No, there is no fountain of youth, but there are foods that we can eat and drink to help us look and feel younger. Anti-wrinkle creams are helpful because they do contain ingredients to replenish the skin with moisture after aiding in removing dead skin cells. Getting plenty of sleep is also vital to good health and a more youthful appearance. Exercise and lower stress levels are yet other ways to renew our youthful appearance.
But why not work on giving your skin a more youthful look from the inside out? By eating and drinking the right foods, we can turn back the hands of time and you will look and feel years younger. It won't happen overnight, but it will happen. And it will happen naturally. Below is a list of foods containing high levels of antioxidants. Antioxidants are the key. Antioxidants fight free radicals, which are toxins to our bodies. There are free radicals in cigarettes and pollution, for example.
Foods of longevity:
-nuts
-peaches
-potatoes
-spinach
-cauliflower
-stringbeans
-carrots
-apples
-mushrooms
-celery
-lettuce
-bananas
-cucumbers
-broccoli
-watermelon
-grapefruit
-oranges
-sweet potatoes
-onions
-cooked corn
-squash
-grapes
-stawberries
-beets
-prunes
-blueberries
-grapes
Eat the fruits fresh, eat the vegetables fresh or steamed is best. A little crispness should be left to the vegetable so not to destroy the nutrient content.
Drinks of longevity include:
-Water first and fomemost. Filtered water flushes the body of toxins, and it also hydrates the body's cells, including the skin. You should have at least 8 or more glasses of water per day.
-grape juice - very high in antioxidant level
-orange juice
-prune juice
-grapefruit juice
-any juices of the above listed fruits and vegetables, in which juices are usually made.
A very "cool" way to enjoy these fruit juices are as slushes or smoothies (where the fruit juice is mixed with ice and nonfat vanilla yogurt.)
*NOTE: You should at least 6 servings of antioxidants per day.
A few more hints for a youthful appearance is to have plenty of roughage in your diet, such as whole grains and green salads, get some fresh air, think holistic health, exercise your mind and relax as well, and take a multivitamin daily. Check with your pharmacist or doctor to find the one that is right for you.
Friday, 31 October 2008
Excessive fat kills
Excessive Fat kills.
In this new century, news media are finally aware that
America's major health problem is obesity. Excess weight
not only contributes to almost every health risk, it can
actually multiply the risk factors, including those from
tobacco. It has already been reported that tobacco causes
more deaths than AIDS / HIV, maternal mortality, automobile
accidents, homicide and suicide combined, yet obesity makes
the risks even higher.
You don't have to be 300 pounds overweight for fat to be
harmful. Being "pleasingly plump" or even leaner can be
enough to increase your risks of various ailments, such as
cancers, diabetes, heart disease, memory loss, menopause,
osteoporosis, PMS, stroke.
Just substituting margarine for butter is not enough,
especially if the spread is made with hydrogenated oils or
"trans fatty acids".
Good fats, the "essential fatty acids" that the body can not
make, can be found in fish, nuts, soy and other foods. For
most fats, if you have none in your diet, your body will
make what it needs.
** Diet with FACTS, not MYTHS. **
Home Nursing Procedures Part II
Turning the Patient on His Side and Away from the Home Nurse.
1. Free the covers; instruct or help the patient to bend his knees.
2. Face the side of the bed, with one foot forward and the knees bent.
3. Slip one hand, palm up, all the way under the patient's shoulders; slip the other hand, palm up, all the way under the patient's hips. The home nurse bends at the hips and knees.
4. On signal, pull the patient toward the home nurse and roll him so that he is on his side.
5. Adjust the patient's hips, knees, and ankles for security and comfort.
6. Adjust the covers.
Turning the Patient Back from Side and Toward the Home Nurse.
1. Tell the patient what is about to be done.
2. Loosen the blanket.
3. Place one hand on the upper shoulder, the other on the upper hip on top of the bedding.
4. On signal, roll the patient all the way toward the home nurse.
5. Adjust the hips, knees, and ankles for comfort.
Essential Points To Remember.
1. Observe good posture.
2. Guide the patient's movements rather than do all the lifting.
PROVIDING SUPPORT FOR THE BED PATIENT
Purpose. To maintain correct and comfortable posture for the bed patient at all times.
Support for a Patient Lying on His Back
Equipment
Firm mattress and springs
Pillows—a variety, such as hard, soft, large, and small, or substitutes, as needed for the individual patient
Foot support—high enough to extend above the toes—to protect against the weight of the bedding
Procedure
The number and type of pillows under the head and shoulders is a matter of preference unless the doctor gives special orders. The normal curves of the spine should be maintained, the head in line with the trunk, i.e., not pushed forward or allowed to drop backward. The knees may be slightly bent for muscle relaxation and comfort.
Using One Pillow.
1. Place the pillow under the patient's head—reaching to the shoulders.
2. Place a foot support for his upright feet to brace against; it should extend above the toes to protect them from the weight of the bedding.
3. Place a small pillow or folded towel under the knees as desired.
Using Three Pillows.
1. Place two lengthwise, overlapping at the top, together at the bottom, and extending under the shoulders.
2. Place one crosswise at the top under the head. (Place a small support at the lower back, if necessary.)
3. Place the foot and knee supports as above.
Support for a Patient Lying on His Side
Procedure
1. Place one pillow under the patient's head.
2. Place one snugly and securely at his back.
3. Place one lengthwise between his legs and feet, supporting the knee, toes, and heel; adjust the position of his legs for comfort by flexing the uppermost leg beyond the knee of the lower leg.
4. Place a small support under his abdomen.
5. Place one pillow for support of the uppermost arm. (The arm should be in line with the trunk, and the elbow in line with the shoulder.)
Support for a Patient Sitting Up in Bed
The doctor will indicate when the patient may sit up in bed and for how long.
Equipment
Back rest
Large pillows, 2-5
Small pillow
Foot support
Procedure
1. Place the back rest, slanting the surface toward the patient.
2. Adjust 3 pillows as described previously.
3. Swing the patient back to the pillows and help him lie back.
4. Place the knee support (a small pillow).
5. Place the foot support.
6. Place a pillow at either side for an arm support.
7. Note on the daily record the length of time the patient sat up and his reaction.
Essential Points To Remember.
1. Change the position from time to time.
2. Maintain correct body alignment.
3. Provide support to avoid strain on the joints, prevent deformities, conserve energy, and promote comfort.
HELPING THE PATIENT FROM THE BED TO A CHAIR AND BACK INTO BED
Purpose. To help stimulate circulation, provide relief from lying in bed, and promote general convalescence.
The doctor will indicate when the patient may sit up in a chair and for how long.
Equipment
Comfortable chair
Blankets, pillows, and footstool, as needed
Dressing gown, hose, and slippers
Extra shawl or wrap, if desired
Blocks for a wheelchair, if required
Preparation
1. Bring the chair near the bed, braced against a wall or other means of support. If a rocking chair or wheelchair is used, blocks will be needed to steady the chair unless an assistant is present.
2. Place the blankets and pillows as needed.
3. Have a footstool handy.
Procedure
Getting the Patient Out of Bed.
1. Help the patient to a sitting position; pause in case he shows signs of dizziness; have him support himself with his hands braced behind. With one hand on the small of the patient's back and the other under his knees, swing the patient, on signal, to allow his legs to hang over the edge of the bed. After abdominal surgery, to prevent strain, first roll the patient toward the home nurse on his side; place one hand under his head and lower shoulder, and one hand back of his knees; the patient places his uppermost hand on the home nurse's shoulder. Raise the patient and swing his legs over the edge of the bed.
2. Put the dressing gown, hose, and slippers on the patient.
3. Face the patient; place one foot forward, legs apart for balance; bend at the hips and knees.
4. Place the patient's hands on the home nurse's hips and grasp the patient's arms at the shoulders from the outer surface.
5. On signal, help the patient slide off the bed to stand on his feet; pause in case he feels dizzy.
6. Still supporting the patient, side-step to the chair, turning the patient so that he can feel the chair at the back of his legs.
7. On signal, help the patient sit down. Stand close to the patient, feet apart, one foot forward; bend the hips and knees to prevent back strain and help him lower himself into the chair.
8. Arrange the pillows, blankets, and footstool for comfort. While the patient is in the chair, the bed may be aired, the mattress turned, and the bed remade with fresh linen.
Getting the Patient Back to Bed.
1. Open the bed—fan fold the upper bedding in thirds to the foot of the bed with the free end toward the head of the bed.
2. Release the blanket about the patient.
3. Face the patient, standing close to him with one foot forward, legs apart and braced for balance. Have the patient put the same foot forward and place his hands on the home nurse's hips. Grasp the patient's arms at the shoulders; bend the hips and knees, and, on signal, help the patient to a standing position. Pause in case he becomes dizzy.
4. Still supporting the patient, side-step to the bed.
5. Lift the dressing gown and help the patient to a sitting position on the edge of the bed with his hands braced behind for support.
6. Remove the dressing gown, hose, and slippers.
7. On signal, swing the patient back into bed, keeping one hand on the small of his back and one under his knees. Help him lie down.
8. Cover the patient and allow him to rest.
9. Note on the daily record the length of time the patient was up in the chair and his reactions to the experience.
Essential Points To Remember.
1. Before getting the patient up, obtain assistance if needed.
2. Place the chair near the bed the first day so the patient can be returned to bed quickly if necessary.
3. Protect the chair against slipping.
4. Avoid chilling and fatigue.
GIVING A BED BATH
Purpose. To cleanse, refresh, and relax the patient; stimulate circulation; provide a mild form of exercise; and aid in elimination by cleansing the pores.
Mouth care or treatments may be given before the bath.
Equipment
Large basin of warm water
Container of hot water
Waste water pail if not near a bathroom
Waste paper container
Towels—2 bath, 1 face
Washcloth
Soap in a dish
Lightweight or bath blanket
Rubbing alcohol (warmed)
Oil (sweet or mineral)
Body powder
Hand lotion and deodorant, if needed
Tray with toilet articles such as a hairbrush, comb, nail file, toothbrush, and mouthwash or dentifrice
Newspapers for protection of the furniture
Clean pajamas or gown
Clean bed linen
Preparation
1. See that the room is warm and that privacy is assured.
2. Assemble the equipment.
3. Remove and fold the spread.
4. Remove the top sheet—if soiled put on a newspaper or in a laundry bag; if to be used again, fold and place on the back of a chair.
5. Replace the regular blanket with a bath blanket if desired. Keep the patient well covered with a hot water bag to the feet if cold.
6. Remove all but one pillow unless ordered by the doctor.
7. Remove the soiled pillow cases; place with other soiled linen.
8. Remove the patient's gown or pajamas.
Procedure
1. Face.
a. Place a towel under the head to protect the bedding. Place another towel across the patient's chest and tuck half-way under the top edge of the blanket.
b. Wet the washcloth. Make a bath mitt by wrapping the cloth around the palm of the hand, anchoring with the thumb and tucking in the ends. Squeeze the cloth to prevent dripping.
c. Wash the eyes gently from the nose toward the ear, using one corner of the mitt for one eye and the other corner for the other eye. Use no soap.
d. Wash the forehead, nose, and cheeks, using firm, even pressure, long strokes, and an S-motion around the mouth and chin. Use soap if desired.
e. Rinse the face, following the same stroke as for washing.
f. Dry the face, following the same order and using the same stroke as in washing and rinsing. Wrap a section of the towel around the hand for a firm stroke and to avoid dragging the ends.
2. Ears and front of the neck.
a. Wash with soap and water, handling the washcloth in the same way as for washing the face. Get well into the folds of skin.
b. Rinse and dry.
3. Chest.
a. Cover the chest with a towel. Turn back the blanket protected with the towel.
b. Soap, rinse, and dry. Observe the skin; if it is reddened under the breasts, use a little body powder or oil.
4. Abdomen.
a. Protect the blanket with a towel; leave one towel over the chest.
b. Soap, rinse, and dry the abdomen, sides of trunk, and well over the upper thighs and pubic area. Use firm strokes.
c. Pull up the blanket and remove the towels.
5. Arm.
a. Place one towel under the arm and shoulder; place the other back over the blanket and tuck under the edge lengthwise.
b. Soap, rinse, and dry the arm. Be sure to include the armpit area. Give support to the arm while washing it.
6. Hand.
a. Place a basin of water and a dish of soap securely at the patient's side on a towel.
b. Soap, wash, and rinse the patient's hand in the basin. Remove the basin and soap. Dry thoroughly.
c. Clean the nails; apply hand lotion, if necessary.
7. Other arm and hand. Repeat the procedure in the same way with the other arm and hand. Work from the same side of the bed. Keep the water warm by adding hot water. Change the water whenever necessary (soiled or too soapy).
