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HOME NURSING

SECTION -1

 INTRODUCTION TO HOME NURSING

Ques 1. What are the qualities of a good nurse?

Ans - A good nurse must possess the following qualities:-

(a) Honesty and Truthfulness. A nurse should be honest to her profession. She should confess her mistake and not risk the life of the patient by hiding it.

(b) Sympathy and Understanding. A good nurse should deal with the patient with understanding and compassion. She must appreciate the pain and suffering of the patient.

(c ) Cheerfulness, Gentleness and Willingness. A cheerful nurse reduces the sufferings of the patients to half. Her gentleness reduces their pain and discomfort. "A warm smile may be more therapeutic than a dose of medicine".

(d) Obedience and Discipline. A nurse should have self discipline and should obey the orders of the doctor and carry them out without argument.

            (e) Observant. A Nurse should observe the minutest details of the patient's condition. If

            there is the slightest change in the patient’s condition, she should immediately report it

            to the Doctor.

(f) Tact and Sense of Humour. A tactful nurse can deal easily with the irritable patients. Her sense of humour helps her to bear the hardships of profession cheerfully.

SECTION -2

THE ROLLER BANDAGE AND ITS APPLICATION

Ques 1.  What are the sizes of various bandages?

Ans -   (a) Bandage for Finger - 1' wide

           (b) Bandage for Head and Arm - 2½'

           (c ) Bandage for Trunk - 6'

           (d) Bandage for Leg - 3 ½'

Ques 2. What are the general rules of bandages?

Ans      (a) Face the causality.

            (b) Hold the head of the bandage in the right hand.

(c ) Apply the outer side of the free end to the part and where possible lock it in position by a superimposed turn.

            (d) Bandage firmly from below upwards and from within outwards over the front of the limb.

            (e) Apply the layer of the bandage so that it covers neither too tight nor too loose.

            (f) When completed secure the bandage by a safety pin or adhesive strapping.

SECTION -3

THE SICK ROOM: PREPARATION, CLEANING,

LIGHTING AND VENTILATION

Ques 1.   What points should be borne in mind while cleaning the sick room?

Ans    (a) All cleaning work should be done without disturbing the patient after the toilet is over and

           the bed remade.

          (b) Light furniture should be removed before the room is swept and dusted. After dusting,

          each piece should be wiped with a weak solution of disinfectant and then polished with dry

          cloth.

           (c ) Dusting should be done with a damp cloth. The floor should be cleaned after scattering

           damp tea leaves so that dust does not rise.

          (d) At night, flowers should be removed from the vases and fresh flowers arranged in the

          morning.

Ques 2 Define Sick Room?

ANS: The sick room should be that room of the house which is away from all noise and through which there is no passage. However, it should have a bathroom and lavatory close by. It should face South or South-West.

Ques 3 Define Sick Room?

Ans      (a) Preparation

(b) Cleaning

(c) Lighting

(d) Ventilation

(e) Cross Ventilation

(f) Wide Streets with Open Spacing.

(g) Cleaning of Air Through Trees

(h) Effects of Heat

SECTION -4

PULSE , RESPIRATION AND TEMPERATURE

TAKING AND RECORDING

Ques 1.  Define respiration?

Ans - The inhalation and exhalation of a person is called respiration

Ques 2. What is the pulse rate of various ages?

Ans      (a) Infants 30-40 per minutes.

            (b) Children 24-28 per minute.

            (c ) Adults 15-20 per minute.

Ques 3.  Define body temperature?

Ans Temperature. The normal temperature of a man is between 97° and 99° F. There is slight

 ½ ° F variation between the daily temperature in the morning and evening. The lowest temperature is between 2 AM and 4 AM.

Ques 4. What is the method of taking temperature?

Ans - Keep the bulb of the thermometer pressed under the armpit or beneath the tongue or in the groin for 2 minutes.

Ques 5. Define pulse?

Ans - The pulse is the heart beat and is most commonly felt at the radial on the point of the wrist. The average pulse rate is 72 beats per minute. In case of infants, is 100 to 140 beats per minute and in case of children 90 to 100 beats per minute.

SECTION -5

OBSERVATION OF THE SICK: SIGNS AND

SYMPTOMS TO BE NOTED

Ques 1.   What important points should be observed in a patient for proper treatment?

Ans - These are as under: -

(a) Appearance of the Patient

                        (i) The colour of the skin whether pale, flushed blue or yellow.

                        (ii) Whether moist or dry, hot or cold, smooth or rough, covered with rashes,

                        bruises or discolored.

                       (iii) If any swelling or edema.

                       (iv) If pain, its place and duration.

                       (v) Facial expression and other signs of discomfort.

(b) Temperature, Pulse and Respiration. Take temperature, pulse and respiration twice a day or four times a day or eight time a day, as desired by the doctor and maintain TPR Chart.

            (c) Stools

(i) Frequency and whether it shows constipation or diarrhoea condition.

                        (ii) Colour

                                  (aa) Normal brown.

                                  (ab) Clay coloured which shows obstructive jaundice.

