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Okay everyone so in this video series we will 
be working on vital signs the different types  
of specimens that you possibly will have to 
collect if you're working with a client at  
home talking about fluid balance both intake 
and output talking about catheter care we're  
going to talk about a little bit about warm and 
cold applications possible dressing changing  
and as well as ostomy care so first things first 
let's talk about vital signs vital signs are the  
measurements the temperature – pulse respiration 
blood pressure and nowadays we also include pain  
level that monitors the functioning of the vital 
organs of the body circadian rhythm on the other  
hand is that 24-hour day/night cycle okay that 
24-hour day a full day pretty much okay so this  
is the ranges for vital signs that we need to 
be able to be understanding just looking at  
the oral temperature rectal and axillary knowing 
that rectal temperatures will always be about a  
degree higher and average and oral and then 
the axillary which is underarm temperature  
taking which is going to be about one degree 
lower from the oral you know looking at blood  
pressure systolic and diastolic those are the two 
different numbers systolic is the number the top  
diastolic is a number in the bottom okay so we 
need to look at the different levels of what our  
pre-hypertensive – what is considered hypertensive 
okay so let's look at temperature there are four  
sites where we can take them we always understand 
that we want to stop using mercury thermometers so  
we're using mercury free thermometers nowadays we 
also have a lot of digital thermometers out there  
it's starting to be used from oral rectal and XL 
air temperatures we're trying to make sure also  
to let you know that you can never use an oral 
thermometer as a rectal rectal thermometer or  
vice versa even if you're using sleeves on these 
thermometers okay so making sure that we need to  
learn that now for a lot of the thermometers 
you don't need to shake them no more like we  
use – back in the days if you've seen videos or 
if you see movies where after to take somebody's  
temperature they shake it those were typically 
for mercury thermometers but since we're not  
using those no more you don't have to do the 
shaking no more so continue into thermometers  
we also use tympanic thermometers which are fast 
and accurate okay now rectal temperature to be  
able to take your temperature rectally is pretty 
much the most accurate level of being able to find  
out your level of your Torah pretty much your 
temperature all the thermometers must always be  
clean after use even when you're using protective 
covers okay and in addition to cleaning them you  
must use protective covers as well moving on 
to pulse pulses the number of heartbeats per  
minutes your radial pulse is inside of the wrist 
and the most common site for measuring your pulse  
the brachial pulse is right inside your elbow 
about one to one-and-a-half inches above your  
elbow the apical pulse is on the left side of the 
chest just below the nipple now when we're talking  
about pulse the normal rate is between 60 to 100 
beats per minute for adults okay slow weak pulse  
may indicate dehydration a possible infection 
or even shock now when we talk about a status  
COPE other than using it to listen to your lung 
sounds it's also instrument to be able to listen  
about listen how your pulse is going you know 
the rhythm is there any abnormal rhythms that  
are happening okay so you want to be able to 
make sure that you know the common pulse sites  
you have your break peel you have your radio you 
have your character pulse which is right on your  
neck and I know you also have your Pinot pulse 
as well which is right on your foot moving on  
let's also talk about respiration pretty much the 
breathing aspect of things you have respiration  
inspiration expiration and apnea so respiration 
is the process of breathing air into the lungs  
and exhaling air out of the lungs inspiration 
is the process of breathing air into the lungs  
and expiration is the process of ex hailing air 
out of the lungs so inspiration expiration hi so  
pretty much you can try it if you want to the next 
term apnea what is that Mia do you know somebody  
that has apnea well apnea is the absence of 
breathing okay so the absence of breathing  
that's what apnea means this knee on the other 
hands that means a difficulty breathing okay P  
and EA means breathing dis is difficulty so when 
we talked about the previous term the apnea a is  
without P Nia breathing so without breathing 
or no breathing you Kia EU that means normal  
respirations orthopnea is shortness of breath when 
lying down and the only way you can relieve it is  
if you're sitting up okay so the next term is 
tachypnea so P MEA means breathing tachy means  
rapid okay so tachypnea is rapid respirations now 
when we talk about cheyne-stokes respiration Zoar  
