S CLINIC
Treating minor illness
Referring the more seriously-ill
children
Instructing about feeding, nutrition
and hygiene
Encouraging child spacing and family
planning
Maintaining the children’s weight
cards, e.g. road to good health cards
Being alert in every conditions so
that the effectiveness of the service can be improved
PHYSICAL FACILITIES FOR A CHILDREN’S CLINIC
Outside compound: playground for
children waiting to be served including swings slides and sand box are needed.
These facilities may be provided by the community volunteer group or by the
health committee
Waiting room should include a
reception table and the record. The area should include child health posters,
display exhibits and play are for the children
Weighing and measuring should be
provided in a separate area if possible or it may be part of the waiting room
Isolation area for children with
signs and symptoms of illness is essential for every child health clinic
CARE OF UNDER FIVE’S – Under Five’s Clinic, Aims of Under Five Clinics, Objectives of Under Five Clinics, Role of a Nurse in Under Five’s Clinic and Physical Facilities for a Children’s Clinic (CHILD HEALTH NURSING)
Here are some key points regarding the care of children under the age of five:
Nutrition: Proper nutrition is crucial for the healthy development of children under five. Breastfeeding is recommended as the best source of nutrition for infants up to six months of age, followed by the introduction of complementary foods while continuing breastfeeding up to two years or beyond. Adequate intake of nutrients such as protein, vitamins, and minerals is essential for growth and development.
Immunization: Following the recommended immunization schedule is essential to protect children under five from vaccine-preventable diseases. Vaccines help build immunity and prevent the spread of infectious diseases, reducing the risk of illness, disability, and death.
Hygiene and Sanitation: Good hygiene practices, including handwashing with soap and water, safe food handling, and sanitation measures, are critical for preventing the spread of infections and diseases among young children. Access to clean water and sanitation facilities is essential for maintaining health and preventing waterborne illnesses.
Healthcare: Regular health check-ups and access to healthcare services are vital for monitoring the growth and development of children under five, detecting and managing health issues early, and providing appropriate treatment and preventive care. Maternal and child health services, including antenatal care, postnatal care, and well-child visits, play a crucial role in promoting child health and well-being.
Safety and Childproofing: Creating a safe environment for young children is essential to prevent accidents and injuries. Childproofing the home, including installing safety gates, securing furniture and electrical outlets, and keeping hazardous substances out of reach, helps minimize the risk of accidents and promote child safety.
Stimulation and Play: Providing opportunities for play, exploration, and stimulation is vital for the cognitive, emotional, and social development of children under five. Engaging in age-appropriate activities and spending quality time with children supports their learning and overall well-being.
Parental and Caregiver Support: Supporting parents and caregivers in providing responsive and nurturing care is crucial for the healthy development of children under five. Providing information, education, and support on child-rearing practices, positive discipline, and early childhood development can empower parents and caregivers to create a nurturing environment for their children.
Care of hair
is part of the personal hygiene. It is another way of helping the patient feel
good about him and maintain a good mental attitude. A patient’s hair should be combed
daily. In addition, other care is necessary to enhance morale, stimulate
circulation of the scalp and prevent tangled, matted hair
Purposes of Hair Care
Hair care improves the morale of the
patient
It stimulates the circulation of the
scalp
Shampooing removes bacteria,
microorganisms, oils, and dirt that cling to the hair
Objectives
To maintain cleanliness of the scalp
and hair
To prevent matting of hair
To promote comfort and to stimulate
circulation of the scalp
It gives an opportunity of
observation of the scalp and hair
It maintains a glossy and healthy
appearance of hair and gives satisfaction to the patient
Scientific Principles
Well-combed and attend hair provide
comfort to the patient and make appearance more attractive
Neglected hair and scalp contain dirt
and microorganism and also produce infection of the scalp
Unbroken skin acts as a barrier to
infection
Types of Hair Care
Daily care: the hair should be
thoroughly combed and brushed daily. A woman usually needs more attention to
the hair due to its length
Hair shampoo: shampooing the hair in
order to maintain its cleanliness
Treatment of hair: pediculosis
treatment – it is the treatment given with DDT 5% of carbolic lotion 1:40
applied thoroughly on the scalp and it is left for overnight, and the next day
a thorough bath is given and the linen is change
MAINTAINING HAIR CARE
Care of hair
means maintaining cleanliness of hair, i.e. free from dandruff, dirt, nits,
lice, flakes, dryness and irritation
Purpose
To keep hair clean and healthy
To promote growth of hair
To have a neat and tidy appearance
To prevent itching, infection,
dandruff, lice, flakes, dryness and irritation
To prevent loss of hair
To prevent accumulation of dirt
To stimulate circulation
To prevent tangles
To promote comfort
To have a sense of well-being
Three Aspects of Hair Care
Daily care by brushing and combing
Head bath in order to maintain to
cleanliness
Treatment of hair for lice
infestation
Factors Influence on Hair
General health of a person
A well-balanced diet
Light and fresh air
Daily practices (hair wash and
combing)
Hair brushing and massage
Endocrine disorder
Factors Affecting Hair
Altered level of consciousness
Physical weakness or disease
condition
Immobility and aging
Insect bite and infestations
Accumulated secretions
Hormonal changes
Physical and emotional stress
Poor health practices
Effects on drug
Common Hair Scalp Problems
Dandruff – sealing of scalp
accompanied by itching
Pediculosis – lice infestation
Alopecia – hair loss
Tangled and matted hair
Dryness
Flakes
Irritation
HAIR COMBING
The hair can
be combed and washed in the morning so that the patient can feel refreshed and
appear well-groomed before starting daily activities
General Instructions
Hair needs to be brushed daily in
order to be healthy
Long air should be combed at least
once a day to prevent it from matting
Teeth of the comb should be dull to
prevent scratching of the scalp
Hair must be kept free from snarls,
combed and brushed without hurting the patient
Preliminary Assessment
Check
Doctors order for specific precautions
General condition and self-care
ability
Condition of the scalp and hair
Mental status to follow directions
Articles available in the unit
Preparation of the Patient and Environment
Explain the procedure
Arrange the article at the bedside
Provide privacy and adequate light
Make the patient to sit on a bedside
chair or stool
Protect the bottom sheet and pillow
case with a towel
Protect the nurse’s uniform by
wearing aprons
Equipment
Clean comb
Mackintosh and towel
Coconut oil in a container
Kidney tray and paper bag
Kidney tray with carbolic lotion 1:20
to destroy the lice and to disinfect the comb
Procedure
Wash hands and take required articles
at bedside
If possible as patient to sit on a
stool otherwise side lying or fowler’s position
Place the Mackintosh under the head
of the patient
Each half of the hair is treated
separately without causing strain on the patient
Separate the hair in small strands.
