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Unit 13 Basic Restorative Services

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1 Unit 13 Basic Restorative Services
Nurse Aide I Course DFS Approved Curriculum-Unit 13

2 Basic Restorative Services
Introduction This unit explores various aspects of restorative care and the role of the nurse aide in this process. Disease, injuries and surgery are often responsible for the loss of a body part or the loss of bodily function. DFS Approved Curriculum-Unit 13

3 Basic Restorative Services (continued)
Introduction Working with the elderly and disabled requires a great deal of patience, caring and understanding from health care workers. Working together to assist the resident to attain the highest possible level of functioning can be a very challenging and rewarding experience. DFS Approved Curriculum-Unit 13

4 DFS Approved Curriculum-Unit 13
Rehabilitation/ Restoration DFS Approved Curriculum-Unit 13

5 DFS Approved Curriculum-Unit 13
Objective 13.0 Demonstrate skills which incorporate principles of restorative care under the direction of the supervisor. DFS Approved Curriculum-Unit 13

6 Rehabilitation/Restoration
Definition - process of restoring disabled individual to highest level of physical, psychological, social and economic functioning possible DFS Approved Curriculum-Unit 13

7 Rehabilitation/Restoration (continued)
Emphasis on existing abilities Encourages independence Promotes productive lifestyle DFS Approved Curriculum-Unit 13

8 Rehabilitation/Restoration (continued)
Goals include: Prevention of complications Retraining in lost skills Learning new skills DFS Approved Curriculum-Unit 13

9 DFS Approved Curriculum-Unit 13
Objective 13.1 Identify the nurse aide’s role in rehabilitation/restoration. DFS Approved Curriculum-Unit 13

10 Rehabilitation/Restoration (continued)
Nurse Aide’s Role Encourage resident Praise accomplishments Review skills taught Report progress or need for additional teaching DFS Approved Curriculum-Unit 13

11 Rehabilitation/Restoration (continued)
Nurse Aides Role (continued) Promote independence praise all attempts at independence overlook failures show confidence in resident’s ability DFS Approved Curriculum-Unit 13

12 Rehabilitation/Restoration (continued)
Nurse Aides Role (continued) Promote independence (continued) be patient and allow time for residents to do things for themselves Be sensitive and understanding DFS Approved Curriculum-Unit 13

13 Self-Care According To Resident's Capabilities
DFS Approved Curriculum-Unit 13

14 DFS Approved Curriculum-Unit 13
Objective 13.2 Provide training in and the opportunity for self-care according to the resident’s capabilities. DFS Approved Curriculum-Unit 13

15 Self-Care According To Resident’s Capabilities
Training in self-care requires that three questions be answered prior to starting: What is the goal to be achieved? What approaches are used to help the resident achieve the goal? How will progress or lack of progress be measured? DFS Approved Curriculum-Unit 13

16 Self-Care According To Resident’s Capabilities (continued)
Resident included in goal-setting process, whenever possible. DFS Approved Curriculum-Unit 13

17 Self-Care According To Resident’s Capabilities (continued)
Functional losses cause: Resentment Anger Frustration Withdrawal Depression Grief DFS Approved Curriculum-Unit 13

18 Guidelines To Assist With Restorative Care And Training
Assist resident to do as much as possible for himself/herself Be realistic Never offer false hope Explain what is going to be done Begin tasks at resident’s level of functioning DFS Approved Curriculum-Unit 13

19 Guidelines To Assist With Restorative Care And Training (continued)
Provide encouragement and reinforcement Praise successes Emphasize abilities Treat resident with respect Explain what resident needs to accomplish, and how you will help. DFS Approved Curriculum-Unit 13

20 Guidelines To Assist With Restorative Care And Training (continued)
Accept residents and encourage them to express their feelings Help to put new skills into use immediately Assist the resident to recognize his or her progress DFS Approved Curriculum-Unit 13

21 Self-Care According To Resident’s Capabilities
Treatment initiated by: Physical therapist Occupational therapist Speech therapist Licensed nurse DFS Approved Curriculum-Unit 13

22 Self-Care According To Resident’s Capabilities (continued)
ADL considerations for resident: Resident to control how and when activities carried out, when possible Use tact in making resident aware of hygiene needs DFS Approved Curriculum-Unit 13

