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

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'''Infection control and health care epidemiology'''
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{{honor header|2|1938|Health and Science|General Conference}}
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is the discipline concerned with preventing the spread of infections within the health-care setting.
 
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As such, it is a practical (rather than an academic) sub-discipline of [[epidemiology]].
 
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It is an essential (though often underrecognized and undersupported) part of the infrastructure of health care.
 
−
Infection control and hospital epidemiology are akin to [[public health]] practice, practiced within the confines of a particular health-care delivery system rather than directed at society as a whole.
 
  
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Infection control concerns itself both with prevention (hand hygiene/hand washing, cleaning/disinfection/sterilization, vaccination, surveillance) and with investigation and management of demonstrated or suspected spread of infection within a particular health-care setting (e.g. outbreak investigation). It is on this basis that the common title being adopted within health care is '''"Infection Prevention & Control".
+
==1. Have the First Aid Honor.==
 +
{{ay prerequisite|Health and Science|First Aid, Standard}}
 +
==2. What foods are included in the following diets:==
 +
===a. Liquid ===
 +
*Creamed or clear soup
 +
*Any drink following the criteria below.
 +
*Pudding
 +
*Jello
  
−
==Infection control in healthcare facilities==
+
For a food to be classified as liquid, it would have to be able to be strained when heated. For example, tapioca pudding would not qualify, but a milkshake without pieces of fruit or other foods would qualify.
−
===Hand hygiene===
 
−
Independent studies by [[Ignaz Semmelweis]] in [[1847]] in [[Vienna]] and [[Oliver Wendell Holmes, Sr.|Oliver Wendell Holmes]] in [[1843]] in [[Boston]] established a link between the hands of health care workers and the spread of [[Nosocomial infection|hospital-acquired]] disease.<ref>[http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm CDC Guideline for Hand Hygiene in Health-Care Settings]</ref> The [[Centers for Disease Control and Prevention|Centers for Disease Control and Prevention (CDC)]] has stated that “It is well-documented that the most important measure for preventing the spread of pathogens is effective handwashing.” <ref>[http://www.cdc.gov/nceh/vsp/cruiselines/hand_hygiene_general.htm CDC General information on Hand Hygiene]</ref>  In the United States, [[Hand washing#Medical hand washing|hand washing]] is mandatory in most health care settings and required by many different state and local regulations as well as good sense http://www.safechemdirect.co.uk]
 
  
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In the United States, [[Occupational Safety and Health Administration|Occupational Safety and Health Administration (OSHA)]] standards<ref>[http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051 OSHA Bloodborne Pathogens Regulations 1910.1030]</ref> require that employers must provide readily accessible hand washing facilities, and must ensure that employees wash hands and any other skin with soap and water or flush mucous membranes with water as soon as feasible after contact with blood or other potentially infectious materials (OPIM).
+
===b. Soft ===
 +
===c. Light===
 +
This diet is culturally diverse, and includes the following:
 +
*Food that is easy to digest.
 +
*Not spicy
  
−
===Cleaning, disinfection and sterilization===
 
  
−
Cleaning, [[disinfection]] and [[sterilization (microbiology)|sterilization]]...
+
===d. Full===
−
{{Expand-section|date=June 2008}}
+
A ''full diet'' is also sometimes referred to as a ''general diet''. It includes all food items, including drinks.
  
