PPE Removal and Postmortem Care

Nursing Practice and Responsibilities

• PPE should be taken off in alphabetical order: gloves, goggles, gown, mask.
• Canes should be held on the strong side.
• Postmortem care includes closing the client's eyes, replacing dentures, disconnecting tubes and lines, straightening the body and limbs, washing the body, allowing family members to assist, placing a pad under the perineum, placing a pillow under the head, and folding a towel under the chin to close the mouth.
• When speaking with an interpreter, address the client directly, speak in short sentences, pre-conference with the interpreter, use a qualified interpreter when possible, and avoid translation through family members. The nurse should choose an interpreter that matches the patient's preferred age and gender.
• UAPs (Unlicensed Assistive Personnel) can perform passive range of motion exercises, take and document vital signs, collect urine specimens, assist clients out of bed to the bathroom, remind clients to use incentive spirometers, pick up blood products from the blood bank, and perform oral suctioning (not sterile).
• LPNs (Licensed Practical Nurses) can administer anticoagulant medications, suction, perform sterile procedures (catheterizations), auscultate lung sounds, monitor RN findings, monitor for bleeding, maintain an IV and document flow, and reinforce teaching. They cannot perform initial teaching, assessments, evaluate a client's condition, start an IV, hang or mix IV meds, push IV meds, administer blood, mess with central lines, plan care, or take care of unstable patients.
• Age and gender are not criteria for prioritization in nursing. Acute cases have higher priority than chronic cases. Post-operative cases within 12 hours have higher priority than medical or other surgical cases.
• A modified radical mastectomy involves the removal of the breast, axillary nodes, and superior apical nodes, while preserving the muscles. Lymphedema can be a complication.
• Chemotherapy can cause bone marrow suppression and tumor lysis syndrome. Filgrastim is used to stimulate neutrophil production.
• Prior to surgery, nursing responsibilities include confirming client allergies and history, conducting assessments, confirming informed consent, ensuring the client is NPO, and witnessing the marking of the correct surgical site.
• Positioning clients for various procedures includes placing them in high fowlers for paracentesis, Trendelenburg position and left lying side for suspected air embolism, with arms raised above head for chest tube placements, on the right side for at least 2 hours and then supine for an additional 12-14 hours after a liver biopsy, and in an upright sitting position on the side of the bed leaning over on a side table with a pillow for thoracentesis.
• Occupational therapy focuses on teaching activities of daily living, while physical therapy focuses on mobility, ambulation, and rehabilitation below the waist.
• In radioactive disasters, victims farthest away from the explosion