 Fundamentals of Nursing

Nursing 102
Module C

Activities of Daily Living Chapter 45 1149-1151 and 1195-1196

Includes:

– Feeding
– Mobility
– Grooming
– Toileting

Special Equipment for Client Toileting and Assisting Clients with Toileting Needs

Objectives

– Identify special equipment for client toileting

– Explain how to assist clients with toileting needs

 Critical Requirements (syllabus)

– Chooses bedpan or fracture pan

– Positions bedpan / urinal properly
– Provides Privacy
– patient comfortable and in good bodily alignment
– Leaves patient clean and dried
– Washes patients hands as needed

May be a symptom…

– Alteration in elimination often is an early sign / symptom of a problem

with the GI /GU or other body system. Report changes in elimination. Can be
symptom of UTI or other problems.

Elimination

– Regular elimination of bowel waste products is essential for normal body

function

Torso and organs

– Urinary system
– When the urinary system fails to function properly, virtually all organ
systems will eventually be affected.
– Normal elimination of urine is a basic function most take for granted.

Client needs…
 – Supportive Nursing respects the clients privacy and emotional needs.
– Sensitivity may be embarrassing to pt.
– Be sensitive to elimination needs and intervene to assist. Offer to pt w/
cognitive disabilities.

Consider…

– Offering bed pan/toileting often

– Pt may soil clothes/ selves if forced to wait
– Pt may avoid toileting needs because it is embarrassing or uncomfortable
– Pt may try to get to the bathroom even if their condition prohibits it
– Risk of falls/ accidents may try to ambulate when they do not need to because
they are trying to get to bathroom.

Consi der…

Gender influences

- Positioning (urination)

- Males stand

- Females sit

Assess Contributing Factors

– Age potty trained? Older adults may need help.

– Environmental Factors
– Medical History
– Psychological Factors memory loss, cognitive impairment
– Muscle Tone loss of tone, bed bound for long periods of time.
– Fluid Balance
– Assess Contributing Factors
– Current Surgical / Diagnostic Procedures Make sure to offer before testing or
other procedures. Help up first time after surgery and watch for dressings, etc…
– Presence of Disease Condition

What is needed…

– Bedpan made mostly of plastic now

– Fracture Bed Pan leg injury, useful for these situations.
– Bedside Commode
– Urinal

For the bedside

Procedure

– Wash Hands
 – Gather Equipment
– Appropriate bed pan, urinal, bedside commode
– Toilet Paper
– Towels, washcloths
– Wear Gloves

Bed Position (fig 45-13)

– Place head of bed up about 30 degrees to avoid overextension of hip joint

– Place pan on chair or foot of bed
– Fold back linen just enough

Mobile Patients

– Have patient raise their hips by bending their knees and lifting hips
forward
– Assist with one hand on their lower back
– Slide bed pan under buttocks (don’t shove)
– If pt is able to help, may need another person to help lift patient on
bedpan

Immobile

– Bed remains flat

– Place patient on their side, backside towards you
– Place bedpan against pt buttocks, open rim towards clients feet
– Roll pt up onto pan
– When on pan raise HOB 30 degrees
– Place rolled towel or pillow under lumbar
– May raise knee gatch if appropriate or ask pt to bend knees
– Ensure pt position: buttocks resting on the rounded shelf
– Place call device and tissue within reach
– May leave pt if appropriate
– Use side rails appropriately

Retrieving pan

– Wear gloves
– Remove pan in the same manner it was offered
– Assist pt as needed
– If needed wrap paper around hand several times and wipe clean—1
stroke pubic area to back
– Retrieving pan
– Discard tissue and use what is needed Until patient is clean
– Cover pan and discard contents
– Offer supplies to wash and dry pt hands
 – Wash your hands

Consider

– Do not place tissue in pan if a specimen is required

– Measure specimen if required

Chart / record

- (be aware of skin care needs of pt)

- what was eliminated

- how did pt respond to elimination.

Urinal

– Keep within easy reach

– Proper placement: between slightly spread legs with penis in urinal and
urinal resting on the bed
– Wear Gloves
– Wash hands
– Measure and record appropriately
– Bedside Commode

Assist pt to commode

– Use good transfer and body mechanics

– Provide privacy, supplies (tissue), call light within reach
– Assist back to bed or chair
– Empty into toilet or hopper; rinse
– Record / chart

Bedpan Brigade

It’s a parade!

On the go

For those busy days