−
Sterilization is a process intended to kill all microorganisms and is the highest level of microbial kill that is possible. Sterilizers may be heat only, steam, or liquid chemical. <ref> (Miller, Chris H.. Infection Control and Management of Hazardous Materials for the Dental Team, 3rd Edition. Mosby Elsevier Health Science, 2005. chpt 11).</ref>
+
==3. Know the symptoms of a fever. Know how to take person's temperature. Know how to bring a high temperature DOWN.==
−
Effectivenss of the sterilizer (oftern called an autoclave") is determined in three ways. <ref> (Miller, Chris H.. Infection Control and Management of Hazardous Materials for the Dental Team, 3rd Edition. Mosby Elsevier Health Science, 2005. chpt 11).</ref>
+
===Definition and Symptoms===
−
First by the mechanical indicators and gauges on the machine itself, second the heat sensitive inicators or tape on the sterilzing bag turn color, and thirdly and most importantly is the biological test. With the biological test, a highly heat and chemical resistant microorganism (often the bacterial endospore) is selected as the standard challenge. If the process kills this microorganism, the sterilizer is considered to be effective. It should be noted that in order to be effective, instruments must be cleaned, otherwise the debris may form a protective barrier, shielding the microbes from the lethal process. Similarly care must be taken after sterilization to ensure sterile instruments do not become contaminated prior to use.<ref> (Miller, Chris H.. Infection Control and Management of Hazardous Materials for the Dental Team, 3rd Edition. Mosby Elsevier Health Science, 2005. chpt 11).</ref>
+
Fever is most accurately characterized as a temporary elevation in the body's thermoregulatory set-point, usually by about 1–2 °C. Fever differs from hyperthermia. Hyperthermia is an increase in body temperature over the body's thermoregulatory set-point, due to excessive heat production or insufficient thermoregulation, or both. The person who is developing the fever has a cold sensation, and an increase in heart rate, muscle tone and shivering attempt to counteract the perceived hypothermia, thereby reaching the new thermoregulatory set-point. A fever is one of the body's mechanisms to try to neutralize the perceived threat inside the body, be it bacteria or a virus.
  
−
Disinfection refers to the use of liquid chemicals on surfaces and at room temperature to kill disease causing microorganisms. Disinfection is a less effective process than sterilization because it does not kill bacterial endospores. <ref> (Miller, Chris H.. Infection Control and Management of Hazardous Materials for the Dental Team, 3rd Edition. Mosby Elsevier Health Science, 2005. chpt 11).</ref>
+
===Measurement and normal variation===
 +
When a patient has or is suspected of having a fever, that person's body temperature is measured using a thermometer.
  
−
===Personal protective equipment===
+
At a first glance, fever is present if:  
−
[[Image:Disp-med-ppe.jpg|thumb|120px|Disposable PPE]]
+
* Temperature in the anus (rectum/rectal) or in the ear (otic) is at or over 38.0°C (100.4°F)
−
[[Personal protective equipment|Personal protective equipment (PPE)]] is specialized clothing or equipment worn by a worker for protection against a hazard. The hazard in a health care setting is exposure to blood, saliva, or other bodily fluids or aerosols that may carry infectious materials such as [[Hepatitis C]], [[HIV]], or other blood borne or bodily fluid [[pathogen]]. PPE prevents contact with a potentially infectious material by creating a physical barrier between the potential infectious material and the healthcare worker.  
+
* Temperature in the mouth (oral) is at or over 37.5 °C (99.5 °F)
 +
* Temperature under the arm (axillary) is at or over 37.2 °C (99.0 °F)
  
−
In the United States, the [[Occupational Safety and Health Administration|Occupational Safety and Health Administration (OSHA)]] requires the use of [[Personal protective equipment|Personal protective equipment (PPE)]] by workers to guard against blood borne pathogens if there is a reasonably anticipated exposure to blood or other potentially infectious materials. <ref>[http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051#1910.1030(d)(2)(i) OSHA Bloodborne Pathogens Regulations 1910.1030(d)(2)(i)]</ref> 
+
The common oral measurement of normal human body temperature is 36.8±0.7 °C (98.2±1.3 °F). This means that any oral temperature between 36.1 and 37.5 °C (96.9 and 99.5 °F) is likely to be normal.
  
