lA STATE BOARD OF HEALTH 
 
 B 3 7 TTDS5 
 
 lENTAR JIKsiNG PROCEDURES 
 
 FOR 
 
 tAINING SCHOOLS FOR NURSES 
 
 ! 
 
 li 
 
 California 
 
 SrrrF, Printixq Oi i-u i: 
 101 --) 
 
CALIFORNIA STATE BOARD OF HEALTH 
 
 BUREAU OF REGISTRATION OF NURSES 
 
 ELEMENTARY NURSING PROCEDURES 
 
 FOR 
 
 TRAINING SCHOOLS FOR NURSES 
 
 Caufobnia 
 State Prtntixo Offtci: 
 
 1 n 1 5 
 
CALIFORNIA STATE BOARD OF HEALTH 
 
 BUREAU OF REGISTRATION OF NURSES 
 
 ELEMENTARY NURSING PROCEDURES 
 
 FOR 
 
 TRAINING SCHOOLS FOR NURSES 
 
 California 
 
 State Printing Office 
 
 1915 
 
 20531 
 

PREFATORY NOTE. 
 
 This illustrated j)amphlet of elementary nursing procedures is issued 
 to instructors of nurses in the training schools of this State, and has for 
 its purpose the establishment of a certain degree of uniformity in teach- 
 ing fundamental nursing technic and to serve as a guide to the 
 instructor during the preliminary part of the course. 
 
 It illustrates the method of carrying on a series of demonstrations 
 which will cover a period of three months' class instruction before the 
 student is permitted to undertake the care of patients. It is not 
 intended to take the place of the textbook, but to emphasize points 
 preliminary to bedside nursing. Blank leaves are left for instructor's 
 notes. 
 
 A li.st of articles required for equipment of demonstration room is 
 given. This list may be amplified according to the requirements of the 
 service of the hospital, the facilities of the training school and the scope 
 of preliminary instruction. 
 
 Anna C. Jamme, Director. 
 
 Sacramento, December 10, 1915. 
 
 52 
 
EQUIPMENT FOR DEMONSTRATION ROOM. 
 
 FURNITURE. 
 
 Students' chairs. 
 
 Unvarnished table (3 feet by 6 feet). 
 
 Instructor's table and chair. 
 
 Blackboard (large size). 
 
 Skeleton. 
 
 Anatomical charts, drawings, etc. 
 
 Pencil sharpener. 
 
 Bed and mattress. 
 
 UTENSILS. 
 
 2 large enamel basins. 
 2 small enamel basins. 
 2 .small enamel bowls. 
 2 curved basins. 
 
 1 foot tub. 
 
 2 enamel pitchers (2 qt.). 
 
 1 enamel graduate (16 oz. 500 c.c). 
 
 1 bed pan. 
 
 1 douche pan. 
 
 1 irrigator and stand. 
 
 1 saucepan (1 qt.). 
 
 1 large tray. 
 
 1 medium size tray. 
 
 1 small tray. 
 
 2 small glass jars. 
 1 small glass dish. 
 
 1 glass graduate (500 c.c). 
 
 1 clinical thermometer. 
 
 1 bath thermometer. 
 
 1 glass douche point. 
 
 2 glass catheters. 
 
 4 medicine glasses. 
 
 1 h.ypodermic syringe. 
 
 2 hypodermic needles. 
 
 2 hypodermoclysis needles. 
 1 hjT^podermoclysis bottle. 
 1 stupe wringer. 
 
ET.KMKXTArxY NTRSIXG PROCEDURES. 
 LINEN. 
 
 6 large sheets. 
 
 4 draw sheets. 
 6 pillow slips. 
 6 bath towels. 
 6 hand towels. 
 6 wa.sh cloths. 
 
 6 dressing- towels. 
 2 bed blankets. 
 1 long mattress pad. 
 1 small quilted pad. 
 
 5 bath blankets. 
 1 bed spread. 
 
 RUBBER GOODS. 
 1 long rubber sheet. 
 1 small rubber sheet. 
 1 piece Stork sheeting (18x24). 
 1 piece bed rubber sheeting (24x36). 
 
 1 rubber ring. 
 
 2 ice caps. 
 
 1 rectal tube. 
 
 1 hard rubber rectal point. 
 
 1 rubber catheter. 
 
 1 proctoclysis point. 
 
 2 hot water bags. 
 
 1 pair rubber gloves. 
 
 1 rubber apron. 
 
 1 Davidson's syringe. 
 
 MISCELLANEOUS. 
 Vaseline. 
 
 Application sticks. 
 Toothpicks. 
 IMouth wash. 
 Comb and brush. 
 1 small dressing forceps. 
 Small whisk broom. 
 Toilet soap. 
 Talcum powder. 
 
 DRUGS. 
 
 Blank tablets. 
 
 Suppositories (cocoa butter). 
 
 Alcohol (70%). 
 
 Turpentine, 4 oz. 
 
 Mustard. 
 
 Lysol solution (10%). 
 
 Carbolic solution (10%). 
 
 Boracic acid. 
 
 Bichloride solution (1-1000). 
 
 Bichloride tablets (7-^ grs.). 
 
 Common salt. 
 
6 CALIFORNIA STATE BOARD OF HEALTH. 
 
 FIRST DEMONSTRATION. 
 
 MAKING A BED. 
 Articles required. 
 
 1. Bed. 
 
 2. ]\rattress of hair, cotton, or ostermoor, to fit bed. 
 
 3. Two pillows, one feather and one hair or both feather of medium 
 
 size, moderately well filled. 
 
 4. ]\Iattress pad, length and width of mattress. 
 
 5. Enbber sheet, double coated, without wrinkles, creases or pinholes. 
 
 6. Rubber protector, quilted pad 36 in. by 24 in., or width of rubber 
 
 sheeting. 
 
 7. Two sheets, large enough to tuck under mattress on all sides. 
 
 8. Draw sheet, single or double. 
 
 9. Two pillow slips to fit pillows loosely. 
 
 10. Two blankets — single blankets preferred. 
 
 11. Spread, dimity preferred. 
 
 Procedure. 
 
 Spread mattress pad over mattress. Spread sheet right side upper- 
 most, wide hem at top, allow it to come well over head of mattress and 
 turn corners wdth box effect ; see that it is smooth and firm. 
 
 Spread rubber sheet across center of mattress and over this the rubber 
 protector and then draw sheet. Pull latter down snugly by grasping 
 ends only and tuck in very securely on each side. 
 
 Spread top sheet, right side down, wide hem at top, the width of hem 
 al)ove edge of mattress, tuck in securely at foot, box corners. 
 
 Spread each blanket, leave about ten inches from top edge of mat- 
 tress ; tuck in each blanket separately at foot of bed, box corners. Turn 
 down top sheet over upper edge of blanket, tuck in blankets and top 
 sheet securely on each side of mattress. The l>ed should now be smooth, 
 firm and corners perfectly square. 
 
