Care of the ears, eyes, nose, hair of a seriously ill patient, algorithms. Ear care Algorithm for caring for the nasal passages of a seriously ill patient

Chapter 4

Nasal care techniques clear the sinuses, stimulate the brain, tone optic nerves and thus improve vision.

"Hatha Yoga Pradipika", II, 30

Until now, not enough attention has been paid to the care of the nasopharynx, which in books on physiology is mistakenly considered an organ of no primary importance, while, on the contrary, it is the main external organ that continues to function until the last moment of our earthly existence. For this reason, cleansing the nasal cavity has not become such a familiar procedure as daily brushing of teeth, mouth and tongue.

1. Importance of cleansing the nasal cavity

Today, practitioners openly acknowledge the fact that many diseases (for example, tonsillitis, parotitis (mumps), sinusitis, and even diphtheria, polio, measles, scarlet fever, influenza, tuberculosis, rheumatism, etc.) can be easily avoided with careful care behind the nasal cavity, of course, performing general hygiene procedures for other organs. Moreover, common diseases of the nasopharynx (such as polyps, adenoids, deformity of the nasal septum and the most common of all diseases - chronic rhinitis) can also be largely prevented with simple regular care of this organ. Even if you do not take into account Special attention, which Yoga gives to the nasal passages - nostrils, pingale(right) and idea(left), - closely related to the nervous system, from a medical and hygienic point of view, cleansing the nasal cavity is of great importance. “Deaf, dumb and crazy, even one who has lost the sense of taste lives as long as the nose functions; and actually cleansing the nasal cavity is a cure for insanity and can reduce the degree of insanity by ninety percent; and at the same time books on physiology teach that it is the least important organ.”

Usually, all the dust that a person inhales settles on the mucous membrane of the nasal cavity and is pushed out by tiny cilia that are constantly moving. In this way, they remove microbes that enter the nasal cavity; and moreover, the mucus in the nasal cavity has bactericidal properties and destroys a large number of bacteria. But still, given the amount of dust that we inhale, the poor-quality food and poisonous drinks that we absorb daily, the disruption of the biophysical mechanism of our body is inevitable. In addition, dust accumulates in the nasal passages. Handkerchiefs cannot remove all the dust and mucus that collects in the nose, especially if a person sleeps on one side, and this dirt begins to dry out at the bottom of the nasal passage and temporarily blocks it. The slightest decrease in the volume of inhaled air, which has arisen in the presence of harmful accumulations in the nasal passages, disrupts the natural ease of breathing, and this, in turn, has a devastating effect on the composition and number of blood cells, as well as on the blood circulation process itself, and, in addition, causes functional disorders of the vascular, digestive, nervous and other systems. As a result of all this, the overall viability of the organism decreases.

In order to start antitoxic treatment at this stage ( mala-suddhi) it is necessary first of all to eliminate the root cause of the disruption of the normal functioning of the body. Therefore, the nasal cavity must begin to be cleaned before other organs. After all, the blockage of one nostril, which is now becoming so common in adults, leads to premature aging due to the fact that there is a chronic lack of air and as a result - the overflow of blood vessels. Yoga claims that blocking one nostril adversely affects the circulation of energy through the human body, since the harmony between the solar (pingala) and lunar (Ida) by electromagnetic flows. It also has an effect on body temperature, on the pulse and, consequently, on general state body, impairs the process of thinking and reduces the ability to concentrate. But such problems can be definitely and easily avoided with daily care of the nasal cavity.

2. Methods for cleaning the nasal cavity

From the foregoing, it becomes more than clear how important a healthy nasopharynx is for a good physical well-being of a person. For the same reasons, yogis emphasized the extreme importance of cleansing the nasopharynx. For this organ to be healthy, it is absolutely essential that the nostrils be fully open and allow air to pass freely through them. The method suggested for this purpose by Yoga Hygiene is very simple and is known as the procedure neti., or cleansing the nasal cavity. In order to fully accomplish its task, it is divided into three separate types: (1) jala-neti, or a method of drawing in water, similar to ordinary nostril rinsing; (2) sutra-neti, otherwise called samanya-neti, or clearing the nasal passages with a thread or rope that is not very stiff, and (3) gharshana-neti, or widening and massaging the nasal passages with a flexible probe.

3. Jala Neti

The procedure for cleansing the nasal cavity, known as jala neti, has three options that differ in execution technique, as well as hygienic value and therapeutic effect. The first is a simple rinsing of the nasal passages, which is also called vyutkrama kapalabhati; this exercise consists in drawing in water through the right and left nostrils alternately or through both at the same time, and then letting it out through the mouth; however, some water can also come out through the nose. The second variant is kapalabhati vyutkrama in reverse and is called kapalabhati sithkrama; when it is performed, water is drawn into the mouth and released through both nostrils. The third method was brought to perfection by the adepts of Yoga, it is called siddha jala-neti. To perform this procedure, you need to draw water into one nostril and, preventing it from flowing into your mouth, let it out through the other, after which you repeat all the steps again, but starting from the other nostril.

(a) Water intake. The common jala-neti exercise, namely vyutkrama, does not damage the nasal passages, does not cause irritation and is extremely easy to perform. Beginners in yoga and even people who do not practice it can perform such washing of the nasal cavity, not only without any negative consequences but also to great benefit. So do not forget, when brushing your teeth and rinsing your mouth in the morning and in the evening, rinse your nose with cold or warm water - as you see fit. Take a glass of water (about a quarter liter) and put half a teaspoon of salt in it. Mix well, pour a little of the resulting solution (about 30 ml) into the palm of your hand and draw it into one nostril (see Fig. rice. 3). If tilting the head to the side is not enough to submerge one nostril, the other can be closed with the thumb of the other hand. Draw in water through the right nostril from the right palm and vice versa. The drawn-in water can pour out either through the same nostril, or through the other, or through both at the same time; or, more likely, it will come out through the mouth. Repeat the exercise twice alternately with each nostril. With a cold or other diseases of the nasopharynx, it can be repeated two to three times a day. After jala neti, do not forget to blow your nose well, closing your nostrils in turn to remove all the water from the nasal cavity.

As mentioned above, the nasal passages are often filled with secretory secretions, which, mixed with dirt and foreign particles, block and poison the body, and also cause damage to the tissues on which they adhere. Therefore, it is important to remove them. Jala Neti dissolves hardened mucus and dirt that accumulates in the nasal passages and often interferes with free and full breathing, which ultimately leads to the occurrence of diseases.

Rice. 3. Drawing in water during jala neti. Pay attention to the position of the palm in which the liquid is located.

It is gratifying to note that recently even insurance companies are beginning to understand the need and value of washing the nasopharynx, especially during epidemics of diseases such as influenza, diphtheria, meningitis, polio and other infectious diseases, the pathogens of which enter the body through the mouth and nose. Articles in brochures and prospectuses issued to insurance company clients emphasize that during these epidemics, cleansing the nasal cavity with an antiseptic rinse, which automatically performs the function of gargling, is the best and the most efficient way disease prevention.

