Module 3B: General Patient Care 1 Flashcards

Question

Semi-Fowler’s Positioning and Draping for Exams

Answer 1

Position: The semi-Fowler’s position is a modified Fowler’s position with the head of the table at a 45-degree angle instead of a 90-degree angle. Use: - postsurgical exams and patients with breathing difficulties or lower back injuries. Draping: - placed over the patient’s lap and covering the legs

Answer 2

Position: requires the patient to be placed on the left side with the right leg sharply bent upward and the left leg slightly bent. The right arm is flexed next to the head for support. *also known as lateral semi-prone recumbent position and formerly known as Sims' position Use: - rectal exams - taking rectal temperatures - enemas - perineal and pelvic exams Draping: - draped from under the arm or shoulders to below the knees at an angle. This allows the health care provider to raise a small section of the drape while keeping the rest of the patient covered.

Answer 3

Position: patient is placed in the prone position and then asked to pull the knees up to a kneeling position with thighs at a 90-degree angle to the table and buttocks in the air. The head is turned to one side, and the arms may be placed under the head or on either side of the head for comfort and support. Use: - proctologic exams - sigmoidoscopy procedures - rectal and vaginal exams

Answer 4

Administered non-orally. Generally, the medication is injected directly into the body, or occurring in the body bypassing the gastrointestinal tract.

Answer 5

Given by mouth, delivered to the gastrointestinal tract.

Answer 6

Subcutaneous: Injection administered below the skin layer into the adipose (fat) layer Intradermal: Injection administered into the dermis Intramuscular: Injection administered into the muscle Intravenous: Injection administered directly into the vein

Answer 7

Taken by mouth

Answer 8

Placed under the tongue

Answer 9

Between the cheek and gums resulting in rapid absorption

Answer 10

Inhaled through the mouth, passes through the trachea into the lungs; inhaled through the nose and absorbed through the nasal mucous membrane

Answer 11

Drops of medication are instilled directly into the eye (ocular) or ear (otic).

Answer 12

Applied to the skin and designed to release slowly and systemically into circulation. Administered in an adhesive patch in a single layer drug, multi-layer drug, drug in resevoir, or drug matrix.

Answer 13

Applied to the skin or mucous membrane (faster) and acts locally. Administered as creams, ointments, or emulsions.

Answer 14

Inserted into rectum

Answer 15

Indicates the strength of the medication or how much of the medication a person should take. Can be in milligrams (mg) for tablets or capsules, grams (g) for creams or ointments, and milliliters (mL) for liquid medications. Some medications and supplements, such as insulin and vitamins, are listed as units (U). *Only the dose stated in the prescription or medical order should be administered.

Answer 16

1. The desired dose (D) 2. The dosage strength or supply on hand (H) 3. The medication’s unit of measurement or quantity of unit (Q)

Answer 17

X=D/H×Q X= amount to administer D= desired dose H= dosage strength or supply on hand (H) Q= medication’s unit of measurement or quantity of unit

Answer 18

Require a medication order by an authorized health care provider to be dispensed to patients. Medication orders are directions provided by an authorized health care provider for a specific medication to be administered to an individual.

Answer 19

aka over-the-counter (OTC), medications do not require a prescription.

Answer 20

- brand name (or trade name) is the name assigned by the medication manufacturer - generic name is the standard or official name and assigned by the United States Adopted Names (USAN) Council and the World Health Organization (WHO) Ex: - metoprolol (generic name) for Lopressor and Toprol (brand names) - Aspirin (generic name) for Bayer (brand name) - acetaminophen (generic name) for Tylenol (brand name) - ibuprofen (generic name) for Advil, Motrin (brand names) *Brand names are usually capitalized and are listed first, followed by the generic name, which is not capitalized Ex: Lopressor (metoprolol) and Toprol XL (metoprolol)

Answer 21

Checking the medication three times helps prevent medication errors: 1. The first check is comparing the medication order to the medication. 2. The second check occurs when preparing the medication for administration. 3. The third check is completed when returning the medication back to the shelf.