 Place spread with upper edge even with mattress, tuck in at foot, 
 square corners and alloAv spread to hang at each side. 
 
 Pillows slipped into cases by first placing pillows on chairs and not 
 on bed, corners of pillows to fit well into covers. First pillow or hair 
 pillow, if used, laid flat on bed, seam side to head of bed, open end away 
 from door. Second pillow standing upright, seam side at lower border, 
 open end away from door. 
 
 SECOND DEMONSTRATION. 
 
 TO OPEN BED FOR OCCUPANCY. 
 Procedure. 
 
 Remove pillows to chair or foot of bed. Turn back spread about four- 
 teen inches. Loosen blankets and top sheet at sides, turn up top sheet 
 towards head of bed, bring up spread and turn upper edge over border 
 of blankets. Turn back sheet, make one more turn so that last turn 
 shall be twelve inches wide. 
 
 Place pillows one over the other, closed ends on one side. See that 
 bed clothing is perfectly smooth, no wrinkles or loose corners. 
 
ELKMKNTARY NURSINO I'lfOfVEDUEES. 7 
 
 THIRD DEMONSTRATION. 
 TO STRIP AND AIR A BED. 
 •Procedure. 
 
 Place two chairs back to back. Remove pillows, place one on each 
 chair. Loosen sheets and blankets around mattress, remove spread and 
 fold in creases, place over chairs. Remove blankets, each separately by 
 gathering in hands while standing at side of ))ed. 
 
 Remove upper sheet and draw sheet in same manner. Hang rubber 
 sheet and small pad on foot of ])ed. mattress protector on head of bed. 
 
 FOURTH DEMONSTRATION. 
 
 TO MAKE A SURGICAL BED. 
 Articles required. 
 
 Same as for First Demonstration, and in addition — 
 
 1. Two special or bath blankets. 
 
 2. Stork sheeting 18 x 24 inches. 
 
 3. Two towels. 
 
 4. Four small safety pins. 
 
 5. Three hot v/ater bags or cans. 
 
 Procedure. 
 
 Spread mattress protector, lower sheet, rubber sheet, small pad and 
 draw sheet as in making ordinary bed. Spread special blankets six 
 inches, from top of mattress ; spread top sheet width of hem above upper 
 edge of mattress, do not tuck in at bottom of mattress. 
 
 Spread bed blankets as in ordinary bed and do not tuck in at bottom. 
 Put on spread, or if preferred, a sheet. 
 
 Turn over upper bed clothes, including the upper special blanket, at 
 foot of bed and make an even fold 8 to 10 inches in width with lower 
 edge of fold on level with end of mattress. 
 
 Turn over in same way at head of bed and on one side, that most 
 convenient for placing patient in bed, making neat smooth folds same 
 width as at foot. Tuck in bedding on opposite side. 
 
 Place small rubber sheet covered with towel and held in place with 
 safety pins, where patient's head will rest. Place hot water bags, or 
 cans, where shoulders, hips and feet will rest. These should be filled 
 with very hot water and in every case removed before the patient is 
 placed in bed. 
 
 Lower blanket may ])e omitted and used only in case of shock or when 
 additional warmth is required. 
 
 Bedside table. On table should be one (preferably two) emesis 
 basins, towels and several small scfuares of gauze. 
 
8 
 
 CALIFORNIA STATE BOARD OF HEALTH. 
 
 FIFTH DEMONSTRATION. 
 TO MAKE A DELIVERY BED. 
 Articles required for demonstration. 
 
 Same as for First Demonstration, and in addition — 
 
 1. Long rubber sheet, length and width of mattress. 
 
 2. One long sheet and draw sheet. 
 
 3. Four large safety pins. 
 
 4. One light warm blanket. 
 
 Procedure. 
 
 Proceed as in making ordinary bed until after draw sheet is tucked 
 in, then cover bed with long rubber and over this place extra sheet, tuck 
 in on all sides, then extra draw sheet and pin securely to mattress with 
 large safety pins. 
 
 For the delivery a sterile sheet is placed over this. After delivery 
 both sheets and long rubber are removed and patient is on clean bed- 
 ding. Blanket will cover patient. 
 
 
 
 
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 A quilted pad protects the mattress. 
 
ELEMENTARY KUHSING rROCEDDRES. 
 
 The lower sheet in place. 
 
 A small quilted pad covers the rubber sheet and lessens the discomfort of the rubbe 
 
 2—20531 
 
10 
 
 CALIFORNIA STATE BOARD OF HEALTH. 
 
 The draw sheet in place. 
 
 The upper sheet is turned back on top of blanket. 
 
ELEMENTARY NURSING PROCEDURES. 
 
 11 
 
 The closed bed. 
 
 In opening the bed for occupancy the spread is turned over the upper border of 
 
 blanket. 
 
]2 
 
 CALIFORNIA STATE BOARD OP HEALTH. 
 
 The bed is open for occupancy. One or both pillows may be used. 
 
 Taking off the blanket to air the bed. 
 
ELEMENTARY NURSING PROCEDURES. 
 
 13 
 
 Bed stripped for airing. 
 
 A surgical bed without blankets. 
 
14 
 
 CALIFORNIA STATE BOARD OF HEALTH. 
 
 A sursical bed with blankets for additional warmth. 
 
 The Hospital Doll. 
 
ELEMENTAEY NUESIXG PROCEDURES. 15 
 
 INSTRUCTOR'S NOTES. 
 
16 CALIFORNIA STATE BOARD OP HEALTH. 
 
 INSTRUCTOR'S NOTES. 
 
i:i.i;mi;\"iaky xiMtsixc I'Uockdfrks. 17 
 
 SIXTH DEMONSTRATION. 
 THE BED-BATH. 
 Articles required. 
 
 1. Bed ])rei)ared for occupancy. 
 
 2. Subject for bath (model doll, nurse, or patient). 
 
 3. Two bath blankets. 
 
 4. One bath towel. 
 
 5. Two face towels. 
 
 6. Two wash cloths. 
 
 7. Soap, alcohol (50%). toilet powder, curved basin. toothl)rush, comb 
 
 and brush, tooth paste, or mouth wash. 
 
 8. Two pitchers containing cold and hot Avater. 
 
 9. Basin, slop jar. hot water bag, bath thermometer. 
 
 Procedure. 
 
 Have two chairs at foot of bed, loosen bedding from all around mat- 
 tress; remove spread and blanket, as in stripping bed, and place on 
 chairs ; spread bath blanket over upper sheet ; remove sheet in a down- 
 ward direction while holding upper border of blanket. 
 
 Remove patient's gown by first drawing up gown from under hips, 
 then remove one sleeve and while supporting the patient remove the 
 gown over the head and other arm. 
 
