Preface It is privilege to participate in this project. I began to ask myself about inspiration to write this procedure file. This procedure record is for multipurpose health worker (Female) at 10+2 level students. The main objective of writing this practical manual is to develop skill, under scientific principles in giving care to the patient to render basic Nursing Care. This procedure manual presents the basic Nursing core and specific Nursing core step by step in performing the activities Nursing responsibilities while doing the procedures. It is my mission and hope that this procedure manual will help the students to better performance of nursing procedures. I extend my thanks to our faculty, who helped in brining up this procedure manual to this shape. This procedure manual dedicated to the all Nursing Students. Smt. D. SAROJINI., B. Sc Nursing P.G.D.H.A. PRINCIPAL SCHOOL OF NURSING, GANDHI HOSPITAL, SECUNDERABAD. TABLE OF CONTENT FUNDAMENTALS OF NURSING Page No.s 1. Standard Abbreviations and Symbols 2. Minimum Standards of Performance of Nursing 01 3. Hand Washing Technique (Medical asepsis) 02-03 4. General Rules of Cleaning 04-05 5. Bed Unoccupied – making of 06-08 6. Special Mouth Care 09-11 7. Morning and Evening Care 12 8. Bed Bath 13-15 9. Pediculosis Treatment 16-18 10. Mustard Plaster 19-20 11. Shampoo (Hair Wash) for a bed patient 21-23 12. Arm soak / Foot soak 24-25 13. Turpentine stupe 26-27 14. Temperature-oral, pulse and respiration group technique 28-30 15. Coat Technique 31-32 16. Surgical Dressing 33-36 17. Retention Enema 37-38 18. Bed pan giving and removing 39-41 19. Sitz bath 42-43 20. Colonic Irrigation-One tube method 44-45 21. Colonic –Irrigation –Two tube method 46-47 22. Enemata 48-51 23. Charting 52-54 24. Rectal Suppositories 55-56 25. Siphonage 57-58 26. Flatus tube 59-60 27. Medical Fomentation 61-62 28. Cold compress 63 29. Cold Sponge 64-67 30. Ice Cap 68-69 31. Hot Water bag 70-71 32. Steam Inhalation 72-73 33. Collection of specimen for laboratory examination 74-75 34. Urine testing 76-79 35. Intake and out put record 80-81 36. Use of Kardex 82-83 37. Method of filling kardex card 84-86 38. Medicine Administration by mouth 87-88 39. Policies and routine relating to administration of medicines 89-90 40. Administration of medicine by intra muscular injection 91-92 Medical Surgical Nursing 1. Abdominal Paracentesis 94-96 2. Preoperative skin preparation 97-98 3. Blood Transfusion 99-100 4. Bladder Instillation 101 5. Care of Gravity Drainage from Body Cavity 102-103 6. Bladder Irrigation 104-105 6a. For Intermittent Irrigation over a period of time 106-106 7. Gastric Analysis 107-108 8. Gastric Gavage Gastrostomy Tube Feeding 109-110 9. Gastric Lavage 111-112 10. Administration of medicine by instradermal injection 113-114 11. Intravenous Infusion 115-117 12. Naso Gastric Intubations 118-119 13. Oxygen Therapy 120-121 14. Post-operative Bed 122 15. Preparation of patients for Radiological investigations 123-124 16. Skin preparation 125-127 17. Subcutaneous injection 128 18. Vene-Section 129-130 19. Tidal Drainage 131-132 20. Catheterisation (Female) 133-135 21. Catheterisation (Male patient) 136-137 22. Femoral Retrograde Angiography (Open Method) 138-139 23. Lumber Puncture 140-142 24. Myelogram 143-144 25. Sternal Puncture 145-146 26. Postural Drainage 147-148 27. Thoracentesis 149-151 28. Water Seal Drainage 152-154 29. Principles and Rules to follow while practicing Sterile Technique 155-159 30. Names and Functions of Instruments 160-161 31. Preoperative preparation and draping in operating room 162 32. Statements pertaining to surgical asepsis to be used as guides in Nursing 163-164 33. Scrubbing 165 34. Salvon ‘Hospital Concentrate’ 166-167 35. Draping a Mayo Stand 168 36. Growing 169 37. Gloving 170 38. Kinds of Sutures 172 39. Basic set of Instruments 173 40. Appendectomy 174 41. Gastro-jejunostomy 175 42. Haemorrhoidectomy 176 43. Operation for rectal fistula 177-178 44. Isolation procedures in Communicable Diseases 179-181 45. Colloid or Emollient Baths 182-183 46. Procedure Involving medical asceptic techniques caring for patient with communicable diseases 184-189 47. Ear Drops Instillation 190-191 48. Ear Dry wiping 192 49. Eye Drops Instillation 193-194 50. Eye Irrigation 195-196 51. Eye Ointment 197 52. Nasal Spray 198-199 53. Nose Drops Instillation 200-201 STANDARD ABBREVIATIONS AND SYMBOLS ABBREVIATION DERIVATION MEANING aa ana of each a.c. ante cibum