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CP 2230 > POD 1 > Flashcards

POD 1 Flashcards

1
Q

What is the difference between medical and surgical asepsis?

A

Medical asepsis (clean technique) involves procedures used to reduce and prevent the spread of microorganisms.

Surgical Asepsis, (sterile technique) requires different precautions from those of medical asepsis. Surgical asepsis includes procedures used to eliminate all microorganisms, including spores, from an object or area.

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2
Q

What are the links in the chain of infection and why is it important for psychiatric nurses to understand the infectious process?

A

The infectious agent
Reservoir
Portal of exit
A mode of transmission (vehicle on or by which mo can travel e.g., direct contact, indirect (vehicle or vector (=thru insects), airborne, droplet)
A portal of entry to a host
A susceptible host

It is important for Psychiatric Nurses to understand the infectious process to facilitate infection prevention and practice to break the chain of infection so infections don’t develop

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3
Q

What do you call an infection that is acquired in a hospital/health care institution?

A

A health care–associated infection (HAI), also known as nosocomial infection or iatrogenic infection

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4
Q

What are the most common microorganisms found in health-care associated infections?

A

An exogenous infection arises from microorganisms external to the individual that do not exist as normal flora; examples are Salmonella organisms and Clostridium tetani.

An endogenous infection can occur when some of the patient’s flora become altered and overgrowth results. Examples are infections caused by enterococci, yeasts, and streptococci.

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5
Q

What are MRSA and Clostridium difficile, and how might they be spread in hospitals?

A

methicillin-resistant Staphylococcus aureus
&
Clostridium difficile, which can produce spores, can live in hospital environments for months.

both can be spread by direct or indirect contact

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6
Q

what is direct contact

A

Physical skin-to-skin contact between an infected or colonized individual and a susceptible host (e.g. touching patient)

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7
Q

what is indirect contact

A

Contact between a susceptible host and a contaminated intermediate object (e.g., via touching soiled linen, equipment, or dressings; transferring pathogens to a patient via hands that are not washed between handling patients)

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8
Q

what is droplet transmission

A

Large particles (droplets) from the respiratory system of an infected source propelled up to 2 m through the air and deposited onto a susceptible host (e.g., droplets produced via coughing, sneezing, or talking)

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9
Q

what is airborne transmission

A

Small airborne particles (droplet nuclei) containing microbes remain suspended in the air for long periods of time (e.g., droplets and aerosolized airborne particles produced via coughing and sneezing); air currents transmit these particles long distances (>2 m); susceptible host inhales them

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10
Q

what is vehicle transmission

A

A single contaminated source (e.g., water, drugs, intravenous fluid, food, equipment) transmits infection to multiple hosts, possibly resulting in an outbreak

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11
Q

what is vector borne transmission

A

Insects (fleas, mites, ticks, mosquitoes) or pests (e.g., mice) transmit microbes to humans

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12
Q

what are the 5 key moments of hand-hygiene

A
  1. before initial contact with the patient, client, resident or the environment
  2. Before any clean (routine) or aseptic (sterile) procedure
  3. after blood or body fluid risk or exposure
  4. After contact or touching the patient, client, or resident
  5. after contact with the patient’s environment
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13
Q

what is a reservoir

A

source for pathogen survival and may or may not multiply

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14
Q

how is HIV transmitted

A

through unprotected sexual intercourse, the use of shared needles for injecting drugs, and infected blood products

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15
Q

how are hepatitis B & C transmitted

A

Hep B - blood and body fluids
Hep C - blood

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16
Q

what are contact precautions

A

prevent the transmission of infection that is spread thru direct or indirect contact with a patient
gown + gloves
MRSA

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17
Q

what are contact plus precautions

A

same as contact precautions (gown + gloves) but hand hygiene should be performed with soap and water
C. difficile

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18
Q

why should hand hygiene be performed with soap and water when working with a patient with c.difficile

A

alcohol based sanitizer is not effect for removing c.difficile spores & the mechanical action of hand washing has been proven more effect to remove spores

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19
Q

what are droplet precautions

A

when a patient has something that can be spread through droplets in the air
- influenza
- gown, gloves, surgical mask, eye protection

