HOME VISIT, BAG TECHNIQUE

AND STEAM INHALATION

MATERIALS:
 Good day! Ma’am Taal, my name is
Darwin Jay L. Sang-an from BSN-2A.
And today, I’ll be demonstrating the
proper procedure for home visit, bag
technique and steam inhalation. And
now let’s begin with the first
procedure.
1. Assess the health and living condition of the client and family to
be visited.
• First, let’s assume that we are still at a health clinic to prepare the
things needed for the home visit. The initial part we would do is to
assess the health and living condition of the client and family to be
visited.
• So, our client today is named Emiery Jane Morales who is a 21-
year-old postpartal women who do laundry as her job, born on
December 20, 2000, residing at Valencia City. She has been living
with her husband named Christian Kyle Morales who is a tricycle
driver. During the home visit, I’m going to assess the general
cleanliness, solid waste disposal, latrine, personal hygiene,
vaccination of women, ante-natal care, family planning, presence
of insects/ rodents in the house and presence of a sick person
• With this procedure, This process is a holistic approach in assessing
the health and familial status within the community.
2. Recognize the needs and determine the health teachings
needed and provide necessary health care activities.
• Since the client that we are about to visit is a postpartal
woman, it is expected that she will have the risk for
infections, blood clots, postpartum depression and
postpartum hemorrhage. So, what we are about to do is to
perform a postpartum care which includes assessments
regarding the health of the mother and the child, do proper
education on good nutrition, fluid intake, breastfeeding
and proper burping. Also, we are going to also give some
health guidelines on family planning, immunization and
parenting role.
• Addressing the problems of the family greatly helps in
recognizing the dilemma that the family is in. Patient
teaching is vital in helping the family or caring of those who
need it most.
3. Prepare for a home visit by consolidating
records and studying the case to be visited.
• Now that we have already assessed the health and living
condition of the family and have recognized the needs and
determined the health teachings needed for the client,
Now I’m going to gather all the records that our patient
have and I’m going to study on how to give the health care
that our client needs.
• If there are any records available, assessing it and reading it
may give the nurse an insight in what to expect and what
needs to be addressed during the home visit.
4. Gather equipment needed.
• Since we are going to do a postpartum care, the materials
that will be used in today’s home visit is our CHN OB bag
which includes all the things that is needed for the
assessments, survey forms and the medical records/ paper
that our patient have.
• By gathering the equipment needed, it helps the nurse to
save energy and use the equipment easily and efficiently.
5. Greet client or household members and introduce
yourself. & 6. Explain to the client the purpose of your
home visit.
• Good day ma’am. My name is Darwin Jay L. Sang-an, your
attending nurse for today. I’m here to do a home visit para kay
mommy sa bagong panganak niya kay baby. So we are doing this
home visit to make sure na okay and safe po yung kalusugan ni
baby and also kay mommy. And also we are going to assess
whether there are underlying problems that our client needs so
that we could prevent all of these.
• Introducing self creates rapport and trusting relationship
between the nurse and the family. Explaining the purpose of the
procedure may reduce anxiety and stress that the family has.
7. Inquire/ask about any health and health
related problems.
• A pleasant morning again to you ma’am, my name is Darwin Jay L.
Sang-an and I’m your attending nurse for today. So, ma’am, I have
some questions regarding about you and your baby para makita po
naten kung okay lang po ba yung kalagayan niyo. Is it okay if we will
proceed now to the questions?
• So unang-una po sa lahat, kumusta naman po kayo ni baby? That’s
good to hear ma’am. So regarding po sayo ma’am nakakaranas po ba
kayo ng pananakit ng tyan or ng puson niyo? Nakaranas po ba kayo ng
pananakit ng ulo? Nanlalabo po ba ang inyong paningin? Nahihilo po
ba kayo? Hanggang ngayon po ba ma’am dinudugo pa po ba kayo?
Tanong ko lang din po ma’am if Nararanasan niyo din po ba na yung
pakiramdam na sobra-sobrang down kayo? Or sobrang lungkot niyo
po? Ah okay ma’am so Mabuti po yan.
7. Inquire/ask about any health and health
related problems.
• Regarding naman po sa family planning, so nakapag
intercourse na po ba kayo ulit ni mister? Ah okay po, so
ma’am gusto niyo po ba mabuntis ulet? Kung sakali po
kelan niyo po gusto ulet mabuntis? May family planning
method na po ba kayong ginagamit? Okay thank you
ma’am for your honest answers. So when it comes to
handling po the baby need po naten maghugas ng kamay
para po maiwasan naten ang mga sakit na dala po ng
microbyo. Okay po ma’am? Proceed na po tayo.
•Collecting specific subjective data gives the
nurse insights on what should expect during
the health assessment that is to be done by
the nurse or the examiner.
8. Place bag in a convenient place before
doing a technique.
• After the assessment, we’ll try to find a convenient place to
put our CHN OB bag.
• The bag contains all the necessary materials that is needed
during the home visit. Having it near during the assessment
helps the nurse to save energy and efficiently.
Preparatory Phase:
1. Upon arrival at the patient’s home, place the bag on the
table lined with a clean paper. The clean side must be out and
the folded part, touching the table.

