APGAR SCORING
A: Activity/muscle tone
0 points: limp or floppy
1 point: limbs flexed
2 points: active movement
P: Pulse/heart rate
0 points: absent
1 point: less than 100 beats per minute
2 points: greater than 100 beats per minute
G: Grimace (response to stimulation, such as suctioning the baby’s nose)
0 points: absent
1 point: facial movement/grimace with stimulation
2 points: cough or sneeze, cry and withdrawal of foot with stimulation
A: Appearance (color)
0 points: blue, bluish-gray, or pale all over
1 point: body pink but extremities blue
2 points: pink all over
R: Respiration/breathing
0 points: absent
1 point: irregular, weak crying
2 points: good, strong cry
BED MAKING
To make the bed tight and free from wrinkles place all linen straight line on the bed
Prevent complications of prolonged bedridden patients such as pressure sores
Soiled line or linen whether clean or dirty should not be throw on the floor, but it is should be
kept in a dirty linen box
After cleaning the bed, dump sop water, and disinfectant property
Try to prevent cross-infection of microorganisms during bed-making
Ensure all bed-making in a nursing unit alike for uniformity of appearance
COMMON TYES OF BED
1. Simple beds
2. Special beds.
TYPES OF BED-MAKING
SIMPLE BED
1. closed bed
2. open bed
3. occupied bed
SPECIAL BED
1. operational bed
2. cardiac bed
3. Blanket bed
4. amputation bed
5. Fracture bed
1. CLOSED BED
- it is an empty bed in which the top covers are so arranged that all linen beneath the spreads is
fully protected from dust and dirt.
- the top sheet and bedspreads are drawn up to the bed head of the matters and under the
pillow, this is prepared in a hospital room before a new client is admitted to the room.
PURPOSED OF CLOSED BED
1. to provide the patient with a comfortable and safe bed to take rest and sleep.
2. to give the unit or ward a neat appearance.
3. to dive medical and nursing treatment to the patient
4. to prevent bed sores.
5. to promote cleanliness.
6. to provide active and passive movements to the patient
7. to create an effective nurse-patient relationship.
EQUIPMENT
1. two large sheets
2. draw sheet
3. blankets
4. bed spread
5. pillow case
6. rubber mackintosh
7. linen hamper
8. bedside table
9. disposable gloves
PROCEDURE
1. wash hands and wear disposable gloves
2. assemble and arrange equipment on bed side table
3. fold and keep reversible linens such as blanket or bedspread on bedside table
4. bundle all soiled linen in bottom sheet and directly place into the laundry bag
5. place the bottom sheet with its center fold in the center of bed and toward the top to have
sufficient sheet to tuck under the head of mattress.
6. unfold the bottom sheet, spread it over the mattress and tuck in severely with mitered
corner.
7. spread the mackintosh at the center of the bed and tuck it along the side
8. place the draw sheets over mackintosh and tuck it along the side
9. move the opposite side and tuck the sheets.
10. place the blanket over the top sheet about 6 inches below the top of the side
11. if the bed spread is used place, it over the blanket
12. tuck the top sheet, blanket and bed spread under the foot of the bed on the side close to
you and miter the corners
13. fold the upper 6 inches of the top sheet down over the spread and make a cuff
14. move to other side and follow the same procedure for careening top sheets
15.. put the pillow case and place the pillow at the head end.
16. fanfold or pie fold top linens
17. rearrange furniture and place personal items within easy reach
18. adjust the bed to a comfortable height
[Link] of soiled linen and wash hands
2. OPEN BED
- the term open bed is used to designate the =hospital bed when it is about to be occupied by a
client
- the top sheet blankets and bedspreads are drawn up to the head of the mattress and under
the pillow, this is prepared in a hospital room before a new client is admitted to the room.
