foreword

 

 

 

            S.Y. 2007-2008. 2^nd Semester

 

            The ladderized curriculum of Health Sciences department has introduced to its freshmen Nursing students the HC 1 (Introduction to Elder Care and Special Needs) subject, which is a 6-month caregiver course and a preparatory course for the nursing profession.

 

            This course prepares the students to be globally competitive in providing and fostering care, comfort, support, and safety to infants, toddlers, preschoolers, school aged-children, adolescents, adults, and the elderly in all aspects of living.

 

            In order to achieve these goals, assessments, and return demonstrations are the required responses of the students to the various competencies taught through methodologies such as discussions, demonstrations, brainstorming, role plays, simulations, and video viewing/ presentations.

             

            It is quite enough difficult to see things through in accomplishing every tasks and topics. Complete attention and careful analysis are needed in tracing and remembering every detail. Albeit, all of these aid in the fulfillment of the vision and mission of creating a youth of pro-humanity.

 

 

 

 

 

!&!

 

 

 

            Being the first batch to pioneer the HC1 subject, we are not just advance in the lessons but we are also honed as early as now in the different objectives of the nursing and caregiving roles. In the learning activities meant to help us progress safely and continuously into performing the skills, practice, practice and more practice is definitely very significant.

 

            Interesting for my part, this course is also exciting and it thrills me more and more each passing day.

 

 

            Well…here are what I have learned during the lectures and in the skills a caregiver and nurse must acquire.

           

 

Pre-liminary Period

November to December 2007

 

            I enrolled late for the 2^nd semester, that’s why I belonged to section K.

 

            For the first weeks of classes, our designated teachers in HC 1 were not yet in permanently; while the rest of the other classes had already started some discussions. We had a complicated start — from schedules, and teachers to lessons, and classroom settlement.

 

            Finally, after everything has been settled down, our Monday to Wednesday teacher, Ma’am Shyr Javier has begun teaching to us the basics, first and foremost, the proper hand washing.

 

 

HAND WASHING

 

            Learning the proper handwashing technique is very different from the usual hand washing taught when I was still little.

 

            The single and most vital practice for averting the transfer of microorganisms, and therefore nosocomial infection, is correct and frequent hand washing. Protecting myself, my coworkers would be most necessary so that I may also provide the protection and safety needed for the patient.

 

            There are two types of hand washing:

(a)    medical procedure — direction starts from the elbow raised above the hands towards                                        the hands

(b)   surgical procedure — direction starts from the hands raised above the elbows towards                                the elbows

 

This procedure is entailed before and after every procedure and work to be made for a healthier wellness assurance of the whole lieu per se.

 

 

In hand washing, friction, running water and soap are the three most essential elements to remove microorganisms or other substances that may be present in the hands. In doing so, vigorous rubbing for approximately 10 seconds must be observed. Only the water, soap and the towelet should get contact with the skin. Avoid touching the sink. Use tissue paper or dry paper towel when turning on or off the faucet. These are due to microorganisms that accumulate in the sink and dirty hands have touched the faucet before doing the hand washing. Lathering the soap is also needed. The areas in the hands that are properly rubbed are the sub-ungal, fingernails, knuckles, interphalanges and of course the arms.  Growing fingernails must be cut short and avoid placing nail polish on fingernails.   

 

What we all performed was the medical hand washing. Having a new skill learned, I have experienced the necessity of doing so and the keen observation provided for the intricate details entailed in the skill. It always leads to the attainment of its objective — basic infection control.

 

Though every section had different instructors, who had different strategies and teachings, the concepts are still the same.

 

 

 

 

VITAL SIGNS

 

            Vital signs indicate the patient’s health status. Under these are temperature, pulse rate, respiratory rate, and blood pressure.

 

            Changes in one vital sign can trigger changes in other vital signs.

 

            Vital signs are assessed when a client is admitted to a health care agency to establish baseline data and when there is a change or possibility of a change in the client’s condition.

 

            Knowledge of the normal ranges of vital signs and of the factors that regulate and influence vital signs helps the nurse interpret the measurements that deviate from normal.

           

            Knowledge of factors affecting heat production and heat loss helps the nurse to implement appropriate interventions when the client has a fever or hypothermia.

 

            Factors affecting body temperature include age, diurnal variations, exercise, hormones, stress, and environmental temperatures.

 

            Pulse rate and volume reflect the stroke volume output, the compliance of the client’s arteries, and the adequacy of blood flow.

 

            Respirations are normally quiet, effortless and automatic and are assessed by observing respiratory rate, depth, rhythm, and sound.

