(1) 1 How do old people make their beds? Close the doors and windows and move the desks and chairs beside the bed.
If conditions permit, put the bedside flat for thorough cleaning. 2. Assist the elderly to turn over to the opposite side, loosen the sheets beside the bed, and clean the debris on the sheets from the head of the bed to the end of the bed with a bed brush. Pay attention to thoroughly cleaning the layers under the pillow and under the old man's body, and then flatten the sheets to help the old man turn over and lie on the cleaned side.
Turn to the opposite side and clean it layer by layer, and press the sheets flat. 3. Tidy up the quilt cover, flatten the quilt and cover it for the elderly.
4. Take off the pillow, loosen it and put it under the old man's head. (2) How to change the sheets for the elderly in bed, close the doors and windows as appropriate, and remove the desks and chairs beside the bed.
2. Let the old man lie flat and help him lie on one side of the bed with his back to the nursing staff. The pillow moved across with the old man. 3. Roll up dirty sheets. Stuff them under the old man's body and clean the crumbs on the mattress.
4. Spread clean sheets on one side (including the front) of the bed, align the center line of overlapping seam with the center line of the bed, roll up the upper part and put it under the old man, and lay the half close to the side flat under the mattress in turn, so as to help the old man lie on the clean sheets on his side, face the caregiver, turn to the opposite side, spread the dirty sheets from the head of the bed to the end of the bed, and then flatten the clean sheets as described above. 5. Cover the quilt and flatten it so that the old man can lie comfortably.
6. Hold the old man's head and neck with one hand, take out the pillow with the other hand, replace the pillowcase and give the old man a good pillow. (3) How to help the bedridden elderly to move 1 to the bedside, put the backrest frame flat, take down the pillow and put it on the chair, so that the elderly can lie on their backs and bend their knees; 2. The caregiver puts one arm under the old man's shoulder and the other arm holds the old man's hip. While helping the old man up, he asked the old man to hold the bedside railing with both hands and guide the old man to stand up against the bed with his feet.
Put the pillow back, and then set up the backrest frame so that the old man can lie comfortably. (4) How to help the bedridden elderly turn over 1. When the supine old man wants to turn over to one side, first make the old man put his hands on his abdomen and bend his knees. The nurse put one forearm into the waist of the old man and the other arm into his thigh. With the help of the arm, the old man was quickly lifted, moved close to the bed and turned to the opposite side.
2. Lift the old man's head and shoulders, turn to the opposite side, put a soft pillow on the old man's back to maintain * * *, and put a soft pillow on the old man's chest to support the forearm to make the old man comfortable. 3. Bend the old man's thigh forward and his calf slightly, and put a soft pillow between his knees to prevent his legs from squeezing and rubbing against each other.
(5) Oral care for the elderly in bed There are many kinds of microorganisms in the oral cavity of normal people. The temperature and humidity of the oral cavity and food residues are suitable for the growth and reproduction of microorganisms. Under normal circumstances, the body has certain resistance. Because of the bactericidal effect of lysozyme in saliva and the mechanical effect of brushing teeth, gargling, drinking water and eating, it plays a certain role in sterilization, so it rarely gets sick.
The body resistance of the elderly is weakened, the secretion of salivary glands is reduced, and the bactericidal effect of lysozyme is reduced, which creates favorable conditions for the reproduction of bacteria in the oral cavity. At this time, bacteria increase, and the functions of sugar decomposition, fermentation and acid production are enhanced. If you don't pay attention to oral hygiene, it will not only lead to bad breath and stomatitis, but also affect the function of eating and digestion, and even lead to complications such as mumps due to oral infection, so oral care is very important.
1. Instruments: a pair of tweezers, a cotton ball, a tongue depressor (or bamboo chopsticks instead), and mouthwash (commonly used physiological saline, 1:5000 nitrofurazone or 3% boric acid solution). 2. Methods: Let the elderly lie on their side, facing the caregivers, gently open their cheeks with a tongue depressor, take a mouthwash cotton ball with tweezers, and wipe the inside and outside of the teeth, occlusal surface, tongue, oral mucosa and hard palate from inside to outside along the longitudinal direction of the teeth. After washing, help the old man rinse his mouth and dry his face.
