BODY MECHANICS
7. Avoid bending for extended
The efficient movement and
balance of the body
Reason for use:
 Best use of muscles
 Makes lifting, pulling, and pushing
easier
 Prevents unnecessary fatigue and
strain
 Saves energy
 Prevents injury
Use proper body mechanics in order to
avoid the following:
 Excessive fatigue
 Muscle strains or tears
 Skeletal injuries
 Injury to the patient
 Injury to assisting staff members
Body Mechanics
1. Maintain a broad base of support
(Maintain a stable center of
gravity)
a. Keep your center of gravity
low
b. Keep your back straight
c. Bend at the knees and
hips; get close to the
person or object
2. Maintain a wide base of support.
This will provide you with
maximum stability while lifting.
a. Keep your feet apart.
b. Place one foot slightly
ahead of the other.
c. Flex your knees to absorb
joints.
d. Turn with your feet.
3. Use the strongest muscles
4. Use your body weight to help
push or pull.
5. Carry heavy objects close to the
body.
6. Avoid twisting of the body.
periods.
8. Get help if the person or object is
too heavy for you to lift.
Techniques of Body mechanics
A. Lifting
a. Use the stonger leg
muscles for lifting
b. Bend at the knees and hips
keep your back straight.
c. Lift straight upward, in one
smooth motion.
B. Reaching
a. Stand directly in front of
and close to the object.
b. Avoid twisting or
stretching
c. Use a stool or ladder for
high objects
d. Maintain a good balance
and a firm base of support.
e. Before moving the object,
be sure that it is not too
large or too heavy.
C. Pivoting
a. Place one foot slightly
ahead of the other.
b. Turn both feet at the same
time pivoting on the heel
of one foot and the toe of
the other.
c. Maintain a good center of
gravity while holding or
carrying the object.
D. Stooping
a. Squat (bending at the hips
and knees)
b. Avoid stooping (bending at
the waist)
c. Use your leg muscles to
return to an upright
position.
Wound Care
Skin Integrity
 Largest Organ System: Integumentary
System
 Largest Organ: Skin
 How do you define SKIN INTEGRITY?
Being Whole or unwounded
 Intact Skin: Normal skin status that
functions well without the interruption
of wounds.
Factors affecting skin integrity
1. Internal factors- Genetic codes and
nutrition
2. External factors:
a. Air: Microbes, Dust, allergens,
fumes
b. Chemical
c. Temperature of fluids
Types of Wounds:
1. Incision – Hiwa
a. Cause: Perfectly sharped
objects
b. First aid: Iodine Povidone
(Betadine) and dressing
2. Laceration – Punit
a. Cause: not perfectly sharp
objects
3. Contusion – Pasa (trauma)
a. Cause: Solid Objects
b. First aid: Cold
Compress/Alcohol (In applying
alcohol inner to outer circular
motion 1 inch)
4. Hematoma – Namuong dugo; patch like
fluid/pocket of blood
a. Cause: chemicals/ hormonal
imbalance/deficiency/nutrition
b. First aid: clean
5. Puncture – Tusok
a. Cause: Long Sharp Objects
b. First Aid: Immobilized; don’t
move!
6. Abrasion – Gasgas
a. Cause: Friction
b. First Aid: Soap and Running
water
7. Avulsion – Wasak
a. Cause: large object, sharp/
shotgun
b. First Aid: Bandage doughnut
(should stop the bleeding)
8. Burn – Sunog
a. Cause: Extreme temperature
b. First Aid: Hot: Cooling tap
running water; loss bandage no
pressure applied
9. Pressure Ulcer – a glimpse; bed sore
a. Irritation of the lining.
Types of Bleeding
1. Capillary Bleeding
a. Bleeding from capillaries oozes.
b. Slow and even flows
c. Bright red color
d. Capillaries are damage, minimal
amount of blood, it can stop
immediately.
2. Venous Bleeding
a. Bleeding from the veins.
b. Steady slow flow
c. Dark red color because blood
passing through the vein is
deoxygenated.
3. Arterial Bleeding
a. Bleeding from the arteries
b. Pulsating flow
c. Spurting blood
d. Bright red in color because
blood passing through the
arteries are oxygenated.
SIGNS OF INFECTION: Pus, Throbbing, Pain,
Sweilling, Fever and Redness
Things needed:
 First Aid:
o Iodine Povidone
o Hydrogen Peroxide (Bubbles
traps microbes)
o Adhesive Bandage
o Triangular Bandage
o Soap
o Water
o Cotton
 Clinical Intervention:
o Micropore
o Cotton
o Gauze Pad
o Bandage scissors
o Forceps
o Normal Saline
 o
Catheterization
Catheterization – is the introduction of the catheter
thru the urethra into the bladder in order to remove
urine.
Purposes:
1. To obtain urine specimen for examination
urine culture.
2. To relieve urinary retention.
3. To ensure emptying of the bladder prior to
delivery and surgery preventing possible
trauma.
4. To prevent bed wetting in an incontinent
patient.
5. To remove urine when it is not advisable for
the patient to void.
6. To determine whether failure to void is due
to urinary retention on urinary suppression.
7. To determine residual urine.
8. To measure hourly urine output.
