In taking the vital signs of the resident, you should always remember to first explain it to them so they will participate in the procedure. It is important to be organized in taking vital signs so as not to waste time and energy. Taking Temperature There are many sites for temperature taking and getting them depends on the site preference of the facility and or the health team. When taking temperature orally, it is important to delay at least 15 minutes before taking if residents have had a hot liquid or smoked only just a moment ago.
Taking temperature through the axilla requires a dry armpit in order to get an accurate reading. Also, document the reading with an A for axilla or follow the guidelines that the facility recommends in the use of such abbreviations. If the results are unclear you should repeat the procedure or use other method. Measuring Blood Pressure Taking blood pressure requires the use of sphygmomanometer with blood pressure cuffs therefore knowing how it works requires some practice. The taking of blood pressure should be taken from the site where the highest readings are present either in sitting or lying down position.
To determine such site requires taking blood pressure in both arms with different positions, comparing these results and recording each taking. Measuring Pulse Measuring pulse rate can be taken at the wrist and it needs to be measured for at least one minute, especially if the resident has heart disease. Taking the apical pulse can be done by listening to the apex or the tip of the heart for a full minute. An irregular pulse may indicate an abnormality in the heart condition. This must be documented and reported immediately so that abnormal heart condition can be determined and treated early.
Measuring Respirations Respirations also should be counted for a one full minute. Counting the respiratory rate consists of counting both inspiration or inhaling of air and also expiration or exhaling as one count. Observe the unusual breathing such as dyspnea or the difficulty in breathing and alterations in the rhythm of respiration such as pauses. One click unbrick tool for android download. When taking vital signs, it is important that a small pad of notes and pen be present for recording, especially if one is taking vital signs for many residents. In weight and height taking, consider also the mobility of resident.
Use a scale suitable for this kind of situation such as a wheelchair scale or other equipment that can be used to immobile residents.
Maintenance is an excellent means of improving the performance and condition of equipment and facilities. An effective maintenance program identified problems long before any equipment or facility breaks down or deteriorate. A good maintenance system presents the early discovery of problems, thus providing plenty of lead time for effective maintenance planning. The trainer has to value the importance of maintaining the training facilities, equipment and tools he is using or under his care if he values the presence and availability of these resources for effective trainin and learning processes.
The Growth of Interest in Maintenance The factors contributing to the rapidly growing interest in maintenance are: 1. Technological development This trend leads to a more mechanized and automated equipment, resulting in great productive potential which must be kept working. This means that training facilities are becoming more complicated and required more advanced maintenance. Increasingly expensive raw materials Finite raw materials, in combination with a growing population and increasing assumption, inevitably result in higher raw material prices.
Unavoidably, the costs of all by-products must rise. It is therefore often more profitable to maintain existing equipment than purchase new ones. Greater complication A complicated facility of piece of equipment includes many components, any or all of which can constitute possible sources of trouble. Although the operational reliability of each individual component may be very high, it is necessary to multiply reliability factor of all components that are dependent on each other in a system in order to arrive at the total system reliability. Increased fixed costs Capital costs constitute a considerable part of the total costs of training and must be covered by the added value created.
If training stops as a result of inadequate maintenance, capital costs (depreciation) must still be paid, so that the standstill results in a net loss. Still, the salaries and overhead expenses must be paid while training is stopped. Reduce delayed activities and eradicate uncompleted work Many work processes depend on an uninterrupted flow of activities to produce desired result.
If an activity is delayed, the entire work stops. If all the facilities and equipment are reliable working well, work delay can be reduced. Environmental concern The growing quantity of electronic wastes (monitors, laptops, cellular phones, other electronic gadgets and its substances), the increasing use of chemicals such as cleaning agents, paints, fuel and its derivatives, the by-products created from its use, and its disposal, pose danger to the environment and all living things. Mass awareness on waste management brings the relevance of conserving the natural resources and the products (machines, tools) thru proper maintenance to lengthen its useful life. Training Equipment and Supplies Training equipment is usually placed in the practical work area or the trainee resource area. The sizes and uses of equipment vary in the different training qualifications and generally classified into five (5): 1.
Large items of equipment – motor vehicles, industrial sewing machines 2. Small items of equipment – video/tape recorder, espresso machine 3. Simple equipment – electric fan, floor polisher 4. Complex equipment – plasma cutting machine, simulator (automotive) 5. Equipment with significant health and safety implications – duplicator machine Why Maintain? General Objective:.