Washing the nasal cavity according to Yoga stimulates the tiny nerve fibers and the delicate mucous membrane of the nasal cavity, as well as the folds and narrow convolutions in this membrane, due to which the air stream, passing through the nasal passages, warms up. In addition, it directly saturates the mucous membrane with two-thirds of the moisture it needs, especially in tropical climates, which is also very important for dust retention. Thus the filtering of the air is undoubtedly greatly improved, the breathing becomes light, rhythmic, and salubrious; air in excess through clear nasal passages cools the brain and soothes nervous system. Yogis claim that due to the cleansing of the nasal cavity, vision improves and diseases that were caused by the appearance of obstacles in the path of the air stream in the nasal passages are cured, and these views of theirs are supported and widely recognized by modern researchers involved in medical problems.

Lindlar, an expert in naturopathy, considered the lavage of the nasopharynx to be the most important hygiene procedure and therefore included it in his daily routine. He notes: “Rinsing the nasopharynx is a wonderful way to clear the nasal passages of any obstruction. it best method treatment of the common cold and excellent natural stimulation of the membrane and nerve endings in the nasal passages. By stimulating the nerve endings, it has a tonic effect on the brain and the entire nervous system.”

However, some physicians object to nasopharyngeal rinsing on the grounds that the nasal mucosa does not tolerate aqueous solutions well and therefore regular dousing and rinsing can cause a chronic painful condition or even infectious diseases of the frontal air sinuses. Of course, this is possible, but only if the nasal passages are not accustomed to cold water; after the mucous membrane of the nasal cavity is gradually hardened with the help of regular washings, such fears can be forgotten. On the contrary, many others medical sources tell us that in order to avoid a cold, it is necessary to harden not only the body, but also the nasal passages. Effective achievement of such hardening is possible with the use of cold (water temperature from 0 to 21 degrees Celsius) or slightly warm (30-32 degrees) baths and cool (15.5-24 degrees) washings of the nasopharynx. Of course, it is better to start with warm water.

Speaking of the jala-neti vyutkrama variant, one can indicate that the sick and people with hypersensitivity can use some tools, the procedure using which is not much different from the original. Such tools include, for example, a siphon, sprayers, a funnel with a tube, and other devices that can be successfully used.

(b) “Reverse” nasopharyngeal lavage. The method of cleansing the nasopharynx of the sheetkrama is difficult for those who are not accustomed to the usual jala-neti exercises. To perform it, you need to take a full mouth of water, close your lips tightly so that the water does not flow out, and release it through your nose. It is best to take a deep breath while holding the water in your mouth. Then tilt your head forward so that the water collects in front of oral cavity, then slightly raise your head and after that, as if exhaling, push the water through your nose, as if you were sneezing. Or you can, holding water in your mouth, touch the sensitive mucous membrane of the nasal cavity with a soft feather, previously washed with soap and carefully disinfected, or muslin rolled into a thin pointed tube, and thus cause a sneeze. Such tickling of the "signal surface", as the nasal mucosa is also called, usually produces the necessary strong reflex expulsion; this irritation of the nasal mucosa eventually becomes mild and arbitrary.

A feature of this method is that, as a result of an energetic reflex movement, accumulated dust, dirt and dried mucus are removed from the nasal cavity more efficiently than with conventional washing of the nasopharynx (i.e., drawing water into the nose). This is especially true for substances that have previously been softened and require strong force to remove. The Shitkrama Kapalabhati procedure is the only effective natural means to achieve this goal.

(3) Siddha jala-neti. After a normal exhalation, dip both nostrils into a glass of saline solution. Then close your throat with jalandhara bandha and draw water into your nose. After the nasal passages are completely filled with water, tilt your head to the right and carefully pull your left nostril out of the water without inhaling air. If the exercise is performed correctly, the water will automatically flow out through the other nostril, as in a vessel. Repeat with the other nostril. At the same time, i.e. alternating nostrils, close the nose with your fingers and open the nostril only after immersing the other nostril in water. We recommend performing this nasal cleansing option under the practical guidance of an experienced teacher.

4. Other medical procedures

The following two methods of cleansing the nasal cavity, known as samanya-neti and gharshana-neti and mentioned above, should be performed only under the personal guidance of a practicing yogi, as they include complex operations which cannot be performed correctly simply by reading a book or listening to verbal instructions. Moreover, if there is no sufficiently competent leader, their implementation can damage the nasal passages. However, this should not make these procedures any less dangerous or less important. On the contrary, they are the best and most suitable method of nasal cleansing currently known to medical science. These cleansing techniques are difficult to perform, and although they are part of the daily cleansing ritual of an experienced yogi, we will skip them in this book for the reason that they cannot be included in the regular hygiene procedures for the average modern person.

X-ray studies and clinical data collected by the Yoga Institute over the past three decades fully justify the use of neti, or Yoga nasal hygiene, in cases of obstruction in the nasal passages, in diseases of the air sinuses and diseases of the eyes caused by blockage of the lacrimal ducts. Legzdins reports that in Riga about fifty members of the Yoga Institute for several years in a row successfully avoided the most common disease in conditions of foggy and wet winters in Northern Europe - acute or chronic rhinitis- only thanks to the performance of jala-neti with saline solution twice a day.

It would be useful to mention here similar studies conducted by a French scientist, which only confirm the real value and scientific importance of various types neti known to yogis for thousands of years. The expansion of the nasal passages through the gradual introduction through the nose into the throat of probes of increasing diameter is welcomed by the French medical academy how effective remedy for the treatment of deafness, headaches, asthma and snoring. Author new methodology(which actually imitated the Hatha yoga technique) suggests that about seventy percent of the people on Earth need such treatment.

It is safe to say that headache in both chronic and acute form, migraine, bronchial diseases, asthma and other diseases arising from the appearance of obstructions in the nasal passages, very quickly respond to the above methods of Yoga. There are even several cases where, thanks to the performance of neti, normal vision was restored and the enlargement of the tonsils was finally stopped.

5. Hygienic care of the nasal cavity according to Yoga

The following table shows the average time required to perform jala-neti and the frequency of repetition of this procedure. To achieve high results, at a time you need to perform three cycles of washing the nasopharynx in the most thorough way. However, the "reverse" washing, the shitkrama, should always be done after the vyutkrama and no more than once a week, usually in the morning.

Caring for the eyes, ears, nose, hair of a seriously ill patient is a technology for performing nursing manipulation.

The algorithm will allow the nurse to quickly navigate the sequence of the procedure.

How to properly care for the eyes, ears, hair of a seriously ill patient - a consistent technique.

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Patient Eye Care: Algorithm

• Sterile kidney-shaped basin with 8 - 10 sterile cotton balls;
• kidney-shaped bowl for used balls;
• two sterile gauze pads; pale pink potassium permanganate solution or furacilin solution 1:5000.

1. Pour a small amount of disinfectant solution into a bowl with balls.
2. A cotton ball soaked in a disinfectant solution is taken with 1 and 2 fingers of the right hand and squeezed lightly
3. Ask the patient to close their eyes. Rub one eye with a ball in the direction from the outer corner of the eye to the inner.
4. If necessary, repeat the procedure.
5. Wipe the remnants of the antiseptic with a sterile napkin from the outer corner of the eye to the inner one.
6. Repeat the manipulation with the second eye.