−
Components of [[Personal protective equipment|Personal protective equipment (PPE)]] include [[Medical gloves|gloves]], [[Hospital gown|gowns]], bonnets, shoe covers, [[face shield]]s, [[CPR mask]]s, [[goggles]], [[surgical mask]]s, and respirators. How many components are used and how the components are used is often determined by regulations or the infection control protocol of the facility in question. Many or most of these items are [[disposable]] to avoid carrying infectious materials from one patient to another patient and to avoid difficult or costly [[disinfection]]. In the United States, [[Occupational Safety and Health Administration|OSHA]] requires the immediate removal and disinfection or disposal of worker's PPE prior to leaving the work area where exposure to infectious material took place.<ref>[http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051#1910.1030(d)(3)(vii) OSHA 1910.1030(d)(3)(vii)]</ref>
+
However, there are many variations in normal body temperature, and this needs to be considered when measuring for fever. The values given are for an otherwise healthy, non-fasting adult, dressed comfortably, indoors, in a room that is kept at a normal room temperature (22.7 to 24.4°C or 73 to 76 °F ) , during the morning, but not shortly after arising from sleep. Furthermore, for oral temperatures, the subject must not have eaten, drunk, or smoked anything in at least the previous fifteen to twenty minutes.
  
−
===Vaccination of health care workers===
+
Body temperature normally fluctuates over the day, with the lowest levels around 4 a.m. and the highest around 6 p.m. (assuming the subject follow the prevalent pattern, i.e, sleeping at nighttime and staying awake during daytime). Therefore, an oral temperature of 37.2 °C (99.0 °F) would strictly be a fever in the morning, but not in the afternoon. An oral body temperature reading up to 37.5 °C (99.5 °F) in the early/late afternoon or early/late evening also wouldn't be a fever. Normal body temperature may differ as much as 1.0 °F between individuals or from day to day. In women, temperature differs at various points in the menstrual cycle. Temperature is increased after eating, and psychological factors also influence body temperature.
−
Health care workers may be exposed to certain infections in the course of their work.   [[Vaccine]]s are available to provide some protection to workers in a healthcare setting. Depending on regulation, recommendation, the specific work function, or personal preference, healthcare workers or first responders may receive vaccinations for [[Hepatitis B#Prevention|hepatitis B]]; [[Influenza vaccine| influenza]]; [[MMR vaccine|measles, mumps and rubella]]; [[TDaP|Tetanus, diphtheria, pertussis]]; [[Neisseria meningitidis#Vaccines|N. meningitidis]]; and  [[Varicella vaccine|varicella]]. In general, [[vaccine]]s do not guarantee complete protection from disease, and there is [[Vaccine#Potential for adverse side effects in general|potential]] for adverse effects from receiving the vaccine. <ref>[http://www.cdc.gov/node.do/id/0900f3ec8005df1f CDC Vaccine Site]</ref>
 
  
−
===Post exposure prophylaxis===
+
There are different locations where temperature can be measured, and these differ in temperature variability. Tympanic membrane thermometers measure radiant heat energy from the tympanic membrane (infrared). These may be very convenient, but may also show more variability.
−
In some cases where vaccines do not exist Post Exposure prophylaxis is another method of protecting the health care worker exposed to a life threatening infectious disease. For example, the viral particles for HIV-AIDS can be precipited out of the blood through the use of an antibody injection if given within 4 hours of a significant exposure.
 
  
−
===Surveillance for emerging infections===
+
Children develop higher temperatures with activities like playing, but this is not fever because their set-point is normal. Elderly patients may have a decreased ability to generate body heat during a fever, so even a low-grade fever can have serious underlying causes in geriatrics.
−
Surveillance is the act of infection investigation using the CDC definitions. Determining an infection requires an ICP to review a patient's chart and see if the patient had the signs and symptom of an infection.  Surveillance definition cover infections of the bloodstream, Urinary tract, pneumonia, and sugical sites.
 
  
−
Surveillance traditionally involved significant manual data assessment and entry in order to assess preventative actions such as isolation of patients with an infectious disease. Increasingly, integrated computerised software solutions are becoming available, such as [http://www.rl-solutions.com/infection-control/infection-monitorpro.html Infection Monitor Pro]. Such products actively assess incoming risk messages from microbiology and other online sources. By reducing the need for data entry, this software significantly reduces the data workload of Infection Control Practitioners (ICP), freeing them to concentrate on clinical surveillance.  
+
===Treatment===
 +
Fever should not necessarily be treated. Fever is an important signal that there's something wrong in the body, and it can be used to govern medical treatment and gauge its effectiveness. Moreover, not all fevers are of infectious origin.
  