8. Back of neck, back, and buttocks.
a. Roll the patient on his side away from the person giving the bath. Fold back the blanket to uncover his back.
b. Protect the bedding; place one towel on the bottom sheet close to the back and one over the blanket, tucked under the free edge.
c. Soap, rinse, and dry, using long, firm strokes. Examine for reddened areas due to pressure. Follow with a back rub. Relieve the pressure by the use of an air cushion or a "donut," if necessary.
9. Leg.
a. Keep the patient covered except for the part being washed. Wrap the blanket snugly at the groin; protect the bedding with towels.
b. Have the patient bend his knee. Support the leg; wash, rinse, and dry with long, firm strokes. Examine the skin, especially the knee, for reddened or roughened areas and apply oil if needed.
10. Foot.
a. Protect the bed near the foot with newspapers and a towel. Place the basin and dish of soap securely on a towel.
b. Lift the foot carefully into the basin; wash and rinse the foot with firm strokes.
c. Remove the foot from the basin and dry, especially between the toes. If the skin is dry, apply oil. If the heel is sore, relieve the pressure with a "donut."
d. Remove the towels and cover the leg.
11. Other leg and foot. Repeat the same procedure with the other leg and foot, working from the same side of the bed.
12. Genitals.
a. The patient may wash his genitals, if able. Place a dry towel under the buttocks to protect the bedding. Place the basin handy for the patient; give him the soaped washcloth and a bath towel.
b. If the patient is unable to do this, cleanse the genitals. If genital discharges are present, use absorbent cotton or soft tissues and burn them later. Special care may be advised by the doctor following childbirth.
c. Remove the towel; arrange the blanket.
13. Replace the gown or pajamas.
14. Comb the hair. If the patient is a woman, she may wish to put on make-up.
15. Straighten the bed.
16. Remove and clean all bath equipment.
17. Arrange the bedside table.
18. Note on the daily record any unusual conditions observed. These may include reddened areas due to pressure, rash, swelling, unusual lumps, sores, or a tendency to fatigue.
Essential Points To Remember.
1. Cleanse all parts of the body.
2. Avoid chilling, fatigue, or embarrassment of the patient.
3. Observe and report to the doctor any unusual conditions.
THE BACK RUB
Purpose. To refresh and relax the patient, stimulate blood circulation, and relieve pressure.
Equipment
Rubbing alcohol, warmed in a container of hot water, or oil
Body powder, if desired
Procedure
1. Warm the hands; trim the nails short enough to avoid scratching the patient.
2. Place the patient comfortably on his side, facing away from the nurse, or on his stomach.
3. Pour a small amount of warmed rubbing alcohol or oil on the hands for lubrication.
4. Stand facing the head of the bed with one foot slightly forward and the knees slightly bent. Then with the flat of both hands and with long, firm, continuous strokes, apply pressure up and down the entire back, including the shoulders, back, and buttocks. Keep the hands lubricated so they will glide comfortably over the body. As the hands move up and down the back, the home nurse swings forward and backward with her knees bent.
5. Observe the condition of the skin and give additional massage where there are reddened areas. Such areas may indicate impaired circulation due to pressure. Pay special attention to the base of the spine and to the shoulder blades.
6. A small amount of talcum on the hands can be used to finish the rub. (Avoid powder crumbs in the bed.)
7. Assist the patient to a comfortable position after the back rub.
8. Report to the doctor any sign of broken skin or an unusually reddened area.
Essential Points To Remember.
1. Have the patient in a comfortable position and avoid chilling.
2. Use a stroke firm enough to relax the muscles yet gentle enough for soothing comfort; continue long enough to be effective.
3. Report to the doctor any unusual condition of the skin.
TUB BATH FOR THE CONVALESCENT, HANDICAPPED, OR ELDERLY PATIENT
Purpose. To give a cleansing bath with safety, comfort, and minimum exertion for the patient who is able to use the bathroom facilities.
Equipment
Washcloth
Towels
Soap
Fresh clothing, warmed if necessary
Blanket, if needed
Chair or stool covered with a pad and placed beside the tub
Bathmat in front of a chair
Rubber suction mat for the tub
Bath seat, if desired
Bathtub one-quarter to one-half full of comfortably warm water
Glass of cool water in case the patient feels faint
Procedure
1. Collect the equipment and draw the water.
2. Assist the patient to the warmed bathroom; help him undress.
3. Help the patient into the tub. Have him grasp some secure object and give him support.
4. Soap and rinse well, rubbing the body briskly but gently all over to promote circulation.
5. Drain the tub and assist the patient to a chair. Protect him from chilling and help him dry his body thoroughly.
6. Assist the patient to dress and return to his room. Suggest that he rest quietly.
7. Clean the tub and straighten the bathroom.
If a shower bath is preferred, care should be taken to adjust the temperature of the water before the patient enters the bath, provide a floor mat and handholds, and protect the patient's hair.
Essential Points To Remember.
1. Get assistance in advance if needed.
2. Prevent chilling, fatigue, slipping, or other accidents.
3. Note the color and condition of the skin. Report any unusual condition to the doctor.
USE OF THE BEDPAN AND URINAL FOR THE BED PATIENT
Equipment
Bedpan—warmed, if necessary—and cover
Urinal and cover
Newspapers to protect the chair or floor where the bedpan or urinal will be placed
Toilet paper
Bell or other call system
Bed protector—a covered rubber or oilcloth sheet or newspaper pad made of several thicknesses of newspapers covered with a clean cloth
Basin of warm water, soap, a washcloth, and a towel or soft cloth
Procedure
Giving the Bedpan.
1. Bring the covered bedpan, the pad for bed protection, the toilet paper, and the bell to the room.
2. Place the pad under the patient's hips.
3. Fold back the covers at the side to prevent soiling.
4. Place the bedpan on the bed beside the patient; grasp by the side or closed end and have the open end toward the foot of the bed.
5. Place one hand under the small of the patient's back and on signal help the patient lift his hips; with the other hand, slip the pan under the patient's hips and adjust for comfort. The patient may wish to be helped to a sitting position, if the doctor permits. Unless there is need to remain with the patient, place the toilet paper and call bell handy and leave the room.
6. Cleanse the patient after use of the pan; the patient does this if he is able. To avoid spreading the soiled area to the openings of bladder and vagina, wipe downward toward the spine.
7. Remove the pan in the same manner as placed.
8. Observe the skin for redness or soreness. Keep the skin dry.
9. Observe the contents of the pan and note on the daily record. If unusual, save for the doctor to see.
10. Clean the pan.
a. Empty it into the toilet, unless the doctor has ordered otherwise.
b. Rinse with cold water (this helps prevent the stool from sticking to the pan).
c. If necessary, loosen the particles of stool with a toilet paper wad; wash thoroughly with hot soapy water and rinse.
d. Wipe dry and put away.
11. Provide for the patient to cleanse his hands.
Giving the Urinal.
Help the patient place the urinal, if necessary. Remove promptly after use. Note the content and cleanse thoroughly. Keep covered before and after use.
Using a Commode.
1. Help the patient out of bed to the commode.
2. Provide robe and slippers if needed to prevent chilling.
3. Give assistance back to bed.
4. Note the content, and cleanse as for the bedpan.
5. It is very important that the commode, which may be kept at the bedside, be clean and free from odors.
Essential Points To Remember.
1. Avoid injury to the patient by lifting his hips high enough to prevent his skin from rubbing against the pan.
2. Offer the bedpan or urinal at intervals even though the patient does not request it and give promptly whenever desired.
MEASURING URINE OUTPUT
Measuring Twenty-four-hour Output
Purpose. To determine the total amount of urine being passed through-out the entire twenty-four-hour period.
The amount of urine passed depends largely on the amount of liquid taken into the body, and the doctor usually wishes liquid intake measured and recorded also.
Equipment
Measuring container, marked in ounces if possible, kept for this purpose alone—commercial or homemade—a tin can, jar, or other container
Bedpan or urinal
Procedure
1. Instruct the patient that the urine is being measured and that the bedpan should not be used at the same time for both bowel movement and urine.
2. Empty the contents of the pan or urinal into the measuring container and record the amount in ounces after each time urine is passed.
3. Cleanse the equipment.
If the patient is using a urinal, the measurements may already be marked on it, or the home nurse may mark the urinal with strips of adhesive tape measuring the amounts exactly in ounces. If the patient is able to go to the toilet, place a bedpan or basin on the toilet seat, and after use measure the contents.
Collecting a Specimen (Sample) of Urine
Purpose. To provide a single specimen of urine for examination.
When a specimen of urine is requested by the doctor, ask him how much he needs and when he wishes it taken. It is usual to take a specimen from the first urine passed in the morning unless a twenty-four-hour specimen is requested, and 4 to 6 ounces is usually sufficient. The patient should understand that the specimen of urine should be kept separate from a bowel movement.
Equipment
Clean bedpan, urinal, or other receptacle
Clean bottle large enough for the specimen ordered by the doctor—with a watertight stopper
Label to be attached to the bottle, giving the following information: "Urine"—name of the patient, date, and hour
Procedure
1. Wash the patient's genitals before urine is passed or have the patient do this if he goes to the bathroom. (If the patient is menstruating or has a discharge, report this to the doctor before the specimen is collected.)
2. The patient urinates into a clean receptacle.
3. Transfer the urine to the specimen bottle and cork securely. Fill in the label and attach to the bottle.
4. Make the specimen available to the doctor as promptly as possible.
5. Cleanse the equipment as usual.
Collecting a Twenty-four-hour Specimen of Urine
Purpose. To provide a specimen from the total twenty-four-hour out-put of urine.
If the doctor wants all urine passed by the patient to be saved (so that he may get a twenty-four-hour specimen), the patient must wash the genitals each time before passing urine. Begin at a stated. hour—usually 7 A.M.; discard the first urine passed at this hour. Pour all urine passed thereafter into a large clean vessel—a large chamber or enamel pail will do. Save all the urine passed up to and including that passed at 7 A.M. the next morning. Keep the vessel tightly covered. The urine may then be measured (if ordered) and a sample collected from this total amount, usually 4 to 6 ounces.
Essential Points To Remember.
1. Cleanliness of the receptacles and genitals.
2. Accuracy in measurement and labeling.
GIVING AN ENEMA
Purpose. To aid in elimination and to rid the lower bowel of waste material.
To an Adult
Equipment
Tray for the equipment
Enema bag, can, or fountain syringe (If a fountain syringe is not available, the solution may be made in a pitcher and poured into a funnel to which the soft rectal tube or catheter used as a nozzle is attached)
Connecting tubing, stopcock, and enema nozzle
Enema solution, as ordered by the doctor (If he does not specify, give 1 pint of plain warm water)
Lubricant for the nozzle
Toilet paper
Warmed bedpan and cover, unless the patient uses the toilet
Bed protection—a rubber sheet, oil-cloth, or bed pad
Extra blanket
Basin of warm water, washcloth, and towel
Newspapers for protection of the furniture
Call bell
Standard on which to hang the enema bag—a floor lamp, stepladder, or hatrack
All equipment should be clean and tested for leaks, and the stop-cock should be checked to be sure it is in working order.
The room should be warm and free from drafts; the door should be closed for privacy.
Preparation
1. Protect the table and chair. Have a bedpan handy.
2. Cover the patient with the extra blanket. Fold back the upper bedclothes and place over the chair at the foot of the bed.
3. Have the patient at the near side of the bed and place the bed protection under his hips.
4. Roll up the gown or remove the pajama trousers.
5. The patient may lie on his side or on his back; one pillow or none.
6. Hang the bag so that the outlet is about 12 to 18 inches above the upper surface of the mattress, assuring a gentle flow.
7. Close the stopcock and pour the solution into the bag.
8. Open the stopcock and allow a little solution to flow into the bedpan to make sure the air is out of the tubing. Test the temperature of the solution on the wrist; it should be comfortably warm. Close the stopcock.
9. Lubricate the nozzle.
Procedure
1. Insert the enema tip into the anus about 2 to 3 inches and hold in place. The patient may wish to do this. If there is blocking, rotate the tip slightly, but gently; withdraw it a little and try again. It may become clogged. If clogged, withdraw the tip; allow the solution to run through; insert again.
2. With the tip in place, open the stopcock. Allow the solution to run in slowly. If the patient complains of pressure or pain, stop the flow; wait; then start the flow gradually. Gentle pressure against the rectum may help the patient hold the enema. Instruct him to open his mouth and take long, deep breaths if he feels pain or pressure.
3. Close the stopcock before all the solution runs out of the bag—to prevent letting air into the bowel.
4. Withdraw the tip gently; allow the balance of the solution to flow out; remove the tip; wrap it in toilet paper and place on the tray until cleaned.
5. Encourage the patient to hold the solution for a few minutes.
6. Give the bedpan and stay with the patient or within call while the enema is expelled.
7. After the enema is expelled, cleanse the patient—the patient or nurse may do this. Dry thoroughly.
8. Remove the bedpan and cover immediately.
9. Remove the bed protection; replace the upper bedclothes; make the patient comfortable. Air the room but do not chill the patient.
