A&P
At this stage, stiffening in the lung wall makes breathing and coughing more difficult
Older adult
Explain the purpose of medication
Prevention, treatment, diagnosis, cure, contraception, health maintenance, palliative, replacement
What is the most important infection prevention action you can take
Hand hygiene
Explain AIDET
Acknowledge
Introduce
Duration
Explain
Thank
Builds report, improves communication, decreases anxiety
Explain how to landmark lead placement for an EKG
Limb leads on the lower legs or the fleshy part above the ankle and fleshy part of both wrists or on the shoulders.
V1= 4th intercostal space to the right of the sternum
V2= 4th intercostal space to the left of the sternum
V3= equidistance between V2 and V4
V4= 5th intercostal space on the left side at the midclavicular line
V5= equidistance between V4 and V6
V6= 5th intercostal space at the midaxillary line on the left side
Which body system controls nutrient delivery to cells
Cardiovascular system
Delivers nutrients and oxygen to cells - requires adequate blood pressure
What needle gauge and length are used for each type of injection. What angle is needed for each type of injection.
IM: 22g-25g, 1-1.5inch, 90 degrees
SQ: 25g-30g, 1/2 - 5/8inch, 45 or 90 degrees bevel up
Intradermal: 25g-30g, 1/4 - 1/2 inch, 5-15 degrees bevel up
When should you use soap & water vs hand sanitizer
Visibly soiled; patient has nausea, vomiting, diarrhea, c diff (positive or rule out)
You notice a famous athlete in the building when you arrive at work. You find their chart in EPIC and open the appointment tab to see what clinic they will be at. This is ok since you didn’t go into the chart.
False. Looking at any information in EPIC not job related is breaking HIPAA and can have serious consequences including being let go.
Explain how to collect an oropharyngeal, anterior nare, and nasopharyngeal specimen
Oral pharyngeal: both sides of oral cavity – back of throat
Anterior nare: ½ inch into nose, 5 slow circles or about 15 seconds; repeat on other nostril
Nasopharyngeal: go all the way back of 1 nostril until meet resistance
What are the maximum volumes for IM, SQ, and intradermal injections
IM:
-Deltoid 1mL
-Ventrogluteal 3mL
-Vastus lateralis 5mL
SQ: 1.5mL
Intradermal: 0.1mL
You have an order to administer 30mg of ketorolac IM. The vial contains 12.5mg/1mL. Demonstrate on the syringe how much you will administer. Where will you administer the medication?
2.4mL
Ventrogluteal
Name at least 3 characteristics that make a person a susceptible host
Age (young/elderly)
Chronic disease
Malnutrition
Immunocompromised
Stress
Unvaccinated
Living environment
Your patient comes in with no known infection. What precautions should you take?
Standard precautions - those taken with every patient
Cleaning room and equipment, hand washing, appropriate PPE
You set up a sterile field for a procedure and notice the provider’s coat touched the sterile field. What do you say and why is it important.
"it looks like something touched the sterile field – let me re-set this up"
Must ensure that sterile field remains sterile to protect patient and prevent infection/complications
Explain how to locate the proper placement for IM injections and subcutaneous injections
Deltoid: 3 fingers down from acromion process
Ventrogluteal: palm on greater trochanter, "pinky to the stinky", middle finger towards head, pointer finger on anterior iliac crest; in the "peace sign" between pointer finger and middle finger
Vastus lateralis: split thigh vertically in half, split thigh in thirds from groin to knee - use middle third lateral side
SQ: back of arm, abdomen at least 1 inch away from navel, upper outer thigh
You have an order to administer 20mg folic acid subcutaneously. The vial contains 15mg/1.2mL. Demonstrate on the syringe how much you will administer. Where will you administer the medication?
1.6mL
Back of arm, abdomen at least 1 inch away from navel, upper outer thigh
*Administer in 2 injections
You have a patient with TB and a different patient with c diff. Explain the differences in isolation requirements
TB: airborne= N95/PAPR; negative airflow room
c diff: contact= gown, gloves; wash with soap & water, bleach wipes to clean
What is included in rooming standards
Maintaining room and equipment cleanliness
Completing chief complaint, vitals, medication reconciliation, allergies, screenings
The provider orders a urine analysis with culture and sensitivity. Explain to your patient how to collect this specimen and why it’s important to do it correctly.
Open container without touching inside of cup or cover, open towelette, clean urinary meatus with towelettes, begin urinating in the toilet, bring specimen container into urine stream and fill until the fill line, secure cover, wash your hands.
Removes bacteria in urethra and identifies bacteria in urine and bladder
Describe at least 3 functions of the integumentary system
Protection
Sensory organ activity
Temperature regulation
Excretion
Synthesis of Vitamin D
What are the rights of medication administration, when are they checked, and what is their purpose.
Right: patient, medication, dose, time, route, documentation
Check 3 times: when withdrawing from pyxis, when preparing medication, prior to administering
Ensures safety, including correct medication given to patient, preventing medication errors, and protecting patients
You have a patient in with influenza and a patient with shingles. Explain the differences in isolation requirements.
Influenza: droplet = face mask, eye protection
Shingles: contact and airborne: PAPR/N95, gown, and gloves; negative airflow room
Explain the Scope of Practice of a Clinic Assistant
Obtain and record patient history & vital signs, administer meds, any skill covered in this course
Cannot:
Administer controlled substances, range doses, dual sign off, or nebulizer medications
Perform assessment
Provide medical advice
Delegate tasks
Perform sterile procedure
Perform complex wound care
Explain how to use a Hoyer lift
You need at least two people. One person to guide the patient and the other person to operate the lift.
Lock the wheels. Place the appropriate sized sling beneath the patient. Criss cross the leg straps so the patient does not fall through.
Attach sling to lift. Transfer patient to desired location. Un-attach sling and remove sling from under patient.