Practical Steps Flashcards
Washing hands
- Have 2 paper towels pre-dispensed
- Wash w/soap & water at least 20 seconds
- Leave water running
- Dry hands with 1st paper towel and dispose
- Use 2nd paper towel to turn off faucet
- do not close faucet with bare hand
- do not close faucet with a damp paper towel
After the IM injection, what is a crucial step to perform?
Engage needle safety device
When taking the cap off a g-tube or ng-tube, what step should be taken 1st?
Occlude line to prevent air intake.
Is PPE needed for checking temperature?
Yes, gloves, if checking oral temperature.
Vitals: BP
Locate brachial artery prior to checking BP
MAX cuff inflation is 30 over baseline (shoot for 20)
Vitals: Respiratory rate
Check for full minute
Vitals: HR
Check for full minute
Apical pulse if giving a BP or cardiac drug
Apical pulse is 4th or 5th intercostal
How long should a med bottle, port, or injection site be cleansed?
10-15 seconds
What is the preferred IM injection site for infants?
Children who are walking?
Infants: vastus lateralis
Walking Children: ventrogluteal
What IM injection sites should never be used?
Dorsogluteal (button)
Rectus femoris
What length and gauge of needle is adequate for most sub-q injections?
5/8” small gauge (25)
90 degree angle
What type of syringe is used for heparin?
Pre-filled
Or
tuberculin syringe
Maximum volume to be administered sub-q?
1ml
Heparin and/or lovenox
- needle gauge and length?
- air bubble?
- administration technique?
- 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.
What is considered standard length and gauge for IM injections?
- 5”, 23-25g
* may need smaller or larger depending on your patient
- *Vastus Lateralis: 1” needle
- *Ventro Gluteal: 1.5” needle
Where should papers be placed during PCS’s?
NOT on the patient’s bed!
Ask CE where it is ok to place them.
How slowly should heparin sub-q be pushed?
Study show less bruising if pushed over 30 seconds vs. 10 seconds.
Regarding pediatric IM injections, what do studies show regarding pain?
No aspiration, rapid injection and rapid withdrawal are associated with less pain.
Should massaging be performed after sub-q injections?
No! Apply gentle pressure - including heparin/lovenox.
There are 2 types of bedpans: standard and fracture. Which direction does each one face?
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.
What position should a patient be in to receive an enema?
How far should the tubing be inserted?
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.
What risk should be considered if assigned digital stool impaction removal?
Can cause vagal stimulation and bradycardia
How much urine should be collected for a clean catch urine sample?
30-60ml
What precaution should be taken when inserting the needle into the vial for medication administration?
Leave vial on stable surface, not held in hand.