PURPOSED OF OPEN BED
1. to prevent bed sores
2. to economize time, material and effort
3. to help the relatives to learn to take care of the sick at home
4. to give to the unit or wards a neat appearance
5. to provide comfort and security
6. to provide rest and sleep
7. to establish an effective nurse patient relationship
EQUIPMENT
1. bottom sheet
2. 36 inches mackintosh
3. 36 inches draw sheet
4. top sheet
5. blanket
6. bed spread
7. pillow case
8. duster-2
PROCEDURE
1. wash hands and collect required linen
2. arrange linen on chair in manner in which it is going to be used
3. explain procedure to the patient and relatives
4. screen patient, if necessary and loosen top bedding
5. lift patients head remove extra pillow
6. loosen bottom bedding and remove top sheet by pulling it down from under cover
7. brush off the mackintosh and roll it back loosely over patient
8. roll bottom sheet as far under patients back as possible
9. place the clean sheet on the mattress with length wise fold at center of the bed.
10. adjust sheet and tuck in at the top making a square corner. The tuck in at the side
11. bring back mackintosh lying over the patient
12. place clean draw sheet at the center of the bed
13. pull and tighten bottom sheet and tuck in at top making a square corner
14. pull and tighten mackintosh and draw sheet and tuck in well
15. turn the top of the counter pan and top sheet back over the blanket
16. return to the other side, fold and tuck in top bedding as on the first side
17. change the pillow case and put it under patient’s head and shoulders.
18. discard soiled linen in dirty box
19. make the patient comfortable
20. wash hands
OCCUPIED BED
- this is to make a bed with the client in. this is made for a client who cannot get out of the bed
PURPOSED OF OCCUPIED BED
1. to provide active and passive exercises to the client
2. to promote cleanliness
3. to establish effective nurse client relationship
4. to prevent bed sores
5. to observe the client’s bed sore, oral hygiene, client ability for self-case etc.
6. to economize time, material and effort
7. to provide the clients with safe and comfortable bed to take rest and sleep.
PROCEDURE
1. assemble the equipment and arrange the linen within the e easy reach
2. loosen the bedding on all sides and remove the spread and the blanket leaving the top sheet
over the client
3. fanfold the draw sheet to the clients and push it as close to the client as possible
4. dust the mattress with a dry duster. Then by raising the mattress, clean the cot with a damp
duster.
5. place the clean bottom sheet over the mattress making sure that the middle fold is in the
middle of the bed
6. bringing the mackintosh back into the place and truck it tightly under the mattress
7. turn the client back over the folded linen and then toward you. Go to the opposite side of the
bed.
8. remove the soiled linen and put them in the laundry bag
9. turn the client back to the middle of the bed. Place a clean top sheet over the client and
remove the soiled top sheet
10. replace the blanket and spread over the top sheet and make the bed as ibn an open bed.
11. tuck the foot end giving enough freedom for movement
12. place a foot board or cradle at the foot of the bed
13. put the clean pillow cases and place the pillow on position and leave the client comfortable.
PURPOSED OF OPERATION BED
1. To receive the patient in a warm, and comfortable bed.
2. to give him necessary position, which is suitable for the operation
3. to protect the patient from being chilled
4. to be prepared to meet any emergency
5. to protect the mattress and bedding from bleeding, vomiting, drainage or discharges.
EQUIPMET
1. gauze, piece, narrow mackintosh and narrow sheet.
2. artery forceps
3. mouth gag, air way
4. TPR Tray B.P apparatus
5. Bed Block-2
6. hot water bags with cover
7. I.V stands
8. Kidney tray and paper tray’
9. suction apparatus and oxygen cylinder
PROCEDURE
1. prepare the foundation of the bed as simple bed.
2. put narrow mackintosh and narrow sheet at the head end to protect the bed from soiling the
linen by vomitus.,
3. the foot end of the top linen are left untucked.
4. the upper bedding is fan folded to one side, opposite the stretcher
5. post anesthetic tray, bed blocks, I.V stands etc. are kept ready at hand
6. the pillow is used to protect the patient from injury by hitting against the bars at the head end
of the bed.
