Hospital Work

Hospital work

Taking care of the sick person is one of the most important and difficult tasks.

In the hospital, this is the responsibility of the nurse.

However, in a private home, the duty is shouldered by the members of the family.

Concept on Hospital Work Provides the following:

I. Feeding the SickII. Giving MedicineIII. Getting Body TemperatureIV. Giving a BathV. Bed Making

Feeding the SickA. Food for the Sick

Food for a sick person should be selected and prepared in such a way that it is tasty and easily digested. Since he is confined either to his bed or room, he needs less food as compared to active persons. His weakened condition may make digestion more difficult. Generally , considered wiser to omit or use only occasionally sweet foods, rich foods, highly seasoned foods and fruit foods. Moderate size of servings of foods like salad, soup and simple dessert are more tempting in order to arouse his appetite.

Food given to a sick person must be selected to:

1) Provide the nutrients needed by the body daily

2) Stimulate all the five senses of the body

3) Conserve energy4) Make eating an enjoyable experience5) Make him realize the importance of

food for his early recovery

Types of Diet Liquid Diet

This type of diet is given in order to furnish easy methods of forcing through the body and to supply enough nourishment in small quantities. This type of diet is usually given every two to three hours.

Milk foods (whole milk, butter milk, malted milk and cream soup)Uncooked egg (beaten and sometimes flavored with fruit juices, cocoa or milk “eggnog”)Cereal foods (gruel using one tablespoon cereal to one cup water cooked and strained)Broth (meat, fish, seafoods, or vegetable broth)Fruit juices

Soft DietThis type of diet includes

strained or softened solid foods.

Toast and cerealStrained cooked vegetableSoft boiled egg and omeletDessert made from milk and eggsMashed banana with milk

Full DietThis type of diet includes foods

ordinarily eaten by a normal person. However, foods which are rich, sweet, fried and highly seasoned foods must be avoided.

B. Preparing the Sickroom TrayThe food of a sick person is

usually served on a tray. This should look as attractive as possible to arouse his appetite. Sick persons are often hard to please because of the discomfort from fever or swollen mouth.

1) Use clean linens to cover the tray, protect the bed and for the patient to use

2) Select dainty table appointments.

3) Serve dainty portions of food.4) Garnish the food attractively.5) Decorate the sickroom tray with

a flower, clippings from a funny story column, toy or animal out of fruit or vegetable.

C. Serving Food to the SickImportant points to consider:

1) To arouse the appetite so that the desire to eat will gradually return. However, the danger of overeating must always be considered.

2) Regularity of serving the meal.

Tips in serving:• Arrange the food for the sick person’s convenience in

eating• It is better to serve a second course than to overload

the tray• Hot foods should be served hot while cold foods should

be served cold• Taste the foods before serving• Place the patient in a comfortable position• A helpless patient should be assisted in eating• Liquid foods may be served though a drinking tube• Give time for the patient to chew and to swallow the

food• Give the bed pan or urinal when necessary before the

meal• Entertain the patient while eating with pleasant stories

Giving MedicineA. Importance of Medicine

Medicine is defined as any substance needed to treat a sickness or to relive pain. Legally, this is prescribed by a doctor after a thorough diagnosis of a sick person. However, the high cost of medical fees has forced majority of the Filipino families to take medicine without the prescription of a doctor. Most medicines are prescribed by a relative, friends, neighbor or classmate. This is a very bad practice since what is good for one person may not be appropriate for another person. One should be extra careful in taking medicine.

Safety purposes in taking medicines

1) All medicines taken must be prescribed by the doctor

2) Medicines may be used basically to cure sickness

3) Best medicine is one that is used to prevent the occurrence of an illness

4) An ounce of prevention is better than a pound of cure

5) In addition to its curative and preventive effect, it is also needed to relieve pain. This palliative effect of medicine is usually abused. This is the root cause of drug abuse which is a problem not only of the poor family but also of the rich family.

Forms of MedicineMedicine is available in the drugstore in various forms:

1) Liquid medicine – are usually taken by drops, teaspoon or tablespoon

2) Powder medicine – is mixed with water to make it easier to swallow. These type of medicine is usually taken by mouth and washed down with a drink of water. The capsule and pill are easier to swallow than the tablet because of the outer covering that prevent one from tasting the medicine.

3) Capsule – small globular or cylindrical container made of some digestible or soluble material where powdered medicine or granules of medicine is packed.

4) Pills – medication prepared in small globular disk with smooth and tasteless surface

5) Powder – a preparation in the form of fine particles6) Tablet – a preparation where powdered medicine is

compressed and molded into a shape of disk or flat square

Ways of Giving Medicine1) Orally through the mouth2) Through the rectum by means of suppository or

enema3) Through the skin by the application of the

medicine on the surface of the inhalator4) Through the tissue by means of injection

Steps in Giving Medicine• Thoroughly wash hands and tools to be used in giving

medicine• Read the label to check on:

Name of medicine Dosage Ingredients Direction in giving medicine Expiration Probable effects of the medicine

• Give the medicine as directed• Observe the changes on the sick person• Record the following

Date Time Dosage Reactions of the sick person after taking the medicine

Tips in Giving Medicine• Give the medicine on time• Read the label in a well-lighted place• Check on the label 2-3 times• Measure accurately• Use clean and appropriate container• Give the medicine after eating• Prepare the medicine as directed. Avoid using

unlabeled medicine.• Pour medicine from the side of the bottle opposite

the label• Avoid talking while giving medicine

Getting Body Temperature

A. Body TemperatureThe body temperature shows the

balance between the heat produced and the heat lost by the body. It changes from time to time.

