Patient care 6p version (13 lessons)
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Questions and Answers

What is the reason for building more healthcare institutions in Singapore?

To handle the increasing population and demand for healthcare services.

Which sectors provide healthcare services in Singapore? (Select all that apply)

  • Public Hospitals (correct)
  • Voluntary Welfare Organisations (correct)
  • International NGOs
  • Private Sector (correct)

    • What types of healthcare institutions exist in Singapore? (Select all that apply)

  • Nursing Homes (correct)
  • Hospitals (correct)
  • Research Institutes
  • Polyclinics (correct)

    • What is one way hospitals are structured to provide services?

    <p>By organizing the public healthcare system into integrated clusters.</p> Signup and view all the answers

    The typical process flow for patients seeking treatment includes registration, consultation, ______, and discharge.

    <p>treatment</p> Signup and view all the answers

    How can technology improve healthcare service delivery?

    <p>By implementing systems like e-tracking and ensuring better patient management.</p> Signup and view all the answers

    The private sector in Singapore provides 80% of primary care services.

    <p>False</p> Signup and view all the answers

    What are some risks in implementing healthcare technologies? (Select all that apply)

    <p>Network connectivity issues</p> Signup and view all the answers

    What is the purpose of community care in the healthcare system?

    <p>To manage non-critical cases and improve resource allocation.</p> Signup and view all the answers

    Name two tools required to facilitate technology use in healthcare.

    <p>LCD TV and CCTV.</p> Signup and view all the answers

    What does quality assurance in hospitals involve?

    <p>Accreditation under various standards to ensure safe and efficient work processes.</p> Signup and view all the answers

    List one medical protection scheme available in Singapore.

    <p>MediShield.</p> Signup and view all the answers

    Which systems are included in the systemic inquiry checklist?

    <p>Cardiovascular system</p> Signup and view all the answers

    It is important to ask open-ended questions when taking a patient's medical history.

    <p>True</p> Signup and view all the answers

    What is the importance of communication in the healthcare setting?

    <p>Good communication ensures that information is accurately conveyed and understood between healthcare professionals and patients.</p> Signup and view all the answers

    Match the types of pain with their descriptions:

    <p>Nociceptive pain = Arises from specific pain receptors such as heat and touch Visceral pain = Originates from internal organs and is poorly localized Somatic pain = Associated with tissues and well localized Neuropathic pain = Results from nerve damage or dysfunction</p> Signup and view all the answers

    Pain is classified into __________ and __________ pain.

    <p>nociceptive, non-nociceptive</p> Signup and view all the answers

    What are the characteristics of somatic pain?

    <p>Often sharp and well localized, can be reproduced by touching or moving the area.</p> Signup and view all the answers

    Define visceral pain.

    <p>Visceral pain originates from internal organs and often feels like a vague deep ache.</p> Signup and view all the answers

    What type of pain originates from within the nervous system itself?

    <p>Neuropathic pain</p> Signup and view all the answers

    Pain scales help patients describe their perception of __________.

    <p>pain</p> Signup and view all the answers

    What is percussion?

    <p>Percussion is tapping using the middle finger of one hand onto the middle finger of the other hand and listening to the sounds.</p> Signup and view all the answers

    What does a dull sound in percussion indicate?

    <p>Presence of fluid</p> Signup and view all the answers

    A hollow sound on percussion indicates a fluid-filled area.

    <p>False</p> Signup and view all the answers

    List the four basic vital signs.

    <p>Temperature, pulse rate, respiration rate, blood pressure.</p> Signup and view all the answers

    What type of questions does the Behavioral Pain Assessment Scale use?

    <p>Open-ended questions</p> Signup and view all the answers

    What is described as a self-reported pain scale that shows a series of faces?

    <p>Wong-Baker 'Faces' Scale</p> Signup and view all the answers

    What are common methods of anesthesia?

    <p>Local, regional, and general anesthesia.</p> Signup and view all the answers

    What is the purpose of a nasogastric tube?