Points to consider:
1. Before starting the procedure, check the
catheter’s expiration date and defects.
2. Insert the catheter, GENTLY.
3. Observe strict surgical asepsis throughout
the procedure.
4. See to it that the patient is protected from
unnecessary exposure and draft.
5. Provide adequate lighting in order to
visualize well the urinary meatus and to
prevent contamination.
6. Use the correct size of catheter to prevent
injury to the mucus membrane of the
urethra or to cause the patients discomfort.
7. See to it that the patient is relaxed during
the insertion of the catheter.
8. In case of severe bladder distention observe
gradual decompression/
9. Ensure adequate cleanliness of the external
genitalia before inserting the catheter.
10. If the specimen is to be collected for a
needed examination, caution the patient
not to void when being given an external
douche.
Key Terms:
1. Polyuria (Diuresis) – refers to the
production of abnormally large amounts of
urine by the kidneys.
2. Oliguria – is low urine output, usually less
than 30 ml an hour.
3. Anuria – refers to a lack of urine
production.
4. Nocturia – is voiding two or more times at
night.
5. Dysuria – voiding that is either painful or
difficult.
6. Urgency – feeling that the person must
void.
7. Enuresis – involuntary urination in children
(4 or 5 years old)
8. Urinary Frequency – voiding at frequent
intervals.
9. Urinary retention – the inability to void
(urinate) to discharge urine.
10. Urinary incontinence – the inability to
retain urine or control one’s urine flow.
11. Urinary Catheter – is any tube system
placed in the body to drain and collect urine
from the bladder.
12. Foley Catheter – A double channel
retention catheter. One channel provides
for the inflow and outflow of fluid; the
second and smaller channel is used to fill a
balloon that holds the catheter in the
bladder.
Normal Urine Output: 30 ml an hour; 500 ml a day
Types of Catheter:
a. Straight or Robinson Catheter – a
single lumen tube with a small eye
or opening about ½ inch from the
insertion tip.
b. Retention or Foley Catheter –
contains a second smaller tube
throughout its length on the inside.
This tube is connected to a balloon
near the insertion tip. After
catheter insertion, the balloon is
inflated to hold the catheter in
place within the bladder.
Catheters – are sized by the diameter of the lumen
and are graded on French scale numbers. The larger
the number, the larger the lumen size.
Small sizes such as F8-F10 are used in children.
F14, 16, 18 are for adults:
Fr 12-14 for female adult
Fr 16-18 for male adult
Vital Signs
Vital signs are indices of health or signposts in
determining client’s condition. This is also
known as cardinal signs and it includes body
temperature, pulse, respirations, and blood
pressure. These signs have to be looked at in
total to monitor the functions of the body.
As indicators of health status, these measures
indicate the effectiveness of circulatory,
respiratory, neural and endocrine body
functions.
Measurements of vital signs provides data to
determine a patient’s usual state of health.
Vital signs or Cardinal signs:
1. Body Temperature
2. Pulse (Pulse Rate)
3. Respiration (Respiratory Rate)
4. Blood Pressure
5. Pain
a. Oxygen Saturation
Body Temperature
The difference between the amount of
heat produced by the body process and the
amount lost to the external environment.
Heat produced – Heat lost = Body Temperature
Types of Body Temperature
a. Core temperature – temperature of the
deep tissues of the body. (Abdomen)
- It remains relatively
constant
b. Surface body temperature – is the
temperature of the skin, the
subcutaneous tissue, and fat.
- It by contrast, rises
and falls in response
to the environment.
Thermometer – instrument use to measure the
temperature.
Parts of thermometer:
a. Bulb – contains mercury which
expands when exposed to heat
& rise in the stem.
b. Stem – is calibrated in degrees
of Celsius or Fahrenheit.
We usually use digital thermometer.
How to clean the thermometer:
1. Unused: from bulb to stem in
circular motion
2. Used: from stem to bulb in circular
motion
 Rationale: To prevent the spread and
transfer of microbes.
Pulse Rate
This is a wave of blood created by
contraction of the left ventricle of the heart.
The heart is a pulsating pump, and the blood
enters the arteries with each heartbeat, cause
pressure pulses or pulse waves. Generally, the
pulse wave represents the stroke volume and
the compliance of the arteries.
 Peripheral Pulse – is the pulse located
in the periphery of the body, away from
the heart. (Foot, hand and neck)
 Apical Pulse – is a central pulse, located
at the apex of the heart. Point of
Maximum Impulse (MI).
Pulse sites:
Temporal artery Facial artery
Carotid artery Brachial artery
Radial artery Femoral artery
Popliteal artery Posterior tibial artery
Dorsalis pedis artery
Normal Pulse Rate:
1 year old – 80-140 beats/min
2 years old – 80-130 beats/min
6 years old – 75-120 beats/min
10 years old – 60-90 beats/min
Adult – 60-100 beats/min
What you need:
1. Watch with second hand
2. Stethoscope (for apical pulse)
3. Doppler ultrasound blood flow detector
if necessary
Procedures:
 1. Wash your hand and tell your client that
you are going to take his pulse.
2. Place the client in sitting or supine
position with his arm on his side or
across his chest.
3. Gently press your index, middle and
ring fingers on the radial artery, inside
the patient’s wrist.
4. Excessive pressure may obstruct blood
flow distal to the pulse site.
5. Counting for a full minute provides a
more accurate pictures of irregularities.
 For short: Wash your hands, put two
finger pads on the radial artery of the
client and count the pulse rate for
about 60 seconds.
Respiratory Rate
This is described in breaths per minute.
A healthy adult normally takes between 12 and
20 breaths per minute. Breathing that is normal
in rate is eupnea. Abnormally slow respirations
are referred to as bradypnea, and abnormally
fast respirations are called trachypnea or
polypnea.
Respiration – the act of breathing.
The mechanism of body uses to exchange gases
between the atmosphere and the blood and the
cells.
 Inhalation or inspiration: intake
of air into the lungs
 Exhalation or expiration:
breathing out or the movement
of gases from the lungs to the
atmosphere.
Types of Breathing
1. Costal Breathing (thoracic) – involves
the external intercostal muscles and
other accessory muscles. It can be
observed by the movement of the chest
upward and out ward.
2. Diaphragmatic breathing (abdominal) –
involves the contraction and relaxation
of the diaphragm, and it is observed by
the movement of the abdomen.
Assessing Respiration:
1. The best time to assess respiration is
immediately after taking client’s pulse.
2. Count respiration for 60 seconds.
3. As you count the respiration, assess and
record breath sound as stridor,
wheezing and stertor.
4. Resting respiration should be assessed
when the client is at rest because
exercise affects respirations and
increase their rate and depth as well.
Consideration in taking respiratory rate
1. Crying infant or child have abnormal
respiratory rate so you need to wait
them to stop before taking their
respiratory rate,
2. Infants and young children use their
diaphragms for inhalation and
exhalation. If necessary place your hand
on the infant’s abdomen to feel the
rapid rise and fall during respirations.
Blood Pressure
This is the force exerted by the blood
against a vessel wall.
 Arterial Blood Pressure is a measure of
the pressure exerted by the blood as it
flows through the arteries. There are
two blood pressure measures:
o Systolic Pressure: The pressure
of the blood because of
contraction of the ventricles,
which is the height of the blood
wave.
o Diastolic Pressure: The
pressure when the ventricles
are at rest. It is the lower
pressure present at all times
within the arteries.
Classification of Blood Pressure
Category Systolic Diastolic
BP BP
(mmHg) (mmHg)
Normal <120 <80
Prehypertension 120-139 80-89
Hypertension, 140-159 90-99
stage 1
Hypertension, >160 >100
stage 2
>But still ask the patient if the BP you get is
normal for the patient.
Blood Pressure Monitoring:
1. Ensure that the client is rested.
2. Use appropriate size of BP cuff.
 3. If too tight and narrow can result in
false high BP.
4. If too lose and wide can result in false
low BP.
5. Position the patient on sitting or supine
position.
6. Position the arm at the level of the
heart, if the artery is below the heart
level, you may get a false high reading.
7. Use the bell of the stethoscope since
the blood pressure is a low frequency
sound.
8. If the client is crying or anxious, delay
measuring his blood pressure to avoid
false high BP.

Pain

The fifth vital sign.

Assessing Pain.

1. You must consider both the patient’s

description and your observations on
his behavioural responses.
2. First, ask the client to rank his pain on a
scale of 0-10, with 0 denoting lack of
pain and 10 denoting the worst pain
imaginable.
3. Ask:
a. Where is the pain located?
b. How long does the pain last?
c. How often does it occur?
d. Can you describe the pain
e. What makes the pain worse?
4. Observe the patient’s behavioural
response to pain (body language,
moaning, grimacing, withdrawal, crying,
restlessness muscle twitching and
immobility)
5. Also note physiological response, which
may be sympathetic or
parasympathetic.
Leopold’s Maneuver