Lesson 1-2 (FINALS) Flashcards
Medical asepsis is also known as…
Clean Technique
Freedom from most pathogenic organisms
Medical Asepsis
The purpose of this asepsis is to reduce transmission of pathogenic organisms from one patient-to-another.
Medical Asepsis
Medical Asepsis
- Know what is dirty
- Know what is clean
- Know what is sterile
- Keep the first three conditions separate
- Remedy contamination immediately
Medical Asepsis. When the body is penetrated, natural barriers such as skin and mucous membranes are bypassed, making the patient _____ to microbes that might enter
Susceptible
Medical Asepsis. Even though skin is an effective barrier against microbial invasion, a patient can become colonized with other microbes if precautions are _____
Not taken
Medical Asepsis. When the body is penetrated, natural barriers such as skin and mucous membranes are bypassed, making the patient susceptible to microbes that might enter
- Perform hand hygiene and put on gloves
- When invading sterile areas of the body, maintain sterility of the body system
- When placing an item into a sterile area of the body, make sure the item is sterile
Medical Asepsis. Even though skin is an effective barrier against microbial invasion, a patient can become colonized with other microbes if precautions are not taken
- Perform hand hygiene between patient contacts
- When handling items that only touch patient’s intact skin, or do not ordinarily touch the patient, make sure item is clean and disinfected (between patients)
Surgical asepsis is also known as…
Sterile Technique
Medical Asepsis. All body fluids from any patient should be considered _____
Contaminated
Medical Asepsis. The _____ and the _____ can be a source of contamination for the patient
Healthcare team & Environment
Medical Asepsis. All body fluids from any patient should be considered contaminated
- Body fluids can be the source of infection for the patient and you
- Utilize appropriate personal protective equipment (PPE)
- When performing patient care, work from cleanest to dirtiest patient area
Injuries due to needles and other sharps have been associated with transmission of ___, ___, and ___ to healthcare personnel
HBV, HCV and HIV
Freedom from all pathogenic organisms
Surgical Asepsis
Medical Asepsis. The healthcare team and the environment can be a source of contamination for the patient
- Health care providers (HCP) should be free from disease
- Single use items can be a source of contamination
- Patients environment should be as clean as possible
Surgical asepsis principles
- The patient should not be the source of contamination
- Healthcare personnel should not be the source of contamination
- Recognize potential environmental contamination
The purpose of this asepsis is to prevent introduction of any organism into an open wound or sterile body cavity
Surgical Asepsis
Surgical Asepsis
- Know what is sterile
- Know what is not sterile
- Keep sterile and not sterile items apart
- Remedy contamination immediately
Required all employers to switch to safety needle devices to minimize the risk of accidental sticks and solicited employee input in choosing safer devices
Needle Stick Safety and Prevention Act of 2001
Things to do when accidently injured by needle stick
- Immediately flood the exposed area with water and clean any wound with soap and water or a skin disinfectant.
- Report this immediately to your employer. Your employer is required to keep a log of such incidents. Follow your facility’s exposure control plan for reporting and medical treatment for an accidental needle exposure.
- Seek immediate medical attention, including counseling for exposure to HIV, HBV, and HCV.
Establishing Rapport. this communicates care and compassion.
Maintain Eye Contact
Establishing Rapport. It can show empathy and interest in your patient’s situation.
Maintain Eye Contact
Establishing Rapport. It is the ability to understand the patient’s situation, perspective, and feelings.
Empathy
Establishing Rapport. together with social touch connect you to your patients and communicates understanding.
Maintain Eye Contact
Establishing Rapport. Understanding your patient’s communication preferences and state of mind will help build rapport.
Open Communication
Establishing Rapport. It allows you to deliver more personalized patient care.
Show Empathy
Establishing Rapport. To help ease their stay, take the time to get to know your patients.
Make it Personal
Establishing Rapport. Informing your patient of new orders or changes in their condition is one way to do this.
Open Communication
Establishing Rapport. Listen to what the patient is saying
Active Listening
Establishing Rapport. Ask about their friends and family, hobbies, and other important aspects of their life.
Make It Personal
Establishing Rapport. Encouraging your patient to share their feelings with you is another.
Open Communication
Establishing Rapport. This is an easy way to learn how to build rapport with your patients.
