Assisting with Medication, Checking vital Signs Duty: Assist Client with Personal Hygiene Task : A.12 Remind client to take medication A.17 Check client s temperature A.18 Check client s pulse A.19 Check client s respirations A.20 Check client s blood pressure Objectives: List four guidelines for assisting with medications. Identify the five rights of medications. Describe steps for assisting a client with medications. Identify observations about medications that should be reported. Identify proper medication storage. Explain importance of monitoring vital signs.
Guidelines for assisting a client with taking their medication: Aides never handle or administer medications unless specifically trained to do so. Aides can assist a client in taking their medication by bringing the medication container to the clients and reminding them to take their meds. Document that client took medication, the time and any other medications or food taken at same time. Record and report any reactions to the medication. Report if client refused to take medication, took wrong medication, dose or at the wrong time, of if medication container is missing or empty.
The five rights of medication assistance are: The right client (check the client s name on the label) The right medication (check the name of medication and expiration date) The right time (check label on what time or how often and compare with instructions in care plan) The right route (check label for instructions on how it is to be taken) The right amount (check label for dosage)
Steps for assisting with medications include: Check the five rights of assisting with medications. Bring container to client. Position client for taking medication Provide food or water.. Open and close containers. Observe client taking medication. Document time that client took medication Report reactions. Return medication to storage.
Actions aides are generally not permitted to do: Touch the inside of the medicine bottle or pills. Put any medication in the client s mouth. Break apart or crush capsules or tablets. Mix medication with food or drink. Assist with medication if the client s name is different from that on the label. Assist with medication when label has been removed. Assist client with medicine at a time when it is not ordered Insert suppositories into the rectum or vagina. Put drops into the eye, ear, or nose Apply prescription medications to the skin
Report side effects such as: Nausea and vomiting Diarrhea Confusion or drowsiness Headache Rash or itching Dizziness Immediately report signs of a serious allergic reaction: Hives or extensive rash Fever Difficulty breathing Swelling of throat or eyes Call 911 if reaction is severe or for an overdose
Guidelines for proper storage of medications: Keep medication in one place. Assure all mediations are properly labeled. Refrigerate if required; place away from food. Keep out of the reach of children or disoriented client. Have client properly discard expired medication not in trash.
Temperature, pulse, respirations and blood pressure are called vital signs. Accurate measurements provide important information about the client s health. Check the care plan for which vital signs should be checked and the frequency. Perform this task only if fully trained to do so. Record accrurately and report abnormal readings. Observations of a client s condition might lead the aide to check vital signs. For example, if the client complains of dizziness, check their pulse; if the client feels feverish, check the temperature. Always report abnormal readings.
Temperature refers to body heat and is measured with a digital or glass thermometer. Areas commonly used for measuring temperature are the mouth (oral), anus (rectal), armpit (axillary) and ear (tympanic). Temperature is measured in Fahrenheit (F) in the United States. Body temperature varies from person to person. Normal ranges are Oral: 97.6-99.0 F Rectal: 98.6-100.0 F (most accurate) Axillary: 96.6-97.6 F (least accurate) Tympanic: 98.6-100 F
Elevate temperature may be caused by: Infection Emotions Exercise Warm surroundings Pain Drinking hot fluids Dehydration Sub-normal temperatures maybe caused by: Shock Burns Drinking cold fluids Cold surroundings
There are different types of thermometers: Glass mercury-filled thermometers: these pose a risk of exposure to the mercury, which is poisonous, if the thermometer breaks. Glass mercury-free thermometer filled with alcohol and not hazardous. These are identified by a red colored temperature measuring column. Digital thermometers display the temperature in a digital display. These are safer and more commonly used for taking temperature for a home client. All thermometers must be cleaned between clients, or protective covers must be used.
Guidelines for using a glass thermometer: Shake down to 96 F or lower. Place the bulb under the client s tongue (slender bulb), or under armpit (slender bulb), or into the rectum (round bulb and colored red). Never leave a client unattended with a thermometer in place. Hold at eye level to read the temperature at the line where the mercury ends. Do not clean a glass thermometer in hot water, as this may cause it to break.