Answer 22

Collection of safety checks that everyone who administers medications to patients must perform to avoid medication errors. 1. right patient 2. right medication 3. right form 4. right dose 5. right route 6. right time 7. right technique 8. right education 9. right documentation.

Answer 23

Use two patient identifiers, usually full name and date of birth, to verify the right patient. Then verify that data with the information on the medical record or medication administration record (MAR).

Answer 24

Check the label three times to verify the medication, strength, and dose—often referred to as the “three befores.” 1. The first time to check the medication label is when taking the medication container from the storage cabinet or drawer. 2. The second is when taking the medication from its container to prepare to administer it. 3. The third check is when putting the container back in storage or discarding it.

Answer 25

Medications can come in several different forms (Ex: liquid, tablet, capsules, suppositories, drops, and creams) The same medication can be available in several different forms. Each form of medication has benefits in terms of effectiveness, ease of use, and safety. Ex: amoxicillin can come in a capsule, tablet, chewable tablet, and liquid. Checking the correct form of medication to be administered is essential when checking all rights of medication administration.

Answer 26

Compare the dosage on the prescription in the patient’s MAR with the dosage on the medication’s label and determine if medication calculations need to be performed to arrive at the prescribed dose.

Answer 27

Compare the route on the prescription in the MAR with the administration route they are planning to use. Determine whether the route is appropriate for the patient and that the medication formulation is right for that route.

Answer 28

Always confirm whether the medication has any timing specifications, such as the patient having an empty stomach or waiting several hours after taking another medication (such as an antacid) that might interact with the new medication.

Answer 29

MAs must know the correct techniques for administering every medication they give by every route. Ex: taking an apical pulse prior to administering digoxin to ensure the patient’s pulse is not less than 60.

Answer 30

Prior to administration of a medication, explain to the patient the name of the medication, the ordering provider, and the reason and intended effect of the medication; disclose any side effects; and confirm any allergies the patient may have.

Answer 31

Always document administering a medication after the patient receives it, not before. If you do not administer a medication as prescribed, the documentation must include this and why the patient did not receive it. Proper documentation includes date, time, quantity, medication, strength, lot number, manufacturer, expiration date, consent obtained, and patient outcome.

Answer 32

Position: the patient should be lying down or sitting back in a chair with the head tilted back. The patient should look toward the ceiling with both eyes open. Clean any debris from the eye area. Provide a tissue to the patient to blot excess medication. Procedure: 1. With your nondominant hand, gently pull down the lower lid of the affected eye using the thumb or two fingers to expose the conjunctival sac. 2. Gently rest the dominant hand on the patient’s forehead and dispense a drop approximately ½ inch above the sac. If a cream or ointment is being administered, evenly apply a thin ribbon of the ointment along the inside edge of the lower eyelid on the conjunctiva, moving from the medial to lateral side. 3. Release the eyelid and instruct the patient to close the eyes. 4. Repeat if the other eye requires treatment. 5. Remove any excess medication with a clean tissue. 6. Ask whether the patient is feeling any discomfort or pain and observe for any adverse reactions. 7. Apply a clean eye patch, if ordered.

Answer 33

Position: Have the patient lie on one side with the affected ear facing up. Procedure: 1. With your nondominant hand, pull the pinna of the auricle (outer ear) outward and upward for adults and outward and downward for infants and children. (This will straighten the ear canal and allow for better medication distribution.) 2. Hold the applicator ½ inch above the ear canal and administer the number of prescribed drops. 3. Have the patient remain in the position for at least 5 min. 4. Ask whether the patient is feeling any discomfort or pain and observe for any adverse reactions. 5. Loosely insert a small, clean wad of cotton, if ordered, before treating the other ear, if applicable.

Answer 34

A condition of sensitivity in which the immune system reacts abnormally to a foreign substance.

Answer 35

Most allergic reactions are common and present with mild symptoms, such as hives, itching, rashes, watery eyes, and nasal congestion. Treatment usually includes an over-the-counter hydrocortisone cream and an antihistamine.

