Skills Exam Tomorrow - and I still have questions!

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Help!

I have a skills exam tomorrow - bed bath/oral hygiene and bed making the occupied bed.

My instructor said to begin changing the linen when I have the patient on their side and finish with peri care, but it seems strange to me to clean the perineal area after I have clean sheets on the bed... I've written myself some notes, because although it's not rocket science, it is a test and it is stressful....

Would you confirm the order of what I have written...I'm sooooooo confused!

Prepare water & Gather materials

Enter room

Introduce self & identify client

Explain what you're going to do

Ask if they need to use the rest room before you get started

Draw curtain for privacy (**sure to only expose those areas being cleaned).

Use hand sanitizer and put on gloves

Raise bed (supine) [explain to the patient what you're doing each step]

Place bath towel over patient and remove blanket, sheet and gown - Place linens in hamper

Lower side rail

Using a towel under each body part you're going to wash

Begin w/eyes [inside out]

[Ask if temperature of water is comfortable] [Do they use soap on their face]

Wash face, ears, neck and pat dry [assessing skin as you go along]

Wash/dry hand, arm, axillary

Wash/dry chest and abdomen (being sure to keep covered)

Wash/dry foot and leg

RAISE SIDE RAIL

Change water

MOVE TO OTHER SIDE

Lower side rail

Using fresh towels and wash cloths

Wash/dry hand, arm, axillary [ask about water temperature)

Wash/dry foot and leg

Raise side rail and

Turn patient on their side

Move to other side of bed

Lower side rail and wash the back [remembering to assess skin]

Place used towels and wash cloths in hamper

***BEGIN CHANGING BED LINEN AT THIS TIME

With client already on their side, peel back old linens

Put fresh sheet in place (along with waterproof pad)

Turn client onto back

Raise side rail

Turn client to other side

Lower side rail

Remove soiled linen and place in hamper

Pull clean sheet into place

Turn client onto back

Remove pillow case and place in hamper

Put on clean pillow case

Raise side rail

Begin perineal care

Put clean gown on client

Put top sheet in place [***Tent sheet at feet]

Remove bath towel

Put blanket in place [***Tent sheet at feet]

REMOVE GLOVES, WASH HANDS AND PUT ON CLEAN GLOVES

PERFORM ORAL CARE (ask if they have dentures)

Brush teeth and gums

[assessing mucous membranes/gums (color, dry/moist, etc.)

LOWER BED

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