 When patient can not be raised, turn first on one side and remove one 
 sleeve, then bringing the goA\Ti over the head, turn on back and remove 
 it entirely. 
 
 Place second bath blanket under patient by first turning her on one 
 side, then place half of blanket over one side of bed, turn patient back 
 and draw blanket over other side. 
 
 The patient is now between two bath blankets. If recjuired, place hot 
 water bag at feet ; place one face towel on upper border of top blanket 
 and turn well over edge to keep blanket from coming in contact with 
 chin. Remove one pillow and place towel under patient's head. 
 
 To give the bath. 
 
 Bathe face, using wash cloth so that ends will not drip or drag over 
 skin ; wash carefully in corners of eyes, around nose and mouth and 
 under chin. Do not use soap unless requested. Dry thoroughly. 
 Bathe neck and ears. l)eing careful not to fill ears with soapy water, dry 
 thoroughly, especially behind ears. 
 
 Spread bath towel under one arm and over edge of blanket. Use 
 second wash cloth and bathe arms Avith soapy water, using a firm even 
 motion and giving special attention to axilla. While bathing arm. the 
 nurse should support it l)y placing hand under patient's wrist, and 
 never allow it to drop suddenly. After arms are well dried with bath 
 toAvel, place hand towel on l)ed and over this set basin and immerse 
 patient's hand in Avater. After A\-ashing thoroughly, remove basin and 
 dry. Bathe other liand in same manner. Renew Avater in basin, bathe 
 chest next, using fii-ni circular strokes. A])douien is then bathed, work- 
 ing under ])lanket in oi'der not to expose })atient. 
 
 3— 20.131 
 
18 CALIFORNIA STATE BOARD OP HEALTH. 
 
 Patient is then turned on side, bath towel placed over lower blanket 
 and brought close to back, back is bathed, using firm circular strokes, 
 dry thoroughly, finishing with long strokes down spine. Renew water 
 in basin. Expose one thigh, place bath towel over blanket, bathe from 
 hip to knee and dry. Expose lower leg and bathe from knee to ankle. 
 Bathe other leg in same manner, covering patient with blanket after 
 finishing each. Have patient flex knees, place bath towel on bed, over 
 this set basin (not too full) and place one foot at a time in basin, bathe 
 carefully and allow it to remain for a few minutes in the water. Renew 
 water. 
 
 In giving a bath to a female patient, the genitals are then bathed, if 
 a male patient, this is done by the orderly, or by the patient himself. 
 In the latter instance the nurse places wash cloth and towel conveniently 
 near and leaves the room until the patient summons her by ringing 
 the bell. 
 
 A general alcohol rub may be given at this point, or it can be given 
 after each part has been bathed. Talcum powder may also be used if 
 desired. 
 
 The night gown is then put on by 'putting first one arm, then the 
 other, into the sleeves and slipping it over the head, shoulders and under 
 hips. Turn patient on side to remove lower bath blanket and change 
 sheet and draw sheet. This is done by pushing up soiled lower sheet 
 and clean sheet close to patient 's back, put on clean lower sheet on half 
 of bed, turn corners and tuck in firmly. Put on draw sheet on half of 
 bed, folding the remainder of both sheets in flat folds close to patient's 
 back with edge towards opposite side. Go to other side of bed and turn 
 patient over, draw out soiled sheets, take edge of lower sheet and draw 
 over, pulling securely, tuck in corners in usual manner. Straighten 
 rubber and rubber protector ; take edge of clean draw sheet, pull and 
 tuck securely in place. Patient is then turned on back, upper sheet put 
 on and upper bath blanket removed. Blankets and spread are put on 
 as in making the ordinary bed. Pillow slips are changed. In doing 
 this the pillow should never be placed on the bed but put on a chair or 
 table ; patient is raised and supported and pillows adjusted comfortably 
 under shoulders and head. 
 
 The care of the mouth, hair and finger nails is part of the bath routine. 
 To clean the nails, a hand towel is placed over the spread under the 
 hands, file and orangewood stick laid on it. If patient is well enough 
 she may prefer to do this for herself. 
 
 To clean the mouth, place hand towel under chin and have patient 
 brush the teeth, or if unable to do so, nurse must clean carefully with 
 a7)plicator, or gauze over finger. Have patient rinse mouth with mouth 
 wash, adjust curved basin under chin for expectoration. 
 
 To arrange the hair, a hand towel is laid over the pillow, the patient's 
 head turned to one side and the hair divided into two parts, brush care- 
 fully and somewhat slowly, combing must be done gently, the hair being 
 held in the hand to prevent pulling. After tangles are removed, the 
 hair is braided near the ears and the ends of the braid tied. In doing 
 the hair the nurse stands on either side of the bed; she should never 
 work across the patient. 
 
 In male patients the hair must be carefulh^ brushed with special 
 attention to the back of the head. 
 
ELEMEXTAUY XURSIXG PROCEDURES. 
 
 19 
 
 Articles prepared for giving the bath. 
 
20 
 
 CALIFORNIA STATE BOARD OF HEALTH. 
 
 Patient prepared for bed bath. 
 
 Bathing the face. 
 
ELEMEXTATtY NTRSIXG PROCEDURES. 
 
 21 
 
 Bathing the arm. 
 
 Bathing the hand. 
 
22 
 
 CALIFORNIA STATE BOARD OF HEALTH. 
 
 Bathing the leg. 
 
 "W 
 
 Bathing the foot. 
 
KLEMENTAKY NURSING rilOCEDURES. 
 
 23 
 
 Putting on the gown. 
 
 Changing the lower bedding. 
 
24 
 
 CALIFORNLV STATE BOARD OF HEALTH. 
 
 The nurse assisting the patient in brushing the teeth. 
 
 The nurse brushes the hair carefully. 
 
ELEMENTARY NUKSING PllOCEDURES. 25 
 
 Attention to finger nails. 
 
 SEVENTH DEMONSTRATION. 
 PREPARATION OF PATIENT FOR THE NIGHT. 
 Articles required. 
 
 1. Basin with -warm water. 
 
 2. Hand towel and wash cloth. 
 
 3. Curved basin, tooth brn.sh, tooth paste or mouth wash. 
 
 4. Comb and brush. 
 
 5. Alcohol (50%), and talcum powder. 
 
 6. Small whisk broom. 
 
 Procedure. 
 
 Place hand towel under chin, wash face and dry. Spread hand towel 
 over spread, set basin conveniently on either side, immerse hand, wash 
 with soap and water, allowing each hand to remain a fe^v minutes in the 
 water. Place hand towel under chin and have patient cleanse mouth as 
 in Sixth Demonstration. Rearrange hair if necessary. 
 
