Unit 8 Review Flashcards
1
Q
What does Aseptic mean?
A
Means without infection
2
Q
Types of sterile preps?
A
Injections, ophthalmic, Nasal inhalation, Soaks for live organs or tissues, Wound irrigations, Tissue Implants
3
Q
What is an Aspetic technique?
A
Careful steps to to keep a compounded product sterile
4
Q
What is CSPs?
A
Compounded Sterile Preparations - Given by injection could incude vials powders ampules
5
Q
What is an IVP?
A
IV Push - Prepared in small volumes 1 ot 10 ml. Commonly used for opioids and antibotics. Injected in a short peroid, usually seconds.
6
Q
What are IV bags?
A
Range from 5 to 4000 ml. Consists of IV piggybacks (IVPB) and large volume parenterals (LVPs), Medication is given over time.
7
Q
What is an Anteroom
A
Contains supplies used in sterile compounding (Needles, syringes, iv bags, aseptic garb), Hand washing and garbing is performed here. Must be ISO class 8 air quality or better except if compounding hazardous medications where it must be 7 or better.
8
Q
What is a buffer room?
A
Sterile compounding is performed here, contains laminar flow hood. Must be at least ISO class 7 air quality, Contains positive air pressure system.
9
Q
What is a laminar flow hood?
A
Uses special filters to sterilize air in the hood. Must be at least ISO class 5 air quality
10
Q
Sterile Compounding Steps?
A
Evaluate Medication order, Calculate, Sterilization process, compounding process, Delivery and cleanup
11
Q
What is done during the Evaluate medication order step in sterile compounding?
A
Identify product to be prepared, verify status of laminar hood, Gather correct meds and supplies
12
Q
What is done during the calculate step of Sterile compounding?
A
Calcuate amount of medication needed for order
13
Q
What is done during the Sterilization process of Sterile compounding?
A
Clean equipment and supplies, wash hands and don appropriate garb
14
Q
What is done during the Compounding Process in Sterile Compounding?
A
Withdraw meds using needle/syringe and insert in iv bag if necessary includes of labelling syringe or iv bag
15
Q
What is done during the Delivery and cleanup process in sterile compounding?
A
Label vials and dispose of garbage, Doff garb
16
Q
What is in USP 797?
A
Mandatory standards for sterile compounding. Does not cover administration of the drug
17
Q
What does PPE mean?
A
Personal Protective Equipment
18
Q
What is the other name for a Hair cover?
A
bouffant cap
19
Q
Donning PPE order?
A
In the anteroom
-Shoe covering
-Hair Cover
-Beard Cover
-Face mask
-Eye shield
- Non Shedding gown
In the bufferroom
Sterile Gloves
20
Q
Where do you remove the PPE?
A
All done in the anteroom
21
Q
What PPE can be reused?
A
Non shedding gown (if nothing was spilled on it), Eye shields (once cleaned)
22
Q
What are the special supplies in aseptic handwashing?
A
Antimicrobial betadine surgical scrub packed, with sponge brush and nail pick.
23
Q
Where is Aseptic handwashing performed?
A
anteroom, performed again after leaving the cleaning rooms
24
Q
Steps to Aseptic Handwashing?
A
- Remove Jewelry nailpolish have nails trimmed to 1/4”
- Don shoe covers, hair cover, and face mask
- Expose arms and elbows
- Turn on the water until it gets warm then wet arms and hands
- Open scrub brush packet and take out sponge brush and nail pick
- Use nail pick to clean underneath each fingernail on both hands
- Squeeze sponge brush until lather forms
- use brush side of sponge brush to clean underneath each fingernail
- Use sponge side on hands
- Use sponge side on forearms starting low
- while keeping fingers and arms pointed upwards rinse hands and forearms
- Keeping fingers and arms pointed upwards, use lint-free towels or electric dryer, to dry hands and arms
25
Description for laminar flow hood?
