NURSING SKILLS 1
HCAI - a healthcare associated infection is spread by contact either indirect or airborne by food or blood it can be prevented by hand hygiene or antibiotics
CHAIN OF INFECTION -
infectious microbe eg bacteria
reservoir eg people
port of exit eg sneezing
modes of transmission eg airborne
port of entry eg open wounds
suscepitble host eg babies
5 MOMENTS OF HAND HYGIENE -
before touch patient
before aseptic procedure
after body fluid exposure
after touching patient
after touching patient sourroundings
ASEPTIC NON TOUCH TECHNIQUE - is an infection control method which prevents the transfer of microorganisms
POST PROCEDURE -
make patient more comfortable
dispose of yellow waste bag
draw curtains back
disinfect hands
document clearly
10 RIGHTS OF MED MANAGEMENT -
patient
reason
drug
route
time
dose
documentation
action
form
response
NEWS - is a bedside score also know as a track and trigger system which includes pulse, blood pressure, respiration rate ans temperature
VITALS - is a sign that pertains to life without it life doesnt exist
ISBAR - is used to identify patients, situations, their background, assessment and recommendation
EYE EXAMS - redness, discharge/crusting, growths, tearing, swollen, pain, pupil size
ADMINISTERING MEDS - diagnose, emergency, healing, lubrication, pain relief, pre/ post op, procedures and surgery
FLUID BALANCE - is the in/output of fluids by metabolic processes
SIGNS - dehydration, reduced appearance, headache, fatigue, hypotension, tachycardia and weak ulse p
BODY TEMPERATURE - SITES; mouth, axilla, rectum, ear, temporal artery
INDICATORS - establish baseline, before and after surgery, early signs of infection, before and during blood transfusions, change in symptoms
RANGES - pyrexia = above average or up to 38 #
hyperthermia = more then 40
fever = shivering and fever
hypothermia = less then 35
malignant hyperthermia = rise to dangerous level 41-45
CAUSES OF PYREXIA - infection/ inflammation
trauma
metabolic disorders
post op complications
INJECTIONS - allows bloodstream to absorb quickly
DIFFERENCES - subcut = admin under fat layer of skin
intramuscular = delivered into muscle
COMPLICATION - sub - redness pain swelling intramuscular - muscle damage nerve damage
RECTAL MEDS - benefits = bioavaliable/ absorbs quickly. types = suppository and enema. indicators =treats pain fever vomiting and sedation
those who cant take meds orally use rectum possible complications = pain and discomfort.
FACTORS EFFECTING - allergies, dose , form, response and reason
PULSE - each time the heart beats it pushes blood through the arteries the pumping action causes the walls to expand and create a wave = a pulse
BASELINE OBSERVATIONS - rate rhythm and strength
MAIN FEATURES - rate rhythm and volume
click to edit
PULSE SITES - cortiod
radial
temporal
brachial
apical
popiteal