What parts of the body require particular attention and why?
Pressure areas require attention to prevent pressure sores. The body parts includes the back of the head, shoulder blades, elbow, spine, buttocks and heels. Special beds are used for clients who are in bed permanently or for long periods, and clients are turned frequently. Pressure sores can develop on these areas and become infected and sore. Another area, which requires particular attention, is the lower part of the body as infection and inflammation can develop. If a catheter is in situ, special attention must be given to prevent infection. The mouth also required attention especially if client is taking antibiotics. Care must be taken to prevent infection in the mouth such as thrush, which could lead to the client not being able to eat or drink.
How can a clients; medical condition, age, personal beliefs and preferences affect the degree of assistance required?
Medical condition - This depends if an all-care nursing is required, which means that this is a one to one and 24 hour nursing care. A surgical nursing client requires a high degree of nursing, until able to carry out self-care.
Age - Clients aged 65 or over on the majority requires a high level of degree of assistance. This may include assistance with mobility, personal hygiene simply due to age rather than health matters. Middle-aged clients on the whole require less assistance with mobility and personal hygiene. Children need a high level of degree of assistance. Children need to be supervised and assisted at all times.
Personal Beliefs and Preferences of all clients should be acquired before nursing and their personal beliefs should be respected and carried out.
Why is it important to report any pain/discomfort to an appropriate member of staff?
Pain or discomfort should be reported to an appropriate member of staff as this could indicate a serious health issue, and prompt attention takes priority for the care of the clients. If such an incident is not reported promptly this could lead to the pain or discomfort becoming worse, thus leading to the deterioration of the patients’ care and health. The client may need extra pain killer tablets such as paracetamol. If the client reports pain in the chest this may indicate that they need urgent medical assistance for cardiology treatment. Discomfort in bed may be another source of pain, which should be reported.
Describe what you understand by the terms ‘prosthesis’ and ‘orthoses’ and how would the care you give differ for a patient with either a prosthesis or orthoses?
Prosthesis is the name given for any artificial device that is attached to the body as a substitute for a missing part. It includes artificial limbs, hearing aids, dentures, and implanted pacemaker. An orthoses is a surgical appliance that exerts external forces on part of the body to correct deformity. The care differs slightly, by that some things would have to be done in a different way to the usual way. There are many accessories that can help, benefit the clients care.
What conflicts might arise between the workers personal beliefs and the client’s choice and how can these be controlled?
Conflicts can arise between the worker’s personal beliefs and the client’s choice when a worker discusses with the client the best possible way to give medical care, and the client disagrees with these suggestions and procedure. The client’s choice must be adhered to and care must be adjusted to suit the client. There are many conflicts that might arise; some are how and when the client wants to do something. If the client doesn’t want to do something that would benefit them because there beliefs doesn’t go with the help may be going through the benefit more in depths and how it works, or even going through other treatment that they could get and go through them with negative and positive point would be of benefit.
Other conflict that might arise is what level the clients need, the client may think they don’t need any help with their needs but you might think different. For example if a client wants to get dress, but is struggling with putting the trouser on, they have asked you not to physically help with lifting the trousers up, you could suggest some ways of doing it. . This then can make them feel that they have achieved a task on their own.
How can culture/personal beliefs affect the clients’ choice/methods of maintaining personal cleanliness – what conflicts might arise between client’s choice and this plan of care?
Many cultures, including Muslim, Sikh and Hindu, may forbid washing or bathing in still water as it is considered unclean. A shower instead of a bath, or washing under a running tap may be appropriate methods for respecting this belief. If the client is ill in bed and cannot get to a sink or shower, then a jug of water being poured into a bowl can provide enough running water for a quick wash. Exceptions can be made if the individual is too ill or dependent, but this is not the worker's decision...the appropriate people should be consulted.
Muslims may wish to wash and purify themselves regularly, and bathing arrangements may be private or communal. The Muslim religion also requires that the right hand (the clean hand) be used for eating and the preparation of food, and the left hand (the dirty hand) be used for other procedures, such as cleaning the perineum. This can cause problems if the client only has the use of one arm or hand, as it would be considered unclean to use one hand for both purposes, especially if the client has a colostomy that cannot be tended with one hand. Although the use of disposable gloves may be acceptable for some, specialist advice from the family or religious leader/advisor may be needed.
Before a worker considers a client's standard of hygiene and cleanliness to be below their own, consideration should be given to the individual’s upbringing, habits and methods of cleanliness, which may have been quite different to the worker's. Some people bathe once a day, some once a week, others less than that, but unless the client's choices are likely to cause harm, distress or discomfort to themselves or others, then these differences should be respected. It may be that the apparent neglect of personal hygiene is connected to their religious beliefs, or it could be due to illness or personal choice.
Why is it important for the worker to demonstrate good standards of personal cleanliness?
It is important that the workers demonstrate infection control to perform good standard of personal cleanliness. Good standard of personal cleanliness include clean and tidy uniform should be worn, hand hygiene is performed, hair an nails always kept clean, and hair tied up at all times. All these should be demonstrated to promote good standard of nursing and good standards of personal cleanliness. This shows a good example to the clients.
Why should the client’s toiletries be individual to them and not shared?
All clients’ toiletries should be individual and not shared in order to prevent the risk of cross-infection from one patient to another. It is also important that clients are using toiletries, such as flannels and towels, of their own choice. Client’s toiletries should be kept in their own lockers at all times. Also the client feeling of privacy, individuality is kept by them having their own toiletries.
How does the hospital environment affect a patient’s choice regarding available clothing/toiletries?
When clients have to need an intravenous drip, the patient’s choice of clothing is limited. It is very difficult for the client to wear a long sleeved garment and preferably a short-sleeved garment should be worn or a very loose garment. Slippers must be worn on the ward, to prevent infections. After surgery the use of heavy scented toiletries should be not used in order to avoid risk of infection to the wound.
There are many things that affect the patient’s choice, but there are things that have been adapted to help the individual choice in regarding clothing/toiletries. For example Mrs P can’t bend over to put her tight on after an operation there are many accessories that can help her that is a tight aid. For the client to be comfortable, and have pleasant surroundings and wearing familiar clothing is a great benefit for their recovery.