also known as just cheyne-stokes it's altering 
periods of slow irregular respirations and rapid  
shallow respirations so talking about respirations 
it consists of an inspiration and an exploration  
your normal rate is around 12 to 20 breaths per 
minute you want to be able to do two counting  
while you're counting the poles as well do not 
let the client know you are counting the breaths  
as that person may start controlling it what 
you can also do is you can put your right or  
your left hand on their shoulder not pushing down 
but just have it there just for that touch and to  
be able to feel whenever there's the rise of the 
shoulder that's a good way to be able to really  
see and count the respiration you want to be 
able to report any unusual sounds or difficulties  
the client that hasn't breathing okay so we're 
moving on to blood pressure right now systolic  
is the measurement of blood pressure it's the 
phase when the heart at work when the heart  
is contracting and pushing the blood from the 
left ventricle of the heart okay diastolic is  
at the second measurement of the blood pressure 
it's the face when the heart relaxes or rests or  
pretty much the heart fills up again hypertension 
hyper means excess okay tension is the pressure  
okay so high blood pressure hypertensive 
patients or clients are people that measures  
on their blood pressure having a systolic of 
140 or higher or a diastolic of 90 and haider
we talk about pre hypertension this is a condition 
which a person has a systolic measurement around  
120 to 139 and a diastolic of around 80 to 
89 these are pre indicators that the person  
does not have high blood pressure now but there 
could be a possibility that they'll have that  
in the future so if hypertension is high blood 
pressure hypotension is low blood pressure and  
that is if there's a measurement between 100 to 
60 or even lower now the next word is though is  
a mouthful it's called a sphygmomanometer pretty 
much it's a blood pressure cuff or a kit okay so  
this is what we use to be able to collect and to 
be able to measure once blood pressure moving on  
to blood pressure the two parts of it are the bps 
a systolic that's the top number diastolic is the  
bottom number so we talked to butteri the normal 
ranges and what's considered pre-hypertensive okay  
when you place the blood pressure cuff you're 
gonna place that in your brachial artery at the  
elbow that's when you actually use that there are 
a lot of blood pressure cuffs and automatic cuffs  
out there nowadays that is for the wrists when 
you are using the blood pressure the automatic  
one that attaches to the wrist you want to make 
sure that it's placed correctly follow the diagram  
or the instructions written with it and you always 
want to make sure that if the kit itself is right  
above your heart okay so let's say for example 
you're sitting down and you put on the client you  
want to make sure you raise their hands up where 
it's always going to be within level to the heart  
so the fifth vital sign nowadays is we're talking 
about paying now we want to be able to measure the  
pain you know it's very important to monitor 
as vital signs and the reason why is we want  
to be able to know if the pain is affecting the 
client so if pain has a high pain rate then that  
could cause problems for the client to be able 
to function on their daily living so the pain  
is an individual experience everyone has their 
own measurements of pain but we not we want to  
be able to accurately question and get the right 
information to be able to put in the clients chart  
okay every time somebody says that they're in pain 
you want to take that seriously okay so let's go  
ahead and talk about several ways to be able to 
reduce the pain you know if somebody is in pain  
we want to be able to make sure we reported 
right away we want to make sure we give them  
the medication if they have something for it all 
right some part of also for pain chore alleviated  
is you know good body positioning sometimes if 
a client has been laying down in bed for a long  
period of time maybe we need to make sure we 
have readjust them and this is where we talk  
about repositioning every two hours if they cannot 
position themselves you know if need be do we need  
to give back rubs okay we need to be able to ask 
and offer the client a warm bath or shower okay we  
want to be able to maybe encourage your client to 
be able to do some breathing concentrations allow  
the client to be able to have a secluded quiet 
environment and remember once again medication  
is important if they have orders for medications 
that they actually take it we of course don't  
want our clients taking medications that they 
don't have orders for because that can cause  
problems later on we want to be patient we want 
to be gentle we want to be empathetic what we're  
caring for our clients as well now for height 
and weight you know typically depends on your  
