Chapter 2 | How to Care for Someone Who is Sick - Wheaton Franciscan Healthcare

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How to Care for Someone Who is Sick

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During an influenza pandemic, instructions for obtaining medical advice and receiving medical care will be provided to residents of Wisconsin through the media and healthcare providers. The following information is a general guide for providing care at home, and is not intended to take the place of medical advice from a healthcare provider.

  • Keep a care log. Record the information below about the ill person at least once each day, or more often as symptoms change, along with the date and time. Bring this information along when seeing a healthcare provider.
  • Keep the ill person as comfortable as possible. Rest is important.
  • Keep tissues and a trash bag for their disposal within reach of the patient.
  • Make sure the patient avoids drinking alcohol and using tobacco. Smoking should not be allowed in the home.
  • Use ibuprofen or acetaminophen or other measures, as recommended by your healthcare provider, for fever, sore throat, and general discomfort. See bottle
  • for directions.
  • Do NOT use aspirin in children or teenagers with influenza because it can cause Reye’s syndrome, a life-threatening illness.

Completing a Care Log

  • Check and record the patient’s temperature.
  • Check and record the patient’s skin color (pink, pale, or bluish) and note the presence and appearance of any rashes.
  • Record the approximate quantity of fluids consumed each day and through the night.
  • Record how many times the ill person urinates each day and the color of the urine (clear to light yellow, dark yellow, brown, or red).
  • Record all medications, dosages and times given.

Preventing Dehydration

When a person is ill, it is important to provide them with enough fluids to prevent dehydration.

Below are steps that can be taken to provide hydration in a variety of situations:

If the patient IS NOT vomiting, offer plenty of fluids to prevent dehydration, even if he or she does not feel thirsty.

  • Offer small amounts of fluid frequently. It is important to drink fluids early and often to prevent dehydration. Regular urination is a sign of good hydration.
  • If the ill person is not eating solid foods, include fluids that contain sugars and salts, such as:
    • Broth or soups.
    • Ginger ale and other sodas, but not diet drinks.
    • Rehydration solution to prevent dehydration. Examples of rehydration solutions are: Pedialyte® for kids and Gatorade® for adults and teens. A recipe for making rehydration solution at home is provided.
  • If the patient IS vomiting, do not give any fluid or food by mouth for at least 1 hour. Let the stomach rest. Next, offer a clear fluid, like water, in very small amounts.
  • Babies who are breast-fed and vomiting can continue to nurse. Feed smaller amounts, more often, by breast-feeding on only one breast for 4-5 minutes every 30-60 minutes or by offering teaspoonfuls of Pedialyte® or Lytren® every 10 minutes

Homemade Rehydration Solution

Ingredients

4 cups of clean water
2 tablespoons of sugar
1/2 teaspoon of salt

Directions

Mix the above ingredients until sugar is dissolved

Providing Hydration to Ill Persons Who Are Vomiting

  • Do not give any food or fluid by mouth for at least one hour after vomiting ceases.
  • Start with 1 teaspoon to 1 tablespoon of clear fluid every 10 minutes.
  • If the patient vomits, let the stomach rest again for an hour.
  • Again, try to give small frequent amounts of clear fluid.
  • When there is no vomiting, gradually increase the amount of fluid offered and use fluids that contain sugars and salts.
  • After 6-8 hours of a liquid diet without vomiting, add solid food that is easy to digest, such as saltine crackers, soup, mashed potatoes or rice.
  • Gradually return to a regular diet.

Recognizing and Treating Dehydration

When caring for someone who is ill, it is important to watch for the following signs of dehydration:

  • Weakness or unresponsiveness
  • Sunken eyes
  • Decreased saliva/dry mouth and tongue
  • Skin tenting: check this by picking up layers of skin between your thumb and forefinger and gently pinching for 1 second. Normally, the skin will flatten out into to its usual shape right away. If patient is dehydrated, the skin will “tent” or take 2 or more seconds to flatten out. This is best checked on the belly skin of a child and on the upper chest of an adult.
  • Decreased output of urine, which becomes dark in color from concentration. Ill persons who are getting enough fluids should urinate at least every 8-12 hours.

If the ill person is dehydrated, give sips or spoonfuls of fluids frequently over a 4-hour period. Watch for an increase in urination, a lighter color of the urine and improvement in the patient’s overall condition. These are signs that the increased fluids are working.

  • Children under 5 years: Give 1 ounce fluid per pound body weight over 4 hours
  • (Example: A 20 lb. child needs 20 oz. or 2-3 cups over 4 hours).
  • Older children & adults will need 1-2 quarts of fluids over the first 4 hours.

Dehydration in infants and the elderly can be dangerous, seek medical attention immediately if symptoms continue to worsen.

Complications from Influenza

Watch for complications of influenza. Complications are more common in individuals with health conditions such as diabetes, heart, and lung problems, but may occur in anyone who has the flu.

Call your healthcare provider or the pandemic influenza hotline if the ill person:

  • Has difficulty breathing, fast breathing, or bluish color to the skin or lips.
  • Begins coughing up blood.
  • Shows signs of dehydration and cannot take enough fluids.
  • Does not respond or communicate appropriately or appears confused
  • Complains of pain or pressure in the chest.
  • Has convulsions (seizures).
  • Is getting worse again after appearing to improve.
  • Is an infant younger than 2 months old with fever, poor feeding, urination less than 3 times per day, or other signs of illness.

How to Use a Thermometer

Use a digital thermometer, with numbers, not the old kind of thermometer with mercury (a silver or red line).

Oral Use (basic digital thermometer only)

  • Place the end of the thermometer well under the tongue. Then mouth should remain closed. Do not bite the thermometer.
  • When you hear “beep” sounds remove the thermometer from the mouth.
  • Read the numbers on the screen. Normal temperature is approximately 98.6º F.

Underarm Use

  • Place the end of the thermometer in the armpit so that the probe touches the skin. Hold the arm next to the body.
  • When you hear “beep” sounds take out thermometer.
  • Read the numbers on the screen. Normal underarm temperature is approximately 97.6º F.

Note: Rectal use is recommended for babies and young children. Instructions for this method are included in the thermometer package. There are also times when you may have to take an adult’s temperature rectally.

How to Clean the Thermometer

  • Use alcohol wipes or a cotton ball saturated with 70% Isopropyl Alcohol or Rubbing Alcohol.
  • Rub the alcohol wipe over the entire thermometer.
  • Dry the thermometer with a clean dry cloth or cotton ball.
  • NEVER return an unclean thermometer to the storage case.

Note: If taking many temperatures use a plastic cover for the end of the thermometer. DO NOT reuse thermometer covers.

Wisconsin Department of Health Services
Division of Public Health