10. See that the patient's hands are washed if he has helped with giving the enema.
11. Note the contents of the bedpan; if unusual, save for the doctor to see. Note also the patient's reaction.
12. Care for the equipment.
a. Empty the bedpan; cleanse and put away.
b. Open the stopcock; rinse the bag and tubing with clear water; hang to drain. When dry, replace in its box or wrap in a clean cloth; leave the stopcock open. If an enema bag is used, stuff it with tissue paper to keep the sides from sticking together. Keep dry.
c. Scrub the enema nozzle with hot soapy water; rinse; boil 3 minutes; dry and place with the bag.
To a Child
The room should be warm and free from drafts.
A child may lie on a well-protected bed on his back or side.
If the enema is given on the home nurse's lap, the rubber sheet and diaper should cover her clothes. A folded towel placed under the buttocks will raise them slightly to the right level to receive the enema.
If the child is old enough, explain what is going to be done and proceed to give the enema as described for an adult, giving the solution very slowly and with a gentle flow. Give the amount ordered by the doctor, usually about one-half pint.
Cleansing or Oil Enema for a Baby
Equipment
Small rubber bulb syringe with a nozzle
Warm water or oil for the enema (the doctor will order the amount)
Toilet paper
Small basin or chamber to receive the enema
Small blanket for warmth
Rubber sheet, oilcloth, or newspapers covered with a diaper to protect the home nurse's lap
Basin of warm water and a soft washcloth for cleansing
Clean diapers
Procedure
1. Place the baby on his back on the lap or on a well-protected table. Remove his diapers. Fold back his clothes.
2. Take up the warm water or oil in the syringe, holding the nozzle up, and squeeze the bulb gently to expel air. Test the temperature of the liquid on the inner surface of the wrist. It should be comfortably warm.
3. Lift the baby's legs with one hand, holding at the ankles with a finger between them. Be sure the liquid is still in point of nozzle (to avoid injecting air). Gently insert the nozzle of the syringe about an inch into the anus.
4. Give the water or oil by very gently and slowly squeezing the bulb of the syringe. A small baby will usually take about 2 or 3 ounces, an older baby more.
5. When the syringe is empty, withdraw it carefully and place on toilet paper. Press the baby's buttocks together with a folded diaper to help the baby hold the enema for a few minutes.
6. Place the edge of the basin or chamber under the baby's hips to receive the bowel movement. If the enema is expelled without a bowel movement, a second may be given.
7. After the bowels have moved, wash the baby with warm water; dry him thoroughly; put on a fresh diaper and put him back to bed.
8. Care for the equipment after use.
a. Note the appearance of the stool and inform the doctor of any unusual condition. Cleanse the chamber.
b. Wash the syringe with hot soapy water; rinse with clear water and boil 5 minutes. Rinse, drain, and dry. Wrap in a clean cloth or paper and put away.
9. Note on the daily record the time the enema was given, the amount taken, the amount and character of the stool, such as undigested food, blood and mucus (jellylike liquid), and whether gas was expelled with the enema. Note the baby's condition after treatment.
Essential Points To Remember.
1. Assure a gentle flow of solution without pressure.
2. Select a good nozzle and lubricate well; avoid injury to the membrane.
3. Give no more solution than ordered by the doctor.
4. Have the patient lying down and in a comfortable position.
5. Avoid chilling.
Source: http://www.healthguidance.org/authors/662/Ruth-B.-Freeman
1. Free the covers; instruct or help the patient to bend his knees.
2. Face the side of the bed, with one foot forward and the knees bent.
3. Slip one hand, palm up, all the way under the patient's shoulders; slip the other hand, palm up, all the way under the patient's hips. The home nurse bends at the hips and knees.
4. On signal, pull the patient toward the home nurse and roll him so that he is on his side.
5. Adjust the patient's hips, knees, and ankles for security and comfort.
6. Adjust the covers.
Turning the Patient Back from Side and Toward the Home Nurse.
1. Tell the patient what is about to be done.
2. Loosen the blanket.
3. Place one hand on the upper shoulder, the other on the upper hip on top of the bedding.
4. On signal, roll the patient all the way toward the home nurse.
5. Adjust the hips, knees, and ankles for comfort.
Essential Points To Remember.
1. Observe good posture.
2. Guide the patient's movements rather than do all the lifting.
PROVIDING SUPPORT FOR THE BED PATIENT
Purpose. To maintain correct and comfortable posture for the bed patient at all times.
Support for a Patient Lying on His Back
Equipment
Firm mattress and springs
Pillows—a variety, such as hard, soft, large, and small, or substitutes, as needed for the individual patient
Foot support—high enough to extend above the toes—to protect against the weight of the bedding
Procedure
The number and type of pillows under the head and shoulders is a matter of preference unless the doctor gives special orders. The normal curves of the spine should be maintained, the head in line with the trunk, i.e., not pushed forward or allowed to drop backward. The knees may be slightly bent for muscle relaxation and comfort.
Using One Pillow.
1. Place the pillow under the patient's head—reaching to the shoulders.
2. Place a foot support for his upright feet to brace against; it should extend above the toes to protect them from the weight of the bedding.
3. Place a small pillow or folded towel under the knees as desired.
Using Three Pillows.
1. Place two lengthwise, overlapping at the top, together at the bottom, and extending under the shoulders.
2. Place one crosswise at the top under the head. (Place a small support at the lower back, if necessary.)
3. Place the foot and knee supports as above.
Support for a Patient Lying on His Side
Procedure
1. Place one pillow under the patient's head.
2. Place one snugly and securely at his back.
3. Place one lengthwise between his legs and feet, supporting the knee, toes, and heel; adjust the position of his legs for comfort by flexing the uppermost leg beyond the knee of the lower leg.
4. Place a small support under his abdomen.
5. Place one pillow for support of the uppermost arm. (The arm should be in line with the trunk, and the elbow in line with the shoulder.)
Support for a Patient Sitting Up in Bed
The doctor will indicate when the patient may sit up in bed and for how long.
Equipment
Back rest
Large pillows, 2-5
Small pillow
Foot support
Procedure
1. Place the back rest, slanting the surface toward the patient.
2. Adjust 3 pillows as described previously.
3. Swing the patient back to the pillows and help him lie back.
4. Place the knee support (a small pillow).
5. Place the foot support.
6. Place a pillow at either side for an arm support.
7. Note on the daily record the length of time the patient sat up and his reaction.
Essential Points To Remember.
1. Change the position from time to time.
2. Maintain correct body alignment.
3. Provide support to avoid strain on the joints, prevent deformities, conserve energy, and promote comfort.
HELPING THE PATIENT FROM THE BED TO A CHAIR AND BACK INTO BED
Purpose. To help stimulate circulation, provide relief from lying in bed, and promote general convalescence.
The doctor will indicate when the patient may sit up in a chair and for how long.
Equipment
Comfortable chair
Blankets, pillows, and footstool, as needed
Dressing gown, hose, and slippers
Extra shawl or wrap, if desired
Blocks for a wheelchair, if required
Preparation
1. Bring the chair near the bed, braced against a wall or other means of support. If a rocking chair or wheelchair is used, blocks will be needed to steady the chair unless an assistant is present.
2. Place the blankets and pillows as needed.
3. Have a footstool handy.
Procedure
Getting the Patient Out of Bed.
1. Help the patient to a sitting position; pause in case he shows signs of dizziness; have him support himself with his hands braced behind. With one hand on the small of the patient's back and the other under his knees, swing the patient, on signal, to allow his legs to hang over the edge of the bed. After abdominal surgery, to prevent strain, first roll the patient toward the home nurse on his side; place one hand under his head and lower shoulder, and one hand back of his knees; the patient places his uppermost hand on the home nurse's shoulder. Raise the patient and swing his legs over the edge of the bed.
2. Put the dressing gown, hose, and slippers on the patient.
3. Face the patient; place one foot forward, legs apart for balance; bend at the hips and knees.
4. Place the patient's hands on the home nurse's hips and grasp the patient's arms at the shoulders from the outer surface.
5. On signal, help the patient slide off the bed to stand on his feet; pause in case he feels dizzy.
6. Still supporting the patient, side-step to the chair, turning the patient so that he can feel the chair at the back of his legs.
7. On signal, help the patient sit down. Stand close to the patient, feet apart, one foot forward; bend the hips and knees to prevent back strain and help him lower himself into the chair.
8. Arrange the pillows, blankets, and footstool for comfort. While the patient is in the chair, the bed may be aired, the mattress turned, and the bed remade with fresh linen.
Getting the Patient Back to Bed.
1. Open the bed—fan fold the upper bedding in thirds to the foot of the bed with the free end toward the head of the bed.
2. Release the blanket about the patient.
3. Face the patient, standing close to him with one foot forward, legs apart and braced for balance. Have the patient put the same foot forward and place his hands on the home nurse's hips. Grasp the patient's arms at the shoulders; bend the hips and knees, and, on signal, help the patient to a standing position. Pause in case he becomes dizzy.
4. Still supporting the patient, side-step to the bed.
5. Lift the dressing gown and help the patient to a sitting position on the edge of the bed with his hands braced behind for support.
6. Remove the dressing gown, hose, and slippers.
7. On signal, swing the patient back into bed, keeping one hand on the small of his back and one under his knees. Help him lie down.
8. Cover the patient and allow him to rest.
9. Note on the daily record the length of time the patient was up in the chair and his reactions to the experience.
Essential Points To Remember.
1. Before getting the patient up, obtain assistance if needed.
2. Place the chair near the bed the first day so the patient can be returned to bed quickly if necessary.
3. Protect the chair against slipping.
4. Avoid chilling and fatigue.
GIVING A BED BATH
Purpose. To cleanse, refresh, and relax the patient; stimulate circulation; provide a mild form of exercise; and aid in elimination by cleansing the pores.
Mouth care or treatments may be given before the bath.
Equipment
Large basin of warm water
Container of hot water
Waste water pail if not near a bathroom
Waste paper container
Towels—2 bath, 1 face
Washcloth
Soap in a dish
Lightweight or bath blanket
Rubbing alcohol (warmed)
Oil (sweet or mineral)
Body powder
Hand lotion and deodorant, if needed
Tray with toilet articles such as a hairbrush, comb, nail file, toothbrush, and mouthwash or dentifrice
Newspapers for protection of the furniture
Clean pajamas or gown
Clean bed linen
Preparation
1. See that the room is warm and that privacy is assured.
2. Assemble the equipment.
3. Remove and fold the spread.
4. Remove the top sheet—if soiled put on a newspaper or in a laundry bag; if to be used again, fold and place on the back of a chair.
5. Replace the regular blanket with a bath blanket if desired. Keep the patient well covered with a hot water bag to the feet if cold.
6. Remove all but one pillow unless ordered by the doctor.
7. Remove the soiled pillow cases; place with other soiled linen.
8. Remove the patient's gown or pajamas.
Procedure
1. Face.
a. Place a towel under the head to protect the bedding. Place another towel across the patient's chest and tuck half-way under the top edge of the blanket.
b. Wet the washcloth. Make a bath mitt by wrapping the cloth around the palm of the hand, anchoring with the thumb and tucking in the ends. Squeeze the cloth to prevent dripping.
c. Wash the eyes gently from the nose toward the ear, using one corner of the mitt for one eye and the other corner for the other eye. Use no soap.
d. Wash the forehead, nose, and cheeks, using firm, even pressure, long strokes, and an S-motion around the mouth and chin. Use soap if desired.
e. Rinse the face, following the same stroke as for washing.
f. Dry the face, following the same order and using the same stroke as in washing and rinsing. Wrap a section of the towel around the hand for a firm stroke and to avoid dragging the ends.
2. Ears and front of the neck.
a. Wash with soap and water, handling the washcloth in the same way as for washing the face. Get well into the folds of skin.
b. Rinse and dry.
3. Chest.
a. Cover the chest with a towel. Turn back the blanket protected with the towel.
b. Soap, rinse, and dry. Observe the skin; if it is reddened under the breasts, use a little body powder or oil.
4. Abdomen.
a. Protect the blanket with a towel; leave one towel over the chest.
b. Soap, rinse, and dry the abdomen, sides of trunk, and well over the upper thighs and pubic area. Use firm strokes.
c. Pull up the blanket and remove the towels.
5. Arm.
a. Place one towel under the arm and shoulder; place the other back over the blanket and tuck under the edge lengthwise.
b. Soap, rinse, and dry the arm. Be sure to include the armpit area. Give support to the arm while washing it.
6. Hand.
a. Place a basin of water and a dish of soap securely at the patient's side on a towel.
b. Soap, wash, and rinse the patient's hand in the basin. Remove the basin and soap. Dry thoroughly.
c. Clean the nails; apply hand lotion, if necessary.