To avoid the transfer of infection from one eye to another, different balls and napkins are used for each eye.

How to organize the processing of the hands of medical staff with an antiseptic

Algorithm for caring for the ears of a seriously ill patient

• Two kidney-shaped basins for clean and used material;
• sterile cotton turundas (wicks);
• 3% hydrogen peroxide solution; a napkin moistened with warm water;
• towel.

Execution technique

1. Nurse washes his hands with soap.
2. A cotton turunda is moistened with a 3% hydrogen peroxide solution, poured from a bottle (hold the bottle with the label to the palm of your hand, first pour a few drops of the medicine into the tray for the used material, and then pour it on the turunda), squeeze lightly.
3. The head is turned to the side.
4. With the left hand, the auricle is pulled up and back, and with the right hand, the turunda is inserted into the external auditory canal with a rotational movement and, continuing to rotate, is cleaned of sulfuric secretions.
5. Wipe the auricle with a damp cloth, then with a dry towel.
6. Repeat the procedure with the other ear.

Instead of hydrogen peroxide, you can use vaseline oil. It is strictly forbidden to use sharp objects (probes, matches) for cleaning ear canal to avoid eardrum injury. With the formation of sulfuric plugs, they are removed by the specialists of the ENT-office.

The algorithm for the care of the nose of a seriously ill patient

Equipment

• Cotton turundas;
• vaseline or other liquid oil: sunflower, olive, or glycerin;
• two kidney-shaped basins: for clean and used turundas.

Manipulation technique

1. The head of the patient is given an elevated position, a towel is laid on the chest.
2. Moisten turundas with cooked oil.
3. Ask the patient to tilt their head back slightly.
4. They take a moistened turunda, slightly squeeze it and introduce it with a rotational movement into one of the nasal passages.
5. Leave the turunda for 1-2 minutes, then remove it with rotational movements, freeing the nasal passage from crusts.
6. Repeat the procedure with the second nasal passage.
7. Wipe the skin of the nose with a towel, help the patient lie down comfortably.

Hair care algorithm for a seriously ill patient

Equipment

• Basin with warm water;
• a jug with warm water (+35...+37 C);
• towel;
• comb;
• shampoo;
• scarf or scarf.

Execution technique

1. Ask the nurse to lift the patient's torso, supporting him by the shoulders and head.
2. The pillows are removed, the head end of the mattress is rolled up to the patient's back, and covered with oilcloth.
3. They put a basin of water on the bed net.
4. Wet the patient's hair, wash with shampoo, rinse thoroughly in the basin.
5. Rinse your hair with warm water from a pitcher.
6. Wipe hair dry with a towel.
7. They remove the basin, spread the mattress, put pillows, lower the patient's head.
8. Comb the hair with a comb belonging to the patient. Short hair comb from the roots of the hair, and long - from the ends, gradually moving towards the roots.
9. Tie the head with a scarf or scarf.
10. Help the patient to lie down comfortably.

What is important to consider when performing nursing manipulation

If the patient does not have his own comb, you can use a common one, which is pre-treated with 70% alcohol, wiping 2 times with an interval of 15 minutes.

Patients need to comb their hair daily. While washing the head, the nurse must support the patient at all times.

Patient's morning toilet

A person's personal hygiene includes a daily morning and evening toilet for body care. An active patient provides hygienic care on his own, a seriously ill patient is helped by a ward nurse or relatives.

The morning toilet of a seriously ill patient includes a set of measures for the care of the face, perineum and the whole body.

Eye care

Purpose of Purification eyelid removal ocular discharge, foreign particles, reducing the risk of infection and creating patient comfort.

Eyelid cleansing is necessary for:

• Removal of secretions that stick together eyelashes;
• Eye preparation for drug administration.

Eye treatment

Prepare: a sterile tray with cotton balls, napkins, sterile gloves, an antiseptic solution (0.02% furacilin solution, 2% soda solution), a container with a disinfectant.

Sequencing:

1. Take two balls with your right and left hands.
2. Moisten the balls in an antiseptic solution at the same time, squeeze lightly and wipe the eyelids in the direction from the outer corner of the eye to the inner one. Drop the balls into the disinfectant.
3. Repeat the procedure as needed; each time use separate balls for each eye.
4. Dry eyes with dry cotton balls/napkins. Throw in disinfectant.
5. Ensure patient comfort.

Nose care

Purpose: ensuring free nasal breathing - removing mucus and crusts from the nasal cavity.

Prepare: a sterile tray with cotton turundas, sterile gloves, glycerin or vaseline oil, a container with a disinfectant.

Sequencing:

Give the position to the patient: sitting (lying).

1. Wash hands, put on gloves.
2. Moisten the turundas in oil, squeeze lightly.
3. Raise the tip of the nose, with the other hand, insert the turunda with a rotational movement alternately into the left and right nasal passages.

If necessary, leave the turunda for 1-3 minutes to soften the nasal crusts.

1. Throw the turunda into the disinfectant.
2. Remove gloves, discard in disinfectant, wash and dry hands.
3. Ensure patient comfort.
4. Document the procedure.

Ear care

Purpose: ensuring hygienic comfort, preventing the formation of sulfur discharge.

With hypersecretion of the sulfur glands in the external auditory canal, earwax can accumulate and cause obstruction. Sulfur plug can cause hearing loss.

Ear treatment

Prepare: sterile tray with cotton turundas, warm 3% hydrogen peroxide solution, soapy water, warm water, wipes, sterile gloves, container with disinfectant.

Sequencing:

Give the patient a position: sitting / lying down, tilt his head to the opposite side.

1. Wash hands, put on gloves.
2. Moisten a cotton turunda in a warm solution of hydrogen peroxide, squeeze lightly.
3. Pull the auricle upwards and backwards with one hand and insert a cotton turunda into the external auditory canal, discard it in a disinfectant.
4. Dry the external auditory canal with a cotton turunda, discard it in a disinfectant.
5. Moisten a napkin in a soapy solution and treat the auricle, behind the ear space.
6. Rinse the auricle, behind the ear space with water and dry.
7. Remove gloves, discard in disinfectant, wash and dry hands.
8. Ensure patient comfort.
9. Document the procedure.

1. Avoid sharp objects when treating the ear in order to prevent injury to the eardrum or the wall of the ear canal.
2. Drop a warm 3% hydrogen peroxide solution (37 degrees) into the external auditory canal when sulfur accumulates.

oral care

The state of severity of the patient determines the degree of nursing intervention. A sister helps a seriously ill patient to carry out oral hygiene, in the absence of consciousness, treats the oral cavity, preventing aspiration of the contents during the procedure.

Poor oral hygiene can lead to bad breath, inflammatory processes: stomatitis, gingivitis, caries. The oral mucosa may be irritated or coated in debilitated and febrile patients. Plaque consists of mucus, desquamated epithelial cells, bacteria, and decaying food debris. Daily examination and oral hygiene procedures will help and maintain patient comfort.

Irrigation (rinsing) of the oral cavity.