 Have patient use bed pan or urinal. If female, wash genitals and 
 douche externally, dry with cotton or gauze. Turn patient on side, 
 brush out crumbs, using small whisk broom (kept for this purpose). 
 Loosen draw sheet from side of mattress, also rubber sheet and lower 
 sheet, pull firmly and retuck under mattress snugly. 
 
 Rub back and over hips, using firm circular strokes, finishing with 
 long strokes down spine. Turn patient ; go to opposite side of bed and 
 proceed as before, pull nightgown down in place. 
 
 Turn spread and blankets over foot of bed, straighten top sheet, turn 
 back each blanket separately over patient ; turn spread over upper edge 
 of blanket, turn back upper sheet. Remove i)illo\vs. sliake and adjust 
 comfortablv. See that bell is within reach. 
 4— 20.-)3i 
 
2f; CALIFORNIA STATE BOARD OF HEALTH. 
 
 INSTRUCTOR'S NOTES. 
 
KI.KMKXTAIJY Mi;s|\(! I'ltOCKDr ItKS. 27 
 
 EIGHTH DEMONSTRATION. 
 
 TAKING THE TEMPERATURE. 
 Articles required. 
 
 1. Clinical thci inoiuctcr fov iiivtni('t(»i' and out' for each nienihor of 
 
 the ehiss. 
 
 2. One rei-tal thcnnoiuetei". 
 
 3. Gla.ss holding' solution (TO^f alcohol) and cotton. 
 
 4. Small dish holding squares of gauze or cotton pledgets. 
 
 5. Small jar of vaseline. 
 
 6. One liand towel. 
 
 Procedure. By mouth. 
 
 Remove thermometer from solution, wipe, .shake down mei'cury to 
 95 degrees by holding end of thermometer firmly between tirst and 
 second fingers and thumb — giving a sharp wrist movement. Place in a 
 slanting position under side of tongue and have patient close mouth. If 
 the lips are dry they should be moistened before the thermometer is 
 introduced. The patient, if out of bed. should not be standing. A hot 
 or cold drink should not be given for several minutes before the ther- 
 mometer is placed in the mouth. The thermometer should be held for 
 at least three minutes. Remove, wipe, and return to the solution. The 
 temperature should be recorded at once. 
 
 By axilla. 
 
 Wipe axilla with towel to remove any moisture, shake mercury down, 
 place bulb well in hollow of axilla, bring arm across chest and' hold in 
 position for five minutes. Remove, read and record at once. 
 
 By rectum. 
 
 I'se special rectal thermometer, have patient turned on one side with 
 knees flexed. Shake down mercury, lubricate with vaseline and insert 
 gently in rectum about one inch ; allow it to remain for three minutes. 
 Remove, wipe, read and record at once. 
 
 Note. — Variations in temperature and reasons for same are taught by instructor. 
 
 The thermometer tray. 
 
28 
 
 CALIFORNIA STATE BOARD OF HEALTH. 
 
 Placing the thermometer under the tongue. Holding the thermometer. 
 
 The thermometer in the axilla. 
 
ELEMENTARY ^•I'T?^;T^•(; I'HOCEDrRES. 29 
 
 NINTH DEMONSTRATION. 
 PULSE AND RESPIRATION. 
 Articles required. 
 
 The iustruetor and each member of tlie class must liave a watch with 
 second hand. 
 
 ]\rembers of the class act as subjects in turn. 
 
 Procedure. To count the pulse at the wrist. 
 
 Subject to be lying- down or sitting, arm at rest. The student places 
 the two first fingers on inside surface of the wrist, one inch below the 
 root of the thumb and in the depression made by the radius and flexor 
 tendons, the pulsation of the artery will be easily felt, the number of 
 beats are counted for one minute and recorded immediately. 
 
 To count the pulse at the temple. 
 
 The first two fingers are placed over the temporal artery immediately 
 in front of the ear and the pulsation counted for one minute. 
 
 XoTE. — Characteristics of, and variations in, pulse are tauglit by tlie instructor. 
 Counting the respiration. 
 
 This is done immediately after the pulse is counted and while the 
 hand is still on the wrist. The patient should not be aware it is being 
 done. The number of respirations should be counted for one minute. 
 
 Note. — Characteristics of and variations in respiration are taught by the instructor. 
 
 TENTH DEMONSTRATION. 
 
 CHARTING. 
 
 Articles required. 
 
 1. Chart forms. 
 
 2. Fine pen points, holders, black and red ink. and a six-inch ritle for 
 
 each member of the class. 
 
 Procedure. 
 
 All lettering must be done in neat legible type. Fill out every blank 
 space. Chart temperature, pulse or respiration with small dots uniform 
 in size, the line connecting the dots must be straight and light, there 
 must be no erasures. 
 
30 
 
 CALIFORNIA STATE BOARD OF HEALTH. 
 
 Taking the pulse at the wrist. Note the position of arm. 
 
 Taking the pulse at the temple over temporal artery. 
 
Ei.KMivS'TAitv XF'iisixd )'iiori;i)rni':;s. 
 
 ai 
 
 Taking the pulse in the neck over carotid artery. 
 
82 
 
 CAI.IKOKXIA STATK BOARD OF IIEAI.TII. 
 
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34 
 
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 Facsimile of bedside record made by a student in a training school in California. 
 
ELEMENTAliY NrUSTNG PROCEDURES. 35 
 
 INSTRUCTOR'S NOTES. 
 
36 CALIFORNIA STATE BOARD OF HEALTH. 
 
 INSTRUCTOR'S NOTES. 
 
i:i.i-:.Mi:x'i"Ai!Y xrifsixd i'iio(i:i)ri;i:s. 37 
 
 ELEVENTH DEMONSTRATION. 
 
 GIVING AN ENEMA. 
 Articles required. 
 
 1. Bed prepari'd fci- ociiipanc}-. 
 
 2. Hospital doll. 
 
 3. Rubber sheet 20 by 80 inches. 
 •1. Sheet or small blanket. 
 
 5. Bath towel. 
 
 6. Irrigating can and stand. 
 
 7. Hard rubber rectal nozzle and soft rubber rectal tube. 
 
 8. Bed pan and cover. 
 
 9. Vaseline, bath thcnnomcter. toilet paper, paper bags. 
 
 10. Pitcher or glass graduate holding two quarts (2.000 e.c.) of .soap 
 
 solution — temperature 100 degrees Fahrenheit. 
 
 11. Small pitcher or graduate to hold warm cleansing fluid. 
 
 Procedure. 
 
 Rubber sheet covered with bath towel is placed under hips; patient 
 turned on left side, hips to edge of bed. knees flexed, right knee brought 
 up more than left. Draw up night gown over hips. Cover shoulders, 
 hips and legs with sheet or small blanket. Turn down bed clothes over 
 feet. 
 