If the oral mucosa has ulcers, you can sprinkle tin powder or indigo powder. If there are false teeth, help the elderly to take them off, brush them with cold water, and then let them wear them after gargling.
(6) How to help the elderly to expectorate and the elderly patients stay in bed for a long time. Because of weak constitution, weak cough and sticky sputum, it is easy to cause respiratory tract infection and pneumonia. Sometimes if you can't cough up phlegm, it will lead to cyanosis, difficulty breathing and even affect your life.
Therefore, keeping the respiratory tract unobstructed can reduce respiratory complications. 1, drink plenty of water; Diet is mainly light; Avoid catching cold and prevent colds.
2. Change your posture frequently and pat your back regularly. Especially before the patient coughs in the morning and evening, encourage the patient to take a deep breath in order to cough up phlegm.
3. Vapor absorption: Pour boiling water into a teacup or a teacup filled with traditional Chinese medicines such as chrysanthemum, olive and boat-fruited Sterculia, and absorb steam from the mouth of the teacup for15-30 minutes each time, 2-4 times a day, which can moisten the throat and eliminate phlegm, which is beneficial to eliminating phlegm. Put another bowl of clear water and wash the catheter at any time to prevent phlegm blockage. 5. Every minute is precious when the patient is suddenly blocked by phlegm and affects his breathing. Immediately wrap the index finger with a handkerchief or gauze, reach the patient's throat and take out the sputum; Or mouth-to-mouth sputum aspiration.
(7) How to bathe the elderly in bed 1. Appliances: clean clothes and trousers, big towel, hot water, bucket, towel, soap, washbasin. 2. Method: Close the doors and windows, remove the tables and chairs, fill three-quarters pots of hot water, loosen the lid, cover the scrubbing area of the elderly with a big towel, first wipe it with a wet towel, then scrub it with a towel dipped in soap, then wipe it repeatedly with a wet towel, and finally dry it with a big towel.
The sequence of scrubbing parts is as follows: (1) Untie the neckline, and wash the eyes, nose, face, ears and neck for the elderly, and pay attention to after washing the ears. (2) Take off the old man's coat (wash the healthy side first, then the affected side) and scrub the arm.
Pay attention to cleaning armpits. Help the elderly lie on their side, facing the nursing staff, put the washbasin on the big towel beside the bed and wash their hands for the elderly.
(3) untie the old man's belt, scrub the chest and abdomen, pay attention to the lower part and navel, help the old man turn over and scrub the back and buttocks. (4) Take off pants and scrub legs, groin and perineum.
Move the washbasin to your feet, spread a big towel on the bed, wash your feet and put on your pants. (5) Make the bed, change the sheets as needed, and clean up the used items.
2. Nursing knowledge of the elderly
The health and longevity of the elderly have a great relationship with the quality of family basic care. It is not the primary disease that eventually leads to the death of some elderly people, but the complications caused by lack of nursing knowledge and improper nursing. It can be seen that basic nursing plays a very important role in the health of the elderly.
Rest environment for the elderly
The factors of family rest environment are:
Maintaining an appropriate indoor temperature not only makes the elderly feel comfortable and stable, but also helps the body to carry out metabolism and prevent diseases. The indoor temperature should be 18 ~ 20℃, and it can be relatively high (22 ~ 24℃) in summer to reduce the indoor and outdoor temperature difference. If the room temperature is too low, the elderly are prone to catch a cold; If the room temperature is too high, it is easy to make people tired and depressed. It should be pointed out that for the elderly with chronic respiratory diseases, too high room temperature is likely to make the elderly feel stuffy, have poor breathing and aggravate dyspnea. Cool room temperature and circulating air will make it easy for the elderly to exchange gases, increase blood oxygen concentration and improve breathing.