 

            Blood pressure reflects cardiac output, peripheral vascular resistance, blood volume, and blood viscosity; peripheral vascular resistance varies according to the size of the arterioles and capillaries, and compliance of the arteries.

 

 

 

 

 

 

 

 

CHILDCARE

 

            Keeping the babies and older children safe and comfortable at home is the major role of a caregiver. It includes giving and providing their usual habits — feeding, clothing, bathing, cleaning, playing, merriment, resting etc.

 

            As a caregiver, it is an accountability to give the children basic lessons on speaking, reading, counting, and writing. Aside from those, it is also necessary to inculcate moral and spiritual values in the child’s mind. Another is that a caregiver must constantly remind the child that good manners and right conduct are a way of life.

 

            In this topic, I have learned that avoiding confusion and uncertainty makes the caregiver do the right thing at the right time.

 

 

 

THE NATURE OF HUMAN GROWTH AND DEVELOPMENT

 

            Growth and development, which are considered a single process, go on constantly, continuing through childhood and into adulthood.

 

            A caregiver may care for children both healthy and unwell. Therefore, it is essential to know and understand normal development in order to be better prepared to care for any child for whom he has responsibility. I have also learned that it is a need to understand normal behavior before understanding the abnormal behavior.

 

            Basic concepts on children are also further viewed. Always remember that children are individuals. They are influenced by genetic factors, home and environment and parental attitudes. Chronological and developmental ages of children are the most important contributing factors influencing their care. Play is a natural medium fro expression, communication and growth in children. In the care of children, the main objective in providing health maintenance is a family-centered environment. Prevention of illness and maintenance of health are the main thrusts in the health care of heath.

 

            Another thing to bear in mind is the pattern of growth of the child — cephalocaudal and proximodistal— and its rates. 

 

            There are four theories which I have learned in order to understand better a child’s nature.

a.)                Psychoanalytical Theory of Sigmund Freud

—    Id (primary process): operates on pleasure principle

—    Ego (secondary process): conscious

—    Superego: operates on ideal principle

—    it consists of psychosexual theory ( oral, anal, phallic, latency, and genital )  

b.)                Psychosocial Model of Erickson

—    Personality development is influenced by biological, psychological, environmental and social factors throughout the life cycle. 

c.)                Interpersonal Theory of Sullivan

—    It is labeled as “self-system” that develops from infancy by the process of learning behaviors, from experiences, which relieves and avoids anxiety.

d.)                Cognitive Theory of Piaget

                        — believes that an individual has a genetically predetermined intellectual or                                     cognitive potentials

 

 

 

INFANCY, TODDLERS, PRESCHOOLERS,

SCHOOL-AGED CHILDREN

 

            Physical growth, motor development, socialization and language, play of the different stages of a child’s growth and development are carefully learned in order to assess and promote health and wellness such as preventing accidents, dental health, good nutrition, cognitive stimulation, and sufficient sleep.

 

 

 

Mid-terms

January to February 2008

 

            A whole new year has started again. There are greater opportunities and new skills are prepared for us to learn, comprehend the rationales, practice, and improve.

 

 

NUTRITION

 

            The study of food in relation to health is what we call nutrition. It is the combination of processes by which the living organ receives and utilizes materials or substances necessary for the maintenance of its function for growth and renewal of components.

 

            It is by studying that I learn to know the proper diet required to be given for the infants, children and elderly, either normal or not.

 

            Nutritional status, the condition of the body from utilization of nutrients, must be always assessed in the patient.

 

            In infants, they have fast metabolism, their kidneys are still unable to concentrate urine, and they have more ECS than the adults, that’s why they need more fluids. It is necessary to learn why infants need more fluids than adults during fluid intake so that the development of the baby is watched over.

 

            I have also learned further information on infant feeding like the different methods, types, when and what are the introductory solid foods introduced to the baby, and the actual calorie values of milk formula. Maintaining a sterilized environment —from the preparation to the equipment — should be also kept in mind.    

 

 

HYGIENIC CARE

 

            The science of health and its maintenance is called hygiene. It promotes cleanliness, provides comfort and relaxation, refreshes the client, and relaxes tired, tense muscles, improves self-image by improving appearance and eliminating offensive odors, and conditions the skin.

It is highly a personal matter determined by individual values and practices.

           

            Its importance is to know exactly how much a client can safely do and how much assistance is required. In doing so, the client must be informed and the purpose of the procedure is explained. Always provide privacy. Position and drape the client. Never forget to perform handwashing before and after the procedure. If also needed, wear clean gloves in order to avoid contact with patient for both the client and the caregiver to safe and protected.

