FOOTCARE URINALYSIS - UA is also known as routine and microscopy.

Thorough nail care prevents infection and promotes good It is a physical, chemical, and microscopic examination of
circulation urine. It involves a number of tests to detect and measure
Protect feet from injury and never walk barefoot, keep clean various compounds that pass through the urine. It has been
and dry, wear footwear a useful tool of diagnosis since the earliest days of
Inspect for redness, lesions, dyrness, or signs of infection medicines.
- Color, Density, and Odor = reveals State of health
HEAT AND COLD APPLICATION - Urine is assess first for its physical appearance
- Color: N = Pale yellow - Deep amber in color
HEAT (depending on the concentration of the urine)
- Can be applied to the body in both DRY & MOIST - The amount and kind of waste make it lighter or
forms darker
- Pigments and other compounds in certain foods
DRY HEAT and medication may change the color of the urine
- Is applied locally by means of a: - Blood in the urine colors it
- Hot water bottle
- Aquathermia pad
- Disposable heat pack or COLLECTION OF URINE SPECIMEN FROM AN
- Electric pad INDWELLING CATHETER

MOIST HEAT A sterile urine specimen can be obtained either by inserting

- Can be provided by: a straight catheter into the urinary bladder and removing
- Compress urine for obtaining specimen from the port from an indwelling
- Hot pack catheter using sterile technique. Urine from the dependent
- Soak or drainage bag should not be used for a specimen. Since it is
- Sitz bath not fresh and would not reflect accurate test results.

DRY COLD VID

- Is generally applied locally by means of a 1. Check specimen container labels
- Ice bag 2. Complete laboratory request
- Ice glove 3. Hand hygiene
- Ice collar 4. Ensure privacy
5. Introduce self
MOIST COLD 6. Identify client
- Can be provided by: 7. Explain the procedure
- Compress or a 8. Empty the drainage tube of the urine
- Cooling sponge bath 9. Don/clean gloves
10. Clamp drainage tube below level of specimen port
for 15-30 mins
The most important step in the recovery of pathogenic 11. Forcep or clamp w/ rubber band
organisms that's possible for infectious disease is the proper 12. Leave for 10-15 mins
specimen collection processing and handling by nurses or 13. Return
the healthcare professional. It is one way of knowing about 14. Don gloves and swab specimen port w/ antiseptic
the patient’s health status by identifying pathogens and swab
analyzing urine, blood, sputum and feces. 15. Clean the port for 15 secs
16. Sterile syringe w/ sterile gauge (21-25 needle)
One of the main responsibilities assigned to nurses is to 17. Insert needle into specimen port and aspirate (5-
collect and label specimen for analysis and to ensure their 10 ml urine)
delivery to laboratory and knowing the proper way of 18. Once you have sample, transfer to sterile
gathering specimen is necessary for self protection and to specimen container
prevent the spread of disease 19. Tightly cap specimen container
20. Label and pack specimen
LABORATORY AND DIAGNOSTIC PROCEDURES 21. Remove clamp from catheter
22. Discard needles and syringe into sharp containers
Nurse’s Role: 23. Bring specimen to lab
● Patient’s interaction 24. Remove gloves
● Selection of supplies 25. Hand hygiene
● Proper collection
● Precise sample identification ROUTINE STOOL EXAM/FECALYSIS
● Up To date transfer to the lab A stool analysis is a series of tests done on a stool from
feces sample to help diagnose certain conditions affecting
the digestive tract. This condition include infections such as 1. Clear your lungs - small breath in and gentle
from parasites, viruses, or bacteria or it can be from poor breath out = 3X in a row
nutrition absorption or cancer 2. Deep breath in, gentle huff cough out
3. Take a small fast breath, gentle huff cough out
PASS STOOL SPECIMEN: 4. Fast small breath, gentle huff cough out
To pass specimen into a toilet, lift lid and place plastic bag 5. Deep breath, strong huff cougH
inside bowl.
Close lid to secure edges of bag. Be careful not to submerge
bag. 8. Spit the sputum in the specimen cap
9. Put the lid back on the specimen
COLLECT STOOL SPECIMEN 10. Label : name, time, date
Carefully remove the vial cap. Using the spoon attached to 11. Place the specimen in the plastic vial hazard bag
the cap, collect a small amount of stool from areas that are 12. Store in the ref
slimy, water, or bloody and place them into each vial. *Healthcare provider need sample in 3 different days
If the stool is hard, collect a small amount from both ends 13. Document the collection of the sputum on the client’s
and the middle, and place into each vial. chart
*Do not feel pass slime indicated on vial.