agency Oh same thing with your vital signs not 
all non-medical private duty companies expects  
you to take their vital signs their clients vital 
signs it all depends on the but he you work for  
and what is expected over you now we're talking 
about height and weight you want to be able to  
report any weight loss no matter how small we 
want to be able to see is there a significant  
drop in weights greater than five pounds or 
greater than five percent what is going on  
with that client because if they're losing weight 
in a in a mass scale we want to be able to see  
if do we need to give them vitamins do we need 
to give them supplements what do we need to do  
for the client so when we're taking the height 
and weight always make sure we provide privacy  
just like any other procedures we do we want to be 
able to provide privacy weighing part we want to  
be able to also make sure we do at the same time 
of day to be able to match up with the routine  
you never know is the client eating a large dinner 
at nighttime and that's why there's a weight gain  
that happens every night when we're recording 
the oral temperature I want you to keep in mind  
remember we had to use a mercury free thermometer 
okay this is the it's an oral thermometer always  
make sure that you use the sleeves on them 
as provided or as purchased okay make sure  
that you wash your hands before and after it's 
just very much important to do that now pretty  
much on any procedure you want to wear gloves you 
always want to wash your hands but now if we're  
talking about rectal temperatures we want to make 
sure that you really wear gloves okay you know  
you have to understand that when you insert the 
thermometer also make sure that it has a sleeve  
and also that you actually keep it lubricated to 
avoid any shearing or any scratches and then this  
procedure especially we want to be able to watch 
and offer the client privacy because we are doing  
something that is evasive okay you want you want 
to be able to make sure that when you place the  
thermometer you don't let it go the whole time 
that is actually within that person or within  
your client and also just like any procedures 
right after this make sure you wash your hands
now when we start talking about tympanic 
temperature thermometers okay these things  
always comes with a lot of disposable sheets as 
well pretty much the Chism panic temperature or  
thermometer is taken through the ear you want to 
be able to pull up the back of the peanut of the  
ear that's the back of the ear to be able to pull 
that up when you're taking your temperature okay  
for children you want to pull your earlobe down 
before you insert the tympanic thermometer when  
you're measuring and axillary temperature right 
under arm right on the on the armpits okay and  
also understand that this is less reliable always 
one degree lesser than the oral thermometers or  
temperature being taken always make sure that the 
site where you're about to place the thermometer  
you want to be able to wipe it down people are 
placing the thermometer if it's wet or whatever's  
going on in there there are powder or anything 
you want to make sure that any time that you  
are about to do a procedure always always wash 
your hands before and after moving on to apical  
pulses so where is the apical pulse where do you 
take your apical pulse before you we go ahead  
and get started with that always understand 
maining home health aids in home care AIDS  
and home health or homemakers or caregivers they 
purchase their own status copes so they can have  
them available in the clients home at all times 
now if it's a requirement that you guys do that  
and you guys need to provide your own items then 
you should have it with you if not make sure your  
facility provides that for you as well you want 
to be able to emphasize that the diaphragm and  
the ear pieces okay the diaphragm is what touches 
your skin or the clients skin and the ear pieces  
are those two things that goes into your ears of 
course it needs to be cleaned at all times and  
always between the client care okay if there's any 
regularities that your hearing or your ear pretty  
much you know listening to make sure you report 
that always make sure before you touch a client  
if you wash your hands first it's a very much 
important for that now moving on to respirations  
and taking those always make sure that you have a 
watch with you okay a watch that has that second  
hand you know that's a mandatory thing when you're 
caring for somebody you always must have watches  
on you the ability to feel the pulse comes with 
practice of course when you're taking the polls  
and when you're recording your respiration it 
takes time and you can practice on yourself  
on a family member a loved one or whomever you 
want to be able to emphasize that a pulse less  
than 60 or more than a hundred has to be reported 
to the supervisor as abnormal you always want to  
observe and document any patterns and character 