Prepare: a spatula, a stick-shaped tray, a pear with a tip, a waterproof napkin, gloves, an antiseptic (0.02% furacilin solution, 2% soda solution), a container with a disinfectant.

Sequencing:

1. Turn the patient's head to one side, place the tray under the chin on a napkin.
2. Wash hands, put on gloves.
3. Dial an antiseptic into a pear.
4. Remove the corner of the mouth with a spatula.
5. Rinse the left and right buccal spaces with a pear, pulling one and the other cheeks in turn.
6. Disconnect the tip from the pear, discard into a container with a disinfectant.
7. Remove gloves, discard in disinfectant, wash and dry hands.
8. Ensure patient comfort.
9. Document the procedure.

Treatment of the oral mucosa

Prepare: spatulas with swabs, a kidney-shaped tray, a pear, a waterproof napkin, a towel, gloves, an antiseptic (0.02% furacilin solution, 2% soda solution), nourishing cream, a container with a disinfectant.

Sequencing:

Give the patient the necessary position in bed: Fowler (lying).

1. Place a napkin on the patient's chest.
2. Wash hands, put on gloves.
3. Ask the patient to open their mouth wide.
4. Moisten a swab with an antiseptic solution and process sequentially, changing swabs:

• Teeth from inner and outer surface,
• sublingual space,
• Tongue from root to tip.

Use a separate spatula to detect teeth, fix the tongue, cheeks.

1. Ask the patient to rinse their mouth.
2. Dry the area around your mouth with a towel.
3. Treat lips with a nourishing cream.
4. Remove gloves, discard disinfectant, wash and dry hands.
5. Ensure patient comfort.
6. Document the procedure.

Teeth cleaning

Prepare: toothbrush and paste, spatula, kidney-shaped tray, towel, waterproof cloth, gloves, a glass of boiled water, nourishing cream, container with disinfectant.

Sequencing:

Place the patient in a comfortable position.

1. Put a napkin (towel) on the chest.
2. Wash hands, put on gloves.
3. Apply toothpaste on the brush.
4. Ask the patient to open their mouth.
5. Brush the surface of the teeth with a brush from top to bottom and from bottom to top in sequence: external, chewing, internal, using a spatula.
6. Instruct the patient to rinse their mouth with water.
7. Dry the area around the mouth.
8. If necessary, treat the patient's lips with a nourishing cream.
9. Remove gloves, discard in disinfectant, wash and dry hands.
10. Ensure patient comfort.
11. Document the procedure.

1. If the patient can brush his teeth on his own, it is necessary to provide him with everything necessary, to motivate him to self-care.
2. In the presence of dentures, rinse them with boiled water (antiseptic) after each meal, remove at night. Store in an individual container.

Caring for removable dentures

Dentures are a reservoir of various microflora.

Lack of care contributes to the appearance of bad breath, which makes communication difficult, gives rise to self-doubt, deprives the pleasure of eating. Improperly fitted dentures are the cause of gum irritation and ulceration of the oral mucosa.

Processing of removable dentures

Prepare: a tray, a glass of water, napkins, a towel, a container for dentures, a toothbrush and paste, gloves, an individual container for storing dentures, a container with disinfectant.

Sequencing:

Give the patient an elevated position or turn the head to the side.

1. Wash, dry hands, put on gloves.
2. Cover your chest with a towel.
3. Place the tray and ask to rinse your mouth with water.
4. Ask the patient to remove the dentures into a special container or help to do this using a napkin.
5. Provide brushing of the patient's own teeth, as well as hygiene of the palate, tongue, sublingual space, gums with a soft brush or napkins.
6. Throw the napkin into the container.
7. Ask the patient to rinse their mouth with water.
8. Dry lips and chin with a towel.
9. Brush all surfaces of dentures with toothpaste, rinse under running water.
10. Help the patient put the dentures back on or place them in a personal container for overnight storage.
11. Remove gloves, discard in disinfectant, wash and dry hands.
12. Ensure patient comfort.

8.1.1. Carrying out a hygienic shower

Contraindications: serious condition of the patient.
Equipment: bath bench or seat, brush, soap, washcloth, gloves, bath treatment products.
Performing manipulation:
- put on gloves;
- wash the bath with a brush and soap, rinse with a 0.5% bleach solution or 2% chloramine solution, rinse the bath with hot water (household cleaners and disinfectants can be used);
- put a bench in the bath and seat the patient;

- help the patient dry himself with a towel and get dressed;
- remove gloves;

8.1.2. Carrying out a hygienic bath

Indications: skin pollution, pediculosis.
Contraindications: severe condition of the patient.
Equipment: brush, soap, washcloth-mitt, gloves, footrest, bath treatment products.
Performing manipulation:
- put on gloves;
- wash the bath (Fig. 73) with a brush and soap, rinse with a 0.5% bleach solution or 2% chloramine solution, rinse the bath with hot water (you can use household cleaners and disinfectants);
- fill the bath with warm water (water temperature 35-37 °C);
- help the patient to take a comfortable position in the bathroom (the water level should reach the xiphoid process);
- wash the patient with a washcloth: first the head, then the torso, upper and lower limbs, groin and perineum;
- help the patient get out of the bath, dry himself with a towel and get dressed;
- remove gloves;
- Escort the patient to the room.
The duration of the bath is not more than 25 minutes.

Possible Complications: deterioration of health - pain in the heart, palpitations, dizziness, discoloration of the skin. If such signs appear, it is necessary to stop taking a bath, transport the patient on a gurney to the ward, and provide the necessary assistance.

To facilitate the work of staff, there are special devices that make it easy to place the patient in the bath (Fig. 74).

8.1.3. Seriously ill skin care

For patients who are indicated for bed rest or strict bed rest, the use of a hygienic bath or shower is contraindicated due to the severity of the condition and the high risk of complications. However, compliance with skin hygiene in this category of patients is also necessary. Such patients wipe the skin at least twice a day with a swab or the end of a towel moistened with warm water or an antiseptic solution (10% camphor alcohol solution, vinegar solution - 1 tablespoon per glass of water, 70% ethyl alcohol mixed with water, 1% salicylic alcohol). Then the rubbed places are wiped dry.
The nurse washes the patient (face, neck, hands) with a sponge moistened with warm water. Then dries the skin with a towel. The patient's legs are washed 2-3 times a week, placing a basin on the bed, after which, if necessary, the nails are cut short. With poor skin care, diaper rash, bedsores and other complications can occur that worsen their condition.
Especially carefully it is necessary to wash and dry the skin folds under the mammary glands in women (especially in obese women), armpits, inguinal folds, since otherwise there is a high risk of developing diaper rash. At the same time, the protective properties of the skin are reduced, and microorganisms are able to penetrate through damaged skin. In order to prevent diaper rash, it is necessary to examine the skin folds under the mammary glands, armpits, and inguinal folds daily. After washing and drying, these areas of the skin must be powdered with powder.