Located in buffer room. Contains a HEPA filter, ISO Air class 5 or better. two types horizontal and vertical flow hood
26
Horizontal flow hood?
Used to compound non hazardouds medicine. Prefilter and hepa filter
27
Vertical flow hood?
Used to compound Hazardous medications. Prefilter and 2 hepa filters
28
Filters Prefilter vs Hepa?
Prefilters captures dirty air before it hits HEPA filter. Changed monthly. HEPA Removes Bacteria, fungi, and viruses from air before it reaches compound. Is inspected and changed every 6 months
29
When do you clean the laminar flow hood?
At start of shift, before beginning batch compound, after 30 minutes of continuous compounding. If visibly dirt or a spill.
30
What is used to clean Laminar Flow Hood?
Lint-free towels or gauze, Sterile water, 70% Isopropyl alcohol
31
Procedure for cleaning Laminar Flow hood?
Fully garbed, must be on 30 minutes before cleaning.
Hang bar and hooks
Ceiling, starting with either back corner, using side-to-side overlapping motions
Side wall, starting in the upper back corner, using up-and-down overlapping motions
Workbench starting with either back corner using side-to-side overlapping motions
inspect hood after cleaning for dirty areas
Repeat steps
Fill out hood cleaning log
32
What is OSHA's Occupational Exposure to Bloodborne Pathogens Standard?
Standard designed to reduce or eliminate exposure to bloodborne pathogens
33
What bodily fluids are considered infectious?
Blood, Serum, Plasma, any other bodily fluid contaminated by blood
34
Bodily fluids not considered infectious?
Nasal secretions, Sputum, Sweat, Tears, Urine, Vomit, Saliva (other than from dental procedures)
35
Hows does bloodborne diseases transmit?
Needlestick (most common), Via mucus membrane (Nose, eyes, or mouth), or when introduced into blood stream
36
What is the needlestick and Prevention act of 2000?
Implemented by osha added to more standards to the bloodborne pathogens standard to reduce needlesticks and other sharp related injuries.
37
What are the types of controls in the Universal precautions?
Work Practice controls, Engineering controls
38
What are examples of Engineering controls in the Universal Precautions?
System design that removes hazard or moves employee away from hazard. Things like accessible hand wash station, punture resisant sharps container, etc...
39
What are Work practice controls in the Universal Precautions?
Controls that change the way a task is preformed to reduce likelihood of exposure
40
What are the steps for effective handwashing?
Remove hand/ arm jewelry, wet hands with warm running water, apply a palmful of soap, scrub for at least 20 seconds, rinse with running water using a rubbing motion, Dry hands
41
When is it okay to use Alchol-Based Hand sanitizers?
When hands aren't visibly contaminated
42
Steps for using Alcohol-Based Sanitizers?
Make sure hands are dry not wet, Apply 3 to 5 ml to palm of one hand, rubs hands together at least 15 seconds
43
What area of the mask should you use to remove it?
Back or sides
44
What area of face shields should you touch when removing?
Back and sides
45
What is the process for exposure to blood borne pathogens?
Immediatly clean the exposed area, report exposure, seek medical care for evaluation and treatment (if treatment needed)
46
When might masks be required?
When there is high risk of splashing exposure or during close patient contact
47
When might Face shields be required?
same as mask provides extra protection against splahes. When there is high risk of splashing exposure or during close patient contact
48
What is the other name for combination chemotherapy treatments?
regimens
49
What are the side effects of chemotherapy?
Immune system suppression (attacks bone marrow where white blood cells are produced, Make patient vunerable to infection), Red blood cells and platelets decrease ( Leads to anemia, bleeding, bruising), Hair loss, diarrhea, fatigue, nausea, vomiting, damage to organs (Kidneys, heart)
50
What are the 2 common dosings for Methotrexate?
Once a day for cancer, once a week for Rheumatoid arthritis
51
What are the common side effects of Methotrexate?