To prevent pulling hold strands above the part being combed, so that there will
be no pain to the patient
Comb the tangle out from the ends
first and then go up gradually. Use oil to remove tangles
After combing the hair thoroughly,
use ribbon to tie the hair
Discard loose hair into the paper bag
After Care
Place the patient comfortable and
tidy
Replace the articles to the utility
room
Wash hands thoroughly
Record and report the procedure in
nurse’s record sheet
Problems of Neglected Hair Care
Neglected
hair care cause sticky and heavy and acquires a sour, unpleasant odor, which
may be quite distressing the patient. Pediculosis is associated with poor
hygiene, crowded living condition and exposure to other individuals.
The people
with pediculosis have complaints of severe itching of the scalp and scratch the
head continuously giving rise to abscess formation. The lice are blood suckers
and cause anemia. They also spread disease, e.g. typhus fever, relapsing fever,
trench fever.
HAIR WASH/BED SHAMPOO
The patient
confined to bed will require a cleansing shampoo at least every two weeks. With
the approval of the medical officer, plan the shampoo for a time when the
patient feels rested and has no conflicting treatments or appointments. If the
patient can be moved to a stretcher, do so and take him to a convenient sink.
If this is not possible, do the shampoo in bed
Definition
Hair
wash/bed shampoo is a special care of the hair may be required for patients who
are in bed for a prolonged period of time
Shampooing
the hair should be performed whenever the hair and scalp are dirty
Principles of Shampooing the Bed Patient’s Hair
The supine position is preferred for
weaker patients
Patients with significant heart or
lung disease will not tolerate being supine; they must be in a sitting position
Hair care should be given regularly
during illness, just as it would be normally
Purpose
To keep hair and scalp clean and
healthy
To promotes sense of comfort and
self-esteem
To complete the treatment of pediculi
General Instructions
The patients are given hair wash at
least once a week for bedridden patients
Avoid hair wash for patients who have
just taken meals at least for an hour
Avoid exposure and chilling by
keeping the patient covered with top clothes
If the patients are very sick, note
pulse before and after the hair wash
Do not let the patient exert and try
to avoid exertion to the patient as far as possible
Preliminary Assessment
Check
Doctors order for specific
precautions
General condition for the patient
Self-care ability
Patients preference for soap,
shampoo, oil, etc
Patients mental state to follow
instructions
Availabilities of ward article
Preparation of the Patient and Environment
Explain the procedure
Arrange the articles at the bedside
Provide privacy
Position the patient (flat)
comfortably to the edge of the bed (if condition permits)
Remove the extra pillows and back
rest
Make an improvised through (Kelly’s
pad) and place it under the hand to facilitate the drainage of water in to
receptacle
Place the bucket on the low stool
close to the side of the bed. The distal end of the Mackintosh (trough) is
received in to it
Plug the ear with cotton balls
Equipment
A tray contains bath towels – 2
Face towel – 1
Long Mackintosh – 1
Cotton swabs – 2
Liquid soap or shampoo
Hair comb
Kidney tray
Paper bag and news paper
Bucket – 1
Mug – 1
Jugs – 2 (hot and cold water)
Safety pins
Procedure
Following is
the procedure for administering a shampoo to a patient in bed
Place a newspaper on the chair and
the bucket on the newspaper. Place the patient of water, shampoo, comb, brush,
and one of the two bath towels on the bedside cabinet
Move the patient to the near side of
the bed. Lower the bed to a level position
Pull the pillow down under the patient’s
shoulders to assisting extending the neck. Fold one bath towel around the neck
Place the narrow side of the rubber
sheet under his head and over the edge of the pillow. Roll the sides of the
sheet to improvise a trough, and place the free end in the bucket
Give the patient a washcloth for his
eyes and face
Check provisions for water drainage
before pouring any water
Wet his hair and apply shampoo.
Lather and rinse it
Reapply shampoo and rinse the hair
again repeatedly until his hair is “squeaky clean”. (a woman will require more
rinse water than a man, but otherwise the procedure is unchanged)
Slip a dry towel under the patient’s
bed. Then roll and remove the rubber sheet. Pull the pillow up into its normal
place
Dry the hair by gently rubbing it
with a clean towel
Remove the equipment and wipe up any
water spilled on the floor
Assist the patient to comb and brush
his hair with a clean comb and brush
After Care
Place the patient in comfortable
position
Dry the hair, comb and arrange hair
when completely dry
Change linen if wet
Replace the articles into utility
room
Wash hands thoroughly
Record and reporting the procedure in
nurses record street
CARE OF HAIR – MAINTAING PATIENT HAIR, HAIR COMBING, HAIR SHAMPOO METHODS, Definition, Purpose, Equipment, Procedure, After care
Here are some general hair care tips to help maintain healthy and beautiful hair:
Regular Washing:
Wash your hair regularly to keep it clean and free from excess oil and product buildup. The frequency may vary depending on your hair type.
