3 Unit #3
Unit #3 Class Preparation-Lesson 1
In this unit, students will develop an understanding of common direction of care orders, including indications for, common abbreviations. and how to transcribe in non-CPOE environments.
Lesson 1 Readings:
Website Review-Nutrition
Visit this Nutritional Services page of a hospital’s website and review their descriptions of their regular and therapeutic diets. As you read these, make a note of the indications for and an example of foods that fall in each of the following categories:
- Clear liquid
- Full liquid
- Dental soft
- Dysphasia diet
- Thickened fluids
Website Review-Physical Therapy
Physiotherapy in the hospital focuses on treating patients to improve and restore their functional mobility through methods such as active and passive exercise, gait training, water therapy, and heat and ice treatments. Physio patients include those injured in accidents, individuals who have had strokes, spinal cord injuries, amputations, and degenerative diseases, as well as patients who have had routine surgical procedures who require post-operative assessment. Visit the SickKids Hospital’s Physiotherapy page and review the scope of services offered through their inpatient and outpatient programs. Note that while these are focused on children, many of the services are applicable amongst every age group.
Reference:
Gillingham, E. A., & Wadsworth Seibel, M. (2014). Health Unit Coordinating, 6th Ed. Elsevier Canada.
Unit #3 Activities-Lesson 1
The following activities will be completed in class for face-to-face course delivery. Students who are absent from class or taking this course remotely should complete these after reviewing course materials and viewing video resources to check their learning in each area.
Diet Exercises
Activity Exercises
Review
Key Terms
Unit 3 Class Preparation-Lesson #2 Preparation
This week’s lesson will focus on intravenous, blood product administration, and oxygenation orders. Please read the following except regarding the indications for IV Therapy from “Clinical Procedures for Safer Patient Care”:
“Intravenous therapy is treatment that infuses intravenous solutions, medications, blood, or blood products directly into a vein (Perry, Potter, & Ostendorf, 2014). Intravenous therapy is an effective and fast-acting way to administer fluid or medication treatment in an emergency situation, and for patients who are unable to take medications orally. Approximately 80% of all patients in the hospital setting will receive intravenous therapy.
The most common reasons for IV therapy (Waitt, Waitt, & Pirmohamed, 2004) include:
- To replace fluids and electrolytes and maintain fluid and electrolyte balance: The body’s fluid balance is regulated through hormones and is affected by fluid volumes, distribution of fluids in the body, and the concentration of solutes in the fluid. If a patient is ill and has fluid loss related to decreased intake, surgery, vomiting, diarrhea, or diaphoresis, the patient may require IV therapy.
- To administer medications, including chemotherapy, anesthetics, and diagnostic reagants: About 40% of all antibiotics are given intravenously.
- To administer blood or blood products: The donated blood from another individual can be used in surgery, to treat medical conditions such as shock or trauma, or to treat a failure in the production of red blood cells. The infusion restores circulating volumes, improving the ability to carry oxygen and replace blood components that are deficient in the body.
- To deliver nutrients and nutritional supplements: IV therapy can deliver some or all of the nutritional requirements for patients unable to obtain adequate amounts orally or by other routes.”
Reference:
Doyle, G.R., McCutcheon, J.A. (2015). Clinical Procedures for Safer Patient Care. Victoria, BC: BCcampus. Retrieved from https://opentextbc.ca/clinicalskills/
Unit #3 Activities-Lesson 2
The following activities will be completed in class for face-to-face course delivery. Students who are absent from class or taking this course remotely should complete these after reviewing course materials and viewing video resources to check their learning in each area.
IV Exercises
Blood Bank Excercises
Oxygenation Exercises
Unit #3 Class Preparation-Lesson 3
Readings
Urinary Catheters
According to Doyle & McCutcheon (2015), urinary catheters are often used to support urinary elimination in patients who are unable to naturally void. Doyle & McCutcheon (2015) state the following:
“The use of urinary catheters may be required:
- In cases of acute urinary retention
- When intake and output are being monitored
- For preoperative management
- To enhance healing in incontinent patients with open sacral and perineal wounds
- For patients on prolonged bedrest
- For patients needing end-of-life care”
Urinary catheters may be broken into different types including intermittent and indwelling, and urethral and suprapubic. A straight catheter is utilized in intermittent catheterization, meaning that it has no bulb to inflate and as such, cannot stay in place. Intermittent catheterization usually is performed for immediate relief of urinary retention, to obtain a sterile specimen, to assess residual urine in the bladder, or for long term management of bladder incompetency.
On the other hand, indwelling catheters have two lumens (allowing them to stay in place) or three lumens (allowing them to stay in place as well as the instillation of fluids into the catheter to irrigate it). Indwelling catheters are most often used to promote urinary elimination, measure urine output accurately, prevent skin breakdown and facilitate wound management, instill medications or irrigation fluids, allow surgical repair of the the GU structures, and assess pelvic and/or abdominal pain.
Interested students may read more about urinary catheters in the hospital by visiting the following link: Clinical Procedures for Safer Patient Care
Reference:
Doyle, G.R., McCutcheon, J.A. (2015). Clinical Procedures for Safer Patient Care. Victoria, BC: BCcampus. Retrieved from https://opentextbc.ca/clinicalskills/
Nasogastric Tubes (N/G Tubes)
A nasogastric tube is a thin pliable rubber tube that is inserted through the nose into the stomach. Although NGs are sometimes used to deliver tube feeds, in hospitals they are more likely used in conjunction with a pump (called a Gomco pump) to remove stomach contents including gases, solids, and solids in order to rest the bowel and allow it to heal. The HUC is likely to see an NG with suction ordered in cases of suspected bowel obstruction, hyperemesis gravidarum (HG), before or after gastric surgery, or to obtain gastric contents for testing. If the unit that the HUC is working on does not have a stock of Gomco pumps, the HUC may have to requisition one from CSR/SPD when an NG tube is ordered for a patient.
Reference:
Thompson, V. D. (2013). Administrative and Clinical Procedures for the Canadian Health Professional (3rd Edition). Pearson Canada.
Unit #3 Activities-Lesson 3
Review
Key Terms