Answer 36

A systemic allergic reaction that can be life-threatening without immediate medical intervention. Can occur within minutes after exposure to the allergen, or a delayed reaction could occur within a couple of hours.

Answer 37

- weakness - sweating - dyspnea can progress to: - hypotension - arrhythmia - difficulty in swallowing - convulsions

Answer 38

Epinephrine

Answer 39

*ADMINISTERED AS AN IM INJECTION - The upper thigh is a common site and, in an emergency, can be injected through the patient’s clothes. 1. Once injected, hold the injector or needle into the thigh for at least 10 seconds. 2. Massage the injection site for a few minutes. 3. Immediately call 911. The autoinjector is for emergency supportive care and does not replace the patient seeking advanced medical care afterwards. If the patient loses consciousness and stops breathing, administer cardiopulmonary resuscitation (CPR).

Answer 40

For medication allergies, ask and document the following: - Name of the suspected medication, prescribed (brand or generic) and non-prescribed (over-the-counter) medications - Timeframe of the reaction from initiation of the medication - Strength and formulation - Description of the reaction - Indication for the medication being taken (if there is no clinical diagnosis, describe the illness) - Date and time of the reaction - Number of doses taken or number of days on the medication before onset of the reaction - Route of administration

Answer 41

1. Critical devices: come in contact with blood or normally sterile tissue ex: surgical forceps, 2. Semi-critical devices: come in contact with mucus membranes ex: endoscopes 3. Non-critical devices: come in contact with unbroken skin ex: stethoscopes

Answer 42

Result in disease transmission Commonly caused by: - Using the same syringe to administer medication to more than one patient - Accessing a medication vial with a syringe that has already been used to administer medication to a patient, then using the remaining contents from that vial or bag for another patient - Using medications packaged as single-dose or single-use for more than one patient - Failing to use aseptic technique when preparing and administering injections.

Answer 43

Sealed glass capsule designed to hold a single dose of medication. Ampules have a particular shape with a constricted neck. They are designed to snap open. The neck of the ampule may be scored or have a darkened line or ring around it to indicate where it should be broken to withdraw medication.

Answer 44

Alcohol swabs are necessary to wipe off vials or wrap around the neck of an ampule, as well as for skin preparation. Cleaning the vial stopper assists in preventing contamination or introduction of germs into the solution as well as keeping the needle sterile. The top of the vial stopper should be wiped with an alcohol swab each time it’s used. Do not introduce the needle into the vial more than once. Each repuncture into a vial dulls the needle and predisposes the equipment to contamination. Allowing solutions to run down a needle also increases the likelihood of contamination. A gauze pad is used to apply pressure or hold at the site after administration. An adhesive bandage should be available if there is bleeding at the site.

Answer 45

Shields that cover the needle or retract the needle after use, such as a needle cap and safety lock. Resheathing covers, as well as other needle safety devices, prevent the repeated use of needles and do not penetrate, cut, or scratch during the disposal of the needles.

Answer 46

Used or unsterile needles should NEVER be recapped to prevent needle stick injuries. They should immediately be disposed of in the sharps waste container.

Answer 47

1. to allow for better absorption into the body 2. to administer a more precise level of medication 3. the patient needing a rapid effect 4. the inability of the patient to receive the medication through a different route of administration (ex: oral due to inability to swallow or the medication can be destroyed in the GI tract)

Answer 48

needle and syringe

Answer 49

1. barrel: a cylinder that holds the medication and has volume marking on its side - Volume: 0.5 mL to 500 mL - Insulin syringes are calibrated in units (U), commonly either 50 U or 100 U. 2. plunger: forces the medication through the barrel and out the needle

Answer 50

These measurements are equivalent 1 milliliter (mL) = 1 cubic centimeter (cc)

Answer 51

1. Hub: is what is twisted on to the syringe. 2. Shaft: the length of the needle 3. Bevel: tip of the needle (beveled, or angled, to allow for better skin penetration) *When inserting a needle, the bevel should be up. 4. Lumen: the opening of the needle

Answer 52

Refers to the size of the opening of the needle, or lumen. The higher the gauge, the smaller or narrower the lumen is. - Ex: 25 G has a smaller lumen than an 18 G needle.