of the breaths and always always always remember  
to wash your hands when you're measuring and 
recording height of a client here's a couple  
points put in mind the procedure will be different 
for been bound and ambulatory clients and always  
remember to wash your hands alright here's a 
few more definitions and what we're going to  
be talking about here is in regards to several 
types of specimens that you as a care giver a  
home maker or somebody that cares for clients at 
their home has to collect okay so talking about  
specimens specimens is that sample that is used 
for analysis in order to try to make a diagnosis a  
sputum is a thick mucus coughed up from the lungs 
where a stool is the feces okay the poopoo hat in  
healthcare is one of those collection containers 
that is sometimes inserted in a toilet to collect  
the measured urine or the stool so it doesn't 
land in the water okay so let's talk about routine  
urine specimen a routine urine specimen is a urine 
specimen that is collected any type of person  
voice they brought to urinate collect a clean 
catch specially on their hand is a urine specimen  
that does not include the first in the last urine 
that is voided also called midstream 24-hour urine  
specimen now that does is is a urine specimen 
specimen consisting of all your invited in a  
24-hour period so if a client needs to collect 
a 24-hour urine specimen they're given a pretty  
much almost a two liter bottle typically the color 
is orange in it and of course has warning sign and  
hazard signs on it now calculi are kidney stones 
you know you may end up working with clients that  
has kidney stones and these are very very tough to 
pass and it's also very much painful for a lot of  
clients so let's look at these points right here 
to three types of specimens that you're gonna have  
to possibly collect in the future our sputum stool 
and urine specimens you as a home health aide as a  
caregiver as a homemaker always must wear gloves 
when you're doing these procedures because there  
is always a possibility that you will be touching 
bodily fluids and in in a couple chapters past ago  
that we talked about the importance of being able 
to not transfer any microorganisms especially when  
we're dealing with blood and as well as other 
bodily fluids always make sure that all the  
specimens that we collect that we actually tagged 
it correctly and store them correctly typically  
you must place the client the clients full name 
whatever their social security number is depending  
on what's ordered for you sometimes it's just 
a full Social Security or sometimes they just  
tell you to put the last four digits they're also 
gonna ask you put the birthdate also there if you  
are obtaining this from a client in a facility you 
might have to put their room number on it as well  
now most typically agencies you know will have a 
specimen containers ready for them so it's easy  
for the client or the caregiver to obtain it okay 
and if there's any questions you can always look  
up all a lot of the different instructions on 
how to use them correctly now here's additional  
points you need to know when you're collecting 
a sputum specimen understand the importance of  
proper PPE protective equipment right so make sure 
you wear your gloves make sure you're wearing your  
masks make sure you're wearing a gown if need be 
early in the morning is always the best time to  
collect sputum because when somebody wakes up 
I'm sure if at one time in your life you woke  
up and you're a little groggy and you had a you 
know a couple thick phlegm a little bit in your  
in your throat and you would have to cop it out 
well that's typically the best time to be able  
to obtain a sputum specimen okay you want to 
make sure you wipe off the excess peuta from  
the container especially if it's in the outside 
area and always don't forget to wash your hands  
now when we're collecting stool specimens you 
know you're in a toilet paper should not be  
included in the sample okay we are containing the 
stool specimen only so removing discard gloves  
and wash hands before they know upon your return 
put on clean gloves understand that the perineal  
care must be necessary if there is any stool that 
comes out you want to be able to make sure that  
both you and the client must wash hands after the 
collection remember in any of these procedures we  
do we always want to be able to offer the client 
to wash their hands also and also you want to be  
able to be familiar with what specimen containers 
that your agency's working and using so that when  
you are faced of having to collect some specimens 
you already know how to use it okay we're talking  
about routine urine specimens now always ask the 
client to put toilet paper in with specimen okay  
you want to be able to make sure that there's no 
toilet paper that's placed with this specimen you  
just want the specimen alone you want to be able 
