hsc MA final practicum

Glucose

• Units: Results are reported in mg/dL.

• Supplies: Gather a lancet, alcohol wipe, gauze, and glucometer.

• Procedure:

  • Locate and warm the 4th digit (ring finger).

  • Insert the glucose strip into the glucometer and wait for the start signal.

  • Clean the site and puncture with the lancet.

  • Wipe away the first drop of blood with gauze.

  • Apply the glucose strip to the blood until the meter fills and beeps.

  • Have the patient hold gauze on the finger and apply a bandage.

Mono

• Supplies: Lancet, alcohol wipe, and gauze.

• Procedure:

  • Locate the finger of choice.

  • Clean the site, puncture with the lancet, and wipe the first drop of blood.

  • Allow blood to drip onto the designated area of the test.

  • Apply one drop of the specific developer solution.

  • Read results after 10 minutes

H. pylori

• Supplies: Lancet, alcohol wipe, and gauze.

• Procedure:

  • Locate the finger of choice.

  • Clean the site, puncture with the lancet, and wipe the first drop of blood.

  • Allow blood to drip onto the designated area of the test.

  • Apply one drop of the specific developer solution.

  • Read results after 10 minutes

Hemoccult

• Sample Collection: The patient provides a stool sample.

• Initial Step: Apply the sample to windows A and B, close the card, and wait 3–5 minutes.

• Development:

  • Flip the card to the back side.

  • Apply two drops of developer over the stool smear.

  • Read results within 60 seconds; any trace of blue is a positive result.

• Control Test:

  • Apply one drop of developer between the positive (+) and negative (-) areas.

  • Read within 10 seconds.

  • A blue color must show in the positive area and no blue in the negative area

covid

COVID-19 Testing

• Preparation: Have the patient blow their nose and tilt their head back.

• Collection: Insert a nasopharyngeal swab, twist, and remove.

• Processing:

  • Place the swab into the solution and twist.

  • Insert the test strip into the solution.

• Reading: Read after 15 minutes.

  • A control line must be present.

  • A positive test is indicated by double lines.

influenza

• Preparation: Have the patient blow their nose and tilt their head back.

• Collection: Insert a nasopharyngeal swab, twist, and remove.

• Processing:

  • Place the swab into the solution and twist.

  • Pipette the solution onto the test card and close it.

• Reading: Read after 15 minutes.

  • A control line must be present.

  • A positive test is indicated by double lines.

Strep (streptoccus screening)

• Setup: Place the tube in the holder and add 4 drops each of reagent A and B. (so 4 drops of reagant A and 4 drops of reagnant B)

• Collection: Swab both sides of the throat; use a tongue depressor if needed.

• Processing:

  • Insert the swab into the tube and wait 1 minute.

  • Squeeze out the swab and discard it in biohazard.

  • Place the strep dipstick into the solution.

• Reading: Read results in 5 minutes.

(Remember - M shape bc of yellow and red=Mcdonalds)

HIV

HIV Testing

• Collection: Gently swab the test stick along the upper and lower gums four times for at least 30 seconds.

• Processing:

  • Insert the stick into the SampleTrainer bottle and snap the shaft at the notch.

  • Replace the cap and shake for at least 10 seconds.

  • Invert the bottle vertically over the sample/buffer well and add 2 full drops.

  • Wait 5 minutes, then add 4 drops of green-cap Running Buffer vertically into the buffer well.

• Reading: Read between 25–40 minutes.

  • One line is negative; two lines are positive.

  • If nonreactive, you must wait the full 40 minutes before reporting a negative.

Ear Irrigation

• Assessment: View the ears with an otoscope.

• Procedure:

  • Prepare a warm solution of water and a dollop of hydrogen peroxide.

  • Draw up the solution and clean the ears.

  • Recheck with the otoscope to confirm progress; repeat as needed.

  • Stool softener can be used to break up stubborn wax (let sit 5 minutes per side).

(10 panel CLIA) Drug Screen

Collecting urine:

General Collection (Clean Catch Mid-Stream)

Male Anatomy: Wipe once, then perform a mid-stream catch.

Female Anatomy: Wipe three times (right, left, middle) from front to back, then perform a mid-stream catch

Actual Procedure:

• Collection: After collection, screw the cap until it clicks.

• Temperature: Check the temperature at 2–4 minutes; read the green color on the indicator strip.

• Security: Donor initials and dates the seal, which is then placed over the cap.

• Reading: Remove the label after 5 minutes to read.

  • 2 lines = negative.

  • 1 line at top = positive.

  • 1 line at bottom = invalid.

  • Positive results must be sent for MRO confirmation.

Urine culture

Collecting urine:

General Collection (Clean Catch Mid-Stream)

Male Anatomy: Wipe once, then perform a mid-stream catch.

Female Anatomy: Wipe three times (right, left, middle) from front to back, then perform a mid-stream catch

Actual Procedure:

• Submerge a stick into urine.

• Puncture the vacuum tube via needle inside the tube holder.

• Label tube with name, date, time, and initials.

• Place in a transport bag.

Gonococcus, Chlamydia (bacterium) aka GC/Chlamydia Testing, Trichomonas (protozoan)

Collecting urine:

General Collection (Clean Catch Mid-Stream)

Male Anatomy: Wipe once, then perform a mid-stream catch.

Female Anatomy: Wipe three times (right, left, middle) from front to back, then perform a mid-stream catch

Actual Procedure:

• Remove the top of the tube.

• Use pipette to draw up urine to the fill area of the tube (2mL).

• Label the tube: Patient’s name, date, time, and initials.

