Introduction into Clinical Practical Skills Flashcards
1
Q
What is the purpose of Aseptic Non-Touch Technique
A
- protect the key parts when you perform a procedure
- the key parts are the parts that will come in direct contact with the patient
2
Q
What are the 4 stages of handwashing
A
1, preparation: Wetting hands under tepid water before applying liquid soap, antimicrobial preparation
- washing - the hands must be rubbed together vigorously or a minimum of 20 seconds
- rinsing - hands should be rinsed thoroughly
- drying: drying with paper towels
3
Q
Name the steps of the washing of the hands
A
- rubbing hands palm to palm
right palm over left dorm with fingers interlaced - palm to palm with fingers interlaced
- backs of fingers to opposing palms with fingers interlocked
- rotational rubbing of left palm callused in right palm and vice versa
- rotational rubbing, backwards and forwards with clasped fingers of right hand in left palm and vice versa
- rotating the right palm over the left wrist joint and vice versa and repeat on each side
4
Q
before engaging in Aseptic Non-Touch Technique what do you have to do
A
- bare below the elbow
- remove wrist and hand jewellery
- make sure that finger nails are short, clean and free of nail polish
- cover cuts and abrasions with waterproof dressings
5
Q
What steps were involved in undertaking setting up an intravenous infusion ?
A
WIPER
- wash your ands
- introduce to the patient and confirm there name, date of birth and if they have an allergies
- permission and pain
- expose the patient
- reposition the patient
- observe cannula site for any signs of inflammation or misplacement
- double check the prescription with another member of staff
five rights
- right patient
- right drug
- right dose
- right route
- right time
- Clean the dressing trolley with the alcohol right
- gather the equipment and check the expiratory dates as you go along
What you will need
- plastic tray
- correct bag of fluid
- correct administration set
- saline flush
- alcohol wipe
- sharps bin
- alcohol hand gel
- gloves and apron
remove the outer wrapper on the fluid bag and check it for transparency
- check its in date
- hang it on a drip stand
- twist of the cap attached to the fluid bag
- open he fluid administration set
- unravel the tube making sure to keep hold of both ends - key parts that must remain sterile
- clamp the tube by using the roller clamp do this by rolling the tube downwards
- remove the cap from the spike - key part and must remain sterile
- push the spike with a twisting motion into the cork
- squeeze the drip chamber several times until it fills halfway with fluid
- prime the tube with fluid by opening the roller clamp slowly
- allow the fluid to pass slowly through the roller clamp till it reaches the end
- air bubbles must not be infused
- remove the easily
- drain it into a sink or pot until the bubbles are clear
- stretch the tube tightly and flick it with a finger which encourages the bubbles to rise to the end of the tube
- now close the clamp
- remove the gloves and wash your hands
- put on a clean pair of gloves to connect the drip to the cannula
- bring the tray containing the alcohol wipe and saline flush closer to the patient
- clean the cap on the cannula with an alcohol wipe
- open the clamp
- make sure there are no air bubbles in the saline syringe
- flush the cannula to make sure it is clean
- then close the clamp
- remove the cap from the administration tube exposing the key part and connect it to the cannula
- open the clamp again to allow the fluids to infuse
- set the drip rate according to the transfusion and sign the drug chart
- and make a note of the procedure int he patients notes
6
Q
How do to venepuncture
A
- Introduce yourself
- explain the procedure
- confirm the patients details
- wash hands - ANTT
- make sure the equipment you will use is clean and safe to use
- first clean the tray with detergent wipes and then allow it to dry
- then wipe with 70% of alcohol solution wipes and allow it to air dry again
- if it is not allowed to air dry it is not aseptic
The procedure
- with gloves on place the tourniquet
- look and feel for a vein
- once you have decided on a vein, clean the area with an alcohol wipe for 30 seconds and allow to dry for 30 seconds
- now get the needle ready, remove the white cap and attach the vacutainer device
- then pull the pink safety back and pull the green cap off
- needle is now exposed
- warn the patient that they can feel a shape scarthc