23 Self-Care According To Resident’s Capabilities (continued)
ADL considerations for resident (continued): Encourage use and selection of clothing Be patient and allow time for slower paced activities DFS Approved Curriculum-Unit 13

24 Self-Care According To Resident’s Capabilities (continued)
ADL considerations for resident (continued): Provide for rest periods Assist to exercise Promote independence by having do as much of activity, as possible Encourage use of adaptive devices DFS Approved Curriculum-Unit 13

25 DFS Approved Curriculum-Unit 13
Bowel And Bladder Retraining DFS Approved Curriculum-Unit 13

26 DFS Approved Curriculum-Unit 13
Objective 13.3 Discuss methods for assisting with bowel and bladder retraining. DFS Approved Curriculum-Unit 13

27 Bowel And Bladder Retraining
Incontinence: Inability to control urination or defecation Embarrassing for resident Uncomfortable DFS Approved Curriculum-Unit 13

28 DFS Approved Curriculum-Unit 13
Bowel Retraining Plan developed to assist to return to normal elimination pattern and recorded on care plan Information collected: bowel pattern before incontinence present bowel pattern dietary practices Plan DFS Approved Curriculum-Unit 13

29 Bowel Retraining (continued)
Participants in plan resident family all staff members Plan DFS Approved Curriculum-Unit 13

30 Guidelines For Bowel Retraining
Enemas may be ordered by physician and given by nurse aide, as directed by supervisor Regular, specific times to evacuate bowels established Fluids encouraged on regular basis DFS Approved Curriculum-Unit 13

31 Guidelines For Bowel Retraining (continued)
High bulk foods given, if not restricted fruits vegetables bread bran cereals DFS Approved Curriculum-Unit 13

32 Guidelines For Bowel Retraining (continued)
Bowel aids ordered by physician and administered by licensed nurse only: laxatives suppositories stool softeners Regular exercise encouraged DFS Approved Curriculum-Unit 13

33 Guidelines For Bowel Retraining (continued)
Ways nurse aide can assist with defecation process: offer bedpan on set schedule assist to bathroom when request is made provide privacy display unhurried attitude DFS Approved Curriculum-Unit 13

34 Guidelines For Bowel Retraining (continued)
Ways nurse aide can assist with defecation process (continued): offer warm drink be patient encourage with positive remarks do not scold when accidents happen (abuse) check on resident frequently DFS Approved Curriculum-Unit 13

35 DFS Approved Curriculum-Unit 13
Bladder Retraining Plan developed to assist to return to normal voiding pattern and recorded on care plan Staff must be consistent and follow plan Plan DFS Approved Curriculum-Unit 13

36 DFS Approved Curriculum-Unit 13
Bladder Retraining Individualized plan includes: schedule that specifies time and amount of fluids to be given schedule for attempting to void Schedule DFS Approved Curriculum-Unit 13

37 Guidelines for Bladder Retraining
Get resident’s cooperation Record incontinent times Provide with opportunities to void: when resident awakens one hour before meals every two hours between meals before going to bed during night, as needed DFS Approved Curriculum-Unit 13

38 Guidelines for Bladder Retraining (continued)
Provide for comfortable voiding position Be supportive and sensitive Provide encouragement Offer fluids according to schedule DFS Approved Curriculum-Unit 13

39 Guidelines for Bladder Retraining (continued)
Provide stimuli as needed: run water in sink pour water over perineum offer fluids to drink place hands in warm water DFS Approved Curriculum-Unit 13

40 Guidelines for Bladder Retraining (continued)
Provide good skin care to prevent skin breakdown Retraining may take 6-10 weeks be patient be supportive ignore accidents respect resident’s feelings Week 2 Week 3 Week 1 Week 4 Week 5 Week 6 DFS Approved Curriculum-Unit 13

41 Guidelines for Bladder Retraining (continued)
Follow facility procedure for use of: incontinent pads adult protective pants incontinent briefs DFS Approved Curriculum-Unit 13

42 Activities of Daily Living (ADL)
Adaptive Devices For Assisting With Activities of Daily Living (ADL) DFS Approved Curriculum-Unit 13

43 DFS Approved Curriculum-Unit 13
Objective 13.4 Identify ways to assist the resident in activities of daily living and encourage self-help activities. DFS Approved Curriculum-Unit 13