to make sure that you're removing discard all the  
gloves and wash hands before leaving the room as a 
home health aide a homemaker caregiver you should  
wipe off the outside of the container with paper 
towel and label it correctly label it according  
to what your standards are for your facility 
you always want to be familiar with what kind  
of collecting materials you're using with the 
particular client so you don't mess things up  
and always always always wash your hands and their 
patients are in the clients hands now in what we  
call a clean catch or a midstream catch we need to 
understand that the lady of the female client or  
the penis of the male client must be clean before 
collecting the specimen the client must start to  
urinate stop midstream and then start again so 
the urine collected is not the first urine voided  
at that time when the containers have fullness 
specimen is completed and the lid is placed on it  
okay you want to be able to wipe off the outside 
of the container with a paper towel and label it  
correctly and also remember to wash your hands and 
to make sure the client washes his hands as well  
a 24-hour urine specimen on the other hand is we 
have to understand that we have to make sure that  
whatever we're filling up is we actually label it 
correctly okay we want to be able to include what  
time we started collecting and what we stopped 
collecting any the specimens should always be  
kept cold at all times during a 24-hour of the 
collection process pretty much your refrigerator  
the urine from the first morning urination is 
discarded the 24-hour begins after that voiding  
and ends 24 hours later after the early morning 
urination now there's gonna be times right where  
the specimens are kept in a special refrigerator 
other times okay the collection may be placed in  
a large bucket of ice to keep it cold you always 
have to be able to explain things carefully to  
the client and the family you know that you should 
not or day should not discard any urine during the  
collection period or the entire 24-hour collection 
will have to be started again and always wash your  
hands before and after anything you do okay 
let's talk about input/output eye nose as we  
like to call them intake is the fluid a person 
could assume in a daily basis and output is the  
all the fluid that is eliminated from the body 
which includes vomits feces urine perspiration  
moisture the air that is even exhale as well as 
fluid balance and emesis fluid balance is taking  
in and eliminating equal amounts of fluids 
whereas emesis is vomiting the echo vomiting  
or addiction stomach contents through the mouth 
or even the nose yuck to maintain how the body  
must take in a certain amount of fluid each day 
generally a healthy person needs to take in from  
64 to 96 ounces of fluid each day that fluid a 
person consumes is called an intake or an input  
if a person's intake is not in a healthy range 
he or she can become dehydrated like right now  
for example I'm talking a lot so I am outputting 
a lot of fluids because where every time you we  
converse and I'm talking I'm actually exhaling and 
fluid is coming out the we nailed see it but it's  
coming out so of course if somebody's talking 
for a longer period of time then of course is  
gonna be the increased chance of me being more 
dehydrated henceforth I'm drinking fluids while  
I'm actually also doing this whole presentation 
now always understand that all fluids taken in  
each day cannot remain in the body it must be 
eliminated as an output the output will always  
include the faeces the urine okay and vomitus as 
well as perspiration and moisture in the air that  
of person exhales if a person intake ink see 
exceeds his or her output fluid buildup in the  
body tissues okay so if we cannot get rid the 
same amount that we bring in then we're taking  
in more fluids that fluid retention can cause 
medical problems and discomfort that's what CHF  
happens to be so we want you also to be familiar 
with conversion tables and this is something that  
you need to be familiar from from ounces to 
milliliters and understand that milliliter is  
also known as a cc okay similar stuff so one ounce 
always equals 30 CC's six ounces always equals 180  
okay so that's always a good thing to know now you 
want to be able to remember these remember these  
points when measuring and recording your intake 
and out prefer client you need to understand  
that measuring containers are necessary for this 
procedure you need to know the different types of  
measuring items including some that are marked 
and ounces and milliliters measuring containers  
should be placed on a flat surface and the years 
should be measured at eye level never ever ever  
splash urine when emptying your graduate also 
remember and understand right and especially  
when somebody is having or somebody is vomiting 
we need to remember these things right here so  
we need to understand comfort measures wearing 