−
As approximately [http://www.cdc.gov/ncidod/eid/vol4no3/weinstein.htm one third of healthcare acquired infections are preventable] , surveillance and preventative activities are increasingly a priority for hospital staff. In the United States, a study on the Efficacy of Nosocomial Infection Control Project (SENIC) by the CDC found that hospitals reduced their nosocomial infection rates by approximately 32 per cent by focusing on surveillance activities and prevention efforts.
+
Even when treatment is not indicated, however, febrile patients are generally advised to keep themselves adequately hydrated, as the dehydration produced by a mild fever can be more dangerous than the fever itself. Water is generally used for this purpose, but there is always a small risk of hyponatremia if the patient drinks too much water. For this reason, some patients drink sports drinks or electrolyte-replacing products designed specifically for this purpose.
  
−
==Outbreak investigation==
+
Most people take medication against fever because the symptoms cause discomfort. Fever increases heart rate and metabolism, thus potentially putting an additional strain on elderly patients, patients with heart disease, etc. This may even cause delirium. Therefore, potential benefits must be weighed against risks in these patients. In any case, fever must be brought under control in instances when fever escalates to hyperpyrexia (temperature about 42°C) and tissue damage is imminent.
−
When an unusual cluster of illness is noted, infection control teams  undertake an investigation to determine whether there is a true outbreak, a pseudo-outbreak (a result of contamination within the diagnostic testing process), or just random fluctuation in the frequency of illness. If a true outbreak is discovered, infection control practitioners try to determine what permitted the outbreak to occur, and to rearrange the conditions to prevent ongoing propagation of the infection.  Often, breaches in good practice are responsible, although sometimes other factors (such as construction) may be the source of the problem.
 
  
−
==Training in infection control and health care epidemiology==
+
Treatment of fever is normally done by lowering the set-point, but facilitating heat loss may also be effective. The former is accomplished with antipyretics such as ibuprofen or acetominophen (aspirin can be given to adults, but can cause Reye's Syndrome in children). Heat removal is generally by wet cloth or pads, usually applied to the forehead, but also through bathing the body in tepid water. This is particularly important for babies, where drugs should be avoided. However, using water that is too cold can induce vasoconstriction, and reduce effective heat loss.
−
Practitioners can come from several different educational streams. Many begin as nurses, some as medical technologists (particularly in clinical microbiology), and some as physicians (typically infectious disease specialists). Specialized training in infection control and health care epidemiology are offered by the professional organizations described below. Physicians who desire to become infection control practitioners often are trained in the context of an infectious disease fellowship.
 
  
−
In the United States, [http://www.cbic.org Certification Board of Infection Control and Epidemiology] is a private company that certifies infection control practitioners based on their educational background and professional experience, in conjunction with testing their knowledge base with standardized exams. The credential awarded is CIC, Certification in Infection Control and Epidemiology.  One must have 2 years of Infection Control experience in order to sit for the boards.  Certification must be renewed every five years.
+
Heat loss may also be accomplished by heat conduction, convection, radiation, or evaporation (sweating, perspiration), or a combination of these.
  
−
A [http://www.shea-online.org/about/shea_courses.cfm course] in hospital epidemiology (infection control in the hospital setting) is offered jointly each year by the Centers for Disease Control and Prevention (CDC) and the Society for Healthcare Epidemiology of America.
+
==4. Know what is a normal pulse rate, respiration rate, and temperature. Practice taking the pulse rate, respiration rate, and temperature of a friend or classmate.==
 +
===Pulse===
 +
A normal pulse rate for a healthy adult, while resting, can range from 60 to 100 beats per minute (BPM), although well conditioned athletes may have a healthy pulse rate lower than 60 BPM. Bradycardia occurs when the pulse rate is below 60 per minute, whereas tachycardia occurs when the rate is above 100 BPM. During sleep, this can drop to as low as 40 BPM; during strenuous exercise, it can rise as high as 150–200 BPM. Generally, pulse rates are higher in infants and young children. The resting heart rate for an infant is usually close to an adult's pulse rate during strenuous exercise (average 110 BPM for an infant).
  