Make it Personal
Establishing Rapport. Repeat what you heard to the patient.
Active Listening
Establishing Rapport. Check with the patient to ensure your reflection is correct.
Active Listening
Establishing Rapport. The goal of active listening is to _____ or intent behind their words. It would help if you _____, not to respond.
Reflect the feeling & Listened to understand
Establishing Rapport. Matching the patient’s demeanor, disposition, and rhythm quickly establishes rapport.
Practice Mirroring
Establishing Rapport. This may even mean raising your voice to match a loud patient to create a synchronized bond.
Practice Mirroring
Signs. color indicating allergy
Red
Establishing Rapport. Then, with a low voice and measured movements, lead the patient to a better place.
Practice Mirroring
Establishing Rapport. Use _____ to become attuned to the patient during difficult conversations.
Mirroring
Establishing Rapport. _____ is one of the most effective ways to build rapport with patients.
Keeping your Word
Family and Visitors. It is best to ask them to _____ the room until you are finished.
Step Outside
Establishing Rapport. If your ability to complete a task changes, communicate this with the patient.
Keep your Word
Establishing Rapport. If you tell them, you will do something, do it.
Keep your Word
Signs. color indicating fall risk
Yellow
Establishing Rapport. _____ and _____. Keeping your word with patients not only builds rapport it also builds trust.
Don’t over-promise & Under-deliver
Signs are typically posted on the _____ to the patient’s room or on the _____ or _____.
Door, wall beside, & behind the head of the patient’s bed
Containing information concerning the patient is an important part of the approach to an inpatient.
Looking for Signs
Signs. color indicating DNR
Blue
_____ indicating that infection-control precautions are to be followed on entering the room and _____ that prohibit the taking of blood pressures or blood draws from a particular arm.
Signs
Signs. color indicating latex allergy
Green
Signs. color indicating limb alert
Pink
Entering a Patient’s Room. 1. Doors to patients’ rooms are usually _____.
Open
Entering a Patient’s Room. 2. If the door is closed, _____, open the door slowly, and say something like “good morning” before proceeding into the room.
Knock Lightly
Entering a Patient’s Room. 3. Even if the door is open, it is a good idea to _____ to make occupants aware that you are about to enter.
Knock Lightly
Entering a Patient’s Room. 4. Make your _____ before proceeding or opening the curtain to protect the patient’s privacy and avoid embarrassment.
Presence Known
Physicians and Clergy. If a physician or a member of the clergy is with the patient, _____.
Don’t Interrupt
Physicians and Clergy. The patient’s time with these individuals is _____ and _____.
Private and Limited
Verifying Name and Date of Birth. _____ (Accuracy in Patient and Sample Identification) recommends having the patient spell the last name.
CLSI guideline GP33-A
Family and Visitors. _____ there are family members or visitors with the patient.
Often
Neonates and Other Infants. The child may be identified by a ___, ____ or ___.
Nurse, relative, or guardian
Verifying Name and Date of Birth. The patient must be _____ involved in the identification process.
Actively
Family and Visitors. Most will prefer to do so; however, some family members will _____ in the room.
Insist on staying
Outpatient ID. Typically, the _____ verifies the patient’s identity and fills out the proper requisition or generates one via computer.
Outpatient collection site’s receptionist
Patient Identification (ID). The process of _____, is the most important step in venipuncture and specimen collection.
Verifying a patient’s identity
Patient Identification (ID). _____ a patient or specimen can be grounds for dismissal of the person responsible and can even lead to a malpractice lawsuit against that person.
Misidentifying
Neonates and Other Infants. ID bands may be placed on the _____ instead of the arm of inpatient newborns or babies _____.
Lower leg & Under 2 years of age
Verifying Name and Date of Birth. When identifying a patient, _____ the patient to state his or her _____ and _____.
Ask, Full name & Date of birth
Verifying Name and Date of Birth. The patient’s response must _____ the information on the requisition and/or computer-generated requests.
Match
Verifying Name and Date of Birth. Any errors or differences must be _____ to the patient.
Resolved before doing anything
Introduce Yourself. Identify yourself to the patient by stating your ___, ___ and ___.
Name, your title, and why you are there
Enumerate the history of presenting complain
- Site
- Onset
- Character
- Radiation
- Associations
- Time Course
- Exacerbating / Relieving Factors
- Severity
Introduce Yourself. This is a part of _____ and _____.