• Place the sample in a transport bag. Send to the lab

hCG (pregnancy test)

Collecting urine:

General Collection (Clean Catch Mid-Stream)

Male Anatomy: Wipe once, then perform a mid-stream catch.

Female Anatomy: Wipe three times (right, left, middle) from front to back, then perform a mid-stream catch

Actual Procedure:

• Ask pt to leave urine sample

• Use a general pipette to drop 3 drops onto hCG labeled cassette.

• Read result in 5min, Control must always be present.

• just the line in the control=negative

• double line = positive.

Urinalysis (automate)

Collecting urine:

General Collection (Clean Catch Mid-Stream)

Male Anatomy: Wipe once, then perform a mid-stream catch.

Female Anatomy: Wipe three times (right, left, middle) from front to back, then perform a mid-stream catch

Actual Procedure:

• Press Start

• Place dipstick into urine, submerge all the squares

• Slide strip off the side of the cup or pat one side on blue chuck pad once--to prevent the colors from running.

• Insert strip into the middle of the open chamber. WAIT. (do not push the chamber inside)

• After 64 seconds, the sample will go into the chamber and the results will print.

  • Press print if the results do not print automatically. Tape results to your U/A Sheet

• Press CANCEL to clear the results

Urinalysis (manual)

Collecting urine:

General Collection (Clean Catch Mid-Stream)

Male Anatomy: Wipe once, then perform a mid-stream catch.

Female Anatomy: Wipe three times (right, left, middle) from front to back, then perform a mid-stream catch

Actual Procedure:

• Place a urine sample onto a blue chuck and remove the dipstick from the bottle.

• Place dipstick into urine, submerge all the squares.

• Slide strip off the side of the cup or pat one side on blue chuck pad once--to prevent the colors from running.

• Wait for the squares to develop (time in seconds is listed next to each square on the bottle; the top leukocytes are finished after 120 sec).

• Line up the stick with the container and record values, bottom up.

Pap Smear

Pap Smear

• Supplies: 1)speculum 2)spatula 3) brush 4)lubricant 5)transport tube

• Patient Prep: Provide a gown; the patient undresses from the waist down.

Sterile gloving

• Lift table waist high

• Open package-only touching the 2-inch margin

• Use one hand to grab non-sterile side of one glove

• Slide in first hand

• Slide sterile hand under sterile side of the glove

• Use leverage to slide in opposite hand

Spirometry (incentive spirometer)

• Inform pt of lung volume goal (moving yellow tab up/down the spirometer)

• Instruct pt to exhale completely, then inhale slowly until the lung volume is met

• Ask pt to repeat goal every so often (e.g. during commercial breaks when watching TV)

Nebulizer

• Assemble nebulizer kit

• Add medication into container

• Attach top of nebulizer and hand to pt

• Have pt seated securely in upright position

• Instruct the pt to inhale aerosol normally-taking a deeper breath during every other breath

• Inform patients of possible lightheadedness and tell them to turn off the machine if this happens.

Epi pen

• Recognize that patient is experiencing a severe allergic reaction

• Hold the EpiPen with the orange tip (where the needle is) pointing downward and the blue safety cap pointing up.

• Remember this phrase: Blue to the sky, orange to the thigh

• Remove the blue safety cap.

• Pull straight up on it.

• Do not bend or twist it

• Place the orange tip against the middle of the outer thigh.

• Using a slight swing, jab the auto-injector into the thigh until you hear the device click

• Hold the EpiPen firmly in place for three seconds.

• Count slowly

• Activate emergency response

Snellen

• Hand pt black eye occluder and position pt to 20 ft away from eye chart

• Ask pt to cover R, then L eye, with eye occluder while reading lowest line possible

• 0-1 letters wrong = pass; go to the line below it

• >1 wrong fail; go to the line above it

• Record the results from each eye (e.g., 20/20 R, 20/15 L, 20/20 both)

• Finally, ask pt to read with both eyes

Jaeger

• Have the patient hold the chart 14-16 inches away from their eyes

• Have them identify the smallest line they can read

• The patient should read the smallest line; ask if they can read the line above it

• The smallest line read correctly is the vision.

• Document results

Ishihara

• Bring out a test packet and ask pt to identify numbers and patterns within the circles

• Pt can identify numbers verbally and/or identify with a finger.

• Certain number combinations will help identify different kinds of color blindness

Elbow

• begin mid-forearm, wrapping a few times

• wrap up the arm, covering half of previous wrap as you go along

• wrap to mid upper arm and secure with fastener.

Wrist

• Ensure you wrap your bandage above and below the joint.

• Begin your wrap at the lower part of your forearm.

• Overlap each layer of the bandage by about 50 percent.

• Make figure-eight patterns around the joint to create stability.

• Use the Velcro or fastener at the end to stabilize your wrap

Ankle

• Begin wrapping at top of foot

• wrap under and around top of foot to secure

• while wrapping, create tension in lateral or medial motion, opposite direction of accident

• multiple diagonal figure 8 motions around ankle

• Finish wrap by fastening.

Knee

• wrap around lower leg, below knee, circle a few times

• wrap diagonally behind knee

• wrap above knee

• continue wrapping diagonally behind the knee, creating figure 8

• repeat multiple times

• finish by wrapping above the knee several times and securing with fastener

ID (give injection type, needle gauge & length, angle, possible locations)

Insulin (Sc) ( give needle gauge & length, angle, possible locations)

SC (give injection type, needle gauge & length, angle, possible locations)

IM (give injection type, needle gauge & length, angle, possible locations)