8.1.4. Washing feet in bed

Equipment: rubber oilcloth, basin, warm water at a temperature of 34-37 ° C, washcloth, soap, towel, vaseline or softening cream.
Performing manipulation:
- put on gloves;
- put oilcloth on the mattress;
- put the basin on the oilcloth;
- pour water up to half of the basin;
- lower the patient's legs into the pelvis with a minimum physical activity for the patient;
- lather your feet well, especially the interdigital spaces;
- rinse the patient's legs clean water, lifting them above the pelvis;
- wipe your feet dry with a towel;
- lubricate the soles and heels with cream;
- take out the oilcloth;
- it is convenient to lay your legs on the bed and cover them with a blanket;
- Wash the hands.

8.1.5. Washing away the sick

Patients who can take care of themselves, wash with boiled water and soap every day, preferably in the morning and evening.
Seriously ill long time those who are in bed and who are not able to regularly take a hygienic bath should be washed away after each act of defecation and urination. Patients suffering from incontinence should be washed several times a day, as the accumulation of urine and feces in the perineum and inguinal folds can cause diaper rash, bedsores or infection.
Indications: perineal hygiene.
Equipment: 8-16 cotton swabs, oilcloth, vessel, forceps, jug, Esmarch's mug with a rubber tube, clip and tip, antiseptic solution (slightly pink solution of potassium permanganate or furacilin solution 1: 5000).
Performing manipulation:
- put on gloves;
- lay the patient on his back, his legs should be bent at the knees and divorced;
- lay an oilcloth under the patient and put the vessel;
- take in right hand forceps with a napkin or cotton swab, and in the left - a jug with a warm antiseptic solution or water at a temperature of 30-35 ° C. Instead of a jug, you can use an Esmarch mug with a rubber tube, clip and tip;
- pour the solution on the genitals, and with a napkin (tampon) make movements from the genitals to the anus (from top to bottom).
First, the labia minora are washed (with two different tampons or one large, but different sides), then the labia majora, inguinal folds, and the anus area is washed last, each time changing the tampons;
- dry in the same sequence, constantly changing tampons;
- at the end of the procedure, remove the vessel and oilcloth;
- Wash the hands.

8.2. oral care

Oral Care - necessary procedure for all patients, since microorganisms accumulate there, causing bad breath and causing inflammatory changes in the teeth, mucous membranes of the oral cavity, excretory ducts salivary glands. Assistance in such care should be given to patients who are not able to do it themselves.
Patients should thoroughly brush their teeth, especially near the gums, 2-3 times a day, preferably after each meal. If this is not possible, rinse your mouth after meals with lightly salted water (*/4 teaspoon of table salt per glass of water) or a solution of baking soda (U2 teaspoon per glass of water). This procedure is also necessary for people who do not have teeth.
For seriously ill patients who cannot brush their own teeth, after each meal, the nurse should treat the oral cavity. Patients rinse their mouths. After that, the gums are gently and thoroughly wiped with a cotton ball or gauze, fixed with a clamp or forceps and moistened with an antiseptic solution.
Application- this is the imposition on the mucous membrane of sterile gauze wipes soaked in any disinfectant solution (0.1% solution of furacilin) ​​for 3-5 minutes. This procedure is repeated several times a day. You can make applications with painkillers.
Patients who have impaired nasal breathing and who breathe almost entirely through the mouth, often suffer from dryness of the lips, mouth. After some time, they develop cracks in the corners of the mouth, which can be painful, especially when talking, yawning, eating. The patient must be taught not to touch these wounds with his hands and not to open his mouth wide. The lips are gently wiped with a swab moistened with a 1:4000 solution of furacilin, and then lubricated with vegetable, olive or vaseline oil, sea buckthorn oil.
To prevent the formation of cracks and drying of the lips, patients in a coma with artificial ventilation of the lungs are given a gauze pad moderately moistened with a solution of furacilin, which is replaced as it dries.
In patients with high fever who have viral infection or severe violation circulation, sometimes develops aphthous stomatitis which produces a strong odor from the mouth. To get rid of this smell, it is necessary to treat, first of all, the underlying disease. Be sure to rinse your mouth with disinfectants (0.2% sodium bicarbonate solution, 1% sodium chloride solution or dental elixir).
If the patient has removable dentures at night, they are removed, thoroughly washed with running water and stored in a dry glass. Wash again before wearing.

8.2.1. Oral treatment

Oral Care Algorithm

Indications: Regular oral care.
Equipment: spatula, cotton balls, clip or tweezers, tray, solutions of the previously listed antiseptics, gloves.
Preparation for the procedure:
- introduce yourself to the patient, explain the course of the upcoming procedure (if he is conscious);
- prepare all the necessary equipment;
- position the patient in one of the following positions:
- on the back at an angle of more than 45°, unless contraindicated,
- lying on the side
- lying on your stomach (or back), turning your head to the side;
- put on gloves;
Wrap a towel around the patient's neck.
Performing manipulation:
Prepare a soft toothbrush (no toothpaste) for brushing your teeth. Ask the patient to open their mouth wide. Soak the brush in the prepared antiseptic solution. In the absence of a toothbrush, you can use a gauze pad attached to a clip or tweezers;
- clean the teeth, starting from the back teeth, sequentially clean the inner, upper and outer surfaces, performing up and down movements in the direction from the back teeth to the front teeth. Repeat the same steps on the other side of the mouth. The procedure is repeated at least two times;
- wet the patient's oral cavity with dry swabs to remove residual fluid and secretions from the oral cavity;
- ask the patient to stick out his tongue. If he cannot do this, then it is necessary to wrap the tongue with a sterile gauze napkin and carefully pull it out of the mouth with the left hand;
- Wipe the tongue with a cloth soaked in an antiseptic solution, removing plaque, in the direction from the root of the tongue to its tip. Release the tongue, change the napkin;
- wipe the inner surface of the cheeks, the space under the tongue, the gums of the patient with a napkin dipped in an antiseptic solution;
- if the tongue is dry, lubricate it with sterile glycerin;
- sequentially treat the upper and lower lips with a thin layer of petroleum jelly (to prevent cracks on the lips).
Finishing the procedure:
- remove the towel. It is convenient to lay the patient;
- collect care accessories and deliver to a special room for further processing;
- remove gloves, place them in a container for disinfection;
- wash your hands, treat them with an antiseptic or soap;
- make an appropriate record of the procedure performed in the medical records.
During this manipulation, the mouth, tongue, and gums are carefully examined. If inflammatory changes occur in the oral cavity, rinsing is carried out, the gums are treated with a solution of furacilin 1; 5000, 2% boric acid solution. Sometimes they apply applications with the same solutions, removing them after 1-2 hours. Treatment is carried out under the guidance of a dentist.
As first aid places of inflammation of the mucous membranes can be treated with a solution of brilliant green. This procedure is repeated 2-3 times a day. On the early stages it sometimes allows the patient to be completely cured before the arrival of a dental consultant.
Patients who are on bed rest for a long time and consume few vitamins may develop stomatitis: round sores appear on the red mucosa. Then they turn yellow, and there are pains in the oral cavity. Sometimes sores appear along the edge of the tongue, on the gums, the inside of the lips and cheeks. Local treatment - applications or irrigation of the oral cavity with the previously listed antiseptic solutions are used. Sores are lubricated with specially prepared ointments or vegetable oil.