Humidity generally refers to the content of water in the air. The air humidity is high, and the evaporation of human body is weak, which inhibits sweating and makes people feel humid and sultry, and the elderly with cardiac insufficiency will feel suffocated. Because the evaporation of skin and breathing water decreases, the amount of urination increases, which increases the burden on the kidneys. When the air is too dry, the human body will evaporate a lot of water, causing discomfort such as dry skin, dry mouth and sore throat. In the elderly with respiratory diseases, dry air makes respiratory mucosa dry, and sputum is not easy to cough up, which increases the chance of lung infection and aggravates the condition. The optimum indoor humidity should be 50%~60%. Proper humidity will make people feel refreshed and relaxed. In recent years, it is a good way for air humidifiers to enter the home. It is also effective to increase humidity by soil methods, such as sprinkling water on the ground, putting a sink on the heater, or putting wet towels. I suggest you buy a thermometer, master the temperature and humidity scientifically, and let it serve your health.
Ventilation Patients with pulmonary heart disease and respiratory failure must put their beds in the center of a ventilated room to feel that breathing is labor-saving. Similarly, fresh air is particularly important for elderly patients. Opening the window in the morning for ventilation can discharge indoor exhaust gas and make fresh air supplement. Generally, it takes 20~3 0 minutes to open the window to update the indoor air. For the frail old people, when they are ventilated, they can temporarily go to other rooms to avoid cold air. This can keep the indoor air fresh and not catch a cold.
Noise research shows that when the noise is 50~60 decibels, the average person will feel noisy. Most of the noise at home is caused by loud noise and excessive volume. Generally, old people like to be quiet. For the elderly with heart disease, quietness is a kind of treatment, and creating a quiet and elegant environment in the family is conducive to the elderly to recuperate.
Daylighting is the best room for the elderly, and indoor sunshine is particularly important for the elderly. When the sun shines, infrared rays are absorbed by the skin, which warms the deep tissues, dilates blood vessels, accelerates blood flow, improves the nutritional status of skin tissues and makes people feel comfortable. If you open the glass window and let the sun shine directly into the room, the ultraviolet rays in the sun also have disinfection and sterilization effects.
Old people should choose a hard bed, and it is best to sleep on a bed without a mattress. The height of the bed should be below the knee and the length of the calf. Too high or too low will bring inconvenience to the elderly and increase the chance of falling.
Family morning and evening care
Morning and evening care can make the elderly feel comfortable, happy and relaxed, which is conducive to the rehabilitation of diseases.
Exercise in bed: wake up in the morning, don't get up in a hurry, lie still in bed for more than ten minutes, and do necessary exercise in bed; Stretch one's limbs; Rub each other with your hands and move your knuckles; Then do "dry face washing" 20~30 times. These actions can make the elderly adapt to the physiological changes from sleep to awakening, so that the body has a relatively transitional stage, so that it will not fall down because of sudden dizziness, and it can also gradually change the frequency of breathing and heartbeat to avoid the recurrence of heart disease.
Toilet exercise: brushing teeth, gargling, washing face and combing hair are also very beneficial exercises for the elderly. When brushing your teeth, your upper limbs are active, so you should do it carefully. Cough exercise should be carried out after gargling to cough up phlegm in the respiratory tract. Cough without phlegm itself (even a few dry coughs) is beneficial to the expansion of alveoli and reduces the chance of lung infection. When washing your face, you can smooth your face and increase blood circulation. On the one hand, combing hair can increase the blood circulation of scalp, improve scalp nutrition and prevent hair loss; On the other hand, combing the hair also exercises the lifting action of the upper limbs. Comb your hair with a blunt wooden comb 100 times every morning and evening, and alternate your hands, which is very beneficial to the health of the elderly.
Outdoor sports: Appropriate outdoor sports, such as walking, jogging, doing exercises and practicing all kinds of boxing are the means for the elderly to enhance their own quality and improve their resistance. Morning exercise also laid the foundation for a day's life and work.
Bath at night: Besides repeating a set of activities in the bathroom in the morning, conditional elderly people can also take a bath before going to bed, which can dilate blood vessels in the whole body, relax muscles, reduce blood supply to the head and help them fall asleep. For most elderly people who are physically inconvenient or have no bathing conditions, soaking their feet with warm water is also very beneficial to promoting health and sleep. Old people's families should prepare a plastic bucket, fill it with warm water to their knees, and soak it for 15~20 minutes before going to bed. People who can move should rub their lower limbs with their hands, so that the blood vessels in the lower limbs will expand, the muscles will relax, and the blood circulation in the whole body will be accelerated, which can relieve fatigue. That warm and relaxed feeling can promote rest and sleep.
