2. The healthy body is in balance….
• When the body is working as it should and everything is in balance-
HOMEOSTASIS occurs
• Metabolism, or physical and chemical processes must be working at a
steady level
• When disease or injury occurs, the body’s metabolism is disturbed
and homeostasis is lost
3.
4. The Healthy human body
• Cell is the basic unit
• Human life begins with the uniting
Ova and sperm cells.
5. tissues
• Groups of cells with similar functions combine to form tissues
• Epithelial- covers internal and external body structures, lines nose,
mouth, respiratory and GI tract- can produce mucus
• Connective-anchors, connects, supports (tendons and ligaments, for
ex.) *blood is connective tissue
• Muscle- stretches and contracts to allow movement
• Nervous- receives and carries impulses to brain and back to body
6.
7. Organ systems
• Groups of tissues with same function form organs. Systems are
formed by organs that work together to perform specific functions
8. System Organs Circulate oxygen, white and red blood cells,
platelets, nutrients, to the body in the blood
Arteries and veins less elastic, arteries are
narrower and may be filled with plaque, heart
doesn’t empty out as well
Integumentary (largest system of the body) Skin (2 layers, epidermis and dermis), hair, nails,
sweat and oil glands
Regulate body temperature, protect from infection
and injury
Skin dryer, more fragile, age spots, wrinkles, nail
become thicker, hair dryer, turns gray, less sweat
and oil production
Circulatory Heart, arteries (carry blood away from heart) and
veins (carry blood to the heart)
Respiratory Nose, pharynx, larynx, trachea, bronchi, two lungs,
alveoli, diaphragm
Take in oxygen and remove carbon dioxide Lungs don’t fill as well, difficulty clearing secretions
Musculoskeletal Bones (206) muscles, tendons, ligaments Allow for movement, create frame of body, protect
organs, heat production
Bones less dense, break easier, muscles stiffen,
person loses some height, joints stiff, without use
contractures (permanent shortening of muscles )
and atrophy (decrease in size of muscle) can occur
Gastrointestinal (digestive Mouth, tongue, teeth, pharynx, esophagus,
stomach, liver, gallbladder, pancreas, small and
large intestines
Take in food and digest nutrients; remove solid
waste (feces)
Peristalsis slows down, food stays in stomach
longer, less appetite, may lose teeth, taste is off,
less saliva production
Renal Kidneys, ureters, bladder, urethra Toxins in blood cleaned or removed by kidneys, and
removal of liquid waste (urine)
Kidneys may not clean blood as well, bladder holds
less urine
9. Endocrine Ovaries
Testes
Pituitary gland
Thyroid gland
Pancreas (makes
insulin)
Organs that produce
hormones to regulate
body functions
Metabolism slows
down, menopause,
male produces less
sperm, may not
produce enough
insulin
Nervous Brain, spinal cord and
nerves
Walking, talking,
seeing, hearing,
breathing, picking up
messages and sending
to the brain for a
response
Memory fails
Loss of balance
May need reading
glasses
Reflexes slower
Impulses slower
Immune Tonsils, adenoids,
lymph nodes, white
blood cells
Protect body from and
fight infections
Increase risk for
infections, slower
healing
Reproductive Male: penis, testicles,
scrotum, prostate
gland
Female: breasts,
uterus, ovaries,
fallopian tubes
Bearing children and
sexual pleasure
Menopause, erectile
dysfunction, breast sag,
vaginal dryness,
