Week Two- Asepsis, Cultures, Parental Intro Flashcards
Principles of surgical Asepsis (Kozier 978)
1) All objects in sterile field must remain sterile
2) Sterile objects become unsterile when touched by unsterile object
3) Sterile items that are out of vision or below waist line of nurse are unsterile
4) Sterile objects can become unsterile from prolonged exposure to airborne dust containing microorganisms
5) Fluids flow in the direction of gravity
6) Moisture that passes through a sterile object draws microorganisms from unsterile surfaces above or below to the sterile surface through capillary action
7) The edges of a sterile field are considered unsanitary (2.5 margin considered unsterile)
8) Skin is unsterile and cannot be sterilized
9) Honesty, conscientious, alertness are essential qualities in maintaining surgical asepsis
Basics of throat culture collection (P&P 1067)
Throat Collection-
Equip= x2 swab, gloves, penlight, tongue depressor
Steps= Tilt head back and say “ah”, visualize pharynx/tonsils by depressing anterior 3rd of tongue and using penlight. Swab tonsils both sides wiping inflamed or purulent areas.
- Avoid immediately after (1hr) meals/drinks d/t vomiting risk
- Perform pre antibiotic admin
- Can’t be delegated
Basics of Nose culture collection (P&P 1067)
Nose collection-
Equip= Swabs, gloves, penlight
Steps= Blow nose first, tilt head back, use penlight, swab area of visible inflame and exudate, return swab to culture tube
-Can’t be delegated
How do you collect a urine sample from an indwelling catheter? (Perry p. 1057)
- Apply gloves, and clamp drainage tubing 15 minutes before collecting sample.2. Locate location of port. Clean for minimum 15 seconds with disinfectant. Allow to dry. 4. Attach needless Luer-Lok to sample port5. Withdraw 3 mL for culture. 20mL for routine urinalysis.6. Transfer from syringe into clean urine container.7. Unclamp catheter and allow urine to flow. Ensure it flows freely.8. Attach label to container (two identifiers, specimen source, date/time).9. Send specimen to lab w/in 20 mins. Or refrigerate.
What are the 3 best locations for IM injections?
- Ventrogluteal 2. Vastus Lateralis 3. Deltoid
What is an Intramuscular injection?
An injection into the body of a muscle.
What is an intradermal injection?
An injection into the dermis just under the epidermis.
What is a Subcutaneous injection?
Injection into tissues just under the dermis of the skin.
What is an Intravenous injection?
An injection into a vein.
What are the benefits of the Ventrogluteal injection site?
- Deep, situated away from nerves and blood vessels
- Easily identified by body landmarks
- Preferred site for large volume of medications.
- Less painful than Vastus Lateralis
- Reccommended pediatric IM site for all children.
What are the benefit of the Vastus Lateralis injection site?
- Absence of major nervs and blood vessels
- Rapid drug absorption.
- Immunization site for children.
- Recommended pediatric IM site for infant thru 12 months.
What are the benefits of the Deltoid injection site?
- Easily accessible (tho not well developed in most)
- Used for small volumes of medications.
- Faster absorption
- Adult vaccination site for adults.
- Recommended as pediatric IM site for children 18 months and older.
What angle do you administer IM injections?
90 degrees
What angle do you adminster Subcutaneous injections?
45 - 90 degrees
What angle do you administer Intradermal injections?
15 degrees
How can you avoid comtamination of solution from an ampule?
Do not let it sit open. Draw medication quickly/immediately.
How can you prevent needle contamination?
Do no let needle touch surfaces (ampule, outter surface of cap, coutertop) Do not touch plunger.Keep tip of syringe covered with cap or needle.
How do you prepair skin for parenteral medications?
Wash, if debris covered.
If using antiseptic swap, clean from in-to-out in 5 cm radius.
Before administering parenterals, what must the Nurse do to prevent transmission of microorganisims?
Perform hand hygiene.
Wear gloves while administering
The smaller the needle guage, the _______ the diameter.
Larger
What are several ways to prevent needlestick injuries?
- Do not recap after administration. Always use safety protective cap, lever to cover used needles.
- Immediately dispose of needles.
- Use needleless systems when available.
What should you always use when drawing medication from an ampule?
A filter needle
What is the maximum subcutaneous dose you should administer?
What is the maximum dose for infants and children?
Adult: 2 mL
Infant/Child: 0.5 mL
What are some examples of subcut medications?
Epinephrine, Insulin, Opiods, Heparin
What are the three best subcut injection sites?
Outter aspect of the upper arm. The abdomen (from below costal margins to the iliac crest). The anterior aspect of the thighs
What are the two typical needle guages for an adult subcut injection?For a child?
Adult:1) A 25 guage 5/8” -inch needle, @ 45 degreesor2) A 25 guage 1/2”-inch needle @ 90 degreesChild: 1) A 26 to 30 guage 1/2”-inch needle @ 90%.
What should you look for when selecting an injection site?
Free from lesions, no bony prominences, no large underlying muscles or nerves. Site rotation is important for those getting a lot of injections (diabetes pts).
Difference between medical and surgical asepsis?
Medical- Basic precautions- Minimize Microorganisms
Surgical-Sterile field Maintained- Absence of all microorganisms
When doing a surgical scrub a nurse should…
Wash for 5 min from fingertips to elbows using a small sponge
Initial dose prime amounts- SCBF
Max-0
Clear link
Max o - 0.4
Clear link- 0.28
Safety intima *SUBCUE BF
24g, 19mm canula, needle free IV connector