44 Adaptive Devices For Assisting With Activities of Daily Living (ADL)
Special utensils available to help with eating Electric toothbrushes for brushing teeth Long-handled brushes and combs for hair care DFS Approved Curriculum-Unit 13

45 DFS Approved Curriculum-Unit 13
Adaptive Devices For Assisting With Activities of Daily Living (ADL) (continued) Supportive devices to assist with walking – canes, crutches, walkers Wheelchairs and motorized chairs to provide movement from place to place DFS Approved Curriculum-Unit 13

46 DFS Approved Curriculum-Unit 13
Adaptive Devices For Assisting With Activities of Daily Living (ADL) (continued) Prosthesis to replace missing body parts Successful use of adaptive devices depends on the resident’s: attitude acceptance of limitations motivation support from others DFS Approved Curriculum-Unit 13

47 DFS Approved Curriculum-Unit 13
Ambulation Devices And Transfer Aids DFS Approved Curriculum-Unit 13

48 DFS Approved Curriculum-Unit 13
Objective 13.5 Discuss the various ambulation devices and transfer aids. DFS Approved Curriculum-Unit 13

49 Ambulation Devices And Transfer Aids
Walker - four-point aid with rubber tips Resident stands erect when moving walker forward Walker adjusted to height of hip joint Elbows at degree angle Walker picked up and put down, not slid DFS Approved Curriculum-Unit 13

50 Ambulation Devices And Transfer Aids (continued)
Walker - four-point aid with rubber tips (continued) Back legs of walker even with toes so resident walks into walker Resident steps toward center of walker Leads with weaker leg DFS Approved Curriculum-Unit 13

51 Ambulation Devices And Transfer Aids (continued)
Canes Types: single-tipped tripod - 3 legs quad - four point DFS Approved Curriculum-Unit 13

52 Ambulation Devices And Transfer Aids (continued)
Canes (continued) Used when weakness on one side of body and resident has use of at least one arm Provides balance and support DFS Approved Curriculum-Unit 13

53 Ambulation Devices And Transfer Aids (continued)
Canes (continued) Should be fitted properly: cane handle level with femur (greater trochanter) elbow flexed at 15 to 30 degree angle shoulders level DFS Approved Curriculum-Unit 13

54 Ambulation Devices And Transfer Aids (continued)
Canes (continued) Gaits ordered by physician or physical therapist: move cane and affected leg together move cane, then affected leg Used on side of body where leg is strongest (side opposite the injury) DFS Approved Curriculum-Unit 13

55 Ambulation Devices And Transfer Aids (continued)
Crutches Provide support and stability through use of hands and arms. Used when one or both legs are weak. DFS Approved Curriculum-Unit 13

56 Ambulation Devices And Transfer Aids (continued)
Crutches (continued) Measured to fit properly by physical therapist. height correct if two fingers fit between armrest and axilla hand grip adjusted to allow degrees flexion of elbows DFS Approved Curriculum-Unit 13

57 Ambulation Devices And Transfer Aids (continued)
Crutches (continued) Gaits four-point gait three-point gait two-point gait swing-to gait swing-thru gait DFS Approved Curriculum-Unit 13

58 Ambulation Devices And Transfer Aids (continued)
Crutches (continued) Weight supported on hand bar, not axilla DFS Approved Curriculum-Unit 13

59 Ambulation Devices And Transfer Aids (continued)
Wheelchairs Available in different sizes and models to allow for proper fit and usage Cleaned with mild detergent and water, rinsed with water and dried DFS Approved Curriculum-Unit 13

60 Ambulation Devices And Transfer Aids (continued)
Wheelchairs (continued) Periodic maintenance needed with 3 in 1 oil Arm rests adjusted to appropriate height Feet rest flat on floor when chair is not moving DFS Approved Curriculum-Unit 13

61 Ambulation Devices And Transfer Aids (continued)
Wheelchairs (continued) Seat should not sag toward center of chair Seat should not reach back of resident’s bent knees Brakes locked when chair not moving DFS Approved Curriculum-Unit 13

62 Ambulation Devices And Transfer Aids (continued)
Wheelchairs (continued) Wheelchair guided backwards when going downhill Wheelchair pulled backwards over indented or raised areas (i.e., entrance to elevators) DFS Approved Curriculum-Unit 13