    <p>To feed and aspirate gastric juice contents.</p> Signup and view all the answers

    What is a key advantage of using verbal intensity pain scales?

    <p>Quick and simple to use</p> Signup and view all the answers

    What should be done to care for a nasogastric tube post-insertion?

    <p>Rinse the mouth regularly, ensure proper positioning, change tapes regularly, and check patency.</p> Signup and view all the answers

    The Visual Analog Scale can be administered electronically.

    <p>True</p> Signup and view all the answers

    What is an urinary catheter?

    <p>A tube inserted through the urethra into the urinary bladder to collect urine.</p> Signup and view all the answers

    What are some common infectious diseases mentioned?

    <p>Avian influenza, Cholera, Dengue fever, Hand-foot and mouth disease, Hepatitis, SARS, Ebola</p> Signup and view all the answers

    The sound of added noises like crepitations in pneumonia can be detected during __________.

    <p>auscultation</p> Signup and view all the answers

    Infectious diseases can be transmitted via _____ or contaminated food.

    <p>bites from insects</p> Signup and view all the answers

    What is meant by 'personal protective equipment'?

    <p>Barriers used to protect from infectious agents</p> Signup and view all the answers

    How do you assess a patient’s vital signs?

    <p>By measuring and recording temperature, pulse rate, respiration rate, and blood pressure.</p> Signup and view all the answers

    Which of the following are methods to prevent the spread of infection in healthcare? (Select all that apply)

    <p>Proper personal hygiene</p> Signup and view all the answers

    What is palpation?

    <p>The act of feeling organs or body parts to assess size, consistency, texture, location, and tenderness.</p> Signup and view all the answers

    What is the correct sequence of putting on PPE?

    <p>Good hand wash technique → Good fitting mask → Eye wear → Gown → Gloves</p> Signup and view all the answers

    The Numerical Rating Scale is a type of self-reported pain scale.

    <p>True</p> Signup and view all the answers

    What was David suspected of having?

    <p>stroke</p> Signup and view all the answers

    What approach is important when taking David's history?

    <p>sensitive communication</p> Signup and view all the answers

    What are the alternative terms for illness?

    <p>all of the above</p> Signup and view all the answers

    Match the following types of illnesses with their definitions:

    <p>Acute illness = Sudden onset and short duration Chronic illness = Long lasting or recurrent over a long period Acute treatment = Short term treatment Chronic management = Requires long term treatment and holistic management</p> Signup and view all the answers

    Chronic illnesses generally require less medical care compared to acute illnesses.

    <p>False</p> Signup and view all the answers

    What are the stages of illness according to the Kubler-Ross model?

    <p>Denial, Anger, Bargaining, Depression, Acceptance</p> Signup and view all the answers

    Which of the following is a possible psychological effect of stroke?

    <p>Depression</p> Signup and view all the answers

    What are the obligations of the sick person in the sick role mentality?

    <p>Try to get well and seek competent help</p> Signup and view all the answers

    The main types of communication in healthcare are ______, non verbal communication, and written communication.

    <p>verbal communication</p> Signup and view all the answers

    What is documented in the case notes?

    <p>Patient's past medical history and current medical records</p> Signup and view all the answers

    Why is good communication crucial in healthcare?

    <p>All of the above</p> Signup and view all the answers

    What should the drug history section in a patient's case notes include?

    <p>List of medications and any drug allergies</p> Signup and view all the answers

    The sick person is responsible for their condition according to the Parson's sick role mentality.

    <p>False</p> Signup and view all the answers

    What are the post care instructions after a urinary catheter insertion?

    <p>Make sure that urine is flowing out of the catheter into the drainage bag. Check for inflammation or signs of infection around the urethra. Keep the urinary drainage bag below the level of the bladder and ensure it does not drag on the catheter. Provide antibiotic cover for prevention of infections.</p> Signup and view all the answers

    What is a colostomy bag?

