Chapter 11 – Basic Healthcare Skills

Monitoring a person’s vital signs provides invaluable health information by showing how well the vital organs of the body, such as the heart and lungs, are working. Chapter 11, "Basic Healthcare Skills," explains how to take vital signs, including body temperature, pulse, rate of respirations, blood pressure, and level of pain. After checking with your loved one’s physician or nurse, you may want to monitor vital signs yourself, or you may use this information to monitor the work of others who are providing care. Procedures included for monitoring vital signs are:

• Taking and recording an oral temperature
• Taking and recording a rectal temperature
• Taking and recording an axillary temperature
• Taking and recording a tympanic temperature
• Taking and recording apical pulse
• Taking and recording radial pulse and counting and recording respirations
• Taking and recording blood pressure (two-step method)

Chapter 11 of Caregiving at Home shows you the normal ranges for adult vital signs, including normal temperature at four different sites, and tells you which changes should be reported to the physician. Different types of thermometers, including mercury-free thermometers, are shown, along with eight common sites for taking a pulse, including those used to measure blood pressure. This chapter explains what blood pressure measures and gives you the ranges for hypertension and prehypertension. The importance of observing for pain, which is known as the "fifth vital sign," is stressed. The chapter includes a list of questions to ask your loved one about pain when reporting to the physician and signs and symptoms that indicate pain may be present. Measures to reduce pain, including back rubs and using pillows for support, are suggested.

In addition to monitoring vital signs, there are other basic healthcare procedures that you may need to know while giving care at home. "Basic Healthcare Skills" describes different types of catheters with guidelines for catheter care. Procedures for catheter care and emptying the catheter drainage bag are also included. Several kinds of gastric tubes are described along with guidelines for tube feedings. This chapter also provides information about oxygen and guidelines for its safe use. It includes information about IVs, including observations about an IV that need to be reported to the physician.

You may at some point be asked to collect a specimen, or sample, from your loved one for medical tests. Chapter 11 tells you how to collect the following kinds of samples:

• Collecting a sputum specimen
• Collecting a routine urine specimen
• Collecting a clean catch (mid-stream) urine specimen
• Collecting a 24-hour urine specimen
• Collecting a stool specimen

Sterile dressings are used to cover open or draining wounds. While a nurse will usually change sterile dressings, you may need to change a dry dressing. A dry, or non-sterile, dressing is applied to a dry wound that has less chance of infection. The procedure for changing a dry dressing using non-sterile technique is found in Chapter 11.

If your loved one has muscle pain or an injury, the physician may prescribe a warm or cold application. "Basic Healthcare Skills" lists different types of warm and cold applications as well as signs and symptoms to observe for during their use. Procedures are included for the following warm and cold applications:

• Applying warm compresses
• Administering warm soaks
• Using a hot water bottle
• Assisting with a sitz bath
• Applying ice packs
• Applying cold compresses

For some people who have poor circulation in their hands and feet, anti-embolic hose are prescribed. This chapter describes the correct procedure for applying anti-embolic hose.

If your loved one is confined to bed for a long period of time, her doctor or physical therapist may recommend range of motion exercises to prevent contractures and improve strength and circulation. You may need to assist if your loved one’s movement is limited or she cannot move on her own. Chapter 11 of Caregiving at Home provides detailed instruction for passive range of motion (PROM) exercises with full-color photos to illustrate each body movement.

If your loved one is paralyzed or is recovering from abdominal surgery, he may need to do deep breathing exercises to expand his lungs. If you have been trained to assist with these exercises, the procedure in Chapter 11 will serve as a reminder of how to do it correctly.

Even if you will not be performing the procedures described in "Basic Healthcare Skills" yourself, this information will help you monitor the care your loved one receives from others and know which signs and symptoms to observe for and to report to the physician. Knowledge of basic healthcare techniques can improve your knowledge of your loved one’s conditions as well as your skill as a caregiver.