Clinical Skills and Procedures

How should ear drops be administered in adults?

Pull the earlobe up and back

How should ear drops be administered for children?

Pull the earlobe down and back

What are some examples of temporary enteral feeding tubes?

NG tubes, nasoduodenal tubes, jejunostomy tubes, and gastrojejunal tubes

How should the bed be positioned during feedings?

Head of the bed elevated 30-45 degrees

Before feeding, the nurse aspirates the stomach contents. The residual volume is greater than 500mL. What should the nurse do next?

Return contents, document, and proceed

Before and after every feed, the tube should be flushed with:

30mL of water

How often should continuous feeds be flushed?

Every 4 hours

How often should you change enteral feeding tubes?

Every 24 hours

The patient has a NG tube inserted and has started to vomit and choke. What should the nurse do?

Stop the feed immediately, keep patient upright, suction, and notify HCP

What are the two types of parenteral nutrition?

PPN (Partial Parenteral Nutrition) and TPN (Total Parenteral Nutrition)

How should parenteral nutrition be administered?

PICC line or central venous catheter only!

What does parenteral nutrition do?

Avoids the GI tract and goes directly into the bloodstream for nutrition

The patient is due to change their fluid bag for parenteral nutrition. There is no new bag available. What should the nurse do?

Change the bag and administer 10-20% dextrose in water until a new bag is ready

For a 24hr UA for creatinine levels, how should the urine be collected?

Discard the first void in the morning, then collect everyone after that including the last one for 24hrs

The patient needs to complete a 24hr urine test for creatinine levels, but just voided 2hrs ago. When should they start the test?

On the patient’s next void

The patient is allergic to shellfish. What does this mean for sterile techniques?

Cannot use iodine on the patient

The patient’s urine output is less than 30mL. What does this mean and what should the nurse do?

Kidney is in distress; draw BUN and creatinine levels

After an indwelling catheteris removed, what should the nurse ask the patient?

When the patient voided after removal to assess bladder ability

Handwashing should take a minimum of:

15 seconds

If the patient’s posture is upright and has a smooth gait, what should the nurse determine?

Activity tolerance

What is the priority risk for a patient with vomiting and diarrhea?

Fluid deficit or dehydration

What type of exercise is ideal for patients who can’t tolerate activity (ie an immobilized patient in bed)?

Isometric exercise

Where should the patient bear weight when using crutches?

Palms of the hands

How should the crutches fit under a patient?

2 inches below the axilla

Where should the arm rest be on crutches?

The middle of the forearm

What’s the ROM exercise you should use for hinge joints, like at the arm?

Bend the arm by flexing the ulnar to the humerus