Bone marror suppression and organ toxicity
52
What is a common abbreviation to avoid for Methotrexate?
MTX (mistaken for Mitoxantrone)
53
What labs are monitored for Methotrexate?
Complete blood count (CBC), kidney (BUN, SCr), and liver
54
What does BSA mean?
Surface area of patients body
55
How many CM is equal to an inch?
2.54 cm = 1inch
56
How many pound is equal to a kilogram?
2.2 pounds = 1kilo
57
What is the equation for Body Surface area?
Square root (Ht (cm) * Wt (kg) / 3600)
58
What are premedications?
Meds taken to prevent sides effects of chemotherapy, such as nausea, vomiting, fever
59
What are the common premeds?
Dexamethasone, prednisone, diphenhydramine, lorazepam, ondansetron, APAP
60
What are the base solutions provided during chemotherapy?
D5W, Normal saline, and Electrolytes
61
Why is a base solution provided during chemotherapy?
To prevent the damaging of kidneys during chemo and replenish electrolytes
62
How is chemotherapy administered?
Slowly to prevent infusion reactions and in rounds.
63
Why is chemotherapy administered slowly
To prevent infusion reactions such as pain and damage to veins
64
What color bins is for chemo meds?
Yellow
65
How should chemo meds be stored?
Separate from non chemo med to prevent contamination of other meds. with tags and separation to avoids Look-alike/sound-alike errors.
66
What direction is airflow for a chemotherapy flow hood?
Vertical (top to bottom)
67
Why is a chemotherapy flow hood have vertical airflow?
To vent aerosolized chemotherapy out of pharmacy and away from compounder
68
What is a BSC?
Biological Safety Cabinet, Chemo flowhood with acrylic barries to help protect compounders upper body and face. Not completely closed off.
69
What is a CACI?
Compounding Aseptic Containment Isolator, Chemo flow hood that is completely enclosed, uses attached gloves for chemotherapy manipulation
70
What is included in Chemo PPE?
Same sterile garb as with hazardous non-sterile medications and also
Safety goggle
Chemo gown (in place of sterile gown used in non-chemo compounding
Chemo gloves(worn over sterile gloves)
Face Shield (facility specific)
71
Where do you dispose of gloves and sterile gowns used in chemo compounding?
Chemo sharps container
72
Where do you dispose of a chemotherapy spill mat?
Chemo sharps container
73
What is a chemo spill mat?
An absorable mat placed on workbench where compounder where be working.
74
What is a CSTD in chemotherapy Preparation?
Closed-System Transfer Device, Needle-less system to transfer chemo meds from a vial to a syringe
75
Where do you dispose of CSTD in chemo in prep?
Chemo sharps container
76
Overview for Chemo transfer compounding procedure?
Clean vial, one swipe of alochol pad towards the side wall of hood
Pierce vial's rubber stopper, using the proper CSTD
Withdraw fluid from vial, using the proper CSTD
Carefully remove bubbles from the syringe
77
IV Tube prep steps?
Gather IV bag, IV tubing, gauze, and needle
Insert tubing spike in IV bag
Attach needle on the other end of the IV tubing
Pinch drip container
Roll tubing clamp upward to allow fluid to flow from IV bag, down the tubing
Stop flow when fluid starts to drip from the needle end of the IV tubing
Check tubing for any air bubbles
78
What must be added when labelling Chemo IV bags?
Warning Sticker for IV bag or syringe
79
What do you need to avoid doing in chemo compounding to avoid disrupting the airflow?
Don't shadow from above or below, since air is vertical in a chemo flow hood.
80
Syringe filling rule for chemo meds?
Meds shouldn't take up more than 75% of syringe. If they do choose a larger syringe.
81
What is required in a chemotherapy spill kit?
Safety glasses, chemo gown, chemo gloves, face mask, biohazard bag, Absorbent towels or mat, Dustpan and broom, clean-up instructions, puncture-resistant container, Sharps container
82
Chemo spill cleanup procedure?
