power point presentation of Clinical evaluation of strabismus
Confidentiality and privacy.pptx
1. M O H A M M E D A ( R N , B S C N )
Confidentiality and privacy
2. Cont.…
The terms 'privacy' and 'confidentiality' are
commonly used interchangeably. Privacy may also
relate to information about oneself, and information
privacy laws regulate the handling of personal
information through enforceable privacy
principles. Confidentiality relates to information
only.
3. Confidentiality
Confidentiality;- is the protection of personal
information.
Confidentiality means keeping a client’s information
between you and the client, and not telling others
including co-workers, friends, family, etc.
Confidentiality is a critical aspect of your duty of
care.
4. Examples of maintaining confidentiality include:
individual files are locked and secured
support workers do not tell other people what is in a
client’s file unless they have permission from the client
information about clients is not told to people who do not
need to know
clients’ medical details are not discussed without their
consent
adult clients have the right to keep any information about
themselves confidential, which includes that information
being kept from family and friends.
5. The types of information that is considered
confidential can include:
name, date of birth, age, sex and address
current contact details of family, guardian etc.
medical history or records
personal care issues
file progress notes
individual personal plans
assessments or reports
income or outgoing personal correspondence.
6. Other information relating to
ethic or racial origin,
political opinions,
religious or philosophical beliefs,
health or sexual lifestyle should also be considered
confidential.
7. There are several instances where total
confidentiality is either impossible, undesirable or
illegal.
These include:
if the health and/or welfare of a child or young
person is at risk. You are required to contact
Department of Community Services and notify them
of your concerns.
if your client tells you he/she has committed a
serious crime. You are required to notify your
supervisor or the police directly.
8. if a worker is subpoenaed to present information in a
court of law
when the client needs to be protected from harming
themselves (eg if suicidal)
where others may need to be protected (if the client
has threatened to harm others or will do so
inadvertently).
when working in conjunction with other
professionals in caring for a client the requirements
of professional supervision, training, workshops or
seminars
9. When we tell the information of patient
If welfare of pt. at risk.
committed a serious crime.
information in a court of law
protected from harming themselves (eg if suicidal)
if the client has threatened to harm others
conjunction with other professionals in caring for a
client
10. Importance of confidentiality
Confidentiality is important for several reasons.
One of the most important elements of confidentiality
is that it helps to build and develop trust.
It potentially allows for the free flow of information
between the client and worker and acknowledges that a
client’s personal life and all the issues and problems
that they have belong to them.
One of the major purposes for obtaining a client’s
consent before speaking to a third party (such as
another agency or a family member/carer) is to protect
the confidentiality and privacy of the client.
11. Cont.…
Informed consent (obtaining personal information
with the formal permission of the client or a person
who has the legal authority to provide permission on
behalf of the client) is considered essential in
maintaining the privacy of the client.
12. privacy
Privacy;-the right of individuals to be left alone and
to be protected against physical or psychological
invasion or the misuse of their property.
What does privacy mean in care?
Medical privacy or health privacy is the practice
of maintaining the security and confidentiality of
patient records.
The terms can also refer to the physical privacy of
patients from other patients and providers while in a
medical facility.
13. Cont.…
The word privacy has four major usages,
corresponding to four distinct forms, dimensions, or
conceptions of privacy:
physical privacy,
Informational privacy,
proprietary privacy, and
decisional privacy.
14. Cont.…
Physical privacy is a restriction on the ability of
others to experience a person through one or more of
the five senses;
Informational privacy is a restriction on facts about
the person that are unknown or unknowable;
Decisional privacy is the exclusion of others from
decisions, such as health care decisions
proprietary privacy ;-confidentiality of works to
protect patient proprieties.
15. The principle of confidentiality and privacy
You must respect and protect patient information
Patients must consent before you share any
information about them.
When asking for consent you should tell the patient:
1. what information you want to share
2. who you want to share it with, and
3. how the information will be use
Anyone you employ must also protect patient
information.