Use a Mild Shampoo and Conditioner:
Choose a shampoo and conditioner that suits your hair type and is free from harsh chemicals. Avoid excessive use of styling products with strong chemicals.
Avoid Hot Water:
Wash your hair with lukewarm or cool water. Hot water can strip the hair of natural oils, leading to dryness and damage.
Proper Conditioning:
Use a good-quality conditioner to keep your hair moisturized and manageable. Focus on the tips and mid-lengths of your hair while applying conditioner.
Protect Your Hair from Heat:
Limit the use of heat-styling tools such as flat irons, curling irons, and blow dryers. When using them, apply a heat protectant spray to minimize damage.
Regular Trims:
Schedule regular haircuts to prevent split ends and keep your hair looking healthy. Trimming every 6-8 weeks is a good rule of thumb.
Gentle Towel Drying:
Pat your hair dry with a soft towel instead of rubbing vigorously, which can cause breakage. Avoid using a towel on wet hair, as it is more prone to damage.
Protect Your Hair from the Sun:
UV rays can damage your hair. If spending extended periods in the sun, consider wearing a hat or using hair products with UV protection.
Balanced Diet:
A nutritious diet rich in vitamins and minerals contributes to healthy hair. Include foods high in protein, iron, and omega-3 fatty acids.
Avoid Tight Hairstyles:
Avoid hairstyles that pull on the hair, such as tight ponytails or braids, as they can cause breakage and damage the hair shaft.
Use a Wide-Toothed Comb:
Detangle your hair gently using a wide-toothed comb, especially when it’s wet to prevent breakage.
Hydrate:
Stay hydrated as it also contributes to the health of your hair. Dehydration can make your hair dry and brittle.
Limit Chemical Treatments:
Minimize the use of chemical treatments like coloring, perming, or straightening, as they can weaken the hair structure.
Choose Silk Pillowcases:
Silk pillowcases can reduce friction, helping to prevent tangles and breakage.
Manage Stress:
High stress levels can contribute to hair problems. Practice stress management techniques like meditation or yoga.
UNDER FIVE ASSESSMENTS – Purposes, Symbol of Under Five Clinics, Equipment Needed and Procedure (COMMUNITY HEALTH NURSING)
Updated 2026
Under five
clinic is also called the well-baby clinic that offers preventive and promotive
services for the benefit of the under-five or preschool children
PURPOSES
To provide carafe during illness
To provide adequate nutrition
To immunize the child at right time
To plan and prepare for family
planning
To provide health teaching or
education to promote health
To assess the growth and development
of children
SYMBOL OF UNDER FIVE CLINICS
Care in illness
Adequate nutrition
Immunization
Family planning
Health teaching/education
EQUIPMENT NEEDED
Weighing machine
Inch tape, Snellen’s eye chart
Shakir tape to measure midarm
circumference
Nutrition cups, infantometer to
measure the length of infant
Flash cards or posters and records or
health chart
PROCEDURE
Wash hands and warm
Keep ready with the articles such as
inch tape, shakir tape, nutrition cups
Explain the procedure to the parent
or the group
Weight the infant using weight
balance or Bar scale weighing machine or path weighing machine
Check the height by using inch tape,
use infantometer, if the child’s age is below 2 years
Record the height and weight in the
chart inform to their parents
Measure the chest and head circumference
and record
Anthropometry should be entered in
health record
General physical examination can be
done by the nurse to rule out any abnormalities
Rule out any refracting errors among
children by using Snellen’s chart
UNDER FIVE ASSESSMENTS – Purposes, Symbol of Under Five Clinics, Equipment Needed and Procedure (COMMUNITY HEALTH NURSING)
“Under Five Assessments” typically refers to a set of key evaluations used in public health to assess the health status of children under the age of five years. Here are some key points related to these assessments:
Nutritional Status: This assessment evaluates the nutritional status of children under five, focusing on parameters such as weight, height, and mid-upper arm circumference (MUAC). Malnutrition, including undernutrition and overnutrition, can significantly impact a child’s health and development.
Immunization Status: It’s crucial to assess whether children under five have received all recommended vaccinations according to the immunization schedule. Immunizations protect against a range of infectious diseases, preventing illness and potentially life-threatening complications.
Growth and Development: Monitoring growth and development milestones is essential for early detection of developmental delays or health issues. Assessments may include motor skills, language development, cognitive abilities, and social-emotional development.
Health Status: This involves assessing the overall health of children under five, including identifying any acute or chronic illnesses, infections, or conditions that may require medical attention. Regular health check-ups can help in early detection and management of health issues.
Access to Healthcare: Assessing access to healthcare services is crucial to ensure that children under five have access to essential healthcare services, including preventive care, treatment for illnesses, and maternal and child health services. Barriers to access, such as distance, cost, and availability of healthcare facilities, need to be identified and addressed.
These assessments play a vital role in monitoring the health and well-being of children under five, guiding interventions and policies aimed at improving child health outcomes and reducing child mortality rates.
TYPES OF COMFORT DEVICES (Role of Nurse in Comfort Measures)
Updated 2024
Comfort is
concerned with rest, with exercise, with the relation of one part of the body
to another, with the bed and the whole environment. Comfort is a phase of every
procedure as it is an aspect of the total care of the patient.
