Many people have bad breath, especially when they just get up in the morning, because they don't pay attention to the cleanliness of oral hygiene, or because their diet is irregular. Let's share the operation method of oral care for the elderly in bed.
Operation method of oral care for the elderly in bed 1 Nurse preparation: wash hands, wear masks and pick jewelry.
Spare items: put the necessary items on the bedside of the elderly (18 cotton balls, therapeutic bowls, tongue depressors, curved boards, flashlights, mouthwashes, small towels, water cups, straws, etc. ).
Put what you need by the old man's bed.
Nursing preparation: nurses should first understand the situation of the elderly. With the cooperation of the old man, help the old man turn his head to one side, put a small towel under his chin and put the curved board next to the place where the old man quarreled.
The nurse helped the old man twist his head to one side, put a small towel under his chin and put the curved plate next to the place where the old man quarreled.
Observe the oral cavity: the nurse wipes the lips of the elderly, lets the elderly gargle (no coma), opens the oral cavity with a tongue depressor, and observes whether there are any symptoms such as bleeding and ulcer in the oral cavity. In case of false teeth, wrap them in gauze and take them out.
The nurse wiped the old man's lips.
Cleaning the mouth: swab mouthwash is scrubbed along the longitudinal direction between teeth, and the scrubbing order is left → right → outside → inside → occlusion; Upper teeth → lower teeth → buccal mucosa → (arc scrubbing); Hard palate → lingual surface → lingual frenulum. Finally, put the used cotton swab in the bending plate.
Clean the teeth in the order of "left → right → outside → inside → occlusion".
Clean teeth in the order of "upper teeth → lower teeth → buccal mucosa → (arc scrubbing), hard palate → lingual surface → lingual frenum".
Observe and then gargle: the nurse opened the old man's mouth with a tongue depressor for observation, let the old man gargle repeatedly, then the nurse dried the old man's face with a small towel and observed whether there was any residue in the old man's mouth.
Let the old man rinse his mouth repeatedly with mouthwash, and the nurse will dry the old man's face with a small towel.
Medication on demand: If symptoms such as ulcer and fungal infection are found in the oral cavity of the elderly, medication should be taken as needed. If there is ulcer, apply 1% gentian violet, tin powder or boron matte powder as needed; In case of fungal infection, apply 1% gentian and nystatin glycerin; In case of chapped lips, apply a proper amount of paraffin oil.
If you find that the elderly have oral ulcers and fungal infections, you should take medicine as needed.
Make the bed: Help the elderly make the bed and make them feel comfortable when they lie down.
Cleaning materials: classify used materials and put them back in their original places.
Key points: When cleaning dentures for the elderly, clean them under running water, and then soak them in cold boiled water. Never soak them in ethanol or hot water. When helping the elderly to clean their oral cavity, the action should not be too heavy, and the cotton swab should not directly contact the oral mucosa of the elderly.
Operation method of oral care for the elderly in bed 2 How to do oral care for the elderly in bed?
Old people should not only keep healthy, but also maintain oral hygiene during bed rest.
The temperature, humidity and food residue of human mouth are suitable for microbial growth and reproduction. Healthy people seldom get sick, because the body has a certain resistance, coupled with the bactericidal effect of lysozyme in saliva, mechanical actions such as brushing teeth, gargling, drinking water and eating have a certain bactericidal effect.
However, the body resistance of the elderly is weakened, saliva secretion is reduced, and the bactericidal effect of lysozyme is reduced, which creates favorable conditions for the reproduction of bacteria in the oral cavity. At this time, the number of bacteria increased, and the functions of sugar dissolution, fermentation and acid production were enhanced. If you don't pay attention to oral hygiene, it will not only lead to bad breath and stomatitis, but also affect appetite and digestive function, and even lead to complications such as mumps due to oral infection, so oral care is very important.
The specific practice of oral care is: prepare a pair of tweezers, a cotton ball, a tongue depressor (or replace it with bamboo chopsticks), and gargle (normal saline, 1:5000 nitrofurazone or 3% boric acid solution).
