Patient Care Case 1
Your supervisor has assigned you a patient, John, a 78-year-old man with Dementia. He fell out of his bed and sprained his wrist. He is diabetic and suffers from left-sided weakness due to a stroke. He requires total care and assistance with everything he does. He has dentures.
He can no longer walk alone, feed himself, bathe or dress himself, and he is incontinent of urine and stool. His vital signs are to be monitored q 4 hrs.
1. You are preparing to shave John. You need to assemble your supplies. What is the first action you should take?
a. Place a warm damp towel around his face to soften his beard and relax him
b. Check the chart to see if you should shave him and if so what type of razor you can safely use.
c. Gather your towels, razor and shaving cream and proceed to John’s room
d. Make certain John has the privacy required to perform ADL’s
2. You have checked the chart and it is safe to shave John using a standard razor. You should
a. Draw the razor in the direction of hair growth
b. Draw the razor opposite the direction of hair
c. Pull the skin taut
d. Both a and c
3. In performing John’s daily care, you note that his toenails need to be trimmed. You should do which of the following?
a. Gather your supplies and carefully trim his nails
after cleaning his feet.
b. Ignore it
c. Note it in your documentation so that a doctor can
cut his nails
d. Plan to trim his nails while you are bathing him
4. When should you clean John’s dentures?
a. Before performing mouth care or cleaning
b. After performing mouth care or cleaning
c. Every 2 hours
d. Before and after each meal
5. Oral care of any type should be performed
a. At least twice per day
b. After each meal
c. Before and after each meal
d. After each meal, in the morning and each night
before the patient goes to sleep
6. In order to make John’s bed, which of the following will you need?
b. Clean linens, gloves, and a bag for dirty linens
c. Clean linens and a bag for dirty linens
d. Clean linens
7. When removing your contaminated gloves after making John’s bed, you would
a. Grasp the fingers of one glove using the other gloved hand and remove it
b. Grasp the cuff of one gloved had using the other gloved hand and remove it
c. Grasp the palm of one gloved hand using the other gloved hand and remove the glove leaving it in your remaining gloved hand. Then you would place your un-gloved fingers beneath the cuff of the remaining dirty glove, removing it by turning it inside out keeping the glove you have already removed inside the palm of the glove you are removing
d. Grasp the fingers of each glove and remove them by gently tugging at the ends and dispose of them in the appropriate receptacle
You should always make certain a patient can be shaved and what type of razor is appropriate. If a patient is septic, it may be dangerous for the patient if you shave him at
all. Shaving risks a cut that could cause issues with his already compromised immune system.
You should always shave in the direction of hair growth which changes depending on where you are shaving. Pulling the shin taut allows shaving with minimal risk of
The only person who can trim a diabetics nails is a doctor due to potential for infection.
The appropriate sequence when administering mouth care to a person with dentures is to clean the dentures first. Then you should perform oral care or cleaning. The dentures
are then clean and ready for the patient as soon as you have completed oral care.
Oral care is an essential part of appropriate nursing care. You should give oral care frequently during the day in order to maintain good oral health.
You always need gloves when removing dirty linens or performing other tasks which could bring your skin into contact with pathogens or body fluids. Clean linens and a
bag for dirty laundry are essential.
The gloves are removed in such a manner that your skin does not come into contact with contaminated areas of the gloves and they are turned so that one is contained within
the other and appropriately disposed of.