682
UNIT 4 Supporting Physiological Functioning
Procedure 32-10 ■ Applying Binders ➤ For steps to follow in all procedures, refer to the Universal Steps for All Procedures on the inside back cover.
Equipment ■ Abdominal binder, triangular arm binder, or T-binder ■ Clean nonsterile gloves ■ Measuring tape Delegation This procedure may be delegated to a UAP.Assessment of the incision line or wound is a licensed professional’s responsibil- ity and cannot be delegated.
Preprocedure Assessments ■ Assess the condition of the wound (if one is present). Note the amount and type of drainage. A wound must be dressed before it is bandaged; if there is a significant amount of exudate, you will need to apply a secondary dressing. ■ Assess for pain and check the circulation of the underlying body parts before and after applying the binder. Look for cool, pale, or cyanotic skin; tingling; and numbness. ■ Determine whether the patient or family has the skills to reapply the binder when necessary.
➤ When performing the procedure, always identify your patient according to agency policy, using two identifiers, and be attentive to standard precautions, hand hygiene, patient safety and privacy, body mechanics, and documentation. ➤ Observe steps 1 through 7, regardless of the type of binder you use. 10. Make sure the binder does not slip upward or downward.
Procedure Steps 1.Choose a binder of the proper size. 2. Perform hand hygiene and don nonsterile gloves. 3.Thoroughly clean and dry the part to be covered. Moisture contributes to skin breakdown. 4. Place the body part in a com- fortable position (e.g., with the joint slightly flexed) whenever possible. Prevents strain on ligaments and muscles. 5. Pad between skin surfaces (e.g., under the axilla) and over bony prominences. Prevents pressure and abrasion of the skin. 6.Fasten from the bottom up, especially for abdominal binders. Make sure the binder is secured with enough pressure to provide the needed support and control bleeding, but not so tightly that circulation is compromised or breathing impaired. Fastening from the bottom up gives upward support. 7.Change binders whenever they become soiled or wet. Proceed to step 8,14,or 20,depend- ing on the type of binder you are using.
Procedure Variation: Applying an Abdominal Binder 8.Measure the patient for the abdominal binder. a. Place the patient in supine position. b. With a measuring tape, encircle the abdomen at the level of the umbili- cus. Note the measurement.This is the length of the binder.
If the binder is positioned too high, it could impair lung expansion and gas exchange. If it is positioned too low, the binder will not provide adequate support. 11. Assist the patient to turn to the other side as you unroll the binder from underneath him. Pad any pres- sure areas or skin abrasions to avoid pressure injury. 12.With your dominant hand, grasp the end of the binder on the side farthest from you and steadily pull toward the center of the patient’s abdomen. With your nondominant hand, grasp the end of binder closest to you and pull toward the center. Overlap the ends of the binder so that the hook-and- loop fasteners (e.g.,Velcro) meet.
c.Measure the distance from the costal margin to the top of the iliac crests.This is the width of the binder. d. Dispose of gloves and measuring tape and perform hand hygiene. e.Based on the measurements, obtain an abdominal binder. 9. Assist the patient to roll to one side. Roll one end of the binder to the center mark. Place the rolled sec- tion of the abdominal binder under- neath the patient. Position the binder appropriately between the costal margin and iliac crest.
94
Powered by FlippingBook