enlarged prostate
10. Integumentary system
• Organs: skin, nails, hair, sweat and oil glands
• Function: protective covering, prevents microbes from entering body,
temperature regulation, sensory organ for pain, pressure, temp
• Two skin layers
11. Regulating body temp
• When we become too hot, blood vessels dilate (widen) to bring more
blood to the body surface and cool us down
• When we become cold, blood vessels constrict (become narrow) to
restrict the amount of blood reaching the skin and conserve internal
heat
• Erector pili- goose flesh
12. Musculoskeletal
• Over 500 muscles and 206 bones to support, protect, create frame
and upright posture while allowing for movement and produce body
heat
• Involuntary muscles work automatically, like your heart, blood vessels
and intestines
• Voluntary muscles do not work unless you move them
• joints (where two bones meet), ligaments (hold bone to bone),
tendons (hold bone to a structure, such as muscles), cartilage
• Without use: atrophy and contractures
13. Nervous System
• Organs: brain, spinal cord and nerves
• CNS=brain and spinal cord PNS=nerves throughout body
• Left side of brain controls right body, vice versa
• Functions: movement, thinking, speech, sight, hearing, emotions,
breathing
14. Circulatory system
• Organs: heart, arteries (carry blood high in O2, bright red) and veins
(carry blood low in O2, dark red) and capillaries (tiny blood vessels)
• Function: circulate blood and blood products to body, defend against
infection, heat regulation
15. Respiratory system
• Organs: nose, pharynx, trachea, bronchi, lungs, alveoli, diaphragm
• Function: take in O2 and remove CO2
16. Digestive system
• Organs: mouth, tongue, teeth, salivary glands, pharynx, larynx,
esophagus, stomach, gallbladder, liver, pancreas, large and small
intestines
• Function: take in food for digestion and remove
solid waste
• Peristalsis moves food and waste through GIT-
Contractions or waves
17. Urinary system
• Organs: kidneys, ureters, bladder, urethra
• Functions: removes waste from blood, maintain water balance
•
18. Reproductive system
• Female: breast, ovaries, fallopian tubes, uterus, vagina
• Male: penis, scrotum, testes, prostate gland, vas deferens
• Function: procreation and pleasure
19. Endocrine system
• Organs that produce hormones to regulate/stimulate body functions
• Pituitary gland-growth hormone, TSH (to stimulate thyroid gland)
adrenocorticotropic hormone (ACTH to stimulate adrenal glands)
• Ovaries-estrogen and progesterone
• Testes- testosterone
• Thyroid glands- thyroxine
• Parathyroid glands- parathormone
• Adrenal glands- glucocorticoids (metab of carbs and response to stress),
mineralocorticoids (regulate amt of salt and water absorbed/lost)
• Pancreas-insulin
20.
21. Immune system
• Organs: lymph nodes, tonsils, adenoids, lymphocytes, thymus gland,
spleen
• Function: protection from infection
22. Common Chronic and Acute conditions
• Acute- comes on suddenly, runs its course
• Chronic- develops over time, may last a lifetime
23. Arthritis
• Osteo or DJD-from aging, obesity, joint injury-stiffness, swelling and
pain with wt bearing and joint motion- affected by cold, damp
weather; treated with anti-inflammatory meds, hot/cold applications,
exercise, rest, wt control
• RA (rheumatoid arthritis)-can begin in 20s- affects entire body, very
debilitating and may lead to immobility; treated with pain meds,
NSAIDS, and humira
24.
