BULACAN STATE UNIVERSITY

CITY OF MALOLOS, BULACAN

TEPID SPONGE BATH

Purpose :

1. To relieve pain and provide comfort.

2. To reduce congestion, inflammation, or swelling.

3. To relieve muscle spasms.

Procedure:

1.Observe patient for elevated temperature. Review physician's orders.

2.Explain the procedure to patient.

3.Prepare the equipment

Materials:

1. bath basin

2. tepid water ( 37°C; 98.6°F)

3. washcloth (7)

4. bath thermometer

5. bath blanket

6. patient thermometer
 STEPS RATIONALE

1. Do initial steps.

2. Take resident's temperature by 2. Provides nurse with a baseline

route appropriate for resident. temperature reading.

3. Exposing one part of the body at
a time, gently sponge with tepid
water (lukewarm) for
approximately 5 minutes. Begin
with face and extremities, then
back.
3. Slow, gentle motions are indicated
because firm rubbing motions increase
heat production.Cool sponges given
rapidly or for a short period of time
tend to increase the body's heat
production.

4. While sponging, place cool 4. The axillary and groin areas contain
compresses on forehead, axillas, large blood vessels that are close to the
and groin. skin's surface, which aid the transfer of
heat.

5. Monitor temperature every ten 5. To evaluate the effectiveness of the

minutes while sponging resident. bath.

6. After completing the bath, take 6. To evaluate the effectiveness of the

resident's temperature again. bath.

7. Do final steps.
 BULACAN STATE UNIVERSITY
CITY OF MALOLOS, BULACAN

MOVING A PATIENT

Purpose :

Procedure:

Materials:
Moving Patients from Bed to Wheelchair
Remember: When patients are weak, brace your knees against theirs to keep their legs
from buckling. Also, transfer toward patient’s stronger side if possible.

Patient safety is often the main concern when moving patients from bed. But remember
not to lift at the expense of your own back. This transfer often requires patients’ help, so
clear communication is essential. If they can’t help much, you’ll need two people.

1
Sit the Patient Up

• Position and lock the wheelchair close to the bed. Remove armrest nearest bed
and swing away both leg rests.
• Help the patient turn over.
• Put an arm under the patient’s neck with your hand supporting the shoulder blade;
put your other hand under the knees.
• Swing legs over the edge of the bed, helping the patient to sit up.

2
Stand the Patient Up

• Have the patient scoot to the edge of the bed.

• Put your arms around the patient’s chest and clasp your hands behind his or her
back. Or, you may also use a transfer belt to provide a firm handhold.
• Supporting the leg farthest from the wheelchair between your legs, lean back,
shift your weight, and lift.
3
Pivot Toward Chair

• Have the patient pivot toward the chair, as you continue to clasp your hands
around the patient.
• A helper can support the wheelchair or patient from behind.

4
Sit the Patient Down

• As the patient bends toward you, bend your knees and lower the patient into the
back of the wheelchair.
• A helper may position the patient’s buttocks and support the chair.

Moving Patients from Bed to Stretcher

(Gurney)
Remember: If you move patient’s legs first, you can decrease the stress on your back by
as much as a third.
Patient safety is often the main concern when moving patients from bed. But remember
not to lift at the expense of your own back. And, never move a patient by yourself. Two
people usually can do this move safely. The leader, who pulls, should be the stronger of
the two. The helper holds the draw-sheet, neither pushing nor lifting.

The leader should have one foot

forward with knees bent.

1
Prepare to Move

• Put the head of the bed down and adjust the bed height.
• Put a garbage bag or plastic slide board between the sheet and draw-sheet,
beneath one edge of the patient’s torso.
• Move the patient’s legs closer to the edge of the bed.
• Instruct patient to cross arms across chest and explain move to patient.

2
Pull to Edge of Bed

• Grasp the draw-sheet on both sides of the bed.