Answer 53

Based on inches and can vary from 5/16 inch to 1 ½ inches.

Answer 54

When selecting a needle, select an appropriate length for the type of injection and size of the patient. The needle should be long enough to penetrate the layers of tissue appropriate to the injection without being too long. Ex: if a patient is obese, a longer needle may be needed in order to penetrate the fat layer.

Answer 55

SC injections are administered beneath the skin and into the adipose (fat) tissue. This allows for slow, sustained release of a medication with long duration of effect. Used to administer smaller doses of medication, usually less than 1.5 mL. Common medications that are injected SC are insulin, heparin, immunizations, and allergy medications. Sites: - Common: upper, outer arm; abdominal region; and the upper thigh - Lesser common areas: scapula (upper back area) and lower back/upper buttocks. Needle Size: 23 -25 G Needle Length: 5/8 inch Angle of Injection: 45 degrees

Answer 56

1. Ensure that you can gently grasp and pinch the area selected as an injection site using your nondominant hand. 2. Hold the syringe in the dominant hand between the thumb and forefinger like a dart and insert the needle quickly at a 45-degree angle. (Since SC administration is to be delivered in the adipose tissue, the injection is 45 degrees from the surface of the skin to penetrate the layers of the skin but not deep enough to enter any muscle tissue. ) 5. After the needle is in place, release the tissue with your nondominant hand. 6. With your dominant hand, inject the medication. Avoid moving the syringe. 7. Withdraw the needle quickly at the same angle at which it was inserted. 8. Using gauze, apply gentle pressure at the site after the needle is withdrawn. 9. Do not massage the site.

Answer 57

ID injections are administered between the upper layers of the skin, between the epidermis and dermis. With ID injections, a very small amount of a medication may be injected, often 0.1 mL or less. Most common site: mid forearm - When using the forearm, measure using one hand width above the wrist and one hand width from the elbow or antecubital space. Any area within the anterior forearm visible is acceptable for the injection. - The forearm is often used to administer a tuberculosis (TB) test. Rare cases: upper chest and scapula (upper back) - The upper chest and scapula may be used for skin tests, such as allergy testing. Needle Size: 25-27 G Needle Length: ¼ to ½ inch Angle of Injection: 5 to 15 degrees

Answer 58

1. Use your nondominant hand, spread the skin taut over the injection site. Taut skin provides easy entrance for the needle and is also important to do for older adults, whose skin is less elastic. 2. Hold the syringe in the dominant hand between the thumb and forefinger, with the bevel of the needle up at a 5- to 15-degree angle at the selected site 3. Place the needle almost flat against the patient’s skin, bevel side up, and insert the needle into the skin. Keeping the bevel side up allows for smooth piercing of the skin and induction of the medication into the dermis. 4. Advance the needle no more than an eighth of an inch to cover the bevel 5. Once the syringe is in place, use the thumb of the nondominant hand to push on the plunger to slowly inject the medication. 6. Carefully withdraw the needle out of the insertion site using the same angle it was placed. *Do not massage or apply pressure or a bandage to the site after injection. In a TB test, a wheal, or a bubble, below the skin must be formed with the ID injection.

Answer 59

IM injections are administered into the muscle of the patient. IM injections generally allow for larger administration of medication than SC and ID injections. However, the amount varies with injections sites. - In general, up to 3 mL of a medication may be administered into the ventrogluteal and vastus lateralis for adults. Older adults and thin patients may only tolerate up to 2 mL in a single injection. No more than 1 mL should be given in the deltoid. Common sites: deltoid (shoulder), ventrogluteal (outer hip), and vastus lateralis (upper, outer thigh) muscles. Common medications: antibiotics (penicillin), hormones (testosterone), and some vaccines. Needle Size: 22-25 G Needle Length: 1 to 1 ½ inch Angle of Injection: 90 degrees

Answer 60

The site of injection on the deltoid should be 1 to 2 inches below the acromion process. The deltoid muscle can only hold up to 1mL of medication. *should be avoided for infants or children younger than 3 years of age.