    <p>A colostomy bag is a pouch fitted to a stoma that collects feces after part of the colon has been removed surgically.</p> Signup and view all the answers

    Why was a colostomy bag fitted on Fred?

    <p>Fred had colon cancer, necessitating a hemicolectomy, which disrupted normal colon functions, and a colostomy was created to facilitate waste removal.</p> Signup and view all the answers

    What are the post care instructions after a colostomy bag insertion?

    <p>Always wash hands before tending to the stoma, keep the site clean and dry, use warm water to clean gently, eat a high-fiber diet, and dispose of used bags properly.</p> Signup and view all the answers

    What should be done to ensure proper care of the stoma?

    <p>Ensure proper training on stoma care, encourage following diet rules, and consider the psychological impact on the patient.</p> Signup and view all the answers

    What are the post care instructions after inserting a pacemaker?

    <p>Avoid pressure on the site, keep the incision clean and dry, monitor for infection signs, and avoid electrical appliances that may affect the device.</p> Signup and view all the answers

    What is a tracheostomy tube?

    <p>A tracheostomy tube is a device inserted into the trachea to facilitate breathing in patients who have a blockage.</p> Signup and view all the answers

    What are the post care instructions after inserting a tracheostomy tube?

    <p>Keep the site dry, monitor for blockages and infection, check tube positioning regularly, observe for distress, and ensure the balloon cuff is inflated.</p> Signup and view all the answers

    What is an oxygen mask?

    <p>An oxygen mask is a device that delivers oxygen to patients and comes in types like non-rebreathing and partial rebreathing masks.</p> Signup and view all the answers

    Which of the following are post care instructions after inserting a pacemaker? (Select all that apply)

    <p>Keep the incision site clean and dry</p> Signup and view all the answers

    Study Notes

    How to Define Illness

    • Illness is the impairment of normal living functions affecting a person's vital processes.
    • Commonly refers to a disease, disorder, medical condition or another alteration of state.
    • Illness can hinder or modify the performance of essential bodily functions such as circulation and respiration.

    Manifestations of Diseases

    • Manifests by distinguishing signs and symptoms.
    • Occurs as acute or chronic types.
    • Caused by:
      • Environmental factors (e.g., malnutrition, industrial hazards, climate)
      • Specific infective agents (e.g., worms, bacteria, viruses)
      • Inherent defects of the organism (e.g., genetic anomalies)
      • Combinations of these factors

    Acute vs. Chronic Illnesses

    • Acute illnesses are of sudden onset and short duration.
      • Require short-term treatment.
      • Examples: Acute Renal (Kidney) Failure, Acute Myocardial Infarct, Acute Hepatitis, Acute Upper Respiratory Disease, Acute Bronchitis, Acute Respiratory Distress Syndrome, Acute Lymphocytic Leukaemia
    • Chronic illnesses have long-lasting effects or recur over a long period of time.
      • Require long-term treatment and holistic management.
      • Examples: Chronic Renal (Kidney) Failure, Coronary Artery Disease, Chronic Cardiac Insufficiency, Diabetes, Chronic Hepatitis, Asthma, all types of cancer (malignant tumors)

    Stages of Illness

    • Kubler-Ross 5 Stages of Grief applied to chronic illness:
      • Denial: Avoidance, unrealistic expectations, emotional overload.
      • Anger: Tantrums, mood swings, rebellion, random anger.
      • Bargaining: Negotiation, charity, prayer, seeking a lesser sentence.
      • Depression: Mood swings, withdrawal, crying, anxiety attacks, regret, fear, uncertainty.
      • Acceptance: Calm, reflective, prepared, close to others, stable, bucket list.
    • Identifying these stages can help patients cope from one stage to another.

    Biopsychosocial Stages Encountered

    • Biological: Physical effects of the chronic illness.
    • Psychological: Changes in emotions and thoughts due to the illness.
    • Social: Adaptations to live with the condition and receive medical care.