25. Total Knee or Hip replacement
• After procedure: IS, cough and deep breathing, elastic stockings, PT,
no crossing legs, deep bending, adduction, skin care, turn on
nonoperative side
• Give grabber, use abduction wedge, elevate toilet seat (see page 609)
• For total knee longer recovery (10-12 weeks minimum); will use a
CPM
26. Antiembolism hose prevent blood clots from
breaking off and traveling
https://www.mskcc.org/videos/how-use-your-incentive-
spirometer
https://www.youtube.com/watch?v=KI9WuZb2aaE
27. Osteoporosis
• Bones become brittle and porous; break easily, especially hip, spine and
ribs
• More in women as menopause is entered (lack of E causes bone changes)
• More in small framed, thin women with family history
• Causes loss of height, stooped posture, back pain
• Have your calcium! E may be ordered for women
28. Fractures
• Closed (simple)
• Open (compound)- bone through skin
• Monitor for limited motion, pain, bruising, deformity of part, swelling
• Either casted or reduced and fixated with nails, rods pins or screws
• Plaster of Paris cast take 24 hours to dry, handle with open palms,
elevate on pillow, keep dry, nothing inserted into cast, use bedcradle,
report rough cast edges, report pain, odor, discoloration, temp
change, numbness to RN
•
29. Report: pain, rough cast edges, numbness of fingers/toes, discoloration, odor
from cast
Elevate on pillow! Use bedcradle to keep linen off legs if lower extremity casted
31. Traction
• System of pulleys and ropes that reduce and immobilize fractures
• Applied to neck, arms, legs or pelvis, head
•
32. Traction
• Traction reduces and immobilizes fractures. A steady pull from two
directions keeps the bone in place. Traction can be skin or skeletal
• Skin traction is applied to skin as a boot, wrap or splint
• Skeletal traction is applied directly to the bone with wires and pins
• **cervical traction is applied to the skull**
33. Guidelines for care of a resident in traction
• Never allow weights to touch floor
• Keep person in good alignment
• Do not add or remove weights from traction set up
• Provide good skin care and assist with toileting
• Never place weights on the bed
• ROM to uninvolved joints are directed
• Report redness, drainage or odor from skeletal traction
34. Parkinson’s Disease
• Slow, progressive do with no cure
• S/sx include tremor, rigidity, shuffling gait, stooped posture,
stony face and impaired balance
• Medications (l-dopa) available to decrease sx, need help with
ambulation, ADLs, meals, speech and swallowing
35. Dopamine is a neurotransmitter that is
missing/too low in people with PD
36. Multiple Sclerosis
• Destruction of myelin sheath covering the spinal cord preventing
nerve impulse from reaching the brain
• Symptoms start in 20s, more in femals
• S/sx: blurred vision, incontinence, numbness in extremities, problems
with concentration, depression, difficulty ambulating, dysphasia
• May be relapsing-remitting, primary progressive (no remissions),
secondary progressive (worsens with each flare up)
38. Paralysis
• May be dt injury or illness
• Paraplegic- weakness from waist down
• Hemiplegic- weakness on one side of body
• Quadriplegic- weakness from neck down
39. Care for person with paralysis
• Safety
• ROM
• I&O
• Prevent burns
• Emotional support
• Prevent skin breakdown
• Assist with toileting
40. Communicating with the speech impaired
• Be patient
• Don’t finish sentences
• Don’t pretend to understand
• Allow for writing down messages
• Use body language & communication boards
**dysphasia is difficulty speaking
**aphasia is lack of speech
42. Macular Degeneration
• Causes a blind spot in the center of vision
• Normal signals not sent to the brain
• Onset is gradual and painless
• Leads to blindness
• Won’t be able to read, sew, see faces, drive or see fine details
• Increase risk with age, smoking, family hx, >females, light colored
eyes, exposure to sunlight and heard disease
• NO cure
43. Glaucoma