16. Cont.…
If an adult patient with capacity tells you not to share
information with other people, you should firstly
discuss this with them, and explain why you need to
share the information.
If they still refuse, you should not share their
information, even if failure to share would leave the
patient (but no one else) at risk of serious harm or
death.
17. If you believe that the patient’s decision to refuse a
service puts them at risk of serious harm, you must
discuss this issue with appropriate colleagues, whilst
respecting the patient’s confidence.
You can share patient identifiable information if you
are required to do so by law, or disclosure is justified
in the public interest
18. Cont.…
There are exceptions to the rule of protecting patients’
confidentiality which are:
you may be required to provide information by law,
for example if ordered by a court, or
you may need to disclose information if it is in the
public interest, for example where failing to disclose
information would expose other members of the
public to risk of death or serious harm.
You may disclose information without patient consent
if you have reason to believe that asking for consent
would put you or other people at risk of serious harm
19. Privacy and confidentiality are also supported by two
principles of the Belmont Report:
Respect for persons – Individuals should be treated
as autonomous agents able to exercise their autonomy to
the fullest extent possible, including the right to privacy
and the right to have private information remain
confidential.
Beneficence – Maintaining privacy and confidentiality
helps to protect participants from potential harms
including psychological harm such as embarrassment or
distress; social harms such as loss of employment or
damage to one‘s financial standing; and criminal or civil
liability
21. Class work
1) Define Confidentiality
2) List types of information that is considered
confidential.
3) What does decisional privacy mean?
4) When we tell the information of patient to the other
person
5) What does physical privacy mean?
22. Transport client
Definition: Transfer is defined as preparing patient,
completing necessary records and shifting patient to
another department within the hospital or to another
hospital/home.
Transfer/referral is the preparation of a patient and
the referral records to the shift the patient to another
department within the hospital or to another
hospital
23. Purpose
To obtain necessary diagnostic tests and
procedure
To provide treatment and Nursing care
To provide specialized care
To place most appropriate utilization or
available personnel and services
To match intensity(quality) of Nursing
care, based on patients level of needs and
problems
24. Types of transfer of the patient
1. Internal transfer: to transfer the
patient in a unit that provide special
care or care suited to his need, e.g.
from general ward to ICU
2. External transfer: to transfer the
patient from one hospital to another
hospital for the purpose of special care,
e.g. from general hospital to specialized
hospital- cancer center
25. Preliminary(preceding) assessment
A. Assess the method for transport, inform
receiving nurse
B. Maintain patient‘s physical wellbeing during
transport to new Nursing unit
C. Provide verbal report about patient‘ s
condition to the receiving unit nurse
D. Be sure all documentation including care
plan is completed
26. E. Assist‘s patients arrival to the new unit
F. Announce patients arrival to the new unit
G. Transport patient to the new room and assist in
transfer to bed
H. Hand over(pass responsibility to someone else) to
receiving nurse
28. Procedure
1.Check the doctor‘s orders for transfer of
patient
2. Inform the patient and relatives
3. Inform to the ward nurse where the patient
needs to be transferred
29. 4. Check the chart for complete
recording of vital signs, Nursing care and
treatment given
5. Collect patient x-ray, medicine and
other belongings
6. Cancel the hospital diet or transfer
30. Cont.…
7. Assist the relative to collect other
belongings
8. Make arrangement to settle the due
bills if patient is goining to be transferred
another hospital
9. Record time, mode of transfer and
general condition of the patient
31. 10. Assist transferring sink patient to
wheel chair/stretcher and accompany
patient to new area
11. Handover patient documents ,
belonging and report verbally to the in
charge nurse
32. Cont.…
12. Collect the ward articles
13. Inform to the concern person /
department regarding transfer of the
patient
14. Clean unit thoroughly and keep ready
for next patient
33. Caring for a patient on discharge
Definition:
Patient discharge is sending the
hospitalized patient to home or to
referral after successful discharge
planning process.
Patient discharge planning is systematic
process for preparing the patient to
leave the hospital & for continuity of
care at home.
