The Ministry of Health of Ukraine Ukrainian Medical Stomatological Academy
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The Ministry of Health of Ukraine Ukrainian Medical Stomatological Academy Approved at the Department of Propaedeutics to Internal Medicine with Care of Patients meeting on 09 10 2018 Protocol No4 The Head of the Department Professor Yu. Kazakov METHODICAL INSTRUCTION FOR STUDENTS’ SELF-PREPARATION WORK Educational discipline Nurse practice Module No 1 Enclosure module No 1 Topic Duties and actions of ward and procedural nurse of therapeutic department. Year 3 Faculty medical 1. The topic basis:it is very important to know duties and actions of ward and procedural nurse of therapeutic department. Great attention must be given to organization of work of ward and procedural nurse. 2. The concrete aims: To explain term “lookout post” To represent documentation, which is filling in by nurse To explain rules of thermometry and measurement of blood pressure and pulse To explain rules of maintenance of patients by preparations To represent documentation of manipulation room 3.Basic knowledge, experience, skills necessary for studying the topic in connection with other subjects (interdisciplinary integration) : Previous disciplines Obtained skills 1.Anatomy To know structure of the main systems of organism. 2.Physiology To know physiology of the main system of organism, mechanisms of thermoregulation. 3. Pharmacology To know classification of the medications according to mechanism of therapeutic action, place of action. Doses of medical preparations. 3. Medical psychology To be able to observe principles of ethics and deontology in medical practice 4. Tasks for self-work during preparation to the class. 4.1 List of the main terms, parameters, characteristics, which should be mastered during preparation to the class: Term Definition 1. Pulse It is rhythmical vibration of the arterial wall caused by the heart contraction. 2. Arterial hypertension It is elevation of systolic pressure over 140 mm and of diastolic over 90 mm Hg 3. Arterial hypotension It is a drop in the systolic pressure below 110 mm and of diastolic below 60 mm Hg 4. Nursing lookout post It is the workplace of ward nurse. 5.Venipuncture It is transcutaneous introducing of the needle in the vein 6. Infusion therapy It is therapy by means of intravenous infusions. 7. Injection It is parenteral method of medicaments’ introduction by means of syringes and needles usually. 4.2. Theoretical questions to be answered before class: 1. Name the functional role of nursing lookout post. 2. Name the medical documents of ward nurse and nursein charge of injections and other medical procedures (procedural nurse) of therapeutic department. 3. What are modern methods of measuring of body temperature ? 4. What is fever? 5. Tell about palpation of pulse on radial artery. 6. What properties of pulse do you know? 7. List vessels, which can be palpated. 8. What methods of measuring of blood pressure do you know? 9. Tell about auscultatory method of measuring blood pressure by N.Korotkoff. 10. Name “five rights” in administering a drug. 11. What treatment is called “etiotropic”? 12. What treatment is called “pathogenetic”? 13. What treatment is called “symptomatic”? 14. What does “therapeutic dose” mean? 15. What dose “toxic dose” mean? 16. Name the rules of keeping medicinal preparations. 17. Name classification of the medications depending on their route. 18. Name routes of administration for parenteral medications. 19. Name topical medication preparations. 20. What are methods of sterilization of syringes and needles? 21. What purpose of use of intradermal injections? 22. What places are the most convenient for giving subcutaneous injections? 23. What places are the most convenient for giving intramuscular injections? 24. Why are intravenous injections more responsible manipulations than subcutaneous and intramuscular ones 4.3. Practical work (tasks), which should be performed during class: 1. To take part in work of the ward and procedural (sister in charge of injections and other medical procedures) nurses. 2. To fill in documentations of ward and procedural nurse. 3. To take part in work of procedural (sister in charge of injections and other medical procedures) nurses, giving injections particularly 4. To fill in documentations of procedural nurse. The contents of topic: Text Professional duties of ward nurse: 1. Careful fulfilling of all administrations of phisician,filling in the administration list accordingwith fulfilling . 2. Preparation of patients for diagnostic examinations (x-ray, endoscopy and others ). 3. Collection of material for examinations (blood, urine, feces) and sending it to the laboratory. 4. Looking for transporting of patients to different diagnostic rooms. 5. Control for providing measures according to sanitary and hygienic regimen and observation of the personal hygiene in patients with serious diseases. 6. According to patients’ feeding: a) drafting of a la carte requirement;b ) control for maintenance of proper diet by the patients ; c) feeding of seriously ill patients; d) control of products, brought by the relatives of patient. 