What is the best position for stephanie bed bath

Reference no: EM133605504

Personal Care and Hygiene Case Study

Stephanie Johnston is a 28-year-old female who is 32 weeks pregnant and expecting her first baby. She has been in the antepartum special-care unit for 5 days, on strict bedrest, for preeclampsia. Her authorized healthcare providers plan to medically manage her preeclampsia until she is at least 34 weeks pregnant. At that time, if necessary, they will deliver the baby. She shows signs of mild preeclampsia: elevated blood pressure, edematous lower extremities, and hyperproteinuria. She is not to get out of bed and is to remain positioned either on her left side or supine with her head elevated. Her baseline blood pressure in the supine position is 130/85. When she sits up fully, her blood pressure goes up as well, as high as 150/90.

Stephanie is on medication for her hypertension, and she is also on seizure precautions. She has an IV line in her left forearm. She has an indwelling Foley catheter, and the nurses are monitoring her urine output.

The nurse asks Stephanie if she would like a complete bed bath and shampoo today. Stephanie states, "I would love to get my hair washed. I normally wash it every day, and I just can't stand it dirty like this! I haven't had much of a bath since I got here." She has very sensitive skin and states that her skin reacts to a lot of things." When discussing her bath, Stephanie states, "It itches down there," and she points to her labia. You notice that there is still betadine visible on her perineum.

Stephanie is very nearsighted and normally wears contact lens. She is accustomed to caring for them herself.

Case Study Questions

1. What is the best position for Stephanie's bed bath? How will you clean her back? State your rationale for your answers.

2. Application of QSEN Competencies: One of the Quality and Safety Education for Nurses (QSEN) (Cronenwett et al., 2007) concepts is Patient-Centered Care (which we call client-centered care). The definition is to recognize the client as the source of control and the full partner in providing compassionate and coordinated care based on respect for the client's preferences, values, and needs. How can Stephanie's preferences, values, and needs be incorporated into her bath?

3. How would you respond, both verbally and with interventions, to Stephanie's complaint about itching?

4. Are there any vital signs you would measure before continuing with hair care? If so, give your rationale.

5. How would you position Stephanie for her shampoo? How could you position Stephanie to make her bed while complying with her position restrictions?

6. Considering Stephanie's IV line and Foley catheter placement, what precautions do you need to take when changing her bed?

7. What assessments would be appropriate to measure Stephanie's tolerance of the procedure?

8. Identify the factors needed to facilitate the care of Stephanie's contact lenses.

9. What interventions are essential before you leave Stephanie's room?

Reference no: EM133605504

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