 Soap solution is poured into irrigating can and hung about two feet 
 above buttocks. Nozzle or rectal tube is adjusted and solution allowed 
 to flow into bed pan to expel air and warm tube. A small but sufficient 
 amount of vaseline is spread over tip. Lift edge of sheet or blanket 
 with one hand, and with the other insert point gently and in a .slightly 
 upward and forward direction; allow solution to run. If there is com- 
 plaint of pain, clamp tube for a few minutes. When fluid is exhausted, 
 or as much as patient can take has been given, clamp tube, withdraw, 
 wrap in toilet paper and drop into paper bag. Place patient on back, 
 adjust bed pan by flrst placing hand over sacral region and raising 
 slightly. When removing soiled bed pan, have a clean and warmed bed, 
 or douche pan ready to slip under hips. Take soiled pan, covered, from 
 room. Cleanse and irrigate vulva and aniLs thoroughly, remove pan 
 and dry, remove rubber sheet and towel. In cases where patient can not 
 be turned on one side, enema may be given in dorsal position. 
 
 Note. — ^Various formulae, their purpose and effect will be taught by instructor. 
 
38 CALIFORNIA STATE BOARD OF HEALTH. 
 
 TWELFTH DEMONSTRATION. 
 GIVING VAGINAL DOUCHE. 
 
 Articles required. 
 
 1. Bed prepared for oeciipaney. 
 
 2. Hospital doll. 
 
 3. Douche can and tu])ing (sterilized). 
 
 4. Glass douche point (sterilized). 
 
 5. Bath thermometer (sterilized in carbolic or lysol solution 10 per 
 
 cent— 1-10). 
 
 6. Solution — two quarts (2,000 c.c), temperature 105 degrees to 110 
 
 degrees, in sterilized pitcher or glass graduate. 
 
 7. Jar of cotton pledgets or gauze, paper bag. 
 
 8. Bath towel, sheet and chest blanket. 
 
 9. Warmed douche pan, folded towel on back of pan where hips rest. 
 10. Hot water, soap and solution for nurse's hands. 
 
 Procedure. 
 
 Place bath towel under hips, draw night gown well up under back, 
 cover patient with sheet and chest blanket. Place sheet crosswise and 
 use a reverse fold, or twist, in center and fold around each leg, small 
 blanket over chest, if desired. Turn down upper bedding to cover feet, 
 adjust douche pan comfortably. Pour solution into can and hang about 
 twenty inches above bed. Scrub hands thoroughly with hot water and 
 soap, using running water if possible, riiLse well and soak for one minute 
 in lysol 1 per cent or alcohol 70 per cent. Adjust point to tube and 
 allow solution to run until air is expelled and tube is warm. Douche 
 over vulva, separate labia, douche vaginal outlet, not allowing nozzle to 
 touch patient. Insert douche point in vagina downward and backward 
 and while solution is flowing, turn point gently round and round in 
 order that every part of the cavity may be cleansed. Kemove tube 
 before solution is completely exhausted ; leave patient on pan for a few 
 minutes, dry w^ell around vulva with cotton or gauze. Remove pan, 
 dry back. 
 
 Note. — Medicated douches and precautions in administering same are taught by 
 instructor. 
 
i:i,i:.Mi:\'iAi;v xi'itsixc! iMtociiDiKKS. 39 
 
 THIRTEENTH DEMONSTRATION. 
 CATHETERIZATION. 
 Articles required. 
 
 1. Bed prepared for oc-cnpancy. 
 
 2. Hospital doll. 
 
 3. Tray covered with towel on which are the following: one dressing 
 
 towel, bowl for warm .solution of boric acid (2%), ba.sin to 
 receive urine, package containing at least 12 sterile pledgets, 
 paper bag. Two glass catheters and one soft rubber catheter 
 basin for boiling catheters. 
 
 4. Basin containing solution for nurse 's hands. 
 
 5. One large sheet and a small chest blanket. 
 
 6. Douche pan. 
 
 Procedure. 
 
 Place catheters in basin, cover well with water and boil for ten 
 minutes. Pledgets may be boiled at same time. 
 
 Preparation of patient. 
 
 Place patient on back, knees flexed, night gown drawn up. Cover 
 with sheet and chest blanket, turn down upper bedding over feet. 
 Drape sheet by giving a reverse fold in center and folding ends around 
 each leg. Place patient on douche pan, cleanse vulva with warm water 
 and soap. Remove douche pan. Take one towel and place one end 
 slightly under hips, on this place basin to receive urine, turn up other 
 end of towel over basin and vulva. Remove catheter basin from stove 
 and place on tray. 
 
 Nurse's hands. 
 
 Scrub hands thoroughly with soap and water, cleanse around nails, 
 scrub again and rinse in hot running water, then immense for one 
 minute in lysol 1 per cent, or alcohol 70 per cent. 
 
 Lower towel covering vulva by a motion of the elbow, or it may be 
 done by the patient when catheterizing without assistance. 
 
 Sponge vulva in a downward direction with pledget saturated in boric 
 solution. Separate labia with first two fingers of left hand and hold in 
 this position until catheter is passed. Take fresh pledget and cleanse 
 meatus with gentle downward movement, using at least four pledgets. 
 Place a small pledget at entrance to vagina. Pick up one of the glass 
 catheters at open end; examine point closely to ascertain if there is a 
 crack ; see that point does not touch anything before it is inserted. 
 Insert carefully in urethra for about three inches, or until urine starts to 
 flow; change direction of catheter if urine does not flow. 
 
 After urine has ceased, remove catheter, placing one finger on open 
 end and put in paper bag, sponge vulva, remove basin of urine, arrange 
 patient comfortably. Measure and record amount of urine at once. If 
 for bacteriological examination, basin and receptacle must be .sterile. 
 
 Note. — Characteristics of normal and abnormal urine will be taught by instructor. 
 
40 
 
 CALIFORNIA 8TATE BOARD OF HEALTH. 
 
 Articles prepared for catheterization. 
 
 FOURTEENTH DEMONSTRATION. 
 HYPODERMIC INJECTION. 
 
 Articles required. 
 1. Tray holding 
 
 (a) Alcohol lamp. 
 
 (&) Small bottle of alcohol. 
 
 ( c ) Hypodermic syringe and needles. 
 
 (d) Jar of sterile pledgets. 
 
 (e) Mimin glass of water, or bottle of distilled water. 
 (/) Spoon for holding needle. 
 
 (g) Small dressing forceps. 
 
 (h) Small glass dish for drng. 
 
 (?") Small box of matches and bowl for waste. 
 
 Procedure. 
 
 First test syringe to see that there is no leakage. Order is then read 
 and tablet is placed in glass dish. Barrel of syringe may be cleansed by 
 drawing np alcohol and rejecting it into waste bowl or by boiling. 
 Needle is then boiled in a spoonful of water and removed with forceps. 
 Draw up hypodermic full of boiled or distilled water and expel into 
 sterile teaspoon. Add tablet, when dissolved fill hypodermic ; screw on 
 needle securely, expel air and allow one or two drops to flow from point 
 of needle. A pledget moistened with alcohol surrounds the needle which 
 is then carried to the bedside; a second pledget moistened with alcohol is 
 also taken. 
 