7. Other arm and hand. Repeat the procedure in the same way with the other arm and hand. Work from the same side of the bed. Keep the water warm by adding hot water. Change the water whenever necessary (soiled or too soapy).
8. Back of neck, back, and buttocks.
a. Roll the patient on his side away from the person giving the bath. Fold back the blanket to uncover his back.
b. Protect the bedding; place one towel on the bottom sheet close to the back and one over the blanket, tucked under the free edge.
c. Soap, rinse, and dry, using long, firm strokes. Examine for reddened areas due to pressure. Follow with a back rub. Relieve the pressure by the use of an air cushion or a "donut," if necessary.
9. Leg.
a. Keep the patient covered except for the part being washed. Wrap the blanket snugly at the groin; protect the bedding with towels.
b. Have the patient bend his knee. Support the leg; wash, rinse, and dry with long, firm strokes. Examine the skin, especially the knee, for reddened or roughened areas and apply oil if needed.
10. Foot.
a. Protect the bed near the foot with newspapers and a towel. Place the basin and dish of soap securely on a towel.
b. Lift the foot carefully into the basin; wash and rinse the foot with firm strokes.
c. Remove the foot from the basin and dry, especially between the toes. If the skin is dry, apply oil. If the heel is sore, relieve the pressure with a "donut."
d. Remove the towels and cover the leg.
11. Other leg and foot. Repeat the same procedure with the other leg and foot, working from the same side of the bed.
12. Genitals.
a. The patient may wash his genitals, if able. Place a dry towel under the buttocks to protect the bedding. Place the basin handy for the patient; give him the soaped washcloth and a bath towel.
b. If the patient is unable to do this, cleanse the genitals. If genital discharges are present, use absorbent cotton or soft tissues and burn them later. Special care may be advised by the doctor following childbirth.
c. Remove the towel; arrange the blanket.
13. Replace the gown or pajamas.
14. Comb the hair. If the patient is a woman, she may wish to put on make-up.
15. Straighten the bed.
16. Remove and clean all bath equipment.
17. Arrange the bedside table.
18. Note on the daily record any unusual conditions observed. These may include reddened areas due to pressure, rash, swelling, unusual lumps, sores, or a tendency to fatigue.
Essential Points To Remember.
1. Cleanse all parts of the body.
2. Avoid chilling, fatigue, or embarrassment of the patient.
3. Observe and report to the doctor any unusual conditions.
THE BACK RUB
Purpose. To refresh and relax the patient, stimulate blood circulation, and relieve pressure.
Equipment
Rubbing alcohol, warmed in a container of hot water, or oil
Body powder, if desired
Procedure
1. Warm the hands; trim the nails short enough to avoid scratching the patient.
2. Place the patient comfortably on his side, facing away from the nurse, or on his stomach.
3. Pour a small amount of warmed rubbing alcohol or oil on the hands for lubrication.
4. Stand facing the head of the bed with one foot slightly forward and the knees slightly bent. Then with the flat of both hands and with long, firm, continuous strokes, apply pressure up and down the entire back, including the shoulders, back, and buttocks. Keep the hands lubricated so they will glide comfortably over the body. As the hands move up and down the back, the home nurse swings forward and backward with her knees bent.
5. Observe the condition of the skin and give additional massage where there are reddened areas. Such areas may indicate impaired circulation due to pressure. Pay special attention to the base of the spine and to the shoulder blades.
6. A small amount of talcum on the hands can be used to finish the rub. (Avoid powder crumbs in the bed.)
7. Assist the patient to a comfortable position after the back rub.
8. Report to the doctor any sign of broken skin or an unusually reddened area.
Essential Points To Remember.
1. Have the patient in a comfortable position and avoid chilling.
2. Use a stroke firm enough to relax the muscles yet gentle enough for soothing comfort; continue long enough to be effective.
3. Report to the doctor any unusual condition of the skin.
TUB BATH FOR THE CONVALESCENT, HANDICAPPED, OR ELDERLY PATIENT
Purpose. To give a cleansing bath with safety, comfort, and minimum exertion for the patient who is able to use the bathroom facilities.
Equipment
Washcloth
Towels
Soap
Fresh clothing, warmed if necessary
Blanket, if needed
Chair or stool covered with a pad and placed beside the tub
Bathmat in front of a chair
Rubber suction mat for the tub
Bath seat, if desired
Bathtub one-quarter to one-half full of comfortably warm water
Glass of cool water in case the patient feels faint
Procedure
1. Collect the equipment and draw the water.
2. Assist the patient to the warmed bathroom; help him undress.
3. Help the patient into the tub. Have him grasp some secure object and give him support.
4. Soap and rinse well, rubbing the body briskly but gently all over to promote circulation.
5. Drain the tub and assist the patient to a chair. Protect him from chilling and help him dry his body thoroughly.
6. Assist the patient to dress and return to his room. Suggest that he rest quietly.
7. Clean the tub and straighten the bathroom.
If a shower bath is preferred, care should be taken to adjust the temperature of the water before the patient enters the bath, provide a floor mat and handholds, and protect the patient's hair.
Essential Points To Remember.
1. Get assistance in advance if needed.
2. Prevent chilling, fatigue, slipping, or other accidents.
3. Note the color and condition of the skin. Report any unusual condition to the doctor.
USE OF THE BEDPAN AND URINAL FOR THE BED PATIENT
Equipment
Bedpan—warmed, if necessary—and cover
Urinal and cover
Newspapers to protect the chair or floor where the bedpan or urinal will be placed
Toilet paper
Bell or other call system
Bed protector—a covered rubber or oilcloth sheet or newspaper pad made of several thicknesses of newspapers covered with a clean cloth
Basin of warm water, soap, a washcloth, and a towel or soft cloth
Procedure
Giving the Bedpan.
1. Bring the covered bedpan, the pad for bed protection, the toilet paper, and the bell to the room.
2. Place the pad under the patient's hips.
3. Fold back the covers at the side to prevent soiling.
4. Place the bedpan on the bed beside the patient; grasp by the side or closed end and have the open end toward the foot of the bed.
5. Place one hand under the small of the patient's back and on signal help the patient lift his hips; with the other hand, slip the pan under the patient's hips and adjust for comfort. The patient may wish to be helped to a sitting position, if the doctor permits. Unless there is need to remain with the patient, place the toilet paper and call bell handy and leave the room.
6. Cleanse the patient after use of the pan; the patient does this if he is able. To avoid spreading the soiled area to the openings of bladder and vagina, wipe downward toward the spine.
7. Remove the pan in the same manner as placed.
8. Observe the skin for redness or soreness. Keep the skin dry.
9. Observe the contents of the pan and note on the daily record. If unusual, save for the doctor to see.
10. Clean the pan.
a. Empty it into the toilet, unless the doctor has ordered otherwise.
b. Rinse with cold water (this helps prevent the stool from sticking to the pan).
c. If necessary, loosen the particles of stool with a toilet paper wad; wash thoroughly with hot soapy water and rinse.
d. Wipe dry and put away.
11. Provide for the patient to cleanse his hands.
Giving the Urinal.
Help the patient place the urinal, if necessary. Remove promptly after use. Note the content and cleanse thoroughly. Keep covered before and after use.
Using a Commode.
1. Help the patient out of bed to the commode.
2. Provide robe and slippers if needed to prevent chilling.
3. Give assistance back to bed.
4. Note the content, and cleanse as for the bedpan.
5. It is very important that the commode, which may be kept at the bedside, be clean and free from odors.
Essential Points To Remember.
1. Avoid injury to the patient by lifting his hips high enough to prevent his skin from rubbing against the pan.
2. Offer the bedpan or urinal at intervals even though the patient does not request it and give promptly whenever desired.
MEASURING URINE OUTPUT
Measuring Twenty-four-hour Output
Purpose. To determine the total amount of urine being passed through-out the entire twenty-four-hour period.
The amount of urine passed depends largely on the amount of liquid taken into the body, and the doctor usually wishes liquid intake measured and recorded also.
Equipment
Measuring container, marked in ounces if possible, kept for this purpose alone—commercial or homemade—a tin can, jar, or other container
Bedpan or urinal
Procedure
1. Instruct the patient that the urine is being measured and that the bedpan should not be used at the same time for both bowel movement and urine.
2. Empty the contents of the pan or urinal into the measuring container and record the amount in ounces after each time urine is passed.
3. Cleanse the equipment.
If the patient is using a urinal, the measurements may already be marked on it, or the home nurse may mark the urinal with strips of adhesive tape measuring the amounts exactly in ounces. If the patient is able to go to the toilet, place a bedpan or basin on the toilet seat, and after use measure the contents.
Collecting a Specimen (Sample) of Urine
Purpose. To provide a single specimen of urine for examination.
When a specimen of urine is requested by the doctor, ask him how much he needs and when he wishes it taken. It is usual to take a specimen from the first urine passed in the morning unless a twenty-four-hour specimen is requested, and 4 to 6 ounces is usually sufficient. The patient should understand that the specimen of urine should be kept separate from a bowel movement.
Equipment
Clean bedpan, urinal, or other receptacle
Clean bottle large enough for the specimen ordered by the doctor—with a watertight stopper
Label to be attached to the bottle, giving the following information: "Urine"—name of the patient, date, and hour
Procedure
1. Wash the patient's genitals before urine is passed or have the patient do this if he goes to the bathroom. (If the patient is menstruating or has a discharge, report this to the doctor before the specimen is collected.)
2. The patient urinates into a clean receptacle.
3. Transfer the urine to the specimen bottle and cork securely. Fill in the label and attach to the bottle.
4. Make the specimen available to the doctor as promptly as possible.
5. Cleanse the equipment as usual.
Collecting a Twenty-four-hour Specimen of Urine
Purpose. To provide a specimen from the total twenty-four-hour out-put of urine.
If the doctor wants all urine passed by the patient to be saved (so that he may get a twenty-four-hour specimen), the patient must wash the genitals each time before passing urine. Begin at a stated. hour—usually 7 A.M.; discard the first urine passed at this hour. Pour all urine passed thereafter into a large clean vessel—a large chamber or enamel pail will do. Save all the urine passed up to and including that passed at 7 A.M. the next morning. Keep the vessel tightly covered. The urine may then be measured (if ordered) and a sample collected from this total amount, usually 4 to 6 ounces.
Essential Points To Remember.
1. Cleanliness of the receptacles and genitals.
2. Accuracy in measurement and labeling.
GIVING AN ENEMA
Purpose. To aid in elimination and to rid the lower bowel of waste material.
To an Adult
Equipment
Tray for the equipment
Enema bag, can, or fountain syringe (If a fountain syringe is not available, the solution may be made in a pitcher and poured into a funnel to which the soft rectal tube or catheter used as a nozzle is attached)
Connecting tubing, stopcock, and enema nozzle
Enema solution, as ordered by the doctor (If he does not specify, give 1 pint of plain warm water)
Lubricant for the nozzle
Toilet paper
Warmed bedpan and cover, unless the patient uses the toilet
Bed protection—a rubber sheet, oil-cloth, or bed pad
Extra blanket
Basin of warm water, washcloth, and towel
Newspapers for protection of the furniture
Call bell
Standard on which to hang the enema bag—a floor lamp, stepladder, or hatrack
All equipment should be clean and tested for leaks, and the stop-cock should be checked to be sure it is in working order.
The room should be warm and free from drafts; the door should be closed for privacy.
Preparation
1. Protect the table and chair. Have a bedpan handy.
2. Cover the patient with the extra blanket. Fold back the upper bedclothes and place over the chair at the foot of the bed.
3. Have the patient at the near side of the bed and place the bed protection under his hips.
4. Roll up the gown or remove the pajama trousers.
5. The patient may lie on his side or on his back; one pillow or none.
6. Hang the bag so that the outlet is about 12 to 18 inches above the upper surface of the mattress, assuring a gentle flow.
7. Close the stopcock and pour the solution into the bag.
8. Open the stopcock and allow a little solution to flow into the bedpan to make sure the air is out of the tubing. Test the temperature of the solution on the wrist; it should be comfortably warm. Close the stopcock.
9. Lubricate the nozzle.
Procedure
1. Insert the enema tip into the anus about 2 to 3 inches and hold in place. The patient may wish to do this. If there is blocking, rotate the tip slightly, but gently; withdraw it a little and try again. It may become clogged. If clogged, withdraw the tip; allow the solution to run through; insert again.
2. With the tip in place, open the stopcock. Allow the solution to run in slowly. If the patient complains of pressure or pain, stop the flow; wait; then start the flow gradually. Gentle pressure against the rectum may help the patient hold the enema. Instruct him to open his mouth and take long, deep breaths if he feels pain or pressure.
3. Close the stopcock before all the solution runs out of the bag—to prevent letting air into the bowel.
4. Withdraw the tip gently; allow the balance of the solution to flow out; remove the tip; wrap it in toilet paper and place on the tray until cleaned.