WASH HAND
Wash hands thoroughly w/ soap and water.

FILL OUT INFORMATION

Fill out vial label w/ all information requested. Check boxes
that best describe your specimen.

SPUTUM SPECIMEN COLLECTION

Sputum expectoration is abnormal and there is always an
underlying pathological cause such : effects of smoking on
the airways
Infection cause by virus, bacteria, fungi, chronic disease and
cystic fibrosis

Color:
N= thick and clear
Infection = white, green, yellow, bloody

Sputum is sometimes confused with saliva.

Saliva is in your mouth not in the lungs and it's a thin, clear,
watery liquid.

In order to diagnose a lung infection, the lab needs a sample

from where the infection may be.

1. Get your supplies ready before going to bed

2. Put the specimen cap and vial hazard bag along BREASTFEEDING
w/ the pen near bed before sleeping - Is the method of feeding an infant directly
3. When you do get up (wake up) use bathroom, from the human breast.
wash hands
*Do not brush teeth, use mouthwash and toothpaste or drink Anatomy of the human breast
and eat anything = could contaminate --- useless
4. Open the specimen cap
5. Set the lid aside, bottom of the lid facing up
(protects from dirt)
*Be careful not touch the inside of the cap or lid (sterilized)
6. Getting ready to cough
7. Sitting and leaning forward (best position)
*If can’t urge to cough = huff coughing
- A technique, deliberately quickly and forcefully
breath out making a huffing sound
Steps:
 Infant sucking ⇾ stimulates PPG to produce OXYTOCIN
(contracts smooth muscles of collecting tubules) ⇾ milk
ejected forward (let-down reflex) ⇾ HINDMILK
3. Through continuous infant sucking, CIS
stimulates the posterior pituitary gland to
produce oxytocin (contracts muscles of
collecting tubules) thus milk is ejected
forward this action is also known as let-down
reflex) means that the milk is ready to flow.
Hindmilk got the baby at the end of the
feeding.

COLOSTRUM
- The very first form of the milk produced by
the mammary gland which contains
antibodies to protect the newborn against
diseases

VID
Breastfeeding is a way to nourish your baby w/
breast milk from your own body.
Breastmilk is produced in mammary gland

Mammary gland ⇾ Milk ducts to openings in the nipples ⇾

when the baby suck, the body releases the hormone
THE PHYSIOLOGY OF BREASTMILK prolactin and oxytocin
PRODUCTION PROLACTIN - controls milk production
There are 3 main actions: OXYTOCIN - controls the release or let down of milk
through milk ducts.
↓Estrogen & Progesterone levels ⇾ stimulates APG to
produce PROLACTIN to produce FOREMILK ⇾ stored in BREASTMILK composes:
collecting tubules IgA
Lactoferrin
1. The decrease of estrogen & progesterone Bifidus factors
levels during the late part of pregnancy Interferon
stimulates the Anterior Pituitary Gland to Lysozyme
produce prolactin. Prolactin produces the Ideal electrolyte & minerals
foremilk w/c are stored in the collecting
tubules and ready for infant sucking ] Nutrients that boosting the immune system of a
Main function of the prolactin: stimulate milk newborn/infant
production and to develop breast tissues. It plays a
role in breast development w/ estrogen & ADVANTAGES OF BREASTFEEDING
progesterone by stimulating breast growth and Mother :
enlargement of alveoli in preparation for lactation ~ Economical
~ Empowering
~ Decrease the risk for breast and cervical CA,
Infant sucking ⇾ Hypothalamus produces prolactin- osteoporosis, hip fracture
releasing factor ~ Enhances bond b/wn mother and child
2. Infant sucking. Upon birth, when the infant ~ Weight loss
starts to suck the hypothalamus is being ~ Delays pregnancy
stimulated thus producing the prolactin- ~ Faster involution
releasing factor *Involution is the return of the uterus to a non-
pregnant state