To keep the optimum condition of physical facilities at acceptable levels and minimum cost to satisfy the expected of programs, services and activities at acceptable and minimum costs Specific Objectives:. To extend the useful life of physical facilities.
To assure the operational readiness of installed equipment and maximum possible return on investments. To properly discard hazardous wastes.
To ensure the safety of personnel using the facilities, physical properties and the environment What can we gain from maintaining our facilities?. Ensured SAFE environment. Improved MORALE of human resources. Reduced operational COST. Increased PRODUCTION. Prolonged LIFE of facilities.
Prompt DELIVERY of services/product. WASTE/Garbage reduction Who are involved?. Who will manage the activities?. Who will monitor and evaluate the operations?. Who will prepare the maintenance schedule?.
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Who will implement the program?. Who will keep the records?. Who will conduct inspection?. Who will certify and accept the work?.
Who will prepare the report? What, Where, When?.
What routine actions must be done to keep the device on working order?. Where is the maintenance activity to be carried out?. When do you perform the maintenance activities? How to maintain? The question on how do we implement the maintenance program will center on the 5Ms as follows:.
Manpower. Money (Financial Resources). Methods and System. Machines (Facilities). Materials and Supplies A maintenance program is a comprehensive list of maintenance and its incidents. This would include all maintenance activities to be undertaken, manpower needed, maintenance methods to be used, all the materials and supplies needed and cost involved in the maintenance. A maintenance schedule is a list allocating specific maintenance of an area, including equipment and tools to a specific period.
The maintenance schedule is just a part of the maintenance program. A maintenance checklist is a list of maintenance tasks (preventive or predictive) typically derived through some form of analysis, generated automatically as work orders at a predetermined frequency.
Podcast: Listen to the entire Nursing Show episode with news, commentary and the Vital Signs Part 2 tip of the week. Assessment of Medication Effects One of the things that we also can use vital signs trending for is to look at the effects of given medications. And not just pain medications, but cardiac medications. A patient is given a dose of beta blockers and they have recently not been on beta blockers; you would expect to see a decrease in the pulse and blood pressure in response to those medications. And the same thing is true for other similar medications.
Patients that are on a wide, broad spectrum antibiotic by IV, we would expect after a certain period of time that their temperature would decrease if the medication is having the desired effect. So these things are all part of what we’re looking at when we trend. Identify acute medical issues Now, vital signs also have other purposes. It’ll identify an acute medical issue if something has cropped up suddenly.
If you have a patient that has a sudden drop in blood pressure and is post-surgical, you could expect that that patient may indeed have developed an internal bleed of some kind. Same thing is true for other signs of shock. So this is also used to identify the onset of an acute issue and not necessarily for long-term trending. And that would be the single instance where you would expect a single set of vital signs to give you any meaningful information. Identify Effects of Stress Also, vital signs are a way of understanding the magnitude of a problem and also how well the body is dealing with any kind of stressors that are going on; in other words, healing from a surgical situation or a patient that’s in a trauma situation or any other shock situation where the body is compensating in some way to maintain homeostasis. We would want to see a gradual return to the patient’s normal baselines and whatever those normal baselines might be.
And if we see a trend in an opposite direction than clearly they’re not physiologically dealing very well with that problem. And of course they’re also a good way to trend over a longer term patients with problems like hypertension, patients with other chronic issues that extended look at respirations over time will give you an idea that they are generally trending upward. We see this a lot, especially for those nurses that are involved in things like parish nursing programs or other community nursing programs where they are regularly taking blood pressures for their patients.
You can look at a patient’s card in a situation where you’re taking their vital signs, taking their blood pressure and pulse every two or three weeks at church or something — you can look at that card and you may see that there is a general trend upward. And in that case, that patient can be advised to return to their physician with the information that their blood pressure is trending upward and they may need to adjust hypertension medications or start hypertension medications. Patient Interaction So when vital signs are taken and you are interacting with the patient, what else can be going on? Well, when you’re taking vital signs with your patients, especially — and this is good advice for students who haven’t yet developed a good routine — is this is a perfect time to meet your patient. It’s a perfect time to ask other health-related questions.