 Select location for injection on upper and outer portion of arm or 
 tliigb. Cleanse skin by ru})])ing vigorously with pledget. Pincli up a 
 good fold of skin and tissue, insert needle quickly and remove slightly, 
 allowing thumb to press on piston of syringe, inject fluid slowly at the 
 same time slightly withdraw needle ; make pressure Avith pledget and 
 slight upward strokes over seat of injection. 
 
 Note. — Instruftion in giving imperial and deep injections is taiiglit by instructor. 
 
i:i.i;mi:ni'akv Mi!si\(i i-itocEUURES. 
 
 41 
 
 Hypodermic tray. 
 
 Boiling the Needle. 
 
42 
 
 CALIFORNIA STATE BOARD OF HEALTH. 
 
 Filling the syringe. 
 
 Expelling the air. 
 
ELEMENTAKY XURSIXG riiOCKUrUKS. 
 
 ■13 
 
 Carrying the syringe to the bedside. 
 
 Inserting the needle. 
 
44 CALIFORNIA STATE BOARD OF HEALTH. 
 
 Injecting the fluid. 
 
 Slight pressure at point of injection. 
 
ELEMENTARY NURSING I'ltOC 10 DUKES. 45 
 
 INSTRUCTOR'S NOTES. 
 
46 CzVLIFORNIA STATE BOARD OF HEALTH. 
 
 INSTRUCTOR'S NOTES. 
 
I'li.KMKX'i' \m' Mi;siN(; i'i;()(i:i)ri;i:s. 
 
 47 
 
 FIFTEENTH DEMONSTRATION. 
 
 HYPODERMOCLYSIS. 
 Articles required. 
 
 1. Bed prepared for oceupaney. 
 
 2. Hospital doll. 
 
 3. Larj^e tray eontaininji;- 
 
 (a) Sterilized ( ontainer or .solution bottle. 
 
 (6) Special needles with rubber tubing attached (may be dry 
 
 Erratum 
 
 (c) Should read "salt .solution 0.1 ^/(" and not "7 per cent." 
 
 (e) Bottle of tincture of iodine 5 per cent and swabs for apply- 
 ing same. 
 
 (/) Glass thermometer (sterilized in lysol or alcohol), paper 
 bag. two dressing towels. 
 
 (g) Collodion or a roll of adhesive. 
 
 Procedure. 
 
 Subject prepared by exposing both breasts, surrounding with dressing 
 towels, paint lower portion of breast heavily with iodine. 
 
 Salt solution at temperature ordered is put into container and hung 
 above patient at height ordered, tubing adjusted ; fluid is allowed to flow 
 through tube until tube is warmed. Needle is then inserted b3^.,doctor 
 and fluid absorbed slowly. After needle is withdrawn, the puncture 
 may be covered with a sterile -sciuare of gauze held in place by a strip of 
 adhesive or sealed with collodion. 
 
 Note. — Methods of maintaining; temnerature of fluid are tauglit bv instructor. 
 
 Articles prepared for hypodermoclysis. 
 
48 CALIFORNIA STATE BOARD OF HEALTH. 
 
 SIXTEENTH DEMONSTRATION. 
 
 PROCTOCLYSIS. 
 
 Articles required. 
 
 1. Bed prepared for occupancy. 
 
 2. Hospital doll. 
 
 3. Rubl)er sheet 20 by 30 inches. 
 ■i. Bath towel, dressing towel. 
 
 5. Irrjo-ating can and stand. 
 
 6. Special nozzle or rubber catheter No. 12 E. 
 
 7. Bath thermometer. 
 
 8. Salt solution 0.6 per cent or one and one-half teaspoons (90 
 
 grains) to one quart of water. Temperature 100 degrees to 
 110 degrees Fahrenheit. 
 
 9. Pitcher or glass graduate containing solution. 
 10. Vaseline. 
 
 Procedure. 
 
 Rubber sheet covered with bath towel is placed under hips of patient, 
 fluid poured into can which is covered with towel and hung not more 
 than 6 to 8 inches above level of bed. Rate of How is controlled by 
 gravity. Allow fluid to run through tube until tube is warm ; spread a 
 small amount of vaseline over nozzle and insert carefully. If catheter 
 is used it may be held in place with a strip of adhesive over top and 
 fastened to thigh. 
 
 XOTE. — Methods of maintaining temperature of fluid is taught by instructor. 
 
 Special proctoclysis tube. 
 
i:i.i:Mi:\'rAi!Y \ri;siv(! iMtocKDritKs. 
 
 49 
 
 SEVENTEENTH DEMONSTRATION. 
 BATH TO REDUCE TEMPERATURE (COLD SPONGE). 
 Articles required. 
 
 1. Bed prepared for occupancy. 
 
 2. Subject (nunse or patient). 
 8. Long rubber sheet. 
 
 •4. Two bath blankets or bath sheets. 
 
 5. Two bath towels, one face towel. 
 
 6. Large basin or foot tub, and bath tlKn-iuoiuctci-. 
 
 7. Pitcher of cold water. 
 
 8. Two large Turkish wash cloths, or several thicknesses of gauze. 
 
 9. Hot water bag, ice cap, basin of crushed ice, or compress for head. 
 
 Procedure, 
 
 Place bath blanket or sheet over patient and turn down upper bedding 
 to foot of bed. Place rubber sheet covered with second bath blanket or 
 sheet under patient. Remove night gown, place hot water bag at feet, 
 ice cap, or compresses, on head. Cover upper edge of blanket, if 
 used, with hand towel to keep blanket from contact with patient s mouth 
 and chin. Temperature of water should be as ordered, or 60 degrees 
 to 70 degrees Fahrenheit, and maintained throughout the bath by 
 adding ice. 
 
 Begin by bathing the face and neck. Expose the arm and place bath 
 towel lengthwise under it. Wringing wash cloth slightly, hold arm at 
 comfortable angle and rub hand and arm with rapid to and fro friction 
 movements, changing wash cloth frequently. Bathe other arm in same 
 manner, then che.st, abdomen, thighs, legs and back. Each part should 
 be gone over several times, the entire procedure occupying about twenty 
 minutes. When finished, if necessary, dry patient thoroughly before 
 removing blankets or sheets and putting on night gown. 
 
 Commencing the cold sponge. 
 
50 CALIFORNIA STATE BOARD OF HEALTH. 
 
 EIGHTEENTH DEMONSTRATION. 
 A HOT BLANKET PACK (WET). 
 Articles required. 
 