63 Ambulation Devices And Transfer Aids (continued)
Wheelchairs (continued) Feet placed on footrests for transport DFS Approved Curriculum-Unit 13

64 Ambulation Devices And Transfer Aids (continued)
Gurneys/Stretchers/Litters Wheels locked when transferring residents on or off Safety belts secured prior to transfer Both side rails raised prior to transfer DFS Approved Curriculum-Unit 13

65 Ambulation Devices And Transfer Aids (continued)
Gurneys/Stretchers/Litters (continued) Residents never left alone on stretcher Backed head first into elevators DFS Approved Curriculum-Unit 13

66 Ambulation Devices And Transfer Aids (continued)
Gurneys/Stretchers/Litters (continued) Always used with assistance when transferring resident on or off Pushed feet first during transport DFS Approved Curriculum-Unit 13

67 Ambulation Devices And Transfer Aids (continued)
Gurneys/Stretchers/Litters (continued) Guided backwards when going downhill Cleaned with mild detergent and water, rinsed with water and dried DFS Approved Curriculum-Unit 13

68 Ambulation Devices And Transfer Aids (continued)
Gait belt (safety belt, transfer belt) Used for residents unsteady on feet Protects resident who loses balance or faints Held at back DFS Approved Curriculum-Unit 13

69 Ambulation Devices And Transfer Aids (continued)
Gait belt (safety belt, transfer belt) (continued) Must be tight enough to provide support but loose enough to be comfortable Used to safely transfer resident DFS Approved Curriculum-Unit 13

70 DFS Approved Curriculum-Unit 13
Objective Identify safety precautions to be considered by the nurse aide when using ambulatory devices. DFS Approved Curriculum-Unit 13

71 Safety Considerations When Using Ambulatory Devices
Correct aids must be used because they are individually fitted Resident observed closely to be sure aids are being used as ordered Faulty equipment reported and not used until repaired DFS Approved Curriculum-Unit 13

72 Safety Considerations When Using Ambulatory Devices (continued)
Shoes must fit and be in good condition Skin breakdown reported Rubber tips on aids in good condition. DFS Approved Curriculum-Unit 13

73 DFS Approved Curriculum-Unit 13
Demonstration and Return Demonstration DFS Approved Curriculum-Unit 13

74 DFS Approved Curriculum-Unit 13
Objective 13.6 Demonstrate the method used to assist a resident to ambulate using a cane or walker. DFS Approved Curriculum-Unit 13

75 DFS Approved Curriculum-Unit 13
Mechanical Lifts DFS Approved Curriculum-Unit 13

76 DFS Approved Curriculum-Unit 13
Objective 13.7 Discuss the use of mechanical lifts. DFS Approved Curriculum-Unit 13

77 DFS Approved Curriculum-Unit 13
Mechanical Lifts Used for transfer of residents Lower end of sling positioned behind knees Hooks turned away from body DFS Approved Curriculum-Unit 13

78 Mechanical Lifts (continued)
Straps, sling and clasps checked for defects Enough assistance available to assure safe transfer Area checked for safety hazards prior to transfer DFS Approved Curriculum-Unit 13

79 DFS Approved Curriculum-Unit 13
Demonstration and Return Demonstration DFS Approved Curriculum-Unit 13

80 DFS Approved Curriculum-Unit 13
Objective 13.8 Demonstrate the procedure for transferring a resident using a mechanical lift (Hoyer). DFS Approved Curriculum-Unit 13

81 DFS Approved Curriculum-Unit 13
Range of Motion Exercises (Movement of all joints of body) DFS Approved Curriculum-Unit 13

82 DFS Approved Curriculum-Unit 13
Objective 13.9 Perform range of motion exercises as instructed by the physical therapist or supervisor. DFS Approved Curriculum-Unit 13

83 Range of Motion Exercises
Types of range of motion: Active - resident exercises joints without help Passive - another person moves body part for resident DFS Approved Curriculum-Unit 13

84 Range of Motion Exercises (continued)
Purpose of range of motion: Maintains muscle tone Prevents deformities Increases circulation Encourages mobility DFS Approved Curriculum-Unit 13

