Patient Care and Basic Nursing Skills
Patient Care and Basic Nursing Skills checks the routine bedside skills a vocational health worker performs daily: admission and discharge, bed making, positioning, hygiene, feeding, elimination, vital signs, intake–output recording and observation.
Core rules
- The nursing process is assessment → nursing diagnosis → planning → implementation → evaluation; evaluation loops back to assessment.
- Positions: supine, lateral, prone, Fowler (head raised 45–60°, aids breathing and feeding), Trendelenburg (feet down, used rarely), and the recovery position for an unconscious breathing patient.
- Pressure injury prevention: reposition at least every 2 hours, inspect skin at each turn, keep skin clean and dry, use a supporting mattress, correct nutrition and hydration, avoid dragging the patient.
- Bath water should be comfortably warm (about 40–43 °C), tested with the elbow, never poured hot directly on skin.
- Record intake (oral fluids, IV fluids, tube feeds) and output (urine, vomitus, drains, stool) in millilitres for a full 24 hours.
- Report, do not interpret alone: any change in consciousness, new breathlessness, bleeding, falling urine output or a rising temperature.
Worked example
A postoperative patient has a 24-hour intake of 1,400 mL IV plus 900 mL oral (2,300 mL). Output is 1,100 mL urine, 200 mL drain fluid and 300 mL vomitus (1,600 mL). Reasoning: balance = intake − output = +700 mL, which looks positive, but the vomiting and drain loss mean real circulating volume may be low. The correct action is to chart accurately, note the losses separately and report to the nurse-in-charge.
Traps that cost marks
- Recording output as "plus" or "normal" instead of millilitres.
- Leaving a dependent, frail patient in one position for a whole shift.
- Giving oral fluids to a drowsy patient.
- Assuming a task is someone else's job and not reporting it.