−
http://www.apic.org/ offers a training course for practitioners called EPI 101 and 102.
+
Pulses are manually palpated with fingers. When palpating the carotid artery, the femoral artery or the brachial artery, the thumb may be used. However, the thumb has its own pulse which can interfere with detecting the patient's pulse at other points, where two or three fingers should be used. Fingers or the thumb must be placed near an artery and pressed gently against a firm structure, usually a bone, in order to feel the pulse.
  
−
== Footnotes ==
+
Make sure the person is calm and has been resting for 5 minutes before reading the pulse. Put the index and middle fingers over the pulse count, and count for 30 seconds, and afterwards multiply by 2, to get the pulse rate. If the person's pulse rate is irregular, count for a full minute, and do not multiply. Averaging multiple readings may give a more representative figure.
−
{{reflist}}
 
  
−
== See also ==
+
Home blood pressure measurement devices also typically give a pulse reading.
−
* [[Infectious disease]]
+
===Respiration Rate===
−
* [[body substance isolation]]
+
The human respiration rate is usually measured when a person is at rest and simply involves counting the number of breaths for one minute by counting how many times the chest rises. Respiration rates may increase with fever, illness, and with other medical conditions. When checking respiration, it is important to also note whether a person has any difficulty breathing.
−
* [[Nosocomial infection]]
 
−
* [[Public health]]
 
  
−
==External links==
+
Average respiratory rate reported in a healthy adult at rest is usually given as 12 breaths per minute but estimates do vary between sources: e.g. 12–20 breaths per minute, 10–14, and between 16–18, etc. With such a slow rate, more accurate readings are obtained by counting the number of breaths over a full minute.
−
* [http://www.apic.org Association for Professionals in Infection Control and Epidemiology] is primarily composed of infection  prevention and control professionals with nursing or medical technology backgrounds
+
===Temperature===
−
* [http://shea-online.org The Society for Healthcare Epidemiology of America] is more heavily weighted towards practitioners who are physicians or doctoral-level epidemiologists.
+
See requirement 3 for this information.
  
 +
==5. What is a communicable disease? How is it transmitted? What precautions should be followed to guard against communicable diseases? List safety measures to be observed when caring for a person with a communicable disease in the home.==
 +
An infectious disease is a clinically evident disease resulting from the presence of pathogenic microbial agents, including pathogenic viruses, pathogenic bacteria, fungi, protozoa, multicellular parasites, and aberrant proteins known as prions. These pathogens are able to cause disease in animals and/or plants.
  
−
[[Category:Epidemiology]]
+
Infectious pathologies are usually qualified as contagious diseases (also called communicable diseases) due to their potentiality of transmission from one person or species to another. Transmission of an infectious disease may occur through one or more of diverse pathways including physical contact with infected individuals. These infecting agents may also be transmitted through liquids, food, body fluids, contaminated objects, airborne inhalation, or through vector-borne spread.
  
−
[[ja:感染管理]]
+
==6. What symptoms tell you that a person is physically ill?==
 +
==7. Know how to help take care of a newborn and an aged person in your home.==
 +
==8. Know when and how to wash your hands when caring for a sick person.==
 +
==9. Know how to make a bedridden patient comfortable in bed.==
 +
 
 +
Use a draw sheet or a piece of cloth under the patient if available, so they can be turned and pulled up in bed with more ease, preventing friction on their skin.
 +
 
 +
Make sure the person is aligned properly, especially when on their back. 
 +
 
 +
Turn the patient every 2 hours during the day and at least 1 to 2 times during the night if possible. 
 +
 
 +
Prop the patient up prior to eating and a half hour afterwards if possible.  Otherwise turn the patient on their left side to eat if able.
 +
 