Clear area of staff and patients
Place warning signs around spill
Check SDS for proper procedure for cleaning spill
grab spill kit and put on included chemo PPE
Places towels on liquid spills or ue dustpan to sweep up powdered drug
Throw towels in chemotherapy bag or powder in puncture resistant container
use appropriate cleaner to clean the area
Place all PPE and other items in biohazard bag
Place biohazard bag in chemo sharps container
83
Process for cleaning vials?
Remove cap on vial, one swipe from 70% ipa across ruubber stopper twoard the hood side wall
84
Steps for compounding sterile preps?
Cleaning vials, Assemble Needle/Syringe, Filling syringe with air, Piercing the Vial's rubber stopper, Withdrawing fluid from vial, removing air bubbles, Injecting meds into iv bags, Labeling IV bags, Disposal and recapping
85
What does filling the syringe with air entail in sterile compounding?
Drawing back and injecting the same amount of air as fluid you need
86
What is the milking technique?
Injecting small amounts of air at a time when drawing medicine from a vial
87
How to remove air bubbles in syringe?
Pull syringe slightly past volume needed and tap syringe where air bubbles are located until they rise to the syringe hub then push plunger to correct volume.
88
What is usually above an injection port on an iv bag?
ADD
89
Where can you place a med label on an iv?
On front beneath list of contents, or on the back or side of the bag
90
Whats the method called for recapping a needle?
One handed scoop method
91
What does IVPBs stand for?
IV piggybacks
92
What does LVps stand for?
Large Volume parenterals
93
What is a y site?
Medical device that merges two iv lines into one
94
What is the purpose of a ysite?
To avoid having to start another iv line in patients vein
95
What is a dispensing pin?
A device that allows you to withdraw from the same vial multiples times
96
What is an IVA seal?
Intravenous Admixture seal, Covers port of an IV after medicine has been injected to avoid contamination. Also known as foil port cover.
97
What is an amber bag?
A bag that covers an IV bag or syringe to protect light-sensitive medications
98
What is a vented needle?
Used to add diluent to powdered medication in a vial. Prevents foaming of powdered medications when diluent is added.
99
What is a filter needle?
Used for withdrawing solution from ampules. Prevents broken glass from contaminating the medication.
100
What does SDV stand for?
Single-Dose Vial
101
What does MDV stand for?
Multi-Dose Vial
102
What is an Ampule?
Made of thin glass
103
What is Lyophilized Powders?
powder that Comes in a freeze-dried powder in glass vial to extend shelf life
104
What is the solution with the Abbreviation NS?
Normal saline or 0.9 sodium chloride
105
What is the solution with the Abbreviation 1/2 NS?
1/2 normal saline or .45 Sodium chloride
106
What is the solution with the Abbreviation D5W
Dextrose in 5% Water
107
What is solution with the Abbreviation D10W?
Dextose in 10% Water
108
What is the solution with the abbreviation D5NS?
Dextrose 5% in normal saline
109
What is the solution with the abbreviation LR?
Lactated Ringer's solution
110
What is the solution with the abbreviation D5LR?
Dextrose 5% in Lactated Ringer's Solution
111
What is the solution with the abbreviation D5LR?
Dextrose 5% in Lactated Ringer's Solution
112
Parts of syringe?
Tip, Barrel, Guard, Plunger
113
What is Luer-to-Luer Connectors?
Used to transfer contents of one syringe to another
114
Parts of needle?
Hub, Shaft, Bevel and tip, cap
115
Luer-lock vs Slip-tip
Luer-lock = Twists on, Slip-tip = slips on
116
What is the hub on the needle?
Part that attaches to syringe tip
117
What is bevel on a needle?
slanted opening at the sharply pointed tip of the shaft
118
What length needle is used during sterile compounding?
1 to 1.5 inch
119
What gauge needle is used during sterile compounding?
18 to 22G