    Biopsychosocial Stages: Examples

    • Kidney failure: Fatigue, wheelchair-bound, dialysis, medications.
      • Possible psychological effects: Depression, feeling useless, hopelessness, guilt, loss of ability to work, dependence on caregivers, costs.
    • Stroke: Loss of functions, cognitive changes.
      • Possible psychological effects: Depression, hopelessness, anger at self, loss of function, dependence on others.
    • Cancer: Fatigue, weight loss, pain.
      • Possible psychological effects: Depression, sense of doom, denial, guilt, fear of death, pain, costs.
    • Heart disease: Fatigue, decrease in function, pain.
      • Possible psychological effects: Denial, depression, fear, guilt.
    • Diabetes: Fatigue, weight loss, complications.
      • Possible psychological effects: Depression, denial, guilt, stereotyping, needles, costs, lifestyle change.

    Holistic Care and Support

    • Healthcare professionals play different roles in holistic care.
      • Case Managers: BioPsycho Support groups and programs
      • Physiotherapists: BioPsycho
      • Occupational Therapists: BioPsycho
      • Patient Counselors: Social
      • Psychologists: Psychosocial
      • Social workers: Social
      • Medical staff: Medical

    Parson’s Sick Role Mentality

    • Acceptance of the sick role: Individually is not only physically sick but adheres to social expectations of being sick.
    • Rights of the sick person:
      • Exempt from normal social roles
      • Not responsible for their condition
    • Obligations of the sick person:
      • Try to get well
      • Seek competent help
      • Cooperate with medical professionals

    Types of Communication

    • Verbal communication: Speaking, tone of voice, specific sounds.
    • Nonverbal communication: Body language, posture, eye contact, touch, actions, often subconscious.
    • Written communication: Writing, art, drawings, SMS, WhatsApp, Email

    Importance of Communication in Healthcare

    • Between healthcare professionals and patients:
      • History taking and physical examination involve verbal and nonverbal communication.
      • Explaining conditions to patients requires tact and understanding.
      • Illness can impair communication ability.
      • Confidentiality and patient integrity must be maintained.
    • Amongst healthcare professionals:
      • Handover of patients during shift changes.
      • Discussions between healthcare colleagues about patients' conditions and medical reports.
      • Written case notes that chart the health progress of the patient.

    Benefits of Good Communication in Healthcare

    • Puts patients at ease.
    • Allows for more openness from the patient.
    • Determines patient anxiety level.
    • Minimizes misunderstandings.
    • Ensures no miscommunication of treatment plans, diagnoses, or drug prescriptions.
    • Prevents malpractice suits.

    Importance of the Case Note

    • Legal document: Contains confidential patient health information.
    • Historical record: Tracks past and current medical records.
    • Documentation: Notes drug allergies, previous treatments, surgeries.
    • Health progress card: Refers for healthcare professionals.

    Sections of a Patient’s Medical Case Notes

    • Systematic Enquiry:
      • History of presenting complaint: Questions about the patient's current complaint.
      • Social history: Occupation, marital status, habits (smoking, alcohol, exercise, sexual practice).
      • Past medical history: Medical conditions (acute or chronic diseases, surgeries, hospital admissions).
      • Family history of diseases: Genetic factors.
      • Drug history: Medications, drug allergies.
    • Systemic Enquiry: Checklist of questions broken down by body systems:
      • Integumentary system
      • Locomotor system
      • Cardiovascular system
      • Respiratory system
      • Gastrointestinal system
      • Nervous system
      • Endocrine system
      • Genitourinary system

    How to Systematically Record Case Notes

    • Be aware of: Common medical terminology, correct history-taking techniques, communication skills required in healthcare.
    • Consider: Multiple healthcare professionals may be present during history taking, ensuring patient consent is obtained.
    • Questioning technique:
      • Open-ended/non-leading questions to let the patient tell their story.
      • Avoid judgmental language and maintain confidentiality.
      • Be sensitive when asking questions, especially to the opposite gender.