• - Now we are going to proceed with the first

step in the preparatory phase for bag technique.
So, the first procedure is to……
•- This protects the bag from any dirt. Also, this
protects the equipment inside the bag.
2. Ask for a basin of water or a glass of
drinking water if tap water is not available
•Good day po maam may I ask if you have a
basin (mag ingon ang patient aha ang basin
kwaon dayon ni nurse)
•This will be used for towel and soap as a
washbasin
3. Open the bag and take out the towel and
soap.
•(Kwaon ang towel ug soap sa bag)
•The towel and soap will be used for
handwashing.
4. Wash hands using soap and water. Wipe to
dry.
•(Proper hand washing tapos pat dry
gamit towel)
•- This prevents the spread of
microorganisms between the nurse and
the equipment.
5. Take out the apron from the bag and put it
on with the right side out.

•This ensures that the clean

side will be in the inside.
6. Put out all necessary articles needed for
the specific care.

•(Ipagawas mga materials)

•This saves time and uses
energy efficiently.
7. Close the bag and put it in one corner of
the working area.

•- (Ipadaplin ang bag)

•- To protect the bag
from dirt
8.Proceed in the performing the necessary
nursing care and treatment.
•- (Proceed na sa steam
inhalation)
•- This depends on what nursing
interventions are needed for the
clientele.
STEAM INHALATION
•Check the doctors order for any
specific instructions Steam inhalation
•Check the General condition and may be
diagnosis of the patient. initiated by a
•Check the Self-care ability to doctor’s order.
follow instructions
•Check the Type, duration and Ensures safety
medication of inhalation and overall
•Check the Articles available in wellbeing of the
the unit client
Explain the procedure to the patient -
- to ensure client cooperation
•Good day Maam today I will be performing
the procedure for steam inhalation in which
it is one of the most widely used home
remedies in order to soothe and open the
nasal passages and get relief from the
symptoms of your cold.
Allow the patient to empty to the bladder and
towels if necessary. Given bedpan or urinal to a
bedridden patient

•A full bladder will make the examination

uncomfortable and can reduce the
accuracy of the procedure.
Provide Fowler’s position with back rest, cardiac
table and extra pillows

•Fowler's position allows for better chest

expansion, improving breathing by
facilitating oxygenation.
Close windows, doors and put off fan to prevent
drought

•Provides privacy and putting off

fan prevent drought
Provide sputum cup within the reach of the
patient

•Promotes easy reach and smooth

procedure
Provide a face towel to remove sweat from face
during inhalation

•to cleanse away sweat and

bacteria to prevent your pores from
getting clogged
Mouth piece should be boiled and cooled before
use

•To kill all the pathogens which

may be infecting the
instruments.
Arrange the articles at the bedside

•Provides organization
Perform hand washing.