 +
Using a pillow between the knees while the patient is on his side can help prevent skin break down or creating a twist in the spine.
 +
 
 +
Have the patient by a window if possible or not contraindicated.
 +
 
 +
Have the things a patient can use within reach if applicable. 
 +
 
 +
Provide an atmosphere conducive to the patient's and families needs if possible.  Example, some people do better being in the middle of the daily activities or they may need a  quiet place.
 +
 
 +
Provide adequate nutrition and fluids if applicable.
 +
 
 +
Keep the patient clean.
 +
 
 +
Be respective of the patient's dignity.
 +
 
 +
==10. Show how to feed a helpless patient in bed.==
 +
==11. Show how to give liquid medicine and tablets, pills, or capsules to children and adults. Know how to properly apply eye drops.==
 +
===Administering Medicines===
 +
 
 +
===Applying Eye Drops===
 +
 
 +
:Instruct your patient of the procedure as appropriate.
 +
:The head of your patient should be tipped back. Gently pull down on the skin below the eye and apply the drop in the pocket formed below the eyeball without touching the dropper on the patient.  Then gently apply pressure at the tear duct area with your finger when the patient closes their eye.  Instruct the patient not the squeeze their eye shut tight.
 +
 
 +
[[Image:Eye_iris.jpg|240px]]
 +
<br style="clear:both">
 +
 
 +
==12. Demonstrate the method of giving fomentations and foot baths. Explain the value of their use and tell the conditions under which such treatments should be given.==
 +
==13. Demonstrate the application of a heating compress and the use of heat and cold for the treatment of inflammation and bruises.==
 +
==14. Explain how the following natural remedies help in preventing disease: Note how the first letter of each item spells NEW START.==
 +
;a. Nutrition:
 +
;b. Exercise:
 +
;c. Water:
 +
;d. Sunshine:
 +
;e. Temperance:
 +
;f. Air:
 +
;g. Rest:
 +
;h. Trust in God:
 +
==References==
 +
 
 +
[[Category:Adventist Youth Honors Answer Book|{{SUBPAGENAME}}]]

Revision as of 03:44, 30 July 2008

Template:Honor header

1. Have the First Aid Honor.

Template:Ay prerequisite

2. What foods are included in the following diets:

a. Liquid

  • Creamed or clear soup
  • Any drink following the criteria below.
  • Pudding
  • Jello

For a food to be classified as liquid, it would have to be able to be strained when heated. For example, tapioca pudding would not qualify, but a milkshake without pieces of fruit or other foods would qualify.

b. Soft

c. Light

This diet is culturally diverse, and includes the following:

  • Food that is easy to digest.
  • Not spicy


d. Full

A full diet is also sometimes referred to as a general diet. It includes all food items, including drinks.

3. Know the symptoms of a fever. Know how to take person's temperature. Know how to bring a high temperature DOWN.

Definition and Symptoms

Fever is most accurately characterized as a temporary elevation in the body's thermoregulatory set-point, usually by about 1–2 °C. Fever differs from hyperthermia. Hyperthermia is an increase in body temperature over the body's thermoregulatory set-point, due to excessive heat production or insufficient thermoregulation, or both. The person who is developing the fever has a cold sensation, and an increase in heart rate, muscle tone and shivering attempt to counteract the perceived hypothermia, thereby reaching the new thermoregulatory set-point. A fever is one of the body's mechanisms to try to neutralize the perceived threat inside the body, be it bacteria or a virus.

Measurement and normal variation

When a patient has or is suspected of having a fever, that person's body temperature is measured using a thermometer.

At a first glance, fever is present if:

  • Temperature in the anus (rectum/rectal) or in the ear (otic) is at or over 38.0°C (100.4°F)
  • Temperature in the mouth (oral) is at or over 37.5 °C (99.5 °F)
  • Temperature under the arm (axillary) is at or over 37.2 °C (99.0 °F)

The common oral measurement of normal human body temperature is 36.8±0.7 °C (98.2±1.3 °F). This means that any oral temperature between 36.1 and 37.5 °C (96.9 and 99.5 °F) is likely to be normal.