                                  (ac) Black shiny which shows bleeding from the stomach or duodenum.

                                  (ad) Full black which shows effect of medicines like iron.

(iii) Composition. Presence of abnormal material as blood, pus, gall stones, worms, undigested food. Specimen of stool is to be left for the doctor to see in a well covered stool box.

            (d) Urine. In case of urine the following should be observed:-

(i) Frequency. Increased frequency is due to inflammation of the bladder.

                        (ii) Quantity

(aa) Urine output is reduced in fever, in conditions of dehydration and in a acute nephritis.

(ab) Urine quantity is increased in case of diabetes and inflammation of the kidneys.

                         (iii) Colour Abnormalities 

                                     (aa) Red - Due to presence of a lot of blood.

                                     (ab) Dark Greenish Brown- Due to presence of bile.

                                     (ac) Smoky - Due to some blood being present.

                                     (ad) Orange, Green or Blue - Due to presence of some drugs.

                        (iv) Deposits. If the urine is allowed to stand, the following may be observed:-

                                     (aa) A sandy deposit white or pink.

                                     (ab) A whitish cloud showing mucous.

                                     (ac) A thick greenish deposit due to pus.

                           (Early morning specimen should be kept in a clear, covered , glass bottle).

(e) Cough and Sputum. Report on it must state:-

                       (i) Amount.

                       (ii) Colour.

                       (iii) Whether expectorated easily or with difficulty.

             (f) Vomit 

                        (a) Quantity.

                        (b) Time in relation to food.

                       (c) Whether it causes pain or relieves it.

                       (d) Material vomited such as blood.

SECTION -6

FEEDING A HELPLESS PATIENT

Ques 1.  What are the important precautions to be taken while feeding a helpless patient with fluid diet?

Ans.     (a) The mouth of the patient should be washed and wiped.

(b) If the patient can sit up, the fluid can be given in a cup or in a glass.

(c) If the patient wants to take fruit juice with a straw he/she should be provided that.

(d) If the patient can not sit up, he/she should be fed with a feeding cup or a feeder.

(e) The bed clothes should be protected by placing a clean napkin beneath the patient's mouth.

(f) The nurse should place her left arm, under the first pillow to raise the patient's head slightly.

(g) The flow of the fluid should be regulated so that too much of it does not flow into the patient's mouth.

(h) One mouthful should be given at one time pausing to allow her time for chewing. Feeding can be done with a tea spoon also.

(j) In case of jaw injuries, a small rubber tube is attached to the spout of the feeding cup and then put between the teeth.

(k) The patient should be given small quantity to swallow at one time.

(l) After feeding the patient, lips should be wiped with a clean towel.

Ques 2. What are the important precautions to be taken while feeding a helpless patient with solid food?

Ans       (a) Food should be served in an attractive manner arranged attractively on a side table.

(b) One dish should be brought at one time.

(c) The food should be served hot. It should be put in a plate in the kitchen before bringing

to the patient.

(d) Patient should be fed with a spoon.

(e) As soon as food is finished the plate should be removed.

SECTION-7

MEDICINES AND THEIR ADMINISTRATION

Ques 1.  What precautions should be taken while administering the liquid medicines to patient?

Ans -    (a) Check the label with the prescription. If handling a new medicine read the instructions carefully.

(b) Shake the medicine well.

(c) Put your thumb near the correct marking of dosage on the medicine glass. Hold the glass in level with the medicine bottle. Pour away from the label so that it does not become illegible. Replace the cork immediately.

(d) Read the instructions once again before actually giving the medicine to the patient.

(e) Take the medicine on a tray with a glass of water and spoon in case the medicine requires stirring. If the medicine has a bitter taste, give the patient some sweet drink.

(f) Put the medicine bottle in the correct place.

(g) Never pour back any unused medicine, throw it away.

Ques 2.   What precautions should be taken while administering the other medicines to patient?

Ans      (a) In case of pills, tablets, capsules and powder, remember that a pill has a sugar coating and a capsule has a gelatine coating and hence can be easily swallowed with water.

(b) Tablets if not swallowed by the patient may be crushed and put on the back of the tongue for swallowing.

(c) Powder must be poured at the back of the patient’s tongue and water poured in his mouth.

(d) Iron mixture should be given with straws so that the teeth are not stained. (e) If the patient is not too weak, he/she should be asked to clean his/her teeth.

 

SECTION -8

FEVER, INFECTION, DISINFECTION AND

SPECIFIC INFECTIOUS DISEASES

Ques 1.  What is fever?

Ans - Whenever there is an inroad of disease germs in the body, due to some infection, it raises its temperature to put up a fight against the invasion. The state of more than normal temperature is called 'Fever'.

Ques 2.   What are various names of fevers considering the temperature?

Ans       (a) The normal temperature of the body is 97° F to 99° F.

(b) The temperature above 99° causes pain, restlessness, headache and body ache.

(c) Moderate temperature from 99° F to 103° F is called Pyrexia.

(d) High temperature from 103° F to 105° F is called High Pyrexia.

