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Students are capable to explain and simulate helping patients in daily activities using appropriate vocabulary and sentence patterns in English | Indicator: Accurate use of vocabulary and sentence patterns in explaining and simulating helps patients in daily activities

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Work in a group of 3-5 students

Identify the objectives

List the Equipment

Jot down the procedure

Simulate the procedure by reading it

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1. NGT Feeding

2. Giving injection

3. Bed making

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By inserting a nasogastric tube, it's can gaining access to the stomach and its content.  This enables to drain gastric contents, decompress the stomach, obtain a specimen of the gastric contents, or introduce a passage into the GI tract. This will allow to treat gastric immobility, and bowel obstruction.  It will also allow for drainage and/or lavage in drug overdosage or poisoning.

In trauma settings, NGT can be used to aid in the prevention of vomiting and aspiration, as well as for assessment of GI bleeding. NGT can also be used for enteral feeding initially

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Nasogastric tube (fine bore)

Stethoscope

Disposable gloves

Pen light

Lubricant and gauze: to lubricate the tip of the NG tube.

Disposable bowl: to be used in the event of vomiting.

Paper towels: to allow the patient to wipe around their mouth if needed.

Large syringe: to obtain an aspirate from the NG tube.

pH testing strips: to assess the pH of the aspirate.

Dressing: to secure the NG tube.

A glass of water for the patient (if swallow is deemed safe).

Local anaesthetic spray: to numb the oropharynx.

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1. Perform hand hygiene and gather supplies.
2. Visually inspect condition of patient’s nasal and oral cavities.
3. Assess for the best nostril before you begin.

(Do this by occluding one side and asking the patient to sniff. Ask the patient about previous injuries or history of a deviated septum.)
4. Palpate patient’s abdomen for distension, pain, and/or rigidity. (Auscultate for bowel sounds.)
5. Assess patient’s level of consciousness and understanding of procedure.
6. Check doctor’s orders for type of NG tube to be placed and reason for placement.
7. Check doctor’s orders to determine whether the NG tube is to be attached to suction or a drainage bag.
8. Position patient sitting up at 45 to 90 degrees (unless contraindicated by the patient’s condition), with a pillow under the head and shoulders.
9. Raise bed to a comfortable working height.
10. Agree on a signal the patient can use if they wish you to pause during the procedure.
11. Place a towel on the patient’s chest and provide facial tissues and an emesis basin.
12. Provide patient with drinking water and a straw if the patient is not fluid restricted.
13. Stand on patient’s right side if you are right-handed and the left side if you are left-handed.
14. Measure distance of the tube from

The tip of the nose, to…

The earlobe, to…

The xiphoid process

and then mark the tube at this point.
15. Lubricate NG tube tip according to your agency policy.
16. Apply clean non-sterile gloves.
17. Curve 10 to 15 cm of the end of the NG tube around your gloved finger, and then release it.
18. Have patient drop head forward and breathe through the mouth.
19. Insert NG tube tip slowly into the patient’s nostril and advance it steadily, in a downward direction, along the bottom of the nasal passage, with the curved end pointing downward in the direction of the ear on the same side as the nostril.
20. You may feel slight resistance as you advance along the nasal passage. Twist the tube slightly, apply downward pressure, and continue trying to advance the tube. If significant resistance is felt, remove the tube and allow the patient to rest before trying again in the other nostril.
21. If there is difficulty in passing the NG tube, you may ask the patient to sip water slowly through a straw unless oral fluids are contraindicated. If oral fluids are not allowed, ask the patient to try dry swallowing while you advance the tube.
22. Continue to advance NG tube until you reach the mark/tape you had placed for measurement.
23. Temporarily anchor the tube to patient’s cheek with a piece of tape until you can check for correct placement.
24. Verify tube placement according to agency policy.

(Colour-coded pH paper is usually used, as an initial and interim check, to confirm that acidic contents are present. Then an X-ray is taken to confirm placement prior to using NG tube for feeding.)
25. Once the tube placement has been confirmed, mark (with a permanent marker) and record the length of tubing extending from the nose to the outer end of the tube.
26. Secure the tube to the patient’s gown with a safety pin, allowing enough tube length for comfortable head movement.
27. Document the procedure according to agency policy, and report any unexpected findings to the appropriate health care provider.

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a way of administering a sterile liquid form of medication into tissues of the body beneath the skin

Usually used for drugs which need to act quickly or do not absorb well in the digestive system

The purpose of Giving Injection is to deliver drugs and vaccines into the body

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1. Syringes
2. Needle
3. Pre injection swabs

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Open the alcohol wipe: Wipe the area where you plan to give the injection. Let the area dry. Do not touch this area until you give the injection.

Prepare the needle: Hold the syringe with your writing hand and pull the cover off with your other hand. Place the syringe between your thumb and first finger. Let the barrel of the syringe rest on your second finger.

Hold the skin around where you will give the injection: With your free hand, gently press on and pull the skin so that it is slightly tight.

Insert the needle into the muscle: Hold the syringe barrel tightly and use your wrist to inject the needle through the skin and into the muscle at a 90 degree angle.

Check the needle: Let go of the skin with your other hand. Hold the syringe so it stays pointed straight in. Pull back on the plunger a little to make sure you did not hit a blood vessel. If blood comes back, remove the needle immediately. Do not inject the medicine. Dispose of both the syringe and the medicine. Get more medicine in a new syringe. When you give the second injection, give it on the other side.

Inject the medicine: Push down on the plunger to inject the medicine. Do not force the medicine by pushing hard. Some medicines hurt. You can inject the medicine slowly to reduce the pain.

Remove the needle: Once the medicine is injected, remove the needle at the same angle as it went in. Place gauze over the area where you gave the injection.

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Bed making is one of the important nursing techniques to prepare various types of beds for patients or clients to ensure comfort and useful position for a particular condition. The purposes of bed making are to make clients comfort, to provide clean and hygienic environment for the client, to provide rest and sleep, etc. But, the main purposes of bed making are to prevent complications by ensuring comfort and security to the patient.

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- Blankets
- Bed spread
- Pillow cases
- Two large sheets
- Draw sheet
- Rubber Mackintosh
- Linen Hampe
- Bedside table
- Disposable Gloves

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1. Wash hand and wear disposable gloves
2. Assemble and arrange equitment on bed side table
3. Fold and keep reversible linens such as blanket or bedspread on bedside table
4. Bundle all soiled linen in bottom sheet and directly place into the laundry bag.
5. Place the bottom sheet with its center fold in the center of bed and towards the top to have sufficient sheet to tuck under the head of the mattress.
6. Unfold the bottom sheet, spread it over the mattress and tuck in severly with mitered corner.
7. Spread the mackintosh at the center of the bed and tuck it along the side.
8. Place the draw sheets over the mackintosh and tuck it along the side.
9. Move the opposite side and tuck the sheets.
10. Place the blanket over the top sheet about 6 inches below the top of the sheet.
11. If the bed spread is used place it over the blanket.
12. Tuck the top sheet, blanket and bed spread under the foot of the bed on the side close to you and miter the corners.
13. Fold the upper 6 inches of the top sheet down over the spread and make a cuff.
14. Move to otherside and follow the same procedure for screening top sheets.
15. Put the pillow case and place the pillow at the head end.
16. Fanfold or pie fold top linens.
17. Rearrange furniture and place personal items within easy reach.
18. Adjust the bed to a comfortable height.
19. Dispose off soiled linen and wash hands.