• Glaucoma damages the optic nerve. It is caused by a build up of the fluid
that bathes and nourishes the eye (vitreous humor). The excessive causes
an increase in intraocular pressure and potential blindness
• Onset can be sudden or gradual. If it occurs suddenly with pain, n&v-
medical ER (closed angle glaucoma)
• Open angle glaucoma develops slowly with decrease in peripheral vision,
“tunnel” vision, blurred vision and halos around lights
• Risk factors: Aas, >60, family hx, DM, HBP
• Tx: no cure; eye drops to prevent further damage
44. Cataracts
• Cataract is a clouding or opacity of the lens
• People describe “waterfall” vision with cloud, blurry or dimmed
vision, faded colors (especially blue and purple), sensitivity to light
and glare, poor vision @ night, halo vision and double vision
• Precipitating factors- DM, smoking, age, family history
• Tx- surgery
• Care postop: eye patch as directed, no rubbing, no bending at waist,
no shower/shampoo as directed, report eye drainage or pain at once
46. Diabetic Retinopathy
• Tiny blood vessels in retina are damaged
• Affects both eyes and leads to blindness
• Vision blurs and person sees floaters
• Laser surgery may help
47. talking with visually impaired
• Announce your arrival and departure
• Tap lightly on shoulder
• Don’t rearrange room, tell resident where items are located,
especially call bell
• Speak in normal voice
• Make sure eyeglasses are clean (with lens paper) and being worn
• Communicate in good lighting
48. Caring for the visually impaired
• When ambulating he/she holds your arm and you walk slightly AHEAD
• Braille
• Corrective lenses
• Contacts
• Ocular prosthesis (p. 592)
49. Care for prosthetic eye when not in use
• Wash eye with warm soap and water
• Line container with 4x4 and fill with sterile water or saline solution
and place eye in
• Wash socket with warm water or saline, remove excess moisture
When reinserting eye:
• Rinse eye and place in wet socket
50. CV and Resp disorders
• Hypertension-
• Causes: renal or heart disease, pregnancy, adrenal gland tumors
• Factors contributing: age, gender, race, obesity, lifestyle, high salt diet,
stress
• May be asymptomatic or c/o headache, bl. Vision, palpitations,
fatigue
• Treated with meds, diet, exercise
51. Hypertension
• Defined as a top (systolic) number of 130 or greater OR a bottom
number (diastolic) of 80 or greater
• Goes up with stress, obesity, heart and renal disease, age
• Treated with medications, exercise and diet
• Called the silent killer- may be asymptomatic
• Some c/o headache, blurred vision, fatigue, chest pain, nosebleeds
and dizziness
52. Factors affecting BP
• Gender- men higher
• Race-esp in AAs
• Blood volume- decrease with hemorrhage, increase with fluid
retention of IVs
• Stress- raises
• Pain-raise
• Exercise-raises
• Weight-raises
• Diet- esp high in NA
• Position- higher when lying down
• Smoking-raises
• Alcohol-raises
54. Coronary Artery Disease (CAD)
• The coronary arteries supply the heart with blood. With aging or
disease they can become hardened and narrow. CAD is usually d/t
atherosclerosis a buildup of plaque (fat & cholesterol) in the arteries
S/SX:
Chest pain
SOB
Treated with stents, intraortic balloon pump, CABG
56. Angina Pectoris
• Feels like a heart attack, but is not
• Associated with exertion (overdoing it)
• Relieved with rest and nitroglycerin tabs taken sublingual (under the
tongue)- if pills fail to stop pain after 3 doses, 5 minutes apart- 9-1-1
• May be precipitated by cold or hot weather and stress
57. Congestive Heart Failure
• Build up of fluid in heart’s chamber from inefficient emptying or poor
venous return-
S/SX:
• Edema
• SOB/dyspnea
• Wt gain
• Cough
• fatigue
58.
59. COPD
• Combination of chronic bronchitis- smoker’s cough + emphysema-
enlarged alveoli that cannot expand and shrink with respirations
causing air to be trapped causing a barrel chest + asthma- wheezing
on expiration triggered by an allergen
60.