Let the elderly lie on their side, facing the caregiver, gently spread their cheeks with a tongue depressor, take a cotton ball soaked in mouthwash with tweezers, and wipe the occlusal surface, tongue, oral mucosa and hard palate on both sides of the teeth from inside to outside along the longitudinal direction of the teeth. After washing, help the old man rinse his mouth and dry his face. If there is an ulcer in the oral mucosa, you can sprinkle tin powder or indigo powder. If there are false teeth, help the elderly to take them off, rinse them with cold water, and let them wear them after gargling.
Operation method of oral care for the elderly in bed 3 There are many kinds of microorganisms in the mouth of normal people. The temperature and humidity of the oral cavity and food residues are suitable for the growth and reproduction of microorganisms. Under normal circumstances, the body has certain resistance. Because of the bactericidal effect of lysozyme in saliva and the mechanical effect of brushing teeth, gargling, drinking water and eating, it plays a certain role in sterilization, so it rarely gets sick. The body resistance of the elderly is weakened, the secretion of salivary glands is reduced, and the bactericidal effect of lysozyme is reduced, which creates favorable conditions for the reproduction of bacteria in the oral cavity.
At this time, bacteria increase, and the functions of sugar decomposition, fermentation and acid production are enhanced. If you don't pay attention to oral hygiene, it will not only lead to bad breath and stomatitis, but also affect the function of eating and digestion, and even lead to complications such as mumps due to oral infection, so oral care is very important.
Good oral care has many advantages, for example, it can keep the mouth clean and moist, and prevent complications such as oral ulcer and infection; It can also prevent bad breath and oral dirt, which is conducive to promoting appetite; By nursing the oral cavity, we can observe the changes of the oral cavity, and those who use antibiotics for a long time should observe whether there are signs of mold infection in the oral mucosa.
The simple methods of oral care for long-term bedridden patients are gargling and brushing teeth. Commonly used mouthwashes include mouthwash, Koutai, 1%-4% soda water and so on.
1, electrical appliances
A pair of tweezers, a cotton ball, a tongue depressor (or bamboo chopsticks instead), and a mouthwash (usually physiological saline, 1: 5000 furacilin or 3% boric acid solution).
2. Method
Let the elderly lie on their side, facing the caregiver, gently spread their cheeks with a tongue depressor, take mouthwash cotton balls with tweezers, and wipe the inside and outside of the teeth, occlusal surface, tongue, oral mucosa and hard palate from inside to outside along the longitudinal direction of the teeth. After washing, help the old man rinse his mouth and dry his face. If the oral mucosa has ulcers, you can sprinkle tin powder or indigo powder. If there are false teeth, help the elderly to take them off, brush them with cold water, and then let them wear them after gargling.
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Skin care of the elderly in bed
Skin care should also be given to patients who stay in bed for a long time. Bathing can make the patient's skin clean, promote blood circulation, enhance the excretion function of the skin, and prevent skin infection and pressure ulcers. Keeping the air moist and applying lip balm and body lotion can effectively relieve dry skin. Nurses should pay attention to the changes of long-term bedridden patients when taking a bath, and observe the changes of consciousness and physical activity to prevent accidents.
1, bathing the elderly in bed
(1) workpiece
Clean clothes, towels, hot water, buckets, towels, soap and washbasin.
(2) Method
Close the doors and windows, remove the desks and chairs, fill three-quarters of the pots with hot water, loosen the lid, cover the area scrubbed by the old man with a big towel, first wipe it with a wet towel, then scrub it with a towel dipped in soap, then wipe it repeatedly with a wet towel, and finally dry it with a big towel.
The order of scrubbing parts:
1) untie the neckline and wash the eyes, nose, face, ears, neck and other places for the elderly. Pay attention to after washing the ears.
2) Take off the old man's coat (wash the healthy side first, then the affected side) and scrub the arm. Pay attention to cleaning armpits. Help the elderly lie on their side, facing the nursing staff, put the washbasin on the big towel beside the bed and wash their hands for the elderly.
3) Untie the belt of the elderly, scrub the chest and abdomen, pay attention to the breasts and navel, help the elderly turn over and scrub the back and buttocks.