5. Encourage the patient to hold the solution for a few minutes.
6. Give the bedpan and stay with the patient or within call while the enema is expelled.
7. After the enema is expelled, cleanse the patient—the patient or nurse may do this. Dry thoroughly.
8. Remove the bedpan and cover immediately.
9. Remove the bed protection; replace the upper bedclothes; make the patient comfortable. Air the room but do not chill the patient.
10. See that the patient's hands are washed if he has helped with giving the enema.
11. Note the contents of the bedpan; if unusual, save for the doctor to see. Note also the patient's reaction.
12. Care for the equipment.
a. Empty the bedpan; cleanse and put away.
b. Open the stopcock; rinse the bag and tubing with clear water; hang to drain. When dry, replace in its box or wrap in a clean cloth; leave the stopcock open. If an enema bag is used, stuff it with tissue paper to keep the sides from sticking together. Keep dry.
c. Scrub the enema nozzle with hot soapy water; rinse; boil 3 minutes; dry and place with the bag.
To a Child
The room should be warm and free from drafts.
A child may lie on a well-protected bed on his back or side.
If the enema is given on the home nurse's lap, the rubber sheet and diaper should cover her clothes. A folded towel placed under the buttocks will raise them slightly to the right level to receive the enema.
If the child is old enough, explain what is going to be done and proceed to give the enema as described for an adult, giving the solution very slowly and with a gentle flow. Give the amount ordered by the doctor, usually about one-half pint.
Cleansing or Oil Enema for a Baby
Equipment
Small rubber bulb syringe with a nozzle
Warm water or oil for the enema (the doctor will order the amount)
Toilet paper
Small basin or chamber to receive the enema
Small blanket for warmth
Rubber sheet, oilcloth, or newspapers covered with a diaper to protect the home nurse's lap
Basin of warm water and a soft washcloth for cleansing
Clean diapers
Procedure
1. Place the baby on his back on the lap or on a well-protected table. Remove his diapers. Fold back his clothes.
2. Take up the warm water or oil in the syringe, holding the nozzle up, and squeeze the bulb gently to expel air. Test the temperature of the liquid on the inner surface of the wrist. It should be comfortably warm.
3. Lift the baby's legs with one hand, holding at the ankles with a finger between them. Be sure the liquid is still in point of nozzle (to avoid injecting air). Gently insert the nozzle of the syringe about an inch into the anus.
4. Give the water or oil by very gently and slowly squeezing the bulb of the syringe. A small baby will usually take about 2 or 3 ounces, an older baby more.
5. When the syringe is empty, withdraw it carefully and place on toilet paper. Press the baby's buttocks together with a folded diaper to help the baby hold the enema for a few minutes.
6. Place the edge of the basin or chamber under the baby's hips to receive the bowel movement. If the enema is expelled without a bowel movement, a second may be given.
7. After the bowels have moved, wash the baby with warm water; dry him thoroughly; put on a fresh diaper and put him back to bed.
8. Care for the equipment after use.
a. Note the appearance of the stool and inform the doctor of any unusual condition. Cleanse the chamber.
b. Wash the syringe with hot soapy water; rinse with clear water and boil 5 minutes. Rinse, drain, and dry. Wrap in a clean cloth or paper and put away.
9. Note on the daily record the time the enema was given, the amount taken, the amount and character of the stool, such as undigested food, blood and mucus (jellylike liquid), and whether gas was expelled with the enema. Note the baby's condition after treatment.
Essential Points To Remember.
1. Assure a gentle flow of solution without pressure.
2. Select a good nozzle and lubricate well; avoid injury to the membrane.
3. Give no more solution than ordered by the doctor.
4. Have the patient lying down and in a comfortable position.
5. Avoid chilling.
Source: http://www.healthguidance.org/authors/662/Ruth-B.-Freeman
Home Nursing Procedures Part I
Simple nursing procedures that can be carried out in the home are presented here step by step. It is difficult to visualize some of these without a demonstration or to acquire skill without guided practice. For this reason, it is expected that those who are responsible for giving this care in the home will have completed the Red Cross Home Nursing courses, or received help from a public health or other professional nurse, and that this section of the article will serve as a handy reference.
The home nurse should remember, however, that there is an art as well as a technic involved in giving good nursing care and that she is caring for a person and not just a patient. The development of a healthy mental attitude may be as important to the recovery of the patient as the required physical care.
It is taken for granted that the home nurse has the doctor's assurance that a patient's condition is such that he can be cared for safely in the home. For patients who do not need highly skilled care of special hospital equipment, the warm, friendly atmosphere of the home is often more conducive to recovery than the more formal, impersonal environment of the hospital.
When caring for a patient at home, whether he is confined to bed or not, the home nurse will find it helpful to remember the following things:
1. It is easier to care for the patient and do the other necessary household tasks if a schedule is planned for the day.
2. It will save time if:
a. Everything needed is collected before care is given, and things are cleared away and cleansed promptly afterward. When the same treatment is given frequently, the necessary articles should be kept together on a tray.
b. Unnecessary laundry can be avoided by protecting the bedding.
c. Work on one side of the bed should be completed, when possible, before going to the other side.
d. Menus should be planned in advance, and food suitable for both the family and patient should be prepared whenever possible.
3. The home nurse will help safeguard her own health or conserve her strength if she:
a. Washes her hands before and after giving care to a patient.
b. Wears comfortable, low-heeled shoes to lessen back strain and short-sleeved, washable clothing to permit freedom of action.
c. Maintains good working posture.
d. Gets someone to help lift a heavy or helpless patient.
e. Obtains the patient's help. When lifting, turning, or moving a patient in bed, the home nurse should ask or help the patient to bend his knees so that he can be moved with less effort. The home nurse and the patient should act upon an agreed signal. For example, when helping the patient lift his hips, both will act on the count of three.
f. Avoids direct contact with nose and throat spray when working in close contact with the patient.
4. The home nurse will help keep her patient as comfortable as possible and also help his recovery if she:
a. Protects him from further infection by preventing exposure to the nose and throat spray or soiled hands of the home nurse or visitors.
b. Checks to see that the room is warm and that the patient is protected against drafts when giving him a bath or treatment.
c. Explains what is to be done and, if he is able, how he may help.
d. Helps the patient maintain good bed posture at all times. When giving a treatment, she should make sure the patient is in the correct position to receive care and that he is comfortable, warm, and dry during and after the treatment. A lightweight, washable blanket is often more convenient to use during baths or treatments than the usual top bedclothes and may save laundry.
e. Maintains a cheerful, wholesome mental attitude at all times to build the patient's morale and confidence.
PUTTING ON AND TAKING OFF A COVER-ALL APRON
Purpose. To provide a means of helping prevent the spread of disease from the patient or to the patient.
The home nurse should wear some type of cover-all apron when entering the sickroom to give care to the patient and take it off when leaving the room, hanging it near the door of the sickroom in readiness for use.
Procedure
1. Don the apron.
a. Slip the arms into the sleeves of the apron without touching the outside, which will be next to the patient.
b. Fasten at the neck and waist for ease in working.
2. Wash the hands after caring for the patient.
3. Remove the apron.
a. Unfasten.
b. Slip the arms out of the sleeves.
c. Hang—keep inside in and clean.
MAKING A NEWSPAPER BAG
Purpose. To provide a means of safe disposal of waste material.
Waste material from a sickroom may carry infection and therefore must be disposed of properly. Paper bags may be used for disposing of many types of waste.
Equipment
Double sheet of newspaper
Procedure
1. Place the newspaper, folded in half, with the center fold toward the person making the bag.
2. Bring the top edge of the upper sheet of the paper down to the center fold. This makes a cuff.
3. Turn the paper over, smooth side up, keeping the center fold toward the person throughout the procedure.
4. Fold it in thirds from the sides; crease well to hold the fold.
5. Lock by tucking one whole side under the cuff of the other side.
6. Bring the flap over the locked cuff.
7. Place a hand in the opening at the top; stand the bag up; shape.
8. Use the flap as a cover for the bag or as a means of fastening the bag to the side of the bed.
WASHING THE HANDS
Purpose. The home nurse washes her hands before and after caring for the patient to help protect the patient, the home nurse, and others from infection.
Equipment
Basin or bowl
Running water or container of clean warm water
Clean towels
Waste container for soiled towels
Soap
Waste pail or other means of disposing of liquid waste
Roll up the sleeves if wearing long ones. Remove the wrist watch, or push it up on the arm. Remove jewelry that is likely to hurt the patient or collect lint and other soil.
The hands should be washed under running water; where this is not available, pour water from the container.
Procedure
1. Keep the hands lowered over the basin throughout the entire procedure.
2. Wet the hands so that the soap will lather.
3 Soap hands well, working up a lather.
4. Rinse the soap (if using a bar), leaving it clean for the next use.
5. Use friction, rubbing well between the fingers and around the nails, and be sure to wash the entire hand and wrist.
6. Rinse the hands to allow the first dirt to run off.
7. Soap again, being sure to work up a good lather, and using friction as before between the fingers and around the nails.
8. Rinse the soap.
9. Rinse the hands again, getting all the dirt off this time.
10. Dry the hands well. Wet skin or dried soap on the skin may cause chapping, and breaks in the skin may admit infection. Also, chapped hands are unsightly and are uncomfortable for both the patient and the nurse.
11. Discard the towels in a waste container.
12. Dispose of the waste container.
Essential Points To Remember.
1. Hold the hands down over the basin and wash under clean running water.
2. Use friction.
3. Dry well.
TAKING THE TEMPERATURE
Purpose. To determine the patient's temperature in order to help the doctor make a diagnosis and prescribe treatment.
Fever or clinical thermometers differ from most other thermometers in that the mercury remains at the highest point registered until it is shaken down. They are fragile and must be handled with care, kept in a safe place when not in use, and protected from heat. The temperature is usually taken by the mouth or rectum, but may also be taken at the armpit. For an accurate reading, keep the thermometer in place in the body for at least 3 minutes, except when the temperature is taken at the armpit, in which case leave the thermometer in place for 10 minutes.
Some mouth thermometers have a slender bulb about ½ inch in length. Others have a short, stubby bulb. Only thermometers with stubby bulbs should be used to take rectal temperatures as there is less danger of their breaking and injuring the patient. If only one thermometer can be purchased, it should be a thermometer with a stubby bulb, which can be used for taking temperatures by any of the above methods. Thermometers have two parts:
1. The bulb end: This holds the mercury and is the part that is placed in the mouth; it must be kept clean.
2. The glass tube: Through this tube the mercury rises and on it are shown the lines and numbers that indicate the degrees. The column of mercury can be seen between the lines and the numbers—through a ridge which extends the length of the tube. When handling the thermometer, always grasp it by the top of the tube.
When the thermometer is in position for taking the temperature, the heat of the body expands the mercury and pushes it up into the tube.
The long lines on the tube of the thermometer are the degrees—94, 95, 96, and so on—while the short lines between are each two-tenths of a degree. However space allows room for printing only the even numbers. The normal temperature by the mouth is usually 98.6° F. (Fahrenheit), which is indicated on the tube by a small arrow.
If the home nurse cannot read the thermometer after taking a temperature, she should cleanse it according to the directions given here and put it away until someone can be called who is able to read a thermometer. At her first opportunity, she should learn how to read the thermometer herself.
When reading the thermometer:
1. Make sure the light is adequate for accurate reading of the thermometer.
2. Hold the thermometer by the top, in line with the eye; turn the ridged side toward you.
3. Look for the thin column of mercury between the lines and numbers through the ridge. It may be necessary to roll the thermometer slowly back and forth to locate the mercury; the end of the mercury column indicates the temperature.
4. Read the scale to include the degree and nearest two-tenths of a degree.
When shaking down the mercury:
1. Stand away from the furniture to avoid striking the thermometer against any object and breaking it.
2. Hold the thermometer firmly by the top between the thumb and first two fingers.
3. Shake with a loose wrist movement—as though shaking water off the hand—to bring the mercury to 95° F. or below.
Taking the Mouth Temperature
Equipment
Clinical thermometer
Container of wipes: absorbent cotton, paper tissues, toilet paper, or pieces of clean gauze or rags
Soap
Waste container
Container of cool, clean water
Procedure
1. Have the patient sit or lie down.
2. Hold the thermometer firmly by the top.
3. Shake the mercury down to 95° F. or below.
4. Rinse the thermometer in clear, cool water to make it easier and more pleasant to hold in the mouth.
5. Place the bulb in the patient's mouth, well under the tongue and a little to one side.
6. Instruct the patient to keep his lips closed, to breathe through his nose, and not to bite down on the thermometer or to talk.
7. Leave the thermometer in place for 3 minutes to assure an accurate registering.
8. Remove by holding at the top and use a wipe to remove any saliva; use a rotary motion from the top toward the bulb and over the bulb. This makes it easier to read. Dispose of the wipe in a waste container.