61. Common Disorders of Respiratory SX
• Chronic Obstructive Pulmonary Disease (COPD)- combination of
emphysema and chronic bronchitis
• Combination of chronic bronchitis- smoker’s cough +
emphysema-enlarged alveoli that cannot expand and shrink
with respirations causing air to be trapped causing a barrel
chest + asthma- wheezing on expiration triggered by an
allergen
• https://www.youtube.com/watch?v=nUGK8hKDpEg
S/SX
• Pain when exhaling
• Cough with mucus (“smoker’s cough”)
62. Digestive and Endocrine disorders
• Gastroesophageal Reflux disease (GERD)-causes heartburn, chest pain
with reclining, hoarseness in AM, dysphagia, sore throat, feeling food is
stuck
• Treated with meds, eating small meals, no smoking, leave up after meals
• Hepatitis B- bloodborne pathogen spread same as HIV, causes jaundice,
light stools, dark urine and hepatomegaly- no cure, meds to slow
progression and vaccine to prevent
• Hep A- fecal oral route, self limiting, vaccine available (esp for childcare
workers and those working around food)
• Hep C- most lethal but curable with Harvoni!-
64. Diabetes
https://www.youtube.com/watch?v=XfyGv-
xwjlI
• Type I: in young, pancreas makes little to no insulin, rapid onset
• Type II: maturity onset, related to weight, body unable to use
insulin well, slow onset
• S/Sx: bl. Vision, wt loss, polyuria, polyphagia, polydipsia, poor
wound healing, increased infections
• Complications: heart disease, stroke, renal failure, amputations
dt poor wound healing blindness
• Treatment: insulin or oral antihyperglycemics, diet and exercise,
eye care and footcare
65. Hyperglycemia (high BS)- too much food, not enough insulin, illness,
stress, BS >200, can lead to Diabetic coma
66. Hypoglycemia- low BS from not eating enough,
not taking insulin, over-exercising, can lead to
insulin shock
67. 2 serious complications of DM
• Insulin reaction- blood sugar drops too low (skipped a meal, over
exercised, took too much insulin)- feels weak, dizzy, perspiring,
tachycardia, low blood pressure, confusion
• Diabetic ketoacidosis (not enough insulin taken, cheated on diet, sick
with other illness or stressor)- fruity, acetone breath, kussmaul’s
respirations, dry, flushed skin, N&V, LOC
69. Special Care for Diabetics
• Feet: toenails only trimmed by podiatrist; should always wear socks
with well-fitting shoes, never allow to go barefoot; examine feet for
problems
• Eyes checked annually
• If meal not consumed- tell CN
70. Hypo and Hyperthyroidism
• Hyperthyroidsm is an overactive thyroid gland-the body processes are
speeded up, metabolism is increased and the person has wt loss, fast
heart rate, skin is warm and sweaty, person is nervous and restless
• Hypothyroidism is an underactive thyroid gland which slow downs
body processes- skin is cold, heart rate is slow, person suffers from
fatigue, has low blood pressure
• Both may have enlarged thyroid glands (goiter) and exophthalmos
(enlarged eyes)
72. Urinary and Reproductive disorders
• Prostate enlargement: gland grows larger with aging, referred to as
benign prostatic hypertrophy; s/sx include urgency, frequency,
nocturia, urinary retention, weak stream of urine; treated with a
TURP
• https://www.youtube.com/watch?v=rdd3aLAwLao
• Urinary diversions: urostomy
• Kidney stones (renal calculi)- flank pain, dysuria, urgency, fever and
chills, N&V; treated with BR, pain meds, treated with a lithotripsy
(crush n’ flush)- strain all urines
74. Renal Failure
• If the kidneys are no longer able to clean the blood of
waste, dialysis may be needed. Hemodialysis
(HD)directly cleans the blood; Peritoneal dialysis (PD)
indirectly cleans the blood thru the abdominal cavity.
**Never take a blood pressure on the arm that is
used for HD treatments**
https://www.youtube.com/watch?v=SgBMoCArNak
79. HIV and HBV
• Both are bloodborne pathogens, only spread by exposure to an
infected person’s blood
• MOT include unprotected sex with an infected partner, blood
transfusions, sharing needles/syringes, mom to baby
• After exposure to HIV person has “flu-like” symptoms, then may be
asymptomatic for years, have diarrhea, lymphadenopathy, wt loss,
night sweats, poor resistance to infections, thrush- diagnosis of AIDS
made when t-cell count below 400 and presence of opportunistic
infections such as pneumonia, Kaposi’s sarcoma and other types of
cancer
80.
