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Skills Lab 3
Medications
| Question | Answer |
|---|---|
| 1 (1pt) | Checks chart for order |
| 2 (1pt) | Review policy and procedure |
| 3 (6pt) | State goals: (a)6 rights: patient, drug, dose, time, route, documentation. (b)no adverse reaction. (c)narcotic = pain relief, heparin = no thrombophlebitis, insulin = wnl blood sugar. (d)minimal discomfort from the injection |
| 4 (2pt) | Compares medical order with information transcribed to the MAR. |
| 5 (2pt) | Reviews pertinent drug info in appropriate text. |
| 6 (1pt) | Perform hand hygiene |
| 7 (2pt) | Selects appropriate size and gauge needle and syringe according to type of med, size of patient, and volume of med |
| 8 (2pt) | Checks expiration date |
| 9 (8pt) | Compares med label with MAR 3 times:(a)when obtaining from drawer (b)after preparing drug. (c)before returning unused med to drawer or at patient bedside. |
| 10 (2pt) Part 1 | Vial: cleanses rubber stopper with alcohol. With needle cap in place pulls back on plunger to draw air into the syringe equivalent to the amount of med to be aspirated. Injects air into the vial so that the tip of the needle is above the liquid contents |
| 10 (2pt) Part 2 | Ampule: breaks ampule safely. Changes to needle with a filter. Do not inject air into ample. |
| 11 (7pt) Part 1 | Vial: pulls back plunger to obtain slightly more med than required; taps syringe barrel to dislodge air bubbles and expels them back into the vial. Withdraws needle and syringe from vial with correct dose. |
| 11 (7pt) Part 2 | Ampule: withdraws appropriate amount of drug; taps syringe barrel to dislodge air bubbles. (Discards ampule in sharps container) |
| 12 (2pt) | Caps or changes needle without contaminating and proceeds to patient’s room. |
| 13 (2pt) | Provides privacy for patient |
| 14 (1pt) | Performs hand hygiene |
| 15 (***) (1, 2, 3) | (1.) Identifies patient 2 ways with MAR at bedside: (a)Have pt. to state name and DOB. (b)wrist band & MR # (2.) Check the 6 rights: patient, drug, dose, route, time, documentation. (3.) Checks patient allergies |
| 15 (1pt, 1pt, 1pt = Total 3pt)(4, 5, 6) | (4.)Explains procedure to patient. (5.)Establishes method of communication during the procedure. (6.)Allow patient verbalization (using established method of communication |
| 16 (3pt) | Raises bed to comfortable working height and raises rail up on the opposite side |
| 17 (3pt) | Correctly positions patient and drapes according to procedure |
| 18 (5pt) Part 1 | Assess patient: (a)allergies, age, body build, muscle size, where last injection was given, condition of tissue to be injected. (b)if pain med, level of pain on 1-10 scale. (c) if insulin, BS |
| 18 (5pt) Part 2 | (d)if Heparin, check last PPT and for s/s thrombophlebitis. (e)if PRN med, time of last dose. (f)if narcotic check vital signs |
| 19 (6pt) | Selects appropriate injection site for med and palpates site for masses, edema, or tenderness. Verbalizes anatomic landmarks. |
| 20 (2pt) | Cleanses site with alcohol in circular motion without retracing steps to a 2” diameter. |
| 21 (2pt) | Applies non-sterile gloves |
| 22 (Procedures: 1) (1pt) | With non-dominant hand, either spreads or pinches up skinfold. |
| 23 (Procedures: 2) (2pt) | Inserts needle at appropriate angle: (a.) sub-q: 45° or 90° (b.) IM 90° |
| 24 (Procedures: 3) (2pt) | Releases pad of tissue and steadies the lower end of the syringe barrel with non-dominant hand (unless z-track method) |
| 25 (Procedures: 4) (4pt) | (IM Only) aspirates to check for blood |
| 26 (Procedures: 5) (1pt) | Injects med slowly and steadily then withdraws needle quickly while placing alcohol swab on skin above injection site with gloved hand. |
| 27 (Procedures: 6) (1pt) | Applies gentle pressure at site. Does not massage. Observes for bleeding. |
| 28 (Post-Procedures: 1) (***) | Does not recap needle. If present, activates needle safety device before disposing syringe in sharp container. |
| 29 (Post-Procedures: 2) (2pt) | Removes gloves correctly and performs hand hygiene |
| 30 (Post-Procedures: 3) (Part 1) (4pt) | (a.) narcotics/cns depressants: safety, side rails up, bed in lowest position. Call light in reach. Return in 30 minutes to assess response to med, rescale pain. Instruct not to get out of bed without assistance. Assess for adverse reactions |
| 30 (Post-Procedures: 3) (Part 2) (4pt) | (b.) insulin: assure pt gets meal tray and monitor % eaten, monitor BS levels. Assess for s/s hypoglycemia. |
| 30 (Post-Procedures: 3) (Part 3) (4pt) | (c.) heparin: assess for for bleeding, monitor PT & PTT and for signs of thrombophlebitis. |
| 31 (Post-Procedures: 4) (Part 1) (4pt) | (a.) teach purpose, effects of meds. |
| 31 (Post-Procedures: 4) (Part 2) (4pt) | (b.) cns depressants: Instruct to not get out of bed with out assistance. |
| 31 (Post-Procedures: 4) (Part 3) (4pt) | (c.) insulin: teach self administration, s/sx or hyper/hypoblycemia, site rotation, etc. |
| 31 (Post-Procedures: 4) (Part 4) (4pt) | (d.) heparin: teach to report bleeding, how to perform leg exercises, use of electric razor, soft toothbrush, how to avoid injury, etc. |
| 32 (Post-Procedures: 5) (4pt) | Leave patient safe and comfortable: (a.) side rails up. (b.) bed at lowest position. (c.) call light with reach. (d.) reposition patient |
| 33 (Post-Procedures: 6) (2pt) | Discards equipment according to policy, cleans up equipment and disposes of appropriately |
| 34 (Post-Procedures: 7) (2pt) | Performs hand hygiene |
| 35 (Post-Procedures: 8)(Part 1) (8pt) | Documents (a.) Date and time medication given (b.) Type of medication (c.) Amount of medication (d.) Location (e.) Route (f.) Identify Initials |
| 35 (Post-Procedures: 8) (Part 2) (8pt) | If narcotics given: sign out on narcotic sheet (if available). If wastage: fill out sheet (or electronically sign) with licensed witness, observing waste and signing wastage sheet with you. |
| 35 (Post-Procedures: 8) (Part 3) (8pt) | If med is a PRN order : narrative documentation needed for patient complaint, assessment, and medication given. After reassessment in 10-30 minutes (depending on route), document patient response to medication. |
| 35 (Post-Procedures: 8) (Part 4) (8pt) | Report any undesirable effects to MD and/or charge nurse and document. |
| 36 (***) | DON STERILE GLOVES CORRECTLY |
Created by:
maggardba
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