Skills Exam 5 part 2

Question 1

what is a Nebulizer?

Answer 1

Machine that is connected to oxygen or air that converts a liquid medication to gas form and should be inhaled over a period of 10 to 15 minutes using a mask or a mouthpiece

Question 2

how should you administer Prescribed ophthalmic eyedrops?

Answer 2

-Wear gloves, tilt patients head back, pull down lower lid, and administer drops in the conjunctival sac.

Question 3

should you ever share your prescribed drops with someone else or use on non infected eye?

Answer 3

No you should never.

Question 4

What should you avoid when administering eye drops?

Answer 4

The cornea and touching the eye or eyelid with dropper or tube.

Question 5

Suppositories contain medications that exert local effects

Answer 5

you should insert suppositories with rounded end entering opening first ( this will prevent trauma during insertion)

Question 6

which route is used to insert a suppository?

Answer 6

Vaginal or rectal

Question 7

Steps before insertion of a suppository

Answer 7

• Hand hygiene
• lubricate suppository
• For vaginal lay patient in dorsal recumbent position
• For rectal lay patient in left lateral sim’s position

Question 8

How far should a suppository be inserted rectally?

Answer 8

you should insert approximately one inch or once you feel the medication bypass the sphincter ( it should be placed on wall and not in the stool)

Question 9

when assessing blood glucose you will need…

Answer 9

• Gauze (at least two pieces)
• Alcohol prep pad
• Lancet
• Glucometer
• Test Strip

Question 10

steps to taking a blood glucose

Answer 10

Step 1: Clean Hands
Step 2: Choose puncture site. Stable adults: select the lateral side of a finger, avoid central tip. Clean site to be punctured with alcohol swab. Allow site to dry completely. Instruct patient not to move hand/finger!
Step 3: Insert test strip into glucometer
Step 4: Don gloves
Step 5: Hold area to be punctured in dependent position. Do not milk or massage. Stick site with lancet.
Step 6: Lightly squeeze around puncture site until drop of blood has formed
Step 7: Wipe first drop of blood with cotton ball
Step 8: Lightly squeeze around puncture site again until drop of blood has formed
Step 9: Collect blood using test strip
Step 10: Await blood glucose results. Interpret appropriately.
Step 11: Place lancet in sharps container. Throw trash in appropriate container.

Question 11

Parenteral routes are?

Answer 11

Subcutaneous (SQ)
Intramuscular (IM)
Intradermal (ID)
Intravenous (IV)

Question 12

What system is completely avoided when a medication is given via parenteral route?

Answer 12

The GI system

Question 13

using the parenteral route medical asepsis technique is required to prevent infection

Answer 13

This means performing good hand hygiene, wearing gloves, and cleaning the skin with alcohol prep.

Question 14

What should be done if a patient is injected routinely?

Answer 14

you should rotate the sites to maintain appropriate skin and tissue integrity, and to decrease infection risk

Question 15

Length of a needle for injection is picked depending on what type is to be given, for example

Answer 15

• 3/8 inches to 5/8 inches (used for subcutaneous or intradermal)
• 1 inch to 1 ½ inches (used for intramuscular)

Question 16

gauge of needle measures what?

Answer 16

the diameter of the needle

Question 17

What happens if the gauge number decreases?

Answer 17

the size (diameter) increases the smaller the number the bigger the needle

Question 18

What is a blunt tip needle used for?

Answer 18

to draw medication out of vials

Question 19

When should you use a blunt filter needle?

Answer 19

when drawing medication from ampules/glass

Question 20

Why is the blunt needles not as sharp as an injection needle?

Answer 20

to decrease risk of harm to self during medication preparation

Question 21

Review steps for injection from a vial with or without a blunt needle

Answer 21

slide #81/82

Question 22

Review Steps for Preparing an injection from an ampule using a blunt filter needle

Answer 22

Slide 86

Question 23

Why can you recap a blunt tip needle and not others?

Answer 23

because you need to protect yourself from a needle stick injury while removing a needle from the syringe or while taking the syringe to the patient

Question 24

should you ever recap after an injection is administered?

Answer 24

NOOOOO! engage safety

Question 25

what technique is used when recapping a blunt tip needle?

Answer 25

The One Hand Scoop Technique

Question 26

What is the priority after an injection is complete?

Answer 26

Activate the safety using one hand, then place in sharps

Question 27

A term used for devices with sharp points or edges that can puncture or cut skin

Answer 27

“Sharps”

Question 28

Where should all sharps go after use?

Answer 28

The Sharps container a puncture resistant, non breakable sealed container

Question 29

How should you place a needle in a sharps container?

Answer 29

Put it in using one hand only, needle facing down or away from you.

Question 30

Before injecting, know

Answer 30

• The volume of medication to administer
• The characteristics and viscosity of the medication
• The location of anatomical structures underlying the injection site

Question 31

Minimize patient discomfort

Answer 31

• Use a sharp-beveled needle in the smallest suitable length and gauge.
• Position a patient as comfortably as possible to reduce muscular tension.
• Select the proper injection site, using anatomical landmarks.
• Divert the patient’s attention from the injection through conversation using open-ended questioning.
• Insert the needle quickly and smoothly to minimize tissue pulling.
• Hold the syringe steady while the needle remains in tissues.
• Inject the medication slowly and steadily.

Question 32

Subcutaneous injection

Answer 32

Occurs in the fatty Layer of skin below the dermis above the muscle and is given at a 90 to 45 degree angle

Question 33

Medications commonly administered SQ:

Answer 33

Insulin
Heparin
Lovenox (Enoxaparin)

Question 34

Review the steps to preparation for subcutaneous injection

Answer 34

Slide 99

Question 35

Review how to perform subcutaneous injection

Answer 35

Slie 101

Question 36

What are some Subcutaneous injection sites?

Answer 36

• Back of arm

- Abdomen

Question 37

Intramuscular injection

Answer 37

injection occurs in the muscle which means faster absorption than subQ

Question 38

What are some Common intramuscular injections

Answer 38

• Vaccines
• Antibiotics
• Glucagon
• Sedatives

Question 39

Review Steps for Intramuscular Injections

Answer 39

Slide 110

Question 40

What is the Z-track method for intramuscular injection?

Answer 40

Performed with larger muscle groups to prevent leakage of medication into sensitive tissues (such as subcutaneous tissue)

Question 41

Review Aspiration technique for intramuscular injections

Answer 41

Slide 112

Question 42

When selecting an IM site, consider the following:

Answer 42

• Is the area free of infection or necrosis?
• Are there local areas of bruising or abrasions?
• What is the location of underlying bones, nerves, and major blood vessels?
• What volume of medication is to be administered?

Question 43

Review Intramuscular injection Site : Ventrogluteal

Answer 43

Slide 116

Question 44

Review Intramuscular injection Vastus laterals

Answer 44

Slide 119

Question 45

assessment after medication administration

Answer 45

• After administering various medications, you may need to follow up with your patient and assess them
• Depending on the patients initial presentation and medication route depends on when you should reassess

Question 46

General rule

Answer 46

• Oral medications: Reassess 30 mins to 1 hour later

- Parenteral medications: Reassess within 30 minutes