Name: Nurul Intan Fatihah

Number: 221212020
Class: 2A / S1 NURSING
INDIVIDUAL DUTIES N.UK
LECTURER : MR. PARADISE

1. VENIPUNCTURE

a. What is a vein puncture?

Venipuncture or venipuncture is the process of obtaining intravenous access for the purpose
of taking venous blood samples or intravenous therapy.

b. When is a vein puncture done?

the act of inserting a needle into a vein which is generally done to draw blood for use in
hematological, biochemical or microbiological analysis

c. How to do a vein puncture?

1. Officers wear handscoons

2. The officer writes patient data on the EDTA venoject tube
3. The officer prepares a sterile 3 cc syringe
4. The officer prepares 70% alcohol cotton / alcohol swab
5. The officer prepares a tourniquet
6. The officer puts all the tools in a plastic tub
7. The officer places the patient's arms straight on the table
with palms facing up
8. The officer ties the arm with a tourniquet to
stem blood flow.
9. The officer asks the patient to clench and unclench
hand several times to test the blood vessels.
10. The officer looks for the location of the blood vessels that will be
stabbed with the tip of the left index finger in the hand
patient clenches.
11. Officers clean the blood collection location
with 70% alcohol cotton in a circular direction
outside and let dry,
12.The officer stretches the skin with his index and thumb fingers
left finger over the blood vessel to be punctured
then, insert the needle with the beveled side
facing upwards forming an angle of ± 25 degrees then
suck the patient's blood as needed.
13.The officer opens the patient's fist and tourniquet
stretched and then suck blood as needed
inspection
14. The officer removes the syringe slowly.
15. The officer places an alcohol swab
16. The officer presses the alcohol cotton on the puncture
and closed with Hansaplast.
17. The officer takes blood and puts it in
tube through the inner wall of the previous bottle
remove the syringe needle.

2. INTUBATION

a. What is intubation?

Intubation is a medical procedure that aims to help someone who is experiencing certain
medical conditions breathe. "This procedure is carried out so that the sufferer can continue
to breathe during surgery, receiving anesthesia or anesthesia, or experiencing a serious
condition that makes it difficult for him to breathe."

b. When is intubation performed?

Intubation is usually performed for someone who is in a coma, has lost consciousness, or is
unable to breathe on their own. This procedure will help keep the respiratory tract open,
thereby reducing the risk of a lack of oxygen supply due to respiratory failure.

c. How do you intubate?

Step 1: administer anesthesia.

Step 2: inserting an endotracheal tube into the windpipe.
Step 3: connect the endotracheal tube with the ventilator

3. BLOOD TRANSFUSION

a. What is a blood transfusion?

Blood transfusion is the process of delivering blood or blood-based products from one
person to another person's circulatory system. Blood transfusions are related to medical
conditions such as large blood loss due to trauma, surgery, shock, and dysfunction of the
organs that form red blood cells.

b. When is a blood transfusion done?

to replace blood in a person's body lost due to surgery, injury, disease, bleeding disorders,
and other reasons. Some examples of conditions that require a transfusion are:
Experiencing heavy bleeding, usually due to surgery, childbirth or a serious accident

c. How to do a blood transfusion?

During a blood transfusion, a needle will be inserted into one of the blood vessels. Donated
blood stored in plastic bags enters the bloodstream through an IV drip. The patient will sit or
lie down for the procedure, which usually takes one to four hours.
 4. TRACHEOSTOMY CARE

a. What is trachoestomy care?

Trachoestomy is a surgical procedure that involves placing a tube through a hole into the
trachea to overcome upper airway obstruction or maintain the airway by sucking out mucus
or for the use of continuous mechanical ventilation. Tracheostomy can be used temporarily
i.e. short term for acute problems or long term it is usually permanent and the tube can be
removed

b. When is a trachoestomy performed?

This procedure is generally carried out in several conditions, including blockages in the
mouth or throat area, respiratory problems due to swelling or injury to the lungs, airway
reconstruction due to trachea or laryngeal surgery, airway protection due to swallowing
disorders, and long-term treatment. in patients who require respiratory support

c. How to perform trachoestomy treatment?

1. Place the patient in a supine position and maintain the stability of the head and neck
using a special pillow in the shape of a ring or donut.
2. Carry out antiseptic measures on the patient's neck area which is positioned
extended. Perform general anesthesia.
3. Make a transverse incision or cut of +3-6 cm in the patient's neck area, until the
tracheal cartilage is visible, which is a marker for access to the tracheostomy tube.
4. Insert the pipe into the hole.
5. Loosely close the incision wound and maintain the stability of the tube with sutures.

6. LIFTING PATIENTS

a. What is wound care?

Wound care is an important procedure that needs to be done when you
experience a wound or injury to the skin. The skin is the largest and outermost
part of the body, making up about 16 percent of body weight. Therefore, skin
wounds, especially open wounds, need intensive care.

b. When is wound treatment done?

Open wound deeper than 1.5 cm. Bleeding does not stop even with direct
pressure. Bleeding lasts more than 20 minutes. Bleeding results from a serious
accident.

c. How do you treat wounds?

The sequence of steps for wound care is to wash your hands, clean the wound
area with running water, apply wound ointment, and cover the wound with a
bandage. Don't forget to regularly change the bandage until the wound heals.
 When should a wound be checked by a doctor? Correct wound care procedures
are important to prevent infection and scars on the skin.

