Comprehensive Nursing Lab and Clinical Skills Review
Module 3: Safe Medication Administration: Reducing Risk of Medication Errors
Administration of Liquid Medications: Techniques for accurately measuring and administering medications in liquid form.
Otic and Ophthalmic Medication Administration: Precise techniques for the delivery of medications into the ears (otic) and eyes (ophthalmic).
Insulin Administration Protocols: * Injection Sites: Proper identification of appropriate anatomical locations for insulin delivery. * Injection Angles: Specific degree of needle insertion for subcutaneous delivery. * Storage Requirements: Guidelines for the storage and handling of insulin vials. * Mixing Insulins: Procedures for safely combining different types of insulin in one syringe.
Vials and Ampules: Safe techniques for withdrawing and administering medications from both sealed vials and glass ampules.
Injection Techniques: * Subcutaneous (SQ): Correct procedure for injecting into the fatty tissue layer. * Intramuscular (IM): Correct procedure for injecting into the muscle tissue.
Special Considerations for Heparin: Specific precautions and protocols required when administering heparin injections.
Post-Injection Care: Management of the injection site following the procedure, including methods to control or manage bleeding.
The Three Checks: Performing the three mandatory safety checks of the medication label against the MAR (Medication Administration Record) prior to administration.
Interpreting Healthcare Provider (HCP) Orders: Understanding and following clinical orders regarding frequency and timing (e.g., once daily orders).
Module 6: Perioperative Nursing and Ensuring Airway, Breathing, and Gas Exchange
Incentive Spirometers: Correct use and patient instruction for the incentive spirometer to promote lung expansion.
Oxygen Delivery Systems: Proper application and management of oxygen therapy via face masks and nasal cannulas.
Oxygen Saturation Monitoring: Utilizing pulse oximeters to monitor and interpret patient oxygen levels.
Post-Operative Exercises: Teaching patients essential techniques for coughing, deep breathing, and leg exercises to prevent complications.
Nasopharyngeal Catheters: Correct techniques for the insertion and suctioning of nasopharyngeal catheters.
Surgical Suctioning Safety: Implementing techniques to prevent mucosal damage during the suctioning process.
Pneumatic Compression Devices: Correct anatomical positioning and operation of pneumatic compression devices.
Graduated Compression Stockings: Proper placement and fitting of knee-length graduated compression stockings.
Surgical Dressing Management: Procedures for managing and performing surgical dressing changes.
Module 7: Sterile Technique, Infection Control, and Providing Wound Care
Sterile Field Management: Protocols for maintaining a sterile field and the immediate recognition of when a sterile field has been contaminated.
Sterile Gloving: Techniques for the proper application of sterile gloves to maintain asepsis.
Wound Closure Removal: Detailed procedures for the safe removal of surgical staples and sutures.
Surgical Drain Management: Protocols for managing and emptying Hemovac and Penrose drains.
Handling Compromised Fields: Appropriate actions to take when sterile fields are contaminated or compromised.
Pressure Injury Risk Reduction: Identifying nursing interventions aimed at reducing the risk of a patient developing pressure injuries.
Module 9: Urinary Elimination
Urinary Catheter Removal: Safe and correct techniques for the removal of urinary catheters.
Catheter Troubleshooting: Recognizing signs of improper catheter placement or device malfunction.
Sterile Catheter Insertion: Proper sterile technique during the insertion and care of catheters, with specific considerations for both male and female genitalia.
Urine Specimen Collection: Methods for the sterile collection of urine samples directly from indwelling catheters.
Module 10: IV Fluid Administration, Fluid Balance, and Venipuncture
Venous Blood Sampling: Safe and correct techniques for the collection of venous blood samples.
Vein Entry Indicators: Identifying the physical indicators (e.g., flash) that a catheter has entered the vein successfully.
Vein Distension Techniques: Methods used to promote vein distension during the venipuncture process.
Site Preparation: Proper cleaning and preparation of the insertion site before a needle is inserted.
Tourniquet Management: Correct timing for the release of the tourniquet during blood draws to ensure sample integrity.
IV Tubing Management: Proper handling of IV tubing and the maintenance of sterile connections.
IV Line Priming: Procedures for priming IV lines while maintaining strict aseptic technique.
Gravity Infusions: Procedures for setting up and monitoring intravenous (IV) infusions delivered by gravity.
Troubleshooting Infusions: Priority nursing actions to take when an IV infusion is flowing slowly or has stopped entirely.
Module 11: Documentation: Communicating Through the Patient Record
Charting Formats: Utilization of different documentation styles, including: * SOAP (Subjective, Objective, Assessment, Plan) * PIE (Problem, Intervention, Evaluation) * DAR (Data, Action, Response) * CBE (Charting by Exception) * Narrative Charting
Subjective and Objective Data: Accurate recording of subjective (patient-reported) and objective (clinically observed) data.
Documentation Abbreviations: Interpretation of common medical abbreviations used in patient records.
Data Trend Identification: Skills for identifying significant trends within patient data over time.
Documentation Errors: Recognizing common errors in documentation and identifying specific actions to avoid making them.
Module 12: NG Tube Insertion, Maintenance, and Removal; Enteral Feeding
NG Tube Insertion: Technique for the insertion of a Nasogastric (NG) tube.
Continuous Feeding: Administration procedures for continuous enteral nutrition.
Intermittent Feeding: Administration procedures for intermittent enteral nutrition.
Tube Maintenance: Techniques for unclogging feeding tubes to maintain patency.
Managing Aspiration Issues: Clinical actions to take when a nurse is unable to aspirate gastric secretions.
Module 13: Bowel Elimination
Enema Procedures: * Patient Positioning: Correct positioning of the patient for enema administration. * Discomfort Management: Techniques for managing patient discomfort during the procedure. * Tolerance Assessment: Recognizing and responding to signs that a patient is not tolerating the enema administration.
Ostomy Care: * Stoma and Peristomal Skin: Techniques for cleaning and caring for the stoma and the surrounding skin. * Ostomy Appliances: Measuring and fitting ostomy appliances properly. * Colostomy Teaching: Educational requirements for a patient receiving a new colostomy.
Toileting Assistance: * Bedpan Use: Identification of bedpan types and appropriate use for patients with limited mobility. * Safe Assistance: Techniques for providing safe assistance during toileting and elimination.
Bowel Distress: Immediate nursing actions to take during episodes of patient bowel distress.