3. Daily nursing knowledge of the elderly
(a) How to clean and disinfect the air?
1. Always open the window for ventilation, let the air circulate, and let germs out of the room. Ventilation should not be less than 30 minutes at a time.
2. Fumigation method: use 5 5- 10/0ml vinegar per square meter indoors, add 1-2 times of water, or add 60ml formalin to 40ml, and heat and evaporate until the doors and windows are closed.
(2) How to clean and disinfect articles
1. Brush with soap and washing powder and rinse with clean water.
2. Sunlight method: Sunlight contains ultraviolet rays, which can be disinfected after 3 to 6 hours of irradiation.
3. Boiling method: Boiling can rapidly coagulate and denature the protein of bacteria. 15 to 20 minutes later, it can kill common bacteria. Disinfection time should be calculated after the water is boiled, and all items should be soaked in water. If possible, it can be disinfected with a domestic pressure cooker. Disinfection for 20 minutes can kill all pathogenic microorganisms from the time the control valve starts to steam, which is suitable for articles that are not afraid of damp heat and high temperature.
4. Soaking method: Soak the articles in 2% Lysol, 70% alcohol or]% bromogeramine solution for 30 minutes.
5. The vomit and excrement of the elderly can be sprinkled with twice as much lime and stirred, and poured into the toilet after 2 hours; The sputum of the elderly with pulmonary tuberculosis can be vomited in a paper box or wrapped in paper for burning.
6. Wipe method: wipe with 1%-3% bleaching powder supernatant (that is, clear water precipitated on bleaching powder) to inactivate the enzymes in bacteria and die.
In addition, wash your hands with soap after contact with the elderly, before and after meals; Old people's bowls, chopsticks, cups and utensils should be dedicated, washed, disinfected and placed separately.
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4. What skills do you need to master to take care of the elderly?
1. Psychological quality: Nurses are the main body of clinical nursing work. To provide the best nursing service, we must strengthen our self-cultivation and have a good mental outlook and healthy psychological quality. Positive, optimistic and confident attitude towards life; Emotional stability, not discouraged when encountering setbacks, not proud of achievements; Be fearless in times of crisis, and be able to deal with it calmly in a difficult and complicated environment; Broad-minded, able to learn from colleagues' new methods and technologies, listen to different opinions, learn from others' strengths, make up for their own shortcomings, and exchange experiences with each other at work.
2. Professional and technical quality:
(1) has solid professional theoretical knowledge, grasps the symptoms, signs and nursing points of various common diseases, and makes timely and accurate nursing plans. Master the knowledge of nursing psychology and nursing ethics, understand the latest nursing theory and information, and actively carry out and participate in nursing research.
(2) Skilled nursing skills. Skilled nursing operation technology is the basic condition of an excellent nurse. In addition to the general internal medicine nursing skills, we should also master the specialized nursing skills of this position, so as to complete all nursing work steadily, quickly, accurately and well. Excellent nursing technology can not only greatly alleviate the patient's pain, but also enhance her self-confidence and give people beautiful enjoyment.
(3) Master the use of first aid technology and equipment, be familiar with the application of first aid drugs, and skillfully cooperate with doctors to complete the rescue of emergency or critically ill patients.
(4) Have a high sense of responsibility, strictly observe the patient's condition changes, strictly implement the operating procedures, conscientiously do a good job in checking the system, always remember that medical safety comes first, and put an end to medical errors and accidents.
(5) Have keen observation and be good at capturing useful information; Rich in imagination and brave in technological innovation. Have strong language expression ability, master communication skills, and be able to flexibly use language for psychological care according to the specific situation of patients.