Infant:
~ Strengthens immune system
~ Safely rehydrates
~ Increases IQ points
~ Provides complete nutritional food
~ Less incidence of GI, resp, ear infection
PREPARING FOR BREASTFEEDING
1. Instruct on the importance of hygiene
- Cleanse breast daily w/o application
of soap and alcohol
- Hand washing (before&after)
2. Observe for feeding cues
- Sucking of fingers
- Tongue thrusting
- Lips smacking
- restlessness/crying
- Tense body posture
3. Assess the nipples
- Normal, flat, inverted
- *Inverted = nipple shield (breastfeeding
product that is used in special situations. A
very thin, soft piece of rubber or silicon that
covers areola and nipples)
= The hoffman technique (place both thumbs on
opposite sides of the nipple at the base. Gently pull
the thumbs away from each other in opposite
directions. Work both up and down and sideways.
Start w/ 2 repetitions per day, gradually building up to
5. This technique is thought to break down the
adhesions at the base of the nipple that keep it
inverted.)
STEPS IN LATCHING ON
1. Hold the baby towards your body and her
nose close to your nipple.
2. Move your baby back an inch or two. Her
head should tilt back, and her mouth will be
open. It's important for the baby's mouth to
be open WIDE.
3. If she doesn’t open her mouth, you can
touch your nipple to her lips to get her to
open up.
4. When she opens her mouth wide, move it
onto the nipple by pulling her towards you.
This is called “latching on”
5. Get as much of your areola into baby’s
mouth as possible
*For a large breast, compress it w/ your fingers not to
cover the nose, to prevent obstruction of baby’s
breathing.
6. Observe if your baby is sucking and
swallowing easily
7. Listen for sounds of a happy feeding baby
HOLDING THE BREAST TO HELP BABY TO LATCH
ON (techniques)
C-Hold
- Thumb above the nipple @ the 12:00
position and the remaining fingers below the
nipple @ the 6:00 position
U-Hold
- Thumb on the areola on one side @ the 9:00
position and remaining fingers at 3:00
position
V-Hold
- Thumb and index finger above the nipple @
12:00 position and the middle finger below
the nipple @ the 6:00 position
SIGNS OF EFFECTIVE SUCKLING
● Slow, deep sucks and swallowing sounds
● Cheeks full and not drawn in
● Baby feeds calmly
● Baby finishes feed by him/herself and seems
satisfied
● Mother feels no pain
SIGNS THAT A BABY IS NOT SUCKLING
EFFECTIVELY OR UNSATISFIED
● Rapid, shallows sucks and smacking or
clicking sounds
● Cheeks drawn in
● Baby is restless and body posture is tense
● Baby feeds very frequently, for a very long
time, but does not release breast and seems
unsatisfied
● Mother feels pain
BREASTFEEDING TIMING
❏ 5 mins 1st day, per breast
❏ 7-8 mins 2nd day, per breast
❏ 10 mins 3rd day, pb
❏ Build up to 20 mins, pb
❏ If baby falls asleep after 10 mins when milk
comes in, cut back ti 5 mins pb
❏ If baby is still hungry, may go back to 1st
breast for another 5 mins
❏ Nurse both breasts at each feeding. Start w/
breast ended w/ at the last feeding
*Air-dry nipples after each feeding: Apply Eucerin
cream around areola but not on tip of the nipple
THE 4 MOST RECOMMENDED BREASTFEEDING
POSITIONS
1. Cradle position - the mum’s arm supports
the baby at the breast. The baby’s head is
 cradled near her elbow, and her arm
supports the infant along the back and neck.
The mother and baby should be chest to
chest.
2. Cross-cradle position - uses the opposite
arm (to the cradle position) to support the
infant, w/ the back of the baby’s head and
neck being held in the mother’s hand.
3. Football hold - also known as the clutch
hold. This position is especially useful if the
mother:
- Had a C-section and want to avoid
her baby against her abdomen
- Large breast
- Premature baby
- twin
4. Side-lying position - this position is a good
choice when breastfeeding in the middle of
the night.
When using this position, there should be no
excess bedding around the infant that could pose a
suffocation hazard.
KANGAROO MOTHER CARE
-The baby is place in an upright position b/wn
mother’s breast, chest to chest
-Position the baby’s hips in a frog-leg position w/ the
arms also flexed
-Secure the baby in this position w/ the support binder
-Turn the baby’s head to one side, slightly extended
-Tie the cloth firmly around the mother’s body
ASSOCIATED PROBLEMS IN BREASTFEEDING
1. Breast engorgement - breast becomes full,
tense, and hot w/ throbbing pain due to inc
lymphatic and venous circulation
- Expected to occur on the 3rd postpartum day
accompanied by fever (milk fever) lasts for
24 hrs
Nursing care:
★ Encourage breastfeeding/pumping
★ Advise use of firm-supportive brassiere
★ Warm packs
*If not going to breastfeed: apply cold compress; no
massage’ no breast pump; apply breast binder
2. Sore nipples - improper positioning
- Forcefully pulling an infant from the breast
- Allowing to suck too long at a breast after it
is emptied
- Permitting a nipple to remain wet from
leaking milk
Nursing care:
★ Encourage to continue bf
★ Expose nipples to air for 10-15 mins after
feeding
★ Exposure to 20 watt bulb placed 12-18 in.
away to promote vasodilation
★ Advise not to use plastic liners that come w/
nursing bras
★ Use nipple shield
★ Apply lanolin to the nipples after air exposure
3. Mastitis - inflammation of the breast
Signs&Symp: pain, swelling, redness, lumps in the
breasts, milk becomes scanty
Nursing care:
★ Supportive brassiere, empty breast w/ pump
★ Continue bf
★ Apply warm compress to inc drainage
★ Ice compress to minimize pain sensation
★ Administer antibiotics as prescribed
★ Varying the feeding position to inc breast
drainage
LAWS THAT PROTECT INFANT & YOUNG CHILD
FEEDING
1. Milk code (EO 51) - ensures safe and
adequate nutrition for infants
- Through promotion of bf and regulation of
promotion, distribution, selling, advertising,
product public relations, and info services for
artificial formulas and other covered products
Policies :
>Exclusive bf from 0-6 mos
> Appropriate and safe complementary feeding starts
from 6 mos. Onwards
> BF is still appropriate for children up to 2 yrs &
beyond
> Other related products such as teats, feeding
bottles, and artificial feeding paraphernalia are
prohibited in health facilities
> Infant or milk formula may be harmful to a child’s
health and may damage a child’s formative
development
Violations:
> Giving of samples
> assistance, logistics, or training, financial or material
incentives, or gifts of any sort from milk companies
health workers
> Information that implies or creates a belief that
bottle feeding is equivalent or superior to BF
 2. Rooming-in & BF act of 1992 (RA 7600) -
Provides incentives to govt and private
institutions w/ cooking-in and bf practices
Declaration of policy: the state adopts rooming-in as a
national policy to encourage, protect and support the
practice of BF. It shall create an environment where
basic physical, emotional, and psychological needs of
mothers and infants are fulfilled through the practice
of rooming-in and BF
Provision of facilities for Breastmilk collection and
storage: the health institution adopting rooming-in and
BF shall provide equipment, facilities, and supplies for
BM collection, storage and utilization, the standards of
w/c shall be defined by the DOH
and/or breastmilk substitutes within the lactation
stations, or in any event or circumstances which may
be conducive to the same.
Lactation Periods : Nursing employees shall be
granted break intervals in addition to the regular
time-off for meals to breastfeed or express milk.
These intervals, which shall include the time it takes
an employee to get to and from the workplace
lactation station, shall be counted as compensable
hours worked. The Department of Labor and
Employment (DOLE) may adjust the same: Provided,
That such intervals shall not be less than a total of
forty (40) minutes for every eight (8)-hour working
period.

