PRACTICAL ARTS 103 - BASIC CAREGIVING

Analog Blood Pressure Monitor

BP Monitor
- designed to monitor blood pressure by measuring the force of the blood in the heart where pressure is greatest. This occurs during the contraction of the ventricles where the blood is pumped from the heart to the rest of the body (systolic pressure). This minimal force is also measured. This occurs during the period when the heart is relaxed between beats and pressures is lowest (diastolic pressure).

Systolic Pressure – is exerted against the arteries during the contraction phase of the heart beat.

Diastolic Pressure – pressure exerted between contractions when the heart muscle is relaxed.


What is blood pressure?
Pressure generated by the heart blood nutrition and oxygen

Unit of measurement: mmHg (millimeters hydrargyrum/millimeters of mercury)
High blood Pressure: 120-139 mmHg (systolic)
80-89 mmHg (diastolic)
Normal Blood Pressure (adult-18 yrs or older): 119 mmHg or below (systolic)
79 mmHg or below (diastolic)



Older Adults (65 & above)
Psychologists have found out that the way people aged is largely a matter of how they live. In many older people, the senses, the eyesight, hearing and taste decline by varying degrees with advancing age. Skin continues to lose the resilience of youth. The lungs can take in as much as oxygen as they once did, and the myocardium heart muscles) contracts less frequently and less forcefully during exercise. It is also true that serious problems can occur in the last decades of life.
Ecclesiastes 12

Midlife (40 -64) The Senescence age
Many things we associate with aging. From brittle bones to forgetfulness and lose of muscle strength are not inevitable results of growing old but are brought on in part by inactivity of physical and mental.

Tips on Changing a Soiled Pad

1. Bend up the patient’s knees.
2. Roll him/her on one side.
3. If you are n the hospital, you have adjust the railing to recline the person on a degree enough for him to sit down.
4. In putting pads, put the half of the pad on the other side of the bed folding the other side of the pad then turn him/her over to the other side and then unfold the folded part of the pad and then back to his/her lying position. In changing the soiled pad, turn him to one side; fold up the other half underneath him up to his back. Underneath him, grab the new one using the same instruction. Turn him up to the ether side, fold up the soiled pad and remove it and then unfold the new pad and back to his normal lying position.

Helping the Patient get seated on the bed

1. Bend up his/her knees.
2. Help them reach his/her arm across their body.
3. Grab his/her shoulders and hips.
4. Roll him/her towards you (ask him/her to hold on something firm).
5. Grab his/her legs off the bed. Have them push up and you push with your hands and bring them up concentrating on using your legs not he upper part of your body.

Transferring the patient from the bed to the chair

1. Use a gate belt or any ordinary belt.
2. Back it around the waist.
3. Make it pretty tight.
4. Give a good hand hold at his/her back then make necessary adjustments if belt is still loose.
5. Make sure that the chair is at an angle so that it is not too far to go.
6. In moving the patient you have guard their body reach underneath their arm grabbing behind down the gate belt then ask them to use their legs to sand up.
7. Keep your knee to block the patient’s knee (you do not pull up the arm, you use the gate belt for holding). From there, take small steps and you hold on to the patient by the gate belt to be secured.
8. Still keeping guard of the patient’s knee, have him reach the chair and slowly sit down guarding her back and of course guarding your back also. Bending your knees and not your back.

Tips on helping the patients walk

1. In ambulating a patient, make sure that they are secures by the gate belt.
2. Wrap up your hand on the top down around the gate belt and give it a tight hold. This way you can control their motion.
3. Your other hand should be underneath their arm. Do not hold them tightly. Just make sure you have a good hold on them.
4. Form this position, begin walking with them and ask them to take small steps as they are being guided by their wheeled walker (move your feet sideways)
5. If they don’t need any help (that is the ambulant), just hold on the gate belt.

