Cleaning/Standard Precautions and Vitals Flashcards
What are the different types of transmission-based precautions?
contact, droplet, airborne
What are the 2 main categories of isolation precautions?
standard and transmission-based
What diseases require airborne precautions?
(MTV)
Measles (Rubeola)
Tuberculosis
Varicella-Zoster
- disseminated herpes zoster (shingles) and chicken pox
Variola - erradicated, but just in case
SARS
What are standard precautions?
Basic precautions used for all patients
What is asepsis?
absence of disease producing micro organisms
When should you wash your hands?
Before and after contact with patient or patient stuff or equipment, after removing gloves too!!
- Some places have policy “Wash in-Gel Out”
Before and after potty break
Before and after eating, smoking or drinking
After sneezing, coughing, blowing or picking nose
Should take at least 30 seconds-some sources say 60 sec
- Jewelry and finger nails can carry germs!
What diseases are most likely to affect us?
Hepatitis B (ABCDE)
AIDs (everyone is scared of this one, but the others are more likely)
Tuberculosis
Staphylococcal
Nosocomial
- Many places are calling this HAI-healthcare-associated infection
What organizations do we answer to?
CDC: Centers for Disease Control
OSHA: Occupational Safety and Health Administration
State Health Departments
EPA: Environmental Protection Agency
CARF: Commission on Accreditation of Rehabilitation Facilities
The Joint Commission
Others-NIOSH-National Institute of Occupational Safety and Health
Follow policy: the facility is responsible but you’re the one who gets it!
List the vital signs
Heart rate (HR) or pulse (P)
Blood pressure (BP)
Respiratory rate (RR)
Oxygen saturation (SpO2)
Temperature (T)
What do you look at when checking pulse rate?
Rate (basal and resting)
- basal is taken first thing in the morning
Regularity
Amplitude
- measured on subjective ascending scale
- scale from 0-4; 4 is strongest pulse, 1 is thready
Pulse rate
Normal: 60-100bpm
Bradycardia (slow): <60bpm
Tachycardia (fast): >100bpm
Regularity: evenness of pulse rate
What are different methods used to check pulse?
Manual palpation with mechanical devices: femoral, dorsalis pedis, popliteal, carotid, radial
- DON’T USE THUMB TO MANUALLY TAKE PULSE
Auscultation
Doppler measurements
Pulse oximeter
- fingernail polish, temperature, and fake nails can throw it off
Pulse Methods
Arterial blood gases (PaO2): measured through blood draw
Oxygen saturation (SpO2) levels: measured using pulse ox
Heart rate: beats per minute (bpm)
Maximal heart rate
Target heart rate
What is arterial patency?
Presence or absence of blood flow at point of pulse palpation
Increased patency = increased blood flow
Observation
Palpation of pulses
Rate of capillary refill: test for blanching
- lose blood flow –> pressure sore
What is blood pressure?
Measure of vascular resistance to blood flow
systolic/diastolic
What types of pressure are measure when taking BP?
Systolic: pressure when heart is contracting
Diastolic: pressure when heart is at rest
What do we use to measure BP?
Sphygmomanometer
Where and how do we measure BP?
Method
- Auscultation of artery using stethoscope while sphygmomanometer applied over artery being auscultated
Site
- Left upper arm
What is normal BP?
120/80 but can change due to stress, physical activity, and age
Prehypertension
Stage 1 hypertension
Stage 2 hypertension
What is respiration/respiratory rate?
Rate of breathing
What methods are used to measure RR?
Auscultation: stethoscope
Observation
Palpation
What are the norms for RR?
Newborn: 30-60 bpm
Adults: 12–20 bpm
What is the purpose of taking temperature?
Basal metabolic state, presence of infection, metabolic response to exercise
What methods are used to take temperature?
Thermometers (electronic, heat-sensitive strips) or palpation
Rectal is the most accurate
What are the norms for temperature?
98.6˚F or 37˚C
Pain is (subjective/objective)
subjective
What is the purpose of measuring pain?
Diagnosis
Prognosis
Appropriate interventions
Responses to interventions
How do we measure pain?
Visual Analog Scale (VAS)
Wong-Baker FACES Pain Rating Scale
What are the norms when measuring pain?
0 = nonexistent
1–3 = minimal
4–6 = moderate
7–10 = severe pain
What are anthropometrics?
Size
Weight
Proportions of human body
Body mass index (BMI)
What are isolation precautions?
Isolation precautions are the preventative steps needed to be taken by healthcare workers and staff to prevent the spread or transmission of infections.
How do you calculate maximal heart rate?
220 - age
How do you measure target heart rate? 60%, 80%?
MHR x 0.6
MHR x 0.8
How long does it take for a pressure sore to develop?
15 minutes
How do you know when to stop pumping up the BP cuff?
When do you not use left arm to take BP?
Stroke - causing flaccidity or spasticity
Amputation
When is activity contraindicated with BP?
Systolic doesn’t rise in proportion with activity
A decrease in systolic > 10
Systolic is >240
Increase in diastolic >20 with activity
When BP is outside the norms, what questions do you want to ask your patient?
Is it normal?
Do you have chest pain?
Are you dehydrated?
Do you take BP meds?
Have you taken your meds yet?
What meds are you taking?
If a client has high BP and feels like they need to have a BM, what is this a sign of?
heart attack
When should you use contact precautions?
ABCDEF
- “A” for abscess; you can use standard precautions with minor drainage
- “B” for bronchiolitis; the 2 more common viruses that cause bronchiolitis (RSV and parainfluenze) require contact precautions
- “C” for cutaneous; any disease involving the skin (herpes zoster, varicella, lice, strep)
- “D” for diarrhea; C. diff, norovirus, rotavirus, hepatitis A
- “E” for eyes; conjunctivitis (pink eye)
- “F” for funky or feisty; MRSA and VRE
When doffing PPE what parts are considered clean?
Mask and glasses (behind ears only)
Inside of gown