7. Taking bodytemperature (in the morning and in the evening; data recording in a temperature chart). 8. Obligatory presence during phisicians’rounds, accounting to him/her about all changes, that ocurred in the state of patient for a last day, receiving new prescriptions. 9. Hospitalization of patients, verification of rightness of conducting of their sanitization , acquaintance of patient with the rules of internal order. 10. Measuring of arterial pressure, pulse rate, breathing rate, day's diuresis and report of these data to the physician. 11. Correct estimation of the state of patient and giving him/her emergency aid, and calling a doctor if it is necessary. In emergency situations a nurse must give first premedical aid (artificial respiration, indirect massage of heart, and others ). 12. Careful filling in medical documentation. 13. Control for work of junior medical personnel (junior nurses, workers of feeding room). Nursing lookout post and its functional role Nursing lookout post is the workplace of ward nurse. It may include 25-30 patients, it always takes place near wards, in order to all patients can be under the permanent care of nurse. Usually it is located in a corridor and is separated from it by partition – wooden from below and transparent glass above. The necessary equipment: 1. Table with sliding boxes, which is locked if it is necessary, for saving of case reports , sheets of the medical administration, different medical forms. 2. The special medical cabinets from plastic material for saving: a) medicines; preparations of group “A” (poisonous) and “B” (drastic), preparations for internal using and for the injections are saved separately; b) medical instrumentation (forceps, packers, scissors, scalpels); c) medical Fig.1. Nursing lookout thermometers; d) the devices of patients care; e) post. disinfecting solutions; f) dressing material. 3. Small table, where drums with sterile material (by cotton wool, bandages) are, jar with disinfecting solution (furacillin), with packer dropped in it . 4. Small table with drum, where sterile syringes are. 5. Small table for distribution of medicines with the separations for every patient. 6. Refrigerator, where different tinctures, decoctions, serums, vaccines, are placed. 7. Panel of the light signal system. 8. Telephone. 9. Facilities of emergency illumination. 10. Wash-bowl for washing of hands, soap, clean towel. Documents of ward nurse: a) sheet of the medical administration, which is signed by a medical sister after their fulfilling; b) temperature charts; c) journal for passing of duties; d) journalfor movement of patients in the department; e) journalfor registration of drugs; f) journalfor registration of patients with the high temperature of body; g) a la carte requirements to the feeding room ( canteen ) of hospital (in two copies); h) journalfor requirements of medicines; i) journalwith the lists of patients who need any laboratory or instrumental research; j) journalfor registration of list of patients which need consultation of doctors-specialists. Reception and passing of duties by ward nurses: Ward nurse, who came for duties, is to check up the following: a) quality of the morning cleaning of wards and other rooms of department; b) cleanness of underwear and the bed-clothes; c) quality of taking the morning toilet, especially in seriously ill patients; d) the presence of the collected material for the morning analyses, its quality (urine, feces, sputum); e) readiness of patients for diagnostic procedures; f) quality and rightness of the morning prescriptions; g) taking of temperature of body and its mark in a temperature chart. At a lookout post nurse on duty checks: reserve and expenditure of medicines, presence of drugs that accordance of their expenditure with a record in the journal for consideration of drugs, presence of necessary documents, temperature charts, sheets of administration, presence of instruments for work . During passing the duties the following things are given : keys from closets, thermometers, hot-water bottles, bedpans, bed-slippers. At the end of duty a nurse must make the report of movement of patients in the department for a previous day. The report of nightly medical sister at a morning conference in the department is very important At a lookout post reception and passing of duties are journalized, in which nurses append the signatures about the reception and passing of duty. Temperature of body, its taking and registration Normal body temperature of healthy man is: in an inguinal area 36,4-36,90С; in the cavity of mouth – 37,1-37,30С in a rectum and vagina – 37,3-37,50С. The lethal (mortal) maximal level of rise of temperature is over 42,50С, minimum – below 330С. There are irreversible violations of exchange of matters and structure of cells, thatincompatibly with the life . Temperature of body takes twice a day usually in the morning between 7.00 and 9.00 and in the evening – 17.00 and 19.00. Sometimes, for the exposure of the latent rheumatism, tuberculosis, and others body temperature is taken by every 2-4 hours. More often the temperature of body is taken in arm-pit .