Basic Nursing Skills and Personal Care
What you must know
Vital signs (adult norms): temperature about 97.6–99.6°F orally, pulse 60–100 beats per minute, respirations 12–20 per minute, blood pressure under 120/80, and oxygen saturation at or above 95 percent. Pain is often called the fifth vital sign - ask and record it. Count respirations without telling the resident (they will change their breathing). Count the radial pulse for a full minute if it is irregular. Use the correct cuff size and keep the arm at heart level for blood pressure.
Hygiene: provide perineal care front to back, using a clean area of the washcloth each stroke. Clean from cleanest to dirtiest. Give oral care at least twice daily; for an unresponsive resident, position on the side and use suction-ready equipment. Remove dentures and clean them over a basin lined with a towel; store them in a labeled container, never in a napkin.
Skin and positioning: reposition at least every two hours, keep heels off the mattress, keep skin clean and dry, and never massage a reddened area - report it. Aides do not stage pressure injuries; describe and report them.
Mobility: use a gait belt for transfers, lock the wheelchair before transferring, and stand on the resident's weaker side. Do not cut the toenails of a resident with diabetes or poor circulation - report to the nurse.
Traps
Massaging red skin; leaving dentures in a tissue; measuring a blood pressure over an IV line or on the same side as a mastectomy without instruction; charting a value you guessed.
Rule of thumb: if a task is outside your training or the care plan, stop and report - that is never the wrong answer.
Worked example: You notice a new blistered area over a resident's heel. Do not open or rub it. Keep pressure off, tell the nurse, and document the location, size, and appearance using objective description.