Answer 61

This site provides the greatest thickness of muscle that is free of nerves and blood vessels, and it has a narrower layer of fat. This injection site can hold up to 3 mL of medication. To locate the site: 1. place the heel of your hand on the greater trochanter (right hand placed on left hip and left hand placed on right hip), the middle finger is placed on the iliac crest, and your fingers are spread. 2. Give the injection where the V is made between your index finger and middle finger (position the thumb pointing towards the groin). *safe injection site for adults, children, and infants

Answer 62

Vastus lateralis muscle is located on the anterior lateral aspect of the thigh and extends from one hand’s breadth above the knee to one hand’s breadth below the greater trochanter. The outer middle third of the muscle is used for injections. The injection site is halfway down the muscle, between the greater trochanter and the lateral femoral condyle. This site is recommended for children younger than 3 years of age.

Answer 63

1. Don nonsterile gloves. 2. Clean the site with an alcohol swab for 30 seconds using firm, concentric circles. 3. Allow the site to dry to prevent introducing alcohol into the tissue, which can be irritating and uncomfortable. 4. Remove the guard cap from the needle by pulling it off in a straight motion. 5. A straight motion helps prevent needlestick injury.

Answer 64

1. stabilize the skin around the injection site by pulling the skin taut with the forefinger and thumb of your nondominant hand. 2. With your dominant hand, hold the syringe like a dart and insert the needle quickly into the muscle at a 90-degree angle using a steady and smooth motion. 3. After the needle pierces the skin, use the thumb and forefinger of the nondominant hand to hold the syringe and inject the medication. 4. Remove the needle at the same angle at which it was inserted. 5. Cover the injection site with sterile gauze using gentle pressure and apply a bandage if needed.

Answer 65

Insulin is always ordered and administered in unit dosage. Only insulin syringes should be used to administer an insulin injection. Insulin syringes are supplied in 30-, 50-, or 100-unit measurements, so read the barrel increments (calibration) carefully. One anatomic region should be selected for a patient’s insulin injections to maintain consistent absorption, and then sites should be rotated within that region. - The abdomen absorbs insulin the fastest, followed by the arms, thighs, and buttocks. - If regular SC injections need to be given, as in the case of insulin, rotate the injection site and avoid using a site that is edematous (swollen) and has too much scar tissue or adipose (fat) tissue.

Answer 66

After administration of any medication, ask the patient to wait 20 to 30 min before leaving for observation of any possible adverse reactions or allergic reactions: - Severe pain at the injection site - Tingling or numbness - Redness, swelling, or warmth at the injection site - Prolonged bleeding - Signs of an allergic reaction, such as difficulty breathing or facial swelling

Answer 67

A tuberculin test is performed as an intradermal injection. The appropriate needle and syringe size would be 26 gauge and ½ inch long.

Answer 68

- vials (most common) - ampules - premeasured syringes and cartridges

Answer 69

A plastic or glass container that has a rubber stopper (diaphragm) on the top. (most common) - The rubber stopper is covered with a metal lid or plastic cover to maintain sterility until the vial is used for the first time. Sizes: single or multi dose *Some manufacturers do not guarantee a sterile top even though it is covered, and therefore it is necessary to wipe the top with alcohol pad with first use and any use after

Answer 70

28 days (unless the manufacturer states otherwise) *Make sure you write the expiration date on the vial upon opening.

Answer 71

Requires the adding a liquid diluent to a dry ingredient to make a specific concentration of a medication.

