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ETHICS

📖 DEFINITION OF PROFESSION

1. Definition Hair washing is the process of cleaning the patient’s hair and scalp to maintain hygiene and comfort, especially in bedridden patients. 2. Purpose To maintain scalp and hair hygiene To remove dirt, sweat, and oil To promote comfort and relaxation To prevent infection 3. Indications Bedridden patients Patients unable to perform self-care Routine hygiene care 4. Contraindications ⚠️ Avoid or use caution in: Head injury Cervical spine injury Severe illness (unless permitted) 5. Articles / Equipment 🧰 Equipment: Shampoo tray / basin Jug or mug 🧴 Supplies: Warm water Shampoo Towel Cotton balls Mackintosh Gloves 📋 Records: Not usually required 6. Patient Preparation Explain procedure to patient Provide privacy Position patient supine with head near edge of bed Place mackintosh under head 7. Procedure Steps (Step-by-Step Sentences) Wash hands and wear gloves. Gather all articles and bring them near the bedside. Position the patient comfortably with head supported near the edge of bed. Place mackintosh and towel under the head and shoulders. Place shampoo tray or basin under the patient’s head. Plug the patient’s ears with cotton balls. Wet the hair thoroughly with warm water. Apply shampoo evenly over the scalp. Gently massage the scalp with fingertips. Rinse the hair thoroughly with clean water. Repeat shampooing if required. Remove excess water and dry hair with towel. Comb and arrange the hair neatly. Remove cotton balls from ears. Make the patient comfortable and reposition. Clean and dry equipment. Remove gloves and wash hands. 8. Post Procedure Care Ensure patient comfort Keep hair dry and neat Observe scalp condition 9. Complications Chilling (hypothermia) Water entering ears Discomfort Scalp irritation 10. Health Education Maintain regular hair hygiene Use mild shampoo Avoid very hot or cold water Keep scalp clean and dry 🎯 Viva Questions Q1. Why are cotton balls used in ears? 👉 To prevent water entry Q2. What is the position for bed shampoo? 👉 Supine with head at edge of bed Q3. What is the purpose of hair washing? 👉 To maintain hygiene

1. Definition Enema is the introduction of fluid into the rectum through the anus to stimulate bowel movement or for therapeutic purposes. 2. Purpose To relieve constipation To clean the bowel before surgery or investigations To administer medications To remove fecal impaction 3. Indications Constipation Pre-operative bowel preparation Diagnostic procedures (e.g., colonoscopy) Fecal impaction 4. Contraindications ⚠️ Avoid or use caution in: Intestinal obstruction Severe abdominal pain Rectal bleeding Post rectal surgery 5. Articles / Equipment 🧰 Equipment: Enema can / enema bag IV stand 🧴 Supplies: Enema solution (warm water / soap solution) Rectal tube Lubricant Gloves Bedpan Mackintosh and towel 📋 Records: Patient record 6. Patient Preparation Explain procedure to patient Provide privacy Position patient in left lateral (Sims’) position Place mackintosh under patient 7. Procedure Steps (Step-by-Step Sentences) Wash hands and wear gloves. Prepare enema solution and fill enema can. Hang enema can on IV stand about 45–60 cm above patient. Expel air from tubing before insertion. Lubricate the tip of rectal tube. Position the patient in left lateral position. Gently insert rectal tube into rectum (7–10 cm in adults). Open clamp and allow solution to flow slowly. Regulate flow by adjusting height or clamp. Instruct patient to retain solution as long as possible. After administration, remove rectal tube gently. Provide bedpan if needed. Assist patient to evacuate bowel. Clean and make patient comfortable. Dispose of waste properly. Remove gloves and wash hands. Record procedure and results. 8. Post Procedure Care Observe bowel movement Monitor patient comfort Maintain hygiene Document findings 9. Complications Rectal irritation Infection Fluid imbalance Injury to rectum 10. Health Education Maintain regular bowel habits Eat high-fiber diet Drink adequate fluids Avoid frequent use of enemas 🎯 Viva Questions Q1. What is the position for enema?👉 Left lateral (Sims’) position Q2. What is the height of enema can?👉 45–60 cm Q3. What is the purpose of enema?👉 To relieve constipation

