• Gatch bed - operation may be done manually by turning the cranks ; they increase the risk of employee back injury
• Electric bed - operated electrically
• Low bed - commonly used in health care facilities for patients who are at risk of falls ; for patient who are at risk of falls

The bed reduces the potential for friction and shear (Warm, dry air circulates through the material to maintain an even temperature and support the body evenly and the bed filled with a sand-like material). 

Provide comfort and faster healing of multiple pressure ulcers, flaps, grafts, burns, management of extensive skin disorders or fresh surgical wounds. It can be defluidezrd rapidly if CPR is necessary.

Clinitron bed

A low air loss bed

• Use body mechanic
• Maintain a neutral posture and bend from the legs, not the waist. Avoid twisting.
• Use a fitted bottom sheet, lowering the risk of back strain
• Elevate the bed
• Make one side of the bed at a time.

Incontinent pad, underpad or bed protector.

The pads may also be called by their brand name, such as Chux (usually 30 to 36 inches square).

Bath blanket.

It is usuallu stored in the closet or bedside stand when not in use.

• Closed bed
• Open bed
• Surgical bed/post-operative bed
• Occupied bed
• Unoccupied bed

Surgical bed/post-operative bed.

The bed should be left open and at strecher height.

• Remove dirt and perspiration
• Increase circulation
• Provides the patient with mild exercise
• Provides an opportunity for close observation

• Face and neck
• Far arm and hand
• Near arm and hand
• Chest and abdomen
• Far leg and foot
• Near leg and foot
• Back and buttocks
• Perineum

• Temperature of the water can be regulated to a constant 97ºF
• The movement of the water stimulates circulation
• Warm circulating water is relaxing and invigorating
• It provides the value of whirpool activity with cleansing.

• Do not put stress on the tube
• Never lower the IV container below the level of the infusion site.
• Never raise the drainage tube above the drainage side

Disinfect the whirpool tub immediately before and after each use.

Cleaning the tub with the proper disinfectant solution.

Cleaning and caring of the teeth, gum and inside surfaces of the mouth.

abnormalities and pocketed food.

• Tooth decay (blackened), any loose or broken teeth
• Red or swollen gum
• Sores or white patches in the mouth or on the tongue
• Changes in eating habits
• Poorly beating denture

• Prevent infection in the mouth
• Remove food particle and plague
• Stimulate circulation of gum
• Eliminate bad taste in mouth

Not only is the mouth vital for eating, drinking, taste, breathing, verbal and non-verbal communication, saliva also has antibacterial properties and is part of the body’s defence against infection.Poor oral hygiene is well known to be associated with painful, unpleasant diseases such as gingivitis, dental caries, halitosis and xerostomia and, more recently, has been linked to chest infections and pneumonia.

• First determine if patient has denture or partial plate.
• Position patient in the  lateral with the head turn toward the side to provide for drainage and prevent aspiration.
• Oral suctioning may be required for the unconscious patient to prevent aspiration.
• A soft toothbrush or gauze-padded tongue blade may be used to clean the teeth and mouth.

Check of sign of  broken teeth, cracks, sharp edges or missing name label, or other problem report to nurse charge.

Bedtime is usually a good time to clean dentures, since it is best if they are left out for 6 to 8 hours each day to allow the gums some time to rest to help avoid irritation or infections of the soft tissues.

Dentures can also be soaked in water with a denture cleaning tablet if desired, but soaking alone will not remove plaque, so this should only be done after brushing.

When dentures are not in the mouth, they should be kept in clean water with or without denture cleaner in a plastic denture cup, since drying them out may change the fit. Denture cleaners must also be completely rinsed off before the dentures are placed back in the mouth.

1. Denture are best clean over a sink half filled with water and with a towel or wash cloth lining in the sink to act as a cushion in case denture should drop.

2. Gently scrub the denture with the denture brush and paste under running water. Being careful to brush both of the inside and outside to remove food, plague and denture adhesive then rinse them under cool water. Do not soak or rinse denture under hot water, since this may effect their shape and fit.

3. For partial denture with metal clasps, also becarefully to brush around the clasps to remove food and plague.

help the denture stay well.

Too much or not cleaning denture adhesive each day  will lead to gum irritation, infection, unpleasant and affect the test of food.

