Nursing Fundamentals

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Nursing Fundamentals

• Pgs. 336-336 old book
• 387-413 new book
• Comfort, Rest, Sleep

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Comfort

• A state in which a person is relieved of distress

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Rest

• Waking state characterized by reduced activity
  and mental stimulation

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Stimulus or Stressors

• Any change in in ones environment which is just
  enough to cause the body to respond is considered
  to be a stimulus or stressor

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Sleep

• State of arousable unconsciousness

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Client Environment

• Refers to
• The room where the pt. receives nursing care
• All of the furnishings in the pts room

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Unaware

• Most pts are unaware that their environment
  matters when they are ill
• The lighting
• The staff
• The landscaping
• The sounds
• All matter

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Client Rooms

• Must be conducive to comfort in order for the pt
  to get better
• Environmental psychologists have studied how the
  environment affects the pt

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Walls

• Blue and colors with blue tints or cool colors
  are found on hospital walls
• This color calms the pt and promotes relaxation
• Art work on the walls depicts country scenes and
  peaceful images

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Floors

• Noise interferes with comfort therefore,
• Most facilities are carpeted in the hallways and
  work station areas
• Clients floors in their rooms are linoleum or
  tile to facilitate easy clean up from spills

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Lighting

• Adequate lighting is important for assessment and
  procedures that are needed to be performed on pts
• Both natural and artificial lighting are used in
  care facilities
• New facilities have large windows so the pt can
  see outside
• Dim light and darkness promote sleep
• More injuries can occur in these dim condition,
  USE CAUTION

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Climate Control

• These are mechanisms for maintaining temperature,
  humidity, and ventilation
• Climate control is a method of promoting physical
  comfort

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Temperature

• Clients are most comfortable when the temperature
  of the room is 68 - 74
• Some facilities have a thermostat in each room
  and pts can change the temp based on their own
  needs

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Humidity

• Amount of moisture in the air
• Some believe that if there is not enough humidity
  in the air, the nasal passage dries out and
  cracks and this is one way that bacteria or
  viruses can enter into the body????? What do you
  think

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Epistaxis

• Nosebleed
• Caused when there is not enough humidity in the
  air
• Nasal spray works well to moisten the area

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Epistaxiseeewww!!!
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Air-conditioning

• Needed to keep the humidity low
• If the environmental temp. becomes greater than
  the skin temp. Evaporation is the only way the
  body can regulate its temp. What happens when
  your facilities A/C goes out? ?
• Fans may not be permitted in some institutions
  d/t the spreading or blowing around of germs
• All hospitals are dry to avoid the spread of
  germs. This takes a toll on pts and healthcare
  workers

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Ventilation

• Movement of air
• Poor ventilation occurs when the A/C goes out.
  There is no circulation of air. This causes
  problems for everyone
• Poorly ventilated rooms smell badly, it is
  important to remove all soiled linens immediately
  to help this
• Air deodorizers can help, some pts find smells to
  be offensives

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Employees Perfume

• d/t ventilation and offensive smells, healthcare
  workers SHOULD NEVER WEAR SMELLY PERFUMES OR
  COLOGNES TO WORK.

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ROOM Furnishings
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The Bed

• Hosp. beds are adjustable
• Not always the most comfortable
• Adjusting ones bed promotes comfort, enables
  self-care and facilitates therapeutic position
• Beds are to remain IN THEIR LOWEST POSITION ALL
  OF THE TIME EXCEPT WHEN CARE IS BEING PROVIDED

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Side Rails

• Provide safety to pts
• Can side rails be unsafe for a pt? Explain
• Side rails are considered to be a form of a
  physical restraintpts cannot get out of the bed
  by themselves

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Removable Headboards

• Used to provide support for the pt during CPR

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Mattress

• A good mattress adjusts to the shape of the body
  while supporting the body
• A flimsy, soft mattress misaligns the spine
  causing pain
• Hosp. mattresses are made of strong, durable
  material to withstand long-term use
• Mattresses are washed not sterilized btwn uses,
  some are covered with waterproof sheets

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Mattress Overlays

• Such as egg crates are placed on top of the
  mattress to provide even more comfort.
• Usually when one is used, it now becomes property
  of that pt d/t germies
• Overlays can be made of foam, gel, air or water

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Pillows

• These are primarily used for comfort
• Pillows are also used to
• elevate parts of the body
• to relieve swelling
• to promote breathing
• to maintain therapeutic positions

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Bed Linens

• Bedding can be used for the following
• Fitted bottom sheets
• Draw sheet
• Top sheet
• Blanket
• Means to secure/restrain a pt who is sitting up
  in a chair

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Skin Care

• Keeping a pts skin clean and dry is the ultimate
  goal of a pt who is lying in bed
• NEVER wait to change soiled linens
• Imagine yourself laying in a soiled mess
• Change wet or soiled linens WHENEVER they need
  it. Dont wait for someone else to do it, demand
  it get done

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Privacy Curtain

• These are usually mounted to the ceiling and ride
  along a track
• The curtain preserves a pts dignity
• Everyone deserves privacy
• Be observant of who needs to have their curtain
  closed

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Over-bed Table

• This is a portable, flat, rectangular shaped
  table that the pt uses primarily to eat on and to
  perform personal hygiene on
• Nurses like to load the table up with medical
  equipment leaving no place for the pt to put
  his/her things
• Most hosp. tables have a small pull out drawer
  used for comb, brush, toothbrush and mirror

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Bedside Stand

• This is a small cupboard with usually 2 shelves
  in it
• This top shelf can hold personal items for the pt
  such as
• Soap, washcloths
• Basin, emesis basin
• The bottom shelf holds TP, urinal, or bedpan

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Chairs

• There is usually 1 chair/room
• Most chairs have a high back for support
• The best sitting position is when the knees, hips
  and ankles are at a 90 angle

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How to comfort new patients to the hospital

• Always listen to their needs
• Offer support esp. when they become emotional
  about being hospitalized
• Allow choices when necessary
• Allow client to bring items in from home whether
  they are young or old, some items need approval
• Ones own bed linens are allowed at times

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THE END