7. hot water bags are used to keep the bed warm and they are removed before receiving the
patient in the bed.
2. CARDIAC BED
- Cardiac bed prepared for heart cases
PURPOSE
1. to relieve dyspnea caused by cardiac disease
2. to provide comfort with least stain
3. to prevent complication
EQUIPMENT
1. bed sheet
2. 36 inches mackintosh
3. 36 inches draw sheet
4. top sheet
5. blanket
6. bed spread
7. pillow case
8. duster-2
9. cardiac table
10. extra pillows
11. back rest
12. foot rest, air cushion
PROCEDURE
1. prepare the bed as open bed, with foot rest at foot of the bed
2. place back rest at patient back, and arrange pillows in comfortable position
3. keep the patient in bed and cover properly
4. adjust the air cushion in place. Place the knee pillow on it. So that the patient may lean
forward to rest his head and warms on it
6. make the patient comfortable
3. BLANKET BED
-Blanket bed is prepared for a patient with renal diseases or rheumatism
PURPOSES
[Link] promote elimination through the skin
2. to provide absorption of patient’s perspiration
3. to carry the weight of the bed clothes off the painful joints
4. to provide extra warm to the body
EQUIPMENT
1. bed sheet
2. draw sheet
3. top sheet
4. blanket
5. bed spread
6. pillow case
7. duster
8. extra pillow
9. two old wooden blankets.
10. narrow mackintosh and sheet
PROCEDURE
1. the bed is prepared as usual
2. cover the bed with blanket instead the bottom sheet
3. place narrow mackintosh and narrow sheet in the usual manner.
4. place second bath blanket over the patient
5. cradle is used to take off the weight of the top linen off the painful joints
6. sand bags are used to immobilize the painful joints.
4. AMPULATION BED
- Amputation bed is prepared for a patient with amputation of the leg to take off the weight of
the clothes off site of the operation.
PURPOSE
1. To keep the stump in good position
2. to be able to watch the stump for hemorrhage and apply tourniquet instantly if necessary
3. to allow the nurse to do repeated procedures such as bladder irrigation, without exposing the patient
4. To allow the nurse to make frequent observation of the leg without disturbing the patient
EQUIPMENT
1. set of top extra bedding
2. blankets and counter pane
3. bed cradle
4. tourniquet
5. pillow and [plastic cover
6. sand bags and draw sheet
PROCEDURE
1. Prepare the bed as simple bed
2. make bottom half of the bed. Fold sheet crosswise at the center of the bed at bottom tuck in and
make corners. Make upper half of the bed. The other set of the linen stars from the stump but
overlapping the first one and the exercise is tucked under the mattress at the foot.
3. when the patient brought back from the operation theatre, fan fold the two sets of linen one side of
the bed and receive the patient on the bed
4. bed cradle is used to take off the weight of the top linen
5. Cover the patient and keep him warm and comfortable
6. amputation bed is usually used for a amputation of the leg, operation bed is used for a amputation of
the hand
7. the two sections of the linen should overlap each other at least by 8 to 10 inches. So that it can easily
lifted to observe the stump and also to prevent unnecessary exposure of the patient.
5. FRACTURE BED
- Fracture bed is prepared for patient with fracture of the truck and extremities. A hard firm
board is used to give support.
PURPOSE
1. To give firm, even support to the fracture limbs and back
2. to maintain position
3. to immobilize the fractured so that the pain is less
4. to make the patient comfortable
EQUIPMENT
1. Bed sheet
2. draw sheet
3. top sheet
4. blanket
5. bed spread
6. pillow case
7. duster
8. fracture board
9. sand bags with cover
10. bed cradle
11. extra pillows
PROCEDURE
1. place the fracture board directly over the bed springs
2. Place a thin firm mattress or pad over the fracture board
3. The bed is prepared as simple open pad