Answer 72

1. Before withdrawing medication from a vial, wipe the top with alcohol and allow it to dry. 2. A vial is a closed system, and air must be injected into it to allow for withdrawal of the medication. If air is not injected into the vial before the medication is withdrawn, a vacuum remains in the vial that makes the withdrawal of medication difficult. Inject air equal to the amount of solution being withdrawn into the air space between the solution and the rubber stopper 3. invert the vial 4. withdraw the desired volume of medication

Answer 73

1. Snap the neck off by grasping it with an alcohol wipe, sterile gauze, or ampule protector. 2. Aspiration of the medication into a syringe occurs easily and may be accomplished with a filter needle, if required by the medical practice’s policy. 3. A filter needle prevents withdrawal of glass or rubber particulate. 4. When the needle is inserted into an ampule, take care to prevent the shaft and tip of the needle from touching the rim of the ampule. 5. Withdraw medication into the syringe by gently pulling back on the plunger, which creates a negative pressure and allows the medication to be pulled into the syringe. 6. Discard the needle used to withdraw the medication and replace it with a new needle.

Answer 74

1. Premeasured Syringes or 2. Hypodermic Syringe, Tuberculin Syringe, and Insulin Syringe

Answer 75

Prefilled syringes that are single dosed and packaged with the needle that is provided by the manufacturer. These syringes are disposable and supplied already loaded with the substance to be injected. Common prefilled syringes are often used for immunizations and for emergency administration, such as naloxone for overdoses and sodium bicarbonate for shock and cardiac arrests. Advantages: 1. Convenient and help ease the administration process 2. Allow for convenience and efficiency, accuracy in dosing, reduced risk of infection and contamination, and reduced waste 3. You do not have to worry about the transfer of a medication from a vial to a syringe or about leaving a small percentage of the dose behind.

Answer 76

Come in a variety of sizes from 0.5 to 60 mL and even larger.

Answer 77

A narrow syringe that has a capacity of 0.5 mL or 1 mL. The volume of a tuberculin syringe can be measured on the milliliter scale. On the milliliter side of the syringe, the syringe is calibrated in hundredths (0.01 mL) and tenths (0.1 mL) of a milliliter. Tuberculin syringes are used to accurately measure medications given in very small volumes (e.g., heparin). This syringe is also often used in pediatrics and for diagnostic purposes (e.g., skin testing for tuberculosis).

Answer 78

It is recommended that dosages less than 0.5 mL be measured with a tuberculin syringe to make certain that the correct dosage is administered to a patient. Dosages such as 0.42 mL and 0.37 mL can be measured accurately with a tuberculin syringe. When using a tuberculin syringe, read the markings carefully to avoid error.

Answer 79

Designed for the administration of insulin only. Insulin dosages are measured in units. Insulin syringes are calibrated to match the dosage strength of the insulin being used. They are marked U-100 and are designed to be used with insulin that is marked U-100. - U-100 insulin should be measured only in a U-100 insulin syringe. - It is important to note that for U-100 insulin, 100 units = 1 mL. Insulin syringes do not have detachable needles. The needle, hub, and barrel are inseparable.

Answer 80

Organization responsible for protecting the public health by ensuring safety, efficacy, and security of human medications.

Answer 81

Maintains oversight for legally prescribed and used narcotic drugs and for containment of illegal drugs.

Answer 82

Refrigerated medications: between 2˚ and 8˚ C (35˚ and 46˚ F). Frozen medications: between –50˚ and –15˚ C (–58˚ and 5˚ F). *The temperatures of the refrigerators and freezers must be checked daily.

Answer 83

it wasn’t done.”

Answer 84

A report that serves as a legal record of the medications administered to a patient at a facility by a health care provider or professional. The following information must be documented in the MAR about the medication: - Any allergies or history of allergies - What medication is being administered - Medication dosage - Administration route - When is it being administered—what time, how often, how long - The name of the health care provider who prescribed the medication A MAR must be filled out each time a patient is administered a medication. *Can also be documented in an EMR system

Answer 85

20˚ to 25˚ C (68˚ to 77˚F)

Answer 86

The process of using a sterile solution to flush the eyes of any foreign bodies or any toxic chemicals.

Answer 87

A group of strategies used to reduce exposure to micro-organisms and keep the patient as safe as possible.