• On the count of three, lean back and shift your weight, sliding the patient to the
edge of the bed. The helper holds the sheet, keeping it from slipping.
3
Position Stretcher

• Have the helper “cradle” the patient in the draw-sheet while you retrieve a
stretcher.
• Adjust the bed to be slightly higher than the stretcher. Then, position the stretcher,
locking it in place.
• Move the patient’s legs onto the stretcher.

4
Slide onto Stretcher

• Have the helper kneel on the bed, holding on to the draw-sheet.

• On the count of three, grasp the draw-sheet and slide the patient onto the
stretcher. You may need to repeat this step.

Pulling a Patient Up in Bed

Think of ways you can decrease friction to make this move more comfortable for the
patient and to reduce the stress on your back. It is easier to slide a patient up in bed by
using a draw-sheet and two people.
1
Grasp the Draw-Sheet
• Put the head of the bed down and adjust the top of the bed to waist- or hip-level of
the shorter person.
• Grasp the draw-sheet, pointing one foot in the direction you’re moving the
patient.

2
Pull Up
 • Lean in the direction of the move, using your legs and body weight.
• On the count of three, lift and pull the patient up. Repeat this step as many times
as needed to position the patient.
• Also, patients can bend their knees, push down with their feet, and pull up with a
trapeze (a device overhead) to help.

Remember:

• Putting a pillow under your patients’ feet helps them push down, making it easier
for you to pull them up.

• Never clasp the underarm to move the patient. This may cause injury to the
shoulder (i.e., dislocation).

Turning Patients Over in Bed

It’s difficult to get close enough to patients in bed to turn them over safely, so concentrate
on putting your body as close to theirs as you can. Usually one or two people can turn a
patient safely. And the patient can sometimes help by pushing down with a heel. Start the
turn with the patient on the side of the bed opposite the direction he or she will be rolling.

1
Cross Arms
• Put the bed rail and head of the bed down; adjust the top of the bed to waist- or
hip-level.
• Cross the patient’s arms on his or her chest; bend the leg farther away from you.
2
Turn the Patient
• Put one hand behind the patient’s far shoulder.
• Put your other hand behind the patient’s hip.
• Turn the patient, supporting the patient’s leg with your knee.

Remember: Putting one knee on the bed gets you closer to the patient, so you pull more
with your body and less with your back.

A. MOVING TO THE SIDE OF THE BED

1. Stand facing patient at the side of the bed.

2. Assume a broad stance, one leg forward of the other with knees and hips flexed,
bring arms to the level of the bed.
3. Place one arm under shoulders and neck pf patient and another arm under small of
patient’s back.
4. Shift body weight from front to back foot, rock backward to a crouch position,
bringing patients towards his side. Nurse’s hips come downwards as he rocks
backwards. Patient should be pulled.

B. HELPING THE PATIENT TURN ON HIS SIDE

1. Stand at the side of the bed towards which patient is to be turned. Place patient’s
far arm across his chest and far leg over near leg, near arm is lateral to and away
from his body.
 2. Stand opposite to the patient’s waist and face side of the bed with one foot a step
in front of the other.
3. Place one hand on patient’s far shoulder and one hand on his far hip.
4. Shift weight from forwarded leg to rear leg, patient is turned towards the nurse
hips come downward.
5. Patient is stopped by nurse’s elbows, which come to rest on mattress at the edge
of the bed.

C. RAISING SHOULDERS OF THE HELPLESS PATIENT

1. Stand at side of the side of the bed and face patient head.
2. Assume a wide stance with foot next to bed behind the other foot.
3. Pass arm over the patient’s near shoulders and rest hand between patient’s
shoulder blades.
4. Rock backward, shift weight from forwarded foot to rear foot, hips coming
straight down.

