Skills 3 Challenge

Question 1

Skill #1 Hand Hygiene

Answer 1

Important first step: You must say the client’s name and say your name

Lathers all surfaces of wrists, hands, fingers
Producing friction for at least 30 seconds
Keeps hands lower than elbow, fingertips down
Clean fingernails by rubbing against palms
Rinse - keep hands lower than elbow, fingertips down (wrists, hands, fingers).

Question 2

Skill #2 Applies One Knee-High Elastic Stocking

Answer 2

Turn stocking inside-out, at least to the heel
Finishes procedure with no twists or wrinkles in stocking, heel of stocking is centered over heel of foot. Opening of toe area is either over or under toe area

Question 3

Skill #3 Assists to Ambulate Using Transfer Belt

Answer 3

Before assisting to stand the following steps must be done:

• client is assisted to a sitting position with feet on the floor “scoot to the edge”
• “Please put on your shoes” - client is wearing shoes non skid footwear/shoes
• “bed is at a safe level”
• puts gait belt securely at waits below ribs over clothing
• counts to three
• check transfer belt before walking
• walks slightly behind and to one side of client for distance of 10 feet while holding the belt.
• walks and assists into bed
• removes belt, gives call signal
• after completing wash hands

Question 4

Skill #4 Assists With Use of Bedpan - Standard Bed Pan

Answer 4

Before placing bedpan:

• bring supplies of toilet paper, hand wipes, two gloves, bed pan
• peanut butter sandwich (privacy, bed, signal)
• head of the bed is flat
• hand hygiene - put on clean gloves
• “can you please lift your hips?”
• place bedpan under, take off gloves and preform hand hygiene
• instruct client to clean hands with wipes when finished and signal when finished
• before removing bedpan put clean gloves on
• head of bed is down
• remove bedpans
• empty bedpan in toilet then rise and empty in toilet again
• put bedpan in dirty supply area
• signaling device in reach, bed low

Question 5

Skill #5 Cleans Upper or Lower Denture

Answer 5

First put on gloves
line the bottom of the sink with paper towels
rise denture
clean denture cup - fills denture cup half way
rise denture in moderate temperature running water before brushing them
brush all surfaces
clean toothbrush etc.
put back in container
rinse all surfaces
clean sink
remove gloves property

Question 6

6 Counts and Records Radial Pulse

Answer 6

Say start and stop, you may restart a total of 4 times
bring your watch
explain the procedure to the client
always make sure signaling device is in reach
preform hand hygiene before recording!

Question 7

7 Counts and Records Respirations

Answer 7

count for one minute
tell evaluator when to “start” and “stop”
you must explain procedure for testing purposes
signaling device is in reach
wash hands then record

Question 8

8 Donning and Removing PPE

Answer 8

removing gloves
removing gown: unfasten at neck and waist without touching yellow outside
get hands inside of cuff, cross arms, pinch, hold gown through the cloth and pull (do not move forward)
do not touch outside of gown
hold away from body turn gown inward, keep inside out with only 1-2 turns
disposes of gown without contaminating self
after completing say “wash hands”

Question 9

9 Dresses Client with Affected (Weak) Right Arm

Answer 9

strip the strong dress the weak
explain everything
peanut butter sandwich
ok to raise bed but do it after shirt sort of
bring two shirts so they can make choice
you must put the affected/weak arm through the right sleeve of the shirt before placing garment on left unaffected arm
chest must be covered

Question 10

10 Feeds Client who Can Not Feed Self

Answer 10

important: client is in upright sitting position (75-90 degrees) - they may sit on edge of bed
“please sit up on the side of the bed”
- ask their full name and check that it is on name card
- wipe hands with hand wipe before feeding
- explain what is on the tray
- offer water
- ask what food on plate
- explain what is in each bite and on plate
- clean client’s mouth with napkin
- clean hands with wipe
- leave them sitting up
- signaling device is within client’s reach
- after completing skill “wash hands”

Question 11

11 Gives Modified Bed Bath

Answer 11

face, one arm, hand, underarm
“air washing” is an automatic fail
supplies: gloves, bath basin, soap, clean pt. gown, 1 hand towel, 1 bath towel, 3 washclothes

Before washing: 
removes gown while keeping body covered
checks water temp 
begin with eyes, using wet washcloth (no soap) wash inner to outer aspect
use different area of the washcloth for each stroke then proceed to wash entire face and nose
dries face
exposes one arm 
places towel underneath arm keeping rest of body covered
applies soap to wet washcloth 
washing fingernails and arm armpit 
puts clean gown on 
empty basin, rinse, dry