1) NASOGASTRIC TUBE - INSERTING & REMOVAL
#INSERTION:-
Introduction
Check patiens id
Explain
Ask for permission
Q_ mid facial trauma, stomach or esophageal surgery , any allergies to
lidocaine(anesthesia).
Prepare the patient(45 degree)
Wash hands and wear gloves . (non sterile)
Check for required equipment .(measurements = from nose - tip of the
ear lobe- xiphoid process to sternum and mark it in tube ), drape, kidney
shape dish, nasogastric tube, 60ml syringe , glass of water, penlight,
lubricant ,stethoscope , tape, collecting bag.
chech the patient's nose and mouth with pen light for any foreign body .
Give the patient drape , kidney shape dish , water
Ask the patient through which naustril he is confortable .
Lubricate the tube .
Make the patient to sit in head tilted position and insert tube slowly
once reaches the esophagus give some water (with water tube flows in
easily)and check for coiling of tube through mouth-
once the tube inserted and secured with tape ,take 30ml air in 60ml
syringe blow the air into the tube and hear it with stethoscope (for
confirmation that the tube is in the stomach),
now aspirate the syringe (u get the things in stomach)- send the liq filled
syring to lab for checking the ph , remove the syringe insert the
collecting bag and hang it in the side of the bed ....
write date and time in collecting bag ..
Remove the gloves and do documentation (date time how long the
tube should be kept)
#REMOVAL:-
using a tissue paper slowly remove the tube while wiping it in the same time-
tissue should be in same position.
2)MALE AND FEMALE URETHERAL CATHERIZATION
#INSERTION:- {MALE}
Introduction
Patient id
Explain procedure
Ask consent
Q_ Surgeries in hip, genital area, ureter, urinary bladder ; Pain or
irritating during urination :Any complications from past catherization
Wash hands
Gloves (sterile)
Cleaning the male genitalia with betadin solution ;Clean bottom to top -
5 times clockwise circular motion
Remove gloves ; Wear the new sterile gloves
Put the drape on
Give lidocaine with lubricant
Check for equipment
Syringe into the tube
Insert the catheter
Push the syringe to inflate the balloon inside
Remove the syringe
Remove the drape
Date and time of insertion of collecting bag.
#REMOVAL:-
Put on the gloves
Insert the syringe and deflate the balloon
Remove the catheter
Remove gloves
Hygiene and documentation.
#INSERTION:- {FEMALE}
Introduction
Patient id
Explain procedure
Ask consent
Q_ Surgeries in hip, genital area, ureter, urinary bladder ; Pain or
irritating during urination :Any complications from past catherization;
alergies to lidocin or betadin
Right position - supine , extend ur legs (lithiotomy position)
Wash hands
Gloves (sterile) , sterile drape under the patient
Cleaning female genitalia with betadin solution ; Clean top to bottom
with 3 cotton balls
Remove gloves ; Wear the new sterile gloves
Put the drape on
Give lidocaine(5ml) with lubricant (by seperating the labia)
Check for equipment
Syringe into the tube(10ml)
Lubricate the catheter
Insert the catheter (by seperating the labia) 5 to 6cm
Push the syringe to inflate the balloon inside
Remove the syringe
Chech the catheter
Remove the drape
Date and time of insertion of collecting bag.
#REMOVAL:-
Put on the gloves
Insert the syringe and deflate the balloon
Remove the catheter
Remove gloves
Hygiene and documentation.
3) BIMANUAL EXAMINATION OF VAGINA
Introduction
Patient id
Explain procedure
Ask consent
Q- any vaginal surgery, from when u r sexually active, when was ur 1st
day of last mensuration, how many pregnancies (if so what kind c-
section or normal) , allergy to betadin and lubricant , past history for any
kind of infection/ pain / discharge .
Wear the glows
Tell the patient to empty her bladder
Make the patient lie in lithotomy position with the dape on
Cleaning female genitalia with betadin solution ; Clean top to bottom
with 3 cotton balls
Lubricate ur finger (index, middle finger) vertically
Insert partially check posterior, anterior, and 2 lateral sides
Insert further more to cervix (closed,round) horizontally
Now press the abdomen outside with ur other hand – feel the ovary,
fallopian tube
Now remove ur fingers
Check for discharge colour and smell
Drape ur patient
Remove ur glowes
Do the documentation.
4) PAP TEST(SPECULUM)
Introduction
Patient id
Explain procedure
Ask consent
Q- any vaginal surgery, from when u r sexually active, when was ur 1st
day of last mensuration, how many pregnancies (if so what kind c-
section or normal) , allergy to betadin and lubricant , past history for any
kind of infection/ pain / discharge .
Wear the glows
Tell the patient to empty her bladder
Make the patient lie in lithotomy position with the dape on
Cleaning female genitalia with betadin solution ; Clean top to bottom
with 3 cotton balls
Lubricate ur finger (index, middle finger) vertically
Insert partially check posterior, anterior, and 2 lateral sides
Insert further more to cervix (closed,round) horizontally
Now press the abdomen outside with ur other hand – feel the ovary,
fallopian tube
Now remove ur fingers
Check for discharge colour and smell
Insert the speculum in the closed way -vertically and then turn it
horizontally and open the speculum and lock it once u see the cervix.
Now take a spatula insert to the tip of the cervix , rotate it 360 degree
and remove it .
Once removed , apply it on the slide and fix it with fixative spray 15 to
20cm away from the slide …so that it will not contaminate.
Now slowly remove the speculum . see for the colour of discharge and
smell it .
Drap the patient on
Send the slide to lab
Remove the glowes
Do the further documentation .