9. Take the thermometer to a good light, still holding by the top, and read.
10. Cleanse the thermometer immediately:
a. Hold by the top, with the bulb down, over a waste container.
b. Moisten a wipe with cool water and soap well. Beginning at the top, rub down with a single rotary stroke with friction, getting well into the grooves of the tube and over the bulb. Discard the wipe.
c. Moisten a fresh wipe with clear, cool water and rinse the thermometer, using the same stroke as above.
d. Soap and rinse again—repeat procedures b and c.
e. Dry with a fresh wipe, using the same stroke, and put the thermometer away in its case, bulb end first.
11. Note the temperature on the daily record.
If there is any marked rise or drop in a patient's temperature, check the reading by taking the temperature again. Report the results to the doctor at once if the second reading confirms the first.
Taking the Rectal Temperature
The temperature of the body in the rectum is usually higher than in the mouth by approximately one degree; therefore, the normal rectal temperature is about 99.6° F. Always indicate on the daily record for the doctor when the temperature has been taken by the rectum.
Equipment
The same equipment will be needed as when taking a mouth temperature, with the exception that a thermometer with a stubby bulb should be used and a lubricant such as petrolatum will be needed.
Procedure for an Adult
1. Explain to the patient what is going to be done and instruct him to lie on his side.
2. Lubricate the bulb end of the thermometer with petrolatum, so that it will slide easily into the rectum. Any mild oil or cold cream may be used instead of petrolatum.
3. Slip the bulb end of the thermometer about 1 inch into the anus (opening of the rectum). Hold in place for 3 minutes to make sure the thermometer registers the actual temperature.
4. Remove the thermometer and follow directions 9 through 12 in Procedure for Taking the Mouth Temperature.
Procedure for an Infant or Child
1. Explain to the child what is going to be done, if he is old enough to understand.
2. Lubricate the thermometer in the same way as when taking the rectal temperature for an adult.
3. Have the child lie down (on his back or abdomen) on either the home nurse's lap, a bed, or a table.
4. Insert the bulb of the thermometer gently into the anus and hold it for 3 minutes. It must be held in place at all times. Help may be needed to hold a restless child.
5. Remove the thermometer and follow directions 9 through 12 in Procedure for Taking the Mouth Temperature.
Taking the Temperature by the Armpit
Temperature taken at the armpit is lower than the mouth temperature and should be recorded as taken in the armpit. To be reliable, it must be taken correctly. It may be ordered for infants and when other methods are difficult to follow. The same equipment will be needed as when taking a mouth temperature. Proceed as directed earlier in preparing the thermometer, except that the thermometer is not moistened.
Procedure
1. Dry the area under the arm.
2. Place the bulb of the thermometer in the armpit and have the patient press his arm firmly against his body with his hand on his opposite shoulder to hold the instrument in place. Leave the thermometer in this position for 10 minutes.
3. Remove the thermometer and read.
4. Cleanse the thermometer according to the directions in Procedure for Taking the Mouth Temperature.
5. Note the temperature and the manner of taking it on the daily record.
Essential Points To Remember.
1. Be sure the mercury is down to 95° F. or below before taking the temperature.
2. Allow sufficient time for an accurate registration of the temperature.
3. Take the temperature by the rectum or armpit when it cannot be taken accurately or safely by the mouth.
4. Cleanse the thermometer immediately after use.
TAKING THE PULSE AND RESPIRATION
Purpose. To count the pulse (number of heart beats) and respirations (breathing) that occur each minute.
Procedure
Pulse. 1. Have the patient lie or sit down. Place his arm and hand in a relaxed position, thumb up, supported on a chair arm, table, or bed.
2. Locate the pulse by placing the forefinger on the thumb side of the patient's wrist between the tendons and the wrist bone.
3. Count the pulse beats for 1 full minute; then check the rate by counting for another minute.
4. Note on the daily record for the doctor the pulse rate per minute, time, date, and any irregularity noted.
Respiration. Respirations may be counted immediately following the counting of the pulse and while the fingers are still on the pulse, as the patient is then less likely to be aware that the count is being made and to change his breathing.
1. Observe the rise and fall of the chest. Count for 1 full minute each rise of the chest.
2. Note on the daily record the rate and any unusual condition in breathing.
CHANGING THE BED LINEN
Purpose. To make a bed which provides for the patient safety, comfort, warmth, a smooth, clean surface to lie on, and freedom of movement.
Without the Patient in Bed
Equipment
Bed—comfortable and single, if possible
Firm, smooth mattress and pad
Clean sheets and pillow cases
Blankets, suited to room temperature
Pillows
Spread, lightweight
Extra sheet for a draw sheet with a waterproof sheet or pad to protect the mattress if necessary
Newspapers or a laundry bag for soiled linen
Procedure
1. Assemble the fresh linen; place newspaper; or a bag to receive the soiled linen.
2. Remove the spread, blankets, pillows, mattress pad, and linen. If the linen is soiled, place it at once on newspapers or in a laundry bag; hold the bedding away from the face and clothing to avoid contact.
3. Turn the mattress.
4. Place the mattress pad.
5. Center the bottom sheet lengthwise and place on the bed. To anchor the bottom sheet well, allow 18 inches to tuck smoothly under the head of the mattress. Make a corner at the head of the bed, as shown.
6. Tuck the sheet smoothly under the mattress all the way down the side of the bed. If a draw sheet is used, fold it end to end and place across the center of the bed, with the top fold high enough to come under the pillow and the open end toward the foot; tuck under well. If additional protection is needed for the mattress, place a rubber sheet or substitute under the draw sheet.
7. Center the top sheet lengthwise and place. Allow enough to fold back over the blanket at the head of the bed and to tuck under the mattress at the foot of the bed. Leave loose at the foot until the blanket is in place.
8. Center the blanket lengthwise and place it at shoulder height. Leave loose at the foot of the bed. If the blanket is not long enough, two may be used, placing one blanket as desired to cover the shoulders and the other to tuck well under the mattress at the foot.
9. Go to the other side of the bed.
10. Tuck the lower sheet smoothly under the head of the mattress. Anchor it well by making a corner. Grip the sheet near the head of the bed; pull diagonally and tuck securely under the mattress. Repeat this three or four times all the way down the second side of the bed.
11. Pull the draw sheet smooth and tuck under.
12. Provide toe space.
13. Tuck the sheet and blankets loosely under the mattress at the foot of the bed; retain the pleat; make loose corners.
14. Center and place the bedspread. If the patient is using the bed at once, fold the spread under the upper edge of the blanket and fold the top sheet back over both the blanket and spread; tuck the bed-spread loosely under the mattress at the foot.
15. Put on the pillow case. Keep the pillow away from the face and clothes.
16. Arrange the bed for occupancy. Fold the top covers—sheet, blankets, spread—in thirds to the foot of the bed with the free edge toward the head of the bed so the covers may be pulled up easily.
17. Remove the soiled linen.
With the Patient in Bed
Procedure
1. Assemble the equipment.
2. Loosen the bedding all around from under the mattress. Use care to avoid tearing.
3. Remove the spread; fold and hang over a chair. Remove one blanket, if using two; fold and hang over a chair. For the comfort of the patient, work from the head to the foot of the bed.
4. Remove the top sheet, sliding it down under the blanket. The patient may be asked to hold the top edge of the blanket while this is done, or the blanket can be tucked under the shoulders. If the top sheet is to be used as the bottom sheet or draw sheet, fold and place on a chair.
5. Remove all but one pillow—or all pillows. Remove the soiled cases and place with the soiled linen.
6. Turn the patient toward the other side of the bed in order to change the bottom sheet; keep him covered.
7. Change the bottom sheet.
a. Gather the soiled bottom sheet lengthwise and roll it up close to the patient.
b. Pull the mattress pad smooth under the patient.
c. Center the clean sheet lengthwise; place and unfold, keeping about 18 inches to tuck under at the head to protect the mattress and to anchor the sheet.
d. Gather the top half of the clean sheet and push in a flat roll under the soiled sheet, close up against the patient's back.
e. Tuck the clean sheet well under the mattress at the head and make a corner; tuck well under the mattress all along the side of the bed. If a draw sheet is used, place on the bed with the folded edge under the pillow; tuck under the mattress.
f. Turn the patient back toward the home nurse. Tell the patient what is about to be done. Loosen the blanket. Lift his feet over the soiled and clean sheets. Place one hand on his upper shoulder, the other on the upper hip on top of the bedding, and, on signal, roll the patient, all the way toward the home nurse. Continue giving support while the bunched sheets are pulled out. Roll the patient on his back. Adjust the position and covers.
g. Go to the other side of the bed and remove the soiled sheet, handling as little as possible; place with the soiled linen.
h. Smooth the mattress pad.
i. Adjust the clean bottom sheet. Tuck the sheet well under the mattress at the head of the bed; make a corner.
j. Tuck the sheet securely under the mattress all the way down the side of the bed, pulling the sheet diagonally.
k. Grasp and pull the draw sheet and tuck under the mattress.
8. Put on the clean pillow case and replace the pillow.
9. Place the top covers.
10. Make the patient comfortable; straighten the room and remove the soiled linen.
Essential Points To Remember.
1. The bottom sheet should be smooth and tight.
2. The top covers should be lightweight and suited to the temperature of the room, should provide for shoulder warmth and permit toe space, and should be held securely together.
3. Handle the soiled linen with care to prevent the spread of infection.
MOVING THE PATIENT IN BED
Purpose. To relax the patient, improve the circulation, prevent continued pressure on any part of the body over too long a time, avoid strain on the joints, prevent deformities, and adjust the position for comfort or for the giving of treatments.
Procedures
Helping the Patient Move to the Near Side of the Bed.
1. Place the hands, palms up, under the pillow, supporting the head and shoulders, and on signal pull toward the home nurse.
2. Place the hands, palms up, all the way under the hips and on signal pull toward the home nurse.
3. Place the hands under the knees and ankles, pull toward the home nurse, and adjust the body for position and comfort.
Helping the Patient Sit Up and Lie Down.
1. Face the head of the bed.
2. Flex the patient's knees.
3. Lock the near arms—the arm of the home nurse under the patient's arm with the hand braced at his shoulder; the patient's arm under her arm with his hand braced at her shoulder.
4. On signal, help the patient to a sitting position and pause in case he feels weak or dizzy.
5. Help the patient support himself, if he is able—hands braced back of him on the bed.
6. Lock arms as before and lower the patient to the pillow.
7. Adjust for correct position and comfort.
Helping the Patient Move Up and Down in Bed.
When the Patient Can Assist.
1. Raise the patient to a sitting position as above.
2. Help the patient support himself—hands braced back of him on the bed.
3. Move toward the head of the bed—face the bed; place one hand low on the patient's back, the other, palm up, well under his thighs and on signal help the patient swing backward as he digs in and pushes with his heels.
4. Move toward the foot of the bed—repeat the same procedure except the patient digs in and pushes with his hands as he swings forward.
When the Patient Is Helpless.
If the patient is entirely helpless, two or even three people may be needed to lift him up or down in bed. For a single bed, two stand opposite each other and join hands under the patient's shoulders and thighs and move him as desired; for a double bed, two or three persons may work on the same side of the bed; one lifting the head and shoulders, one the hips, and one the legs and feet, supporting the knees and ankles. The drawsheet may also be used to help move or roll the patient.
Source: http://www.healthguidance.org/authors/662/Ruth-B.-Freeman
The home nurse should remember, however, that there is an art as well as a technic involved in giving good nursing care and that she is caring for a person and not just a patient. The development of a healthy mental attitude may be as important to the recovery of the patient as the required physical care.
It is taken for granted that the home nurse has the doctor's assurance that a patient's condition is such that he can be cared for safely in the home. For patients who do not need highly skilled care of special hospital equipment, the warm, friendly atmosphere of the home is often more conducive to recovery than the more formal, impersonal environment of the hospital.
When caring for a patient at home, whether he is confined to bed or not, the home nurse will find it helpful to remember the following things:
1. It is easier to care for the patient and do the other necessary household tasks if a schedule is planned for the day.
2. It will save time if:
a. Everything needed is collected before care is given, and things are cleared away and cleansed promptly afterward. When the same treatment is given frequently, the necessary articles should be kept together on a tray.
b. Unnecessary laundry can be avoided by protecting the bedding.
c. Work on one side of the bed should be completed, when possible, before going to the other side.
d. Menus should be planned in advance, and food suitable for both the family and patient should be prepared whenever possible.
