Intro Benchmark

Steps for Inserting a Small-Bore NG Tube:

  1. Verify order and gather supplies

  2. Perform hand hygiene and apply gloves

  3. Explain procedure to patient

  4. Place patient in high Fowler’s position (90°)

  5. Measure tube: From tip of nose → earlobe → xiphoid process

  6. Lubricate tube tip

  7. Insert through nostril gently while patient sips water (if allowed), advancing with each swallow

  8. Check placement:

    • Aspirate gastric contents and check pH (usually <5)

    • Confirm with X-ray (gold standard)

  9. Secure tube to nose and gown

  10. Document procedure, tube size, insertion depth, patient tolerance, and confirmation method

Denture Hygiene for Healthcare Personnel:

  • Wear gloves when handling patient dentures.

  • Remove dentures carefully to avoid damage.

  • Clean with lukewarm water (never hot – can warp plastic).

  • Use a denture brush and non-abrasive cleaner.

  • Store in a labeled container with water or denture solution.

  • Encourage patient to remove dentures at night.

  • Always maintain patient privacy and dignity.

Role of Nurse in Physician-Assisted Suicide:

  • Depends on state law – it’s legal in a few U.S. states under specific regulations.

  • Nurses do not administer the life-ending medication.

  • Role includes:

    • Providing emotional support

    • Educating patients and families

    • Advocating for patient autonomy

    • Following facility policy and legal guidelines

    • Refusing participation if it conflicts with personal beliefs (ethically permissible with proper handoff)

Nurse’s Role in Advanced Directives (Including Living Will):

  • Understand what the document says and ensure it's in the medical record.

  • Clarify and honor patient wishes.

  • Educate patients about options like:

    • Living will (what treatments the patient wants/refuses)

    • Durable Power of Attorney for Healthcare (names a decision-maker)

  • Advocate for the patient’s choices, especially if others challenge them.

  • Notify the healthcare team if there are updates or conflicts.

Medication Administration and Patient Rights:

Patients have the right to:

  1. Right patient – verify using 2 identifiers.

  2. Right medication

  3. Right dose

  4. Right route

  5. Right time

  6. Right documentation

  7. Right reason

  8. Right response (assess effectiveness)

  9. Right to refuse

  10. Right to be informed (about the medication’s purpose, side effects, etc.)

Contact Transmission (Direct or Indirect)

Precautions: Gown & gloves

Common Conditions:

  • MRSA (Methicillin-Resistant Staph Aureus)

  • VRE (Vancomycin-Resistant Enterococcus)

  • C. difficile (spores – handwashing required, not hand sanitizer)

  • RSV (also droplet)

  • Herpes simplex virus (HSV)

  • Scabies

  • Impetigo

  • Lice (Pediculosis)

  • Wound infections with drainage not contained by dressings

💦 Droplet Transmission (Large respiratory droplets)

Precautions: Surgical mask; gown/gloves if contact with secretions

Common Conditions:

  • Influenza

  • COVID-19 (also airborne in some cases)

  • Pertussis (Whooping cough)

  • Mumps

  • Rubella

  • Meningitis (N. meningitidis)

  • Diphtheria (also contact)

  • RSV (also contact)

🌬 Airborne Transmission (Tiny particles that stay suspended in air)

Precautions: N95 respirator, negative pressure room

Common Conditions:

  • Tuberculosis (TB)

  • Measles (Rubeola)

  • Varicella (Chickenpox)

  • Disseminated Herpes Zoster (Shingles)

  • COVID-19 (in some aerosol-generating procedures)