Education of Blood pressure in Nepal

As we know that we should maintain our blood pressure to be healthy. For that we always should regular check our blood pressure. Blood pressure is the force exerted by the blood in the wall of the arteries. e.g. 100/70 mm of Hg.Force exerted bu the blood in the wall of the arteries when the left ventricle contracts to pump out blood kin to large arteries is called Systolic Blood Pressure.

Normal Blood Pressure

i) Infant :- 80/50 mm of Hg

ii) Child :- 90/60 mm of Hg

iii) Adult :- 120/80 mm of Hg

iv) Elder :- 140/90 mm of Hg

Abnormal Blood Pressure

i) Hypertension:- If the blood pressure is higher than normal level , it is called hyper tension.(High Blood Pressure)

ii) Hypotension:- If the blood pressure is lower than normal level then it is called hypotension. (Lower Blood Pressure)

Equipments use for taking blood pressure.


i) Sphygmomenometer





ii) Stethoscope




Method of taking Blood Pressure

• Explain the procedure to the patient. Make him sit or lie a comfortable position with arm supported.
• Remove the patient's sleeve of his arm .
  
• Wrap the cuff of the sphygmomenometer smoothly around the lower two third of the patient's arm about 2.5 cm above his elbow.
• Do not wrap cuff too tightly because this will be uncomfortable to the patient but if the cuff is wrapped too loose the sound will not be heard clearly.
• Pace the menometr in paient's heart level facing towards the care giver.
• Fell the pulsation of thebrachial artery using finger tips.
• Pump up the cuff until the pulse disappear. This is the palpatory method of taking blood pressure. This will give an idea of bow much the cuff should be inflated for taking blood pressure by listening with the stethoscope.
• After taking palpatory blood pressure, Place stethoscope over the brachial artery of the elbow.
• Inflate the cuff to approximately 20 mm of Hg hgher than the palpatory systoloic blood pressure.
• Open the valve a little to the pressure release slowly and listen until sharp sound is heard. Read the pressure at this point. This is called systolic blood pressure.
• Let the pressure release further and continue to listen attentively to the sound as the air is gradually released from the cuff. At the certain point the sound changes from loud to a soft sound and then it disappears or become inaudible. Note the pressure just before the sound become inaudible. This is called diastolic blood pressure.
• As soon as both systolic and diastolic readings have been taken, release the air from cuff completely and remove the cuff from the patient's arm.
  

Education about Vital Signs

Well, vital signs are the signs of life. Vital sign includes body temperature, pulse, respiration and blood pressure. The presence of these signs indicate the existence of life. In healthy person, these vital signs remain early constant . Abnormal or diseased condition in the body which affect body function also change these signs. So any changes in the normal value of these signs is considered as abnormal condition . In order to access the patients condition, we should measure vital signs accurately and regular interval.

Here I'm describing the vital signs . They are as follows:

TEMPERATURE:

Body temperature is the degree of heat maintain by the heat. The body produce its own heat and maintain its temperature relatively constant level. We all should maintain our body temperature. Body temperature is measured in degree celcius ore in degree fahrenheit.

Normal temperature of the body is 98.6 degree Fahrenheit or 37 degree celcius. 99 degree Fahrenheit - 103 degree fahrenheit is considered as fever or pyrexia. Temperature above 104 degree fahrendeit is considered as hyperpyrexia. Below 97 degree fahrenheit is considered as hypothermia.l 97 degree fahrenheit -99 degree fahrenheit is considered as normal range of temperature. 93 degree fahrenheit is considered as expiry.

