Care of bedridden patient

Fundamentals of nursing- care of a Bedridden Patient

1. CARE OF A BEDRIDDEN PATIENT Prepared By Jannet Reena Purani

2. INTRODUCTION Caring for a bedridden patient can be difficult, and requires a great deal of patience and understanding. Most of these patients have a hard time adjusting to this lifestyle and may develop significant health problems. As a caregiver, it is our responsibility to help the patient adjust – both physically and mentally. You will also need to help the patient with numerous daily tasks. 

3. Level of Conscious ness Fracture Accident/Injury Terminally ill CHECK PATIENT FOR: Post- operative orders

4. Causes For Getting Bedridden Unconsciousness or Coma Major accidents Fractures, Traction Surgeries- Abdominal, Open Heart surgeries etc. Neurological problems – stroke, paralysis etc. Chronic illness Terminal illness- cancer Psychological factors

5. Complications of Immobility: Skin:- Pressure sore, laceration. Respiratory:- Hypostatic pneumonia, pull. Embolism. C.V. complications:- DVT, postural hypotension, thrombo embolism. G.I. system:- Paralytic ilius , constipation, distention. Urological:- UTI, stone. Muskulo skeleton:- Contracture, osteoporosis, dystrophy, weakness. Neurological:- Foot drop. Psychological:- Anxiety, depression.hopelessness Other:- Lack of sleep, Loss of appetite. Backpain

6. Assessment of bedridden patients Emergency assessment: - A.B.C. Physical assessment Atonic bowel: - Paralytic illius , Abdominal distention, Nausea/Vomiting, Pain. Orthostatic Hypotention Neurogenic status: - Hypotension, cold, temp. etc. Skin: pressure sore, bruise, wound. D.V.T.: - Pain, tenderness, pulse, temp. etc. Psychological: - Sad, depression, agitated, anxious, critical, fear etc.

7. Care of bed ridden patients Nursing Aims: Identify problems. Prevent secondary complications. Maximize functional recovery. Education of patient and relatives. Care of psychological aspects

8. Care of bed ridden patients Prevent bed sores Maintain personal hygiene Understand patient’s needs, and requests, empathise Provide comfort. Pay attention to the back Keep the bed linen clean and fresh Feed the right way Provide skin care Provide Elimination care Psychological aspects Exercise and Prevention of physical deformities

9. Prevent bed sores

10. Prevent bed sores Keep checking all pressure areas regularly. Provide frequent position change. Observe for any skin rashes, redness, dryness etc. Provide back care. Apply emollients. Provide passive exercises.

11. Maintain personal hygiene Providing personal hygiene care plays a very important role Because the patient is not able to take care of daily hygiene practices in a regular way, it is solely the responsibility of the caregiver to make sure that the patient is clean and follows daily hygiene practices. In some cases, a patient may need a little assistance to follow hygiene routine, while in severe cases a patient may be entirely dependent on the carer for even the simplest of hygiene based tasks. Some things you need to take care of are to give a bath or sponge daily, change clothes and underwear, help brush and comb. You may also have to look after hair and nail trimming. If the patient is able to do these things with some assistance, encourage it and help with assisting tools.

12. Maintain personal hygiene BATHING- Sponge bath Assisted bath Hair wash

13. Understand patient’s needs, and requests, Empathise While it is hard for you to constantly care for a bedridden person, remember that it is more difficult for the patient to be completely dependent on someone for their daily needs, especially when it comes to hygiene. Put yourself in their position and understand their problem too.

14. Provide Comfort. Pay attention to the back Because a bedridden patient is mostly lying on the back, it is important to pay extra attention to that area. Try to change the patient’s position from left to right and right to left every alternate hour, or at a gap of 2 hours. Make sure you take the doctor’s permission to do so. You can lightly tap the patient’s back to ease out any fluid build-up and to give a light soothing massage to prevent or ease any aching muscles. If possible, help the patient sit up for some time every few hours

15. * Using betadine. * Stroke from inner to outer. * Keep the wound clean. * Do dressing daily.

16.  Always support patient (Limbs & Back).  Arms & legs position comfortably.  Communicate with patient always.  Guide to lift do things.  Provide pillows.

17. Keep the bed linen clean and fresh It is very important to keep changing the linen regularly and in fact, it is always better to do it every day. Using fresh linen will help the patient feel comfortable and clean, and will also prevent any risk of infection. In many instances, when a patient is constantly on the bed and does most things on the bed, such as eating and passing urine, there are chances of spills. Not changing the linen regularly can keep the place dirty and invite germs and infection.

18. Feed the right way At mealtimes, make sure to prop up the patient’s head and give very small bites or sips. If the patient can sit up for some time, provide assistance at the back by placing a few pillows and make sure there is a rail at the sides of the bed or something that will prevent the patient from falling over. Often, when a patient gets up after lying down for hours, it could result in dizziness and fall.

19. * NG tube * Gastro tube feeding * IV infusion * Through mouth

20. Provide Elimination care Assess urinary status: - retention, incontinence, UTI, calculi etc. Assess for the need for bowel elimination:- constipation, Incontinence, Abdominal distension Provide adequete fluid intake: - 2-3 lit/day. Indewling catheter – provide catheter care, check for any obstruction or infection Maintain – I/O chart, fluid balance. Fibre rich diet to prevent constipation Provide skin care. Pelvic muscle exercise. Supra pubic stimulation. etc.

21. Psychological Aspects Provide recreation therapy as per need like games, newspaper reading, radio etc.. Provide divertional therapy like relaxation exercises, meditation, therapeutic touch etc.. Provide psychological support to ventilate patient’s feeling and reduce anxiety and depression

22. Exercise and Prevention of Physical Deformities Due to immobility there might be problems like- Wrist drop, Foot drop, Quadriplegia, disuse syndrome. Care: perform exercises such as Soft ball on hand, use of splint, slab, foot board, sand bag Active and passive exercise, Position change 2 hrly , Rom = 1-2 hrly ,

23. “Healthy Life Is A God’s Gift Get Well Soon’’ Thank you..