 

            Later on in the final period of the school year, we also learned and performed bedbathing for patients who are ill, bathing and changing diapers of infants as part of hygienic care. Privacy of the client is observed. Proper sanitation and cleanliness provide wellness of the patient and proper nourishment of the growth and development of the child.

 

 

 

Final Term

February to March 2008

 

 

WASTE DISPOSAL

 

            Our main objective here is to apply the fundamental principle of waste disposal in the hospital and in the community setting.

 

            There are some principles that must be always bear in mind. A) All patients are source of microorganisms. S) Spread of infection from the source to the others can be prevented by various methods to stop the spread as close to the source as possible. E) Effectiveness of asepsis is dependent on the conscientiousness of the ones carrying them out. P) Patient’s microorganisms leave through specific routes. S) Specific microorganisms harmful to man can be transmitted by direct or indirect contact. I) In observing asepsis, areas are considered to be contaminated if they are touched by any object that is not sterile. S) Suspected contaminated areas are considered contaminated.

 

            Standard precautions have to be observed during waste disposal too. These precautions are intended to prevent transmission of blood borne and moist body substance pathogens.

W) Wash your hands frequently. Follow hand washing techniques. A) Always use protective barriers. Wear clean gloves when touching blood, body fluids, secretions and excretions, and items containing these substances; mucous membrane; non-intact skin. Wear a mask, eye protection and face shield. Wear a cover gown. S) Suctioned fluids, blood, and excretions that contain blood and body fluids should be carefully poured and drained to the sewer. T) Items soiled should be removed promptly when the potential for contact with reservoirs of pathogens is no longer present. E) Ensure correct handling of soiled linen. Hold it away from your uniform. Don’t shake or toss linen. Place and transport linen soiled with blood or body fluids in leakage resistant bags. D) Disinfect, clean and reprocess all equipment before use by another patient. Clean least contaminated areas first then move to more concentrated areas. I) Items that are single use should be discarded promptly in appropriate containers with secure lids to prevent leakage during traqnsmission. S) Sharps (scalpels and needles) should be handled correctly to prevent injury. Never recap, remove, bend or break used needles. Never point the needle towards a body part.  Use one handed scoop method. Deposit disposable and reusable syringes and needles in puncture-resistant containers. P) Prevent direct patient care or handling. O) Observe good personal hygiene. S) Segregate waste. A) All health care workers with open or draining lesions should refrain from all direct patient care and from handling patient care equipment until lesions are resolved. L) Labeled items should be discarded properly.

 

 

 

THERAPEUTIC POSITIONS

 

 

Fowler’s Position – promotes lung expansion; decreases intracranial pressure for patients with             neurologic problems. Patient is in supine position with the head of the bed elevated 18-20   inches (approx 45 degrees).

                        High Fowler’s Position – angle of more than 45 degrees (60 – 90 degrees)

                        Semi-Fowler’s Position – angle of less than 45 degrees (often 20 – 30 degrees)

 

Orthopneic Position – used to promote lung expansion for the patient who has extreme           difficulty of breathing and who is unable to lie flat or with the head only moderately            elevated. Patient sits up in or at the edge of the bed with an overbed table across the lap.     The table is paddled with a pillow and elevated to a comfortable height. The patient leans             forward and rests head and arms on the table for support.

 

Dorsal Recumbent Position – used as a position of comfort for patients with back strain. Patient        is in supine position with the knees flexed and soles of the feet flat on the bed.

 

Lithotomy Position – Patient is supine. Both knees are flexed simultaneously so that the feet are           brought close to the hips. The legs are then separated widely, maintaining the flexed position. Position is used for examining the pelvic organs and examination to view the             perineal area. It is used as a birth position, since it essentially fights gravity leading to a    less active birthing process. Also used for surgical procedures and medical examinations       involving lower abdomen.

 

Sims’ Position – A side lying position that uses only a single supporting pillow under the head. The patient is turned afar enough onto the abdomen that the lower arm is extended behind            the back and both knees are slightly flexed and wider. It is used for the administration of            enemas or for examination of the rectal area, or for unconscious patients, in inserting            suppositories.

 

Prone Position – The patient lies on his abdomen with the head turned to one side and supported         with a pillow. Position is used to examine the back; to improve respiratory mechanics; to         homogenize the pleural pressure gradient, the alveolar inflation and the ventilation distribution. It is also used as an alternative for patients who are on prolonged bed rest or are immobilized; used for patients with spinal cord injury.

 

Supine Position – Patient is resting on his back. It is recommended after spinal surger

{ music } the will of the wind
{ mood } full

Filed under kyooiku kankei no | hn. your pen's toilet