Perhaps you’re concerned about a new medication that’s been started. You’ll want to follow-up on any side effects that you may be looking for. So again, while you’re taking your vital signs and you’re in the room, it’s a good time to interact with your patients and build rapport. Physical assessment Also when you’re in there you can also do a basic quick head-to-toe assessment of your patient. How’s their color? You can check basic things like capillary refill. Are they getting good profusion to their extremities?
Obviously a good peripheral pulse and blood pressure would indicate this but you may notice problems with individual extremities with certain types of issues like blood clots where they’re showing signs of edema or showing signs of poorer profusion on one side compared to the other; that would be an indication. And these are things that can happen very quickly and easily during the process of getting vital signs. I also want to urge you to remember that you’ve got that thing around your neck for a reason. It is a stethoscope and you should be using your stethoscope for some basic auscultation of the patient while the automatic blood pressure machine is running. And that seems to be more and more the standard in most facilities, so the ability to take a manual blood pressure is not necessarily something that you need to use on a regular basis. So you have the stethoscope there; go ahead and have the patient get their blood pressure while you listen to apical heart rate and compare it to what you’re seeing on the monitor. You can do things like check the patient for good breath sounds all the way to the basis.
These are all things that can happen during a vital signs period and are assessments that need to occur but certainly don’t have to take up extra times if you get into a good routine. And so that’s kind of — you have an excuse to go in and take vital signs anyway.
That’s something that’s very important. Get This Episode of the Nursing Show Subscribe to the free weekly Nursing Show using iTunes here. —— Get study files like this one and tools complete with at Nursing Top Student.com.
Tools Equipment And Paraphernalia For Taking Vital Signs
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If you're considering pursuing a career as a CNA, or, you should learn as much as you can about the job before starting your training. You probably already have a decent idea about what CNAs do, but what about the tools they use? You will get acquainted with the most common CNA tools while completing your training program, but it never hurts to learn more about them ahead of time. By knowing what to expect, you are sure to get through your training easily. Most Commonly Used Tools for a CNA Although vary from employer to employer, the vast majority rely on the following tools throughout their workdays:. Stethoscope - CNAs are usually responsible for taking patients' vital signs, and a stethoscope really comes in handy for that.
It can be used to not only check a patient's pulse and heart rate, but their blood pressure too. As a CNA, you're sure to have a stethoscope dangling from your neck more often than not. Gait Belt - As a CNA, you will regularly have to help patients get around. This typically entails moving patients from their beds into their wheelchairs and vice-versa or helping support their weight while they walk. For safety's sake, CNAs use gait belts for such tasks.
It helps ward off back injuries and protects patients too. Surgical Scissors - Because CNAs are often responsible for changing patients' dressings and general wound care, they typically carry around surgical scissors. These scissors can also be used to quickly remove clothes from a patient in distress, so they are crucial to have on hand. Most CNAs own at least a few pairs, so you can expect to stock up on them for your first job. Thermometer - Obtaining a patient's temperature is an important part of getting their vital signs.
Naturally, a thermometer is quite useful under such circumstances. While some CNAs use traditional thermometers, which patients hold under their tongues, some have more advanced electronic models.
Many thermometers don't need to be used orally or rectally, either. For instance, many can take a patient's temperature through the ear or simply by being pressed against the forehead. Protective Gear - During the course of a typical workday, a CNA can expect to come into contact with various bodily fluids.
CNAs often administer suppositories, collect urine samples, and, in some states, perform catheterizations. Needless to say, they must take steps to shield themselves, so protective gear is a must. Gloves, masks, protective eyewear, gowns, and caps are all examples of the type of gear you can expect to use as a CNA. Aids for the Disabled - CNAs work closely with disabled individuals who need a lot of assistance to take care of everyday tasks. Special aids for the disabled make the work much easier. They include special stools and seats for more safely showering and bathing patients as well as bedpans and bedside commodes. These devices help keep patients comfortable and make CNAs' jobs a lot easier.
As a new CNA, it's easy to feel overwhelmed by all the tools and equipment needed to get through your days. You'll quickly get the hang of them and soon understand why they are so essential. Before too long, you'll be using them like a seasoned professional. ABOUT US Whether you are researching your best options for entry into the healthcare industry, or ready to start the journey towards becoming a Certified Nursing Assistant, licensure can help. Our website can guide you to the best CNA training programs, through the steps of obtaining your CNA license, and what to do to maintain a valid license.
Be sure to browse the featured schools or use the search box above to find an accredited CNA training program in your area, or use the links to the right to explore different aspects of obtaining and maintaining your license.
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