    Documenting Patient Case Notes

    • Current approach: e-documentation (EPIC System).
      • Electronically entered.
      • Central source of information for patients' care from admission to discharge.
      • Analytics for patient and disease management.
      • Security controlled access.
      • System prompts for alerts (e.g., drug allergies).
      • Generates billing invoices.

    Helping a Patient

    • Approach with care and sensitivity.
    • Communicate effectively: Obtain information respecting verbal and nonverbal cues.
    • Be sympathetic and empathetic: Listen to the patient's plight.
    • Document accurately: All aspects of the patient's condition in the case notes.
    • Use proper terminology: Ensures all healthcare professionals understand and follow up accordingly.

    Key Learning Objectives

    • Define disease: and the types of disease.
    • Define: signs, symptoms, and syndrome with examples.
    • Explain: Psychological implications and social adjustments during chronic illness.
    • List: Acute and chronic illnesses and their accompanying psychosocial impacts.
    • Explain: The Kubler-Ross model for grief and its application to helping patients with chronic illness.
    • Explain: The BioPsychoSocial Model in chronic illnesses.
    • Apply: The principles of Parson's "sick role."
    • Evaluate: Condition-specific psychosocial implications and discuss varied approaches to care (e.g., pediatric conditions, chronic vs. acute conditions, psychiatric conditions).

    Communication in Healthcare

    • Communication can be verbal, nonverbal, and written.

    • Verbal communication involves spoken words.

    • Nonverbal communication includes body language, facial expressions, and gestures.

    • Written communication involves letters, emails, and reports.

    • Importance of good communication: Effective communication is essential for building trust with patients, providing accurate information, and coordinating care.

    Medical/Case History Taking

    • Function of medical/case history taking: Gathering information about a patient's health history, including past illnesses, medications, and family history to help diagnose and treat the patient.

    Systemic Inquiry

    • Basic categories of information collected during systematic inquiry:

      • Presenting complaint/chief complaint: The reason for the patient's visit.
      • History of Present Illness (HPI): Detailed description of the patient's current symptoms.
      • Past Medical History (PMH): Previous illnesses, surgeries, and injuries.
      • Family History (FH): Health conditions in the patient's family.
      • Social History (SH): Lifestyle, habits, and environment.
      • Medication History (MH): Current and past medications.
      • Allergies (ALL): Patient's allergies.
      • Review of Systems (ROS): A systemic inquiry about each body system.

    • Components of systematic inquiry in patients' medical case notes:

      • Subjective (S): Patient's own report of their symptoms.
      • Objective (O): Healthcare provider's observations of the patient.
      • Assessment (A): Healthcare provider's interpretation of the patient's condition.
      • Plan (P): Course of action to address the patient's health condition. This could include medication, treatment, further testing, or referral to a specialist.

    Closed vs. Open-Ended Questions

    • Closed questions: Questions that can be answered with a "yes" or "no" or a short, specific answer. They are useful for eliciting specific information and confirming details.
    • Open-ended questions: Questions that invite a detailed explanation or opinion. Helpful for understanding the patient's perspective and gathering comprehensive information.

    Pain and Pain Assessment

    • Definition of pain: An unpleasant sensory and emotional experience associated with actual or potential tissue damage.

    Different Types of Pain

    • Nociceptive pain: Arises from stimulation of specific pain receptors in response to stimuli like heat, cold, stretch, or touch.
    • Non-nociceptive pain: Occurs due to actual nerve damage.
    • Somatic pain: Originates from tissues such as skin, muscles, joints, bones, and ligaments.
    • Visceral pain: Arises from internal organs within the main body cavities.
    • Neuropathic and Sympathetic pain: Occurs due to problems within the nervous system itself.

    Pain Scales

    • Used to measure a patient's experience of pain.
    • Common types:
      • Verbal intensity scale: Descriptive, uses numbers assigned to pain levels.
      • Visual analog scale: A line representing pain intensity.
      • Numerical rating scale: A numerical scale ranging from 0 to 10 or higher.
      • Wong-Baker ‘Faces’ Scale: Uses faces to represent pain levels.
      • Behavioral Pain Assessment Scale: Uses open-ended questions to assess the impact of pain on the patient.