• In the morning, the body temperature is low because of the cool atmosphere.

• In the afternoon, the body temperature rises because of the light that brings warmth to the surroundings.

Factors affecting body temperature are:• Presence of infection• Environment• Amount of exercise or work and emotional status

Normal average temperature of the body is as follows:

• Oral (36.1 – 37.2; 97 – 99)• Axillary (35.6 – 36.7 ; 96 – 98)• Rectal (36.7 – 37.8 ; 87 – 100)

Thermometer An instrument used for measuring the body temperature. Made of graduated glass tube with a sealed capillary bore

wherein the mercury rises or falls as it expands or contracts from the changes in temperature.

1) Oral thermometer – this type has slender and longer bulb so that the mercury can be warmth more quickly by the mouth and usually placed under the tongue or armpit to register body temperature.

Two Types of Thermometer used to assess body temperature:

2) Rectal thermometer – this type has a short and round bulb so that it is easier to insert in the rectum as it is a sensitive part of the excretory system.

How to Take Body Temperature

The body temperature may be taken by mouth; axilla is commonly used for adults. Among the children, it is usually taken through the rectum since they are very active and movable. Wherever the thermometer is placed, the basic procedure is the same. The only difference lies on where to place the thermometer to assess the temperature of the body.

Taking the Body Temperature by Mouth

Have the patient lie or sit down Hold the thermometer firmly by the top with the thumb, the index and

middle finger Shake the mercury down to 5 or 35 below to ensure accurate

temperature Moisten the thermometer with clear, cool water to make the instrument

easier and more pleasant for the patients to hold in his mouth Place the bulb of the thermometer under the tongue, a little to one side Instruct the patient to keep his mouth closed, breathe through his nose

and not bite the thermometer or to talk Leave the thermometer under the tongue for three minutes to ensure

accurate registration Wipe the thermometer to remove the saliva using a firm rotary motion

from top downward over the bulb Read the thermometer where the light is good still holding it by the top Record the thermometer, clean and keep the thermometer in place

Taking the Temperature by the Rectum

The temperature taken by the rectum is usually approximately One degree higher than that by mouth. This is because of the large vessels in the walls of the rectum that bring warm blood to the area. This is usually used for a child or infant.

1) Have the child be either in lateral dorsal position. Flex the knee if the child is in the dorsal position.

2) Hold the thermometer firmly and shake.3) Lubricate the bulb end of the thermometer

with oil or cold cream so that it will slide easily into the rectum.

4) Slip the bulb end of the thermometer about one inch into the anus. Hold it in place for three minutes.

5) Remove the thermometer. Read and record the temperature registered. Clean and keep the thermometer in place.

Taking the Temperature by Axilla

1) Have the patient sit or lie down.2) Hold the thermometer firmly, clean

and shake.3) Dry the area under the arm and

place the thermometer. Press his arms firmly against his body putting his hands on his opposite shoulder and hold the thermometer with the bulb towards the chest for five minutes.

4) Remove the thermometer. Read and record the temperature registered.

5) Clean and keep the thermometer in place.

Tips in Getting the Body Temperature

Keep the patient comfortable. Be sure to disinfect the thermometer before

using. Take the temperature before eating frozen

foods or taking hot soup or beverage. Allow sufficient time for accurate registration

of temperature. Verify any marked rise or fall in temperature

by taking it again using another thermometer.

Giving a BathA. Importance of a Bath

As a considerable amount of body waste is eliminated through the skin. It is necessary that it be kept clean at all times. If the pores of the skin is blocked with dirt, the body waste cannot be eliminated easily causing discomfort to the sick person. This sometimes lead to infection r poisoning of the body. Therefore, a sick person must be given a daily bath. This is given preferably in the morning about an hour after breakfast, just before the bed is made. Basically, this is given to make the sick person comfortable.

A good bath results to: Clean skin pores Body free from germs Better circulation of the blood Reduced body temperature Mild form of exercise

Types of BathBasically, a bath is given to a sick person to

make him feel fresh and relaxed. The bath given may be abbreviated, partial or complete.

