More new nurse questions - ice water & dressing changes?

[tsm007]

I feel like my mentors aren't very knowledgeable. Actually there are a ton that are, but the particular one that's been training me is showing me time and time again that her care is subpar. She's the one that charted pedal pulses +2 on an amputee. So with that double checking two more of her instructions here with more experienced people.

1. Ice water. A patient was on fluid restrictions and an aide let her trade her coffee for ice water. Nurse tells me she can't have water with ice in because if there was ice in there she'd be getting twice as much water.

I think she's got that backwards! They give ice chips when people can't have water, but can have ice and I was always taught to chart a cup of ice as half the amount as it would be for water. So in reality putting ice in the patient's water should be cheating the patient of water right??

2. Dressing changes - Orders said cleanse with normal saline and pat dry. She tells me to just wash it with wash clothes instead of using the little pink saline tubes to squirt water on it because cleaning with wash clothes is just nicer for the patients. I don't know that I should be doing that? I mean in some cases I can see if they have lotions and stuff that need to be washed off, but the actual wound I'm thinking no? I wanted some thoughts on this.

I have found a couple people that seem to be better mentors than this particular nurse, but I'm finding they don't want to help me that much. If it's not a big deal to use wash clothes then I'll probably do that because it was easier, but I want to make sure I'm being told things correctly because I have never done a dressing change that way before.

[Surprised1, MSN, RN]

You should talk to your clinical educator and wound care nurse, and check the P&P.

I laughed at the ice water comment 😃

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[tsm007]

You should talk to your clinical educator and wound care nurse, and check the P&P.

I laughed at the ice water comment 😃

Sent from my iPhone using allnurses

There is no clinical educator. There is no wound care nurse. It's a nursing home and I'm on the skilled medicare side. There is however a policies and procedures book! Didn't think to look there.

[benegesserit]

I can't picture a rough old washcloth as being nicer, plus it's an infection risk. I do wet down a sterile gauze and use that when it seems appropriate.

You are right about the ice water. Ice has some of it's volume taken up by air, so they're getting less water than they would be if the glass was equally full of plain water. If the ice wasn't being taken into account in the fluid measurement, it might be a problem.

[Mavrick, BSN, RN]

I am still laughing at the ice water comment.

A container of ice, is water plus air (the spaces between the ice do not count as fluid.)

A container of ice water has no air spaces so all of it counts as fluid.

The tiny amount of air trapped in the ice is too insignificant to make a difference.