Difference between revisions of "AY Honors/Home Nursing/Answer Key"

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[[Image:SchoolchildrenWashingHands.jpg|right|thumb|Schoolchildren washing their hands before eating lunch.]]
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A [[soft diet]] is recommended in many situations, including some types of [[dysphagia]] (difficulty swallowing), surgery involving the mouth or [[gastrointestinal tract]], and pain from newly adjusted [[dental braces|braces]].  
'''Hand washing''' is the act of [[cleaning|cleansing]] the [[hand]]s with [[water]] or other [[liquid]], with or without the use of [[soap]] or other [[detergent]]s, for the purpose of removing [[soil]] or [[microorganism]]s.
 
  
==Purpose==
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In some situations, there are additional restrictions.  For example, patients who need to avoid excessive [[Gastroesophageal Reflux Disease|reflux]], such as those recovering from esophageal surgery for [[achalasia]], are also instructed to stay away from foods that can aggravate [[Gastroesophageal Reflux Disease|reflux]], which include ketchup and other tomato products, citrus fruits, chocolate, mint, spicy foods, alcohol, and caffeine.
The main purpose of washing hands is to cleanse the hands of [[pathogen]]s (including [[bacterium|bacteria]] or [[virus]]es) and chemicals which can cause personal harm or disease. This is especially important for people who handle food or work in the medical field.  Washing your hands is one of the most effective ways to maintain health and prevent infection. {{Fact|date=February 2007}}
 
  
While hot water may more effectively clean your hands, this is primarily due to its increased capability as a solvent, and not due to hot water actually killing germs.  Hot water is more effective at removing dirt, oils and/or chemicals, but contrary to popular belief, it does not kill micro organisms.  A temperature that is comfortable for hand washing (about 45 °C) is not nearly hot enough to kill any micro organism.  It would take more than double that temperature to effectively kill germs (100 °C, which is boiling).
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Many of the foods listed here can be adapted for a [[liquid diet|"full liquid"]] diet (not a [[liquid diet|"clear liquid"]] diet) by processing in a blender with an appropriate thinning liquid, such as a meat broth, fruit or vegetable juice, or milk.
  
==Personal hand washing==
 
To maintain good [[hygiene]], hands should always be washed after using the toilet, changing a diaper or tending to someone who is sick; before eating; before handling or cooking food and after handling raw meat, fish or poultry. Conventionally, the use of soap and warm running water and the washing of all surfaces thoroughly, including under fingernails is seen as necessary. One should rub wet, soapy hands together outside the stream of running water for at least 20 seconds, before rinsing thoroughly and then drying with a clean or disposable towel<ref>[http://www.mayoclinic.com/health/hand-washing/HQ00407 Hand washing] from [[Mayo Clinic]]</ref>. After drying a dry paper towel should be used to turn off water and open exit door.  Moisturizing [[lotion]] is often recommended to keep the hands from drying out, should one's hands require washing more than a few times per day. <ref>[http://www.tufts.edu/med/apua/Patients/handwashing.html Hand washing] from [[Tufts University]]</ref>
 
  
Antibacterial soaps have been heavily promoted to a health-conscious public.  To date, there is no evidence that using recommended antiseptics or disinfectants selects for antibiotic-resistant organisms in nature.<ref>Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America. (Infect Control Hosp Epidemiol) 2006 Oct; 27(10): 1107-19
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== Grains/starches ==
</ref>  However, antibacterial soaps contain common antibiotics such as Triclosan, which has an extensive list of resistant strains of organisms.  So, even if antibacterial soaps do not select for antibiotic resistant strains, they might not be as effective as they are marketed to be.  These soaps are quite different from the non-water-based hand hygiene agents referred to below, which also do not promote [[antibiotic resistance]]<ref>[http://www.cdc.gov/cleanhands/ Clean hands] from the [[Centers for Disease Control and Prevention|CDC]]</ref>.
 
  
==Medical hand washing==
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*Pasta cooked soft
The purpose of hand washing in the health care setting is to remove or destroy (disinfect) [[pathogens|pathogenic microrganisms]] ("germs" in common parlance) to avoid transmitting them to a patient.  Water alone is fairly effective, simply by removing many agents loosely adherent to the skin. Ordinary soap aids in removal and also helps to kill [[pathogen]]s. Other "medicated" soaps or hand disinfectants are used in certain settings when higher levels of disinfection are required (e.g. surgery).
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*Rice cooked soft
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*Cooked cereals: oatmeal, porridge, Weetabix/Cream of Wheat
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*Macaroni & cheese
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*Mashed potatoes and gravy
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*Skinless baked potatoes with sour cream or cream cheese
  
The proper washing of hands in a [[medicine|medical]] setting generally consists of the use of generous amounts of soap and water to lather and rub each part of ones hands systematically. Hands should be rubbed together with digits interlocking. If there is debris under fingernails, a bristle brush is often used to remove it. Finally, it is necessary to rinse well and wipe dry with a paper towel. After drying, a dry paper towel should be used to turn off water and open exit door.
 
