In this section of free PCT Exam Study Guide , we covers Patient Care which is mention in domain 1 and represent 30%of PCT exam content. Patient Care includes five essential tasks that every Patient Care Technician must mastered for effective skill to assist patients with everyday needs and monitor their well-being.
- Assessment and Monitoring
- Mobility and Positioning
- Wound and Skin Care
- Tubes , Lines and Medical Devices
- Respiratory Supports and Rehabilitation
These are the main topics of Patient Care with detail explanation are given below:
1-A: Assessment and Monitoring
Vital Signs Collection
Monitor the blood pressure, breathing, pulse and temperature of the patient. Record them on the chart at the times and when you notice a difference.
As an example, normal adult vitals are: temperature 98 o F, pulse 60-100 bpm, respiratory rate 12-20 bpm, blood pressure less than 120/80 mmHg. Call the nurse immediately in case something appears to be wrong.
Pain Assessment Using Scales
Have the patient rate his/her pain on a scale between 0 and 10- 0 no pain and 10 worst. Determine the location of pain, its nature (sharp, dull, burning), and the factors which aggravate/severe it.
An example is a patient stating, The incision is a 7 out of 10, sharp, stabbing and it is even worse when I cough. Note it down, so that the nurse would schedule pain medications.
Intake and Output Monitoring
Monitor all that is taken in (water, food) and out (urine, poop, vomit, drainage). This will assist in monitoring the kidney well-being, fluid retention, and recovery.
When a patient consumes 240 mL of water and 120 mL of juice, and only passes 200 mL of urine in eight hours, then it may be an indicator that the patient is retaining fluids.
1-B: Mobility and Positioning
Safe Patient Repositioning
Roll bedridden patients at an interval of 2 hours in order to prevent pressure sores as well as to enhance circulation. Make use of a draw sheet or lift sheet to facilitate the move.
As an illustration, when a patient has to be rolled on his back to his left, position one of the staff at the head and the other at the hips, roll them and place the pillows between the knees and behind the back.
Mechanical Lift Operation
When the patient is unable to lift the weight or is too heavy to be lifted by hand, then a mechanical lift must be used with the correct sling. Safety: there should always be two on the lift.
An example is to place the lift above the bed, place the sling, then smoothly lift the patient, then transfer them to a chair or stretcher, then down, holding their head and arms.
Range of Motion Exercises
Passive ROM implies that the staff moves the joints of the patient. Active ROM indicates that the patient moves them through assistance.
In passive shoulder ROM, add support to the arm by the elbow and wrist, and carefully move the arm through extension and rotation as well as flexion. Do not push it when it stings or it is against.
1-C: Wound and Skin Care
Dressing Assessment and Changes
Look to check how much drainage the wound has and its appearance:
- Serous drainage: clear or light yellow (normal healing)
- Sanguineous drainage: bloody (sometimes okay early on)
- Purulent drainage – thick, coloured, may have a bad smell (infection possible)
To make it simple, collect your supplies, wash your hands, remove the old dressing, inspect the wound, clean it (where necessary) and replace it with a new sterile dressing. Record what you see.
Pressure Injury Prevention
Prevention of bedsores consists in maintaining clean skin and dry skin, regularly turning patients, applying pressure-relieving devices, and searching red spots. Areas of high risk include heels, tailbone, hips and elbows.
As one example, place a foam wedge between knees when the patient is on his or her side, use heel protectors when the patient cannot get out, and apply lather barrier cream on wet areas.
1-D: Tubes, Lines and Medical Devices
Nasogastric (NG) Tube Care
Maintain patients with NG tube at a 30 angle to prevent inhaling. Look at the skin around the nose to see whether it is being irritated by the tape then clean it by use of warm water. Note to keep the tube in place and to avoid pulling or irrigating unless trained and advised to.
Peripheral IV Care and Removal
Removing a peripheral IV, you should take your gauze and tape and gloves, tell the patient what you are about to do, remove the tape, in one quick movement, the catheter, apply the gauze to the area 2 minutes, then a small bandage. Ensure that the tip is fine after which record time and site appearance.
Urinary Catheter Maintenance
Always keep the drainage bag lower than the bladder to prevent the urine from flowing back, ensure that the tubing runs straight, wash the area around the insertion on a daily basis with mild soap, and empty the bag when half full.
An example is during personal care, when you wipe around the entry point of the catheter, take the motion to the direction outside the hole to avoid bringing any germs into the hole.
1-E: Respiratory Support and Rehabilitation
Oxygen Therapy Assistance
Assist patients using nasal cannulas and face masks by maintaining a proper fit and proper flow rate. Ensure that prongs are placed in the nostrils, the tube is not bent and the patient is comfortable.
When the order is 2 L/min through cannula, ensure that the wall meter indicates that it is 2 L/min and the patient does not complain of dryness or discomfort.
Incentive Spirometry Coaching
Educate patients to operate incentive spirometer to combat postoperative pneumonia. Make them sit up, close lips around the mouthpiece, inhale slowly and deeply to lift the ball or strike the target, retain the breath 2-3 seconds and also exhale smoothly.
Have them take it every hour when awake and to cough and walk before getting out of bed.
Breathing Deep and Coughing.
Demonstrate to the patients how to clear their lungs through effective coughing. Make them have a deep breath, take a moment and cough hard with a pillow covering any surgical wounds.
In the case of post-op patients, demonstrate splinting with a pillow placed on the abdomen during coughing to reduce the pain and increase the effectiveness.
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