8.2.2. Oral irrigation

Indications: phenomena of stomatitis.
Equipment: spatula, cotton balls, clip or tweezers, tray, antiseptic solutions, gloves, oilcloth, pear-shaped balloon or Jeanne's syringe. Performing manipulation:
- put on gloves;
- draw a warm antiseptic solution into a pear-shaped balloon or Jeanne's syringe;
- so that the solution does not get into Airways, the patient's head must be turned on its side (if possible, seat the patient);
- put an oilcloth (or diaper) on the chest and neck of the patient, put a tray under the chin;
- pull the corner of the mouth with a spatula, insert the tip into the vestibule of the mouth;
- alternately rinse the left and right buccal space with a jet of liquid under moderate pressure.
Manipulation of irrigation of the oral cavity is not used in seriously ill patients because of the danger of fluid entering the respiratory tract, which can cause irreversible consequences.

8.3. Ear care

Patients who are on a general regimen wash their ears on their own during the morning daily toilet. Patients on bed rest should periodically toilet the external auditory canals.

8.3.1. Removing dirt and sulfur plug

Performing manipulation:
- put on gloves;
- seat the patient;

- drip a few drops of a 3% hydrogen peroxide solution into the ear (the solution should be warm);
- pull the auricle back and up and rotate the cotton turunda into the external auditory canal;
- changing the turunda, repeat the manipulation.
To remove wax from the ears, do not use hard objects to avoid damage to the eardrum.

8.3.2. Putting ointment in the ear

Performing manipulation:
- put on gloves;
- seat the patient;
- tilt the patient's head in the opposite direction;
- apply the required amount of ointment to a sterile cotton turunda;
- pull the auricle back and up and with rotational movements insert the turunda with ointment into the external auditory canal.

8.3.3. Drops in the ears

Performing manipulation:
- put on gloves;
- seat the patient;
- tilt the patient's head in the opposite direction;
- draw the required number of drops into the pipette (they should be warm);
- pull the auricle back and up and introduce drops into the external auditory canal;
- at the end of the procedure, put a cotton swab into the external auditory canal.

8.4. Nose care

Walking patients during the morning toilet take care of the nose on their own. Seriously ill patients who are not able to monitor the hygiene of the nose, it is necessary to free the nasal passages daily from secretions and crusts that form. The nurse should do this daily.

8.4.1. Nasal processing

Performing a manipulation
- put on gloves;
- in a lying or sitting position (depending on the patient's condition), slightly tilt the patient's head;
- moisten cotton turundas with vaseline or vegetable oil or glycerin;
- insert the turunda into the nasal passage with rotational movements and leave it there for 2-3 minutes;
- remove the turunda and repeat the manipulation.

8.4.2. Instillation of drops in the nose

Another way to clear the patient's nose is to instill drops. In this case, a sterile pipette is used. Patients are in a sitting or lying position (depending on the condition), the head is tilted to the opposite shoulder and slightly tilted back. The nurse must check the compliance of the drops with the doctor's prescription, seat the patient and draw the required number of drops into the pipette. Drops are first instilled into one, and then, after 2-3 minutes, into the other nasal passage, after changing the position of the head.

8.4.3. Help with nosebleeds

The causes of nosebleeds are varied. They can be the result of local changes (injuries, scratching, ulcers of the nasal septum, skull fracture), as well as appear in various diseases (blood diseases, infectious diseases, influenza, hypertension, etc.).
With nosebleeds, blood flows not only outside, through the nasal openings, but also into the pharynx and into the oral cavity. This causes coughing, often vomiting (when blood is swallowed). The patient becomes restless, which increases bleeding.
Performing manipulation:
- seat or lay the patient down and calm;
- it is not recommended to throw back the head in order to avoid swallowing blood and its entry into the nasopharynx;
- press the wings of the nose to the nasal septum;
- put a cold compress or ice pack on the partition;
- if the bleeding does not stop, insert cotton balls (dry or moistened with 3% hydrogen peroxide) into the nasal passages;
- if nosebleeds recur or bleeding is massive, consultation of an otorhinolaryngologist is indicated.

8.5. Eye care

Walking patients during the morning toilet take care of their eyes on their own. Seriously ill patients often develop discharge from the eyes, sticking together the eyelashes and making it difficult to look. Such patients need to wipe their eyes daily with sterile gauze or cotton swabs moistened with disinfectant solutions. It must be remembered that a separate sterile swab is taken for each eye. After manipulating the treatment of the patient's eyes, the sister should thoroughly wash her hands with soap and wipe them with alcohol.

8.5.1. Rubbing eyes

Indications: eye hygiene.
Equipment: sterile tray, sterile gauze balls, antiseptic solutions, gloves.
Performing manipulation:
- put on gloves;
- put 8-10 sterile balls in a sterile tray, and moisten them with an antiseptic solution (furatsilin solution 1: 5000, 2% solution
soda, 2% solution of boric acid, 0.5% solution of potassium permanganate), 0.9% solution of sodium chloride or boiled water;
- slightly squeeze the swab and wipe the eyelashes with it in the direction from the outer corner of the eye to the inner one;
- repeat wiping 3-4 times;
- blot the remaining solution with dry swabs;
- Wash the hands.

8.5.2. Eye wash

Indications: disinfection of the conjunctival sac, removal of mucus, pus from it, first aid in case of eye burns chemicals. Equipment:
- tray;
- sterile rubber can;
- solutions of antiseptics, gloves.
Performing manipulation:
- put on gloves;
- lay down the patient;
- tilt the patient's head slightly back;
- from the side of the temple to substitute the tray;
- collect an antiseptic solution in a rubber can;
- push both eyelids with the thumb and forefinger of the left hand;
- rinse the eye with a jet from a can, directing from the temple to the nose;
- Wash the hands.
Seriously ill patients, in whom, for one reason or another, the eyelids do not close during sleep, it is necessary to apply gauze pads moistened with warm saline solution to the eyes (to prevent the conjunctiva from drying out).
Performing manipulation:
- put on gloves;
- seat or lay down the patient;
- draw ointment on a sterile glass rod so that it covers the entire shoulder blade;
- throw back the patient's head;
- lay the spatula with ointment behind the lower eyelid so that the ointment is directed towards eyeball, and the free surface to the eyelid;
- lower the lower eyelid and ask the patient to close the eyelids;
- remove the spatula from under the closed eyelids and then lightly press the ointment to the eyeball;
- remove excess ointment with a cotton ball;
- Wash the hands.

8.5.3. Other eye care procedures

8.5.3.1. Eversion of the upper eyelid

Indications:
- diseases of the conjunctiva of various etiologies (bacterial, viral, allergic) (Fig. 75);

Availability foreign body;
- wearing contact lenses. Contraindications:
- pronounced cicatricial adhesions of the conjunctiva of the eyelids with the conjunctiva of the eyeball;
- consequences of injuries;
- Consequences of burns.

Equipment:
- desk lamp;
- glass rod;
- magnifying glass 20x;
- binocular loupe (if necessary). Recommendations to the patient before the procedure: when eversion and examination of the conjunctiva upper eyelid you need to look down at your knees.