1. Make sure the dentures are clean and moisten them with little water.

2. Apply three or four small ribbons of adhesive paste evenly towards both the front and back.

3. Have the resident place the dentures in the mouth and bite their teeth together to seat the dentures correctly.

1. Eliminate dirt

2. Eliminate body odor

3. Refreshes the patient

4. Stimulates circulation and helps prevent bed sores

5. Exercise muscles that otherwise may not be used

• Face, hands and axilla
• Feet
• Back - include back rub
• Perineal area - includes thighs
• If patient is heavy, the skin folds under the brest and abdomen

• prevent tooth decay (caries)
• Eliminate bad breath (halitosis)
• Contribute to the patient's comfort

Upper denture : Downward and then forward and remove them from the mouth

Lower denture : Upward and then forward and remove them from the mouth

1. Electric razor (wearing gloves is usually not necessary)
2. Non-electric razor

• always wear gloves when shaving patients with a nonelectric razor
• discard the razor in a puncture resistant (sharps) container

• Hold skin taut and bring razor down over cheek toward chin
• Use firm, short strokes.
• Shave in direction of hair growth
• Shave from the nose to the upper lip in short, down-ward strokes
• Shave the chin in downward  strokes
• Stroke up the neck area toward the chin

• Working with one section at a time
• Grasp the hair near the scalp to reduce pulling
• Start combing or brushing tangles out starting at the ends and working toward the scalp
• if the hair tangles applying a small amout of alcohol or oil (examples : apply baby oil to the scalp, not the hair)

Bridging

It is useful for patients with healing pressure ulcers, used for sacrum, hips, heels and ankles (using pillows, foam props and bath blankets to support an area).

Orthopedic (fracture) - narrow end is positioned under the patient's buttocks, with the handle end facing the foot of the bed

Bedpan - buttocks should rest on the rounded shelf of the regular bedpan

• Do not let bedpan uncover
• Do not place bedpan on the bedside table or overbed table
• Place protector on the chair and put bedpan on the chair

• keep the labia separated as much as possible
• Every single wash turn the washcloth to a clean are 
• Wash the center, using single downward stroke from top to bottom
• Wash the far side of the labia, using a single downward stroke from top to bottom
• Wash the near labia, using a single downward stroke from top to bottom
• Expose the anal area stroking from perineum to coccyx (front to back)

• wash, rinse, and dry the perineal area surrounding the urinary meatus and catheter
• Change the wash cloth
• Beginning at the urinary meatus, wash down the catheter approximately 3 to 4 inches, use single downward stroke
• continue with perineal care.

• Insert the toothbrush into the mouth with bristles pointing downward
• Turn the toothbrush with bristles toward teeth
• Place the head of the goothbrush beside the teeth, with the bistle tips at a 45º against the gumline. Using brush back and forth in short strokes several times, a gentle scrubbing motion.
• Use the "toe" end of the brush to clean the inner surfaces of the front teeth, using a gentle up-and down motion.
•  Brush the fronth of the tongue gently if tolerated, avoid the back of the tongue, may cause gagging and coughing

Use toothettes or lemon-glycerine applicators.

Note : lemon glycerine swabs  are drying, and should not be used frequently.

• To remove upper dentures, grasp the dentures firmly, ease them downward and then forward, and remove them from the mouth
• to remove lower dentures, grasp the dentures firmly, ease them upward and then forward and remove them from the mouth
• Insert upper denture first

• Never rub red areas that may be stage I pressure ulcers
• Avoid massaging the legs (gently pat it on), massage can cause complications related to blood clots.
• Avoid putting lotion vetween the toes, lotion keeps the area moist, which promotes fungal growth

• Unconscious
• Vomiting
• Experiencing a high temperature
• Receiving sertain medications
• Dehydrated
• Breathing through the mouth
• Receiving Oxygen
• Receiving tube feeding 
• Dying

1 foot = ___ inches

1 lbs    = ___ pounds

• determine and record empty wheelchair by weighing it on the scale
• Record weight of the patient and wheelchair
• Substract the wheelchair weight to obtain the patient's weight

Area between the scrotum and the anus

Circular motion begining with the urinary meatus, working outward over the glans (head of the penis). Continue to wash down the penis and the rest of the perineal area, including the scotrum, using downward strokes and working outward to the thighs.

Expose the anal area, wash the area, stroking from perineum to coccyx (front to back).

Clipped straight across, then rounded at the edges with an emery board.

Push the cuticles back with a wash cloth or the dull end of the orange stick

• Fitted sheet
• Draw sheet
• Incontinent pad
• Top sheet
• Blanket
• Pillow

the far side of the bed

Raise the bed to stretcher height

inward

Keep soiled linen away from your uniform

During assist patient to the bedside commode, position the bedside commode :

A. Facing the foot of the bed

B. Facing the head of the bed

C. 30º angle toward the bed

D. None of the above