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Funds II Lab > Would Care, Sterile Technique, Ostomy Care, & Foley Catheters > Flashcards

Would Care, Sterile Technique, Ostomy Care, & Foley Catheters Flashcards

1
Q

Incision

A

made from a sharp instrument

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2
Q

Contusion

A

blow from an object; BRUISE

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3
Q

Abrasion

A

surface scrape

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4
Q

Puncture

A

penetration of skin and underlying tissues by a sharp object

can’t see bacteria inside

PIN/NAIL/ ETC

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5
Q

Laceration

A

tissues torn apart

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6
Q

Penetrating

A

penetration of skin and underlying tissues (bullet or metal fragments)

can’t see extensive injuries from outside

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7
Q

Pressure Ulcers

A

redness, sores or ulcers over a bony prominence

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8
Q

Wound Assessment: Appearance

A

signs of healing or infection
foreign bodies

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9
Q

Wound Assessment: Drainage

A

location, color, consistency, odor, amt
serous (thin, clear)
serosanguineous (thin, watery, pale red or pink)
purulent (thin/thick, opaque tan, yellow, or green)

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10
Q

Wound Assessment: Other

A

size (measure w/ disposable ruler)
depth and tunneling
edema
peri area
pain
drains and tubes in place and functioning

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11
Q

Dressings should be inspected regularly to ensure they are:

A

clean, dry, intact

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12
Q

Dressing Changes

A

sterile vs. clean technique
prevent growth of microorganisms

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13
Q

Post Op Considerations for Dressing Changes

A

surgeon may want to change first dressing

if excess drainage, contact HCP

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14
Q

Type of dressing is determined by:

A

location, size, and type of wound

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15
Q

Closed wounds

A

post op or laceration

dry dressing

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16
Q

Open wounds

A

no dry packing (bc will stick to healed tissue)

moist dressing (wet to dry)

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17
Q

Telfa Dressing

A

slick/shiny surface that is absorbent
non-adherent
have to put outside dressing to cover it

pulls drainage away from wound

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18
Q

Island Dressing

A

telfa with an adhesive border, eliminates need for an outer dressing

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19
Q

Surgipads or Abdominal (ABD) Pads

A

very absorbent; often used over additional dressings (outside)
blue stripe faces outward

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20
Q

Transparent Film (Tegaderm)

A

semipermeable, nonabsorbent
used to cover IV sites
can see site

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21
Q

Impregnated Nonadherent (Vaseline Gauze)

A

material is impregnated with petroleum jelly (vaseline gauze) or other agents
covers partial and full-thickness wounds without drainage
requires an outer dressing

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22
Q

Hydrocolloids (DuoDerm)

A

waterproof adhesive wafer
gelatinous/rubbery
absorbs drainage and forms an occlusive seal
can stay on up to 7 days
used for pressure ulcers

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23
Q

Alginate (Algiderm, Curasorb)

A

nonadherent dressing available in many forms
very absorbent (up to 20x their wt)
made from seaweed
all previous alginate must be removed prior to adding new
need something on top of it