However, there are many variations in normal body temperature, and this needs to be considered when measuring for fever. The values given are for an otherwise healthy, non-fasting adult, dressed comfortably, indoors, in a room that is kept at a normal room temperature (22.7 to 24.4°C or 73 to 76 °F ) , during the morning, but not shortly after arising from sleep. Furthermore, for oral temperatures, the subject must not have eaten, drunk, or smoked anything in at least the previous fifteen to twenty minutes.

Body temperature normally fluctuates over the day, with the lowest levels around 4 a.m. and the highest around 6 p.m. (assuming the subject follow the prevalent pattern, i.e, sleeping at nighttime and staying awake during daytime). Therefore, an oral temperature of 37.2 °C (99.0 °F) would strictly be a fever in the morning, but not in the afternoon. An oral body temperature reading up to 37.5 °C (99.5 °F) in the early/late afternoon or early/late evening also wouldn't be a fever. Normal body temperature may differ as much as 1.0 °F between individuals or from day to day. In women, temperature differs at various points in the menstrual cycle. Temperature is increased after eating, and psychological factors also influence body temperature.

There are different locations where temperature can be measured, and these differ in temperature variability. Tympanic membrane thermometers measure radiant heat energy from the tympanic membrane (infrared). These may be very convenient, but may also show more variability.

Children develop higher temperatures with activities like playing, but this is not fever because their set-point is normal. Elderly patients may have a decreased ability to generate body heat during a fever, so even a low-grade fever can have serious underlying causes in geriatrics.

Treatment

Fever should not necessarily be treated. Fever is an important signal that there's something wrong in the body, and it can be used to govern medical treatment and gauge its effectiveness. Moreover, not all fevers are of infectious origin.

Even when treatment is not indicated, however, febrile patients are generally advised to keep themselves adequately hydrated, as the dehydration produced by a mild fever can be more dangerous than the fever itself. Water is generally used for this purpose, but there is always a small risk of hyponatremia if the patient drinks too much water. For this reason, some patients drink sports drinks or electrolyte-replacing products designed specifically for this purpose.

Most people take medication against fever because the symptoms cause discomfort. Fever increases heart rate and metabolism, thus potentially putting an additional strain on elderly patients, patients with heart disease, etc. This may even cause delirium. Therefore, potential benefits must be weighed against risks in these patients. In any case, fever must be brought under control in instances when fever escalates to hyperpyrexia (temperature about 42°C) and tissue damage is imminent.

Treatment of fever is normally done by lowering the set-point, but facilitating heat loss may also be effective. The former is accomplished with antipyretics such as ibuprofen or acetominophen (aspirin can be given to adults, but can cause Reye's Syndrome in children). Heat removal is generally by wet cloth or pads, usually applied to the forehead, but also through bathing the body in tepid water. This is particularly important for babies, where drugs should be avoided. However, using water that is too cold can induce vasoconstriction, and reduce effective heat loss.

Heat loss may also be accomplished by heat conduction, convection, radiation, or evaporation (sweating, perspiration), or a combination of these.

4. Know what is a normal pulse rate, respiration rate, and temperature. Practice taking the pulse rate, respiration rate, and temperature of a friend or classmate.

Pulse

A normal pulse rate for a healthy adult, while resting, can range from 60 to 100 beats per minute (BPM), although well conditioned athletes may have a healthy pulse rate lower than 60 BPM. Bradycardia occurs when the pulse rate is below 60 per minute, whereas tachycardia occurs when the rate is above 100 BPM. During sleep, this can drop to as low as 40 BPM; during strenuous exercise, it can rise as high as 150–200 BPM. Generally, pulse rates are higher in infants and young children. The resting heart rate for an infant is usually close to an adult's pulse rate during strenuous exercise (average 110 BPM for an infant).

