b. The bladder should be emptied regularly to prevent infection or stone
formation.
(1)
Adequate fluids should be given to prevent dehydration.
(2)
Keep accurate intake and output records.
(3)
Report low urine output to professional nurse.
(4) Provide catheter care at least once per shift to prevent infection in
catheterized patients.
2-27. POSITIONING
a. When positioning the unconscious patient, pay particular attention to
maintaining proper body alignment. The unconscious patient cannot tell you that he is
uncomfortable or is experiencing pressure on a body part.
(1) Limbs must be supported in a position of function. Do not allow flaccid
limbs to rest unsupported.
(2) When turning the patient, maintain alignment and do not allow the arms
to be caught under the torso.
(3) Change the patient's position to a new weight-bearing surface every two
hours. This decreases the likelihood of complications such as decubitus ulcers,
orthostatic pneumonia, and thrombophlebitis.
(4)
Utilize a foot board at the end of the bed to decrease the possibility of
foot drop.
b. When joints are not exercised in their full range of motion each day, the
muscles will gradually shrink, forming what is known as a contracture. Passive
exercises must be provided for the unconscious patient to prevent contractures.
(1) Exercises with a range of motion (ROM) are performed under the
direction of the physical therapist.
(2)
Nursing personnel must be proficient in ROM exercises.
(a) Physical therapy personnel will not always be available.
(b) It is a nursing care responsibility to maintain the patient's range of
motion.
MD0919
2-35