before meals ad ad to up, to ad lib. ad libitum freely as desired aq. aqua water aq. dest. aqua destillata distilled water b.i.d. bis in die two times a day b.i.n. bis in noctis two times a night c. cum with caps capsula capsule comp. compositus compound dil. dilutus dilute elix. elixir elixir ext. extractum extract fid. fluidus fluid Ft. fiat make Gm. Gramme gram gr. granum grain gtt. gutta a drop h. hora hour h.s. hora somni hour of sleep(bed time) M.C. misce mix m. minimum a minim mist. mistura mixture non rep. non repetatur not to be repeated noct. nocte in the night O. octarius pint ol. oleum oil o.d. omni die every day o.h. omni hora every hour o.m. omni mana every morning o.n. omni nocte every night os os mouth oz. uncial ounce p.c. post cibum after meals per per through or by pil. pilula pill p.r.n. pro re nata when required q.h. quaque hora every hour q.2h. every two hours q.3h every three hours q.4h every four hours q.i.d. queter in die four times a day q.s. quantum sufficit as much as is required Rx recipe take thou S. sine without Sig. or S. signa without S.O.S. siopus sit if necessary sp. spiritus spirits ss. semis a half stat. statim immediately syr. syrupus syrup t.i.d. ter in nocte three times a night tr.or tinct. tinctura tincture ung. unguentum ointment vin. vini wine FUNDAMENTALS OF NURSING 1 Fundamentals of Nursing MINIMUM STANDARDS OF PERFORMANCE IN NURSING ARTS LABORATORY I. For the first laboratory practice after class-room demonstration, the student should have. 1. Knowledge of equipment needed. 2. Knowledge of procedure-principles, sequence of performance of procedure and standards of performance expected. 3. Knowledge of underlying principles and application of the same. 4. Appreciation for neatness of work areas and completed work. II. After the first laboratory practice under supervision, the student is expected to practice individually in the free time in the laboratory until she has developed skill in performing and handling the equipment she should be able to perform the procedure within a period specified by the instructor and at the designated standard. III. For the designated procedures, by the date specified by instructor, student must be ready to give a satisfactory return demonstration before they may be allowed to perform the procedure on the ward. IV. Satisfactory performance indicates: 1. Knowledge and application of under lying scientific principles 2. Knowledge of equipment needed. 3. Knowledge of sequence of performance. 4. Ability to adopt procedure to the needs of individuals patients. 5. Gentle and considerate attention to handling the patient. 6. Economical in time, effort and materials. 7. Implementation of good body mechanics for the patient and the Nurse. 8. Neatness in work area and completed work. 9. Accurate concise, clear, complete recording and reporting. 2 Fundamentals of Nursing Hand Washing Technique (Medical Asepsis) PURPOSE: To cleanse the hands to minimize the cross infection to an each patient self and in the environment for aesthetic sense. REQUIREMENTS: 1. Soap in a dish 2. A sink equipped with a tap 3. Towel 4. A nail brush and hand brush 5. A nail file 6. A container with disinfectant 7. A timer. HAND WASHING TECHNIQUE: 1. Stand well away from the sink, turn on the tap and adjust its flow. 2. Wet hands, for arms and, elbow thoroughly. Holding them down ward over the sink to allow the water to run toward the finger tips. 3. Apply enough soap on hands and fore arms to make a good lather. 4. Rinse soap cake and replace to the soap dish. 5. Scrub each hand with the other creating friction by interlacing the fingers and moving the hands back and forth. Continue scrubbing for 1-2 minutes starting from the areas around the finger nails in 3 Fundamentals of Nursing N.B. 1. Washing of the hands should be done for 2 to 3 minutes with a brush if the hands are grossly contaminated. 2. A nail file is used to clean the sub ungula area, if the nails are dirty. 3. Use paper pieces if sink is used with and controlled tap to open or to close the tap, depending up on the areas whether it is clean or contaminated. 4. Scrubbing the hands with a brush is not re-commended for medical aseps is because brushing may force some bacteria into the skin crevices while others are being brushed out. 5. Always use running water as it removes the bacteria and dirt along with soap mechanically. 6. If a tap is not available an assistant is needed to pour the water for hand washing.