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Hold cone snugly against stoma rationale this

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13.Hold cone snugly against stoma.Rationale: thisprevents backflow of solution14.Open roller clamp on tubing and allow water to runthrough cone while inserting cone into stoma15.Instill solution (750-1000mL) over 5-10 minutes.Rationale: the container height and rate of water flow affectresults obtained. If client complains of feeling light headedor has vertigo, take pulse and stop instillation. These aresymptoms of vagal response.*Clinical alert: colostomy irrigations are done only if normal bowelevacuation cannot be achieved.33. BMS catheter insertionRead pages 833-836 (implementing the Zassi bowel managementsystem)
SUPER LONG PROCEDURE!!!34. Removal of a fecal impaction*Read procedures on 828 and 829*Clinical alert:removal of fecal impaction is usually performed insmall steps to reduce the risk of injury to the rectal tissue. A seriesof suppositories may be given between manual removal attemptsto assist in clearing the bowelClinical alert:stimulation of rectum could result in excessive vagalnerve (in rectal wall) stimulation with subsequent cardiacarrhythmiasClinical alert:due to risk factors manual evacuation should beconsidered an acute intervention not a regular intervention. Riskfactors include autonomic dysrefexia, rectal trauma or perforation,rectal bleeding, and history of abuse.-Vagal stimulation can result from manual removal of feces. Itshould only be used as a last resort and with specific physiciansorders. It causes a decreased pulse rate by decreasing conductivityat the SA node and decreasing the rate of impulse firing at thenode.-NOTE- an oil retention enema may be used before removing theimpaction. It helps soften and lubricate stool.Chapter 25 Wound Care and Dressings (16)35. Managing prepared sterile packagesProcedure:
1.Perform hand hygiene2.Ensure working surface is clean and dry. Clients over bedtable is frequently used as a preparation area.Rationale:this prevents contamination of sterile package3.Remove outer plastic wrap4.Place package in center of work area and position so thatyou first open package flap away from you.Rationale: thisprevents reaching across the sterile field as you continue toopen package.5.Grasp edge of first flap of the wrapper, move it away fromyou, and place it on the working surface6.Grasp the first side flap, lift it up, grab the second side flap,and together move both hands out toward the sides. Placethe flaps down on the working surface.7.Grasp the last flap of the wrapper open towards you, takingcare not to touch the inside of the flap or any of thecontents in package.Guidelines for a sterile field:Never turn your back to the sterile fieldAvoid talking, coughing, sneezing, or reaching across sterilefieldDo not spill solutions on sterile fieldOpen all sterile packages away from sterile field to preventcrossover and contaminationOne inch around edges is considered contaminatedKeep sterile objects above waist level, below chin level

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Term
Fall
Professor
N/A
Tags
scaly skin, Hand Hygiene

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