34. Purpose
To continue self care at home
To adjust the patients setting out of
the hospital
To ensure adequate home health care
support
To minimize the patient‘s anxiety at
discharge
35. Indications for discharge
Progress in the patient's condition
(cured)
No change in the patient's condition
(Referral)
Against medical advice
Death
36. Procedure
1.Check for the doctor‘s written order that
pt. to be discharged.
2. Inform patient and relative about
discharge
3. Document relevant dis charge
information
37. 4. Make sure all the fees(a payment
made to a professional person) are
included
5. Send admission card to registration
office
38. Cont.…
6. Plan for continuing care of the patient
Give information for a person
involved in the patient care.
Contact family or significant others, if
needed.
Facilitate transportation with
responsible unit
7. Assist patient to dress up
39. Cont.…
8. Teaching the patient about ;
What to expect about disease outcome
Medications (Treatments)
Activity
Diet
Need for Follow up and others as needed
9. Do final assessment of physical and emotional
status of the patient and the ability to continue own
care.
40. Cont.…
10. Check and return all patients‘ personal
property (bath items in patient unit and those
kept in safe area).
11. Help the patient or family to deal with
business office for customary financial matters
and in obtaining supplies.
12. Accompany(occur at the same time as)
patient to the gate, if possible
41. Cont.…
13. Write Discharge summaries note which usually include:
Time and date of discharge
Description of client‘s condition at discharge
Treatment (e.g. Wound care, Current medication)
Diet
Activity level
Restrictions
N.B: If a patient insists upon going home against medical
advice he should be requested to sign a statement indicating
that he is responsible for his action.
42. Discharging a patient against medical
advice (AMA)
1. When the patient want to leave an agency
without the permission of the physician –
unauthorized discharge the following
activities are indicated:
2. Ascertain why the person wants to leave the
agency
3. Notify the physician of the client‘s decision
43. 4. Offer the patient the appropriate form
to complete
5. If the client refuses to sign the form,
document the fact on the form and have
another health professional witness this
44. Cont.…
6. Provide the patient with the original of
the signed form and place a copy in the
record
7. When the patient leaves the agency,
notify the physician, nurse in charge, and
agency administration as appropriate
45. 8. Assist the patient to leave as if this
were a usual discharge from the agency
(the agency is still responsible while the
patient is on premises)
46. Lifting the patient
Dangling ; is sitting on the side of the bed with the feet
hanging down .
Purpose ;
To prepare patient before walking ,moving to chair
or wheelchair or performing others
To relive pressure in case of pulmonary edema (fluid
accumulation in the tissue and air spaces of the lungs.
It leads to impaired gas exchange and may cause
respiratory failure)
Indication
Moving patient out of bed
47. Cont.…
Contraindication ;-
Unconscious patient
Spinal injury
Precaution
Do not leave the patient alone when dangling.
If the patient becomes dizzy lie him down.
Have the patient cough, deep breathe, and exercise
their leg muscles when dangling
Check the person‘s pulse and respirations
48. Cont.…
Equipment
Turn sheet or draw sheet
Screen
Procedure
1. Greet the patient and explain the procedure
2. Perform hand hygiene
3. Collect the necessary material
4. Provide privacy
5. Assess the patient condition
49. Cont.…
6. Position yourself and client appropriately before
performing the move
a. Assist the client to a lateral position facing you
b. Raise the head of the bed slowly to its highest
position
c. Position the clients feet and lower legs at the edge of
the bed
d. Stand beside the client‘s hips and face the far corner
of the bottom of the bed
50. Cont.…
7. Move client to sitting position
a. Place one arm around the client shoulder and the other
arm beneath both of the client thighs near the knee
b. Tighten your gluteal , abdominal, leg and arm muscle
c. Lift the client thighs slowly
d. Private on your feet in the desired direction facing the
foot of the bed while pulling the client feet and legs off the
bed
e. Keep supporting the client until client is well balanced
and comforted
f. Assess vital signs as indicated
52. Log rolling
Definition: Logrolling is a technique used to turn a
patient whose body must at all times be kept in a
straight alignment.