Informed consent and Patient rights
Introduce Yourself. The patient has a _____ to have blood drawn by a student or anyone else.
Right to refuse
History of Presenting Complaint. When did it start, was it constant/intermittent, gradual/ sudden?
Onset
This is what the patient tells you what is wrong.
Presenting Complain
History of Presenting Complaint. Where exactly is the pain?
Site
Measurement of the heart rate, or the number of times the heart beats per minute.
Pulse Rate
History of Presenting Complaint. What is the pain like e.g. sharp, burning, tight?
Character
History of Presenting Complaint. Does it radiate/move anywhere?
Radiation
History of Presenting Complaint. Is there anything else associated with the pain, e.g. sweating, vomiting.
Associations
History of Presenting Complaint. Does it follow any time pattern, how long did it last?
Time Course
The normal body temperature of healthy adult
97.8 degrees Fahrenheit (36.5 degrees Celsius) to 99 degrees Fahrenheit (37.2 degrees Celsius)
History of Presenting Complaint. How severe is the pain, consider using the 1-10 scale?
Severity
History of Presenting Complaint. Does anything make it better or worse?
Exacerbating / Relieving Factors
Find out what medications the patient is taking, including dosage and how often they are taking them.
Drug History
Past Medical History. It is important to take note the _____, _____ and _____.
Procedure/surgery name, Year and Institution it was done.
Usually noticed by other people.
Signs
Past Medical History. Gather information about a patient’s other medical problems, ___ surgeries, or past hospital admissions.
Past
At this point it is a good idea to find out if the patient has any allergies
Drug History
Normal pulse for adults.
60 to 100 beats per minute
Enumerate the site for body temperature
Oral, Rectal. Axillary, By Ear and By Skin
Family History. Find out if there are any _____ within the family.
Genetic Conditions
Gather some information about the patient’s family history.
Family History
Enumerate some of the signs of an illness
- Rapid pulse
- High temperature
- Limping
- Sweating
- Coughing
- Bruising
Complete your history by reviewing what the patient has told you.
Summary of History
Is an indication that something is not right in a person’s body.
Signs of an Illness
Summary of History. _____ back the important points so that the patient can correct you if there are any misunderstandings or errors.
Repeat
Is an indication that something is not right in a person’s body.
Symptoms of an Illness
This is what the person experiences and communicates.
Symptom
Enumerate some symptoms of an illness
- Chills
- Abdominal pain
- Weakness
- Nausea
- Headache
- Backache
Generally, it is not noticed by anyone else.
Symptom of an Illness
Pulse rate for Infants 1 to 11 months old
80 to 160 beats per minute.
Measurements of the body’s most basic functions
Vital Signs
Useful in detecting or monitoring medical problems.
Vital Signs
The number of breaths a person takes per minute
Respiration Rate
The respiration rate is usually measured when a person is at ___ and simply involves counting the number of breaths for one minute by counting how many times the chest rises.
Rest
Normal respiration rates for an adult person at rest
12 to 16 breaths per minute.
The force of the blood pushing against the artery walls during contraction and relaxation of the heart.
Blood Pressure
Is systolic is 130 to 139 or diastolic between 80 to 89
Stage 1 high blood pressure
Is systolic of less than 120 and diastolic of less than 80 (120/80)
Normal blood pressure
Is systolic of 120 to 129 and diastolic less than 80
Elevated blood pressure
Is when systolic is 140 or higher or the diastolic is 90 or higher
Stage 2 high blood pressure
Enumerate the inclusion for documentation
- The time of day
- The drug name
- The dose
- Route of administration (must be included in the documentation)
Enumerate establishing rapport
- Maintain eye contact
- Show empathy
- Open communication
- Make it personal
- Active listening
- Practice mirroring
- Keep your word
No health care worker may prescribe or administer drugs that are not ordered by a _____ to do so.
Person Licensed
The supervising physician then _____ the entry.
Countersigns
An order must be ___, ___ and ___ by the physician.
Dated, written, and signed
Syringe Parts: the end of the syringe to which the needle is fastened
Tip
When a radiographer, acting under the supervision of a radiologist, administers a medication to a patient, it must be recorded in the _____.