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24
Q

VAC means

A

vacuum assisted closure

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25
Wound VAC Purpose
applies a negative pressure to a variety of wounds using suction equipment pulls fluid from the wound and helps wound edges pull together provides a moist protected environment for wound healing
26
Wound VAC Use
sterile pieces of foam and vacuum tubing are inserted into wound and covered with transparent, occlusive dressing to create an artificial seal very important the seal is maintained (maintains the negative pressure)
27
Drains Use
permit drainage of excessive serosanguineous fluid/purulent material promote healing of underlying tissue
28
Open Drain
open end that drains onto a dressing penrose drain (flimsy tube)
29
Closed Wound Drainage System
drain connected to either an electric suction or a portable drainage suction Hemovac (holds more drainage/accordion-looking) Jackson-Pratt (make sure it's squeezed to ensure suctioning) (bomb)
30
Closed Wound Drainage System Benefits
reduces entry of microorganisms into the wound through the drain drainage tubes are sutured in place connected to a reservoir provide an accurate measurement of drainage inserted in surgery; discontinued 3-5 days (minimal drainage)
31
Who is responsible for maintaining wound suction?
nurses
32
Stryker
postoperative reinfusion in clients with knee or hip arthroplasty
33
Argyle
autotransfusion-ready chest drainage unit
34
Changing a Dressing
pt centered (pre-med if necessary) wash hands apply clean gloves remove old dressing remove gloves and hand hygiene set up sterile field clean wound, as ordered apply new dressing
35
Principles of Sterile Technique
outer wrap/covering is non-sterile sterile items that are out of sight are unsterile no coughing/sneezing over sterile field hands/objects must stay above waist/table height do not reach over sterile field (go around) when using forceps (tweezer), tips stay pointed down
36
What part of the sterile field is unsterile?
outer 1 inch at least
37
Surgical Hand Scrub
used in surgery and other specialties (OB) hands must stay higher than elbows pre-wash with antimicrobial solution and then use a scrub brush with antimicrobial solution scrub for the appropriate amt of time (agency policy)
38
Establishing a Sterile Field
don't need sterile gloves to set up opening towel/drape (away, sides, towards) drop items into sterile field
39
Wound/Incision Care Prep
remove and discard soiled dressings (use biohazard bag if saturated in blood) complete wound assessment set up sterile field apply sterile gloves
40
Clean Wound/Incision ***
top to bottom, in to out outward from the incision circular (around a drain) use a clean sterile swab for each stroke dry surrounding skin-pat or air dry apply dressings to drain site/incision document
41
Cleansing Agent: Normal Saline
does not disinfect; moves bacteria top to bottom inward to outward
42
Cleansing Agent: Chlorhexidine
antiseptic agent friction scrub back and forth at least 30 sec
43
Cleansing Agent: Betadine
top to bottom, OUT to IN
44
Irrigating a Wound
used to flush excessive drainage, foreign bodies, etc... out of an area premedicate solution temperature syringe w/ catheter (18 or 19 gauge) attached or irrigating tip if using catheter to reach crevices, insert only until resistance is met irrigate until clear dry before applying dressing
45
Packing a Wound Purpose
facilitates formation of granulation tissue, removal of drainage, and necrotic (eschar) tissue heals from the inside to outside
46
Packing a Wound Procedure
premedicate use sterile technique remove old packing and clean as ordered prepare new packing material (correct length/damp) pack the wound using sterile forceps or sterile swab don't pack too tight, pack in one continuous strip apply the outer dressing
47
Retention Sutures
BIG (for bigger/obese people)
48
Removal of Sutures/Staples
requires physician's order usually done 7-10 days after (retention sutures are usually longer, 14-21 days) may be removed by RN if allowed by agency use sterile technique suture scissors/staple remover
49
Removing Sutures
using suture scissors, clip suture close to skin (under the knot) CONTINUOUS: take out every other (not the ends), reassess and make sure wound is well approximated, then take out the rest
50
Removing Staples
place lower tip of sterile staple remover under staple squeeze handles until completely closed gently remove staple
51
Clean suture/staple line with:
antimicrobial solution (betadine or chlorhexidine) chlorhexidine: friction scrub
52
Stoma Appearance
pink or red; moist; pt does not feel (getting bl flow)
53
Ileostomy, Ascending ostomy, Transverse ostomy
need appliance to catch feces
54
Ileostomy stool
liquid consistency, mild odor
55
Ascending Ostomy Stool
liquid, more odor
56
Transverse Ostomy Stool
mushy and stinky
57
Descending Ostomy and Sigmoid Ostomy
may not need appliance
58
Descending Ostomy stool
more formed/solid
59
Sigmoid Ostomy stool
formed stool
60
What makes peristomal skin at risk for breakdown
fecal matter and digestive enzymes
61
How often are ostomy appliances changed?
at least weekly; more often if manufacturer recommends or if peristomal skin needs treatment don't let bag get more than half full
62
Changing Ostomy Appliance
determine need to change appliance select appropriate time position pt (sitting up) empty the pouch and remove skin barrier clean and dry peristomal skin assess stoma and peristomal skin (no breakdown or redness) measure stoma (1/8" clearance around stoma) cut skin barrier to appropriate size and apply if two pieces, attach pouch to skin barrier
63
Colostomy Irrigation
only done for pts with sigmoid or descending ostomies purpose is to distend the bowel enough to stimulate evacuation use warm tap water
64
Reasons a catheter may be inserted
acute urinary retention open sacral or perineal wound comatose critically ill pts
65
CAUTI; Prevention
catheter-associated UTI cath care, aseptic technique, bag below level of bladder
66
S&S of CAUTI
redness around insertion site discharge dark and concentrated and cloudy foul smelling urine change in LOC
67
Foley Insertion Steps
perineal cleaning open bag, put on bed open wrapping sterile gloves drapes (shiny side down) lube saline syringe attach open betadine and pour over lollipops hand spreads labia clean with betadine (side, side, middle) move tray to between legs lube catheter insert until see urine, then 2 more inches inflate balloon attach catheter to leg hang bag on bed
68
Foley Removal Steps
deflate balloon (passively) pt take deep breath remove by wrapping around fingers check tip for intactness discard appropriately

Funds II Lab (5 decks)

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