  
To 'scrub' one's hands for a [[surgery|surgical operation]], one requires a tap that can be turned on and off without touching with the hands, some [[chlorhexidine]] or [[iodine]] wash, sterile towels for drying the hands after washing, a sterile brush for scrubbing and another sterile instrument for cleaning under the fingernails. All jewellery should be removed. This procedure requires washing the hands and forearms up to the elbows, and one must in this situation ensure that all parts of the hands and forearms are well scrubbed several times. When rinsing, it is ensured at all times that one does not allow water to drip back from the elbow to your hands. When done hands are dried with the sterile cloth and the surgical gown is donned.
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== Proteins ==
  
In the late 1990s and early part of the 21st century, non-water-based hand hygiene agents began to gain popularity.  Most are based on [[isopropyl alcohol]] formulated into a gel or lotion for ease of use and to decrease the drying effect of the alcohol. The increasing use of these agents is based on speed and ease of use it is easier to do a good job quickly with these agents than with soap and water. However, soap and water are as good as the non-water-based agents when used properly.
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*Tofu
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*Cottage cheese
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*Yogurt
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*Scrambled eggs
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*Fish cooked soft
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*Meat loaf, meatballs, cottage pie, and other soft dishes with ground meat
  
Despite their effectiveness, the non-water agents do not clean hands, they simply disinfect them.  Visible soiling of any sort on the hands must be washed with soap and water. Alcohol-based disinfectants are similarly ineffective in the presence of large, visible amounts of extraneous material.
 
  
The [[New England Journal of Medicine]] reports that hand washing remains at unacceptable levels in most medical environments, with large numbers of doctors and nurses routinely forgetting to wash their hands before touching patients.<ref>{{cite journal |quotes= |last=Goldmann |first=Donald  |authorlink= |coauthors= |year=2006 |month=July |title=System Failure versus Personal Accountability — The Case for Clean Hands |journal=[[New England Journal of Medicine]] |volume=355 |issue=2 |pages=121-123 |id= |url=http://171.66.123.143/cgi/content/full/355/2/121 |accessdate=2007-01-05 }}</ref> One study has shown that proper hand washing and other simple procedures can decrease the rate of catheter-related bloodstream infections by 66 percent.<ref>{{cite journal |quotes= |last= Pronovost |first=Peter |authorlink= |coauthors=Dale Needham, M.D., Ph.D., Sean Berenholtz, M.D., David Sinopoli, M.P.H., M.B.A., Haitao Chu, M.D., Ph.D., Sara Cosgrove, M.D., Bryan Sexton, Ph.D., Robert Hyzy, M.D., Robert Welsh, M.D., Gary Roth, M.D., Joseph Bander, M.D., John Kepros, M.D., and Christine Goeschel, R.N., M.P.A |year=2006 |month=December |title=An Intervention to Decrease Catheter-Related Bloodstream Infections in the ICU |journal=[[New England Journal of Medicine]] |volume=355 |issue=26 |pages=2725-2732 |id= |url=http://content.nejm.org/cgi/content/abstract/355/26/2725 |accessdate=2007-01-05 }}</ref>[http://www.technewsworld.com/story/54899.html]
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== Fruits and vegetables ==
  
==Hand washing as compensation==
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*Applesauce
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*Bananas
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*Peeled pears or peaches
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*Avocados
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*Creamed spinach
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*Many kinds of [[soup]]
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*Carrots, broccoli, or other vegetables cooked soft or processed in the blender
  
Excessive hand washing is commonly seen as a symptom of [[obsessive-compulsive disorder]] (OCD).
 
