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12 Cards in this Set
- Front
- Back
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catheterizing female
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1. close curtains. discuss procedure with pt.
2. assess for allergies (esp. latex) 3. assist pt. to dorsal recumbent position 4. clean gloves, peri care. remove gloves. 5. secure bag to bedframe 6. open kit on table, sterile gloves. 7. ask pt. to lift bottom, place sterile drape under 8. place fenestrated drape over. 9. lubricate cath tip 10. open labia with thumb and finger non dom hand. antisceptic swabs 11. insert cath. until urine return, advance another 2-3 inches, inflate balloon with sterile water. 12. secure tubing with velcro strap or clip. |
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male catheterizing
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1. close curtains, ID, check allergies, explain procedure
2. assist pt. to dorsal position. waterproof pad under 3. clean gloves. clean genital area with washcloth and cleanser. 4. secure recepticle. put cath tray on overbed table. 5. sterile gloves. sterile drape over penis. lube cath. 6. hold penis with nondom heand. antisceptic swabs. 7. ask pt. to bear down as if voiding. advance cath to Y or until return. 8. inject sterile water. 9. clip cath to gown or velcro strap. 10. |
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piggyback meds
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1. MAR, intx, check exp. dates
2. pt. IDs, pull curtain, check allergies. 3. assess IV site 4. hang and spike. 5. label tubing 6. swab port above roller clamp on primary tubing, connect piggyback. |
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IV push
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1. MAR, exp. dates, etc.
2. pt. ID, clamp tube, swab site. 3. flush, push med, flush. |
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7 evaluation positions
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1. pt. is seated, stand in front (resp, HEENT, chest, hearing)
2. pt in supine position with head slightly elevated (JVD, cardiac 5 areas + palpate, ausc.+palpate carotid) 3. left lateral (auscultate 5 areas with bell) 4. supine position (GI assessment, inspect, auscultate, percuss, palpate, palpate for aortic pulsation) 5. sitting. (skin characteristics, nails, temp, pulses, patellar reflexes) 6. examiner behind pt. (punch kidneys) 7. pt. stands (Rhomberg, spine inspection, walking normally and heel to toe) |
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quick run through of positions
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sitting, supine, left lateral, supine, sitting, standing
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1st assessments of sitting
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a. INSPECTION of head, ears, face, skin
b. EYES (PERRLA, corneal light reflex, cardinal fields of gaze). c. MOUTH exam (mouth, palates, tonsils, tongue, speech, clench teeth, squeeze eyes, tongue out, tongue side-to side, puff out cheeks, smile, shoulder shrug, shoulder shrug w/ resistance) d. HEARING and ear (whisper, palpation) e. Lymph nodes f. CHEST inspection, respiration palpation. g. AUSCULTATE breath sounds. |
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supine CV series (2nd assessments)
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JVD
Palpate heart, apical pulse auscultate 5 areas ausc. apical pulse while palpating carotid Ausc carotid with bell. |
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left lateral CV series (3rd assessments)
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Auscultate 5 areas with BELL
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supine (4TH assessments)
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Abdomen:
inspect auscultate percuss palpate palpate for aortic pulsation |
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sitting (5th assessments)
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skin, hair, and nails
temp, edema, pedal pulses patellar reflexes punch kidneys |
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standing (6th assessments)
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spine inspection
rhomberg normal walking heel-to-toe walking |
