Vaccinations Flashcards
What should be checked prior to giving vaccines? (4)
No C/I to vaccine e.g. allergies
Px or carer informed of vaccine receiving.
Understand vaccine procedure
Aware of possible ADR that could occur
What are the types of injections? (3)
IM
SC
Intradermal
What are the types of injections sites? (3)
Anterolateral aspect of the thigh
Deltoid area of upper arm
Buttocks not used (risk of injecting into fatty tissue and sciatic nerve damage)
Explain the process of skin cleaning. (4)
Visibly dirty skin needs to be cleaned,
It’s not necessary to disinfect the skin.
Disinfecting the skin makes no difference
Hand hygiene of the vaccinator is important.
Explain the injection technique of IM. (2)
Give with needle at 90 degrees to the skin.
Skin stretched
Explain the injection technique of SC. (2)
Given with needle 45 degrees to the skin
Skin is bunched up.
What equipment is required to administer a vaccine? (8)
Tray
Syringe
Injecting needle
Drawing up needle
Alcohol wipe
Gauze or cotton swabs
Sharps container
Vaccine
What are types of injection needles?
Brown 10mm
Orange 16mm
Blue 25mm
Green 38mm
Perform an IM injection.
Wash hands
Draw up vaccine
Remove drawing up needle and dispense needle in sharps box.
Attach giving needle
Choose appropriate injection site
Position px
Cleanse the site (if needed)
Place gentle traction on skin
Warn px of sharp scratch
Hold syringe like a dart in your dominant hand.
Pierce skin at 90 degrees.
Aspirate for blood.
If no aspiration, injection syringe contents
Inject at rate of 1ml every 10 seconds.
Remove needle and dispose immediately
Release traction of skin
Apply pressure with cotton or gauze swab, avoid rubbing.
Replace gauze with plaster
Dispose of used clinical equipment
Record details of vaccination.
What records are made when a vaccine is given?
Vaccine name
Product name
Batch No
Expiry date
Dose
Site used
Date vaccine given
Name and signature of vaccinator
Explain the use of multi-dose vials.
Pre-checks to vaccination:
- Vaccine is in date
- Vaccine stored appropriately
- Bung is visibly clean
- Sterile needle/syringe are used each time
- Drawing up needle not used for multiple redraws.
Vials to be marked with:
- Date and time of reconstitution or first use.
- Initials of the person who reconstituted it or first used the vial.
- Period that the vaccine can be used for.
What happens after a vaccine is given? (2)
Monitor px for signs of reaction and anaphylaxis.
Explain specific s/e of vaccine.
What are the main features of urinalysis?
Common ranges of tests: bloods, WBC types, pH glucose, ketones, protein, nitriles.
Urine appearances: pale/colourless, yellow/orange, brown, pink, red, green, black and white/milky.
Perform a urine test.
Inspect colour of urine: Straw-coloured urine (normal), dark concentrated (dehydration), red (blood), brown (bile pigments)
Inspect clarity of urine: Clear (normal), cloudy with sediments (UTI, Renal stones, high protein) Frothy (proteinuria)
Urine left to stand for long periods = cloudy.
Assess odour of urine: Offensive odour (UTI), sweet odour (glycosuria = diabetes)
Obtain consent
Check product expiry date
Wash hands, x gloves
Remove reagent dipstick and replace cap.
Immerse dipstick into urine then remove.
Lay horizontally to prevent cross contamination.
Wait for appropriate length of time
Wipe edge of strip against rim of container to remove urine excess.
Read reagent pads against reference guide.
Dispose of urine, dipstick and gloves.
Document results.
What are the main features of diabetes testing?
Fasting plasma glucose
Venous blood tests e.g. HbA1c
OralGlucose Tolerance Test
Random BM
Urinalysis
What are the main features of BM testing?
T1DM = regular self monitoring x4/day.
T2DM don’t have to perform a BM test unless they are: on insulin, taking medication that cause hypoglycaemia, hypoglycaemic episodes, ensure safety during high-risk activities e.g. work and driving.
State the importance of self-monitoring.
Avoid hypoglycaemia
Optimise insulin doses
Give HCP trends of a px blood glucose levels.
Suggest poor BM control e.g. hypo/hyperglycaemia.
What are the advantages of self-monitoring? (3)
Can be performed by px.
Easy to perform
Can be recorded in diary with px comments.
What are the disadvantages of self-monitoring? (4)
Poor technique gives inconsistent results.
Only gives a blood glucose reading for time of test.
Gives a rough guide to BM levels.
Test sticks can be expensive.
What situations can problems of self-monitoring occur? (6)
Using wrong test strips for meter.
Incorrect calibration of meter.
Dirty meters
Inadequate hand washing
Improper strips storage
Not using an aseptic technique to obtaining the sample.
Where in the body can BM tests be taken? (5)
Fingertips
Palm
Heel
Forearm
Upper arm
Fingertips, palm and heel give the most accurate reading.
What equipment is needed to perform a BM test?
Alcohol gel
Gloves
BM meter
Test strips
Alcohol wipe
Lancet
Sharps bin
Cotton wool/Gauze
Perform a BM test.
Measuring range = 0.6-33.3mmol/L (10-600mg/dL)
Stores the last 500 results
Meter will automatically switch off after 5 seconds after test strips has been removed, 2 mins if meter not used.
- Wash your hands
- Put gloves on
- Clean side of the px fingertips
- Ensure test strips is in date
- Load test strip into meter
- Open lancet
- Prick side of px’s finger
- Place drop of blood onto test strips.
- Record reading.
- Dispose of lancet in the sharps bin.
What are the normal parameters for T1DM? (3)
5-7mmol/L (90-126mg/dL) on waking
4-7mmol/L (72-126mg/dL) before meal
5-9mmol/L (90-162mg/dL) 90 mins after meal.
What are the normal parameters for T2DM? (2)
4-7mmol/L (72-126mg/dL) before meals.
< 8.5mmol/L (153mg/dL) 2 hrs after meals.