Purpose
To turn a patient to the side of bed
Indication
Spinal injury
56. Cont.…
Procedure
1. Wash your hands
2. Greet and explain the procedure
3. Provide privacy
4. Position the bed in the flat position at a comfortable
working height
5. Lower the side rail on the side of the body at which
you are working
6.Position yourself with your feet apart and your knees
flexed close to the side of the bed
57. Cont.…
7. Fold the patient's arms across his chest
8. Place your arms or turn sheet under the patient so
that a major portion of the patient's weight is centered
between your arms.
9. The arm of the other nurse should support the
patient's head and neck.
10. On the count of three, move the patient to the side
of the bed, rocking backward on your heels and keeping
the patient's body in correct alignment.
58. Cont.…
11. Move to the other side of the bed.
12. Place a pillow under the patient's head and another
between his legs.
13. Position the patient's near arm toward you.
14. Grasp the far side of the patient's body with your hands
evenly distributed from the shoulder to the thigh.
15. On the count of three, roll the patient to a lateral
position, rocking backward onto your heels.
16. Place pillows in front of and behind the patient's trunk
to support his alignment in the lateral position. Provide for
the patient's comfort and safety.
59. Cont.…
15. On the count of three, roll the patient to a lateral
position, rocking backward onto your heels.
16. Place pillows in front of and behind the patient's
trunk to support his alignment in the lateral position.
Provide for the patient's comfort and safety.
17. Report and record as appropriate
60. Moving patient up in bed with two nurses
using draw sheet
Definition ;- Moving patients up in bed refers to
returning the patient to previous correct position in bed
if he/she slides to the foot side of the bed.
Purpose
To make patients in comfortable position in bed
To maintain good body alignment
Indication
Patient slides to the foot of the bed
62. Cont.…
Procedure
1. Explain the procedure
2. Perform hand washing
3. Collect necessary equipment
4. Lower head of the bed to flat position and raise level of bed to
comfortable height
5. Remove all pillows from under the client. Leave one at head of bed
6. One nurse stands on each side of the bed with leg positioned for wide
base of support and one foot slightly in front of bed frame
7. Each nurse rolls up and grasps edges of turn sheet close to client‘s
shoulder buttocks
8. Flex knees and hips tighten abdominal and gluteal muscle.
9. Raise the patient up in bed
10. Observe the condition of the patient
11. Record the procedure
63. Positioning the patient
Definition ;-Positioning is turning or putting the
patients in a proper body alignment for the purpose of
preventive, promotive ,curative and rehabilitative
aspects of health.
64. Purpose of positioning
To relief pressure on various parts or lessen possible
stress on pressure points
To prevent formation of deformity
To Improve circulation
Preserve muscle function as different muscle group‘s
contract and relax.
To provide comfort, support, and good body
alignment
To make the patient ready for different procedures
65. Type of positioning
Common positioning methods of patient in a bed include
but not limited to
1. Front lying (prone):
2. semi-prone position(or Sims‘ position)
3. Dorsal Supine (back lying):
4. Dorsal recumbent position
5. Lateral recumbent (on either side)
6. Fowler‘s position position
7. Knee chest position
8. Trendelenburg position
9. Lithotomy position
66. Front lying (prone)
Definition ;- Prone position is putting the patient in a
flat on the abdomen, legs extended, feet over the edge of
the mattress, and toes pointing to the floor.
Purpose
To Promotes drainage from mouth
To prevent contractures of hips and knee
To examine the spine and the back
67. Cont.…
Indication
Patient with excessive secretion from mouth
Patient with potential risk of knee and hip
contracture
Contraindication
Cervical –spine fracture
Respiratory impairment/breathing difficulties
Foot drop (DAMAGE OF FRONT FOOT)
Pregnant women
Clients with abdominal incisions
68. Cont.….
Equipment
1. Small pillow (3)
2. Bed with side rails
3. Draw sheet or turn sheet
4. Documentation format
5. Receiver for drainage( if any)
69. Procedure
1. Great the patient ( if conscious ) and explain the procedure
2. Perform hand washing
3. Collect all necessary equipment's
4. Provide privacy
5. Elevate bed to highest position.
6. Place turn or draw sheet under client‘s back and head
7. Assist the client to lie on abdomen.
8. Place a small pillow under client‘s head; turn head to side.
9. Extend the client‘s arms near side or flexed toward head.
10. Place a small pillow under chest for female clients and for clients
with barrel chest.