85 Guidelines When Performing Range Of Motion
Expose only part of body being exercised Be gentle and stop if resident complains of pain Use good body mechanics DFS Approved Curriculum-Unit 13

86 Guidelines When Performing Range Of Motion (continued)
Follow directions from supervisor on number of times each joint to be exercised and how to perform exercises safely, based on each resident’s condition DFS Approved Curriculum-Unit 13

87 Guidelines When Performing Range Of Motion (continued)
Each movement is repeated three times unless otherwise ordered. Support joint as it is exercised Report complaints of pain or discomfort to supervisor DFS Approved Curriculum-Unit 13

88 Guidelines When Performing Range Of Motion (continued)
Exercise joint slowly, smoothly and gently Do not exercise swollen, reddened joints; report condition to supervisor DFS Approved Curriculum-Unit 13

89 Range Of Motion Exercises Types of Joint Movement
Abduction Adduction Extension Hyperextension Flexion Plantar flexion Dorsiflexion Rotation DFS Approved Curriculum-Unit 13

90 Range Of Motion Exercises Types of Joint Movement (continued)
Pronation Supination Eversion Inversion Radial deviation Ulnar deviation Encourage residents capable of doing active ROM exercises DFS Approved Curriculum-Unit 13

91 DFS Approved Curriculum-Unit 13
Demonstration and Return Demonstration DFS Approved Curriculum-Unit 13

92 DFS Approved Curriculum-Unit 13
Objective 13.10 Demonstrate the procedure for performing range of motion exercises. DFS Approved Curriculum-Unit 13

93 DFS Approved Curriculum-Unit 13
Prosthetic Devices DFS Approved Curriculum-Unit 13

94 DFS Approved Curriculum-Unit 13
Objective 13.11 Assist in care and use of prosthetic devices. DFS Approved Curriculum-Unit 13

95 DFS Approved Curriculum-Unit 13
Prosthetic Devices Artificial Eye (glass eye) encourage resident to remove, clean and replace eye prosthesis if able DFS Approved Curriculum-Unit 13

96 Prosthetic Devices (continued)
Eyeglasses  Lens made of glass or plastic  Stored in protective case to prevent damage when not in use  Held by frames DFS Approved Curriculum-Unit 13

97 Prosthetic Devices (continued)
Eyeglasses (continued)  Washed under running water using mild detergent.  rinsed with clear water  dried with tissue or soft cloth  DFS Approved Curriculum-Unit 13

98 Prosthetic Devices (continued)
Eyeglasses (continued) Tops of ears and nose observed for redness or irritation from glasses Wash hands before and after cleansing resident’s glasses DFS Approved Curriculum-Unit 13

99 Prosthetic Devices (continued)
Contact Lenses (hard or soft) Resident encouraged to care for lenses DFS Approved Curriculum-Unit 13

100 Prosthetic Devices (continued)
Contact Lenses (hard or soft) (continued) Unusual observations to be reported: redness itching swelling complaints of pain, blurring, or scratching sensations DFS Approved Curriculum-Unit 13

101 Prosthetic Devices (continued)
Hearing Aid Ear piece cleaned daily with soap and water; this is the only washable part Ear piece and tubing should be soft Wax cleaned from tubing with special equipment DFS Approved Curriculum-Unit 13

102 Prosthetic Devices (continued)
Hearing Aid (continued) Batteries checked for power Skin observed for redness or irritation in or around ear Ear wax build-up reported to supervisor DFS Approved Curriculum-Unit 13

103 Prosthetic Devices (continued)
Removing hearing aid: turn volume to lowest level or off gently lift ear piece up and out of ear use tissues to wipe wax off ear piece store in safe place remove battery when not in use or open battery case DFS Approved Curriculum-Unit 13

104 Prosthetic Devices (continued)
Inserting hearing aid: turn volume toward maximum until whistle is heard replace batteries if whistle cannot be heard turn volume to low setting DFS Approved Curriculum-Unit 13

105 Prosthetic Devices (continued)
Inserting hearing aid (continued): gently insert ear piece into ear canal and adjust for comfort loop over ear for over-the-ear models adjust volume to resident’s satisfaction DFS Approved Curriculum-Unit 13

106 Prosthetic Devices (continued)
Braces Uses support a weak part of the body prevent movement of joint correct deformities prevent deformities DFS Approved Curriculum-Unit 13