Giving a bath to a non ambulant patient

1. Even before bathing a patient, the caregiver has to do a clinical hand washing
2. Remove all jewelries.
3. Fold up your sleeves if you are wearing long sleeves.
4. Gather all the stuff needed within you reach.
a.) paper towels
b.) hand towels
c.) soap, sanitizers, etc.
5. Avoid touching the sink.
6. Get a paper towel to open the faucet.
7. Apply mercurial thermometer to the temperature of the water on washing.
8. Go the patient’s room and have courtesy. (“Sir, I am here to give you a bath on your bed as well as your perennial area.
9. Gather all the materials needed in giving a bath.
10. Take all the vital signs (Pulse rate, Blood pressure, Body temperature).
11. If the vital signs are normal, proceed to the bath.
12. Assuming that the patient is using a hospital bed.
a.) Lock up the wheels
b.) Adjust the height of the bed.
c.) Put down the side range
13. Offer the urinal (pee), bed pan (pooping).
14. If the patient agreed to pee, afterwards check for the blood, smell, color, or mucus. If you don’t find any negative signs, go discard it. Pour it to the toilet bowl.
15. In case of poop, grab the bed pan and put it under their butt. Spread their legs apart.

Transferring Patients without stretchers

A. By the hands and arms without the sheet.
1. Position the patient in such a way that it will be easier for you into one bed to another.
2. See to it that the pillow is placed under the neck or shoulder of the patient.
3. Slip in your hands and arm, reaching to the other caregiver’ hands and arms. Lock them up to give greater strength for the weight of the patient.
4. Begin moving the patient to the other bed, stay close to the bed so that it would not harm your back.
B. By using a king size folded bed sheet
1. Fold up the sheet right in the middle then do another fold.
2. Do many foldings up to the middle of the sheet.
3. Ask the patient to turn on the other side.
4. Put the sheet on his back and ask him to lie down on the other side again.
5. Both the caregivers grab both cord.


Personal Protective Equipment
- is designed to protect employees from serious work place injuries or illnesses resulting from contact with chemical, radiological, physical, electrical, mechanical or other workplace hazards. Besides face shields, safety gadgets, hard hats, and safety shoes, PPE includes variety of devices of devices such as goggles, overalls, gloves, vests, earplug and respirators.

Purpose of Gloves
1. Helps prevent the spread of infections.
2. Protect you – the caregiver
3. Protect the person receiving care – your patient.

Gloves most often are made of latex. They are used once only and they are discarded.

Touching is important
1. It shows love and respect.
2. It shows caring and acceptance.
3. It provides comfort

Gloves prevent contact from:
1. Blood/pathogens
2. body fluids
3. excretions such as urines and feces
4. mucus membrane – from mouth or genitalia
5. non-intact skin

Process in putting a glove
1. Wash and dry your hands.
2. Pull the gloves out with one hand. Slide glove on to other hand.
3. With your gloved hand, pull out another glove.
4. Slide glove on to bare hand.
5. Interlace your fingers to fit in both gloves in your hands to fit more smoothly and comfortably.
Remove your gloves immediately!
1. When procedure is complete.
2. If gloves are heavily soiled.
3. If gloves are torn.
4. Before touching another part of the body.
5. Before touching any clean object
In removing your gloves, your intention is avoiding to touch your bare hand with your contaminated gloves. To take it off:
1. Grip glove at base of the palm and pull it off inside out
2. Slip bare fingers under wrist without touching the surface.
3. Push the glove down and off. One glove is inside of the other.
4. Drop gloves in bag and seal tightly.
5. Drop bag in trash.
6. Wash your hands clinically.

Perennial Wash

1. Take heed of the doctor’s instructions in cleaning the urethral metus.
2. Wash and dry your hands.
3. Assemble the following equipments:
• Pair of disposable gloves
• Bed protector
• Sealable plastic storage bag
• Basin with warm soapy water.
• 2 clean wash clothes
• 1 towel
4. Place the equipment tray on stable surface adjacent to the bed.
5. Remove the bed covers but keep the patient warm with private cover.
6. Remove your disposable gloves and wash and dry your hands again. Put on another set of gloves.
7. Place bed protector under patient’s thighs covering the perinial and annul parts of the body to keep the bed dry.
8. Place on a triangular meet over your hand and squeeze washed cloth in soapy water.
9. With the other hand, gently grasp the male genitalia (male patient) and retract foreskin. Hold the foreskin back if the patient is uncircumcised and with the warm soapy mitt and clean the glands or the head of the penal.
10. Rewash the mitt and clean the first four inches of the catheter without pulling on it.
11. Dry the genitalia with a clean towel (of course you have to repeat the process by a deliberate washing and cleaning of the part).
12. To make the patient move comfortable, ask the patient to turn on his other side and put the other leg higher than the other.
13. The perineum and the anus can now be cleaned
14. The second wash cloth is a mitt. Wash from top to bottom and have a great care and be careful not to touch the cleaned area already.
15. Dry and clean the area carefully with a clean towel.
16. Remove the bed protector.
17. Check the catheter – tube connection.
18. Remove your gloves and discard them in the garbage bag. Take the equipment tray into the bathroom.
19. Place the wash cloths and towel in washer.
20. Seal the plastic bag and discard in into the trashcan.
21. Clean the basin which held the warm soapy water and dry it with a paper towel.
22. Wash and dry the bed protector.
23. Wash and dry your hands.