3. Expanded BF act of 2009 (RA 10028) CREATING BF SUCCESS IN HEALTHCARE

Declaration of Policy - the state adopts rooming-in as FACILITIES
a national policy to encourage, protect and support
the practice of BF Educate about the benefits and management

Provision of facilities for BM collection and storage for Initiate w/in half an hr after birth
health institutions: The health ins. adopting rooming-in
and bf shall provide equipment, facilities, supplies for Maintain lactation even if mothers should be
bm collection, storage, and utilization. Health ins are separated from their infant
likewise encouraged to set up milk banks for storage
of bm donated by mothers and w/c have undergone Exclusive for the 1st 6 mos of life
pasteurization. The stored bm will primarily be given
to children in the neonatal intensive care unit whose Not giving pacifiers
mothers are seriously ill.
Integration of bf education in the curricula: integrate in Practice rooming in 24 hrs a day
the relevant subjects in the elem, hs, and college
levels, esp in the medical and nursing education, the Encourage bf on demand
importance, benefits, methods or techniques of bf and
change of societal attitudes towards bf. Establish support groups and referral system

BF awareness month: to raise awareness on the

importance of and to further promote bf, the month of
August in each and every yr throughout the Ph shall
be known as “BF awareness month”
: On Feb 23, 2011, the DOH launched the exclusive
bf campaign dubbed as “BF TSEK : (Tama, Sapat,
Eksklusibo)” The primary target of this campaign is
the new and expectant mothers in urban areas

Establishment of Lactation Stations: all health and

non-health facilities, establishments or institutions
shall establish lactation stations. The lactation
stations shall be adequately provided with the
necessary equipment and facilities
: In addition, all health and non-health facilities,
establishments or institutions shall take strict
measures to prevent any direct or indirect form of
promotion, marketing, and/or sales of infant formula