Medical Patient Care (Intermediate)

Recipients of the Medical Patient Care credential have demonstrated concept proficiency and completed  the following tasks:

Activity 1 – Medical and Surgical Asepsis

Medical Asepsis
(a) Put on gown (mask and hat as desired); stood in front of sink and turned on warm water, not touching sink.
(b) Held hands and forearms lower than elbows.
(c) Wet hands and applied soap.
(d) Washed the palm and back of each hand to 10 count.
(e) Cleaned around fingernails with fingernail brush and file.
(f) Washed fingers using interlaced thumbs and 10 count.
(g) Rinsed hands holding so water runs from wrists to fingers.
(h) Dried each hand with a separate paper towel.
(i) Turned off water using a paper towel.
(j) Put materials away.
(k) Held one hand under hand sanitizer; used towel to push pump.
(l) Rubbed palms together and then fingers to clean hands.
(m) Put away all materials.

Surgical Asepsis
(a) Put on gown and gloves (mask and hat as desired).
(b) Filled both forceps container and instrument container half full of water.
(c) Placed transfer forceps in forceps container; put all other instruments in instrument container.
(d) Folded towel in half; placed on tray to form “sterile” surface; folded second towel next to tray.
(e) Raised the basket of the instrument container out of the solution and let instruments drain; placed basket on hand towel next to tray without touching anything.
(f) Grasped transfer forceps and lifted out of container; letting liquid run off blades and not letting liquid touch towel.
(g) Picked up instruments one at a time using transfer forceps and placed them on the sterile towel without touching instruments to anything, nor dropping instruments.
(h) Replaced forceps in container.
(i) Showed work to instructor.
(j) Emptied both containers; dried off instruments and put them away.

Activity 2 – Medical History
(a) Got a Medical History Form (if on computer, saved copy with student’s name).
(b) Asked “patient” to have a seat; asked patient all questions on form; recorded answers.
(c) Placed scale on flat surface on ground; made sure arrow pointed to zero.
(d) Read weight; recorded on form.
(e) Asked patient to stand against wall; used tape measure to measure height; recorded on form.
(f) Showed work to instructor; thanked patient and put away materials.

Activity 3 – Vital Signs: Taking Temperature

Part 1 – Oral Thermometer
(a) Reviewed parts of oral thermometer.
(b) Put on hospital gown (gloves, mask and hat as desired); washed hands.
(c) Greeted patient and explained process.
(d) Made sure thermometer was clean before use; cleaned if necessary.
(e) Properly inserted thermometer tip cover onto thermometer.
(f) Turned on thermometer; held thermometer (not by tip), and inserted into patient’s mouth under tongue, toward back of mouth.
(g) Had patient close lips; measured one minute of time.
(h) Removed thermometer after one minute; found temperature on display window.
(i) Recorded temperature on scratch paper including whole number and tenths of a degree.
(j) Got a TPR Form (if on computer, saved copy with student’s name); entered patient’s room number, name and date.
(k) Accurately recorded patient’s temperature on form in time slot nearest when temperature was taken.
(l) Turned off thermometer; used disposable towel to remove tip cover and discarded. Washed thermometer.
(m) Showed TPR Form to instructor.

Part 2 – Temple Thermometer
(a) Reviewed parts of temple thermometer.
(b) Cleaned thermometer and allowed to dry two minutes before use.
(c) Pressed on button and waited two seconds.
(d) Asked patient to hold back hair; found temple and made sure it was clean. Held sensor to temple and listed for long beep.
(e) Removed thermometer and read display window.
(f) Recorded temperature on scratch paper.
(g) Accurately recorded temperature on TPR Form on 8:00 pm slot.
(h) Turned off thermometer; cleaned and allowed to dry.
(i) Accurately recorded patient’s temperature on Graphic Nurse’s Notes Form (if on computer, saved copy with student’s name).
(j) Saved work and showed instructor; put materials away.

Activity 4 – Vital Signs: Taking Pulse, Respiration and Blood Pressure

Part 1 – Taking Pulse
(a) Put on hospital gown (gloves, hat and mask as desired); washed hands. Greeted patient and explained procedure. Placed patient’s arm in comfortable position, not holding it up nor bending the arm.
(b) Placed tips of first two fingers on artery on inside of wrist just below thumb.
(c) Pressed fingers firmly to feel pulse.
(d) Counted beats for one minute; noted whether beats were strong or weak.
(e) Got out TPR Form from Activity 3; accurately recorded pulse on Form.

Part 2 – Taking Respiration
(a) Put on hospital gown (gloves, hat and mask as desired); washed hands.
(b) Observed rise and fall of chest; counted respirations for one minute.
(c) Accurately recorded respirations on TPR form.
(d) Accurately charted patientʼs TPR on Graphic Nurseʼs Notes Form
(e) Accurately charted new patient’s temperature, pulse and respiration on a new Graphic Nurse’s Notes Form.
(f) Showed work to instructor; checked work with Answer key. Saved work and put away materials.

Part 3 – Taking Blood Pressure
(a) Listened to audio of human heartbeat.
(b) Put on hospital gown (gloves, hat and mask as desired). Washed hands; greeted patient and explained procedure.
(c) Used cotton ball and alcohol to clean stethoscope.
(d) Placed the deflated cuff snugly and evenly around the arm, placing the lower edge of the cuff about 1 or 2 inches above the antecubital space with the tubes hanging on the inside of the elbow.
(e) Made sure tubes were not twisted or being leaned upon.
(f) Put gauge in slit on cuff; found brachial artery by placing fingers on inside of arm and feeling for pulse.
(g) Firmly placed earpiece of stethoscope in ears.
(h) Placed end piece of stethoscope (the bell) directly over artery where pulse was found.
(i) Closed the valve on the rubber bulb; squeezed the bulb to inflate the cuff until dial read 170-180 mm or until no pulse heard (not exceeding 180).
(j) Opened valve very slowly, deflating the cuff; watching dial and listening for pulse beat again.
(k) Recorded systolic pressure on Graphic Nurseʼs Notes Form.
(l) Continued to release pressure slowly until last clear pulse beat heard and then recorded diastolic pressure on Graphic Nurseʼs Notes Form.
(m) Removed cuff; cleaned stethoscope.
(n) Recorded systolic and diastolic values in correct format. (S/D)
(o) Switched places with patient and reversed roles.
(p) Saved work and showed to instructor; thanked patient; put away materials.

Activity 5 – Measuring Intake and Output
(a) Got a Measuring Intake and Output Worksheet (if on computer, saved copy with student’s name).
(b) Completed activities.
(c) Showed work to instructor; checked work with Answer Key.
(d) Got an Intake and Output Worksheet (if on computer, saved copy with student’s name).
(e) Recorded correct intake and output values for Mrs. Swanson.
(f) Recorded correct output values for Mr. Miller on a new Intake and Output Worksheet.
(g) Showed work to instructor; checked work with Answer Keys.
(h) Put materials away.

Activity 6 – Patient Nutrition
(a) Divided food models into food groups using the MyPlate guide.
(b) Found nutritional information on back of food models.
(c) Selected a luncheon meal for a patient using food from each food group.
(d) Put food models on plate; determined calorie count for meal.
(e) Evaluated if meal met patient’s calorie requirements; if not, adjusted meal to meet patient needs.
(f) Got Nutritional Plans for three patients (if on computer, saved copies with student’s name).
(g) Reviewed patients’ nutritional plans and reviewed patient’s needs to confirm plan was appropriate for patient; if not, revised plan.
(h) Showed work to instructor; put away materials

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