gloves removing soiled linens and offering a  
drink or toothbrush afterwards we want to be able 
to provide kritis e if possible clients may be  
very sensitive about vomiting in front of others 
now always cover the basin of emesis with a paper  
towel as quickly as possible now moving on with 
catheter care catheter is a thin tube inserted  
to the body that is used to drain fluid or inject 
the fluids a urine catheter is a catheter is used  
to drain urine from the bladder and a straight 
catheter is a catheter does not remain inside  
the person it removes or it is removed immediately 
after urine is drained or collected an indwelling  
catheter that is a type of catheter remains inside 
the bladder for a period of time urine drains into  
a bag a condom catheter is a catheter has an 
attachment at the end that fits into the penis  
also called an external or a Texas catheter so 
it pretty much looks like a condom and it just  
has the same type of method of being able to 
place into a person's genitals is to roll into  
just like a condom but it has a hole on the on 
the tip that attaches to a bag now when we're  
talking about providing care for somebody that 
has a catheter pay attention to these following  
rules you want to keep the drench bag lower than 
the clients hips or bladder to prevent gravity of  
flow back right or back flow because if the bag 
is above their bladder so what you're doing is  
that you're trying to do something like an enema 
and having the urine that's in the bag go back  
into the person so you don't want that to happen 
because that can cause infection and irritation  
you of course also want to keep the drainage bags 
off the floor okay you want to prevent any kinks  
any twists and pressures on the tubing you always 
want to make sure that you keep the genitals clear  
and clean if there is any blood be urine or like 
stoppage of urine or if the bag feels suddenly if  
bag is out of place leaks clients discomfort and 
orders make sure that those are being reported you  
want to collect urine specimens directly from the 
catheter not in the bag never ever click from the  
bag because why the bag sometimes does not get 
changed on a daily basis so at the same time as  
you have a pool of bacteria probably pooling up in 
there so you want to avoid that and that's why you  
don't want to also have the bag above the person's 
bladder because what happens is you're bringing it  
back to your inside the person same thing at the 
time Esther is build up there already and you may  
actually have a false reading when you actually 
collect those urines so you want to make sure  
you're collecting that you're collecting specimens 
coming directly from the Foley catheter so you  
would have to clip onto the bag to keep it closed 
detach it from the Foley catheter and collect  
urine specimen from the catheter itself urine is 
an inspection s'matter and must be handled with  
gloves on and disinfected with solutions of bleach 
and water so if you have any spillage you have to  
make sure you clean it up correctly okay so why 
it's important to offer fluids to clients who have  
catheters in place well the most important thing 
to understand is that we're actually draining  
them with fluids were you know we're really 
measuring things so we need to make sure that  
we're replacing the person with fluids okay so we 
need to make sure that it's done correctly also I  
need to repeat this again and I will always repeat 
this as wearing gloves and wash your hands when  
providing any type of catheter care you want to 
be able to make sure you're familiar with what an  
actual catheter is what a tubing is and drainage 
bag look like you want to make sure that you use  
soap and water or antiseptic wipes when you're 
actually wiping the catheters you want to be  
able to make sure you wipe down the tubing's away 
from the body never towards the body you want to  
be able to wipe once and use a new wipe or clean 
area of a washcloth each time you wouldn't want  
to be able to remember you wear gloves and wash 
your hands so now we're moving on to emptying a  
catheter during each bag you know the bag that 
clicks to urine the drainage system is a closed  
system so that no infection can enter it must 
remain a closed system even when being emptied  
the drain spouts should be cleaned with alcohol 
every time it is emptied and open so that the bag  
remains lower than the clients hips you always 
want to observe urine for color smell clarity  
and amounts okay you want to be able to remember 
to wear gloves and wash your hands as well now  
when you're changing condom catheters you want to 
be able to leave a space between the drainage tip  
and the glans of the penis you want to be able 
to make sure the condom is secure to the penis  
with a special tape applied in a spiral manner 
but also when you actually apply the tape that  
you also make sure that you don't make it tight 
too much that you actually cause restriction okay  