107 Prosthetic Devices (continued)
Braces (continued) Materials metal leather plastic Bony parts under brace require protection in order to prevent skin irritation Report any wear noticed and when brace parts are loose or missing DFS Approved Curriculum-Unit 13

108 Prosthetic Devices (continued)
Braces (continued) Shoes custom fitted and checked for: broken shoe laces heels and soles that are worn leather that is worn or torn damage from perspiration odors – stains DFS Approved Curriculum-Unit 13

109 Prosthetic Devices (continued)
Devices for use with amputation Definition of amputation - partial or complete removal of a body part usually arm or leg  below knee most common amputation  DFS Approved Curriculum-Unit 13

110 Prosthetic Devices (continued)
Devices for use with amputation (continued) Examples of prosthetic devices: artificial leg  artificial foot  artificial arm  artificial hand  DFS Approved Curriculum-Unit 13

111 Prosthetic Devices (continued)
Devices for use with amputation (continued) Prosthesis fitted and made for each individual. Devices must be handled with care and stored in appropriate place when not in use. DFS Approved Curriculum-Unit 13

112 Devices For Use With Amputation
Assisting with artificial limbs: have right device check all parts for damage evaluate resident’s limb for irritation and swelling pad area of prosthesis touching resident DFS Approved Curriculum-Unit 13

113 Devices For Use With Amputation
Assisting with artificial limbs (continued): clean according to individual instructions report any needed repairs to supervisor observe and report any skin changes to supervisor DFS Approved Curriculum-Unit 13

114 DFS Approved Curriculum-Unit 13
Prosthetic Devices Breast Forms – used following removal of breast Assist female residents with adjustments of forms when dressing Follow care suggested by manufacturer Keep form separate and in safe place when handling clothing for laundry DFS Approved Curriculum-Unit 13

115 DFS Approved Curriculum-Unit 13
Body Mechanics For Residents DFS Approved Curriculum-Unit 13

116 DFS Approved Curriculum-Unit 13
Objective 13.12 Assist the resident in the proper use of body mechanics. DFS Approved Curriculum-Unit 13

117 Body Mechanics For Residents
Broad base of support leads to better balance and stability Keep weight the same on both feet Stoop using the hips and knees DFS Approved Curriculum-Unit 13

118 Body Mechanics For Residents (continued)
Keep the back straight Lift and carry objects close to body for better balance. Use both hands to lift or move objects Use smooth, even movements DFS Approved Curriculum-Unit 13

119 Body Mechanics For Residents (continued)
Do not bend or reach if injury possible; ask for help Do not twist body to reach an object Keep body in good alignment DFS Approved Curriculum-Unit 13

120 DFS Approved Curriculum-Unit 13
Dangling, Standing and Walking DFS Approved Curriculum-Unit 13

121 DFS Approved Curriculum-Unit 13
Objective 13.13 Provide assistance for the resident with dangling, standing and walking. DFS Approved Curriculum-Unit 13

122 DFS Approved Curriculum-Unit 13
Dangling Dangling - sitting on edge of bed before getting up Standing up too quickly may cause feeling of dizziness and fainting may occur DFS Approved Curriculum-Unit 13

123 DFS Approved Curriculum-Unit 13
Dangling (continued) Dangling for several minutes allows resident to progress to standing and walking without feeling faint Taking deep breaths helps to prevent light-headedness DFS Approved Curriculum-Unit 13

124 DFS Approved Curriculum-Unit 13
Dangling (continued) Most common signs/symptoms if feeling faint: pale face complaints of dizziness or weakness DFS Approved Curriculum-Unit 13

125 DFS Approved Curriculum-Unit 13
Dangling (continued) Return resident to supine position if they have difficulty dangling If dangling is well tolerated, progress to standing position DFS Approved Curriculum-Unit 13

126 DFS Approved Curriculum-Unit 13
Standing Get assistance if resident is weak or unsteady Assist resident to stand by placing your hands under the resident’s arms with hands around the shoulder blades, and use good body mechanics to assist to standing position DFS Approved Curriculum-Unit 13

127 DFS Approved Curriculum-Unit 13
Standing (continued) Have resident stand by side of bed for several minutes prior to ambulating Return to bed or assist to chair if having difficulty standing If standing tolerated, progress to ambulating DFS Approved Curriculum-Unit 13