Pulses are manually palpated with fingers. When palpating the carotid artery, the femoral artery or the brachial artery, the thumb may be used. However, the thumb has its own pulse which can interfere with detecting the patient's pulse at other points, where two or three fingers should be used. Fingers or the thumb must be placed near an artery and pressed gently against a firm structure, usually a bone, in order to feel the pulse.

Make sure the person is calm and has been resting for 5 minutes before reading the pulse. Put the index and middle fingers over the pulse count, and count for 30 seconds, and afterwards multiply by 2, to get the pulse rate. If the person's pulse rate is irregular, count for a full minute, and do not multiply. Averaging multiple readings may give a more representative figure.

Home blood pressure measurement devices also typically give a pulse reading.

Respiration Rate

The human respiration rate is usually measured when a person is at rest and simply involves counting the number of breaths for one minute by counting how many times the chest rises. Respiration rates may increase with fever, illness, and with other medical conditions. When checking respiration, it is important to also note whether a person has any difficulty breathing.

Average respiratory rate reported in a healthy adult at rest is usually given as 12 breaths per minute but estimates do vary between sources: e.g. 12–20 breaths per minute, 10–14, and between 16–18, etc. With such a slow rate, more accurate readings are obtained by counting the number of breaths over a full minute.

Temperature

See requirement 3 for this information.

5. What is a communicable disease? How is it transmitted? What precautions should be followed to guard against communicable diseases? List safety measures to be observed when caring for a person with a communicable disease in the home.

An infectious disease is a clinically evident disease resulting from the presence of pathogenic microbial agents, including pathogenic viruses, pathogenic bacteria, fungi, protozoa, multicellular parasites, and aberrant proteins known as prions. These pathogens are able to cause disease in animals and/or plants.

Infectious pathologies are usually qualified as contagious diseases (also called communicable diseases) due to their potentiality of transmission from one person or species to another. Transmission of an infectious disease may occur through one or more of diverse pathways including physical contact with infected individuals. These infecting agents may also be transmitted through liquids, food, body fluids, contaminated objects, airborne inhalation, or through vector-borne spread.

6. What symptoms tell you that a person is physically ill?

7. Know how to help take care of a newborn and an aged person in your home.

8. Know when and how to wash your hands when caring for a sick person.

9. Know how to make a bedridden patient comfortable in bed.

Use a draw sheet or a piece of cloth under the patient if available, so they can be turned and pulled up in bed with more ease, preventing friction on their skin.

Make sure the person is aligned properly, especially when on their back.

Turn the patient every 2 hours during the day and at least 1 to 2 times during the night if possible.

Prop the patient up prior to eating and a half hour afterwards if possible. Otherwise turn the patient on their left side to eat if able.

Using a pillow between the knees while the patient is on his side can help prevent skin break down or creating a twist in the spine.

Have the patient by a window if possible or not contraindicated.

Have the things a patient can use within reach if applicable.

Provide an atmosphere conducive to the patient's and families needs if possible. Example, some people do better being in the middle of the daily activities or they may need a quiet place.

Provide adequate nutrition and fluids if applicable.

Keep the patient clean.

Be respective of the patient's dignity.

10. Show how to feed a helpless patient in bed.

11. Show how to give liquid medicine and tablets, pills, or capsules to children and adults. Know how to properly apply eye drops.

Administering Medicines

Applying Eye Drops

Instruct your patient of the procedure as appropriate.
The head of your patient should be tipped back. Gently pull down on the skin below the eye and apply the drop in the pocket formed below the eyeball without touching the dropper on the patient. Then gently apply pressure at the tear duct area with your finger when the patient closes their eye. Instruct the patient not the squeeze their eye shut tight.

Eye iris.jpg

12. Demonstrate the method of giving fomentations and foot baths. Explain the value of their use and tell the conditions under which such treatments should be given.

13. Demonstrate the application of a heating compress and the use of heat and cold for the treatment of inflammation and bruises.

14. Explain how the following natural remedies help in preventing disease: Note how the first letter of each item spells NEW START.

a. Nutrition
b. Exercise
c. Water
d. Sunshine
e. Temperance
f. Air
g. Rest
h. Trust in God

References

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