or constriction remember to wear gloves and always 
wash your hands that's very important okay moving  
on to what we call warm and cold applications all 
right so heat relieves pain it reduces swelling  
it elevates the temperature in the tissue and it 
also increases blood flow bringing more oxygen  
and nutrients to tissues the cold stuff now they 
stop the bleeding they prevent swelling also and  
relieves the pain and brings down high fevers 
so if you look at the cold and the heat the  
heat reduces swelling cold prevents the swelling 
okay and we want to be able to make sure that we  
are using the right applications at the right time 
anytime that you actually make something too cold  
or too hot you want to be able to observe the area 
okay are there any blisters coming up you know  
that means possibly did you use something that's 
really really hot you know is there a increased  
pain in that site for that person we want to 
be able to understand and we want to be able  
to measure and we also want a document to what we 
actually see and hear and we do okay so here is a  
typical graph of what you need to know so you can 
pause this video just to take a look at it further
okay let's go ahead and move on let's go ahead 
and talk about the benefits of warm and cold  
applications so we want to be able to understand 
in warm compresses we want to be familiar with any  
commercial type of warm compresses whether it's 
a plug-in compressed or if it's one of those warm  
comforts that you have to kind of break a seal to 
be able to mix two different chemicals to create  
the heat you also want to be able to consider 
using plastic wrap to keep the compresses warm and  
wet longer and to prevent getting the better the 
client's bedclothes wet when we're administering  
warm soaks we have to understand the importance 
of using the correct temperature you don't want  
it to be higher than 105 degrees Fahrenheit and 
you don't want it to be on the person or have the  
person there for longer than 15 to 20 minutes now 
the client may feel chilled so use a bath blanket  
you also want to carefully add warm water to Basin 
periodically to keep the water continuously warm  
now let's talk about using a hot water bottle you 
also want to make sure you want to pay attention  
to the temperature when you're using a hot water 
bottle it's a different temperature used for an  
adult than for a child also same thing for about 
the amount of time we need to make sure that we  
read the rules and as well as what's covered in 
regards to how long it should be on always want  
to cover the water bottle and check the skin 
every five minutes okay it alleviates that you  
know a little bit pressure from the skin but 
to be able to reassess things as well we want  
to practice filling the bottle and pressing out 
the excess air at all times another procedure we  
should talk about our sitz baths it's a procedure 
given you know is for the use of eight you know  
since fat so when we're doing a sitz bath we 
have to understand what this is gonna do it's  
gonna help out with you know any swelling with any 
joint pain and you know since baths are typically  
ordered by a therapist or by the physician for 
them when we're providing somebody a sitz bath  
okay we want to make sure that you are always 
wearing your gloves you washed your hands you  
should always be familiar with of equipments 
being used everything will vary at times because  
there are different companies that will actually 
provide the products for this so when we're using  
ice packs now you want to be able to know that 
the ice bag should only be filled 2/3 full and  
never filled completely you want to be able to you 
know remove the excess air in it and you also want  
to make sure that whatever you're using has to be 
always covered always make sure that when you put  
the ice pack on an area of your skin that you 
actually check it always for several you know  
within like about 10 to 15 minutes every time you 
have that on a person you want to pay attention  
to the skin are there any blistering happening 
are there any paleness are there any white or  
gray skin or discoloration that's happening now 
the climate may feel chilled or obviously they  
should feel chilled that they have ice packs 
on them so blanket is always suggested to be  
able to be there and remember that it should not 
be it should not stay longer than 20 minutes so  
now we're talking about cold compresses so you 
can add ice and then you can add water to it to  
keep it cold but always remember that when 
you're using cold compress always allow and  
give the client a blanket now for cold compresses 
because it's directly in the skin there's always  
that risk or that greater risk for blisters 
and paler and white skin so make sure for cold  
compresses we're actually checking the client 
every five minutes instead of every 10 minutes
the next thing we're going to be discussing is 
how to apply non sterile dressings so why do  