Comfort
devices are invented articles which would add to comfort of patient when used
in appropriate manner.
These devices relieve the discomfort and help in maintaining correct posture. Various comfort devices are used for giving comfort to the patient, such as: pillows, back rest, foot rest, bed block, bed cradles, sand bags, air cushion, rubber and cotton rings, air and water mattresses and knee rest.
Here are some common types of comfort devices:
Heating Pads:
These devices generate warmth and are often used to soothe muscle aches, cramps, or provide general comfort during colder weather.
Cooling Fans:
Fans help circulate air and can provide relief during hot weather. Some are portable, while others are built into air conditioning units.
Massage Chairs/Devices:
Designed to provide relaxation and relieve muscle tension, these devices come in various forms, including massage chairs, handheld massagers, and massage cushions.
Electric Blankets:
These blankets have integrated heating elements to provide warmth during colder nights, offering a cozy and comfortable sleep environment.
Orthopedic Pillows and Mattresses:
These are designed to support proper body alignment and reduce pressure points, offering comfort and relief for individuals with specific sleep or posture needs.
Humidifiers:
Humidifiers add moisture to the air, which can be beneficial in dry environments. They can help relieve respiratory issues, dry skin, and enhance overall comfort.
Aromatherapy Diffusers:
These devices disperse essential oils into the air, creating a pleasant and calming atmosphere. Certain scents are believed to have relaxation and stress-relief properties.
Foot Massagers:
These devices are designed to provide relief to tired and achy feet, often using massage techniques to improve circulation and reduce tension.
Weighted Blankets:
These blankets have added weight, which is believed to provide a calming effect and help alleviate anxiety or stress by providing a sense of security.
Eye Masks:
These masks are often used for relaxation or sleep aid, blocking out light and promoting a more restful environment.
Electric Foot Warmers:
Devices designed to keep feet warm and cozy, especially in cold weather. They often come in the form of heated slippers or foot warmer pads.
Therapeutic Cushions:
Cushions designed for specific purposes, such as lumbar support cushions for chairs or seat cushions with cooling gel for improved comfort.
PILLOWS
Pillows are
used to give comfortable position to the patient. These are most commonly used
to support various body parts.
Purpose
To maintain proper body alignment
To support body part in good
alignment
Help to reduce pressure
It can be folded, rolled or tucked
firmly against the body to maintain position
It is used to support head, neck,
arms, legs and part of the back adds to the physical comfort
BACK REST
Back rest is
a mechanical device which provides a suitable support and rest for the back of
the patient in sitting position
Purpose
To support back
To facilitate easy breathing
It is given especially for heart
patients and asthma patients
Used in postoperative period
ROLLS
Hand rolls are made of cloth that
rolled into a cylinder’ about 4-5 inches long and 2-3 inches in diameter and
stuffed firmly
Purpose
These used
to keep the fingers from being held in a tight fist leading to flexion
contracture in patients who are unable to move hands due to paralysis, injury
or disease. Thigh rolls are made by folding a sheet to the desired length of
2-3 feet and then rolled into a tight cylinder.
Thigh rolls
are used to support hips and thighs preventing them from outward rotation and
keeping the feet in good alignment in case of paralysis, fracture of femur of
hip surgery.
FOOT RESTS
Foot rests
are the mechanical device used to give rest to feet. Sands bags or foot board
may be substituted.
Purpose
It helps to maintain the normal
position of feet
It is used for the comfort
To prevent foot drop
SAND BAGS
Sand bags
are canvas, rubber or plastic bags filled with sand and are 1, 5 and 10 lbs in
weight. Sand bags are used to immobilize a part.
Purpose
To relieve discomfort
Used to support the body part
Used to immobilize the body part
Used to support as in fractures bones
To prevent foot drop or wrist drop
AIR AND WATER MATTRESSES
Air and
water mattresses are used for very thin or obese patients and for those who are
prone to get pressure sores. The principles is that pressure exerted by the
body, will be distributed equally in all directions.
Air and
water mattresses are plastic mattresses with two sets of chambers. To use them
place the mattress on the bed and fill air or water in the compartment. Cover
the mattress with light bottom clothes.
Purpose
To improve circulation
To provide comfort
To prevent pressure sores
Used in very thin or very obese
patients
Used in chronic bed ridden patients
Caution
Avoid
punctures in the mattress with needles, pins or other sharp objects
RINGS
Air rings
are made of rubber. The air rings is inflated about half full tested for
leakage, covered and the placed under the patient’s hip in such a way that the
value is on side and not in contact with body.
Cotton rings
are made wrapped with bandage. These are placed under the bony prominences such
as heels and fastened in place if necessary.
Purpose
Used to lift the hip from bed to
prevent bed sores
It helps to prevent direct pressure
on bony prominence
It improves the circulation
BED CRADLES
Bed cradles
vary widely in size and in material. Bed cradles are of wooden, metal or
electronic. The bed cradles support and take off the weight of the bedding.
Bed cradle
are semi-circular in shape made of wood or metal or entirely made of metal tubing
or slats.
Purpose
Used to prevent the top cloth is
coming in contact with the patients especially in burns patients
To apply heat in case of dying
plaster casts
Electronic bed cradles are used to
supply the desired warm to the case of shock
BED BLOCKS
Bed blocks
are made up of wood size; it may be high or low. These are placed under the
foot of bed for various reasons.
Purpose
To prevent shock
To arrest hemorrhage
To retain enema
After spinal anesthesia
After tonsillectomy
To provide traction
To position in postural drainage
AIR CUSHION
Air cushions
are round in shape and made up of rubber. These can be inflated with air. These
are used to take off the weight of the body.
Air cushion
should not be applied directly in contact with skin. They should have a cover.
