BASIC INTERVENTIONS
Presented by: Mr. Ryan Caoile Ricana, RN
BASIC INTERVENTIONS TO MAINTAIN NUTRITION
Measures to stimulate appetite to eat
Serve food in pleasant and attractive manner Place patient in a comfortable position Provide good hygiene measures Provide comfort Remember that color affects appetite to eat. Include red, yellow, green colored foods Engage in pleasant conversation Assist weak patient in feeding
Client with nausea and vomiting
Position to prevent aspiration.
Conscious semi fowlers Unconscious lateral
Provide good oral hygiene.
Suction mouth as needed.
Relieve sensation of nausea by providing any of the following:
Ice chips, Hot tea with lemon and calamansi Hot ginger ale, Dry toast or crackers
Replace fluid-electrolyte losses (oral or IV fluid).
Client with nausea and vomiting
Observe for potential complications as follows:
Dehydration
Thirst (first sign) Dry mouth and mucus membrane Warm, flushed and dry skin Fever, tachycardia, low BP Weight loss Sunken eyeballs Oliguria Poor skin turgor
Acid base imbalance: due to loss of gastric acids Hypokalemia:
Muscle weakness (initial sign) Provide potassium rich food banana, raw tomato, raw carrot, baked potatoes, citrus fruits and dried fruits
Administer anti-emetic: (Metoclopramide) Plasil
Special Diets
Clear liquids General liquids Soft diet DAT Acid ash diet Alkaline ash diet Bland diet BRAT diet Low salt, low fat diet Diabetic diet Halal diet High fiber diet
Alternative feeding methods
Nasogastric feeding (Gastric gavage)
Purposes of NGT insertion
To provide feeding (gavage) To irrigate stomach (lavage) For decompression (drainage of gastric content) To administer medications
Common problems of tube feedings
Vomiting Aspiration Diarrhea Constipation Hyperglycemia Abdominal distention
BASIC INTERVENTIONS TO MAINTAIN OXYGENATION
Common Problems
Dyspnea Orthopnea Cough Wheezing Clubbing of the fingers Hemoptysis Cyanosis
Measures That Promote Adequate Respiratory Function
Adequate oxygen supply from the environment Deep Breathing Coughing Exercises Positioning Patent airway Adequate hydration Avoid environmental pollutants, alcohol and smoking. Chest physiotherapy (CPT) Steam Inhalation Suctioning Incentive Spirometry Oxygen Therapy
Chest Physiotherapy (CPT)
Percussion (clapping) Vibration Postural drainage
BASIC INTERVENTIONS TO MAINTAIN ELIMINATION
Constipation
Nursing Interventions: Adequate fluid intake between 1500-2000 ml. High fiber diet . Establish regular pattern of defecation. Respond immediately to the urge of defecate Minimize stress. Adequate activity and exercise. Administer laxatives as ordered.
Fecal impaction
Nursing Interventions: Manual extraction or fecal disimpaction as ordered. Increase fluid intake. Sufficient bulk in the diet. Adequate activity and exercise.
Diarrhea
Nursing Interventions: Replace fluid and electrolyte losses. Provide good perianal care. Promote rest. Diet:
Small amount of bland foods Low fiber diet BRAT Avoid excessively hot or cold fluids. Potassium rich food and fluids.
Anti-diarrheal medication as ordered.
Flatulence
Nursing Intervention: Avoid gas forming foods. Provide warm fluids to drink.
Other Problems:
Fecal Incontinence Pain Upper abdominal discomfort or distress associated with eating (commonly called indigestion) Belching (the expulsion of gas from the stomach through the mouth) Flatulence (the expulsion of gas from the rectum). Vomiting Changes in bowel habits
Bladder elimination
Common problems: Genitourinary pain include frequency, urgency, dysuria, hesitancy, incontinence, enuresis, polyuria, oliguria, and hematuria.
BASIC INTERVENTIONS TO MAINTAIN HEALTHY LEFESTYLE
Nutrition and Diet
A low-fat, high-fIber diet is recommended.
Fat: no more than 30% of calories Fiber content: 20 to 30 g Five servings of fruits and vegetables Six servings of breads, cereals, and legumes should be included daily
Nutrition and Diet
Cutting down on fats Add fiber to the diet (whole grain breads and cereals; raw or minimally cooked fruits and vegetables (especially citrus fruits, squash, cabbage, lettuce and other greens, beans); and any nuts, skins, and seeds. If weight loss is desired, have the patient weigh in monthly, and review the diet and give praise or constructive criticism at this visit.
Exercise and Fitness
helps achieve optimal weight, control blood pressure, increase high-density lipoprotein, lower risk of CAD, increase endurance, and improve the sense of well-being. Suggest walking, jogging, bicycling, swimming, water aerobics, and low-impact aerobic dancing as good low- to moderateintensity exercise, performed three to five times per week for 45 minutes. Exercise programs should include 5- to 10-minute warm-up and cool-down periods with stretching activities to prevent injuries.
Exercise and Fitness
GERONTOLOGIC ALERT Due to physiologic limitations of old age, maximum effective exercise for the elderly is 20 to 40 minutes at 50% to 60% of maximum heart rate.
NURSING ALERT Severe cases of COPD, osteoarthritis, and coronary disease are contraindications for unsupervised exercise; check with the patient's health care provider to see if a physical therapy or occupational therapy referral would be helpful.
CONTROLLING WEIGHT
Increase fiber in diet to 20 to 30 g daily. Reduce fat content to no more than 30% of total calories each day. Eat five servings of fruits and vegetables each day. Include six or more servings of cereal or bread per day. Maintain moderate protein intake of fish, beans, nuts. Limit salt and alcohol consumption.
Smoking Cessation
related to about 30% of all cancer deaths, is the leading risk factor for coronary artery disease and emphysema, and has many other effects on health and hygiene People who smoke tend to have more dental problems, premature aging of the skin, increased acid in the stomach, decreased exercise tolerance, loss of taste bud function, problems with pregnancy and fetal growth, more frequent respiratory infections, and bad breath.
Sexual Health
Education about sexuality should begin with school-age children, increase during adolescence, and continue through adulthood. Topics to cover include: Relationships, responsibilities, communication. Normal reproduction - the menstrual cycle, ovulation, fertilization Unwanted pregnancy Contraception - ideally should begin before sexual activity is started; discuss various methods, adverse effects, effectiveness, convenience. Sexually transmitted diseases (STDs) - mode of transmission, prevalence, signs and symptoms, methods of prevention.
Sexual Health
Safer sex or abstinence - primarily adopted to prevent HIV transmission, but can also prevent other STDs and pregnancy.
Abstinence Mutual monogamy Use of female or male latex condoms For individuals infected with HIV, avoid vaginal, anal, and oral intercourse, deep kissing, and any practices that may injure tissues.