Answer 88

1. As with all procedures, review the patient’s medical record and the health care provider’s order. 2. Introduce yourself and identify the patient. 3. Explain the procedure to the patient and reason why it needs to be performed. 4. Assemble the equipment and two sets of the supplies and equipment if both eyes are to be irrigated. 5. Perform a triple check of the medication and provider’s order and the rights of administration and check for expiration dates on the medication and all supplies. 6. Warm the irrigation solution to normal body temperature by placing the solution in a basin of warm water. Supplies: - sterile basin - return basin - sterile solution - sterile irrigating syringe - sterile gauze - tissues - towel - waterproof drape - nonsterile gloves.

Answer 89

1. Place the patient in a supine or sitting position 2. Place a waterproof drape on the patient’s shoulder to absorb any solution if any spills. 3. Perform hand hygiene. 4. Cleanse the eyelid with a gauze pad moistened with the sterile solution, making sure to maintain sterility at all times. - Clean from the inner to outer canthus (corner) of the eye, where the upper and lower lids meet. 5. Repeat with a newly moistened gauze pad until the eyelid is free of dirt and other debris.

Answer 90

1. Instruct the patient to tilt the head toward the side that is being irrigated, to hold the return basin below the affected eye, and to look straight ahead on a fixed object while keeping both eyes open. 2. Using the thumb and index finger of your nondominant hand, pull upward on the patient’s upper lid and downward on the patient’s lower lid—hold the eye open and maintain this position throughout the irrigation. 3. With the dominant hand, hold the irrigating bottle of solution on or near the bridge of the nose and hold the tip of the solution about an inch above the eye. *Do not to touch any part of the eye or skin with the tip of the solution applicator. 4. Start squeezing the bottle so that the solution flows from the inner canthus to the outer canthus in a steady stream directed toward the lower conjunctiva. 5. Continue the flow until the irrigation solution is empty and the desired results are achieved, such as removal of debris. Repeat if the other eye requires treatment. 6. Take the collection basin from the patient and dry the eyelid with gauze, once again moving from the inner to outer canthus. 7. Provide the patient with a towel to dry any skin that may have gotten wet during the procedure and help the patient to a comfortable position. 8. Examine and take note of any visible debris in the return basin. 9. Discard the solution from the return basin, throw away disposable items, remove gloves, and wash hands.

Answer 91

Necessary to remove impacted cerumen, or earwax, or a foreign matter from the ear.

Answer 92

Set up: 1. As with all procedures, review the patient’s medical record and the health care provider’s order. 2. Introduce yourself and identify the patient. 3. Explain the procedure to the patient and reason why it needs to be performed. 4. Assemble the equipment and two sets of the supplies and equipment if both ears are to be irrigated. 5. Perform a triple check of the medication and provider’s order and the rights of administration and check for expiration dates on the medication and all supplies. 6. Warm the irrigation solution to normal body temperature by placing the solution in a basin of warm water. Patient Prep: 1. Place the patient in a sitting or lying on the side with the affected ear facing up. 2. Place a waterproof drape on the patient’s shoulder to absorb any solution if any spills. 3. Perform hand hygiene. 4. Using an otoscope, examine the affected ear, taking note of any cerumen or foreign bodies (if allowed by practice policy). 5. Cleanse the outer ear with a gauze pad moistened with the irrigating solution. Supplies: ear syringe, sterile basin, return basin, warmed irrigation solution, a waterproof drape, towel, and gauze or cotton balls.

Answer 93

1. Instruct the patient to tilt their head toward the side that is being irrigated and to hold the ear wash basin tightly below the affected ear. 2. Gently insert the disposable tip into the ear so that it is positioned toward the top of the ear canal. 3. Start spraying the solution by pushing the trigger on the spray bottle, checking to be sure the tubing remains straight. 4. Continue to spray until you have used up the solution, the maximum time has been reached, or you have obtained the desired results (cleared the ear of cerumen). 5. Remove the tip from the patient’s ear, allow any residual solution to drain out, and place a loose cotton ball in the canal. 6. Take the return ear basin from the patient, observing for any debris, and instruct them to lie on the side that was irrigated for 15 minutes. 7. Dry the outside of the ear. If policy allows, examine the ear with an otoscope to see if all cerumen has been removed. (If not, check with provider about proceeding.) 8. Have the provider check the ear and follow any additional orders. 9. Dispose of the supplies in a waste can and clean the area. 10. Remove gloves and wash your hands.