81. • HBV- after exposure, person has “flu-like” symptoms, then
asymptomatic for 3-5 years then jaundice, hepatomegaly, cola colored
urine, pale or ash colored stools, fatigue
• HIV treated with anti-retrovirals
• HBV treated with steroids such as interferon
• Vaccine available for HBV, prophylactics such as Descovy available for
HIV
83. Cancer care and prevention
• Etiology (where it came from) not always known, but radiation,
chemicals (such as asbestos and talc in baby powder), hormones
(such as in birth control pills), substances (nicotine), environment
(ultraviolet exposure), genetics (breast cancer), lifestyle (obesity
linked to breast and colon cancer), diet (starch linked to stomach
cancer, lack of fiber to colon cancer)
• Cancer cured after 5 years of no cancerous cells evident; early
detection is the trick: pap smears, DREs, mammograms, SBE, annual
physical, body scans, knowing family history, preventing HPV
84. Benign vs Malignant
• Benign growths grow slowly and don’t metastasize (spread)- can be
harmless and may not be treated, just monitored (fibroids, lumpy
breast)
• Malignant growths are composed of abnormal cancer cells that mets
and spread quickly
• Treatment for malignancies: surgery, chemotherapy, radiation
• Not all cancers are created equal- pancreatic, ovarian, esophageal,
stomach cancers have poor cure rates
85. Care of the cancer client
• Pain management
• Comfort measures
• Mouthcare- may have stomatitis or thrush
• Anorexia
• Nausea and vomiting
• Fatigue
• Depression
• Altered body image
87. terms
• Polyuria- excessive urination
• Oliguria- scant amount of urination (<500 ml in 24 hrs)
• Dysuria- painful urination
• Hematuria- blood in urine
• Nocturia- nighttime urination
88. Urinary Elimination
• Urination is also called voiding
• Urine should be clear, without a strong odor, pale yellow, straw-
colored or amber
• Hematuria (blood in urine) and dysuria (pain with urination) must be
reported
• Urinary urgency and frequency may signal prostatitis for men or a UTI
for women
89. Bedpans,Urinals & Commodes
• Standard- wide part placed toward the
head
• Fracture- handle placed toward the feet
• Never placed on overbed table or bedside
stand
• Urinals are used for male voiding; hooked
on side rail after use
• A commode is a portable, bedside toilet
90. Bedpans,Urinals & Commodes
• Standard- wide part placed toward the
head
• Fracture- handle placed toward the feet
• Never placed on overbed table or bedside
stand
• Urinals are used for male voiding; hooked
on side rail after use
• A commode is a portable, bedside toilet
92. Types of incontinence
• Stress- dribbling that occurs with sneezing, lauging, coughing-
>common in women during menopause as pelvic muscles weaken
• Urge-urine is lost in response to sudden urgent need to void,
associated with AD, UTIs, bladder cancer and enlarged prostate
• Overflow-small amounts leak from a full bladder, weak stream
• Functional- due to immobility, restraints, unanswered call bell,
confusion
• Reflex- urine is lost at predictable intervals when the bladder is full,
person doesn’t feel the need to void dt CNS disorders and injuries
93. Indwelling Urinary Catheter
• Catheters are inserted under sterile conditions and must be kept clean to
prevent introduction of bacteria into body
• Guidelines for use:
1. Never allow collection bag to touch floor
2. Keep tubing kink free
3. Keep bag below level of bladder at all times**
4. Secure catheter to body with adjustable strap or tape to abdomen/inner
thigh
5. Empty collection bag at end of shift
6. Perform catheter care after BM & during bath
7. Attach bag to frame of bed, never the side rail (page 344)
95. Catheter Care
• Hold the catheter @ the insertion site
• Clean from the insertion site toward the bag about 4 inches down
• Use a prepackaged kit or soap and water
• Done after each BM and with AM/PM care
• https://www.youtube.com/watch?v=jcOT5EXsH1s
• https://www.youtube.com/watch?v=JBlq2A7dT1g
96. Condom Catheters
• Also referred to as Texas Catheters
• For men who are active and don’t want a catheter inserted into the