Types of the thermometer.

i) Oral thermometer

ii) Rectal thermometer


Steps of taking Temperature

1. We should wash our hand properly.
2. Explain the procedure to the patient.
3. Keep the patient in comfortable position.
4. Clean the thermometer from bulb to end by the spirite swab.
5. Dry the axilla or groin by towel or guaze if there is sweating.
6. Before taking the temperature reach the mercury level in glass tube. Shake the mercury down to the bulb.
7. Shake the thermometer away from the body and things. So that it doesn't strike against any thing.
8. Level the thermometer to ht adequate time.
9. Never hold the thermometer from bulb area because warmth of the finger may further expand the mercury level
10. Measure the tempoerature bu holding th thermo metr in eye level.
11. clean the thermometre from steam to bulb.
12. Record and report the temperature.

Education about first aid

Hi friends, today I'm going to tell you something about first aid . Of course, it's a minor for all but very important to us. We all should have the education about the first aid. Well, first aid is the treatment given to the patient after accident and before taken to the hospital. First aid helps the patient to prevent in different ways. There are different types of the first in different accident. Here I'm just telling you about Dressing.

DRESSING:-
Dressing is the procedure of protection the wound from germs and further injury.It also helps to feel relief from injury for few time before reach to the hospital. There are two types of the dressing. They are as follows:-

1. Medical Dressing:- Dressing is done for closed wound, for example; application of megnesium sulphate on abscess. It doesn't require sterile technique.
2. Surgical Dressing:- It requires sterile technique. It is done in open wound.

Articles required for the dressing are as follows:

• Kidey tray
  
• Bowl
• Artery forcep
• Descecting forcep
• scissors
• anticeptic soluton(betadine, savlon solution, dettol)
• sterile gloves
• Makintosh/rubber sheet
• Gauze (steriled) /cotton
• Bandage

There are some of the purposes for dressing. They are as follows:

• To protect the wound from further injury.
  
• To prevent entry of micro organism and also to prevent discomfort that arise due to temperature change.
• To provide pressure on the wound to minimize the collection of fluid and oedema of tissue.
• Control bleeding by application of pressure on the blood vessels.
• To absorb discharge e.g.d pus, blood and to keep the wound area dry.
  

After getting the education about the purposes of dressing we should get education about procedure of the dressing. Then only we can help to the injury patient. The procedure are as follows:

1. At first collect all the articles in bed side.
2. Explain the procedure to the patient.
3. Before doing the procedure we have to wash our handwith soap and water.
4. Expose the area of wound and drap the patient properly.
5. Open the dressing site and pous the anticeptic solution in the bowl for cleaning the wound.
6. Wear sterile gloves.
7. Avoid touching the wound directly.
8. Never touch or sneeze over the wound.
9. Put extra dressing pads to control bleeding and absorb discharge with the help of bandage.
10. Discard the soiled dressing if any.
11. Record the condition of the wound.
    

Education about Oral and Eye care

ORAL CARE :-

Well, I'm telling you something about Oral care is the cleanliness of the teeth including artificial denture, gum , oral mucosa and tongue. Well, we all do oral care but should do properly to keep our teeth strong. Usually we give oral care twice a day in the morning and at the night after meal but in case of unconcious patient , high fever patient and oral infected patient we give oral care frequently. We should give proper oral care to the unconcious patient. If the patient is unconcious it is our duty to give education and method to the family members.l

Purpose of the Oral care:
The main purpose of the oral care is to clean the mouth. To get refresh the patient oral care is necessary. To stimulate appetite oral care is also needed. The patient also can get relieve from bad order. Oral care also prevent and treat oral infection.


Articles required for oral care of unconcious Patient:

• Small bowl with boiled water.





• Artery forcep
  





• Desecting forcep Kidney tray
  





• Cotton swabs and guaze piece
  





• Face towel
  





• Rubber Sheet





• Boroglycerine





• Tongue depressor





• Sodium Bicarbonate powder

Now, the procedure of the oral care are describing below:

• We have to bring all the articles to the bed side.





• Place the patient in lateral position.





• Hold the swab socked in sodium bicarbonate solution with artery forcep and squeezed it with the help of desecting forcep.





• Throughly clean the patient's teeth, oral mucosa , tongue and chewing surface.