Answer 94

The most efficient, electronic process is a medication order created by e-prescription tool in the EHR software that is automatically sent to the pharmacy through a secure electronic transmission.

Answer 95

- allows providers to enter prescription information into a computer device and securely transmit the prescription to pharmacies using a special software program and connectivity to a transmission network. - When a pharmacy receives a request, it can begin filling the medication right away. - can also reduce opportunities for diversion of controlled substances by eliminating the use of paper forms, which can be lost, stolen, and used illegally.

Answer 96

Both the pharmacy and the health care provider must use software that is DEA Electronic Prescription for Controlled Substances (EPCS) approved. The software may be either a standalone product or a part of the EHR software

Answer 97

Prepares and dispenses medication for complex, chronic, and rare diseases. It can also create a medication specific to the needs of a specific patient, such as weight. Ex: A young patient needing a weight-based dosage of a medication for leukemia

Answer 98

Created by combining, mixing, or altering two or more drugs or ingredients to create a medication tailored to the needs of a specific patient. It may be in many forms, including capsules, injectables, syrups, and creams. It may be prepared by a licensed pharmacist or physician.

Answer 99

1. Demographic Data - Name - Address - Birthdate - Sex - Gender - Social Security number - Phone number - Employment information 2. Administrative Data - Notice of privacy practices form - Advance directives - Consent forms - Medical records release form 3. Correspondence - Any correspondence related to the patient (e.g., from patient’s insurance company, attorney, or the patient themselves) 4. Schedule, Financial, and Billing Information - Information regarding any appointments, insurance information, balances

Answer 100

1. Health History - Chief complaints - Present illness - Past medical history - Family history - Social history - Review of systems 2. Physical Examination - Assessment of each body part 3. Allergies - All known patient allergies 4. Medication Record - Detailed information related to patient’s medication 5. Problem List - Problems identified, updated each visit 6. Progress Notes - New information each time the patient visits or telephones the office 7. Laboratory Data - Any laboratory reports obtained on the patient 8. Diagnostic Procedures - Electrocardiogram report - Holter monitor report - Spirometry report - Radiology report - Diagnostic imaging report 9. Continuity of Care - Consultation report - Home health care report - Therapeutic service documents - Hospital documents

Answer 101

Health care providers and organizations are required to report statistics on communicable and infectious diseases (HIV/AIDS, tuberculosis, sexually transmitted infections) to local and state government agencies. These agencies will also collect this data and report it to the federal government and agencies, such as the CDC.

Answer 102

Electronic process in which providers enter and send treatment instructions, including medications, laboratory, and radiology orders, via a computer application rather than paper, fax, or phone. Once you have electronically entered an order for lab tests, prescription medications, radiology tests, and referrals, the CPOE system interfaces or integrates with other EHR components, such as the pharmacy or laboratory system, to process the order.

Answer 103

By reducing the use of written orders, this reduced medical and medication errors since it prevented transcription errors, misplaced decimals, and illegible handwriting. - Reducing the potential for human errors - help prevent errors of medication ordering and suggest recommendations for medication dosage, routes of administration, and frequency - Prevent medication allergies or drug–drug or even drug–laboratory - Reducing time to care delivery - Improving order accuracy - Decreasing time for order confirmation and turnaround - Improving clinical decision support at the point of care (ex: assist in recommending treatment options for diseases) - Making crucial information more readily available - Improving communication among health care providers and professionals and patients

Answer 104

Patients who have difficulty with transportation and getting to an in-person medical visit, such as older adult patients, those who have disabilities, those who are bed- or homebound, and those in rural areas

Module 3B: General Patient Care 1 Flashcards

(131 cards)