Basic Nursing Skills and Personal Care
Personal care questions test three things: sequence, scope, and observation - what you do, in what order, and what you notice and report.
Core concepts
- Bed bath and perineal care: wash from cleanest to dirtiest. Perineal care is always front to back, one stroke, a fresh washcloth for each stroke. For an uncircumcised male, retract the foreskin, clean, then replace it.
- Skin and pressure injuries: reposition at least every two hours, keep skin clean and dry, inspect bony prominences, and report reddened areas that do not blanch when pressed. Never massage a reddened area.
- Vital signs: know adult norms - oral temperature about 97–99°F, pulse 60–100, respirations 12–20, blood pressure under 120/80, oxygen saturation 95–100%. Count respirations without announcing it, since breathing changes when people know it is being counted.
- Output and specimens: measure urine at eye level in a graduated cylinder, keep the drainage bag below bladder level, and label specimens correctly.
- Scope: you may reinforce a dressing but never change a sterile one. Do not cut the toenails of a resident with diabetes or poor circulation - report instead.
Traps
Rectal temperatures are contraindicated with diarrhea, recent rectal surgery, or certain cardiac conditions. Oral temperatures are unsafe for a confused resident who might bite the thermometer. Also watch for repositioning a resident by pulling on the arms.
Rule of thumb
Clean to dirty, front to back, and report anything new, red, swollen, draining, or painful.
Worked example
A resident's heels are red and the redness does not fade when you press it. Correct action: relieve the pressure, keep the heels off the mattress, report to the nurse, and document - do not rub the area.