- with the bevel facing up hold the skin taut with the other hand - this helps anchor the vein as you place the needle in
- go into the vein at a 30 degree angle and you should fill give as you go into the vein
- get the blood bottles and start taking the blood
- once you are done taking blood do not take the needle out yet, take the toniquet off
- get the cotton wool ready and take the needle out and put it into a sharps bin
- apply pressure or tape with the gauze
- thank the patient
- wash your hands and get rid of your waste
7
Q
What equipment do you need for a venepuncture
A
- plastic tray
- gloves
- sharp box
- pair of gloves
- cleaning produces for the tray - detergent wipes and 70% alcohol wipes
- apron
- face mask
- tourniquet
- gauze
- alcohol wipe
- vacutainer tube
- vacutainer needle
- collection bottle for blood
8
Q
how do you place an IV cannula
A
- introduce yourself
- explain the procedure
- confirm the patients details
- wash hands
- make sure the equipment you will use is clean and safe to use
- first clean the tray with detergent wipes and then allow it to dry
- then wipe with 70% of alcohol solution wipes and allow it to air dry again
- if it is not allowed to air dry it is not aseptic
Procedure
- put the tourniquet on
- palpate and feel a good vein
- clean the area
- allow to dry for 30 seconds
- get the cannula
- put the wings down
- pull the back to make sure it works
- go to the area but don’t touch it
- pull the skin taut
- warn the patient about a sharp scratch
- advance the cannula in
- then you can see here a bit of flashback - means you have the vein
- undue the tourniquet
- advance the cannula in as you pull the needle out
- take the gauze and put it underneath
- here press at the top
- take the needle out fully
- and put it in the sharps bin
- take the extension set and fix it all up
- take the gauze away
- clean up around the area
- then you apply the cannula dressing - look around and flush it through to make sure everything still is okay
- take the syringe out
- place it over the cannula
- date inserted the cannula written down on the patient -document in the notes
9
Q
equipment you will need to place an IV cannula
A
- Sharps box
- tray
- cleaning produces for the tray - detergent wipes and 70% alcohol wipes
- Apron
- gloves
- gauze
- alcohol wipe
- face mask
- tourniquet
- gauze/cotton wool
- alcohol wipes
- cannula dressing
- saline flush
- extension set
- cannula
10
Q
what do you use for ophthalmoscopy
A
an ophthalmoscope
11
Q
What is an ophthalmoscope for
A
- its for looking at the inside back of the eyes the fundus
- the fovea, the optic disc, the macula, the posterior pole of the retina
- usually done with eye drops to open up the pupil and dilate the pupil
12
Q
How much of the back of the eye does the ophthalmoscope let you see
A
- only capable of seeing a 1/3 of the back of the eye
13
Q
What parts of the eye are at the back of the eye
A
- the fovea, the optic disc, the macula, the posterior pole of the retina
14
Q
what equipment do you need for an ophthalmoscopy
A
an ophthalmoscope
- take the handle and the ophthalmoscope piece, push it in and twist
- once you done that you need to turn it on
- press the green button and rotate it round
the light will come on the further round it is rotated the more light is produced
- one the other side the dial can change the shape of the projection and any colours
- large disk that you want when your starting off
- can change the numbering the windows - should be on 0 - only useful for refocusing if you are not using glasses
- at the bottom unscrew to release the battery
- button which changes filters and shapes - red and green filter useful for looking at blood
15
Q
How to do ophthalmoscopy
A
- “I would like to examine the back you your eye “
- warn then about dazzle
- asks them to focus on a fixed distance point and keep looking there
- warn that you will dim lights and will get close to their face
examination
- hold the ophthalmoscope so that your right eye is examining there right eye
- should be at 15 degrees form the central line
- narrow angle
- ask the patient to look over the should r
- put the ophthalmoscope right next to your eye
- hand on their brow or shoulder and start to move in
- should be able to see the red reflex early on and follow that in
- then you should be able to see the retina
- change the focus of the dial to bring it into focus
- follow the blood vessels until you reach the optic disc
- the optic disc is the nasal side of the retina
- check all 4 quadrants
- once you have had a good view pull out