body
• Rolled on same as regular condom with about an inch between end
of penis and catheter
• Secured with elastic adhesive tape
• Attached to collection bag
98. Bowel Elimination
• Constipation- infrequent passage of hard, dry stool d/t not enough
fluid, inactivity, not enough fiber in diet
• Diarrhea- loose stool- usually d/t bacterial infection or a food source
• Fecal Impaction- serious form of constipation
99. Bowel Elimination
• Feces should be brown, formed, semisoft
• Ideally, a person has (1) BM/day
• Blood in the stool is called melena
• Black or tarry stool may indicate bleeding, but also beets, tomato
juice, red Jell-o
• Clay colored or white stools may be rt liver disease
• Note odor, consistency, presence of mucus, shape and frequency of
defecation
100. Factors affecting BM
• Privacy
• Habits
• Diet
• Fluids
• Activity
• Drugs
• Disability
• Aging- slows down peristalsis, may have incontinence
101. Fecal Impaction
• Prolonged retention of feces in rectum that is hard or putty-like and
cannot pass
• More water is absorbed from the already hard feces and liquid stool
passes around the hard mass and seeps from anus
• There is abdominal distention, nausea, cramping, rectal pain
• The RN does a digital exam and may remove the mass with a
lubricated, gloved finger
102. Terms
• Flatulence-excessive formation of gas
• Flatus-passing gas
• Fecal impaction- prolonged retention of feces in rectum- must be
removed by nurse (digitally or with enemas)
• Bowel retraining- done to address incontinence, remove diaper at
regular intervals, sit on toilet/bedpan
103. Enemas
https://www.youtube.com/watch?v=zScF55mo7h
0
• Introduction of water, saline, or water and soap into the intestines to
stimulate a BM and break up hard stool
• Done pre and post tests and surgery, for constipation
• Place resident in sims position with bed well padded and bedpan
ready to use, encourage slow deep breathing and insert tube 2 to 4
inches, as fluid is allowed to enter body; fluid suspended on IV pole
12-18 inches high (runs by gravity)
• Always show the CN the “return” before flushing
• Pg 363
104. Types of enemas
• Saline- salt and water
• Soapsuds (SSE) water and castile liquid soap
• Tap water enema (TWE)
• Small volume (fleets)
• Oil-retention- made with mineral or olive oil
106. Ostomies
• A person may require an ostomy after bowel cancer, an injury or to
treat certain GI diseases such as crohns or ulcerative colitis
• Two types: a) colostomy- opening into large intestine to create a
stoma, solid stool will drain b) ileostomy-opening into small intestine,
liquid stool removed
https://www.youtube.com/watch?v=4NAJuycN4Co&t=568s
107. Colostomy Care
• Stoma should be pink and fleshy
• Keep skin clean and dry
• Remove, change or clean pouches PRN
• Encourage diet that doesn’t stimulate gas and odor (deodorants are
available to put in pouch)
• Treat person with dignity and respect
111. Rules for collecting specimens
• Standard precautions
• Use correct container
• Don’t touch inside of container or lid
• Identify person, check id band against requisition slip
• Label the container
• Collect at proper time
• Place specimen in biohazard bag
• Take to lab or specimen fridge
112. Urine Specimens
• Routine urinalysis (U/A)
1. Simple have resident void in cup, attach label and lid
• Mid-Stream Clean Catch
1. Separate labia, clean from front to back, begin to void then collect urine
in middle of stream
2. For men, clean in circular motion, then void and collect urine
• Strain Urine for stones
1. Place signs to strain all urine over toilet
2. Use a strainer to collect any stones which are place in specimen cut and
sent to lab for analysis
**urine must be refrigerated or kept on ice**
113. 24 Hour Urine Collection
• Supplies: large collection jug, signs posted over bed and toilet,
specimen collection ‘hat’
• When person awakes on first day and voids, DISCARD the first
specimen. The 24 hour collection will begin with the second void
• If John wakes up and voids at 10am on Tuesday and then again at
12:30pm, when is the 24 hour collection completed????
