Physical Care Skills
Core concepts
Physical care is the largest domain, and most questions hide a safety step. Know infection control cold: hand hygiene is the single most effective way to prevent the spread of infection, and it is required before and after every resident contact and after removing gloves. Gloves are never a substitute for washing hands. Standard precautions apply to all body fluids, for every resident, every time.
Know vital sign values and technique: adult pulse 60–100, respirations 12–20, oral temperature about 98.6 °F. Place the blood pressure cuff at heart level; the first sound is systolic, the last is diastolic. Count respirations without announcing it, because residents change their breathing when they know you are watching.
Reposition immobile residents at least every two hours and inspect pressure points. Report non-blanching redness - early pressure injury - and never massage it.
For transfers, lock the bed wheels, lower the rail on the receiving side, and move the resident toward the strong side. Use a gait belt and walk on the resident's weaker side. During range of motion, stop at pain; never force a joint.
With swallowing precautions, sit the resident upright at 90 degrees, offer small bites, cue a chin tuck, and watch for pocketing, coughing, or a wet voice - signs of aspiration. Measure intake and output in milliliters: 1 ounce equals 30 mL.
Trap: a question asking what to do first rarely wants the procedure itself - it wants hand hygiene, privacy, or a safety check.
Rule of thumb: safety, then privacy, then the task, then documentation and reporting.