 1. Bed prepared for oeenpaney. 
 
 2. Subject (niir.se or patient). 
 
 3. Five thick light, single blankets. 
 
 4. One hot water bag. 
 
 5. Basin of ice water, two gauze compresses (1^ yards gauze folded 
 
 four times) for head and neck. 
 
 6. One bath towel, one hand towel. 
 
 7. Drinking glass, drinking tube and pitcher of hot water. 
 
 8. Pail or foot tub filled with boiling water. 
 
 Procedure. 
 
 Cover patient with bath blanket, turn down upper bedding to foot of 
 bed. Place two single blankets, each one a little more to one side of bed, 
 or opposite side, under patient. Kemove night go\^Ti ; fold two bath 
 blankets lengthwise, then in two. The process of wringing out the 
 blankets will require two nurses, or where a wringer is available, this can 
 be done by one nurse. Holding ends of blankets, immerse in boiling 
 water and wring by twi.sting in opposite directions until nearly dry. 
 Place one blanket under patient as quickly as possible and as soon as 
 temperature permits, fold over arms and legs so that surface between 
 arms and body and between thighs will not come in contact. Cover 
 patient with second wet blanket, then cover with dry blanket, turn up 
 blanket at side of bed, tucking over on each side securely and around 
 neck. Protect chin from hot blankets by hand towel. Place hot water 
 bag at feet, wring compresses from ice water nearly dry and envelop 
 head, side of face and neck. 
 
 Cover patient with upper bedding or with one thick, light blanket. 
 Give hot drink. Take pulse at temporal artery. Change cold com- 
 presses frequently, as they get Avarm, and give plenty of fluid to drink. 
 Patient to remain in pack from twenty to thirty minutes, or until per- 
 spiration is induced, if pack be borne well, or until heating effect has 
 ceased. 
 
 To take out of pack, turn down upper bedding, slip hands under 
 upper dry blanket and remove upper wet blanket. Turn down the 
 lower Ijlankets Avhich were folded over on one side, remove lower wet 
 blanket, dry with bath towel, remove lower dry blanket, rub chest, arms 
 and legs vigorously, put on night gown. 
 
 Note. — Methods of giving this treatment to unconscious, paralyzed, or elderly 
 patients, noting precautions to be used to avoid burning, will be taught by Instructor. 
 
ELEMENTARY NITESTNG T'ROOEDTTRES. 51 
 
 NINETEENTH DEMONSTRATION. 
 A HOT BLANKET PACK (DRY). 
 Articles required. 
 
 1. Bed prepared for occupancy. 
 
 2. Subject (nurse or patient). 
 
 3. Four single, thick, light blankets (warmed). 
 
 4. Five hot water bags or bottles. 
 
 5. Basin of ice water with gauze compresses (1^ yards folded four 
 
 times). 
 
 6. One bath towel, one hand towel. 
 
 7. Drinking gla.ss, drinking tube, pitcher of hot water or lemonade. 
 
 Procedure. 
 
 Cover patient with bath blanket, turn down upper bedding to foot of 
 bed ; place two bath blankets under patient, same as in wet pack. Bring 
 up each lower blanket, fold over and under each arm and leg, so that 
 surfaces of body will not come in contact. Place two hot water bags on 
 each side and one at feet ; cover patient with two remaining blankets and 
 tuck in securely on sides and around neck. Protect chin with soft hand 
 towel. Place compresses on head, as in wet pack, and change fre- 
 quently. Give plenty of fluid to drink. If pack be well borne, allow 
 patient to remain twenty to thirty minutes or until perspiration is 
 induced. 
 
 Remove from pack by taking away hot bottles first and blankets next 
 to skin, rubbing dry with bath towel as in hot pack. 
 
52 
 
 CALIFORNIA STATE BOARD OP HEALTH. 
 
 Hot dry pack; hot water bottles in place. 
 
 Hot dry pack; patient enveloped in blankets. 
 
KI,HMi:\''l"Ain' \ri!SIN(! riJOf'HDURES. 53 
 
 TWENTIETH DEMONSTRATION. 
 PREPARATION OF PATIENT FOR SURGICAL DRESSING, VAGINAL 
 
 EXAMINATION, RECTAL EXAMINATION, CHEST EXAMINATION. 
 Articles required. 
 
 Siiroicjil dressini;' — nhdomiiicil. 
 
 1. Bed prepared for oeeiipaiicy. 
 
 2. Subject (hospital doll). 
 
 3. Four dressing towels. 
 
 Patient's head on one or not more than two pillows; upper bedding 
 turned down to thighs and night gown rolled well up under arms. One 
 towel turned over top of upped bed clothes, one over night gown, and 
 one on each side. If gall bladder dressing, one towel or pad should be 
 placed under right side. 
 
 VAGINAL EXAMINATION. 
 Articles required. 
 
 1. Bed prepared for occupancy. 
 
 2. Subject (hospital doll). 
 
 3. Large sheet. 
 
 4. Long or obstetrical stockings. 
 
 5. Tray containing 
 
 (a) Jar or tube of sterile vaseline. 
 
 (6) Speculum, tenaculum forceps, long uterine dressing forceps 
 
 (sterilized). 
 (c) Jar of cotton pledgets. 
 (cZ) Two dressing towels, paper bag. 
 
 6. Hot water, soap, brush, sterile rubber gloves for doctor. 
 
 Procedure. 
 
 Have patient urinate and, if necessary, give an enema. Wash vulva 
 with soap and water. Turn down upper bedding, place subject across 
 bed, hips well to edge, feet resting on two cliaire, head on one pillow. 
 Put on stockings, drape sheet by giving a reverse twist in middle, place 
 one end of dressiiig towel under buttocks and turn other end up, cover- 
 ing vulva until doctor is ready. Place tray of instruments where doctor 
 can reach easily. Nurse stands on one side of patient and holds legs 
 in position, flexed on abdomen, during the examination. After exam- 
 ination, if necessary, bathe vulva, place patient in bed comfortably. 
 
 RECTAL EXAMINATION. 
 Articles required. 
 
 1. Bed prepared for occupancy. 
 
 2. Subject (hospital doll). 
 
 3. Large sheet. 
 
 4. Long or obstetrical stockings. 
 
 5. Vaseline. 
 
 6. Hot water, soap, bru.sh, sterile gloves for doctor. 
 
54 CALIFORNIA STATE BOARD OF HEALTH. 
 
 Procedure. 
 
 If exaniiiuition is to be made with patient in dorsal position, place 
 in same position as for vaginal examination, if on side, turn patient on 
 left side, draw hips to edge of bed, tiex knees, turn down upper bedding 
 to foot of bed. Cover with sheet, draw up night gown well above hips 
 and place dressing towel under buttocks. 
 
 CHEST EXAMINATION IN BED. 
 Articles required. 
 