• Abbreviated bath (face, arm, hands, legs and feet)

• Partial bath (face, neck, chest, arms, hands, legs and feet)

• Complete bath (head down to the feet)

Materials and tools needed in giving a bath

The first step in giving a bath is to prepare all the materials and tools needed. This will help prevent exposing the sick person which may cause him to chill. The following are the materials and tools needed:

Large basin with lukewarm water

Bath soap to clean the germs and remove the dirt and perspiration

Wash cloth for washing the different parts

Towel to dry the different parts of the body

Rubbing alcohol used for giving massage in order to give a stimulating effect to the

body

Powder to prevent skin irritation and to give a refreshing feeling

Blanket to prevent chilling

Pillow to support the head and upper part of the body

Brush/comb used to massage the scalp and comb the hair

Rubber sheet to protect the bed from getting wet

Steps in giving a bath to a sick person Clean the eyes with gentle but firm strokes. Wash the inner and outer part of the ears. Continue cleaning the neck, chest and abdomen. Rinse

and dry the towel. Continue cleaning the arms and legs. Clean the legs and feet. Wash the back of the body down to the buttocks. Wash external genitalia. Rub alcohol using firm strokes to aid in the circulation

and check for signs of bed sores. Apply powder or lotion. Put on a clean/dress/gown.

Tips in giving a bath First, check the body temperature to

know if he is in good condition. Close windows to prevent chilling. The best temperature of the water is

about 38 or 110. Rinse wash cloth as often as possible. Begin cleaning from top to bottom and

from inner to outer part.

Bed MakingA Desirable Bed

To induce a sound sleep and afford a greater degree of relaxation, a bed must have desirable qualities. To have these qualities, the first consideration is the size of the bed. It must have a dimension of about 6 and a half feet long, 3 and one-fourth wide and 2-2 and a half feet high. Regardless of materials used, smooth surface is desirable because of the ease in cleaning. A desirable bed must be clean at all times, the spring must be comfortable and not sagging. The mattress must permit a more natural and relaxed posture for an individual in any position he may assume. It must be thick, smooth or allergy-free of the person to use the bed. The sickness or allergy of the person to use the bed must be taken into consideration. The headboard must contribute to both the beauty and comfort of the bed.

Materials in Preparing the Bed Bed Sheet – this should

be long enough to give allowance for tucking the four sides of the mattress. Correct length provides adequate covering for the mattress which prevents unnecessary soiling of the blanket. Long bed sheets also protect the sensitive individual from the possibility of some irritation by preventing it from touching any part of the body.

The bed sheet used in making the bed is of three types:

• The draw sheet which covers the rubber sheet.

• The top sheet which covers the draw sheet.

• The bottom sheet which is placed after the mattress cover.

Mattress Cover – this is made of heavy cotton. It is needed to protect the mattress from dust and dirt.

• Rubber sheet this is placed on top of the mattress cover in order to protect the mattress from getting wet. The rubber sheet should be wide enough to cover approximately.

Pillow – the choice of pillows must take into consideration individual needs. The size of the pillow will depend upon the individual large pillows, others prefer small ones. Another important consideration is the allergic reaction of individual to some materials used in making pillows.

Pillow case – the most important consideration on the selection of a pillow case is the material from which it is made. The most appropriate materials is cotton as it is absorbent and washable. Pillows require frequent cleaning, sunning and airing. Above all, it must fit the pillow on which they are to be used.

Bedspread– this is the top covering used to dress the bed. It is usually removed before using the bed and placed after using the bed. The bedspread is used at daytime to protect it from dust or microorganism.

Procedure of Preparing the Bed

Preparation1) Prepare all materials needed.2) Wash your hands to prevent contamination of

materials used for bed making.

Actual Preparation of the Bed1) Dust the different parts of the bed.2) Cover the mattress with a mattress cover.3) Place the bottom sheet with a centerfold at the

center of the mattress to prevent it from touching the floor.

4) Place the rubber sheet (if needed) to cover two-thirds of the mattress.

5) Place the draw sheet, using the same procedure as in the bottom sheet.

6) Place the top sheet on top of the draw sheet using the same procedure as in the bottom and draw sheet.

7) Cover the pillow with the pillow case and place it on the upper part of the bed just in front of the head board.

8) Place the blanket with the centerfold at the center of the mattress. Fold the upper part of the blanket horizontally downward to leave one-thirds of the bed covered. Tuck in the two sides, leaving one side for the individual to enter when making use of the bed.

9) Cover the bed with bedspread to protect it from dust and dirt.

10) Give the finishing touches to make the surface smooth and the edges well tucked in.

Steps to ensure well-mitered corner Tuck the sheet well under

the mattress at the two heads of the bed.

Lift the sheet at the corner, marked A and bring it along the side of the mattress.

Grasp the sheet in the upper part marked B and brings the points directly up, releasing the sheet at A.

Tuck in the lower part of the sheet that hangs below the mattress.

Bring B down. Pull firmly and tuck under the mattress. The part marked C should be even with the edge of the mattress.

Tips on Making the Bed Bedding must be clean and dry. Pillow cases should be changed at least once a day. Bed linens should never be allowed to come in contact with the

floor. Rubber sheets should be rolled to prevent it from cracking. Top sheet should be changed as often as possible. Place pillows under the sun to kill the germs and to keep it dry. Beddings must be free from wrinkles, stains, and tears. Keep the pillow of various sizes adds comfort. Colored beddings give life and enjoyment to the individual

using the bed.