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20
Q

what are airborne precautions

A
  • TB, Measles spread by airborne particles
  • gown, gloves, N95 mask, eye protection may be needed if there is a risk of being exposed to spray in the eyes
  • negative pressure room is required; pulls air into the room to prevent air from back flowing out of the room and into the rest of the facility spreading infection
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21
Q

what are cytotoxic precautions

A

cytotoxic drugs can damage or mutate DNA of people who handle the drugs
cytotoxic precautions are for up to 48 hours after the last administration of a cytotoxic medication
- when interacting with a pt on these precautions or handling their body fluids you need to: double-glove, special gown with long sleeves and is water resistant (usually plastic disposable), eye protection/face protection
- soiled briefs or soiled linens need to be disposed of in a special container
- if the person is using the toilet, they need to cover the toilet and double flush
- soiled reusable equipment needs to be sent to the sterile processing department

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22
Q

How could the psychiatric nurse be exposed to pathogenic blood or body fluids in the work place?

A

Urine splashes in your eye when emptying a catheter or urinal
Saliva or sputum lands on your lip when a client is coughing or spitting
You are poked with a used syringe

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23
Q

How do psychiatric nurses control or reduce their risk of contact with blood or body fluids that may be infected?

A

Know the risks of the situation in which you may be exposed to infectious material
Follow proper PPE and handwashing guidelines
Handle sharps safely and dispose of them properly
Immediately wash the exposed area with running water, or the emergency eye wash, if applicable
Report immediately for first aid, and to your supervisor

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24
Q

What information is usually required on the special form used for recording controlled substances?

A

the prescribers name, the date, time, amount removed, wastage if appropriate in the narcotic book or automated system

25
Q

What does the count of controlled substances at the end of a shift include?

A

counting all of the narcotics in the cupboard, signed by two nurses and any discrepancies need to be reported immediately

26
Q

What is the appropriate technique for pouring narcotic medications?

A

another nurse must witness the waste of the narcotic and sign

27
Q

What are the nurse’s professional and legal responsibilities in preparing and administering medications safely?

A

Nurses are responsible for following and understanding legal provisions when administering controlled substances

A controlled substance is anything that can affect the mind or behavior

Must understand patient’s diagnosis, why giving medication, and symptoms that might be associated with medication

Must follow the process of 7 rights and 3 checks

28
Q

What is the safe time frame that a medication may be administered?

A

Within 30 minutes, before or after scheduled time

29
Q

In your textbook, what are the 10 rights of medication administratio

A

1.The right medication
2.The right dose
3.The right patient
4.The right route
5.The right time and frequency
6.The right documentation
7.The right reason
8.The right to refuse
9.The right patient education
10.The right evaluation

30
Q

When are the 3 checks performed for medication preparation?

A
  1. Checking the medication with the MAR or the medication information system when removing it from the medication drawer, refrigerator, or controlled substance locker.
  2. Checking the medication when preparing it, pouring it, taking it out of the unit-dose container, or connecting the IV tubing to the bag.
  3. checking the medication before administering it to the patient
31
Q

When is the oral route for medication administration contraindicated?

A

An oral medication route is contraindicated for patients who cannot tolerate oral drugs, such as those who have altered mental status (decreased LOC) or have nausea or vomiting, and swallowing difficulties that hinder them from safely ingesting the drug orally (risk for aspiration)
NPO (nothing by mouth) status (surgery, tests, interventions

32
Q
  • How does the nurse pour medications from a ward stock container?
A

Pour the medication into medication cap of ward stock container and than transfer to medication cup- do not touch medication
There is a higher rate of medication error when dispensing medications from ward stock

33
Q
  • Which tablets can be broken?
A

If they are scored by the manufacture

You cannot crush or break time release or extended-release medications -> CR, ER, enteric coated (pantoprazole, tamsulosin)

34
Q
  • How does the preparation of medications differ for drugs that require special assessment data?
A

medications that require a pre-assessment like cardiac meds may be poured into a separate cup
- in case they need to be held due to assessment results

35
Q

What can the nurse do for patients who have swallowing difficulties

A

Check if the medications can be crushed and placed in apple sauce
Connect with pharmacy and physician for other route options- liquid form

36
Q

What is the appropriate technique for pouring liquid medications

A

Gently shake the liquid
If in a unit dose container, it is ready to be given
Multi dose- remove the cap and place so it is not exposed to the surface
Hold medication cup at eye level and fill to the desired scale- should be even with the fluid level at its surface

37
Q

What is the meniscus?