  
It has also been found that people, after having recalled or contemplated unethical acts, tend to wash hands more often than others, and tend to value hand washing equipment more. Furthermore, those who are allowed to wash their hands after such a contemplation are less likely to engage in other "cleansing" compensatory actions, such as volunteering.<ref>Benedict Carey. Lady Macbeth Not Alone in Her Quest for Spotlessness. ''[[The New York Times]]'', 12 September 2006</ref><ref>Chen-Bo Zhong and Katie Liljenquist. [http://www.sciencemag.org/cgi/content/abstract/313/5792/1451?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=Liljenquist&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT Washing Away Your Sins: Threatened Morality and Physical Cleansing]. ''[[Science (journal)|Science]], 8 September 2006:
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== Desserts ==
Vol. 313. no. 5792, pp. 1451 - 1452</ref>
 
  
==Symbolic hand washing==
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*Cheesecake
[[Image:Tsukubai2.JPG|Tsukubai|thumb|230px|left|[[Tsukubai]], provided at a Japanese temple for symbolic hand washing and mouth rinsing]]
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*Pudding
{{main|ablution}}
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*Fruit [[smoothies]]
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*[[Milkshakes]]
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*Ice cream
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*Custard
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*Biscuits or cookies dipped in tea or milk
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*Yogurt
  
*[[Ablution]] in the [[Bahá'í Faith]]
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== See also ==
*[[Ablution]] in the [[Hebrew Bible]]
 
*[[Ablution]] in [[Hinduism]]
 
*[[Ablution in Judaism]]
 
*[[Lavabo]] in [[Christianity]]
 
*[[Misogi]] in [[Shintoism]]
 
*[[Wudu]] in [[Islam]]
 
  
==Idioms==
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[http://www.nidcd.nih.gov/health/voice/dysph.asp NIDCD information on dysphagia]
When someone "washes their hands of" something, this means that they are declaring their unwillingness to take responsibility for it or share complicity in it.  [[Gospel of Matthew|Matthew]] 27:24 gives an account of [[Pontius Pilate]] washing his hands of the decision to crucify [[Jesus]]:  "When Pilate saw that he could prevail nothing, but that rather a tumult was made, he took water, and washed his hands before the multitude, saying, I am innocent of the blood of this just person: see ye to it."
 
  
==See also==
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[http://dysphagiaonline.com Dysphagia Online]
* [[Escherichia coli O157:H7|E. coli O157:H7]]
 
* [[Antibiotic resistance]]
 
* [[Ignaz Semmelweis]]
 
* [[Soap dispenser]]
 
  
==References==
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[http://www.dentalhealth.org.uk/faqs/leafletdetail.php?LeafletID=53 British Dental Health Foundation]
<references/>
 
  
==External links==
 
* [http://www.tufts.edu/med/apua/Patients/handwashing.html Alliance for Prudent Use of Antibiotics on hand washing]
 
* [http://www.cdc.gov/handhygiene/ Centers for Disease Control on hand hygiene in healthcare settings]
 
* [http://www.publichealthgreybruce.on.ca/Communicable/Handwashing/  Hand Washing Video - Grey Bruce Health Unit, Canada ]
 
  
[[Category:Hygiene]]
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[[Category:Nutrition]]
[[Category:Medical hygiene]]
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[[Category:Diets]]
 
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[[de:Händedesinfektion]]
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avoid milk if lactose-intolerant
[[fr:Lavage des mains]]
 
[[ja:手洗い]]
 
[[simple:Hand washing]]
 

Revision as of 18:23, 29 May 2007

A soft diet is recommended in many situations, including some types of dysphagia (difficulty swallowing), surgery involving the mouth or gastrointestinal tract, and pain from newly adjusted braces.

In some situations, there are additional restrictions. For example, patients who need to avoid excessive reflux, such as those recovering from esophageal surgery for achalasia, are also instructed to stay away from foods that can aggravate reflux, which include ketchup and other tomato products, citrus fruits, chocolate, mint, spicy foods, alcohol, and caffeine.

Many of the foods listed here can be adapted for a "full liquid" diet (not a "clear liquid" diet) by processing in a blender with an appropriate thinning liquid, such as a meat broth, fruit or vegetable juice, or milk.


Grains/starches

  • Pasta cooked soft
  • Rice cooked soft
  • Cooked cereals: oatmeal, porridge, Weetabix/Cream of Wheat
  • Macaroni & cheese
  • Mashed potatoes and gravy
  • Skinless baked potatoes with sour cream or cream cheese


Proteins

  • Tofu
  • Cottage cheese
  • Yogurt
  • Scrambled eggs
  • Fish cooked soft
  • Meat loaf, meatballs, cottage pie, and other soft dishes with ground meat


Fruits and vegetables

  • Applesauce
  • Bananas
  • Peeled pears or peaches
  • Avocados
  • Creamed spinach
  • Many kinds of soup
  • Carrots, broccoli, or other vegetables cooked soft or processed in the blender


Desserts

  • Cheesecake
  • Pudding
  • Fruit smoothies
  • Milkshakes
  • Ice cream
  • Custard
  • Biscuits or cookies dipped in tea or milk
  • Yogurt

See also

NIDCD information on dysphagia

Dysphagia Online

British Dental Health Foundation

avoid milk if lactose-intolerant