Module 3 part 2

Question 1

How long to wash hands

Answer 1

20 seconds

Question 2

How much alcohol in alcohol based rub for hands

Answer 2

60 to 95%

Question 3

My 5 Moments for Hand Hygiene

Answer 3

1. Before touching a patient.
2. Before clean/aseptic procedures.
3. After body fluid exposure/risk.
4. After touching a patient.
5. After touching patient surroundings.

Question 4

What are contact precautions

Answer 4

• known or suspected infections w/ contact transmission
• gloves, gown
  *gloves gown before entering room
  *discard gloves gown before exiting room
• disinfect common use equipment before use for next patient

Question 5

Droplet precautions

Answer 5

• Droplets are the “bigger” particle
• mask before entering
  *no gloves
  Limit transport and movement of patients outside of the room to only medically necessary purposes. **If transport or movement outside of the room is necessary, instruct patient the to wear a mask **and follow respiratory hygiene/cough etiquette.

Question 6

Airborne precautions

Answer 6

• small particle that can fly through your regular mask in air
• airborne infection isolation room
• fit tested NIOSH N 95 mask
  *no gloves

Question 7

What viruses are airborne

Answer 7

• chickenpox, covid-19
• TB
• measles

Question 8

Where do you wash your hands?

Answer 8

In front of the patient.

Question 9

Whats a HAI?

Answer 9

• Healthcare associated infections
• a patient is recieving care for a UTI for example, and then contracts the flu from the healthcare provider who didn’t wash hands.

Question 10

Whats a concern about latex gloves?

Answer 10

The patient could be allergic to latex

The equipment could have latex.

make sure you check their allergies

Question 11

CDC guidelines in 2020 for covid

Answer 11

• 6 feet away
• wash hands 20 seconds or sanitizer w 60%
• Clean and disinfect routinely high-touch surfaces (i.e., electronics, doorknobs, light switches, tables).
• Wear a face covering in public settings and when around people who don’t live in your household, especially when other social distancing measures are difficult to maintain

Question 12

What side is best for assessing the patient

Answer 12

the right side of the patient

Question 13

Sequence of assessment

Answer 13

1. Inspection
2. Palpation
3. Percussion
4. Auscultation

unless abdomen

Question 14

What is direct inspection?

Answer 14

observing and inspecting a specific area or the whole individual.

Question 15

what is indirect inspection?

Answer 15

using specific equipment to improve your visualization of an area (i.e., ophthalmoscope to look at the internal structures of the eyes).

Question 16

What senses does inspection use?

Answer 16

Inspection requires the use of three of your senses:
1. Seeing
2. Hearing
3. Smelling (body odor)

Question 17

Fluorescent lights vs normal lights?

Answer 17

normal.

florescent lights change skin color.

Question 18

What PPE while palpating?

Answer 18

Gloves
* gloves and eyewear IF palpating open wound area, tongue, mouth, mucous membranes

Question 19

How to assess temperature?

Answer 19

Dorsal surface of the hand (back of hand)

Question 20

Finger pads assess what?

Answer 20

texture, shape, consistency, pulses, and crepitus

Question 21

What is used to assess fremitus (vibe thru body) and thrills (vibration over chest wall)

Answer 21

Ulnar surface or ball of the hand

Question 22

How deep do you press down for light palpation and what is the motion

Answer 22

1 cm or 1/2 inch
light circular motions
USING FINGER PADS

Question 23

How is deep palpation done?

Answer 23

• one OR two hands
• dominant hand on top
• press 5 cm or 2 inches

Question 24

What are you feeling for with deep palpation vs light palpation

Answer 24

light:
Texture
Masses Moisture Pulsations Temperature Tenderness

deep:
Organ size and location
Masses
Tenderness

Question 25

What are 3 types of percussion?

Answer 25

direct, indirect, indirect fist (blunt)

Question 26

What PPE for direct percussion?

Answer 26

gloves additional PPE if needed

Question 27

What are you assessing for using direct percussion and what is it

Answer 27

* directly tapping the patient (not thru DIP) * one to two fingertips * size, consistency and borders of body organs * see if fluid is present

Question 28

Direct percussion soft tones? moderate tones? loud tones?

