Patient Care and Bedside Assistance
This domain covers the routine bedside tasks a health worker performs: bed making, positioning, hygiene, feeding, elimination and observation. Questions ask for the correct sequence or the safer technique.
Core rules
- Privacy and dignity first: screen the patient, explain each step, obtain consent.
- Hand hygiene before and after every contact; gloves whenever body fluids are expected.
- Unoccupied bed making when the patient can move out; occupied bed making when bed rest is ordered. Work from the near side, never leave the far side rail down.
- Reposition a bedridden patient at least every two hours; check pressure points - sacrum, heels, elbows, ears.
- Positions: supine (flat), lateral (side), Fowler (head raised 45 to 60 degrees for breathlessness or feeding), semi-Fowler (about 30 degrees), prone, Trendelenburg (head down, only on medical order).
- Record intake and output in millilitres; report urine output below 400 mL a day.
Worked example
A patient bedridden for three days has a red area over the sacrum that does not blanch and the skin is unbroken. Reasoning: this is a stage 1 pressure ulcer. No dressing is needed yet because skin is intact: reposition two-hourly, keep the area clean and dry, do not massage the redness, use a soft or air mattress, improve protein intake, and record and report to the nurse or medical officer. If the skin breaks, it becomes stage 2 and needs dressing.
Traps that cost marks
- Dragging a patient up the bed instead of lifting with help; friction causes ulcers.
- Massaging a reddened pressure area.
- Sitting a shocked patient upright instead of following the ordered position.
- Charting intake but never charting output.