11. Place a small pillow under ankles or allow toes to rest in space
between foot of bed and the mattress.
70. Cont.…
12. Assess client for comfort.
13. Lower the bed and elevate the side rails
14. Wash your hand
15. Note the patient reaction
16. Document the procedure
72. Semi-prone position
Definition ;Semi-prone position putting or assisting
patients with upper arm flexed at shoulder and elbow;
lower arm positioned behind client and both legs
flexed in front of client with more flexion in upper leg
either of body side.
Purpose
To promotes drainage from mouth
To prevents aspiration
Comfortable for sleeping
sacrum and greater trochanter of hip
Promotes comfort especially in pregnant clients
73. Cont.…
Indication
For rectal examination
Pressure sore on the buttocks/sacrum and hips
Contraindication
lumbar lordosis (EXCESSIVE INWARD
CURVATURE OF THE SPINE)
Foot drop
client with leg injuries or arthritis
74. Cont.…
Equipment
1. Small pillow (3)
2. Bed with side rails
3. Draw sheet or turn sheet
4. Sand bag
5. Documentation format
6. Receiver for drainage( if any)
75. Procedure
1. Great the patient ( if conscious ) and explain the
procedure
2. Perform hand washing
3. Collect all necessary equipment's
4. Provide privacy
5. Elevate bed to highest position.
6. Place turn or draw sheet under client‘s back and head
7. Flexed at shoulder and elbow
8. Position lower arm behind and away from the back
9. Put pillow between chest and upper arm;
76. Cont.…
10. Flex both legs in front with more flexion in upper
leg.
11. Put pillow between legs
12. Support ankle with sand bag (if necessary )
13. Lower the bed and elevate the side rails
14. Wash your hand
15. Note the patient reaction
16. Document the procedure
78. Supine (back lying)
Definition: Supine position is putting patient in back lying
often with a small pillow to support the head and shoulder.
Purpose
Promote comfort
To help healing after certain abdominal operations
Indication
After abdominal, chest and neck surgery
For physical examination of anterior part of the body
Usual position for the patient
79. Cont.…
Contraindication
Spinal injury
Cardiac patient (CHF)
Breathing impairments
Pressure sore (buttock, scrum, heal and shoulder )
Equipment's
1. Pillow of different size (3)
2. Bed with side rails
3. Draw sheet or turn sheet
4. Wrist splint
5. Air rings
6. Cotton rings
7. Footboard or high-top tennis shoes
8. Documentation format
80. Procedure
1. Great the patient ( if conscious ) and explain the procedure
2. Perform hand washing
3. Collect all necessary equipment's
4. Provide privacy
5. Elevate bed to highest position.
6. Place turn or draw sheet under client‘s back and head
7. Place bed in a flat position.
8. Place the patient‘s head in a straight line with his or her
back, shoulders, hips and knees
9. Place small pillows under head, back and ankles.
81. Cont.…
10. Place air ring under the hips/buttock
11. Flex the arm and rest on the stomach or
straighten and support with wrist splint
12. Support the feet with padded footboard or high-
top tennis shoes
13. Place the cotton ring under the heal
14. Lower the bed and elevate the side rails
15. Wash your hand
16. Note the patient reaction
17. Document the procedure
83. Dorsal recumbent position
Definition: Dorsal recumbent position is putting
patient in back lying position with knees are flexed and
the soles of the feet flat on the bed.
