Thermometer Technique

Planning/Implementation:

Identify your client and explain the procedure. Using the bag technique lay out, put out the thermometer leaving the case inside the bag. Check if mercury in the thermometer is at the level of 35ºC. Place the thermometer beneath. Wiping is done from a clean the tongue or in patient’s axilla to a dirty area and take the temperature, pulse and respiration following the procedure in taking “vital signs”

Remove the thermometer from patient’s mouth/axilla and wipe with the one dry cotton ball from your fingers downward to the bulb in a twisting motion. Discard used cotton ball. Read the thermometer. Clean the thermometer in a downward spiral motion from the stem to the bulb, holding it over the waste paper bag using the following bag technique: 1^st – 3 cotton balls moistened with soap. Discard. 2^nd – 3 cotton balls moistened with alcohol, then wrap around the bulb of the thermometer and lay it inide the kidney basin.

Note: Oral temperature is taken 2-3minutes; per axilla 5-8 minutes and per rectum, 1 minute. After the care is given and health teaching is over, remove the cotton ball wrapped around the thermometer. Wipe with a dry cotton and return to the case.

Evaluation and Documentation:

Clients condition. Intervention done. Health teachings given.

Nebulization

Assessment:

Assess patient for obstruction of the airway. Assess patient respiratory status. Assess characteristics of secretions. Check with doctor’s order.

Planning:

Prepare materials needed, as follows: Nebulizer machine, mouthpiece, T-piece, cap, medication cup, nebulizer air – inlet connector, bottle, tubing and aerosol mask. Gather and bring to bedside.

Implementation:

Wash your hands before preparing medications. Identify patient. Before initial operation place the nebulizer on a leveled surface. Open door to storage equipment. Make sure the power is in the OFF position. Unwrap power cord and plug power cord into an appropriate wall outlet. Assemble clean nebulizer parts by placing a buffle on medication cup. Holding cup stationary, screw on nebulizer cap. Add prescrined medication through the opening on cap using a medicine dropper or pre-measured container. Assemble mouthpiece and T-piece (if applicable) and insert into the top of the nebulizer cap. If usig an aerosol mask, insert the bottom part of the mask directly into the top of the nebulizer cap. Attach tubing to nebulizer air-outlet connector. Press the power switch ‘on’ to the start the compressor. Begin treatment by placing  the mouthpiece between teeth. With mouth closed, inhale deeply and slowly through mouth as aerosol begins to flow, then exhale slowly through the mouthpiece. If the treatment needs to be interrupted, simply press power switch ‘off’. If an aerosol mask is used, place the mask over mouth and nose. As aerosol begins to flow, inhale deeply and slowly through mouth then exhale slowly. After nebulization, turn the switch off. Unplug power cord from wall outlet. Disconnect the parts and the tubing to set aside. Disassemble mouthpiece or  mask from cap. Wash all items, except tubing in a hot water/dishwashing detergent. Rinse under top water for 30 seconds to remove detergent residue. Allow air to dry.

Evaluation:

Increased comfort and breathing efficiency for patient’s with ASTHMA & COPD. Clear breath sounds and liquefied secretions.

Documentation:

Record the date and time of the treatment. Note the amount of secretions.