Answer 28

* Soft tones are heard over solid tissue (vibration absorbed) * Moderate tones are heard over fluid-filled areas (hearing someone yell when you are underwater) * Loud tones are heard over air-filled spaces (vibration carries through air like speakers in a concert)

Question 29

Quality of sound Tympany? Dullness? Resonance? Hyperresonance? Flatness?

Answer 29

* **Tympany** is heard over abdominal areas that may be filled with abdominal gas or air-filled structures. (concert) * **Dullness** is heard over solid organs, fluid collection, or areas of consolidation (such as a tumor or mass). * **Resonance** is heard over normal lung fields. (lungs are resonant) * **Hyperresonance** is heard over air-filled spaces such as lung fields in a patient with emphysema. (air sacs are bigger than normal) * **Flatness** is heard over increased tissue density such as bones.

Question 30

Again, what is flatness, and what is dullness?

Answer 30

Dullness is solid organs, fluid, or consolidation of a mass Flatness is increased density like bones

Question 31

pitch and quality of: Tympathy Dullness Resonance Hyperresonance Flatness

Answer 31

* **Tympany**: high pitch, drumlike * **Dullness**: medium pitch, thudlike * **Resonance**: low pitch, hollow (normal lung sounds) * **hyperresonance**: pitch low, booming * **flatness**: high pitch, dull quality

Question 31

What is indirect percussion and what is it used for? & what equipment?

Answer 31

To assess the size, consistency, and borders of body organs, and the presence or absence of fluid in body areas **Equipment**: Gloves, additional PPE (if needed) middle finger of left hand is called the pleximeter. it is struck at the DIP by the right hand's middle finger (the plexor).

Question 32

What is indirect fist percussion (blunt percussion) PPE needed and procedure?

Answer 32

To assess organ tenderness (kidneys usually) gloves 1. Explain the technique to your patient. 2. Expose only the area that you will be percussing. 3. Gently lay your nondominant hand over the area to be assessed. 4. Make a fist with your dominant hand. 5. Using the **ulnar surface of your closed fist,** firmly **thump the dorsum of the nondominant hand ** 6. Ask the patient if he or she experiences any discomfort.

Question 33

Auscultation is used to assess? What equipment and why?

Answer 33

Auscultation is used to listen to and assess cardiovascular, respiratory, gastrointestinal, and peripheral vascular sounds produced by the body. If you don't hear the peripheral blood flow with a stethoscope, use a doppler ultrasonic blood flow detector

Question 34

Two types of auscultation and explain what they mean.

Answer 34

direct and indirect direct is WITHOUT a stethoscope. indirect is WITH a stethoscope (or other device like doppler).

Question 35

What are the measurements of auscultation?

Answer 35

Duration (length of time) Intensity (loud or soft) Pitch (high or low) Quality (e.g., musical, blowing, bubbly)

Question 36

How long do you auscultate?

Answer 36

one full minute.

Question 37

What are the most common sounds that are heard during direct auscultation? How do you confirm the sound?

Answer 37

Most common sounds that can be heard without equipment are respiratory and gastrointestinal sounds. Always confirm sounds with a stethoscope to tell what it is.

Question 38

What can the bell and diaphragm hear?

Answer 38

The **bell** - low- pitched sounds (e.g., vascular sounds and heart murmurs); the **diaphragm**- high- pitched sounds (e.g., respiratory sounds and bowel sounds).

Question 39

During indirect auscultation, what do you do if the patient has a lot of hair?

Answer 39

* If the patient has much hair on the area to be auscultated, wet the hair with a warm washcloth to decrease the friction. * Concentrate and listen to the sounds. * When finished auscultating, clean off your stethoscope with an * alcohol swab (you would anyway)

Question 40

What is the idea with stethoscope cleaning between patients?

Answer 40

Stethoscopes may transmit infectious agents, which could result in healthcare-associated infections (HCAI)

Question 41

How do you clean your stethoscope

Answer 41

alcohol swabs, hydrogen peroxide wipes, and alcohol-based hand sanitizers, all work; if Clostridium difficile is suspected, a bleach wipe should be used do it while you do hand hygeine when entering room and before exiting room