Patient’s chart
Needle Parts. the sharp angulated tip of the needle
Bevel
Equipment for drug administration. Enumerate the needle parts
- The Hub
- The Shaft
- The Lumen
- The bevel
The radiographer, or whoever administers the medication, must also ___ the chart for identification purposes.
Sign
Needle Parts. the part that attaches to the syringe
Hub
Needle Parts. the hollow tube that runs the length of the shaft
Lumen
Needle Parts. the elongated part of the needle
Shaft
Rules for working with syringes and needles. Syringes and needles are to be discarded in _____ that are required to be provided in all areas where drugs are administered even if they contain safety features
Puncture- proof containers labeled sharps container
Equipment for drug administration. Enumerate the syringe parts
- The tip
- The barrel
- The plunger
Syringe Parts: the body of the syringe
Barrel
Syringe Parts: the part that fits into the barrel
Plunger
Rules for working with syringes and needles. Needles that have been used for an injection must _____. If it has a protective mechanism, it must be engaged after use.
Not be recapped
Rules for working with syringes and needles. Syringes and needles are _____ and are to be discarded after ___ use.
Disposable & One
Rules for working with syringes and needles. The used syringe must be held by the _____ and carried immediately to the sharp’s container.
Barrel
Rules for working with syringes and needles. _____ place a used syringe and needle back onto a tray to be disposed of later.
Never
Rules for working with syringes and needles. If a needle does not have a protective mechanism in place, a _____ method may be used to prevent injury.
Needle Scoop
Glass container with a rubber stopper circled by a metal band; the band holds the stopper in place; The rubber stopper is protected from contamination by a plastic cap
Vials
Packaging of Parenteral Medications. If they are intended for intramuscular, subcutaneous, or intradermal injection, they are either in an _____ or a _____.
Ampule or a Vial
Rules for working with syringes and needles. If a needle-stick injury should occur, it must be reported as a _____ as soon as possible following the event.
Critical Incident
Packaging of Parenteral Medications. Drugs intended for parenteral administration are packaged to maintain _____.
Sterility
Made of glass and contains a single dose of a drug; Labeled with the name of the drug, the dosage per mL, and the route for administration.
Ampules
Obtaining a drug from a vial
- Remove the plastic protective cap from the top of the vial.
- If this a multidose vial and has been opened previously, check the date and time opened and cleanse the rubber top with an alcohol wipe.
- Determine the dosage desired from the vial and draw up the equivalent amount of air into the syringe.
- Insert the needle into the vial and inject the air. The fluid will replace the air in the syringe rather quickly.
- Draw the plunger back until the exact amount of drug is obtained
Obtaining a drug from an ampule
- The indented area at the neck of the ampule may be opened by filing with a metal file or by simply snapping off the top of the vial.
- The health care worker must never attempt to snap off the top of an ampule without protecting his hands as the glass may break unevenly and cause a laceration
- If a vial shatters when broken open, the medication must be discarded as there may be glass shards in the drug.
- If all the drug in an ampule is not used, it must be discarded because it will not remain sterile after the ampule is opened.
Venipuncture proper procedure
- Approach the patient, identify him, and assess for latex or iodine allergies. Explain the procedure and answer any questions he may have.
- Wash your hands.
- Secure the tourniquet over the site selected in such a manner that it can be removed by pulling on one end
- Instruct the patient to make two or three tight fists to force more blood into the veins to make them more visible.
- Put on clean gloves.
- Gloves need not be sterile; however, all other equipment used that cleans or penetrates the skin must be sterile.
- Cleanse the area for the venipuncture using firm strokes from center of site to outside.
- Do this at least three times using a separate swab each time.
- Allow the area to dry.
- Hold the skin taut above or below the insertion site.
- Insert the needle or catheter bevel side up into the vein
- When the needle enters the vein, blood returns into the flashback chamber immediately.
- For IV cannula, Pull out the needle and the catheter will be left inside the vein.
- For IV cannula, Attach the heplock immediately and flush with saline solution
- Secure the venipuncture site with tape.
Venipuncture failed procedure
- If no blood returns, the venipuncture was not successful.
- If this is the case, remove the needle and obtain a new needle to start the IV and select a new site.
- Apply pressure to the failed area with a sterile gauze pad until bleeding stops.
- If the second effort fails, call a member of the IV team or an anesthesiologist to start the IV.