4) Take off pants and scrub legs, groin and perineum. Move the washbasin to your feet, spread a big towel on the bed, wash your feet and put on your pants.
5) Make the bed, change the sheets as needed, and clean up the used items.
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Postural nursing care of the elderly in bed
Correct posture nursing can prevent pressure sores and limb contracture. It is very important to maintain a good lying posture from the early stage of the disease. For example, change the body position every 1 hour, and perform passive limb activities for about 30 minutes every day, 1-2 times a day, so as to promote blood circulation of limbs and prevent limb contracture and joint stiffness.
1. Help the bedridden elderly to move to the bedside.
(1) put the backrest frame flat, take off the pillow and put it on the chair, so that the old man can lie on his back and bend his knees;
(2) The caregiver puts one arm under the old man's shoulder and the other hand holds the old man's hip. While helping the old man up, he asked the old man to hold the bedside railing with both hands and instructed the old man to stand up with his feet against the bed. Put the pillow back, and then set up the backrest frame so that the old man can lie comfortably.
2. Help the bedridden elderly turn over
(1) When the supine elderly want to turn over to one side, they should first put their hands on their abdomen and bend their knees. The nurse put one forearm into his waist and the other arm into his thigh. With the strength of his arm, he can quickly lift the old man, move him close to the bed and turn to the opposite side at the same time.
(2) Lift the old man's head and shoulders, turn to the opposite side, put a soft pillow on the old man's back to maintain posture, and put a soft pillow on the old man's chest to support the forearm, so as to make the old man comfortable.
(3) Bend the old man's thigh forward and his calf slightly, and put a soft pillow between his knees to prevent the legs from squeezing and rubbing against each other.
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Nursing care of the elderly in bed
For patients with urinary incontinence, put a disposable urine pad under the buttocks. If conditions do not allow, you can use soft and absorbent old cloth instead (to be disinfected). Clean the perianal skin with hot water after defecation, and clean the perianal and vulva after defecation for female patients. For male patients with urinary incontinence, urine can be collected by urinal or a white plastic bag can be tied at the root of [Yin] stem, and it should be changed every time. Also pay attention to the cleanliness around the urethral orifice to avoid urinary tract infection.
In nursing, it is essential to give timely anti-infection treatment to infectious diseases, psychological nursing and basic nursing skills are also very important. First of all, it is necessary to analyze the age, condition, causes and time of urinary incontinence in the elderly, and make a personalized nursing plan according to the analysis.
If the elderly are awake, but weak and involuntarily defecate, this situation can be achieved by observing the defecation law of the elderly, and then formulating and arranging a nursing plan for defecation according to the law, so as to achieve purposeful and prepared active nursing and reduce the number of bedridden urination and defecation.
If the effect is not good, the catheter can be indwelling according to the actual situation, and the urethra can be disinfected 1-2 times a day, and routine nursing can be carried out according to the indwelling catheter. The stool should be cleaned in time, and tannic acid ointment should be properly applied to protect the perianal skin.
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Psychological nursing care of the elderly in bed
Because the elderly stay in bed for a long time, the chances of contact with the outside world are reduced. Most elderly people often have negative emotions such as hesitation, depression, irritability, pessimism and disappointment, and the pain of illness aggravates these unstable emotions. Therefore, we should take care of each elderly person according to their different psychological characteristics.
First of all, nurses should respect the elderly, pay attention to their words and deeds, be dignified in appearance, say more words of encouragement, use respectful names and honorifics when addressing, use the tone of suggestion and discussion before operation, and give satisfactory answers to the questions raised by the elderly in time.
Secondly, emotional counseling should be carried out in time, and nurses should talk to them with warm attitude and kind words, sympathize with, understand and comfort them. For the elderly who are easily excited, we should take advantage of the situation, comfort and sympathize with them in time, or change the subject.
Don't care too much about some stubborn and irritable old people, and don't force them to stop. Nurses should put themselves in their shoes, give them more spiritual support and comfort, and enhance their confidence in overcoming diseases and living a happy life. By listening to music, listening to opera, watching TV, reading newspapers, chatting with the elderly and other ways to distract the attention of the elderly from their own diseases, in order to adjust their emotions.