• For cleaning th tongue and chewing surface of the teeth use tongue depressor to open the mouth.





• We should never use finger to open the mouth as uncouncious patient may bite the finger.
  





• We should use many swabs as needed to clean the mouth throughly.





• We should dry the patient mouth with towel.





• Lubricate the patient's lips with boroglycerine.





• We should record the procedure and condition of the oral cavity.

EYE CARE :-

We know that eye care means to take care and clean eye by using the proper way. To make our eye healthy we should have proper education about the eye care. Then only we can take care our eyes by ourselves and others too. For the care of our eyes we need the following articles required. They are given below:

• Boiled water in small bowl





• Sterik Cotton





• Kidney Tray





• Eye drop (if prescribed by the doctor)





• Gauze Piece

Now about the procedure of the eye care:

STEPS:

• At first we have to explain the procedure to hte patient.





• Assist the patient to lie on his back with his head hyper extended.





• Wash your hand with soap and water.





• Clean the eye lid and lasher by wiping from the inner canthus to outer canthus with sterile cotton socked in boiled water or normal saline.





• Draw the required amount o medicine in dropper. Don't touch the tip of the dropper.





• tell the patient to look up to the ceiling and give him piece o guaze to wipe as needed.l





• Place yor inger at the check bone below the ecy using a cotton, sponnge.





• se the side approach, instill the required amount o fmedifcine on to the outer third o the lower conjucntival sac.





• Apply the eye pad as needed.





• Help the patient to the comfortable position.





• We have to wash our hand.





• At last record the drugs instilled lin eye both left and right and also time.
  

Education about Pressure Sore

Well friends , pressure sore is one of the problem for the patent lying in the bed for long time due to many types of diseases. So we have to take proper care of the patient lying in the bed and should provide proper hygiene and health care of the patient . As well as the education about the pressure sore also should be provided to the family members too. Pressure sore is the sore or ulcer which develops the bony prominent area due to constant pressure. Pressure sore is usually caused by prolong lying n bed So, it is also called bed sore.

There are some of causes of the pressure sore . Some of the causes are as follows:-

• Due to the pressure of the body .
• Due to the friction .l
• Wet bed and wrinkle bedsheets.
• During giving and removing bed pan.

There are also some common site of the pressure sore. We should be careful about it and should give proper attention on the given site while caring the patient. They are as follows:-

1. Back of the head is the site for the pressure sore and should take proper care of this site.
2. The next site is the Ear.
3. Cheek bone.
4. Elbow
5. Ribs
6. Sacrum
7. Toes
8. Malleolus
9. Breast in female
10. Genitalia in male
11. Scapula

There are also some of the high risk patient for which the pressure may occure. the proper care should be given to these patient and should give education to the family members too. They are as follows:-

1. There is the high risk in these elderly bed ridden patient. The proper care should be give to these patient.
2. Paralysised Patient is also another high risk patient.
3. Fractual patient i s also another high risk patient .
4. Unconcious Patient
   
5. Obese patient
6. Very thin patient
7. Sedated patient
   
8. Odematous patient

There are also some of the bed sore. In the first we should have to change the position of the patient. For that change the patient position frequently to prevent form constant pressure over the area (min two hourly position change. Secondly, we have to massage the patient . In this step massage pressure are frequently to stimulate he blood circulation. We have to use back rub lotion or olive oil for massaging. We have to gibe back care at least twice a day to the patient. Thirdly, we have to care in moving the patient. We should avoid pulling and sliding while moving the patient in bed to prevent fiction. We should gently lift the patient while moving him.

Forthly, we should give physical care to the patient. For that we to keep the skin dry and clean of the patient so that the patient can feel relief. We should give plenty of fluid and balance diet. We should ambulate and exercise to the patient. It helps to circulate the blood in the body and exercise the body muscles. Fiftly, We have to provide mechanical devices. We should provide air mattress , water mattress , air rings and pillows.