1. Definition Immunization is the process of administering vaccines to protect individuals from specific infectious diseases by developing immunity. 2. Purpose To prevent infectious diseases To reduce morbidity and mortality To promote community (herd) immunity 3. Indications All infants, children, and adults as per schedule High-risk groups During immunization programs 4. Contraindications ⚠️ Avoid or postpone in: Severe illness or high fever History of severe allergic reaction to previous dose Immunocompromised conditions (for live vaccines) 5. Articles / Equipment 🧰 Equipment: Vaccine carrier with ice packs Syringe and needle 🧴 Supplies: Vaccine vial Cotton swabs Hub cutter / safety box Hand sanitizer 📋 Records: Immunization card Register 6. Patient Preparation Explain procedure to parent/caregiver Check immunization history Ensure correct vaccine and dose Maintain cold chain 7. Procedure Steps (Step-by-Step Sentences) Wash hands thoroughly before starting the procedure. Check doctor’s order or immunization schedule. Verify vaccine name, dose, expiry date, and batch number. Maintain cold chain and take vaccine from carrier when required. Identify the child correctly. Explain procedure to parent/caregiver. Position the child properly. Select correct site and route: BCG → Intradermal (left arm) OPV → Oral Pentavalent → Intramuscular (thigh) Clean the injection site if required. Administer the vaccine using proper technique. Do not massage the site after injection (for most vaccines). Dispose of syringe immediately in safety box. Observe the child for 15–30 minutes for any reaction. Record vaccine details in immunization card and register. Inform next visit date to caregiver. Wash hands after completing procedure. 8. Post Procedure Care Observe for adverse reactions Provide comfort to child Manage mild fever or pain 9. Complications Fever Pain and swelling at site Allergic reaction (rare) Anaphylaxis (emergency) 10. Health Education Importance of complete immunization schedule Do not miss doses Keep immunization card safe Report any severe reaction immediately Continue breastfeeding 🎯 Viva Questions Q1. What is immunization?👉 Protection against diseases using vaccines Q2. What is cold chain?👉 Maintaining proper temperature for vaccines Q3. Where is Pentavalent vaccine given?👉 Intramuscular in thigh

1. Definition Suctioning is the removal of secretions from the airway using a suction catheter to maintain airway patency and effective breathing. 2. Purpose To maintain clear airway To remove secretions, mucus, or vomitus To prevent aspiration To improve oxygenation 3. Indications Excessive respiratory secretions Inability to cough effectively Noisy breathing (gurgling sound) Patients with tracheostomy or on ventilator 4. Contraindications ⚠️ Use caution in: Severe hypoxia Cardiac arrhythmias Bleeding disorders 5. Articles / Equipment 🧰 Equipment: Suction machine Suction catheter 🧴 Supplies: Sterile gloves Normal saline Sterile water Oxygen supply 📋 Records: Patient chart 6. Patient Preparation Explain procedure to patient Position patient: Conscious: semi-Fowler’s Unconscious: lateral position Check suction machine functioning Provide oxygen if required 7. Procedure Steps (Step-by-Step Sentences) Wash hands thoroughly and prepare all required articles. Check the suction machine and set appropriate pressure. Explain the procedure to the patient and ensure comfort. Position the patient properly (semi-Fowler’s or lateral). Wear sterile gloves. Connect suction catheter to suction tubing. Gently insert the catheter into the airway without applying suction. Advance catheter until resistance is felt or patient coughs. Apply suction while withdrawing the catheter slowly. Rotate catheter gently during withdrawal. Limit suction time to 10–15 seconds. Allow the patient to rest and provide oxygen if needed. Repeat suctioning if required after a short interval. Clean the catheter with sterile water after use. Observe patient’s breathing and comfort. Dispose of waste properly. Remove gloves and wash hands. Document the procedure and observations. 8. Post Procedure Care Monitor oxygen saturation and breathing Ensure airway is clear Provide comfort Continue oxygen therapy if needed 9. Complications Hypoxia Trauma to airway Infection Cardiac arrhythmias 10. Health Education Encourage coughing and deep breathing Maintain hydration Report breathing difficulty Follow respiratory hygiene 🎯 Viva Questions Q1. What is the maximum suction time?👉 10–15 seconds Q2. Why is suction not applied during insertion?👉 To prevent mucosal injury Q3. What is the purpose of suctioning?👉 To clear airway

