Bedpan PDF

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Summary

Bedpan usage...

Description

BEDPAN • A receptacle used by a bedridden patient as a toilet • A female client uses bedpans to pass urine and feces

Types of Bedpans 1. Metal or hard plastic bedpan • It has a curved, smooth upper and a tapered lower end • Size is approximately 5cm 2. Fracture bedpan • Designed for clients with body or leg cast or clients restricted from raising their hips • Has shallow upper end • Size is approximately 1.3 cm

Equipment • • • • • • •

Disposable gloves Appropriate type of clean bedpan Bedpan cover Toilet paper Specimen container Wash basin, wash cloth, towels and soap waterproof, absorbent pads

Assessment 1. Assess client’s normal bowel elimination habits: routine pattern effect of certain foods or fluids. • Helps the nurse to anticipate when to offer bedpan. 2. Auscultate abdomen for bowel sounds, and palpate for abdominal distention • Normal bowel sounds occur irregularly at the rate of 5-35 per minute A • fecal filled colon can be palpated as firm rounded mass 3. Assess client to determine level of mobility and amount of assistance required. • Determine if client can tolerate in positioning on bedpan or client is totally

4. Assess if client is allowed to sit up or must lie flat when using bedpan. Determines most appropriate type of • bedpan. 5. Assess client’s level of comfort. • Pain can limit client’s ability to assist with positioning. (rectal pain or abdominal pain can reduce client’s ability to bear down during defecation) 6. Determine if stool specimen is needed.

Planning 1. Explain the procedure to client, including self-help tips. • Information promotes client’s independence, reduces anxiety, and helps client to better assist the nurse during the procedure. 2. Obtain assistance from additional nursing personnel as warranted. • Adequate personnel resource minimize muscle starin for both client and nurse.

Implementation 1. Perform hand hygiene and apply gloves. • Reduces transmission of microorganisms. 2. Provide privacy by closing curtains around bed or close the door of the room. • Reduces embarrassment and promotes bowel elimination. 3. Place bedpan under warm, running water for few seconds, then dry. Metal pan is very cold. Warm pan helps • client relax anal sphincter. 4. Put side rail up on opposite side of the bed. • Protect client from falling out of bed. • Client can use side rail to hold onto and assist self to move about in bed. 5. Raise bed horizontally according to nurses’ height.

• Promotes use of good body mechanics and prevents muscle strain on both the client and nurse. 6. Have client assume supine position. 7. Place client who is mobile in bed and can assist with procedure on bedpan. 1. Raise client’s head 30 to 60 degrees. • Prevents hyperextension of back and provides support to upper when client raises hips. Sitting position promotes defecation. 2. Do not unduly expose client. • Prevents embarrassment to client. • Demonstrate respect. 3. Remove bedpan cover and place in accessible location. 4. Instruct client on how to flex knee and lift upward. • Little effort should be required of client. 5. Place hand closest to the client palm up, under client’s sacrum, to assist lifting. As client raises the hips, use other hand to slide bedpan under client. Be sure open rim of bedpan is facing towards foot of the bed. • Nurse must ensure that bedpan is placed high enough under buttocks. 6. If using fracture bedpan, simply slip it under the client as the hips are raised. (fracture bedpan require less maneuvering by client) 8. Place client who is immobile on bedpan. 1. Lower the head of the bed flat. • Assist client for whom it is unsafe to exert effort when lifting hips, whom remain flat. 2. Remove top linens as necessary to turn client while minimizing exposure. • Prevents embarrassment to client.

3. Remove bedpan cover and place in accessible place. 4. Assist client to roll onto one side, backside towards you or turn client side lying position, then place bedpan firmly against client’s buttock and down into mattress. (make sure that the rim of the bedpan is facing toward foot of the bed) 5. Keeping one hand against the bedpan, place the other around the client’s far hip. Ask client to roll back onto bedpan. 6. Ensure that client is comfortable; place a small pillow or rolled towel under lumbar curve of back. Provides added comfort and reduces • pain to client. 9. Ensure the call bell and toilet tissue are within easy reach for client. • Promotes safety to client. 10. Ensure that bed is in lowest position and upper side rails are up. 11. Remove gloves and perform hand hygiene. 12. Allow client to be alone, but monitor status and respond promptly to call signal. 13. Apply new pairs of gloves. • Reduces transmission of microorganism. 14. Position client’s bedside chair close to working side of bed. • Provide area to place bedpan and content on chair after removal from client. 15. Collect basin of warm water. • Allow client to perform hand hygiene after wiping perineal area. 16. Move aside linens, keep client covered with towel. • Maintain privacy.

17. Determine if client is able to wipe own perineal area. 1. Wipe from mons pubis towards rectal area • Cleansing from lesser contamination to greater contamination. 2. Dispose contaminated tissue in bedpan. 18. Remove bedpan (mobile client) 1. Ask client to flex knees, placing body weight on lower leg, feet, and torso. • The nurse should avoid pulling or shoving pan from under hips to prevent 2. Lift buttocks up from the bedpan. 3. Place hand farthest from client on side of bedpan to support it. 4. While placing your other hand under the sacrum to assist lifting. 19. Wipe anal area with toilet tissue, depositing contaminated tissue in bedpan. 20. Wash perineal area with warm, soapy water and then dry thoroughly. • Cleansing from lesser contamination to greater contamination. • Promote personal hygiene. 21. Cover bedpan and content. • Reduces spread of offensive odor. 22. Return client to comfortable position. Ensure bottom linens are clean and wrinkle free. • Reduces chance of skin breakdown. 23. If stool specimen is to be obtained, this is the appropriate time to collect and place it into specimen bottle. 24. Return all equipment in appropriate place. Dispose all soiled linens correctly. 25. Remove gloves and perform hand hygiene.

Evaluation 1. Assess to characteristic of stool. Note for the color, odor. consistency, amount, shape, and constituents. • Identifies significant changes. 2. Evaluate client’s ability to use bedpan. • Provides continual assessment of ability to use bedpan. 3. Inspect client’s perineal area and surrounding skin while removing bedpan. • Liquid stool predispose client to skin breakdown. 4. Evaluate client’s overall activity tolerance and comfort. Defecation and use of the bedpan can be • energy consuming....