Fundamentals - Practice & Skills, part 5: Bed Baths, Bed Making, Oral/Denture Care, and Seizure Precautions

by Meris Shuwarger July 22, 2021 Updated: July 29, 2021

Full Transcript

Hi, I'm Meris, and in this video, we are going to be talking about bedmaking, bed baths, oral and denture care, and most importantly, what to do with a patient who is on seizure precautions. I'm going to be following along with our Fundamentals of Nursing flashcards. These are available on our website, levelupRN.com. If you already have a set for yourself and you're following along, I am on card number 55. So let's get started.

So first up, we're going to be talking about bed baths and bed making.

You will see here on this card we do have step-by-step for how to give a bed bath.

I'm not going to go into everything in detail here, but one of the things I wanted to make sure to point out is that we start by washing the eyes first without soap.

That way, we can make sure to decontaminate that skin area without bringing bacteria in towards the eyes and ending up with an infection that way.

And then we're going to wash the face, chest, arms, abdomen, legs, feet, and back. The last thing we should wash is the perineum. So that's going to be the patient's genitals and rectum. We're going to make sure that we change the water before we wash the perineum.

And remember that if you have a patient with a vulva, you need to be wiping from front to back to avoid bringing any kind of fecal bacterial up towards the urethra because if you have a shorter urethra, you are more likely to get a urinary tract infection. So very important to remember that.

Now when it comes to bed making, just a few key points. You want to make sure that you raise the bed to waist height for yourself so that you don't injure yourself.

We don't shake the linen. So I know that at home, you might shake out your fitted sheet or your comforter.

We don't do that in the hospital because we don't want to disperse any skin cells or any pathogens.

And then we want to make sure that the soiled linens go immediately in the soiled linen bag, not on the floor. So that is it for that card.

Let's move right along to card number 56. This is going to be talking about basic care and comfort as it relates to oral care and denture care.

If my patient is alert and oriented, I'm going to make sure that I have a basin underneath their mouth, and I'm going to give them a cup to rinse and spit with.

Now obviously, if I have a patient who is unconscious or who cannot protect their airway if I'm messing with it, then I need to make sure that I angle their head 45 degrees and turn them to the side to prevent aspiration.

I should also make sure that I have suction readily available in case I should need it.

We don't ever place our fingers in the patient's mouth, alert, oriented, or unconscious. It's just asking for trouble. Don't do it.

Now when it comes to denture care, dentures are very expensive. So you want to make sure that you are being very careful when caring for them, and in fact, you want to place some towels in the sink basin, so that if you accidentally drop those dentures, they don't break. It'll cushion the fall and, hopefully, keep them intact.

The nice thing is, you can just brush the dentures with a toothbrush and toothpaste, or you can use dedicated denture cleanser.

When storing the dentures, though, you want to make sure that they are stored in a labeled denture cup, meaning that it has your patient's name and date of birth, and you want to have denture solution or water in the cup.

You don't want it to dry out.

Okay. Now, moving on to a very, very, very, very important card. This is going to be card number 57 on seizure precautions.

So a patient who's on seizure precautions has a few things that you need to take care of. One is that we've got to pad the side rails of the bed.

So if I'm on seizure precautions and I start to seize, I don't want to hit my head against the hard side rail in my bed, so you're going to pad it.

Usually, you might have specific pads, or you can even just use lots of blankets and tape it around the side rail.

Also want to make sure that we have oxygen in the room with a delivery device, that we have suction equipment set up and ready to go, along with vital signs equipment.

All of that should be in the room and ready to go if you have a patient on seizure precautions.

Now, let's talk about what we do during a seizure. And this is it's just so important, not only for your nursing exams and the NCLEX, but just so that you are prepared for what to do if this ever happens because it can be really scary if you've never seen somebody have a seizure before.

So if we are standing-- if the patient is standing, my job is to lower them to the floor as controlled as possible, perhaps using my leg like a slide to lower them to the floor.

No matter what, once they're on the floor or in bed, I want to turn them to their left side. That's going to be very important. Make sure that any secretions are coming out of their mouth and not-- that they're not choking on their secretions.

I also want to loosen restrictive clothing. Maybe they're wearing a suit and tie. I want to loosen that tie, unbutton those buttons so that as they seize, they're not straining against something that's putting pressure on their airway.

When your patient is seizing, you want to protect them from harm. That's the number one priority there, is to protect them from harm.

So what does this mean? It means that if there is something in the way, I'm going to move the thing out of the way.

If my patient is seizing on the floor, and they're right next to a chair, I'm going to move the chair so that they don't hit their heads.

The other thing that is really, really, really important to understand about seizures is that previously, you might have heard of some guidance to restrain a patient or put something in their mouths.

This is why we talk about evidence-based practice. That used to be what we did, but it is not anymore because the evidence says you should never restrain a patient who is having a seizure because they hurt themselves by pushing against the restriction.

And also, you don't want to put anything in their mouths. You could injure them. You could get bitten. They could choke. So we don't put anything in the patient's mouth.

Not their belt, not their wallet, not a tongue blade, nothing, and especially not your hands, please.

You also want to make sure that you note when the seizure started and stopped. All of that is very important to know because that's going to factor into what kind of seizure it is.

After a seizure, your patient is going to be in something called the postictal phase, and during this phase, they may be really disoriented. They might be confused, upset, combative, even.

So you're just going to try and reorient your patient as much as you can, keep them calm and reassure them, and then you're also going to want to record their vital signs and perform a brief neurological exam.

So all of those things are just so desperately important for a Fundamentals student to understand, "What's my role as the nurse when I care for a patient?" If you stay to the at the end of this video, I'm going to tell you a little bit about the time that I had a seizure.

Okay, so that is it for bed baths, bed making, oral and denture care, and seizure precautions.

I hope this review was helpful. If it was, please like this video, and if you have anything to add or a great way to remember something, I want to hear it, so please comment below.

And the next video I bring to you is going to be talking about pains, different types of pain, and how we treat it. So be sure you subscribe because you don't want to miss that. You'll be the first to know. Thanks so much, and happy studying.

Okay, so the first time I had a seizure, I had just gotten to my friend's house. I was going to watch a movie with her and her mom. I picked up McDonald's.

I went to her house, and we started watching the movie. And the next thing I know, I'm waking up on the couch looking up, and my best friend and her mom are staring down at me, and I'm covered in french fries because I was holding the french fries when I started to seize, and so I shook them all over the place.

And my best friend and her mom said, "Hey, Meris, you just had a seizure. Are you okay? Can you hear me? We've called 911. They're on their way."

And I, being postictal and coming out of it very confused and disorientated, and I said, "I didn't have a seizure. I just fell asleep during the movie."

And they were like, "No, you had a seizure." And I called my mom and started crying and said, "They're making me go to the hospital by ambulance. I'm sorry. I don't know how we're going to pay for it."

And my mom said, "Honey, don't worry about it. We'll figure it out. Please go to the hospital."

But the point being, in that postictal phase, your patients may be really out of it and maybe acting in a way that is not their normal self. So just be kind and calm and compassionate because they are very scared and confused. I promise you.


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