1. Define important words in the chapter. central venous line a type of intravenous line (IV) that is inserted into a large vein in the body. chest tubes
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1. Identify yourself by name. Identify the resident. Greet the resident by name.
2. Wash your hands.
3. Explain procedure to resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible.
4. Provide for the resident’s privacy with a curtain, screen, or door.
5. Remove nail polish from digits to be used for pulse oximetry, if necessary.
6. Remove sensor probe from package and place clip-on probe on finger, toe, or earlobe. The index finger is usually preferable. The probe must be placed fully onto the finger or toe; it should not be placed just on the tip of the finger or toe.
7. Blood pressure and pulse measurements may be needed prior to placing the device. If device does not seem to be working, make sure wires on pulse oximetry device are in place and that device is plugged in. Turn on the device. The pulse oximetry reading should appear on the screen quickly.
8. Ask resident to not remove or adjust pulse oximetry device. Ask resident to press call signal if the device comes off or dislodges.
9. Make resident comfortable.
10. Remove privacy measures.
11. Leave call light within resident’s reach.
12. Wash your hands.
13. Be courteous and respectful at all times.
14. Report any changes in the resident to the nurse. Document procedure using facility guidelines.
Observe and report the following related to tube feedings (cont’d.):
Cyanosis, pale, gray, or darkening skin or mucous membranes
Nausea, vomiting, and cramping
Fluid gathering at mouth
Signs of infection at the tube site
Bleeding or drainage
Signs of aspiration
Resident pulling on tube