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What is asepsis?
absence of microorganisms
what 3 things are nurses capable of doing?
Reduce spread of disease.
Minimize complications.
Reduce adverse outcomes.
___________________ _________________ is clean technique. Decreases number & transfer of pathogens
Medical asepsis
how can we decrease the spread of microorganisms?
Hand hygiene
Wearing gloves
_________ _______________ is sterile technique. Keeps objects free of microorganisms.
Surgical asepsis
when cleaning something what is one factor to always remember?
Clean from cleanest to dirtiest areas.
when pouring liquids into a drain what should we try not to do?
splash the liquid on ourselves or around the sink/on the outside of the sink.
When opening a sterile pack, how should we open it?
open it directed away from you
Should forceps be dry or wet when using them in a surgical procedure?
completely dry
What are the 5 moments for hand hygiene?
Before touching a patient.
Before a clean or aseptic procedure.
After body fluid exposure risk.
After touching a patient.
After touching patient surroundings
when should we use alcohol-based hand rubs?
Use when hands are not visibly soiled OR there was no contact with blood or body fluids.
Use before & after any patient contact; after patient environment surface contact; after removing gloves.
why do people like using alcohol-based hand rubs?
Easy, Fast acting & typically causes less irritation
when must hand washing be done?
-Hands are visibly soiled
-Hands are contaminated with blood or any body fluid
-Before eating
-After using restroom
-Exposure to certain organisms
Anthrax
Norovirus
Clostridium difficile
When should we practice hand hygiene?
Before & after patient contact.
Prior to putting on gloves or performing any invasive procedure.
After contact with any body fluids, excretions, mucous membranes, non intact skin, or wound dressing.
When moving from an area of contamination to a cleaner area.
After contact with any objects near the patient.
After doffing gloves.
When are standard precautions used?
Used for ALL patients to decrease risk of microorganism transmission.
What are the 3 transmission based precautions?
airborne, droplet, contact
what are some examples of what a patient may have if they're on airborne precautions?
Tuberculosis
Varicella (chicken pox)
Rubeola (measles)
Severe acute respiratory syndrome (SARS)
when transporting a patient with airborne precautions what should we do?
Use surgical mask for patient transport.
what are some examples of what a patient may have if they're on droplet precautions?
Rubella
Mumps
Diphtheria
Adenovirus
what kind of room should a patient with airborne precautions be in?
private room with negative pressure. Door must stay closed & patient should stay in room.
can the door be open to a patients room that is on droplet precautions?
yes
how far should visitors stay from a patient that is on droplet precautions?
3 feet away
when should contact precautions be used?
patients with excessive wound drainage, fecal incontinence, or other bodily discharges that could indicate increased potential for contamination & transmission.
Use private room.
what is the order of donning PPE?
gown, mask, goggles, face shield, gloves
what is the order of doffing PPE?
gloves, face shield, goggles, gown, mask
what are the restraint guidelines for nonviolent restraints?
after 24 hours the patient must be removed from restraints and if restraints are needed again another doctors order must be ordered
what are the restraint guidelines for violent adults 18 yrs or older?
4 hours
what are the restraint guidelines for violent children/adolescents 9 yo -17 yo?
2 hours
what are the restraint guidelines for violent children less than 9 yrs old?
1 hour
when a person is on restraints what must the nurse do ?
Vital signs must be routinely checked. Personal needs (fluids, nutrition, toileting) must still be addressed every 2 hours for nonviolent. Skin integrity & ROM must be provided every 2 hours for nonviolent. All of these interventions must be documented!
how many fingers should you be able to put in between a restraint and the patients skin?
2
What is 1kg in grams?
1000g
what is 1 gram in mg?
1000mg
what is 1mg in mcg?
1000mcg
a kilogram is ____________ than a gram
greater
a gram is ___________ than a milligram
greater
The physician has ordered 0.4 g of medication. How many milligrams is contained in the medication?
400mg
Order: 500 mg
Supply: 1 g
What conversion do you need to make?
500 mg = 5 g
Order: 0.1 mg
Supply: 200 mcg
You want to convert milligrams to micrograms.
0.1 mg = 100mcg
1 tsp equals how many ml?
5 mL
1 tbsp equals how many mL?
15 mL
1 oz or fl oz equals how many ml?
30 ml
1 cup equals how many ounces?
8 ounces
1 cup equals how many mL?
240-250 milliliters
1 pt equals how many mL?
500 mL
1 qt equals how many mL
1000 mL
1 qt equals how many liters?
1L
2.2 lb equals how many kg?
1 kg
1 lb equals how many ounces?
16 ounces
1 inch equals how many centimeters?
2.54 cm
The order is to administer 10 mL of a medication. How many teaspoons of the medication will you administer to the patient/client?
2 tsp
what does ac mean?
before meals
What does PC mean?
after meals
What does BID mean?
twice a day
What does TID mean?
three times a day
What does QID mean?
four times a day
what does stat mean?
immediately
what does qn mean?
every night
What does qh mean?
every hour
What does q2h mean?
every 2 hours
what does q4h mean?
every 4 hours
What does q6h mean?
every 6 hours
What does q8h mean?
every 8 hours
What does q12h stand for?
every 12 hours
What does PRN stand for?
as needed
What does BIW stand for?
twice per week
military time 2 pm
1400
military time 1:30am
0130
In military time, 9AM is stated as?
0900
military time 9:15pm
2115
military time 6:20 pm
1820
convert standard time to military time
0500
5:00 am
convert standard time to military time
2015
8:15 pm
convert standard time to military time 1745
5:45 pm
convert standard time to military time
1100
11:00 am
convert standard time to military time
1910
7:10 pm
What does parenteral mean?
by injection
What are the parenteral routes?
IM, IV, subcutaneous
Morphine sulfate 15 mg subcutaneously stat and 10 mg q4h prn
what does this mean?
Morphine sulfate 15 mg subcutaneously immediately and 10 mg every 4 hours as needed.
Chloromycetin 0.01% ophthalmic ointment left eye bid
what does this mean?
Chloromycetin 0.01% ophthalmic ointment left eye twice a day.
Ampicillin 1 g IVPB q6h
what does this mean?
Ampicillin 1 gram intravenous piggyback every 6 hours.
when should you assess the skin?
daily & after incontinence.
hygiene
•Personal hygiene maintains personal cleanliness & grooming which promotes physical & psychological wellbeing.
•Varies depending on preferences & abilities.
can a bed bath be delegated?
yes
can you delegate oral care?
yes
what does oral care promote/prevent for the patient?
Promotes well being & prevention of oral cavity deterioration. Prevents gingivitis & caries.
when making an occupied bed what method should you use?
turning method
can you delegate bed making?
yes
what may specialty beds or mattresses not need?
These may not require sheets or may have special pads
what are the importances of nutrition?
•Important for bodily function
•Restores & maintains health
•Disease prevention
Poor nutrition decreases __________
wellness
when hemoglobin is decreased what does that indicate?
anemia
what is decreased with anemia?
hematocrit
what is increased with dehydration?
hematocrit
When is serum albumin decreased?
with malnutrition, higher risk of morbidity & mortality
when is transferrin decreased?
with anemia, protein deficiency
when are lymphocytes decreased?
with impaired nutritional intake or severe debilitating disease
what is increased with blood urea nitrogen?
starvation, high protein intake, severe dehydration
what is decreased with blood urea nitrogen?
malnutrition or over hydration
When is creatinine increased?
dehydration
Note
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