Purpose
Promote comfort
For visualize the perineum
To insert urinary catheter
To relief pressure from ileum, knee and ankle
86. Equipment's
1. Pillow of different size (3)
2. Bed with side rails
3. Draw sheet or turn sheet
4. Bath Blanket or sheet
5. Air rings
6. Cotton ring
7. Bed block ( if necessary)
8. Documentation format
87. Procedure
1. Great the patient ( if conscious ) and explain the procedure
2. Perform hand washing
3. Collect all necessary equipment's
4. Provide privacy
5. Elevate bed to highest position.
6. Place turn or draw sheet under client‘s back and head
7. Place bed in a flat position
88. Cont.…
8. Cover the client with a sheet or a bath blanket folded
once across the chest.
9. Place the patient‘s head in a straight line with his or
her back, shoulders, hips and knees
10. Place small pillows under head and shoulder or
elevate the top of the bed with block.
11. Place air ring under the hips/buttock
12. Flex the leg and wide apart
13. Place cotton ring under the heels
89. Cont.…
14. Lower the bed and elevate the side rails
15. Wash your hand
16. Note the patient reaction
17. Document the procedure
91. Lateral recumbent (on either side)
Definition: Lateral recumbent position is putting
patient on either of the side with the legs flexed at knee
(The upper leg is more flexed than the lower leg).
Purpose
To perform back care
To relieves pressure on sacrum and heels
To perform enema
To take rectal body temperature
To insert suppositories
92. Cont.…
Indication
Enema and colonic irrigation
Pressure sore on heel and sacrum
Rectal examination
To measure rectal temperature
Contraindication
Arm and rib fracture
Spinal injury
Flank injury
93. Cont.…
Equipment's
1. Pillow of different size (4)
2. Bed with side rails
3. Draw sheet or turn sheet
4. Documentation format
94. Procedure
1. Great the patient ( if conscious ) and explain the
procedure
2. Perform hand washing
3. Collect all necessary equipment's
4. Provide privacy
5. Place turn or draw sheet under client‘s back and head
6. Elevate bed to highest position
7. Logroll client to side
95. Cont.…
7. Logroll client to side
a. For left lateral position, place the patient on left side
with buttocks to the edge of the bed both thighs flexed
and left arm underneath
b. For right lateral position, Place the patient on right
side with buttocks to the edge of the bed both thighs
flexed and right arm underneath
96. Cont.…
8. Place a small pillow under client‘s head.
9. Place pillow or foam wedges behind client‘s back.
10. Put a pillow tucked by the client‘s abdomen.
11. Place a pillow between client‘s legs.
12. Run your hand under the client‘s dependent
shoulder and move the shoulder slightly forward
13. .Lower the bed and elevate the side rails
14. Wash your hand
98. Knee chest
Definition: Knee chest position is putting a patient on
the Knee and the chest with the head turned one side,
arms above the head and one cheek on a pillow.
Purpose
1. Used for vaginal and rectal examination
2. Used in first aid treatment in cord Prolapse or
retroverted uterus
3. Assumed for postpartum and gynecologic exercises
100. Contraindication
Cardio-pulmonary problem
Upper arm, spine and ribs fracture
Increased intra-cranial pressure (IICP)
Equipment's
1. Pillow (1)
2. Drape/ Bath Blanket or sheet
3. Screen
4. Documentation format
101. Procedure
1. Great the patient ( if conscious ) and explain the
procedure
2. Perform hand washing
3. Collect all necessary equipment's
4. Provide privacy
5. Elevate bed to highest position.
6. Make the patient on the knees and chest
7. Turn the head to one side with the cheek on pillow
102. 8. Extend the arms on the beds and flex it at the elbows
to support the patient partially
9. The weight should rest on the chest and knees which
are flexed so that the thighs are at right angles to the legs
10. Cover the client with a sheet or a bath blanket.
11. Lower the bed and elevate the side rails
12. Wash your hand
13. Note the patient reaction
104. Fowler's position (semi-upright with back
and knee rests elevated)
Definition: Fowler's position is sitting position in which the
head is elevated at different angle (15-90) o angle and may
have knees either bent or straight.
