The basics are the same no matter how the client is positioned. So you do the knock, wash, intro/explain, gather supplies, curtain, lock wheels if they're in bed. If your skill is foot care, chances are they'll be in a chair (that's how we were instructed) but if they're in bed, you will have to assist them to a sitting position. With vitals, it's more likely they'll be in bed. Doesn't matter. This is where you have to think "what would i do in the real world". If you have BP, raise the head of the bed. If you have radial pulse, it's unnecessary. If you have respirations/pulse, again, leave them supine. If you have tympanic temperature, it's easier if they're semi Fowlers. If your examiner gives you a scenario where the client must be positioned a certain way, you go with that. Otherwise, take charge and do whatever vitals you get in a way that makes it easiest for you. If you get weight with ambulation just DON'T FORGET to zero out the scale before and after the skill. If you are lucky, like me, and get fluid intake, you just get three containers with pee-colored liquid. Do your best estimate of how much liquid is missing and make sure you record everything on paper. Especially do it before you forget what the numbers were and before moving on to another skill.
Oh yeah, and don't forget to give the call button.
Order of the basic steps isn't critical as long as you remember to do them all. If Headmaster is your testing authority, the only skill with steps required to be in a set order is female perineal care.
In our state we didn't have to check wristbands. That depends on your testing authority. We were told who the patient was before the skill, and all we had to do was greet them by that name. Don't get too wrapped up in the order of steps. Remember the basics of privacy, safety, dignity and universal precautions and just do the skill without skipping the critical steps or forgetting to wash your hands and glove. You won't be docked for washing too much. I think it's a good idea to wash anytime you remove gloves, even if it's only a simulated wash.
If you KNOW the skill, your knowledge will kick in and you'll do fine with that boost of adrenaline. I know it sounds ridiculous now, but try to have fun with it. If you feel goofy, joke a little. Your BP will go down, and you'll feel a lot better.
Quote from dallet6
I'm hoping I could hear from others what their test was like for a few questions I have. I've been watching skills videos on youtube and practising everyday on my family. I have a couple questions though as I'm not sure how my patient will be positioned in some circumstances.
On the videos the client is sitting in a chair when the candidate "enters the room" to perform all vitals. Is this how you performed it? Or were they in bed? Also, for foot care were they laying in bed and you assisted them to sit at the edge and performed their foot care on the floor (naturally with nonskid footwear on one foot and towel under basin). Or were they in bed and you had to do footcare with them laying down? Same with hand care. Did you perform it with their hand on the bed and towels under basin, or did you set up on a bedside table and they sat in bed while you did it?
One other question--did you go to the patient and introduce yourself and check wrist band before the first skill (hand washing)? Or did you go do that and then do the introducing when you performed a skill that was interacting with them?
These may seem trivial, but it will help me alot if I can study them with advice!