3. Professional ethics: The nurse is angels in white, saving lives is her bounden duty, so she should have good professional ethics. Nurses and patients are two individuals with equal status, but the social division of labor is different. We should create a clean, comfortable, safe and orderly diagnosis and treatment environment for patients like friends and relatives, receive patients warmly in time, listen to their complaints with sympathy and compassion, try our best to meet their reasonable requirements and provide humanized medical services.
4. Physical quality: Nursing is a special occupation, which combines manual labor with mental labor, serves people and is related to people's lives. A little carelessness in the work will ruin a life, so the spirit is highly concentrated at work, so nurses are required to have a healthy body and abundant energy to ensure the smooth progress of the work.
5. Quality of cultural instruments: Nurses should not only have rich medical knowledge and skilled nursing professional knowledge, but also strengthen their own cultural cultivation, have an enterprising thirst for knowledge, actively participate in continuing education, expand their knowledge and keep up with the pace of medical development; Learn more about linguistics, philosophy, social relations, humanities and medicine to enrich your knowledge; Learn etiquette knowledge, make your words and deeds, dress more appropriately and have more temperament, enhance your image, enhance your self-confidence and public belief, and cope with various challenges.
6. Health education volunteer propagandist: Because of the particularity of nursing work, nurses should not only know medical knowledge, but also have close contact with patients. Nurses should make use of this favorable condition to publicize and educate patients and their families about health knowledge, and give guidance on diet, daily life and medication for some common chronic diseases, such as diabetes, hypertension and cardiovascular and cerebrovascular diseases. According to the local actual situation, do a good job in the propaganda of infectious disease prevention and control. With the rapid development of medicine, new requirements are constantly put forward for the theory and technology of nursing work, and the requirements for nurses, the main executors of nursing work, are also constantly improving. In order to meet the requirements of nursing work under the new medical model, contemporary nurses should keep forging ahead and improve their self-cultivation in order to be invincible in the competition.
5. Nursing responsibility in sanatorium
1, smiling, dignified appearance, civilized language and proper nursing behavior.
2, wear nursing overalls to work, the care of the elderly are carried out according to the nursing process, the operation should be standardized in place.
3. Maintain a serious work attitude, not afraid of being dirty, tired and troublesome.
Care for the elderly should be considerate, and care for every elderly person should be full of love.
5. During the work, you are allowed to leave your post, and the elderly should respond to the call in time. Don't abuse the elderly, don't contradict your family, and don't do private work during working hours.
6. Keep the body, clothes, bedding and indoor cleanliness of the elderly.
7. Caregivers in apartments for the elderly shall not accept red envelopes and articles from the elderly and their families, and offenders will be held accountable.
8. Warm reception should be given to visiting guests and the families of the elderly, and the response should be objective and realistic.
9, a 24-hour nursing system, patrol once every ten minutes.
10, all staff should be thrifty, and nursing homes in China Nursing Home Network are not allowed to make personal calls at will (except for work), so pay attention to saving water, electricity and gas.
1 1. If you don't take the public property of the family in the courtyard, you should pay compensation according to the price if it is damaged.
12, intrigue or disunity, and quarreling with the elderly or colleagues in our hospital are not allowed.
6. Nursing knowledge of common diseases of the elderly
Diet nursing of chronic bronchitis
Drinking enough water for the elderly and keeping the respiratory mucosa moist are beneficial to the discharge of sputum. The daily drinking water should be above1500ml, so as to provide adequate nutrition and high-protein and high-vitamin food for the elderly. Eat a small amount of food and keep enough nutrition.
Nursing care of angina pectoris
For the overweight elderly, we should encourage them to find ways to lose weight, eat less foods with high cholesterol and fat, and eat more foods with high cellulose. This kind of food can not only prevent constipation, but also reduce the frequency and severity of angina pectoris, reduce the blood sugar concentration and reduce the occurrence of hypertension. Usually eat less and eat more meals, do not drink strong tea and coffee, eat less spicy food, smoke less or not, so as to reduce the harm of harmful substances in tobacco to the elderly.
Nursing care of constipation in the elderly
Adjust your diet, eat more foods with high cellulose content, such as coarse grains, vegetables, fruits, honey, walnuts, etc., and pay attention to drinking more water.