    Infectious Diseases

    • Diseases caused by organisms such as bacteria, viruses, fungi, or parasites.
    • Transmission routes:
      • Person-to-person.
      • Animal or insect bites.
      • Contaminated food or water.
      • Environmental exposures.

    Preventing the Spread of Infection

    • Chain of infection: The sequence of events that contribute to the transmission of an infectious disease.
    • Breaking the chain of infection involves interrupting the transmission cycle at one or more points.
    • Personal Protective Equipment (PPE): Includes barriers like gloves, gowns, masks, and eye protection to protect healthcare professionals from infectious agents.
    • Hand hygiene: Frequent and thorough washing of hands is essential to prevent the spread of infection.

    Safety Practices for Healthcare Professionals

    • Infection control: Strategies used to prevent the transmission of infectious diseases.
    • Standard precautions: Guidelines for infection control, including hand hygiene, use of gloves, and PPE.
    • COVID-19 patient precautions: Special precautions implemented when caring for patients with COVID-19.

    Physical Examination

    • Inspection: Visual examination of the patient.
    • Palpation: Using touch to assess the patient's body.
    • Percussion: Tapping on the body to assess underlying structures.
    • Auscultation: Listening with a stethoscope to sounds produced by the body.
    • Vital signs: Measurements like temperature, pulse, respiration, and blood pressure used to assess the patient's health status.

    Empathetic vs. Sympathetic Language

    • Empathy: Understanding and sharing the feelings of another person. It involves putting yourself in their shoes and acknowledging their emotions.
    • Sympathy: Feeling sorry for someone else, but not necessarily understanding their feelings.

    Challenges in Communicating Bad News

    • Delivery of bad news: Sharing sensitive or difficult information with patients.
    • Ethical Considerations: Honesty, clarity, and compassion are essential when communicating bad news.

    Patient Confidentiality

    • Healthcare privacy: The legal and ethical right of patients to have their health information kept confidential.
    • HIPAA (Health Insurance Portability and Accountability Act): Federal law protecting the privacy of patient health information.

    Communication Etiquette in Digital Communication

    • Professional conduct: Maintaining appropriate communication behaviors when using digital devices for healthcare purposes.
    • Respectful language: Avoiding slang, informal language, and unprofessional communication.
    • Privacy and security: Protecting confidential information and ensuring secure communication.

    Communication Skills in Healthcare

    • Verbal communication: Using clear and concise language, active listening, and effective questioning.
    • Non-verbal communication: Maintaining eye contact, using appropriate body language and facial expressions, and demonstrating empathy.
    • Written communication: Using professional and accurate language in medical documentation.

    Communication Barriers in Healthcare

    • Language barriers: Difficulty understanding or communicating due to different languages.
    • Cultural differences: Variations in communication styles and perspectives.
    • Cognitive impairments: Difficulties with understanding or processing information.
    • Hearing or vision impairments: Challenges with receiving information.

    Overcoming Communication Barriers

    • Using interpreters: Providing translation services for non-English speakers.
    • Adjusting communication style: Adapting communication strategies to the patient's needs.
    • Using visual aids: Employing images or diagrams to convey information.
    • Patiently explaining: Taking time to explain information clearly.

    Non-Verbal Cues

    • Facial expressions: Can indicate pain, anxiety, or confusion.
    • Body language: Can reflect discomfort, pain, or reluctance to move.
    • Vocal tone and pitch: Variations can indicate changes in health status or distress.
    • Eye contact: Lack of eye contact can suggest pain, disorientation, or fatigue.

    Fred's Condition

    • Fred had stage 2 colon cancer and was scheduled for a partial hemicolectomy.
    • The surgery was to be performed under general anesthesia (GA).