(e) Very high temperature over 105° F is called Hyper -Pyrexia.

Ques 3.  What are various types of fevers as per severity?

Ans      (a) Constant. In this the temperature remains the same all the 24 hours as

in pneumonia and scarlet fever.

            (b) Intermittent. The temperature rises very high and falls very low. It appears when there

            is severe infection.

            (c) Remittent Fever. This is a very high fever. It rises more than 1° during 24 hours. It is

            found in case of tuberculosis and sepsis.

           (d) Irregular. It has no set pattern of rise and fall of temperature.

Ques 4.    Define infection?

ANS: The spreading of germs of a disease from a sick person to a healthy person is called infection.

Ques 5 - What are the media of infection?

ANS: (a) Through Air. Disease germs spread from a sick person to a healthy person when the sick person breathes out foul germs and fit person inhales it. The germs are harboured by the healthy person till they multiply and become strong enough to show symptoms of the disease. Diseases like tuberculosis and influenza spread in this manner.

(b) Through Water. Water gets contaminated when patients of a disease wash into it their faeces, urine, sputum and vomit. These germs are carried by rivers and streams and sink into wells, ponds and lakes. When this water is used by healthy persons for washing and drinking, the germs remain dormant in his body till his resistance becomes poor and he falls victim to diseases. Cholera, enteric fever, dysentery, typhoid and jaundice spread in this manner.

(c ) Through Insects. Germs of various diseases are carried by insects. The anopheline female mosquito, house fly, sand fly, fleas, ticks all act as carriers of disease. The mosquito, sand fly, fleas and ticks bite a patient, take the germs of the diseases in their blood, harbour them till they find a healthy man to bite and pass on the germs into his blood, till after a period, the healthy person also starts showing signs of the disease. Malaria, plague and sand fly fever, all spread like this. Cholera, diarrhoea, dysentery, jaundice, typhoid spread in this manner.

Ques 6 - Define disinfection?

ANS: It means destroying the disease germs through various methods. It is to break the chain of infection.

Ques 7 : what are the physical and the chemical agents of disinfection?

ANS:

(a) Physical Agents

                       (i) Light.

                       (ii) Heat - both dry and moist.

             (b) Chemical Agents

                       (i) Gases.

                       (ii) Liquids.

                       (iii) Solids.

SECTION - 9

OPERATION: AFTER CARE, DRESSING OF WOUNDS

Ques 1 - Discuss some of the points while dressing the wound of the patient?

Ans - The following should be done to help in quick healing of wounds and keep them from turning septic:-

(a) The hand should be properly washed.

(b) Everything that is used while dressing the wound should be properly sterilized so that he wound does not get infected

(C) Soiled dressing should be thrown properly in a covered waste bin and not allowed

(d) The wound should be cleaned with proper solutions

(e) Fresh air and sunshine assist in the quick recovery of a patient

(f) There should be no obstruction to the free circulation of blood so that the healing process is not restricted

           (g) Proper diet should be given to the patient. Sufficient quantity of vitamin C must be

            ensured for quick healing.

(h) The patient should be made to feel fit and kept cheerful.

 

SECTION -10

POISONS AND FIRST AID

Ques 1 What is poison ?

ANS: Any substance which, if taken in large quantity causes damage to the human system or may cause death, is called poison.

Ques 2 What are the means of poison intake?

ANS:    (a) Poisons can be swallowed by eating or drinking.

             (b) Poisons enter the system by breathing in the form of fumes or smoke.

(c ) Poisons enter the body through injections or through bites such as snakes or rabid dogs.

Ques 3 : What are the types of poison?

ANS:    (a) Corrosive

(b) Irritants

(c) Stimulants

(d) Depressors.

Ques 4: What is the first aid for the patient who has consumed poison?

ANS:    (a) Arrange to remove the patient to hospital immediately.

(b) Note down the name of the poison if the empty bottle is there. Preserve if there is any remaining portion of the poison.

            (c ) Keep in some container any vomited matter, if it is there.

            (d) If the patient has not taken any corrosive matter induce vomiting.

(e) If he is unconscious lay him with head turned to one side keeping his tongue out. If his respiration is failing, give artificial respiration.

(f) If the patient is conscious and the poison which he has taken is known, the following steps may be taken:-

                       (i) If he has taken some acid give him some alkali such as chalk, milk of magnesia

                         and baking soda water.

(ii) If it is alkali give him 2 table spoonful of vinegar or lime juice water. Make the patient drink plenty of water or give something to drink such as milk or barley water or raw eggs.

(iii) If the patient has taken some disinfectant like cresol, carbolic acid or sleeping tablets like luminal, give two table spoonful of common salt with water or raw eggs.

(iv) In case of opium and morphia poisoning, give a few crystals of potassium permanganate in a tumbler of water and make the patient vomit.

(v) If there is gas poisoning, move casualty out of the room having gas. If the breathing is obstructed give artificial respiration. The domestic antidote for poisoning is a mixture of tea powder or burnt toast and milk of magnesia mixed in equal portion.

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