A

Is the curve in the upper surface of a liquid close to the surface of the container or another object, caused by surface tension.

38
Q

How does the technique change for liquid medication doses that are less than 10 mls?

A

use a needless syringe

39
Q

What is the purpose of capillary blood glucose resting (glucometer testing)?

A

To understand your patients blood sugar levels and assess for complications
(i.e. Decreased level of consciousness, dizziness, confusion, blurred vision, falls)

40
Q

What are the normal capillary blood glucose (glucometer) levels?

A

4-6 mmol/L

41
Q

What part of the fingers should be used for glucometer testing?

A

Poke side of finger with lancet; not the pads of finger as these have more nerve endings

41
Q

What part of the fingers should be used for glucometer testing?

A

Poke side of finger with lancet; not the pads of finger as these have more nerve endings

42
Q

When are glucometer readings done?

A

Glucometer readings are typically done before meals. They will be ordered by the physician and range from once daily to QID. Blood sugars are also checked four hours prior to surgical procedures

When a patient has a change in level of consciousness, a fall, feels dizzy or is confused it is a good idea to do a glucometer check to rule out hypoglycemia

43
Q

What are the 3 most common types of syringes?

A

Leur-lok syringe
TB syringe
Insulin syringe

44
Q

What are the 3 parts of the syringe?

A

Plunger
Barrel
Tip

45
Q

What are the 3 parts of a needle?

A

Bevel
Shaft
Hub

46
Q

What are the differences in calibration with the different types of syringes?

A

Leur-lok syringe marked in 0.1 tenths - 3 mL capacity
Tb syringe long thin barrel- calibrated in sixteenths of a minim and in hundredths of a milliliter- 1 ml capacity

Insulin syringe (Insulin 1ml) and calibration in units (10-100)- pre attached needle (cap often orange)

Insulin syringe (Insulin 0.5 ml) and calibration in units (5-50) - pre attached needle (cap often orange)

47
Q

How do ampules and vials differ?

A
  • A vial is a closed system where air must be injected into the vial to assist with easy withdrawal – a blunt needle is used to draw up from vials - Vials can be single or multidose

-Ampules contain a single dose of medication and are made of glass that is broken open with a plastic shield –
Air is not injected into ampules to withdraw medication - A filter needle is used to prevent small glass fragments from entering the syringe when drawing up from an ampule

48
Q

How do you decide whether to inject at a 45-degree or a 90-degree angle for subcutaneous injections?

A
  • size of patient, location
  • if you can grasp 5 cm of tissue inset 90 degrees
  • if you can grasp 2.5 cm of tissue insert 45 degrees
49
Q

Do you aspirate by pulling back on the plunger for all subcutaneous injections?

A

we never aspirate subcutaneous injections

50
Q

What is the usual needle size used for a subcutaneous injection?

A

The standard needle used for subcutaneous injections is 25-gauge 1.6-cm needle inserted at a 45-degree angleor a 1.3-cm needle inserted at a 90-degree angle

51
Q
  • What are the sites for subcutaneous injections?
A

Recommended sites for insulin injections include the upper arm and the anterior and lateral portions of the thigh, buttocks, and abdomen

The abdomen has the quickest absorption – faster than arms, thighs and buttocks

52
Q
  • Why do injection sites need to be systematically rotated?
A

Sites should be rotatedsites for greater consistency in absorption of insulin, to preserve skin and subcutaneous tissue integrity

53
Q
  • How much medication can be injected via the subcutaneous route?
A

Only small doses (up to 1 ml) of medications should be given because the tissue is sensitive to irritating solutions and large volumes of medications – reminder that this volume increases up to 2 ml in certain agencies like FHA

54
Q

how long does fast acting insulin take

A

10-15 mins

55
Q

how long does long-acting insulin take

A

45 mins lasts 4-5 hours

56
Q

what insulin can be mixed

A

Humulin can be mixed, others cannot

57
Q

the number gauge of the needle means

A

higher the number, finer the needle

58
Q

what are subcutaneous injections

A
  • Subcutaneous injections involve administering medications into the loose connective tissue under the dermis
  • Subcutaneous tissue is not as richly supplied with blood as the muscles, therefore, medication given this routeis absorbed more slowly than medication given by IM injections
  • Medications injected subcutaneously are absorbed completely if the patient’s circulatory status is normal

CP 2230 (1 decks)

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