3. The home nurse will help safeguard her own health or conserve her strength if she:
a. Washes her hands before and after giving care to a patient.
b. Wears comfortable, low-heeled shoes to lessen back strain and short-sleeved, washable clothing to permit freedom of action.
c. Maintains good working posture.
d. Gets someone to help lift a heavy or helpless patient.
e. Obtains the patient's help. When lifting, turning, or moving a patient in bed, the home nurse should ask or help the patient to bend his knees so that he can be moved with less effort. The home nurse and the patient should act upon an agreed signal. For example, when helping the patient lift his hips, both will act on the count of three.
f. Avoids direct contact with nose and throat spray when working in close contact with the patient.
4. The home nurse will help keep her patient as comfortable as possible and also help his recovery if she:
a. Protects him from further infection by preventing exposure to the nose and throat spray or soiled hands of the home nurse or visitors.
b. Checks to see that the room is warm and that the patient is protected against drafts when giving him a bath or treatment.
c. Explains what is to be done and, if he is able, how he may help.
d. Helps the patient maintain good bed posture at all times. When giving a treatment, she should make sure the patient is in the correct position to receive care and that he is comfortable, warm, and dry during and after the treatment. A lightweight, washable blanket is often more convenient to use during baths or treatments than the usual top bedclothes and may save laundry.
e. Maintains a cheerful, wholesome mental attitude at all times to build the patient's morale and confidence.
PUTTING ON AND TAKING OFF A COVER-ALL APRON
Purpose. To provide a means of helping prevent the spread of disease from the patient or to the patient.
The home nurse should wear some type of cover-all apron when entering the sickroom to give care to the patient and take it off when leaving the room, hanging it near the door of the sickroom in readiness for use.
Procedure
1. Don the apron.
a. Slip the arms into the sleeves of the apron without touching the outside, which will be next to the patient.
b. Fasten at the neck and waist for ease in working.
2. Wash the hands after caring for the patient.
3. Remove the apron.
a. Unfasten.
b. Slip the arms out of the sleeves.
c. Hang—keep inside in and clean.
MAKING A NEWSPAPER BAG
Purpose. To provide a means of safe disposal of waste material.
Waste material from a sickroom may carry infection and therefore must be disposed of properly. Paper bags may be used for disposing of many types of waste.
Equipment
Double sheet of newspaper
Procedure
1. Place the newspaper, folded in half, with the center fold toward the person making the bag.
2. Bring the top edge of the upper sheet of the paper down to the center fold. This makes a cuff.
3. Turn the paper over, smooth side up, keeping the center fold toward the person throughout the procedure.
4. Fold it in thirds from the sides; crease well to hold the fold.
5. Lock by tucking one whole side under the cuff of the other side.
6. Bring the flap over the locked cuff.
7. Place a hand in the opening at the top; stand the bag up; shape.
8. Use the flap as a cover for the bag or as a means of fastening the bag to the side of the bed.
WASHING THE HANDS
Purpose. The home nurse washes her hands before and after caring for the patient to help protect the patient, the home nurse, and others from infection.
Equipment
Basin or bowl
Running water or container of clean warm water
Clean towels
Waste container for soiled towels
Soap
Waste pail or other means of disposing of liquid waste
Roll up the sleeves if wearing long ones. Remove the wrist watch, or push it up on the arm. Remove jewelry that is likely to hurt the patient or collect lint and other soil.
The hands should be washed under running water; where this is not available, pour water from the container.
Procedure
1. Keep the hands lowered over the basin throughout the entire procedure.
2. Wet the hands so that the soap will lather.
3 Soap hands well, working up a lather.
4. Rinse the soap (if using a bar), leaving it clean for the next use.
5. Use friction, rubbing well between the fingers and around the nails, and be sure to wash the entire hand and wrist.
6. Rinse the hands to allow the first dirt to run off.
7. Soap again, being sure to work up a good lather, and using friction as before between the fingers and around the nails.
8. Rinse the soap.
9. Rinse the hands again, getting all the dirt off this time.
10. Dry the hands well. Wet skin or dried soap on the skin may cause chapping, and breaks in the skin may admit infection. Also, chapped hands are unsightly and are uncomfortable for both the patient and the nurse.
11. Discard the towels in a waste container.
12. Dispose of the waste container.
Essential Points To Remember.
1. Hold the hands down over the basin and wash under clean running water.
2. Use friction.
3. Dry well.
TAKING THE TEMPERATURE
Purpose. To determine the patient's temperature in order to help the doctor make a diagnosis and prescribe treatment.
Fever or clinical thermometers differ from most other thermometers in that the mercury remains at the highest point registered until it is shaken down. They are fragile and must be handled with care, kept in a safe place when not in use, and protected from heat. The temperature is usually taken by the mouth or rectum, but may also be taken at the armpit. For an accurate reading, keep the thermometer in place in the body for at least 3 minutes, except when the temperature is taken at the armpit, in which case leave the thermometer in place for 10 minutes.
Some mouth thermometers have a slender bulb about ½ inch in length. Others have a short, stubby bulb. Only thermometers with stubby bulbs should be used to take rectal temperatures as there is less danger of their breaking and injuring the patient. If only one thermometer can be purchased, it should be a thermometer with a stubby bulb, which can be used for taking temperatures by any of the above methods. Thermometers have two parts:
1. The bulb end: This holds the mercury and is the part that is placed in the mouth; it must be kept clean.
2. The glass tube: Through this tube the mercury rises and on it are shown the lines and numbers that indicate the degrees. The column of mercury can be seen between the lines and the numbers—through a ridge which extends the length of the tube. When handling the thermometer, always grasp it by the top of the tube.
When the thermometer is in position for taking the temperature, the heat of the body expands the mercury and pushes it up into the tube.
The long lines on the tube of the thermometer are the degrees—94, 95, 96, and so on—while the short lines between are each two-tenths of a degree. However space allows room for printing only the even numbers. The normal temperature by the mouth is usually 98.6° F. (Fahrenheit), which is indicated on the tube by a small arrow.
If the home nurse cannot read the thermometer after taking a temperature, she should cleanse it according to the directions given here and put it away until someone can be called who is able to read a thermometer. At her first opportunity, she should learn how to read the thermometer herself.
When reading the thermometer:
1. Make sure the light is adequate for accurate reading of the thermometer.
2. Hold the thermometer by the top, in line with the eye; turn the ridged side toward you.
3. Look for the thin column of mercury between the lines and numbers through the ridge. It may be necessary to roll the thermometer slowly back and forth to locate the mercury; the end of the mercury column indicates the temperature.
4. Read the scale to include the degree and nearest two-tenths of a degree.
When shaking down the mercury:
1. Stand away from the furniture to avoid striking the thermometer against any object and breaking it.
2. Hold the thermometer firmly by the top between the thumb and first two fingers.
3. Shake with a loose wrist movement—as though shaking water off the hand—to bring the mercury to 95° F. or below.
Taking the Mouth Temperature
Equipment
Clinical thermometer
Container of wipes: absorbent cotton, paper tissues, toilet paper, or pieces of clean gauze or rags
Soap
Waste container
Container of cool, clean water
Procedure
1. Have the patient sit or lie down.
2. Hold the thermometer firmly by the top.
3. Shake the mercury down to 95° F. or below.
4. Rinse the thermometer in clear, cool water to make it easier and more pleasant to hold in the mouth.
5. Place the bulb in the patient's mouth, well under the tongue and a little to one side.
6. Instruct the patient to keep his lips closed, to breathe through his nose, and not to bite down on the thermometer or to talk.
7. Leave the thermometer in place for 3 minutes to assure an accurate registering.
8. Remove by holding at the top and use a wipe to remove any saliva; use a rotary motion from the top toward the bulb and over the bulb. This makes it easier to read. Dispose of the wipe in a waste container.
9. Take the thermometer to a good light, still holding by the top, and read.
10. Cleanse the thermometer immediately:
a. Hold by the top, with the bulb down, over a waste container.
b. Moisten a wipe with cool water and soap well. Beginning at the top, rub down with a single rotary stroke with friction, getting well into the grooves of the tube and over the bulb. Discard the wipe.
c. Moisten a fresh wipe with clear, cool water and rinse the thermometer, using the same stroke as above.
d. Soap and rinse again—repeat procedures b and c.
e. Dry with a fresh wipe, using the same stroke, and put the thermometer away in its case, bulb end first.
11. Note the temperature on the daily record.
If there is any marked rise or drop in a patient's temperature, check the reading by taking the temperature again. Report the results to the doctor at once if the second reading confirms the first.
Taking the Rectal Temperature
The temperature of the body in the rectum is usually higher than in the mouth by approximately one degree; therefore, the normal rectal temperature is about 99.6° F. Always indicate on the daily record for the doctor when the temperature has been taken by the rectum.
Equipment
The same equipment will be needed as when taking a mouth temperature, with the exception that a thermometer with a stubby bulb should be used and a lubricant such as petrolatum will be needed.
Procedure for an Adult
1. Explain to the patient what is going to be done and instruct him to lie on his side.
2. Lubricate the bulb end of the thermometer with petrolatum, so that it will slide easily into the rectum. Any mild oil or cold cream may be used instead of petrolatum.
3. Slip the bulb end of the thermometer about 1 inch into the anus (opening of the rectum). Hold in place for 3 minutes to make sure the thermometer registers the actual temperature.
4. Remove the thermometer and follow directions 9 through 12 in Procedure for Taking the Mouth Temperature.
Procedure for an Infant or Child
1. Explain to the child what is going to be done, if he is old enough to understand.
2. Lubricate the thermometer in the same way as when taking the rectal temperature for an adult.
3. Have the child lie down (on his back or abdomen) on either the home nurse's lap, a bed, or a table.
4. Insert the bulb of the thermometer gently into the anus and hold it for 3 minutes. It must be held in place at all times. Help may be needed to hold a restless child.
5. Remove the thermometer and follow directions 9 through 12 in Procedure for Taking the Mouth Temperature.
Taking the Temperature by the Armpit
Temperature taken at the armpit is lower than the mouth temperature and should be recorded as taken in the armpit. To be reliable, it must be taken correctly. It may be ordered for infants and when other methods are difficult to follow. The same equipment will be needed as when taking a mouth temperature. Proceed as directed earlier in preparing the thermometer, except that the thermometer is not moistened.
Procedure
1. Dry the area under the arm.
2. Place the bulb of the thermometer in the armpit and have the patient press his arm firmly against his body with his hand on his opposite shoulder to hold the instrument in place. Leave the thermometer in this position for 10 minutes.
3. Remove the thermometer and read.
4. Cleanse the thermometer according to the directions in Procedure for Taking the Mouth Temperature.
5. Note the temperature and the manner of taking it on the daily record.
Essential Points To Remember.
1. Be sure the mercury is down to 95° F. or below before taking the temperature.
2. Allow sufficient time for an accurate registration of the temperature.
3. Take the temperature by the rectum or armpit when it cannot be taken accurately or safely by the mouth.
4. Cleanse the thermometer immediately after use.
TAKING THE PULSE AND RESPIRATION
Purpose. To count the pulse (number of heart beats) and respirations (breathing) that occur each minute.
Procedure
Pulse. 1. Have the patient lie or sit down. Place his arm and hand in a relaxed position, thumb up, supported on a chair arm, table, or bed.
2. Locate the pulse by placing the forefinger on the thumb side of the patient's wrist between the tendons and the wrist bone.
3. Count the pulse beats for 1 full minute; then check the rate by counting for another minute.
4. Note on the daily record for the doctor the pulse rate per minute, time, date, and any irregularity noted.
Respiration. Respirations may be counted immediately following the counting of the pulse and while the fingers are still on the pulse, as the patient is then less likely to be aware that the count is being made and to change his breathing.
1. Observe the rise and fall of the chest. Count for 1 full minute each rise of the chest.
2. Note on the daily record the rate and any unusual condition in breathing.
CHANGING THE BED LINEN
Purpose. To make a bed which provides for the patient safety, comfort, warmth, a smooth, clean surface to lie on, and freedom of movement.
Without the Patient in Bed
Equipment
Bed—comfortable and single, if possible
Firm, smooth mattress and pad
Clean sheets and pillow cases
Blankets, suited to room temperature
Pillows
Spread, lightweight
Extra sheet for a draw sheet with a waterproof sheet or pad to protect the mattress if necessary
Newspapers or a laundry bag for soiled linen
Procedure
1. Assemble the fresh linen; place newspaper; or a bag to receive the soiled linen.
2. Remove the spread, blankets, pillows, mattress pad, and linen. If the linen is soiled, place it at once on newspapers or in a laundry bag; hold the bedding away from the face and clothing to avoid contact.
3. Turn the mattress.
4. Place the mattress pad.
5. Center the bottom sheet lengthwise and place on the bed. To anchor the bottom sheet well, allow 18 inches to tuck smoothly under the head of the mattress. Make a corner at the head of the bed, as shown.
6. Tuck the sheet smoothly under the mattress all the way down the side of the bed. If a draw sheet is used, fold it end to end and place across the center of the bed, with the top fold high enough to come under the pillow and the open end toward the foot; tuck under well. If additional protection is needed for the mattress, place a rubber sheet or substitute under the draw sheet.
