Comprehensive Clinical Nursing Skills and Procedures

Vocabulary practice flashcards covering fundamental clinical nursing skills, including IV therapy, physical assessment techniques, perioperative communication, respiratory care, wound drainage, PPE protocols, and patient mobility procedures.

Smart Pumps

Multifunctional electronic infusion devices (EIDs) equipped with built-in software programmed from healthcare pharmacy databases with unit-specific profiles, featuring audible and visual alerts when programmed settings fail to match medication administration guidelines.

Phlebitis Scale Grade 4

The highest severity score on the phlebitis scale, characterized by pain, erythema, and edema at the IV site, streak formation, a palpable venous cord greater than $1\,\text{inch}$ ($2.5\,\text{cm}$) in length, and purulent drainage.

Gravity Drip Rate Calculation

A two-step mathematical calculation used to regulate IV solutions by gravity: first calculating hourly volume (total volume in $\text{mL}$ divided by hours of infusion), then calculating drops per minute using the formula: $\text{gtt/min} = \frac{\text{Hourly volume} \times \text{gtt factor}}{60}$.

Transparent Semipermeable Membrane (TSM) Dressing

A sterile dressing applied over a vascular access device (VAD) insertion site, leaving the Luer-Lok connection uncovered, and replaced at least every $7\,\text{days}$ or immediately when loose, damp, or soiled.

Catheter Embolus

A serious complication resulting from an intravenous catheter shearing or breaking off inside the vein; prevented during catheter removal by never using scissors on dressings, withdrawing slowly and parallel to the skin, and visually confirming catheter tip intactness.

Continuous Administration Set Replacement Interval

The standard infection-control schedule requiring primary and secondary continuous IV tubing (delivering solutions other than lipids, blood, or blood products) to be replaced no more frequently than every $96\,\text{hours}$ but at least every $7\,\text{days}$.

Lipid and Parenteral Nutrition Tubing Hang Times

Administration set replacement intervals requiring sets infusing fat emulsions or propofol to be replaced at least every $12\,\text{hours}$, and sets delivering parenteral nutrition to be replaced every $24\,\text{hours}$ with each new container.

Chlorhexidine Skin Antisepsis

The preferred single-use alcohol-based chlorhexidine solution applied with vigorous back-and-forth friction to prepare and decontaminate vascular access sites; if contraindicated, povidone-iodine or $70\%$ alcohol is used.

CATS PRRR

A safety mnemonic for intravenous medication administration: C (compatibilities), A (allergies), T (tubing correct), S (site checked), P (pump safety checked), R (right rate), R (release clamps), and R (return and reevaluate the patient).

Intravenous Piggyback (IVPB)

An intermittent infusion arrangement where a small ($25\text{ to }250\,\text{mL}$) medication container is hung higher than the primary IV solution container, utilizing a back-check valve on the primary line to automatically halt the primary infusion while the piggyback infuses.

Tandem Setup

An intravenous setup where a small secondary medication container is positioned at the exact same height as the primary infusion bag and attached to a lower Y-port, causing both solutions to infuse concurrently.

Mini-Infusion Pump

A battery-operated infusion device designed to deliver small volumes ($5\text{ to }60\,\text{mL}$) of medication over precise infusion times using standard syringes.

Pulse Amplitude Scale

A numerical scale ranging from 0 to 4 used to grade peripheral pulses: $4$ (bounding or aneurysmal), $3$ (full or increased), $2$ (expected normal amplitude), $1$ (diminished or barely palpable), and $0$ (absent or not palpable).

Pitting Edema Scale

A 4-point clinical scoring system based on indentation depth and rebound duration: $1+$ ($2\,\text{mm}$ pit with rapid disappearance), $2+$ ($2\text{ to }4\,\text{mm}$ pit lasting $10\text{ to }15\,\text{seconds}$), $3+$ ($4\text{ to }6\,\text{mm}$ pit lasting $> 1\,\text{minute}$), and $4+$ ($6\text{ to }8\,\text{mm}$ pit lasting $2\text{ to }5\,\text{minutes}$).

Mean Jugular Venous Pressure (JVP)

A clinical hemodynamic measurement representing the vertical distance between the highest point of internal jugular vein pulsation and the midaxillary line at nipple level, normally measuring less than $9\,\text{cm H}_2\text{O}$.

Healing Ridge

An expected palpation finding along a surgical incision healing by primary intention, presenting as an accumulation of firm tissue beneath the skin extending about $1\,\text{cm}$ ($\frac{1}{2}\,\text{inch}$) bilaterally, typically appearing $5\text{ to }9\,\text{days}$ postoperatively.

Wound Exudate Classifications

The categorisation of drainage according to color and consistency: serous (clear plasma), sanguineous (bright red indicating fresh bleeding), serosanguineous (watery pink), and purulent (thick yellow, pale green, or white drainage indicating infection).

Romberg Test

A balance and proprioceptive examination technique in which the patient stands with feet together and arms at their sides, first with eyes open and then with eyes closed, while the nurse spots the patient to detect swaying.

Cubitus Valgus and Cubitus Varus

Deviations in the normal carrying angle of the extended elbow; cubitus valgus is defined as a lateral carrying angle exceeding $15^\circ$, whereas cubitus varus is a medial carrying angle deviation.

