NPLEX 2: Minor Surgery Flashcards
Define universal precaution
Universal precaution applies to what bodily fluids?
What does it NOT apply to?
Recommended by the CDC to minimize the risk of exposure for healthcare workers to infectious blood, body fluids, and tissue.
It assumes that ALL patients may be potentially infected with blood-borne or fluid-borne pathogens; adherence is crucial
Applies to:
- Bodily fluids including visible blood, semen, vaginal secretions, cerebrospinal, synovial, pleural, peritoneal, pericardial, and amniotic fluids.
Does NOT apply to:
- Feces, nasal secretions, sputum, saliva, sweat, tears, urine, and vomitus unless they contain visible blood.
Define:
- Droplet precautions
- Airborne precautions
- Contact isolation
Droplet precautions for patients known or suspected to have serious illness transmitted by large droplet particles (ex. diphtheria, pertussis, influenza, rubella, scarlet fever, etc.)
Airborne isolation for patients known or suspected to have serious illness transmitted by airborne droplet mechanism (ex. TB, measles, etc.)
Contact isolation for patients known or suspected to have serious illness transmitted by direct contact (ex. clostridium difficile, methicillin-resistant Staphylococcus aureus, E. coli 0157:H7, etc.)
All blood and bodily fluids are treated as ___
infectious
Work surfaces: shall be maintained in a clean and sanitary fashion and cleaned immediately with appropriate cleaning materials (ex. __% bleach or __% sodium hypochlorite) after contamination.
10% bleach
1% sodium hypochlorite (bleach)
Soiled laundry:
In hospital settings, seal all linen with blood or body fluid exposure in a _____ inside an appropriately labeled red biohazard bag.
Temperatures of at least ____ F and ____ ppm of chlorine bleach are usually used in washing cycle.
water soluble bag
160 degrees
50-150 ppm of chlorine bleach
In general, chemicals should all be treated as ___ unless proven otherwise and disposed of at hazardous waste disposal sites in sealed containers.
Known biodegradable and basically benign substances such as ___ and ___can be washed down the sink.
Toxic
glycerin & ethanol can go down the sink
Proper disposal of the following:
• Biohazardous materials
• Non-recyclable, non-contaminated medical supplies
• Recyclable, non-contaminated medical supplies
• Non-contaminated, non-recyclable packaging materials
• Contaminated
Biohazardous materials:
- must be treated like sharps and disposed of in appropriately marked biohazard containers.
Non-recyclable, non-contaminated medical supplies:
- Containers lined with heavy plastic, disposed as solid waste
- Plate glass, Pyrex, light bulbs, broken glass containers, and other similar materials
Recyclable, non-contaminated medical supplies:
- Recycling
- intact, clean triple-rinsed glass and plastic containers without caps
Non-contaminated, non-recyclable packaging materials
- Trash
- Foil, plastic bags, paper towels, masks, gloves, aprons, and head covers
Contaminated:
- Biohazard red plastic bags
- Stocks, plates, gauze, bandages, gloves, fluid-filled containers from patients, and other contaminated materials (other than sharps)
Contraindications of venipuncture?
- Do not collect from?
Do NOT draw blood specimen from an arm with
- an IV device
- dialysis AV fistula, unless physician authorized
o Do NOT take specimens from the side of an axillary lymph node dissection to avoid cellulitis
• Equipment: needle attached to syringe under vacuum or Vacutainer to which a needle and blood collection
If venipuncture cannot be done in the upper extremity, use which vein?
- Usually go for the antecubital fossa: basilic, cehalic, median cubital vein.
- If not, go to hand and wrist
- If not, femoral vein or ankle
The needle bevel should be __, enter With needle bevel up, vein through skin at a __°angle.
bevel up, 15 degrees
The order of tube to be collected during venipuncture
Non-additive tubes before additives
- Blood culture tubes are drawn first to maintain sterility.
- Red top: non-additive tubes; allow blood to clot when serum needs to be tested; useful for chemistry, bilirubin, BUN, calcium
- Blue top: coagulation tubes; contain sodium citrate, which prevents blood from clotting when testing plasma; useful for hematology, prothrombin time, partial thromboplastin time
- Green top: heparin tubes; contain heparin to prevent blood from clotting when testing plasma; useful for chemistry, ammonia, carboxyhemoglobin
- Lavender top: EDTA-K3 tubes; EDTA prevents blood from clotting; useful for hematology, CBC, platelet count
- Gray top: oxalate-fluoride tubes; additive prevents glycolysis; useful for chemistry, glucose, lactose tolerance
Common sites for fingerstick
which population is it indicated to
fingertips, earlobes, heel surfaces.
Fingertips (second, third or fourth) most commonly used in adults and small children
Heel sticks (lateral or medial heel surface) most commonly used in infants
Fingertip phlebotomy procedure
- what do you do with the first drop?
- correct collection by?
- always discard the first drop with sterile pad
- do no milk or apply pressure to obtain blood
Equipment-types of needles and catheters (pros and con)
Buttery catheter: easy to insert but does not reliably stay in place for long IV drips; used to deliver small quantities of medicines for short pushes, to deliver fluids in infants, and to draw samples. Generally, small gauge needles (23 gauge) used.
Over-the-needle catheters: angiocatheters; harder and more painful to insert than butterfly needles but will stay in place for long IV drips without infiltrating the vein
Inside-the-needle catheters: midline and extended dwell catheters
To deliver large amounts of fluid, select a larger vein and use a __ or __ gauge catheter.
To administer medication, use an __ or __ gauge catheter in a ___ vein
14 or 16 gauge to deliver more fluid
use 18 or 20 gauge in a small vein to deliver medication