Purpose
To relieve pressure on certain parts
of the body
It provides relaxation as it yields
to shift off body weight and it relieves pressure on certain parts of the body
Uses: air
cushion vehicles work by creating a large force of those points to the ground.
This lifts the vehicle off the ground letting it ride on a cushion of air.
CARDIAC TABLE
A table is in the hospital for patient’s use
during hospitalization. It is used to maximize safety of both patients and
staff. Improve patient’s surrounding by modifying the current cardiac table to
one that can be kept and folded.
Bed table placed in front with a
pillow on it, patient can lean forward and take rest
Table without pillow is used for
writing and meals
Used for patients with cardiac
conditions and asthma
Position should be changed to relieve
fatigue
Purpose
Patient can rest over the table with
the help of pillow
Helps to take meals and in writing
TRAPEZE BAR
An overhead
trapeze is a triangle-shaped metal bar. It hangs from a metal frame, which is
attached to the headboard and footboard of the bed. A trianglular metal
apparatus above a bed, used to help the patient move and support weight during
transfer or position change.
Trapeze bar
is suspended from an overhead frame that extends from the foot to head of bed.
Patient can grasp the bar to raise the trunk off the bed surface or to move up
in bed.
ROLE OF NURSE IN COMFORT MEASURES
Nurse identify comfort needs of patients and family members
Nurses design interventions to meet identified needs
Intervening variables are considered when designing interventions
When interventions are delivered in a caring manner and are effective, and when enhanced comfort is attained, interventions are called “comfort measures”
Patients and nurse agree on desirable and realistic health seeking behaviors
If enhanced comfort is achieved, patients and family members are more likely to engage in health-seeking behaviors these further enhance comfort
When patients and family members are given comfort care and engage in health-seeking behaviors, they are more satisfied with health care and have better health-related outcomes.
When patients, families, and nurses are satisfied with health care in an institution, public acknowledgement about that institution’s contributions to health care will help the institution remain viable and flourish.
COMFORT DEVICES USED IN HOSPITAL (Definition, Purpose, Principles, Preparation, Factors influencing Comfort and Types)
Updated 2024
Comfort is a
sense of mental and physical well being. Physical comfort gets affected due to
a dirty and wet bed and lack of body alignment. High temperature and humidity,
poor ventilation too much noise, unpleasant odors and glaring lighting make the
patient uncomfortable. To promote comfort for the patients, certain mechanical
devices can be used.
Pillows can
be used for giving support for the various part of the body. Sometimes –
patient feels comfortable in a propped up position. In a hospital, a backrest
is provided for the patient to keep him in a sitting position. For relaxation
of abdominal muscles, when patients are in pain or after an abdominal
operation, knees can be kept flexed by means of a knee rest. Comfort devices
are mechanical devices which are used to provide comfort to the patient
DEFINITION
Comfort is a state of free from pain
and discomfort tension and anxiety
Comfort is defined as the contented
enjoyment in physical or mental well being freedom from pain or trouble
Discomfort is defined as want of
comfort or ease due to pain or annoyance
Comfort devices are the mechanical
devices to promote comfort to the patient
Comfort devices are invented articles
which would add to the comfort of the patient when used in the appropriate
manner, by relieving the discomfort and helping to maintain correct posture
PURPOSE
To promote comfort
To prevent discomfort
To alleviate discomfort
To ensure that the patient has rest
To assist the patient to obtain an
adequate sleep to meet his requirement
To maintain correct posture
PRINCIPLES OF COMFORT
Definite periods of sleep are a
essential component of the circadian rhythm in human being
Adequate amounts of sleep are needed
for optimal physical and psycho-social functioning of the individual
Individual needs for sleep vary with
age, growth patterns, health status and individual differences
Lack of sufficient sleep impairs a
person’s physical functioning, his mental alertness and his social relationship
Individual habits vary with regard to
bed time rituals
Sleep pattern may be disturbed by
changes in person’s normal daily living patterns by social and emotional
problems by physical problems and by minor irritation or discomforts
Sleeps at terms are almost invariable disturbed by illness
PREPARATION OF AIDS
The use of
aids for positioning helps to keep the patient in the desired position so as to
avoid pressure ulcers developing as well as facilitate the moving of the
patient.
Aids that help to keep the patient in
the desired position, or prevent pressure ulcers developing
Decubitus pad or mattress
Small or large cushions
Feet or elbow pads (or foam rings)
for reducing pressure on the skin
Trochander roll or other aids to
prevent external rotation of the hip
A roll (e.g. inflatable) placed under
knee
Block (box) of foam or inflatable
FACTORS INFLUENCING COMFORT
Pain
Restriction of movements due to
weakness
Wrinkled soiled and wet sheets
Delayed or inadequate attention to
meet the personal needs
Lack of exercise
Temperature extremes
Too bright lights and glares
Fear and anxiety due to illness
Insecurity feeling
Lack of sleep
Uncomfortable position
Indigestion and irregular bowel
movements
The ‘English
word ‘hospital’ originates from the Latin word “HOSPILE” and also some viewed
that it comes from the French word “hospitale.”
Types of
Comfort
Relief – the state of having a
specific comfort need met
Ease – the state of calm or
contentment
Transcendence – the state in which
one can rise above problems of pain
Psychospiritual
– pertaining to internal awareness of self, including esteem, identity,
sexuality, meaning in one’s life, and one’s understood relationship to a higher
order or being
Environmental
– pertaining to the external background of human experience (temperature,
light, sound, odor, color, furniture, landscape, etc)
Sociocultural
– pertaining to interpersonal, family, and societal relationships (finances,
teaching, healthcare personnel, etc). Also to family traditions, rituals, and
religious practices
COMFORT DEVICES/MECHANICAL DEVICES
PILLOW – used for support to maintain
correct body alignment. Used under head, arms, legs and along spine or abdomen.