D. RAISING THE SHOULDERS OF TH SEMI HELPLESS PATIENT

1. Stand at one side of the bed facing the head of the patient. Foot next to bed is to
rear and the other foot forward. Provide wide base of support.
2. Bend knees to bring arm next to bed down to a level with a surface of the bed.
3. With elbow on the patient‘s bed grasps the nurse’s arm in the same manner.
4. Rock forward, shift weight from forwarded foot to rear foot to bring hips
downward. Elbow remains on bed, which serves as fulcrum.

E. MOVING THE HELPLESS PATIENT UP IN BED

1. Stand at the side of the bed and face the far corner of the foot of the bed.
2. Flex knees so that arms are leveled with the bed. Put arm under patient, one arm
under patient’s head and shoulders, one hand under small of his back.
3. Rock forward. Shift weight from forwarded foot to rear foot, hips coming
downward. Patient will slide diagonally acrossthe bed towards the head and side
of the bed.
4. Repeat from tuck and legs of patient.
5. Go to the other side of the bed and repeat number 1 – 3. Continue this process
until patient is satisfactorily positioned.

F. MOVING THE SEMI HELPLESS PATIENT UP IN BED

1. Patient flexes knees, bringing heels up to his buttocks.

2. Stand at the side of the bed, turn slightly towards patient’s head. One foot is
stepped in front of the other foot closer to bed. Feet are directed towards the head
ofthe bed.
3. Place one arm under patient’s shoulders, one arm under thighs. Flex knees to
bring arms to the level of the surface ofthe bed.
 4. Patient places chin on his chest and pushes with his feet. Nurse shifts weight from
rear foot to forwarded foot. Patient grasps the head ofthe bed with his hands to
pull on his own weight.

G. HELPING THE SEMI HELPLESS: PATIENT RAISE HIS BUTTOCKS

1. Patient flexes knees and brings heels towards the buttocks.

2. Nurse faces the side of the bed and stands opposite to the patient’s buttocks.
Assume a board stance.
3. Flex knees to bring arms to the level of the bed, place one hand under sacral area
of the patient. The elbow is resting firmly on the 3 bed.
4. As the patient raises his hips, the nurse comes to a crouching position by bending
his knees while his arms act as a lever to help support the patient’s buttocks.
Nurse’s hips come straight down. While supporting patient in this position, free
hand can place bedpan under the patient’s sacral area.

H. ASSISTING THE PATIENT TO A SITING POSITION ON THE SIDE OF

THE BED

1. Patient is turned to the side towards the edge of the bed.

2. The nurse ensures that the patient does not fall out of the bed by raising the head
of the bed.
3. Face the far bottom corner of the bed, support the shoulders of the patient with
one arm and the other arm helps patient extend lower legs over the side of the bed
top the rear of the other foot.
4. Bring patient to a natural sitting position on the bed; support the patient’s
shoulders and legs over the side of the bed. Pivot body to lower legs of the
patient. Patient’s legs are swung downward. Nurse’s weight is shifted form front
to rear leg.

I. ASSISTING THE PATIENT TO GET OF BED AND INTO A CHAIR

1. The patient assumes a suiting position on the edge of the bed, put on shoes/slipper
and gown.
2. Place the chair at the side of the bed with back towards foot of the bed.
3. Stand facing patient with foot closer to the chair and a step in front of the other to
give the nurse a wide base of support.
4. Place patient’s hands on the nurses shoulders and the nurse grasps patient’s waist.
5. Patient steps on the floor and the nurse flexes her knees, forwarded knee is against
the patient knee. This provides patient’s knees bending involuntarily.
6. Turn with the patient while maintaining a wide base of support. Bend knees as the
patient sits on chair.
Moving

Moving a Patient Up in the Bed. There is a tendency for the mattress and
the patient to slip down when the head of the bed has been elevated. Lower the head
rail to a level position and move the mattress up before repositioning the patient, as free
space at the foot of the bed is needed to adjust the bedding
 BULACAN STATE UNIVERSITY
CITY OF MALOLOS,BULACAN

COLLEGE OF NURSING