Guidelines for using a digital thermometer: Use a disposable sheath over the stem. Be sure the reading is zero before taking temperature. Read temperature when thermometer beeps. Replace the battery when indicator reads low. Sanitize the stem after removing and discarding the sheath.
Guidelines for taking an oral temperature: Wait at least 15 minutes to take a temperature after client eats or drinks or smokes. Never take an oral temperature if client is confused or, cannot breath with mouth closed, is unconscious, is under six years of age, has seizures or is on oxygen. Place under tongue for 5 minutes when using a glass thermometer.
Guidelines for taking a rectal temperature: Always wear gloves and provide privacy. Place client in side-lying position and prevent any movements that could cause injury. Lubricate thermometer tip before inserting. Leave glass thermometer in place for 3 minutes. Hold on to thermometer at all times. Guidelines for taking an axillary temperature: Place the thermometer in the center of the armpit. Place the clients arm across his or her chest. Leave a glass thermometer in place for 10 minutes.
Pulse - the number of heartbeats per minute. Measuring the rate, rhythm and force can provide important about the client s health. Normal rate is 60 100 beats per minute for adults. Count for a full minute. A slow/weak pulse may indicate dehydration, infection, shock or be caused by certain medications. An increased pulse may be caused by exercise, pain, fever, emotions, heart conditions, illness. Report and record all abnormalities.
The pulse can be felt easily at the points of the body where the arteries are closest to the skin. Three most common points for checking the pulse are: Radial felt at the wrist. Brachial felt a t the bend in the elbow; pulse tends to be stronger than at the wrists. Apical using a stethoscope, the heart beat can be heard at the apex of the heart. The pulse can be felt at the carotid artery in the neck. The carotid site is used only when the pulse is too weak to feel radial or brachial pulse, as pressure on the carotid artery can interfere with heart s rate.
Respirations - breathing air into and out of the lungs. Each respiration as two parts: inspiration (breathing in) and expiration (breathing out). One inspiration and one expiration equals one respiration. Normal rate is 12 20 breaths per minute. Count for a full minute. To count respirations, watch or feel the client s chest rise and fall. Count when the client is resting and do not let the client know you are counting breaths.
Increased respirations may be caused by fever, emotions, exercise, or infections. Decreased respirations may be due to medications or illness. Breathing problems may indicate a medical emergency. Report immediately if respirations are: Very slow or fast Noisy Shallow Shortness of breath Labored Wheezing
Blood pressure (BP) measures the pressure in the arterial system. BP varies form person to person and can change from minute to minute. Age, hereditary and physical condition, health problems and medications can affect BP. Systolic The top number, which is also the higher of the two numbers, measures the pressure in the arteries when the heart beats (when the heart muscle contracts) Diastolic The bottom number, which is also the lower of the two numbers, measures the pressure in the arteries between heartbeats (when the heart muscle is resting between beats and refilling with blood).
Equipment used to measure BP are a stethoscope and sphygmomanometer. It is important to use the correct cuff size to get an accurate BP reading. The cuff must be completely deflated before positioning it on the client s upper arm. BP is heard a the brachial artery. It is not always easy to perfect the skill of hearing the first and last sounds of the BP. Students may have to do the procedure over and over again and have the instructor or another student check technique and results for correctness.
Hypertension is high blood pressure. Hypotension is low blood pressure Normal BP = <120/80 Pre-hypertension = 120-139/80-89 Hypertension = >140/90 Hypertension crisis = >180/110 Hypotension = <90/60
Weight changes may indicate problems. Accurately measuring the client s weight can provide important information about the client s health such as poor nutrition or water retention. Guidelines for measuring weight of an ambulatory client: Report any weight loss no matter how small. Weigh at the same time of the day. Have the client wear same or similar clothing and empty their bladder. Client should not lean on or touch the scale or nearby fixtures or furniture, as this could alter the reading.