    Pre-Surgical Procedures

    • Fred was to have the following inserted for the surgery:
      • Nasogastric (NG) tube
      • Urinary catheter
      • Stoma bag

    Post-Surgery Complications

    • Fred developed complications during surgery with respiration due to GA.
    • He developed a tension pneumothorax causing his oxygen saturation to fall.
    • The anesthetist noted the complications.

    Immediate Intervention Plan

    • Rescue and reduce the pneumothorax: This refers to treating a collapsed lung, a condition where air leaks into the space between the lung and chest wall.
    • Monitor the O2 saturation: Keeping a close eye on the patient's oxygen levels in the blood.
    • Provide immediate increased levels of oxygen: Delivering supplemental oxygen to improve respiratory function.

    Devices

    • Nasogastric Tube (NG Tube):
      • A tube inserted through the nose and into the stomach for feeding and aspirating gastric contents.
      • Fred's NG tube assists in aspirating gastric secretions and providing liquid food post-operatively due to poor intestinal function after surgery.
    • Urinary Catheter:
      • A tube inserted through the urethra into the bladder to collect urine.
      • Used for patients with urinary obstruction, retention, post-surgery, or critical illness to monitor urine output.
      • Fred likely had a urinary catheter to monitor his urine input and output following surgery.
    • Colostomy Bag:
      • A bag fitted onto the stoma, a passage created after hemicolectomy (partial colon removal) to allow for waste evacuation.
      • Fred's colostomy was necessary due to colon cancer and its potential to affect other organs.
    • Pacemaker:
      • An electronic device implanted to correct abnormal heart rhythms like atrial fibrillation.
      • Pacemaker electrodes stimulate the heart's atria and ventricles to restore normal heart rhythm.
    • Tracheostomy Tube:
      • A tube inserted into the trachea to help patients breathe when there is a blockage in their trachea.
    • Oxygen Mask:
      • Used to deliver oxygen to patients with breathing difficulties.
      • Types include non-rebreathing mask for high oxygen concentration and partial rebreathing mask for lower concentration.

    Post-Care Instructions

    • Nasogastric Tube (NG Tube):
      • Regularly rinse the mouth to prevent bacteria growth.
      • Position the patient semi-erect to prevent backflow of stomach contents.
      • Change tapes regularly to prevent scars and keep the area clean.
      • Regularly check the tube's patency by aspirating contents with a syringe.
      • Inspect lips and nose for damage.
      • Adhere strictly to diet orders.
      • Lubricate lips and nose for comfort.
      • Consider the psychological impact of having an NG tube on the patient.
    • Urinary Catheter:
      • Ensure proper urine flow into the drainage bag.
      • Check for inflammation or signs of infection at the insertion site.
      • Keep the drainage bag below the bladder level.
      • Prevent the drainage bag from pulling on the catheter.
      • Provide antibiotics to prevent infections.
    • Colostomy Bag:
      • Always wash hands before tending to the stoma bag and site.
      • Keep the area clean and dry, disinfecting regularly.
      • Wash gently with warm water and pat dry, never rub.
      • Eat a high-fiber diet.
      • Discard used bags properly.
      • Encourage patient and caregiver training on stoma care.
      • Address the psychological impact of having a colostomy.
      • Clean the stoma area gently after removing the pouch.
      • Sprinkle ostomy powder and wipe off excess before reapplying the pouch.
    • Pacemaker:
      • Avoid pressure on the pacemaker site.
      • Keep the incision clean and dry.
      • Monitor for signs of infection.
      • Avoid electrical appliances that may affect the device, such as MRI machines, car engines, and airport security gantries.
    • Tracheostomy Tube:
      • Keep the tracheostomy tube site dry.
      • Monitor the tube for blockages, excessive mucus, and infection around the skin.
      • Regularly check the tube's positioning and prevent dislodgment.
      • Observe for patient distress or breathing difficulties.
      • Ensure the balloon cuff is always inflated to ensure full oxygen access.
    • Oxygen Mask:
      • Observe for any signs of respiratory distress.

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