Irrigating a wound, applying a dry dressing, Applying a saline-moistened dressing

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Author:
astinson
ID:
5292
Filename:
Irrigating a wound, applying a dry dressing, Applying a saline-moistened dressing
Updated:
2010-01-26 21:03:53
Tags:
Nursing check off
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Description:
irrigating a wound, apply a dry dressing/saline-moistened dressing check off
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  1. Step 1
    place a pad under wound area
  2. Step 2
    wash hands. Put on clean gloves
  3. Step 3
    remove soiled dressing
  4. Step 4
    • assess the wound for size, appearance, and drainage on the dressing.
    • assess the appearance of the surrounding tissue (was it saturated through)
    • (describe in chart)
  5. Step 5
    Discard the dressing in the trash receptacle. Remove gloves and put them in the trash receptacle
  6. If irrigating, follow step 6-11. If not irrigating, skip step 6-11
    step 6
    Position the client so that the irrigation solution will flow from the clean to dirty end of the wound
  7. Step 7
    wash hands. Put on clean gloves
  8. Step 8
    Gently direct a strem of solution into the wound. Kepp the tip of the syring at least 1 inch above the wound. Watch for solution to flow smoothly and evenly
  9. Step 9
    • dry the surrounding skin with a guaze sponge
    • Note: if irrigation did not occur, wearing clean gloves, clean the wound from top to bottom and from center to the outside using gauze. Following this pattern, use a new gauze for each wipe, placing the used gauze in the trash receptacle. Once the area is cleansed, dry the area using a gauze sponge in the same manner.
  10. Step 10
    • Saline-moisten dressing:
    • a. soak gauze with saline
    • b. squeeze excess fluid from the gauze dressing. Unfold and fluff the dressing
    • c. gently press to loosely pack the moistened gauze into the wound
    • d. apply dry gauze pads over the wet gauze
    • e. apply tape to secure the dressing
    • f. date, time, and initial the dressing
  11. Step 11
    • Dry dressings:
    • a. apply two layers of dry gauze over the wound
    • b. apply tape to secure the dressing
    • c. date, time and initial the dressing
  12. Step 12
    Remove gloves and wash hands

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