Diet nursing for preventing calcium deficiency in the elderly
Osteoporosis is the main cause of fracture in the elderly. At ordinary times, we should actively assist the elderly to exercise, often accompany them for outdoor activities, get more sunshine, and eat more foods containing protein and vitamins. Eggs, vegetables and fruits can be supplemented with calcium tablets and vitamin D when necessary to improve osteoporosis.
Prevention of foot complications
Because the elderly have progressive arteriosclerosis, such as peripheral nerve disorder, it is easy to have itchy feet and bad marks. Therefore, keep your feet clean, keep your nails clean, and wear shoes with proper size, good softness and warmth to avoid scratching your feet. Check the color of foot skin every day to see if the skin is damaged. If it is damaged, handle it in time. Wash your feet with warm water every day and do * * * on your feet and legs to promote blood circulation. The poor metabolism and circulatory function of the elderly leads to the weakening of arterial elasticity, which leads to the occurrence of many senile diseases. Besides often taking part in outdoor activities, * * * also plays a considerable role. * * * can not only promote blood circulation, but also relieve the mental stress of the elderly and improve their mental state.
7. Matters needing attention in aged care
brief introduction
The health and longevity of the elderly are directly related to the quality of basic home care. Some elderly people ended their lives not because of the primary disease, but because of complications caused by lack of nursing knowledge and improper nursing. It can be seen that basic nursing plays a very important role in the health of the elderly. Nowadays, many people have little time to take care of their parents because of their busy work, so they will hire professional family caregivers for their parents. These nurses usually have some experience in caring for the elderly, and after understanding the physical condition of the elderly, they can respond to the physical discomfort of the elderly in a timely and effective manner. However, both children and family caregivers should pay attention to the following points when taking care of the elderly:
Create a good rest environment
The elderly have poor physical resistance and weak immune ability, so we should pay attention to whether the surrounding environment is suitable for the elderly in the nursing process. The suitable indoor temperature is 18 ~ 20℃, the best indoor humidity should be around 50%~60%, the indoor lighting is good, and it is best to keep quiet. In addition, it is necessary to open the window frequently, keep the indoor air circulating, and discharge the germs outdoors. Ventilation should not be less than 30 minutes at a time. When the weather is cold, the elderly with weak constitution can be temporarily transferred to other rooms during ventilation to avoid cold air. This will keep the indoor air fresh and the elderly will not catch a cold.
Disinfect the daily necessities used by the elderly
The immunity of the elderly is weak, so the daily consumption appliances should be disinfected, otherwise it is likely to be infected with bacterial viruses and cause diseases. Disinfection includes sun exposure, boiling, soaking and wiping. For special circumstances, special methods should be adopted. For example, the vomit and excrement of the elderly can be sprinkled with twice as much lime and stirred, and then poured into the toilet after 2 hours; The sputum of the elderly with pulmonary tuberculosis can be vomited in a paper box or wrapped in paper for burning. Pay attention to washing hands with soap before and after meals after contact with the elderly; Old people's bowls, chopsticks, cups, tableware, etc. It should be used by special personnel, washed separately, disinfected separately and stored separately.
Assist the elderly to exercise moderately.
Moderate exercise can not only increase the physique and immunity of the elderly, but also bring them a good mood. An excellent domestic servant, whether a chaperone or a nanny, should not regard these as things that are not his own responsibility, but should be indifferent. Instead, he should actively help the elderly to carry out sports. Exercise should be appropriate, the intensity should not be too large, and the time should not be too long. When you get up in the morning, you can let the old man lie on the bed, stretch his limbs, rub his hands with each other, move his knuckles, and then "dry his face" for 20 to 30 times. These actions can make the elderly gradually transition from sleep to full awakening, so as to avoid falling down due to sudden dizziness, and can also gradually change the frequency of breathing and heartbeat to avoid the recurrence of heart disease. Bathing before going to bed for the elderly with conditions can dilate the whole body blood vessels, relax muscles, reduce blood supply to the head and help them fall asleep. For most elderly people who are physically inconvenient or have no bathing conditions, soaking their feet with warm water is also very conducive to promoting healthy sleep.