Open sterile inhaler mouth – piece and cover with

sterile gauze and attach to clean inhaler.

Close spout of inhaler with cotton ball. Pour

boiling water up to spout.

Add medicine (tincture benzoin) if needed. Close

inhaler with mouth piece and take to bed side
Face spout away from patient and remove cotton
ball

Instruct to take in deep breath through mouth and

breathe out through nose

Continue procedure for 15 to 20 minutes keep

patient warm throughout to prevent chilling

Give chest physiotherapy and encourage patient

ot bring out sputum
Remove the inhaler from the patient

Use face towel to wipe of perspiration from his face

Remove the accessories and make the patient

comfortable

Replace the articles after cleaning

Perform hand washing.

Document the findings in the client’s record.

9. After giving the treatment, clean all things
that were used and perform hand washing
•(Clean ang materials gamit tissue or
bisag unsa basta ma limpyohan)
•Cleaning the equipment prevents
contamination. Handwashing prevents
the spread of microorganisms
10. Open the bag and return all things that were
used in their proper places after cleaning them.
11. Remove apron, folding it away from the
person, the soiled side in and the clean side out.
Place it in the bag.

•The soiled side should be in so that

microorganisms will not spread within
the bag.
12. Fold the lining, place it inside the bag and
close the bag.
•This promotes orderliness and prevents
the nurse from messing up the
equipment for the next use.
13. Take the record and have the talk with the mother. Write
down all the necessary data that were gathered, observations,
nursing care and treatment rendered. Give instructions for care
of patients in the absence of the nurse.

•Documenting the data is vital, it will

serve as a baseline for nursing diagnoses
and interventions for the next
procedure.
10. Perform physical assessment and nursing
care needed.
• This gives the nurse the necessary data that the
he/she needs. Having perform the physical
assessment establishes nursing diagnoses that is vital
during the home visit to address the need of the
family.
14. Conduct postnatal physical examination.
• Now for the conduct of postnatal physical examination
we will follow the BUBBLE HE Technique which stands
for BREAST, UTERUS, BLADDER, BOWEL, LOCHIA,
EPISIOTOMY, HOMAN’S SIGN AND EMOTIONAL STATUS.
• In assessing for the breast of our patient, we are going
to check whether the size, and shape is normal. Palpate
and observe whether the breast is tender or the patient
is feeling discomforts. Check for swelling and breast
tenderness to check whether the patient is having a
breast engorgement.
14. Conduct postnatal physical examination.
• In assessing for the uterus of our patient, we want to know
whenever its firm or boggy. maintain the patient on a flat
position expose the abdomen so place one hand at the
fundus
• and the other one at the bottom of the uterus the uterus
should be going back to its pre-pregnant state or one to two
centimeters every 24 to 48 hours so palpate deeply if the
phone loose so you can feel if it is firm or buggy
• massage if bobby so that it will start to contract to prevent
bleeding too much ask the patient
• when is her last void and up and ask how much you should
take precaution in doing this with a cesarean patient
14. Conduct postnatal physical examination.
•In assessing for the bladder of our patient,
ask the patient when is her last time she
emptied her bladder so usually if postpartum
patients
•don't feel like they are going to empty their
bladder so um feel their bladder and remind
them that their intake must be the same with
their output
14. Conduct postnatal physical examination.
•In assessing for the bowel of our patient, listen
to the patient's vowel sounds but before that
don’t forget to warm the diaphragm of the
stethoscope.
•there's no reason for the patient to not have
vowel sounds because her pregnancy doesn't
affect her bowel movement as for her last bowel
movement so three to five days post delivery of
not having her bowel movement is is not usual
so health teaching should be done
14. Conduct postnatal physical examination.
• Since we are done with the assessment of the lochia
of our patient we will now proceed with the
assessment of the episiotomy. this area must be kept
clean and dry so the dissolvable suture takes two
• weeks to dissolve so no intercourse to five to six
weeks until the tissue has been healed to check for
the episiotomy we will use the rida scale it is a tool
that assesses the inflammatory process in tissue
healing in the perennial trauma we will evaluate the
redness edema ecomosis discharge and the
approximation of the wound edges
14. Conduct postnatal physical examination.
•Now for the homan’s sign, we support the
back of the patient's knee then remain flat
on the bed and ask the patient or help the
patient to dorsiflex if the patient felt any
pain which means that she is positive for
•homan sign or or she has dvt if there is no
pain on both calf which means that she is
negative for homan sign
14. Conduct postnatal physical examination.
•Lastly for the emotional assessment we will just
observe the mother how she has been and how
she is with her baby we can also ask her how is
she feeling or does she feel any problems or any
red flags that needs to be addressed
•Now for the assessment for your psychological
adjustment, can I ask you ma’am if you’re
disappointed or happy with the appearance of
her baby? Are you glad to be through with the
pregnancy or still longing to be back in it?
11. Give necessary health teachings and
advice based on client’s needs and condition.
• Performing the patient teaching gives adequate knowledge
that is needed by the family. This also gives them the chance
to adopt to the new teachings that is given by the nurses. If
there is enough time, perform the procedures that is needed
by the family and allow them to perform this procedure to
the nurse in order to correct any mistakes that the family
may do while performing the procedures.
12. Teach the client to:
a. Good nutrition
b. increase fluid intake
c. breastfeeding per demand and proper burping.