Tips on Transferring depending on the patient’s mobility

Body Mechanics
- The way that you position and use your body to perform a movement or an activity. It is important to know the right body posture in order not to strain your back and for keeping yourself safe as well as your patient.

Four Important Things:
a. Keep your feet apart
- To have a wide base support
- To make your body balanced and stability stronger
b. Bend your knees and keep your back straight.
- The moment that you bend your back, it will receive the weight (good bodily ergonomics)
- Helps you use the stronger muscle
- Keeping your back straight prevents you form using the weaker muscle to do the work.
c. Keep the object or weight close to you.
- Keep the object close to the center of you gravity taking the job easier.
d. Place feet in weight direction.

Safety Considerations
1. Know your patient’s ability.
2. Have an equipment needed available ready for the transfer.
3. Inspect the equipment.
4. Do a visual inspection whether the adjustments are done already.
5. Keep surfaces level.
6. Have the wheelchair locked, also when not in use.
7. In moving a patient to a chair, see to it that the back of the chair is put against the wall to a secure surface.
8. Put non-skid shoes.
9. Have patients dressed up properly.

Monitor Your Blood Sugar

Knowledge helps you plan or modify medication, diet and exercise.

Equipments used:
• Glucose Testing Meter
• Packet of test strips
• Automatic Lancing Device
• Facial tissue

Steps in Getting your Blood Sugar
1. Code the meter.
This is done by following the manufacturer’s instruction found in manual. Use the mater to calibrate and match a meter number on a meter’s display. Coding is done whenever a new package of test strips is opened and daily to check coding to ensure the codes correctly. Check if the whole system is working correctly. Practice good meter technique and follow manufacturer’s instructions.
2. Wash your hands vigorously and dry it with a towel.
3. Remove test strip from its package.
4. Insert test strip into test a lot of meter. This usually turns the meter on.
5. Remove the end cap from lancing device.
6. Insert a short lancet into lancet holder. Twist off the protective cap and sve it for the disposal of the lancet.
7. Replace the end cap.
8. Re-cock the lancing device.
9. Choose your puncture site. The sides of the end segments of the fingers are the best sites.
10. Place the end cap against the puncture site.
11. After the puncture, remove the lancing device. If the blood does not pour on its own, stroke down the fingers towards the puncture site without going as far as beside it.
12. Hold tip of the test strip in the drop of blood unlit the meter tells you it’s filled. You will usually know this by beeping. Remove the test strip from the blood and the strip aside until the reading is complete.
13. Wipe the puncture site with clean dry tissue and hold pressure to it unlit the bleeding stops.
14. Remove the end cap and the lancet.
15. Replace the used lancet in protective cap.
16. Once the reading is complete, grasp and pull the test strip out meter. Use the tissue. This usually turns the meter off.
17. Discard the lancet in puncture –proof container.

Remember:
1. Clean the lancing device weekly according to the instructions.
2. Use only the lancet once.
3. Do not use the same end cap to another person.
4. Teach another person to use the whole system so you have a backup when you need assistance.

What are normal blood sugar levels?
Fasting (blood sugar level after not eating for eight hours) blood sugar should be between 70 mg per deciliter to 100mg/dl. Your blood sugar should not be above 100 at any given time. If it is, this suggest a pre-diabetes condition. A level of 100-199 suggests pre-diabetes. A level over 200 suggests that you have either Type 1 or Type 2 diabetes.

Steps in lowering your blood sugar level
1. Begin slowly lowering your carbohydrate intake.
2. Test your blood sugar more frequently.
3. Pay attention to how and when your type of insulin works.
4. Stop snacking and limit yourself to 3 meals per day. Snacking is habitual and it can be easily be broken.