Unit 7: Foundation Skills

Students will be able to connect theory into practice:
Vital Signs

1. Temperature
Students learn to accurately measure and record body temperature using various routes and devices.
Key Skills:
Performing hand hygiene (washing hands) before and after the procedure.
Identifying the patient and explaining the procedure.
Selecting the appropriate equipment (e.g., digital, tympanic, or temporal artery thermometer).
Applying a sterile or disposable probe cover.
Oral: Placing the probe in the posterior sublingual pocket (under the tongue) and instructing the patient to keep their mouth closed.
Tympanic (Ear): Gently pulling the ear up and back (for adults) to straighten the ear canal before inserting the probe.
Temporal (Forehead): Ensuring the forehead is dry, placing the scanner flat, and sliding it across the forehead to the hairline.
Axillary (Armpit): Placing the probe in the center of a dry axilla and holding the patient's arm down.
Reading the measurement accurately and documenting the reading, including the route (e.g., "98.6°F Oral").
Cleaning and returning equipment to its proper storage.

2. Pulse (Heart Rate)
Students must be able to measure a patient's pulse manually by palpation.
Key Skills:
Performing hand hygiene and explaining the procedure.
Locating the radial pulse (on the thumb side of the patient's wrist) using the first two or three fingertips (never the thumb).
Applying gentle pressure to feel the pulse.
Counting the beats for one full minute to ensure accuracy. (Alternatively, counting for 30 seconds and multiplying by 2 if the rhythm is regular, though 1 minute is the standard for certification).
Noting the rate (beats per minute), rhythm (regular or irregular), and strength (strong, weak, thready).
Recording the measurement accurately.

3. Respiration (Breathing Rate)
This is often measured immediately after taking the pulse, while still appearing to check the pulse, so the patient does not consciously change their breathing pattern.
Key Skills:
Continuing to hold the patient's wrist after counting the pulse, while discreetly observing the rise and fall of their chest.
Counting each full breath (one inhalation + one exhalation = one breath) for one full minute.
Noting the rate (breaths per minute), rhythm (regular or irregular), and character (e.g., deep, shallow, labored).
Recording the measurement accurately.

4. Blood Pressure (BP)
This is the most complex vital sign to implement manually and requires proficiency with a sphygmomanometer (BP cuff) and stethoscope.
Key Skills:
Performing hand hygiene and explaining the procedure.
Choosing the correctly sized cuff for the patient's arm. (A cuff that is too small will give a falsely high reading; one that is too large will give a falsely low reading).
Placing the deflated cuff snugly on the patient's bare upper arm, with the artery marker aligned over the brachial artery.
Locating the brachial pulse with fingertips.
Placing the earpieces of the stethoscope in the ears and the diaphragm (bell) of the stethoscope over the brachial artery.
Inflating the cuff to a pressure above the patient's expected systolic pressure (often by finding the palpated systolic first).
Slowly releasing the cuff valve (2-3 mmHg per second) while listening.
Identifying the systolic pressure: The first clear, repetitive "thumping" sound heard.
Identifying the diastolic pressure: The last "thumping" sound heard, or the point where the sound disappears.
Deflating the cuff completely, removing it, and recording the measurement as a fraction (e.g., "120/80"), noting which arm was used.

Intake and Output
What is Intake and Output (I&O)?
In healthcare, I&O is the measurement of all fluids that enter a patient's body (intake) and all fluids that leave their body (output) over a specific period, usually a 24-hour shift.

Think of it like balancing a checking account:

Intake = Deposits

Output = Withdrawals

The goal is to make sure the patient's "fluid account" is balanced. This is crucial for monitoring their hydration, kidney function, and overall health.

What Counts as Intake?
Intake is any liquid that goes into the body. This includes:

Oral fluids: Water, juice, milk, soda, coffee, tea, soup, and broth.

Foods that are liquid at room temp: Ice cream, Jell-O, popsicles, and sherbet.

Ice chips: These are recorded as half their volume (e.g., a cup of ice chips = half a cup of water).

Medical fluids: IV (intravenous) fluids, tube feedings (like a nasogastric tube), and blood products.

What Counts as Output?
Output is any liquid that comes out of the body and can be measured. This includes:

Urine: This is the most common output measured.

Vomitus (vomit)

Liquid stool (diarrhea)

Drainage: Fluid from surgical drains, chest tubes, or a nasogastric (NG) tube.

Blood loss

Note: Sweat and moisture from breathing are also "outputs," but since they can't be easily measured, they are called "insensible losses."

How Is It Measured and Recorded?
The process is straightforward:

Use a Standard Unit: All fluids are measured in milliliters (mL). A key conversion to know is 1 ounce = 30 mL.

Measure Accurately: Healthcare workers use a graduated cylinder (a marked measuring cup) to get a precise measurement of urine, vomit, or drainage. For oral intake, they use the known volumes of cups, bowls, and bottles.

Basic Nursing Skills
Theory of Patient Bathing
Bathing is about much more than just cleanliness. The theory focuses on hygiene, assessment, and patient well-being.
Why?
Hygiene: To remove sweat, oils, dirt, and microorganisms from the skin. This prevents body odor and reduces the risk of skin infections.

Comfort: A bath can be refreshing and relaxing, helping a patient feel more comfortable and human.

Skin Integrity: It's a critical time to assess the patient's skin. Students learn to look for redness, rashes, sores (especially pressure ulcers), or dry, flaky areas that could signal a problem.

Circulation: The friction of the washcloth and the warm water can help stimulate blood circulation

Theory of Patient Ambulation
Ambulation simply means walking. The theory centers on regaining mobility, preventing complications, and ensuring safety.

Why?
Prevents Complications: Immobility is a major risk. Walking helps prevent:

Blood clots (Deep Vein Thrombosis or DVT) in the legs.

Pneumonia (fluid in the lungs).

Pressure ulcers (bed sores).

Muscle atrophy (weakness) and constipation.

Promotes Independence: It helps the patient regain strength and confidence, which is vital for recovery and mental well-being






























































































Students will be able to :
*identify parts of the nursing lab and its supplies
*identify normal and abnormal vital signs Temperature Pulse Respiration Blood Pressure and Pain Management
*perform basic mathematical skills related to health care-Intake and Output
* continue to use basic med terminology and abbreviations
*identify risk factors for heart attack and stroke
* be introduced and learn some basic nursing skills in the lab

Students will engage in various activities -much demo by RN Teacher and some return demo back due to large class sizes. (Vital Signs)
Students will engage in group activities related to subject matter as to create a patient menu and count the ccs taken in daily.
RN/Teacher will demonstrate skills at this level and introduce CNA tasks.

multiple formative assessments

Group projects -VS and I &O

Case studies/scenarios-use critical thinking skills

RN/Teaacher demo CNA skills to increase pathway interest