Morning care

Definition:
a care provided as patient awaken in the morning. It is often provided after clients breakfast although it
may be before breakfast

Purpose:
• To clean the patient before the physician will visit him/her
• To promote comfort and hygiene
• To help improve self- image
• To give the nurse an opportunity to strengthen the nurse- patient relationship

Principles
• Medical handwashing should not be done before and after the procedure
• Comfort and safety of the client should be considered
• Observe proper body mechanics

PROCEDURE RATIONALE

Assemble all necessary equipment, wash and dry the To save time and energy
hands
Explain the procedure to the client To gain patient’s cooperation
Screen the client and close the door To provide privacy
Don gloves: put up the side rails on the opposite side To avoid contamination and to avoid the patient
from where you stand. Help the client assume a high- from falling
fowlers position, with knee flexed and heels pressed
against the bed. Pie-fold the top linen
Assist the client to lift his buttocks and placing the hand Prevent the patients from acquiring bath pain
under the back slid the bedpan to client’s buttocks.
Place rolled towel on the lumbar area.
Raise the rail and leave signal device and toilet tissue, To provide privacy
place a waste receptacle for tissue paper if stools are for
examination
Remove the bedpan by turning the patient away from Prevents offensive cold and skin irritation.
you, while holding the bedpan firmly. Cover and place
under the foot part of the bed. Clean the perineal area.
Remove gloves
Line the edge of the bed with towel near the working Prevents bed from getting wet
area. Place a paper lining over the towel, then the
basin. assist client in doing hand washing
Place the towel under the clients chin. Put on gloves Prevent cross- contamination from any
microorganisms
Inspect the mouth and teeth, buccal mucusa and gums Facilitates toothbrushing
Identify common oral problems Helps determine type of hygiene that the
client’s needs
Ask the client to hold the kidney basin with his non To assist in toothbrushing
dominant hand, fitting the small curve around the chin
Hand the brush with toothpaste/ denifirice to the client It facilitates removal of plaque and tartar and
(or brush the client’s teeth ). Instruct client to brush the cleanses the surface area of the teeth
teeth and tongue properly
Offer the water cup or mouth wash to rinse the mouth Helps remove debris form patient’s mouth
vigorously
Wipe the client’s mouth with the towel place over the Helps provide cleanliness and neat appearance
chest area
For male client assist in shaving This can be done with patients consent
Place the bath towel under the client’s head. Adjust Prevents bed form getting wet
towel under the chin
Wash the region of the eyes with clear water from the Prevent secretion from entering and irritating
inner to the outer canthus using the different surfaces the nasolacrimal ducts
of the washcloth for each eye. Start from the farther
eye.
Ask if the patient prefer soap to his/ her hair. If not use Soap has drying effect and irritation maybe
plain water in cleaning the face, ears, and neck avoided or matter of personal reference
thoroughly using gentle but firm upward stroke. Rinse
well and dry
Remove face towel and place it on a towel rack Firm upward strokes prevent the skin from
sogging
Comb patient’s hair if unable to do it by himself. Prevent the spread or microorganism
Remove the bath towel by rolling It from the farther
side and straighten the linens
Place patient in a comfortable position. Adjust the table Provide warmth and comfort and privacy in
in preparation for patient’s meal and leave bell near the eating
patient
Do after care of the equipment. Return to it’s proper To prepare for the next use
place
 OFFERING AND REMOVING A BEDPAN AND URINAL

Definition:

This procedure cover and offers an aspect of elimination by providing a barrier to prevent shopping and
irritation and to maintain comfort, modesty, and privacy to the patient.

Purposes:

• Provides facilities for elimination if the patient is unable to use the bathroom or bedside
commode
• Provides privacy and comfort to the patient
• Maintains modesty to the patient

Principles:

• Observe infection control measure throughout for your protection as well as the patient.
• Maintain straightforward attitude and respect the patient’s privacy, keeping exposure to the
minimum
• if bedpan is metal, warm it by rinsing it with warm water

PROCEDURES RATIONALE
Assemble all equipment and place them at the To save time and effort
bedside
Explain the procedure to the client To gain patient’s cooperation
Provide privacy, wash hands and apply gloves To secure the patient’s privacy and to avoid the
spread of microorganisms
Place the bedpan or urinal under the foot part of To avoid the spread of microorganisms because
the bed with paper lining and cover floor is considered contaminated
FOR DISABLED CLIENTS : To prevent muscle strains and promote body
Elevate the head part of the bed to a high- mechanics.
fowler’s position. Pie fold the top sheet. Be sure
the height of the bed is within comfortable
working height. If elevation is contraindicated,
support the client’s back with pillow as needed to
prevent hyperextension of the back
Raise the side rail on the opposite side of the bed To avoid the patient form risk of falling
warm bedpan with warmwater if using a stainless Soiled bedpan makes patient tense thus hinder
bedpan. If using a plastic bedpan, wipe it with a elimination. Poder prevents sticking of the
tissue paper. Powder the rim PRN bedpan to patients buttocks
If the client needs assistance to move into the To facilitate easy insertion of bedpan
bed pan, have him flex his knees and rest some of
his weight on his heels pressed against the bed
Help the client as needed by placing your hand To support the client
under the lower back, resting your elbow on the
mattress, and using your forearm as a lever
Help the client as needed by placing your hand To support the client
under the lower back, resting your elbow on the
mattress, and using your forearm as a lever
Place the bedpan under the client’s buttocks on To avoid back pain
the smooth rounded rim. Place a rolled towel
under the client’s back
Check the placement of the bedpan, if the client To prevent spillage of fluids
is male; the urinal is then properly placed
between slightly spread legs with the bottom of
the urinal resting on bed.
Fix the top sheet, leave a bell/ buzzer and toilet To provide privacy
paper within the client’s reach. Leave the client if
it is safe to do so. Raise the side rails.
When removing bedpan, don gloves. Hold the Prevents transferring of microorganisms into the
bedpan and place the client on his side facing urinary meatus
away from you and wipe the clients perineal area
with several layers of toilet paper. Cleanse form
the urethra ( female client) towards the anus)
Wash the perineal area of the dependent client Washing prevents skin abrasion and excessive
with soap and water as indicated and thoroughly accumulation of microorganism
dry the area. Wash the clients hands by lining the
edge of the bed with a towel. Place over the
towel a paper lining, then the basin. Offer warm
water, soap, rise and dry
Remove the draw sheet if it is a soiled, (with Soiled draw sheet can make patient prone to skin
glove on), roll the sheet towards the opposite irritation.
side of the bed
Move to the opposite side of the bed and remove To make patient comfortable
the soiled sheet. Remove the gloves and replace
with a new cotton draw sheet
Assist the client to a comfortable position. Don Don gloving can prevent direct contact with
gloves , empty and clean the bedpan and return it microorganisms
to the bedside
Remove and discard the gloves and wash your To avoid the spread of microorganisms
hands
For an unconscious client, after doing the To avoid spillage of the fluids
perineal care, apply a diaper
Document the procedure done, date and time, To leave an accurate documentation
the nurse who performed the procedure.
Evaluate the color, odor, amount and clarity of
urine an presence of abnormalities of feces and
the condition of the perineal care