Performing manipulation:
1st way. Turning the upper eyelid with fingers. The subject looks down. Doctor:
- raises with the thumb of the left hand upper eyelid(Fig. 76A);
- fixes the eyelid by the edge and eyelashes with the thumb and forefinger of the right hand, pulling it down and forward (Fig. 76B);
- with the thumb or forefinger of the left hand shifts the upper edge of the cartilage down (Fig. 76B);
- the everted eyelid is pressed by the eyelashes to the upper edge of the orbit and held in this position until the end of the examination (Fig. 76D).
2nd way. Inversion of the upper eyelid with a glass rod.
All steps are performed in the same way as in the first method, only when performing point “B”, a glass rod is used, on which the upper eyelid is turned out. To study the conjunctiva of the upper transitional fold with an everted upper eyelid, it is necessary to slightly press on the eyeball through the lower eyelid. At the same time, the conjunctiva of the upper transitional fold, loosely connected with the underlying tissues, becomes available for inspection. Recommendations to the patient after the procedure: no.
Possible complications:
- infection of the conjunctival cavity;
- if the procedure is performed roughly, corneal erosion is possible.

8.5.3.2. Instillation (instillation) of eye drops

Indications:
- treatment;
- diagnostics;
- Anesthesia during various manipulations. Contraindications: drug intolerance.
Methods of anesthesia: not required.
Equipment:
- instilled solution;
- pipette;
- cotton or gauze ball.
Advice to the patient before the procedure:
- raise the chin;
- fix the look up and inside.
Performing manipulation:
Put on gloves. Seating or laying down the patient. Immediately before the procedure, check the correctness of the administered medication. Ask the patient to tilt their head back slightly and look up. Take a cotton ball with your left hand, put it on the skin of the lower eyelid and, holding the cotton wool with your thumb, pull the lower eyelid down, and hold the upper eyelid with the index finger of the same hand. Without touching the tip of the pipette to the eyelashes and the edges of the eyelids, inject one drop of the solution into the space between the eyelids and the eyeball, closer to the inner corner palpebral fissure(Fig. 77). Remove the part of the medicine flowing from the eyes with a cotton ball. You can also instill drops on the upper half of the eyeball - with the upper eyelid pulled back and when the patient looks down. When instilled into the eyes of potent drugs (for example, atropine) in Fig. 77. Instillation to avoid getting them into the nasal cavity and for reducing eye drops. solutions general action followed by index finger
press the lacrimal ducts for 1 minute. Wash your hands at the end of the procedure.

Recommendations for the patient after the procedure: close your eyes and gently press on the inner corner of the eye for 3-5 minutes.
Possible complications:
- allergic reaction for the drug
- damage to the conjunctiva;
- damage to the cornea due to careless manipulation.

8.5.3.3. Applying eye ointment

Indications: introduction of soft medicinal product into the conjunctival sac inflammatory diseases anterior segment of the eye of various etiologies.
Contraindications:
- drug intolerance;
- Suspicion of a penetrating injury to the eyeball.
Methods of anesthesia: not required.
Equipment:
- used ointment;
- sterile glass rod;
- cotton ball.

Advice to the patient before the procedure:
- raise the chin;
- Fix your eyes up.
Performing manipulation:
Put on gloves. Seating or laying down the patient. Dial the ointment on a sterile glass rod so that it covers the entire shoulder blade and, holding it parallel to the eyelids, place the tip of the stick behind the lower eyelid with ointment to the eyeball, and with the free surface to the eyelid. After the patient closes his eyes, remove the stick from the palpebral fissure. Next, perform circular stroking with a cotton ball of closed eyelids to evenly distribute the ointment over the eye. Remove excess ointment with a cotton ball. The ointment can be administered directly from a specially produced tube. At the end of the procedure (Fig. 78), wash your hands.
Possible complications: see point 8.5.3.2.

8.5.3.4. Removal of superficial foreign bodies from the conjunctiva

Indications: foreign body of the cornea or conjunctiva.
Contraindications: no.
Anesthesia methods:
- when removing a foreign body from the conjunctiva, anesthesia is not required;
- when removed from the cornea - installation anesthesia with a 0.25% solution of dicaine (or other anesthetic).
Equipment:
- anesthetic solution;
- cotton swab;
- injection needle or spear;
- slit lamp or binocular loupe.
Recommendations to the patient before the procedure: fix the gaze at the request of the doctor. Performing manipulation:
Removal of foreign bodies from the conjunctiva is performed using a small cotton "bannichka" moistened with some kind of disinfectant eye drops.
To remove foreign bodies located on the conjunctiva of the upper eyelid, you must first turn it out. After removal of the foreign body, a 0.25% solution of levomycetin is instilled into the conjunctival sac. With a foreign body of the cornea, a solution is instilled into the eye local anesthetic. Superficially lying foreign bodies are removed with a damp cotton swab. Foreign bodies that have penetrated into the superficial layers of the cornea are removed with an injection needle or spear (the procedure is performed by a doctor).
Possible complications: see point 8.5.3.2 and reaction to the anesthetic.

8.5.3.5. Foreign body in the conjunctival sac

The search for a foreign body should begin with pulling back the lower eyelid. If found, it can be removed with a cotton "bannichka". If there is no foreign body behind the lower eyelid, then you need to look for it on the inner surface of the upper eyelid; to do this, it must first be unscrewed. It is important to remember that a foreign body in the conjunctival sac should be looked for without prior anesthesia. After removing the foreign body, drops containing an antibiotic are instilled into the affected eye.

8.5.4. Chemical burns to the eyes

If a powdered chemical gets behind the eyelids, it is necessary to remove it with a dry “bannichka” and only after that proceed with washing the eye. For liquid chemical burns, eye rinsing should begin as soon as possible. Washing is best done with a weak stream of water for 10-15 minutes. If the burn is caused by alkali, a 2% solution of boric acid or a 0.1% solution is used for washing. acetic acid. For acid burns, a 2% sodium bicarbonate solution or an isotonic sodium chloride solution is used. In no case should you limit yourself to a 1-2 minute rinse, especially for burns with powdered chemicals. After irrigation, the burned skin of the eyelids and face is lubricated with an antibiotic-containing ointment: 1% tetracycline ointment, 1% erythromycin ointment, 10-20% sulfacyl sodium ointment. A 0.25% dicaine solution or a 3% trimecaine solution is instilled into the conjunctival sac and an antibiotic-containing ointment is applied. 1500-3000 IU of tetanus toxoid is injected subcutaneously. For burns of the 2nd, 3rd and 4th degree, urgent hospitalization is necessary.
Specific antidotes:
- lime, cement - 3% solution of disodium salt of ethylenediaminete-raacetic acid (EDTA);
- iodine - 5% sodium hyposulfite solution:
- potassium permanganate - 10% sodium thiosulfate solution or 5% ascorbic acid solution:
- aniline dyes - 5% solution of tonin;
- phosphorus - 0.25-1% solution of copper sulfate:
- resins - fish fat, vegetable oil.