Correct positioning reduces strain on muscles and joints back rest. Support
patients back at an angle, so that he may maintain a sitting position. Can be
adjusted to desired angle. Extra pillows are needed. Arms of patient are well
supported. Used for patients suffering with cardiac and pulmonary distress
Purposes:
To relieve dyspnea
To promote drainage from abdominal
cavity
To provide a comfortable change of
position
Backrest – it is a mechanical device
which provides support for the patient in sitting position
Cardiac cradle – it is a frame used
to hold the bed linen from touching the patient. It is used to prevent pressure
from the weight of linen. It is used to allow air to circulate around lower
limbs. Cradle is often a semicircular frame of metal. Maybe made of wood or
bamboo. It may be made into a rectangular shape
Cardiac table – usually for patients
who are propped up in a sitting position for change of position. Bed table
placed in front with a pillow on it, patient can lean forward and take rest.
Table without pillow is used for writing and meals. It is used for patients
with cardiac conditions and asthma. Make it possible to use accessory muscles
of respiration. Position should be changed to relieve fatigue and prevent
embolism
Bed boards – boards are usually made
of wood and are placed under the mattress to provide support chairs bed. Beds
can be placed into the position of chair for patients who cannot move from the
bed but require a sitting position
Knee rest – knee rest may be
substituted by a pillow, gives relaxation and thus relieves pain on abdominal
muscles and tendons beneath the knees
Foot rest/board – foot board is the
device that is placed towards the foot of patient’s bed to serve as support for
his feet. Some fit onto the sides of bed frame and rest on the mattress at any
point along the bed. Usually made up of wood/plastic/heavy canvas
Trapeze bar – trapeze bar is
suspended from an overhead frame that extends from the foot to head of bed.
Patient can grasp the bar to raise the trunk off the bed surface, or to move up
in bed
Fracture board – fracture board is a
support that is placed under patient’s mattress to give added rigidity to the
mattress. Usually made of wood/canvas and is constructed to fit the standard
hospital bed
Balkan frame – Balkan frame is made
of wood or metal that extends lengthwise above the bed and is supported at either
ends by a pole. Trapeze may be attached to the frame just above patient’s head
as an aid to the pt in lifting himself up in bed fracture board
Bradford frame – it is a canvas
stretcher like device that is supported by blocks on the foundation of bed. It
used to immobilize patients who have injured spines. Canvas is divided into 3
parts so that small center portion can be removed to insert a bedpan
Trochanter board – trochanter rolls
prevents external rotation of legs when patient is in supine position. A cotton
bath blanket/sheet is folded lengthwise to width extending from greater
trochanter of femur to lower border of popliteal space blanket is placed under
the patient until thigh is in neutral position with patella facing upward
Bradford frame
Sand bags – it provides support and
shape to body contours. Immobilize extremities and maintain specific body
alignment. They are filled plastic bags that can be shaped to body contours. It
can be used in place of or in addition to trochanter rolls
Hand rolls – hand rolls maintain
thumb in slightly adducted and in opposition to fingers. Maintain fingers in
slightly flexed position. It can be made by folding a washcloth in half,
rolling in lengthwise and securing roll with rape. Roll is placed against palmar
surface of hand sand bags
Hand-wrist splints – individually
molded for the patient to maintain proper alignment of the thumb in slight
adduction and wrist in slight dorsiflexion. These splints should be used for
the patient whom the splint was made.
Side rails – side-rails are bars
positioned along the sides of the length of the bed. Ensure patient’s safety
and are useful for increasing mobility. Provide assistance in rolling from
side-to-side or sitting up in bed
Air and water mattress – these are
used for very thin, obese and those who are prone to bed sores. The principle
exerted on the bony prominences will be equally distributed in all directions,
thus pressure against bony prominences or areas subject to develop pressure
sores will be reduced
Rubber and cotton rings – it is used
to relieve pressure on certain parts of the body like elbows and heels
Air cushions – it is used to take off
the weight of the body and to relieve pressure on certain parts of the body.