7. SPLINTS AND CASTS

A. What are splints and casts?

A cast is a supportive device used to help keep the injured bone in place while it heals. A
splint or splint, sometimes called a half cast, is a less supportive and less restrictive version
of a cast.

b. When do splints and casts take place?

dressing the wound with gauze and placing a cast or splint on the affected bone area. The
recovery process itself usually takes 6-8 weeks. However, this time period can vary and
depends on the type of fracture and the location of the fracture

c. How to do the splint and cast?

Before placing a cast, the doctor will first straighten the broken bone so that it returns to the
right position. If the fracture is more complicated or serious, a surgical procedure may be
needed to straighten the broken bone. After the operation and the bones are in the right
position, the doctor will put a cast on the body part.

8. CATHETERIZATION

a. What is catheterization?
The catheterization process can be carried out on blood vessels in the hand or foot area. In
this blood vessel a small hole will be made to insert the tube after previously placing a small
tube at the puncture site to keep the channel open.

b. When is catheterization done?

such as coronary heart disease, cerebrovascular disease, rheumatic heart disease, and
other conditions. Well, about four out of five deaths due to CVD are caused by heart attacks
and strokes.

d. How to do catheterization?
Before cardiac catheterization is performed, the patient must wear a hospital gown. Patients
can receive general anesthesia or local anesthesia as needed. If you only receive local
anesthesia, the patient will remain conscious during the catheterization procedure. The
nurse may need to shave the hair at the location where the catheter will be inserted.

The catheter will then be inserted into an artery or vein in the arm or groin and directed to
the left or right heart. Once the catheter reaches the heart, the doctor will carry out a
diagnosis. One way is to insert contrast fluid through a catheter so that the doctor can see
the condition of the blood vessels and heart chambers using a special X-ray machine.
Another way is to take a biopsy to take samples of heart tissue for further investigation.
Cardiac catheterization generally lasts 10 minutes to 30 minutes, depending on the type of
examination and the complexity of the heart abnormality
9. EAR IRRIGATION

a. What is ear irrigation?

Ear irrigation is a procedure that can be done to clean the ear canal from cerumen impaction
or remove small foreign objects from the ear. The ear irrigation procedure involves warm
water or body temperature flowing into the ear canal. It is hoped that the pressure caused by
the flow of water will mechanically remove prop cerumen or foreign objects.

b. When is ear irritation done?

Hearing disorders. Chronic cough. Itching and pain in the ear.

c. How do you do ear irritation?

The patient is positioned sitting upright (Fowler's Positions). Then, examine the ear with an
otoscope. Make sure the tympanic membrane is intact, there is no tympanostomy tube and
there are no anatomical abnormalities
If the cerumen is still hard, cerumenolytic is given 15-30 minutes before carrying out the
irrigation procedure
Take warm fluids at a temperature appropriate to body temperature using a syringe. Once
full, remove the syringe needle and replace it with an intravenous catheter
Position a bent cup under the ear to catch the flow of water
Position the catheter in the external ear canal. Don't go too deep so that the cerumen that is
about to come out is blocked by the catheter. Flow the water slowly and make room for it to
flow out again. Stop for a moment if vertigo occurs
Direct the intravenous catheter superiorly and posteriorly into the middle ear canal. This
aims to separate the cerumen that is attached to the ear canal. It is important to remember
not to direct the intravenous catheter at the tympanic membrane because the strong water
pressure can cause perforation
After completing irrigation, gently use alligator clamps or a cerumen spoon to remove any
remaining cerumen
Dry your ears. The patient may stand if he is not dizzy [1,3,7]

10.PATIENT COUNSELING

a. What is patient counseling?

Counseling is the process of providing assistance through face-to-face discussions to
someone who is experiencing certain problems. This method is carried out with
experts called counselors and focuses on solving a problem or learning certain
techniques to deal with or finding ways to avoid the problem.

b. When is patient counseling carried out?

 Patients with special conditions (pediatrics, geriatrics, impaired liver and/or kidney
function, pregnant and breastfeeding women). Patients with long-term
therapy/chronic diseases (eg: TB, DM, AIDS, epilepsy).

c. How to do patient counseling?

Introduce yourself as a counselor and ask the client to introduce themselves and
agree on what language to use.
Get general information about clients
Explain your role and responsibilities as a counselor: listening, providing support,
helping them identify problems and possible solutions
Transferring the case if the counselor is unable to do so
Maintain confidentiality but...
Discuss time issues
Provide opportunities for clients to express their feelings
Ask the client's opinion regarding the counseling process record
Make sure that clients feel comfortable and safe (never touch them without asking
permission, open the door if that's what they want)
Talk to clients according to their age (especially for children)
Be honest, what can be achieved, positive but still realistic
Cares about client problems authentically/purely
Sensitive/sensitive to client culture
Respect the principle of confidentiality - do not discuss it with family or friends
Do not judge clients
Find general information about the client (not interrogate)
There is no quick and special formula for building trust with clients. If the counselor
shows empathy, listens actively, and is able to reflect on problems from the start of
the meeting, this can also build a relationship of trust with the client
Provide ventilation for clients