Tanner Stages of Breast Development

A five-stage sexual maturity rating system (M1 to M5) describing adolescent female breast development from the preadolescent stage (M1) through bud elevation (M2), contour enlargement (M3), secondary areolar mound formation (M4), to adult projection (M5).

Montgomery Tubercles

Normal, nontender, non-suppurative sebaceous gland elevations distributed across the surface of the areola of the breast.

Abdominal Examination Sequence

The mandatory sequence of physical examination for the abdomen: inspection, auscultation, percussion, and palpation; ordered deliberately because percussion and palpation alter the frequency and character of bowel sounds.

Vertical Liver Span

The distance determined by percussing from lung resonance downward and intestinal tympany upward along the right midclavicular line, normally measuring $6\text{ to }12\,\text{cm}$ in healthy adults.

I-PASS

A structured patient hand-off communication tool composed of Illness severity, Patient summary, Action list, Situation awareness and contingency plans, and Synthesis by receiver.

ISBAR

A standardized clinical communication framework consisting of Identification (self, patient, location), Situation, Background, Assessment, and Recommendation.

Phases of the Cough Reflex

The four sequential stages required for an effective directed cough: irritation (inflammatory, mechanical, chemical, or thermal), deep inspiration, compression (glottic closure and intrathoracic pressure buildup), and expulsion (glottic opening with high-velocity gas release).

Incentive Spirometry (IS)

A lung-expansion therapy that mimics natural sighing to prevent postoperative pulmonary atelectasis; contraindicated in patients with a vital capacity less than $10\,\text{mL/kg}$ or an inspiratory capacity less than one-third of predicted capacity.

Processes of Respiration

The three components of respiration: ventilation (mechanical movement of gas into and out of lungs), diffusion (gas exchange across alveoli and red blood cells), and perfusion (blood flow to and from pulmonary capillaries).

Apnea

The cessation of respiration for several seconds, representing an abnormal finding in adults that requires medical evaluation, but occurring as normal brief spells in newborns.

Pulse Deficit

A clinical finding wherein the auscultated apical pulse rate exceeds the palpated peripheral radial pulse rate, indicating inefficient cardiac contractions that fail to transmit a blood volume wave to the periphery.

PQRSTU Pain Assessment Framework

A mnemonic for pain assessment: P (Provocative/Palliative), Q (Quality), R (Region/Radiation), S (Severity), T (Timing), and U (You: the personal impact of pain on activities of daily living and function).

Apical-Radial Pulse Deficit Criterion

A condition identified when two clinicians simultaneously count the apical and radial pulses for $60\,\text{seconds}$; a difference of more than $2\,\text{beats/min}$ confirms a pulse deficit.

S1 and S2 Heart Sounds

The primary apical heart sounds: $S_1$ ('lub') produced by tricuspid and mitral valve closure before systole, and $S_2$ ('dub') produced by aortic and pulmonic valve closure at the completion of systole.

Point of Maximal Impulse (PMI)

The anatomical location of the cardiac apical impulse, palpated and auscultated at the fifth intercostal space along the left midclavicular line (fourth to fifth intercostal space lateral to the sternal border in infants).

Closed-Drain Wound Systems

Negative-pressure drainage collection devices including the Jackson-Pratt (JP) bulb drain, collecting $100\text{ to }200\,\text{mL/24 hr}$, and the Hemovac spring-activated drain, collecting up to $500\,\text{mL/24 hr}$.

Restraint Alternatives

Non-restrictive interventions and devices used to protect patient safety and prevent self-injury or falls without restraints, such as bed alarms, chair alarms, floor cushions, barrier signs, wedge cushions, and roll guards.

Airborne Precautions

Transmission-based isolation measures indicated for infectious agents suspended on aerosolized particles smaller than $5\,\mu\text{m}$ (e.g., tuberculosis, Aspergillus), mandating the use of an Airborne Infection Isolation Room (AIIR) and an N95 respirator or PAPR.

Sequence of PPE Doffing

The standardized protocol for removing personal protective equipment to prevent self-contamination: first remove gloves, followed by eye protection (goggles/face shield), then the gown, and lastly the mask or respirator after exiting the patient area.

Virchow Triad

The three pathophysiological factors contributing to the development of venous thromboembolism (VTE): blood hypercoagulability, venous wall damage, and venous stasis.

Sequential Compression Device (SCD)

A mechanical device consisting of inflatable extremity sleeves connected to an air pump that sequentially compresses the calves or thighs to drive blood into deep veins, reducing venous stasis and pooling.

Hip Arthroplasty Lift Contraindication

A mandatory patient transfer safety restriction prohibiting the use of a mechanical lift for any patient who has had a recent total hip replacement or who is at risk for hip dislocation.

Gait Belt Placement Criterion

A mobility safety device secured snugly over clothing around a patient's center of gravity with enough space to allow two fingers to slide comfortably inside the belt.

Friction-Reducing Transfer Rule

An ergonomic patient-handling guideline mandating the use of a friction-reducing device or slide board whenever healthcare personnel are expected to lift more than $35\,\text{pounds}$ ($15.9\,\text{kg}$) of a patient's body weight.