DRESSINGS
ORAL CARE
DOCUMENTING
CHG
ODDS+ENDS
100
What day do we change PICC/CVC dressings?
Sunday
100
Patient states she is having pain in her mouth, and you note her lips are dry, her mucous membranes are red with no ulcers. What grade of mucositis does she have?
Grade 2
100
You just changed your patient's PICC dressing and note the time of 1248. What time do you write on the dressing and chart in the documentation? 1. 1200 2. 1230 3. 1300 4. b or c
4. b or c
100
If you wanted to show your patient an informational video on CHG wipes, where would you direct them?
Get Well Network
100
Which of the following is not an indication for a central line? 1. Vesicant/Irritant 2. Long term IV infusions 3. Patient with difficult veins for blood draws 4. Hyperosmolar solutions
3. Patient with difficult veins for blood draws
200
List the different types of dressing kits we have.
PICC, PORT, CVC
200
Your patient has Biotene and Chlorhexidine mouth rinses ordered QID. When do you instruct them to use rinse their mouth?
After they eat. Biotene first followed by Chlorhexidine
200
Where do you document that your patient has refused her CHG wipes?
ADLs-Personal Care Provided- "Other"- Chart she refused and why.
200
Your patient is refusing to use CHG wipes even after you educated him/her on the importance. What is your next step?
Notify the Lead RN
200
How many CHG wipes are there in one package?
6
300
You note your patients external catheter length was 1 cm prior to the dressing change, and as you are about to place the new dressing down you note it is at 4 cm. What step do you not take? 1. Apply the dressing 2. Push the catheter back in until it's at 1 cm 3. Notify the Lead RN 3. Chart the current external catheter length at 4 cm
2. Push the catheter back in until it's at 1 cm
300
Your patient has Biotene and Chlorhexidine rinses ordered QID. Upon your assessment you note grade 2 mucositis. What do you do?
Notify the physician and request him/her to change the Chlorhexidine rinse to Daniel's mouthwash.
300
TRUE or FALSE You just changed your patients PORT dressing, but not the needle. Your first step in documenting is inactivating the current PORT dynamic group.
FALSE. Stay in the same dynamic group, but chart that you changed the dressing.
300
What is your first step if a patient states they have a CHG allergy, but it is no where to be found in their chart?
Do a sensitivity test on their forearm
300
According to the policy, how long should you swab the injection caps for prior to each accession?
15 seconds
400
Step 1 for the dressing change is chlorhexidine cleaning. How long do you apply (clean)?
30 seconds
400
What is the definition of mucositis?
It's an inflammatory process affecting the mucous membranes of the oral cavity and gastrointestinal tract.
400
You just removed your patient's PORT needle. What do you chart under "Activity" in the patients chart?
Non-coring needle removed
400
CHG wipes can be applied all areas below the chin and _____ away from the catheters point of entry into the body.
6 inches
400
How long must the central venous catheter be in the patient in order for a positive blood culture to be considered a CLABSI?
Greater than 2 days
500
What items do you need in order to change a PICC dressing?
1. PICC dressing change kit 2. Two NS syringes
500
With what chemotherapy agent do we instruct the patient to chew on ice prior to, during, and post infusion in order to protect their oral mucosa?
Melphalan
500
Name 2 of the education care plans you must chart that you provided when you initiate Infection Surveillance.
Education on: CLABSI, CHG, Infection prevention, PICC/midline care
500
Give 2 situations in which you would not use CHG wipes on your patient.
Patients receiving radiation, TBI, Thiotepa. Patients with a known allergy to CHG. To clean around the face or mucous membranes. For lumbar punctures or in contact with the meninges. To clean open skin wounds or as a general cleanser.
500
Your patient is receiving magnesium which has just completed, and you intend to unhook that line from the Y-site of your primary line. How long can you keep the magnesium line prior to changing it?
Once you unhook the line for one time use medications, throw it away.
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