NGT
A nurse in inserting an ngt. She aspirates and tests the ph. The ph is 7.0. what does this tell the nurse about the position of the ngt?
It is not in the stomach- could be in lungs or intestines
How often should an immobile patient be repositioned/turned?
At least every 2 hours
A nurse is caring for a patient who had tuberculosis (TB). What PPE needs to be donned before entering the patient’s room?
A fit tested N-95 mask (or disposable respirator)
Gloves and gown
Face shield/goggles if indicated
What kind of precautions are these consistent with?
When cleaning a sterile dressing the nurse knows to clean from “dirty” to “clean”.
False
What is a sign or symptom of chronic hypoxia?
Clubbing
hypercapnia
peripheral edema
right sided heart failure
How do you remove an ngt?
Raise hob
disconnect suction
remove tape
clamp tube
have patient hold breath and remove
What is the range of motion movement in which a limb is moved in a circular motion?
circumduction
When is it appropriate for healthcare providers to use handrub? List 3 instances.
•Before and after direct contact with patients
•After contact when hands are not visibly soiled
•After removing gloves
•Before donning gloves
•During care if moving from a dirty to clean site
•After contact with objects in patient’s environment
You are performing a sterile procedure. You notice there is a hole in your sterile glove. What do you do?
Stop procedure, remove gloves, discard sterile field, and start over with a new sterile field and gloves
What is the fio2 for 3lnc?
32 %
Name 2 purposes of an ngt
Decompression
feeding
medications
What complications of immobility is associated with the respiratory system? Name 2
Decreased movement of secretions
Thickening of secretions
atelectasis
pneumonia
Define universal/standard precautions.
•An approach to infection control to treat all human blood and certain human body fluids as if they were known to be infectious for HIV, HBV and other bloodborne pathogens
•
•Standard precautions—used in care of all hospitalized patients
–Apply to blood, body fluids, secretions, excretions, nonintact skin, mucous membranes
Name 3 ways sterile technique can be broken.
Turning back on field
placing hands below the waist
leaving the room
touching sterile to nonsterile
spilling something on sterile field
reaching over sterile field
talking/coughing/sneezing over field
How much fio2 can a nonrebreather mask give?
Close to 100%
How should the nurse confirm placement of an ngt after it is initially placed?
xray
How does immobility affect the GI system?
It slows peristalsis leading to constipation
What are characteristics of the Prodromal phase of an infection? Name at least 2.
•The most contagious or infectious stage
•Early signs and symptoms are present but non-specific to disease
•Fatigue, low grade fever
The patient is not usually aware that they are contagious
List the correct order of opening a sterile tray.
Open flap furthest from you
Open side flaps
Open flap closest to you last
How long should suctioning time last when performing NT suction on a patient?
10-15 seconds.
Do we suction while inserting?
What needs to be done before and medication or feeding is given through and ngt?
Check residual
check placement
Name three aspects of good body mechanics
Engage abdominal muscles when lifting
do not twist the torso
hold object close to you
bend at the knees when lifting
pivot
List the correct order of donning PPE.
1. Gown
2. Mask
3. Goggles/Face Shield
4. Gloves
Which of the following indicates that sterile technique is maintained? Select all that apply
A.Turns back on sterile field.
B.Changes sterile gloves if they are positioned below the waist.
C.Avoids touching the outer 1 inch margin of the sterile field with sterile gloves.
D.Avoids spilling any solution on a cloth or paper used a sterile field.
B, C, D
You have a patient with copd that is feeling sob. His o2 sat is 89%. What should you do first?
Have the patient do pursed lip breathing