8.5.5. Thermal eye burns

The substance that caused the burn is carefully removed from the skin of the face, eyelids and mucous membranes of the eyes with tweezers or a stream of water. The conjunctival sac is washed with water, a 3% trimikain solution, a 0.25% dicain solution, a 20% sodium sulfacyl solution, a 0.25% levomycetin solution are instilled into the eye. Over the eyelids, a 1% tetracycline or erythromycin ointment is applied. If there are bubbles on the skin, they must be cut off, and the wound surface should be generously lubricated with antibiotic-containing ointments. Anti-tetanus serum (1500-3000 IU) is injected subcutaneously. An aseptic bandage is applied to the eye.

Test tasks:

1. When treating the eyes:
a. Use different tampons.
b. Movements are made from the sides to the center.
c. Swabs must be sterile.
2. Rubbing the patient is performed:
a. Warm water with soap.
b. Warm water without soap.
c. Warm solution of furacilin.
d. At least once a week or when contamination occurs.
3. Processing of the perineum is performed:
a. Movements from the genitals to the anus.
b. Movements from anus to the genitals.
4. Treatment of the oral cavity:
a. Performed by the patient independently.
b. According to indications, it is performed by a nurse.
5. When caring for the ears, the following is instilled into the external auditory canal:
a. salicylic acid solution.
b. 70% alcohol.
c. Sterile glycerin solution.
d. 3% hydrogen peroxide solution.
6. Washing the patient in the hospital should be carried out:
a. Every day.
b. At least 1 time per week.
c. 1 time in 10 days.
d. 1 time per month.
e. Every 3 days.
7. When treating the nasal cavity, use:
a. Dry turundas.
b. Turunds moistened with a solution of furacilin.
c. Turundas moistened with sodium bicarbonate solution.
d. Turundas soaked in vaseline oil.
e. Cooking salt.
8. In case of nasal hemorrhage, it is necessary:
a. Tilt the patient's head back.
b. Lay down or seat the patient.
c. In case of recurrence of bleeding, call an otorhinolaryngologist.
d. Perform an emergency endoscopic examination of the nasal passages.
e. Place an ice pack on the nasal septum.

In a seriously ill person, mucus and dust accumulate on the nasal mucosa, which makes it difficult to breathe and aggravates the patient's condition. Seriously ill patients cannot free their nasal passages on their own. During the morning toilet, if there is discharge from the nose or if a crust forms, they should be removed with cotton turundas:

Prepare: rubber gloves, a bottle of vaseline oil, cotton wool, a plastic bag for discarding waste material;

Make turundas from cotton wool (4-6 pieces);

Wash and dry hands;

Put on gloves;

Moisten the turunda in a bottle with vaseline oil, squeeze it slightly on the edge of the neck of the bottle;

Take the turunda in the right hand, lift the tip of the patient's nose with the left hand and insert the turunda with rotational movements into one of the nasal passages;

Leave the turunda for 1 - 3 minutes;

Remove the turunda with rotational movements from the nasal passage;

Treat the other nasal passage in the same way;

Remove waste material in a plastic bag;

Remove gloves, wash hands, dry.

Ear care

In the external auditory canal, a yellowish-brown mass is released - sulfur, the accumulation of which can form sulfuric plugs and cause tinnitus, hearing loss. These additional symptoms may disturb the seriously ill.

Healthy ears require regular washing auricle and external auditory canal with warm soapy water. In no case should you clean the external auditory canal with sharp objects that can damage the eardrum or the wall of the auditory canal. If formed sulfur plug, it is removed under the supervision of a physician.

Nail cutting

The patient's nails require careful weekly care. Since nails become stiffer with age, it is necessary to dip them in a container with warm water and liquid soap before cutting.

For this manipulation, you need to prepare: a container with warm water (temperature 36-37 ° C), liquid soap, scissors, a plastic bag for waste material, towels for hands and feet, a napkin for hands and a napkin for feet, a nail file, oilcloth, nourishing cream , nail clippers. First - cutting the nails on the hands: put a chair next to the patient's bed; lay out all the items necessary for manipulation;

Seating the patient comfortably (if the patient can sit);

Lay an oilcloth on your knees;

Put a container of water on the oilcloth (if the patient cannot sit, then lay the oilcloth under the right hand, put a container of water next to it);

Pour liquid soap into the water;

Lower the right hand into the container first for 3-4 minutes;

Remove the brush after time;

Dry the brush with a tissue;

Trim the nails carefully, carefully, from the 1st to the 5th finger, over the towel, leaving 1-2 ml of the nail protruding;

Drop into container left hand patient for 3-4 minutes and cut the nails in the same sequence;

File the patient's nails on both hands;

Apply a nourishing cream with rubbing movements from the nail phalanges to the forearm.

Trimming toenails:

Have the patient sit on the bed with a
well extra pillows;

Lower your legs from the bed;

Place the legs in a container with warm water (if the patient cannot sit, bend his knees, lay an oilcloth under his feet, put a bowl of warm water on it, the temperature is 36-37 ° C);

Pour liquid soap into the water and lower the patient's foot into the container for 5 minutes;

Remove the patient's foot from the water;

Dry it with a napkin;

Lay on a foot towel;

Place the other foot in a container of water;

Shorten your nails with tweezers;

Treat your nails with a nail file;

Treat the nails on the second leg, repeating the steps above;

Apply nourishing foot cream with rubbing movements from the nail phalanges to the ankle joint;

Pour out the water;

Rinse the container;

Put napkins and towels in a plastic bag;

Wash scissors, nail file, tweezers with soap;

Wash and dry your hands.

Facial skin care(Fig. 32)

An unshaven patient looks rather untidy and feels uncomfortable. Not only men suffer, but also women who, in old age, begin active hair growth in the area upper lip and chin.

This problem is easily solved by having an electric razor or by learning how to shave with a safety razor.

Prepare: a container for water; napkin for compress; towel; safety razor; shaving cream; shaving brush; oilcloth; napkin; lotion. Note: examine the patient's face - whether there are moles on the face, since their damage is very dangerous for the patient's life.

After shaving, it is better to use a lotion containing alcohol, which is an antiseptic that prevents suppuration in case of violation of the integrity of the skin of the face. Shaving includes the following steps:

Help the patient to take a half-sitting position (put additional pillows under the back);

Cover the patient's chest with oilcloth and a napkin;

Prepare a container with water (40 - 45 ° C);

Wet a large washcloth in water;

Wring out the tissue and place it on the patient's face (cheeks and chin) for 5 to 10 minutes;

Note: when preparing a woman for shaving, it is not necessary to apply a napkin to her face.

Whip the shaving cream with a brush;

Apply it evenly on the skin of the face along the cheeks and chin (for a woman, moisten the face with warm water in the places of hair growth, without using a cream);

Shave the patient, pulling the skin in the opposite direction to the movement of the machine in the following sequence: cheeks, under the lower lip, neck area, under the chin;

Wipe your face after shaving with a damp cloth;

Dry with a clean cloth, with gentle blotting movements;

Wipe the patient's face with lotion (apply a nourishing cream to the woman's face after the lotion);

Remove the razor, napkin, water container;

Wash and dry your hands.