we provide sterile dress non sterile dressings 
why are we putting dressings on a site well the  
reason why we're doing that is we now have an 
open site and if you have one of those you can  
increase the chance of getting an infection so by 
having a site such as that we can actually and we  
actually put a dressing on a wound we are actually 
trying to prevent the access of a microorganism to  
be able to enter that site and possibly cause an 
infection so you always want to make sure that  
you are actually changing your gloves every time 
you're about to do something you always want to be  
able to observe the dressing the wound for odor 
the amount of color of drainage and any redness  
or swelling that's surrounding the area you only 
want to touch the outer edges of the dressing when  
you're applying it and never in the center you 
always want to make sure that when you're applying  
dressing you always are washing your hands now 
let's talk about 10 hoses I'm sure you've heard  
this before or also known as an anti embolic 
hose what this does it prevents any swelling  
and blood clots and promote circulation in the 
feet in the hands so typically when a client has  
poor circulation and they start having an email 
or swelling in the lower extremities they have  
anti embolic hoses also known as Ted hoses that 
we actually put onto the client when they're up  
and they're out of bed but when they get back 
in bed we typically remove that from the client  
because you know they are laying flat so moving 
on to ostomies so what is an ostomy an ostomy is  
a surgically created opening from an area inside 
of the body to the outside a stoma a other hand  
is that artificial opening in the body okay a 
colostomy that is a surgically created opening  
through the abdomen into the large intestine that 
allows feces to be expelled and an ileostomy is a  
surgically created opening into the end of the 
small intestines to allow feces to be expelled  
so let's think about this question what are the 
different body locations of the three types of  
openings and why is care the skin and the stoma 
so important well the most important reason why  
the care for the storm is important is because 
you know anything that comes from the inside of  
our body whether it's your inner species has 
a high acidic rate so if you know stools for  
example or urine is touching that area that can 
cause some irritation that we should always clean  
that out so some of the careful guidelines when 
we're caring for somebody with an ostomy is you  
always want to observe for any changes in the 
skin it's very important you want to be able to  
empty it clean the ostomy bag whenever stool 
is eliminated you always want to wear gloves  
especially when you're dealing with body fluids 
you know skin beers can be used depending on the  
facility that provides it for you guys you know 
food blockage can occur if large amounts of high  
fiber food are ingested and if the food is not 
shoot well so we want to make sure if somebody  
is actually using a colostomy we want to make 
sure that that person has adequate fluids and  
at the same time we monitor that actually they're 
not having any blockages so if charging fluids is  
important to somebody with a colostomy or a knee 
ostomies now there are gonna be a lot of clients  
out there who are embarrassed about having an 
ostomy because there is a differentiator about  
you and another person so always always provide a 
privacy for that particular client if there's any  
odors that are coming from the client meaning 
it's escaping the area we need to report those  
to our caregivers we want to be able to report 
any changes in color amount frequency or even  
odor in the area as well as whatever's coming 
out we need to be able to you know look into  
things and make sure that everything is working 
properly in a lot of cases the client is very  
experienced using the ostomy equipment and will 
even teach you about their products so you want  
to be able to at least have a general look and 
a general feel of what is actually being used  
for that particular client so we just literally 
covered a few information here I hope that we're  
able to share that with you guys that be able 
to give you guys some information you know we  
we covered a lot of different topics here from 
vital science and different types specimens that  
we collect you know the in ticket output as well 
as catheter care and then also talking about non  
sterile dressings warm cold applications as 
well as ostomy care now keep on watching our  
videos there's gonna be an examination right 
after this particular section if you have any  
questions always you know shoot over an email 
to us and we would love to be able to answer  
that for you so keep on watching our videos and 
thank you so much and you guys will be able to  
be educated on how to be able to provide great 
care for clients at the comfort of their home

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