 1. Bed prepared. 
 
 2. Subject (nurse, patient or hospital doll). 
 
 3. Large square of thin fine muslin, steel tape line (centimeter), 
 
 large soft pencil. 
 ■4. Square of flannel (1 yard). 
 
 Procedure. 
 
 If female patient, remove hair ribbons, pin hair neatly and closely to 
 head, or pin towel around head. Remove patient's gown, turn down 
 upper bedding to waist line, place flannel across chest until doctor is 
 ready. Nurse stands on opposite side of bed and assists doctor raise 
 and support patient when back is examined. An auscultating towel is 
 used when doctor places' his ear on chest wall. Dry well under arms 
 or elsewhere, if patient perspires. 
 
 CHEST EXAMINATION OUT OF BED. 
 
 Remove all clothing to waist and pin up hair neatly if female patient. 
 Have patient sit on a stool if possible. Tuck sheet or two hand towels 
 around clothing at waist. Cover patient's shoulders w^th flannel 
 square, or sheet. Nurse to stand near patient to assist doctor and sup- 
 port patient if necessary. 
 
ELEMENTARY NURSING I'ROCEDURES. 
 
 55 
 
 Articles prepared for surgical dressing. 
 
 Patient prepared for dressing. 
 
56 
 
 CALIFORNIA STATE BOARD OP HEALTH. 
 
 Patient prepared for vaginal examination. 
 
 TWENTY-FIRST DEMONSTRATION. 
 
 FOMENTATIONS AND STUPES. 
 Articles required. 
 
 1. Bed prepared for occupancy. 
 
 2. Subject (hospital doll). 
 
 3. Four flannel fomentation cloths sufficiently large to more than 
 
 cover part to be treated. 
 
 4. Fomentation cover, of light woolen material, sufficiently large to 
 
 more than cover fomentation cloth. 
 
 5. Basin of boiling water. 
 
 6. Stupe wringer, bath towel, soft hand towel, small rubber sheet. 
 
 7. Basin or tray to carry stupes to bedside. 
 
 Procedure. 
 
 Protect bed under part to be treated, with rubber sheet, covered with 
 bath towel. Expose area, take one, or if needed for greater heat, two, 
 fomentation cloths put in stupe wringer, immerse in basin for one 
 minute. Wring by twisting .sticks in opposite directions until water is 
 well wrung out. Carry to bedside, in basin or on tray covered with 
 stupe cover. Shake stupes lightly and apply slowly, as patient can 
 bear the heat. If unbearable apply over a dry hand towel. Cover with 
 stupe cover. Draw up bedding in place. Renew at least everj^ five 
 minutes until time ordered for treatment has expired. To renew, pre- 
 pare in same way and do not remove first fomentation cloth until ready 
 to put on second. Dry part with hand towel quickly before applying 
 second. Change should be made rapidly to get effect. Degrees of heat 
 may be tested on back of hand. When treatment is finished, dry with 
 soft towel and powder lightl,y. 
 
 Note. — Precautions against burning, especially in cases of paralysis, dropsy or 
 unconsciousness, also in very nervous and sensitive subjects are here emphasized by 
 the instructor. 
 
ELEMENTATvY NURSING PROCEDURES. 
 
 57 
 
 Articles prepared for application of stupe. 
 
 Wringing stupe. 
 
58 
 
 CALIFORNLV STATE BOARD OP HEALTH. 
 
 TWENTY-SECOND DEMONSTRATION. 
 APPLICATION OF COLD COMPRESSES TO THROAT. 
 Articles required. 
 
 1. Subject (nurse or patient). 
 
 2. Basin of ice water. 
 
 3. Compress cloths of gauze, four to six thicknesses, fourteen inches 
 
 long. 
 
 4. Piece of tlannel or flannelette 16 inches long, 6 inches wide. 
 
 5. Gauze bandage three inches wide, small safety pins. 
 
 Procedure. 
 
 Wring compress cloth from ice water nearly dry, apply to throat and 
 neck, cover with flannel and pin securely in place with three small 
 safety pins. Measure a length of bandage from ear to ear, across top 
 of head. Split each end about two inches and fasten with safety pins 
 to upper edge of flannel on each side of ear. This will hold compress 
 in place and prevent sagging. This should be renewed frecpiently if 
 cold is to be maintained but it can usually be kept on all night. 
 
 APPLICATION OF COLD COMPRESS TO EYE. 
 Articles required. 
 
 1. Absorbent cotton and gauze. 
 
 2. Basin containing a good sized piece of ice suspended in gauze or 
 
 a towel. 
 
 Procedure. 
 
 Compresses made of the absorbent cotton or gauze (two thicknesses) 
 and cut round or oval. Compress must be very light, moistened and 
 placed on ice. These compresses must be renewed every two minutes 
 and continued for length of time ordered by doctor. 
 
 Compress applied to throat. 
 
ELEMENTARY NURSING PROCEDURES. 59 
 
 TWENTY-THIRD DEMONSTRATION. 
 LAVAGE. 
 Articles required. 
 
 1. Stomach tube boiled and in basin of cold water. 
 
 2. Basin to receive stomach contents. 
 
 3. Glycerine in medicine glass to lubricate tube. 
 
 4. Light weight rubber apron. 
 
 5. Two towels. 
 
 6. Foot tub. 
 
 7. Pitcher of solution, boric or soda, for washing out stomach. 
 
 8. Glass of drinking water. 
 
 Procedure. 
 
 If patient is out of bed remove collar and loosen clothing at neck. 
 Tie rubber apron around neck and tuck towel over edge around neck. 
 Patient to sit on chair, foot tub placed at feet to receive washings. 
 
 If patient is in bed, move to edge of bed toward operator, head and 
 shoulders propped up with pillows ; place towel over pillows, tie rubber 
 apron around neck, tuck towel over edge around neck. Make a trough 
 of apron into foot tub beside bed. If foot tub is small, place news- 
 papers on floor under tub to avoid soiling floor or rug. Patient may 
 require a glass of water after lavage. 
 
 If contents are to be saved, see that basin is covered with towel on 
 taking from room or ward to laboratory. 
 
60 
 
 CALIFORNIA STATE BOARD OP HEALTH. 
 
 Articles prepared for lavage. 
 
 Patient prepared for lavage. 
 
ELEMENTAEY KTTRSTN-G TriOCEDURES. 61 
 
 INSTRUCTOR'S NOTES. 
 
62 CALIFORNIA STATE BOARD OP HEALTH. 
 
 INSTRUCTOR'S NOTES. 
 
ELEMENTARY NURSING rUOCEDURKS. 63 
 
 INSTRUCTOR'S NOTES. 
 
64 CALIFORNIA STATE BOARD OF HEALTH. 
 
 INSTRUCTOR'S NOTES. 
 
:i.i:.mi:n'iai;y mi.-sinc iMjocioDrnKS. 65 
 
 INSTRUCTOR'S NOTES. 
 

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