Type
1. High Fowler's position is when the patient's head is raised
80-90 degrees,
2. Semi-Fowler's position is when the patient's head is
elevated 30-45 degrees.
3. Low Fowler's position is when the head of bed is elevated
15-30 degrees
4. Fowler's which is 45-60 degrees
105. Cont.…
Purpose
1. To relive dyspnea
2. To improve circulation
3. To prevent thrombosis
4. To prevent aspiration during the introduction of feeding
tubes
5. To facilitate drainage from abdomen and pelvic cavity
post operatively
6. To relax the muscle of the abdomen, back and thighs
7. To relive tension on abdominal suture
8. To promote comfort
9. Increase comfort during eating
10. To relieve edema of the chest and abdomen
106. Indication
Cardio-pulmonary problem (Respiratory distress,
CHF, pulmonary edema..)
Increased intra abdominal pressure
Thrombosis
Abdominal, back and thigh muscle strain
Nasal or oral passageway procedures (e.g. NGT…)
108. Equipment
1. Small pillow (3)
2. Foot rest/foot board
3. Back support
4. Hand wrist support
5. Screen if necessary
109. Procedure
1. Great the patient ( if conscious ) and explain the
procedure
2. Perform hand washing
3. Collect all necessary equipment's
4. Provide privacy
5. Place the patient in sitting position with arms at sides
knees raised with pillow
6. Place bed in a 15° to 30° angle for low-Fowler‘s position,
45° to 60° angle for Fowler‘s position, or 70° to 90° angle
for high-Fowler‘s position.
7. Turn patients head to one side and align the patient in
good position
110. 8. Place a small pillow under client‘s head.
9. Support the backs and arms with pillows.
10. Place a pillow between client‘s legs.
11. Lower the bed and elevate the side rails
12. Wash your hand
13. Note the patient reaction
14. Document the procedure
112. Trendelenburg position
Definition: Trendelenburg is putting the patient in a
flat on the back with the feet higher than the head by
15-30 degree.
Purpose
To increase cerebral perfusion pressure
To allow better access to pelvic organ during pelvic
surgery
To help in surgical reduction of hernia
To enhance access to central venous line
116. Procedure
1. Great the patient ( if conscious ) and explain the
procedure
2. Perform hand washing
3. Collect all necessary equipment's
4. Provide privacy
5. Place the patient‘s head lower than the feet with arms
at the side
117. Cont.…
6. Place bed blocks at the foot end of the bed.
7. Lower the bed and elevate the side rails
8. Wash your hand
9. Note the patient reaction
10. Document the procedure
118. Lithotomy position
Definition: Lithotomy position is positioning the
client feet above or the same level as hips with
perineum positioned at the edge of examination table.
Purpose
To provide good visual and physical access to
perineum
To perform simple pelvic procedures to major
surgeries
To conduct delivery
120. Cont.…
Equipment's
1. Pillow (1)
2. Bed with side rails/examination table/delivery couch
3. Draw sheet /drape
4. Screen
5. Documentation format
121. Procedure
1. Great the patient and explain the procedure
2. Perform hand washing
3. Collect all necessary equipment's
4. Provide privacy
5. Elevate bed to highest position.
6. Place bed in a flat position.
7. Cover the client with a sheet or a bath blanket
122. Cont.…
8. Lie the patient flat with pillow under the head
9. Flex the feet above or the same level as hips and
support with knee rest over a couch ( if available)
10. Wash your hand
11. Note the patient reaction
12. Document the procedure
124. patient Ambulation
Definition: Client ambulation is assisted or unassisted
walking which encouraged soon after the onset of illness
or surgery to prevent the complications of immobility.
Purpose
To Keeps client more active
To prevent the complications of immobility
To improves muscle tone and strength in his legs
To slow down loss of bone mass and density related to
osteoporosis
125. Cont.…
To improves appetite , peristalsis and circulation
To give a sense of accomplishment and maintains
greater independence for clients( psychological
wellbeing)