1. Definition Blood transfusion is the administration of whole blood or its components from a donor to a recipient intravenously to restore blood volume or specific components. 2. Purpose To replace blood loss To increase hemoglobin level To improve oxygen-carrying capacity To correct coagulation disorders 3. Indications Severe anemia Hemorrhage Shock Surgical patients Blood disorders 4. Contraindications ⚠️ Relative contraindications: History of transfusion reactions Heart failure (risk of overload) 5. Articles / Equipment 🧰 Equipment: IV stand Blood transfusion set (with filter) 🧴 Supplies: Blood bag (cross-matched) IV cannula Normal saline Gloves Antiseptic swabs Adhesive tape 📋 Records: Blood transfusion chart Consent form 6. Patient Preparation Explain procedure and obtain consent Check doctor’s order Verify patient identity Check blood group and cross-match Record baseline vital signs 7. Procedure Steps (Step-by-Step Sentences) Wash hands thoroughly and prepare all articles. Verify doctor’s order and patient identity. Check blood bag details: Blood group Expiry date Cross-match compatibility Inspect blood for any clots or discoloration. Record baseline vital signs (TPR, BP). Insert IV cannula using aseptic technique if not already present. Start IV normal saline. Connect blood transfusion set to blood bag. Prime the tubing with blood to remove air. Attach the transfusion set to IV cannula. Start transfusion slowly (first 15 minutes). Stay with the patient and observe for reactions. Monitor vital signs frequently. Adjust flow rate as prescribed. Complete transfusion within recommended time (usually within 4 hours). Flush line with normal saline after transfusion. Dispose of blood bag as per protocol. Remove gloves and wash hands. Record all details in transfusion chart. 8. Post Procedure Care Monitor patient for delayed reactions Check vital signs Maintain documentation Ensure patient comfort 9. Complications Transfusion reaction (fever, chills) Allergic reaction Hemolytic reaction Circulatory overload Infection 10. Health Education Inform patient about procedure Report symptoms immediately: Fever Chills Rash Breathlessness Importance of blood safety 🎯 Viva Questions Q1. What is the most serious complication?👉 Hemolytic reaction Q2. Why is transfusion started slowly?👉 To detect reaction early Q3. What solution is used with blood transfusion?👉 Normal saline

1. Definition IV infusion is the administration of fluids, medications, or nutrients directly into a vein through a sterile intravenous line. 2. Purpose To maintain fluid and electrolyte balance To administer medications To provide nutrition (IV fluids) To maintain circulatory volume 3. Indications Dehydration Shock Inability to take oral fluids Electrolyte imbalance Drug administration 4. Contraindications ⚠️ Avoid or use caution in: Infected or damaged vein Edema at site Severe coagulation disorders 5. Articles / Equipment 🧰 Equipment: IV stand Tourniquet 🧴 Supplies: IV fluid bottle (e.g., Normal saline) IV set (infusion set) Cannula Antiseptic solution (spirit/alcohol swab) Sterile gloves Adhesive tape Cotton swabs 📋 Records: IV fluid chart 6. Patient Preparation Explain procedure to patient Check doctor’s order Select suitable vein (usually forearm/hand) Position patient comfortably 7. Procedure Steps (Step-by-Step Sentences) Wash hands thoroughly and prepare all articles. Check IV fluid for correct type, expiry date, and clarity. Assemble IV set and remove air from tubing (priming). Apply tourniquet above selected vein. Clean the site with antiseptic solution and allow to dry. Wear sterile gloves. Insert IV cannula into the vein at appropriate angle. Confirm blood return in the cannula. Remove needle and secure cannula in place. Connect IV tubing to cannula. Fix the cannula with adhesive tape. Adjust flow rate as prescribed. Remove tourniquet. Observe for proper flow of fluid. Make the patient comfortable. Dispose of waste properly. Remove gloves and wash hands. Record procedure in IV chart. 8. Post Procedure Care Monitor IV site for swelling or redness Check flow rate regularly Maintain aseptic technique Replace fluids as prescribed 9. Complications Infiltration Phlebitis Infection Air embolism 10. Health Education Do not touch IV site Report pain, swelling, or redness Avoid bending the arm excessively Inform nurse if IV stops flowing 🎯 Viva Questions Q1. What is IV infusion?👉 Administration of fluids into vein Q2. What is the common site for IV?👉 Forearm vein Q3. What is infiltration?👉 Leakage of fluid into surrounding tissue