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CPNE > Practical Steps > Flashcards

Practical Steps Flashcards

1
Q

Washing hands

A
  1. Have 2 paper towels pre-dispensed
  2. Wash w/soap & water at least 20 seconds
  3. Leave water running
  4. Dry hands with 1st paper towel and dispose
  5. Use 2nd paper towel to turn off faucet
  • do not close faucet with bare hand
  • do not close faucet with a damp paper towel
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2
Q

After the IM injection, what is a crucial step to perform?

A

Engage needle safety device

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3
Q

When taking the cap off a g-tube or ng-tube, what step should be taken 1st?

A

Occlude line to prevent air intake.

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4
Q

Is PPE needed for checking temperature?

A

Yes, gloves, if checking oral temperature.

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5
Q

Vitals: BP

A

Locate brachial artery prior to checking BP

MAX cuff inflation is 30 over baseline (shoot for 20)

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6
Q

Vitals: Respiratory rate

A

Check for full minute

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7
Q

Vitals: HR

A

Check for full minute
Apical pulse if giving a BP or cardiac drug
Apical pulse is 4th or 5th intercostal

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8
Q

How long should a med bottle, port, or injection site be cleansed?

A

10-15 seconds

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9
Q

What is the preferred IM injection site for infants?

Children who are walking?

A

Infants: vastus lateralis

Walking Children: ventrogluteal

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10
Q

What IM injection sites should never be used?

A

Dorsogluteal (button)

Rectus femoris

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11
Q

What length and gauge of needle is adequate for most sub-q injections?

A

5/8” small gauge (25)

90 degree angle

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12
Q

What type of syringe is used for heparin?

A

Pre-filled
Or
tuberculin syringe

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13
Q

Maximum volume to be administered sub-q?

A

1ml

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14
Q

Heparin and/or lovenox

  • needle gauge and length?
  • air bubble?
  • administration technique?
A
  • 3/8”, 25gauge, 90 degree
  • leave bubble on pre-filled or add 0.2ml air if drawing up med
  • for skinny patients: 5/8” @ 45 degrees
  • slow push (20seconds) and wait 10 seconds after push before removing needle.
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15
Q

What is considered standard length and gauge for IM injections?

A
  1. 5”, 23-25g
    * may need smaller or larger depending on your patient
  • *Vastus Lateralis: 1” needle
  • *Ventro Gluteal: 1.5” needle
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16
Q

Where should papers be placed during PCS’s?

A

NOT on the patient’s bed!

Ask CE where it is ok to place them.

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17
Q

How slowly should heparin sub-q be pushed?

A

Study show less bruising if pushed over 30 seconds vs. 10 seconds.

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18
Q

Regarding pediatric IM injections, what do studies show regarding pain?

A

No aspiration, rapid injection and rapid withdrawal are associated with less pain.

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19
Q

Should massaging be performed after sub-q injections?

A

No! Apply gentle pressure - including heparin/lovenox.

20
Q

There are 2 types of bedpans: standard and fracture. Which direction does each one face?

A

Standard: wide part towards the head
Fracture: wide part toward the feet.

It does not matter which way the pt. turns for placing the pan.

21
Q

What position should a patient be in to receive an enema?

How far should the tubing be inserted?

A

Left side with right knee flexed

3-4”

Remove fluids from IV pole and lower to hip level prior to beginning flow, then slowly raise to 12-18” above hips. Adjust height as needed.

If ordered, enema may be held in for 5-15 minutes

***some enemas may be pre-packaged. If so, just administer slowly with bottle slightly tipped. Instruct patient to hold for 5-15 minutes.

22
Q

What risk should be considered if assigned digital stool impaction removal?

A

Can cause vagal stimulation and bradycardia

23
Q

How much urine should be collected for a clean catch urine sample?

A

30-60ml

24
Q

What precaution should be taken when inserting the needle into the vial for medication administration?

A

Leave vial on stable surface, not held in hand.

25
Q

What is a trochanter roll?

A

Rolled up blanket to prevent lateral rotation of hip. Should not extend past the knee.

26
Q

What is a contracture?

A

Permanent shortening of muscle, or other connective tissue, causing deformity.

27
Q

What is a hip abduction pillow?

A

Slides between legs with upper and lower straps to hold legs together.
Goal is to prevent internal hip rotation and hip adduction.

28
Q

What is “orthopneic” position?

A

High fowlers with overhead table and pillow provided for pt. to lean on. Can assist with shortness of breath.

29
Q

When ambulatory a patient, what safety device should be used?

A

Transfer belt to have something to hang onto if they stumble or fall.
Belt should be placed around abdomen or center of gravity.

30
Q

What is the benefit of ROM exercises?

A

Increased joint mobility and circulation.

31
Q

What preparatory items should be considered prior to standing or ambulatory a patient?

A

“Dangling” -This reduces risk of dizziness or falls

Non-skid socks

Floor is clear

Use a transfer belt

Have a backup plan (chair close by or additional help)

32
Q

When repositioning a patient, even when just sliding them up in bed, what should be used?

A

Friction reducing device

33
Q

When sliding a patient up in bed, how should they be instructed?

A

Arms crossed, knees flexed, neck flexed, pillow removed and at headboard.
Have them assist by pushing with their feet if able

34
Q

What is the ideal psi for irrigating wounds? How would you achieve this?

A

4-15 psi

30-60ml syringe w/19g angiocath (with needle removed.

35
Q

How are ice chips measured?

A

At half their volume:

1 cup ice = 1/2 cup water

36
Q

What is wound bed undermining?

A

When tissue under the wound edges becomes eroded.

37
Q

What is the absolute MAX time for application of hot or cold pack?

A

15 minutes

38
Q

Is pt. education required for vitals?

A

No

39
Q

What info is needed prior to checking oral temp?

A

Any hot/cold foods/liquids, smoked or chewed gum within last 30 minutes?

40
Q

What does the PICC line dressing change require that the other sterile fields don’t?

A

Face mask

41
Q

What supplies are needed for wound packing?

A 
Clean Gloves
Sterile Gloves
(2) 4x4 trays
Saline bottle
Tape
42
Q

Can you chart with gloves on?

A

Absolutely not!

43
Q

What should g-tubes be flushed with?

A

Ask CE what hospital policy is.

44
Q

What should baby formula be mixed with?

A

Should be pre-mixed. If not, ask CE.

45
Q

How long to wait between checking BP?

A

2 minutes

46
Q

Can ice or heat be used anytime you think it’s needed?

A

No, it must be assigned.

CPNE (8 decks)

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