128 DFS Approved Curriculum-Unit 13
Ambulating Effects on body stimulates circulation strengthens muscles relieves pressure on body parts increases joint mobility improves function of digestive and urinary systems DFS Approved Curriculum-Unit 13

129 Ambulating (continued)
Effects on body (continued) increased independence leads to more positive self-image provides sense of accomplishment prevents lung congestion DFS Approved Curriculum-Unit 13

130 Ambulating (continued)
Encourage to ambulate as much as possible Suggest use of handrails for support DFS Approved Curriculum-Unit 13

131 Ambulating (continued)
If resident starts to fall, ease to the floor by: grasping under arms resting buttocks against nurse aide’s leg sliding down aide’s leg to floor DFS Approved Curriculum-Unit 13

132 Ambulating (continued)
Be prepared to assist, but allow the resident to do as much as possible Safety considerations: use gait belt get assistance if needed allow adequate time for walking so resident does not feel rushed DFS Approved Curriculum-Unit 13

133 DFS Approved Curriculum-Unit 13
Demonstration and Return Demonstration DFS Approved Curriculum-Unit 13

134 DFS Approved Curriculum-Unit 13
Objective 13.14 Demonstrate the procedure for assisting the resident to dangle, stand and walk. DFS Approved Curriculum-Unit 13

135 DFS Approved Curriculum-Unit 13
Cast Care DFS Approved Curriculum-Unit 13

136 DFS Approved Curriculum-Unit 13
Objective 13.15 Provide cast care for the resident. DFS Approved Curriculum-Unit 13

137 DFS Approved Curriculum-Unit 13
Cast Care Cast used to immobilize body part, providing time for part to heal DFS Approved Curriculum-Unit 13

138 DFS Approved Curriculum-Unit 13
Cast Care (continued) Cast materials Plaster of Paris 24-48 hours to dry expands and gives off heat while drying Fiberglass dries rapidly lighter than plaster casts Plastic DFS Approved Curriculum-Unit 13

139 DFS Approved Curriculum-Unit 13
Cast Care (continued) Care of Casts Allow to air dry Keep cast uncovered Use pillows to support cast Support cast with palms of hands DFS Approved Curriculum-Unit 13

140 DFS Approved Curriculum-Unit 13
Cast Care (continued) Care of Casts Never put pressure on cast Turn and position frequently to allow air to circulate around cast DFS Approved Curriculum-Unit 13

141 DFS Approved Curriculum-Unit 13
Cast Care (continued) Maintain good body alignment Keep cast dry Observe cast for rough edges and report Over-bed trapeze provided if appropriate DFS Approved Curriculum-Unit 13

142 Cast Care: Observations To Report To Supervisor Immediately
Drainage Odors Swelling of fingers or toes, inability to move parts Change in color of skin: paleness, cyanosis DFS Approved Curriculum-Unit 13

143 DFS Approved Curriculum-Unit 13
Cast Care: Observations To Report To Supervisor Immediately (continued) Vomiting Elevated temperature Skin irritation around edge of cast DFS Approved Curriculum-Unit 13

144 DFS Approved Curriculum-Unit 13
Cast Care: Observations To Report To Supervisor Immediately (continued) Resident reports of: Pain Numbness Tingling sensations Chills Hot or cold skin Itching Tightness Inability to move fingers or toes Nausea DFS Approved Curriculum-Unit 13

145 DFS Approved Curriculum-Unit 13
Demonstration and Return Demonstration DFS Approved Curriculum-Unit 13

146 DFS Approved Curriculum-Unit 13
Objective 13.16 Demonstrate the proper technique for transferring a resident from a bed to a chair. DFS Approved Curriculum-Unit 13

147 DFS Approved Curriculum-Unit 13
Objective 13.17 Demonstrate the proper technique for transferring a resident from a bed to wheelchair. DFS Approved Curriculum-Unit 13

148 DFS Approved Curriculum-Unit 13
Objective 13.18 Demonstrate the proper technique for transferring a resident from a bed to a stretcher. DFS Approved Curriculum-Unit 13

149 DFS Approved Curriculum-Unit 13
The End DFS Approved Curriculum-Unit 13


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