Basic Nursing Care and Personal Care Skills
The sequence every skill shares
Before touching a resident: check the assignment or order, gather supplies, knock, identify the resident by name and identifier, explain what you will do, provide privacy, and wash your hands. After care: leave the bed low and locked with the call light in reach, clear the clutter, wash your hands, and report and document objectively. This opening and closing is exactly where exam questions hide their errors.
Bathing, grooming, and mouth care
Wash clean to dirty: face first, perineal area last, and front to back for female perineal care. Remove dentures with gauze, clean them over a basin or lined sink, never in hot water because they warp, and store them in a labeled cup. For an unconscious resident, provide oral care with the head turned to the side, no water, and swabs, and check for secretions. Never cut the nails or corns of a resident with diabetes - report to the nurse. Use an electric razor unless directed otherwise.
Dressing, toileting, and measurement
Dress the weak or affected side first and undress that side last. Provide perineal care after toileting and catheter care with downward strokes away from the meatus, keeping the bag below bladder level. Know normal vital sign ranges and report values outside them. Oral temperatures are avoided with confusion, seizure risk, or recent hot or cold intake; rectal temperatures are avoided with diarrhea or cardiac history. Count a regular radial pulse for 30 seconds and double it; count a full minute if it is irregular.
Traps and a rule of thumb
Traps: hot water on dentures, cutting a diabetic resident's toenails, taking a blood pressure through a sleeve, and charting subjective judgments such as 'resident cheerful.' Rule of thumb: clean to dirty, front to back, weak side first, and always explain before you touch.