• Healthy Eating Tips

• Eat a variety of foods. Try to eat a balanced diet of fruit, vegetables,
grains, protein foods and diary each day.
• Drink plenty of liquids. Your body needs lot of fluid (about 6-10 glasses
a day) especially if you are breastfeeding your baby. Drink mostly water,
milk, and fruit juice.
• Eat foods that have protein such as milk, cheese, yogurt, meat, fish and
beans. Protein rich foods are important to help you recover from
childbirth and keep your body strong. If you are under 18, or were
underweight prior to pregnancy, you need to eat more protein.
• Eat your fruits and vegetables. Try to make half your plate fruits and
vegetables. Fruits and vegetables have vitamins and minerals that keep
you healthy. They also have fiber, which helps prevent constipation.
Make sure to wash fruits and vegetables under running cold water before
eating them.
• Lose weight safely. Talk to your doctor about safely losing weight after
your baby is born. Losing weight too quickly can affect your breast milk
supply. Do not take diet pills. They contain harmful drugs that can be
passed to your baby through breast milk.
• Take prenatal vitamins. If you are breastfeeding, it is a good idea to
continue to take your prenatal vitamins. Your doctor can prescribe these
pills so that your health insurance will cover a portion of the cost.
• Limit junk foods. Soda pop, cookies, donuts, potato chips and french fries
are okay sometimes, but don’t let them take the place of healthy foods!
• When it comes to breastfeeding per demand and proper burping, you
should always breastfeed your baby per demand to prevent infants getting
hungry and being inadequate in nutrition and sucking. Burping helps to get
rid of some of the air that babies tend to swallow during feeding.
• Avoid these Foods when Breastfeeding
• There are some foods and other substances that can be harmful to both
you and your baby if you are breastfeeding.
• Alcohol: Wine, wine coolers, beer, drinks like hard lemonade and other
malt liquor beverages, shots and mixed drinks contain alcohol that passes
to your baby through your breastmilk and can harm your baby’s brain and
body development.
• Caffeine: Caffeine is a stimulant that passes through breast milk to the
baby and may affect growth. Caffeine is found in tea, coffee, chocolate,
many soft drinks and over-the-counter medicines.
11. Prevent/alleviate breast engorgement and promote breast
hygiene by:

• Now ma’am, I will be teaching you how to alleviate

or even prevent breast engorgement. First is to
• a. Application of warm compress or standing under
a warm shower.
• – You can use warm compress on your breast or
even standing under a warm shower as this may
help your breasts "let down," increasing the flow of
milk.
• b. Good support from bra offers a degree of relief. –
• Your bra should also be able to fully support your breasts
but should be comfortable for you and not too tight or
loose.
• c. Washing her breast daily at the time of her bath or
shower. Soap should be avoided. –
• You should also clean your breasts especially when you
are taking a bath or shower and you shouldn’t use soap
for in cleaning your breasts.
• Breast tissue may appear reddened as if an acute
inflammatory or infectious process were present and
some moms experience increased tenderness or
throbbing.
• b. Good support from bra offers a degree of relief. –
• Your bra should also be able to fully support your breasts
but should be comfortable for you and not too tight or
loose.
• c. Washing her breast daily at the time of her bath or
shower. Soap should be avoided. –
• You should also clean your breasts especially when you
are taking a bath or shower and you shouldn’t use soap
for in cleaning your breasts.
• Breast tissue may appear reddened as if an acute
inflammatory or infectious process were present and
some moms experience increased tenderness or
throbbing.
15. Give health guidelines about the following
a. family planning
•In family planning ma’am there are some
common methods I want to give to you.
•First is the Birth Control Pills -Birth control
pills are oral contraceptives that must be
taken daily. The method is often
recommended for both women who are
religious in remembering daily doses and
those who desire to restore fertility quickly.
• Next is barrier methods, Diaphragms, female and male
condoms, as well as cervical caps all belong to the barrier
family planning methods. Basically, they work in
preventing the sperm from getting close or in contact to
the egg.
• Next is Long-term Contraceptive Methods, For individuals
who would want to get pregnant in the future, but are
not into regularly prepping up against contraception,
long-term methods are the best tools to use.
• The methods include vaginal ring, contraceptive shots,
intrauterine device or IUD, and implantable rod.
•Lastly, the Natural Family Planning (NFP) -
NFP is the sole option that produces no
negative health impact and is completely
free. The American College of Obstetricians
and Gynecologists explained that NFP only
necessitates full awareness of a woman’s
body's cycles especially when she is the
most fertile.
b. immunizations and;
Hepatitis B was given to your baby immediately and
Influenza, Tdap and MMR vaccine was given to you
also. These postpartum vaccination will help protect
you from getting sick, and they will pass some
antibodies to the baby through breastmilk if they are
able to breastfeed. Vaccination after pregnancy is
especially important if moms did not receive certain
vaccines before or during pregnancy.
c. parenting roles.
• Your husband should provide physical and emotional
support to you as the one carrying his child. Also he
must learn to change diaper, how to bath the baby
safely and how to give comfort when the baby's
crying as soon as possible, both to help your partner
and to help you bond with your baby. You as the
mother should take good care of yourself in order to
rebuild your strength by getting plenty of rest, good
nutrition, and help especially from your husband
during the first few weeks.
•It helps protect women from any
health risks that may occur
before, during or after childbirth.
These include high blood
pressure, gestational diabetes,
infections, miscarriage and
stillbirth.
12. Wash hands and close bag.

•This prevents the contamination

of the equipment and the
spread of the microorganisms to
the nurse’s body.
Doffing of the Gloves and Perform hand
washing or hygiene
•To prevent the contamination
of other materials and To
prevent the spread of
microorganisms
13. Make an appointment for return visit.

•This allows the clientele to

prepare for the next home
visit by the nurse.
14. Make referrals as needed.

•If there are any needs for referrals,

the nurse should do it immediately
to address the problem properly.
15. Paper and pen for documentation

•- Timely documentation helps

to ensure patient safety.