Air cushion should not be used directly in contact with the skin. They should
have covers
Bed blocks – these are made of wood,
may be high or low. These are placed under the foot of the bed for various
reasons, e.g. surgical shock, traction and postural drainage. This may be
placed under the head of bed to promote drainage and improve cerebral
circulation. It is used to prevent shock, to arrest hemorrhage, to retain enema
and after giving spinal anesthesia
Thigh rolls – these are made by folding a sheet to a desired length of 23 feet and then rolled into a tight cylinder. These are used to support the hips and thighs, preventing them outward rotation and keeping the feet in good alignment, in case of paralysis, fracture of the femur or hip surgery. To use the roll, place the lose end (flap) under the patients hips and thighs with the role under the flap end and then tucking snugly along the hip and thigh
CHILD SURVIVAL AND SAFE MOTHERHOOD PROGRAM (CSSM) (CHILD HEALTH NURSING)
Updated 2024
INTRODUCTION
CSSM program launched on 20th
August 1992
CSSM program is directed at achieving
9 of the 17 goals of National Health Policy (1983) which are related to
maternal and child health
OBJECTIVES OF CSSM
Giving strength to universal
immunization program
Giving continual ORT to children
below 5 years of age against respiratory infections
Protect children below 3 years of age
against blindness caused by deficiency of vitamin A
Providing iron and folic acid tablets
to pregnant mothers, lactating mothers and children below 5 years of age to
protect them against malnutritional anemia
To bring improvement in the care of
infants and mothers at community level
ACTIVITIES OF CSSM
Children
Essential newborn care
Immunization
Appropriate management of diarrhea
Appropriate management for acute
respiratory infections
Vitamin “A” prophylaxis
Mother
Immunization
Prevention and treatment of anemia
Antenatal care and early
identification of maternal complications
Deliveries by trained personnel
Promotional of institutional
deliveries
Management of obstetric emergencies
Birth spacing
GOALS OF CSSM
To decrease IMR, MMR and under five
mortality rate
Polio eradication by 2000 AD
Neonatal tetanus elimination by 1995
Measles prevention
Diarrhea – prevention of 70% deaths
and 25% cases by 2000 AD
Acute respiratory infections (ARI),
prevention of 40% deaths by 2000 AD
COMPONENTS OF CSSM – 3E’S
Essential maternal care
Early identification of complications
Emergency obstetric care
STRATEGIES OF CSSM
To improve maternal care and promote
birth spacing
To train medical and other health
personnel in essential newborn care
To use of low cost effective and
locally available equipment for newborn
To provide basic facilities for care
for low birth weight and sick newborns in first referral units and district
hospitals
Create awareness about essential
newborn care among healthcare providers, pregnant women and mother of the
newborns
CHILD SURVIVAL AND SAFE MOTHERHOOD PROGRAM (CSSM) (CHILD HEALTH NURSING)
PATIENT POSITIONING – Purpose, Principles, Factors Involved, Types, General Instructions, Preliminary Assessment, Equipment and Procedure
Updated 2024
Positioning
defined as placing the person in such a way to perform therapeutic
interventions to promote the health of an individual.
Positioning
defined as placing the person in a proper body alignment for the purpose of
preventive, promotive, curative, and rehabilitative aspects of health.
PURPOSE
To provide comfort to the patient
To relieve pressure on various parts
To improve circulation
To prevent formation of deformity
To carry out investigations
To perform surgical and medical
investigations
To prevent pressure sores
To provide proper body alignment
To conduct delivery/labor
To carryout nursing interventions
PRINCIPLES OF POSITIONING
Systemic and orderly way of doing
Cooperation between two
Follow safety measure to prevent
accidents
Active participation
Using a right technique at right time
FACTORS INVOLVED INN POSITIONING
Need of an individual
Self care ability
Extend of disability
Nature of disease condition
Level of consciousness
Protocol of the hospital
TYPES OF POSITION
Dorsal position
Dorsal recumbent position
Lithotomy position
Lateral position
Prone position
Slim’s position
Knee-chest position
Trendelenburg’s position
Fowler’s position
SUPINE POSITION
Supine position,
the patient lies on his back with his head and shoulders are slightly elevated.
One pillow is given under the head. His legs should be slightly flexed. A small
pillow is placed under his knees.
LATERAL POSITION
Patient lies
on left side with legs flexed at thighs. The upper leg is flexed more than the
lower. A pillow is kept in front of the abdomen and at the back and one under
the upper leg.
PRONE POSITION
A patient
lies flat on abdomen. Head turned to sideways. One soft pillow is given under
head. An extra pillow is given under the ankles to keep toes from touching the
bed.
DORSAL RECOMBENT POSITION
Patient lies
on back, knees fully flexed, thighs flexed and externally rotated feet flat on
the bed
SEMI-FOWLER’S POSITION
The
semi-fowler’s position is the position of a patient who is lying in bed in a supine
position with the head of the bed at approximately 30 to 45 degrees.
FOWLER’S POSITION
Fowler’s
position is a sitting position in which the head is elevated, at least, a 45
degree angle. Back rest and two pillows are used for the back and head.
Fowler’s position the main weight bearing areas of the patient are the heels,
sacrum and the posterior aspects of the ileum.
LITHOTOMY POSITION
The patient
lies on her back. The legs are separated and thighs are flexed on the abdomen
and the legs are on the thighs. The patient’s buttocks are kept the edge of the
table and legs are supported by stirrups.
ASSISTING THE PATIENT IN KNEE-CHEST POSITION
A prone
position in which the individual rests on the knees and upper part of the
chest, assumed for gynecologic or rectal examination. It is also called
genupectoral position.
KNEE CHEST POSITION
Patient
rests on the knees and the chest. The head is turned to one side with one check
on a pillow. A pillow is placed under the chest. The weight is on the chest and
knees.
CARDIAC POSITION
The client
is propped-up in a sitting position by means of back rest and pillows. Place an
over bed table in front with a pillow on it. The client has an aircushion to
sit and a small pillow under the knees.
TRENDELENBURG’S POSITION
The patient
lies on his back. The patient’s head is low. The foot of the bed is elevated at
45 degree angle. The body is on an inclined place and the legs hang downward
over the end of the table.
TYPES OF PATIENTS NEED SPECIAL CARE
Unconscious patient
Infant and children
Hemiplegic and paraplegic position
Immediate postoperative patients
Orthopedic patients
Cardiac patients
GENERAL INSTRUCTIONS
Maintain good body alignment of the
patient at all times
Support body parts in good alignment
by using supportive devices to promote comfort and prevent undue muscle strain
Avoid prolonged flexion of any one
body segment by changing the position at least every two hours
Reduce the pressure caused by body
weight of his or her body or object by changing the position and using
protective devices
PRELIMINARY ASSESSSMENT
Check the patient’s general condition
Check the physician’s order for any
limited movements
Assess the self-care ability of an
individual
Arrange the comfort devices near the
bedside
Identify the deformed extremity
Support the immobilize area during
positioning
Identify the rationale before
positioning
EQUIPMENT
Extra man power if needed
Extra pillows
Sheets and sheet rolls
Comfort devices such as back rest, cardiac table, sand bag, etc
PROCEDURE
Explain the procedure to the patient
Provide privacy
Arrange the articles and manpower (if
needed)
Untie the bed sheets
Turn/lift/ambulate gently
Place and support with extra pillows
under pressure points
Special care taken at pressure areas
Cover the patient with top sheet
Hand wash
Record the time, position and
condition of the skin
Positioning a patient in bed is
important for maintaining alignment and for preventing bed sores (pressure
ulcers), foot drop, and contractures. Proper positioning is also vital for
providing comfort for patients who are bedridden or have decreased mobility
related to a medical condition or treatment. When positioning a patient in bed,
supportive devices such as pillows, rolls, and blankets, along with
repositioning, can aid in providing comfort and safety.