7. Center the top sheet lengthwise and place. Allow enough to fold back over the blanket at the head of the bed and to tuck under the mattress at the foot of the bed. Leave loose at the foot until the blanket is in place.
8. Center the blanket lengthwise and place it at shoulder height. Leave loose at the foot of the bed. If the blanket is not long enough, two may be used, placing one blanket as desired to cover the shoulders and the other to tuck well under the mattress at the foot.
9. Go to the other side of the bed.
10. Tuck the lower sheet smoothly under the head of the mattress. Anchor it well by making a corner. Grip the sheet near the head of the bed; pull diagonally and tuck securely under the mattress. Repeat this three or four times all the way down the second side of the bed.
11. Pull the draw sheet smooth and tuck under.
12. Provide toe space.
13. Tuck the sheet and blankets loosely under the mattress at the foot of the bed; retain the pleat; make loose corners.
14. Center and place the bedspread. If the patient is using the bed at once, fold the spread under the upper edge of the blanket and fold the top sheet back over both the blanket and spread; tuck the bed-spread loosely under the mattress at the foot.
15. Put on the pillow case. Keep the pillow away from the face and clothes.
16. Arrange the bed for occupancy. Fold the top covers—sheet, blankets, spread—in thirds to the foot of the bed with the free edge toward the head of the bed so the covers may be pulled up easily.
17. Remove the soiled linen.
With the Patient in Bed
Procedure
1. Assemble the equipment.
2. Loosen the bedding all around from under the mattress. Use care to avoid tearing.
3. Remove the spread; fold and hang over a chair. Remove one blanket, if using two; fold and hang over a chair. For the comfort of the patient, work from the head to the foot of the bed.
4. Remove the top sheet, sliding it down under the blanket. The patient may be asked to hold the top edge of the blanket while this is done, or the blanket can be tucked under the shoulders. If the top sheet is to be used as the bottom sheet or draw sheet, fold and place on a chair.
5. Remove all but one pillow—or all pillows. Remove the soiled cases and place with the soiled linen.
6. Turn the patient toward the other side of the bed in order to change the bottom sheet; keep him covered.
7. Change the bottom sheet.
a. Gather the soiled bottom sheet lengthwise and roll it up close to the patient.
b. Pull the mattress pad smooth under the patient.
c. Center the clean sheet lengthwise; place and unfold, keeping about 18 inches to tuck under at the head to protect the mattress and to anchor the sheet.
d. Gather the top half of the clean sheet and push in a flat roll under the soiled sheet, close up against the patient's back.
e. Tuck the clean sheet well under the mattress at the head and make a corner; tuck well under the mattress all along the side of the bed. If a draw sheet is used, place on the bed with the folded edge under the pillow; tuck under the mattress.
f. Turn the patient back toward the home nurse. Tell the patient what is about to be done. Loosen the blanket. Lift his feet over the soiled and clean sheets. Place one hand on his upper shoulder, the other on the upper hip on top of the bedding, and, on signal, roll the patient, all the way toward the home nurse. Continue giving support while the bunched sheets are pulled out. Roll the patient on his back. Adjust the position and covers.
g. Go to the other side of the bed and remove the soiled sheet, handling as little as possible; place with the soiled linen.
h. Smooth the mattress pad.
i. Adjust the clean bottom sheet. Tuck the sheet well under the mattress at the head of the bed; make a corner.
j. Tuck the sheet securely under the mattress all the way down the side of the bed, pulling the sheet diagonally.
k. Grasp and pull the draw sheet and tuck under the mattress.
8. Put on the clean pillow case and replace the pillow.
9. Place the top covers.
10. Make the patient comfortable; straighten the room and remove the soiled linen.
Essential Points To Remember.
1. The bottom sheet should be smooth and tight.
2. The top covers should be lightweight and suited to the temperature of the room, should provide for shoulder warmth and permit toe space, and should be held securely together.
3. Handle the soiled linen with care to prevent the spread of infection.
MOVING THE PATIENT IN BED
Purpose. To relax the patient, improve the circulation, prevent continued pressure on any part of the body over too long a time, avoid strain on the joints, prevent deformities, and adjust the position for comfort or for the giving of treatments.
Procedures
Helping the Patient Move to the Near Side of the Bed.
1. Place the hands, palms up, under the pillow, supporting the head and shoulders, and on signal pull toward the home nurse.
2. Place the hands, palms up, all the way under the hips and on signal pull toward the home nurse.
3. Place the hands under the knees and ankles, pull toward the home nurse, and adjust the body for position and comfort.
Helping the Patient Sit Up and Lie Down.
1. Face the head of the bed.
2. Flex the patient's knees.
3. Lock the near arms—the arm of the home nurse under the patient's arm with the hand braced at his shoulder; the patient's arm under her arm with his hand braced at her shoulder.
4. On signal, help the patient to a sitting position and pause in case he feels weak or dizzy.
5. Help the patient support himself, if he is able—hands braced back of him on the bed.
6. Lock arms as before and lower the patient to the pillow.
7. Adjust for correct position and comfort.
Helping the Patient Move Up and Down in Bed.
When the Patient Can Assist.
1. Raise the patient to a sitting position as above.
2. Help the patient support himself—hands braced back of him on the bed.
3. Move toward the head of the bed—face the bed; place one hand low on the patient's back, the other, palm up, well under his thighs and on signal help the patient swing backward as he digs in and pushes with his heels.
4. Move toward the foot of the bed—repeat the same procedure except the patient digs in and pushes with his hands as he swings forward.
When the Patient Is Helpless.
If the patient is entirely helpless, two or even three people may be needed to lift him up or down in bed. For a single bed, two stand opposite each other and join hands under the patient's shoulders and thighs and move him as desired; for a double bed, two or three persons may work on the same side of the bed; one lifting the head and shoulders, one the hips, and one the legs and feet, supporting the knees and ankles. The drawsheet may also be used to help move or roll the patient.
Source: http://www.healthguidance.org/authors/662/Ruth-B.-Freeman
Andropause and Testosterone
Andropause occurs as a result of plummeting levels of testosterone, the dominant male hormone. This hormonal function starts to decline gradually as men age. Just like menopause, when decreasing levels of estrogen (the most dominant female hormone) play havoc on the female body – it can apply to men as well. Because of this condition, symptoms such as the loss of libido, impotence, and depression may present themselves.
Let’s shy away from Andropause for a second and focus on testosterone. What comes to your mind when you think of the word: testosterone? Body builders hugging their 10 lb jars of whey protein before a pose down? Mark McGwire and the bottle of andro found stored in his locker? Pumped-up, muscle-packed men strutting the boardwalk in Venice Beach?
Testosterone is much more than defining the idea of an alpha male. This hormone regulates numerous processes in the male body besides sex-related functions and muscle building. Blood sugar controlled to normal levels, the regulation of cholesterol, oxygen uptake, enhances the immune system, and helps to create healthy, strong bones. All of these are all attributed to the work of this one hormone.
Metabolic processes are also speeded up, like cell production and cell growth. In addition, Testosterone appears to help in mental concentration, improves mood and is reported to prevent depression and even Alzheimer’s disease. Testosterone isn’t simply an ingredient found in steroids that pack muscle mass. It is an integral part of the human body that helps shape, build, and maintain bodily processes.
Andropause is responsible for plummeting testosterone levels. Before learning more about testosterone, let’s examine how Andropausal men’s bodies work and result in this decline. Testosterone is developed in the brain. The pituitary glands in the brain produce a hormone called luteinizing hormone responsible for giving one special order to the testicles: produce testosterone! Remember, the brain does not produce T.
It regulates the glands which produce the hormones that send receptor messages directly to the testes. The combination of failing testes and the inability of the pituitary gland to send messages to the testes is the reason for testosterone decline. If the pituitary gland is not secreting enough of the luteinizing hormone, the testes will not function. On average, 5 grams of testosterone are made daily. The secretion of this hormone is prominent during certain times of the day, most notably in the morning and sundown. Semen is also affected – less is produced as we age.
T hormones work by connecting themselves to proteins in the blood. These proteins follow through the bloodstream and reach the vital areas of the body where the hormone works. A small amount of testosterone does not attach themselves to any protein – these are called free testosterone. This free hormone is the most impactful hormone in your system. When Andropause comes to fruition, more testosterone attach themselves to proteins, leaving less of the free testosterone available. As you can see, proteins can have a reverse effect on us as well! It is a paradox – a hormone working too hard does more damage than good!
As men grow older, androgen levels start to decline. Remember guys, estrogen is to women as androgen is to men. Androgens are produced in the adrenal gland (located above the kidneys) and in the testicles. These hormones are responsible for producing sperm, promoting sex drive, aiding with erectile function, and helping determine the gender of an unborn child. If you are a bodybuilding enthusiast, please note that lack of androgen will affect your muscle build, causing decreased muscle mass and loss of strength.
No amount of whey protein, creatine, or glutamine can remedy this problem. Instead of building six-pack abs, you will have increased body fat in the areas you need it least. Squats (total body building exercise) and deadlifts (compound exercise that works the back) are nearly impossible to perform, as Andropause can cause osteoporosis (loss of bone tissue) and back pain. This should not deter you from having a daily exercise regimen, however. Exercise has been scientifically proven to lessen the effects of testosterone loss and your routine should be altered to accommodate this as you age.
There are also alternatives such as testerone cream that can help you regain your sex drive and stamina. With the right nutrition
, including diet and exercise, Andropause can be a comfortable passage.
Source: http://www.healthguidance.org/authors/53/Cathy-Taylor
Let’s shy away from Andropause for a second and focus on testosterone. What comes to your mind when you think of the word: testosterone? Body builders hugging their 10 lb jars of whey protein before a pose down? Mark McGwire and the bottle of andro found stored in his locker? Pumped-up, muscle-packed men strutting the boardwalk in Venice Beach?
Testosterone is much more than defining the idea of an alpha male. This hormone regulates numerous processes in the male body besides sex-related functions and muscle building. Blood sugar controlled to normal levels, the regulation of cholesterol, oxygen uptake, enhances the immune system, and helps to create healthy, strong bones. All of these are all attributed to the work of this one hormone.
Metabolic processes are also speeded up, like cell production and cell growth. In addition, Testosterone appears to help in mental concentration, improves mood and is reported to prevent depression and even Alzheimer’s disease. Testosterone isn’t simply an ingredient found in steroids that pack muscle mass. It is an integral part of the human body that helps shape, build, and maintain bodily processes.
Andropause is responsible for plummeting testosterone levels. Before learning more about testosterone, let’s examine how Andropausal men’s bodies work and result in this decline. Testosterone is developed in the brain. The pituitary glands in the brain produce a hormone called luteinizing hormone responsible for giving one special order to the testicles: produce testosterone! Remember, the brain does not produce T.
It regulates the glands which produce the hormones that send receptor messages directly to the testes. The combination of failing testes and the inability of the pituitary gland to send messages to the testes is the reason for testosterone decline. If the pituitary gland is not secreting enough of the luteinizing hormone, the testes will not function. On average, 5 grams of testosterone are made daily. The secretion of this hormone is prominent during certain times of the day, most notably in the morning and sundown. Semen is also affected – less is produced as we age.
T hormones work by connecting themselves to proteins in the blood. These proteins follow through the bloodstream and reach the vital areas of the body where the hormone works. A small amount of testosterone does not attach themselves to any protein – these are called free testosterone. This free hormone is the most impactful hormone in your system. When Andropause comes to fruition, more testosterone attach themselves to proteins, leaving less of the free testosterone available. As you can see, proteins can have a reverse effect on us as well! It is a paradox – a hormone working too hard does more damage than good!
As men grow older, androgen levels start to decline. Remember guys, estrogen is to women as androgen is to men. Androgens are produced in the adrenal gland (located above the kidneys) and in the testicles. These hormones are responsible for producing sperm, promoting sex drive, aiding with erectile function, and helping determine the gender of an unborn child. If you are a bodybuilding enthusiast, please note that lack of androgen will affect your muscle build, causing decreased muscle mass and loss of strength.
No amount of whey protein, creatine, or glutamine can remedy this problem. Instead of building six-pack abs, you will have increased body fat in the areas you need it least. Squats (total body building exercise) and deadlifts (compound exercise that works the back) are nearly impossible to perform, as Andropause can cause osteoporosis (loss of bone tissue) and back pain. This should not deter you from having a daily exercise regimen, however. Exercise has been scientifically proven to lessen the effects of testosterone loss and your routine should be altered to accommodate this as you age.
There are also alternatives such as testerone cream that can help you regain your sex drive and stamina. With the right nutrition
, including diet and exercise, Andropause can be a comfortable passage.
Source: http://www.healthguidance.org/authors/53/Cathy-Taylor
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