Good body
alignment can be achieved in any of the bed rest positions. The following
points should be checked.
Head should be in midline with the
trunk
Back should be straight, with normal
body curves (cervical, thoracic, and lumbar) maintained
Ribs should be elevated to prevent
constriction of the chest
Arms and legs should be in a position
of function (the position for maximum usefulness of the joints, feet and hands)
Position of function of leg and feet. This position favors
standing upright and walking. In general, if the toes point to the ceiling when
in a back-lying position and point to the floor when in a front-lying position,
the feet, legs, and hips are in good alignment.
Position of function of arms and hands. This position favors raising arms and grasping things with the fingers. The hand should not droop at the wrist, be clenched in a fist, or be flat. The position of function for the hand is dorsiflexion (at a slight upward angle) at the wrist, with the fingers and thumb in position to write with a pencil.
COLD COMPRESS (Cold Application) – Definition, Purpose, General Instructions, Preliminary Assessment Check, Effects, Physiologic Effects, Indications, Preparation of the Patient and Environment, Equipment, Procedure, After Care and Contraindications
Updated 2026
Cold
compress is a local moist cold moist application made out of folded layers of
gauze, lint piece or old soften linen, wring out of cold or ice water or in
some evaporating lotion.
DEFINITION
A cloth
wrung from cold or ice water which may be applied to any part of the body.
PURPOSE
To provide comfort
To reduce body temperature
To reduce inflammation and edema
To relieve pain, burning sensation
and irritation
To anesthetize for short time
To control hemorrhage
To inhibit bacterial growth and thus
prevent suppuration
GENERAL INSTRUCTIONS
Application of cold compress over the
skin helps in conduction of heat
Cold application beyond 20 minutes
leads to secondary effects
Check the temperature every 15
minutes, it helps in detection of any variations in the body temperature
PRELIMINARY ASSESSMENT CHECK
The doctor order for any specific
instruction
General condition and diagnosis of
the patient
Self-care ability of the patient
Assess for the need of cold
applications
Frequency and duration of application
For any contraindication of cold
application
Articles available in the unit
EFFECTS
To prevent
the depression that often occurs following heating treatments. The most
effective form of cold compress is a small towel wrapped around the head like a
turban during the treatment. The same receptors, or special nerve endings,
which serve to convey stimuli to the blood vessels and nerve endings, hence to
all the organs reflex connected with them, are affected as much by cold
applications as by hot. The more intense is the stimulation, the greater the
reaction.
PHYSIOLOGIC EFFECTS
To decrease blood flow locally and distally
To prevent and relieve congestion
For relief of pain due to edema
and/or trauma
If applied over the heart: will slow
the heart rate, increase the force and raise the arterial blood pressure
To increase the reflect effect of
thermal applications by increasing the difference between hot and cold; an
example is using the cold compress following a fomentation.
INDICATIONS
Throbbing pain due to edema or
trauma, such as sprains
Fevers
Congestion in the face and
head-sinusitis and head-ache (use with a hot foot bath)
As a precordial compress in
tachycardia-fast heartbeat (more than 100 beats/min)
May be applied as a turban to the
head or cravat to the neck with general applications of heat
Headache-apply cold compress to head
while using a hot foot bath
Passive chest congestion in lung
problems, together with fomentations
PREPARATION OF THE PATIENT AND ENVIRONMENT
Explain the procedure to the patients
Arrange the articles at the bedside
Provide privacy
Place the patient in a comfortable
position
Bring the patient to the edge of the
bed
Place the Mackintosh and towel under
the patient to protect the bed
EQUIPMENT
A clean tray containing:
Bowel with ice water
Folded gauze pieces in a bowl
Mackintosh and towel
Small cotton balls in a bowl
Thermometer tray
PROCEDURE
Wash hands
Pack the ear with cotton balls if
compress is to be applied to forehead
Take the gauze pieces immerse it in
the water wring it
Make sure that there is not dripping
of water and apply it to the part ordered
Change it as soon as it becomes warm
Check the temperature every 15
minutes
Keep a constant watch on the color of
the skin. Test the skin for numbness
AFTER CARE
When the time is over, remove the
compress
Wipe the part and make the patient
comfortable
Take out the cotton balls from the
ears
Inspect the part for discoloration or
numbness
Place the patient in a comfortable
position
Check the vital signs end of the
treatment
Replace the articles after cleaning
Wash hands
Record the procedure in nurse’s
record sheet
Record the vital signs in TPR sheet
CONTRAINDICATIONS
Diabetes use with caution
Local skin inflammation
Patients who cannot tolerate cold
Patient who is chilled – wait until
the entire body is warm
COLD COMPRESS (Cold Application) – Definition, Purpose, General Instructions, Preliminary Assessment Check, Effects, Physiologic Effects, Indications, Preparation of the Patient and Environment, Equipment, Procedure, After Care and Contraindications
