Sterile Procedures Midterm Study Guide

Front 1

what is a "critical site"

Back 1

any point at which a sterile prof=duct or packaging may become contaminated

Front 2

what are some examples of critical sites?

Back 2

entry point of sterile container

exposed needle shaft and hub

syringe tip and plunger

luer-lock connections and ports on IV tubing

Front 3

what are some sources of contamination?

Back 3

touch (you)

distractions

airborne

materials

equipment

Front 4

what kind of equipment may cause an air embolism?

Back 4

Pump administration systems

(NOTE: 150-200 mL will harm and adult)

Front 5

where would an intrathecal IV go?

Back 5

into the spinal column fluid

Front 6

where would an intrasynovial IV go?

Back 6

into the joint

Front 7

where would an intravitreal IV go?

Back 7

into the rear chamber of the eye

Front 8

how many times is air filtered in a LAFH?

Back 8

Twice.

Pre-filtered then through the HEPA filter

Front 9

what are the most common vertical hoods used?

Back 9

Class II- Type A

and

Class II- Type B

Front 10

what equipment is used to clean LAFH?

Back 10

sterile water

isopropyl alcohol (70%)

sterile gauze pads

Front 11

true or False:

it is recommended that the LAFH be left running continuously.

Back 11

True.

Front 12

true or False:

Manipulations should be performed 6 inches inside the hood.

Back 12

True.

Front 13

True or False:

LAFH should be in high traffic areas.

Back 13

False.

Front 14

True or False:

LAFH should be tested by qualified personnel every 6 months, when the hood is moved, or if the filter damage is suspected.

Back 14

True

Front 15

what part of the syringe should never be touched?

Back 15

plunger and luer-lock (tip)

Front 16

when determining the syringe to use for a task, what should be the criteria.

Back 16

when picking a syringe use the smallest one required for the task, yet do not use more than 75% of the volume of the syringe.

Front 17

what information is required on a IV Admixture Label?

Back 17

your name todays date RM #

Generic name strength

diluent (NS or D5W) volume of diluent

expiry date

Auxillary labels

Front 18

when withdrawing or adding volume from glass bottles what else is required?

Back 18

venting needle

Front 19

what is another term for Elastomeric Infuser Pumps? and what are they used for?

Back 19

Also known as the Intermate.

Portable device providing 1-7 days of continuous drug infusion.

Often used for home care (cytotoxics).

Front 20

What are Multiple Additive Sets (MAS) used for?

Back 20

used to reconstitute large numbers of powdered vials.

Think Cefazolin/ bag spiked, draw up in 60 mL syringe. lock the line, remove the syringe and reconstitute the vials.

Front 21

how would you remove air from a solution bag?

Back 21

swab port

insert the needle into the bag

hold the bag upright position

tilt the bag to collect the bubbles

cap the needle, discard the syringe and needle

Front 22

define IV Batching

Back 22

compounding multiple units if same items

items usually have good stability (30 days+)

Front 23

what should go on an IV Batching label?

Back 23

product name

strength of product

LOT or batch number

dosage form

expiry form

storage conditions

auxilary labels

WHMIS labels where appropriate

Front 24

what sort of additional documentation must be recorded when doing IV batching?

Back 24

sign off on each step

date, LOT, batch or control number

manufacturer name, LOT, expiry

final yeild

label details + sample label

results of QA testing

Front 25

what are 9 factors to consider when preparing ophthalmic preparations?

Back 25

1. sterility

2. toxicity

3. pH buffering

4. tonicity

5. need for preservatives

6. solubility

7. stability

8. viscosity

9. packaging

Front 26

when should a filter needle be used when preparing ophthalmic preparations?

Back 26

Whenever either a sterile powder or ampoule is used.

Front 27

what information goes on the master formula?

Back 27

name of product

dosage form and quantity of each ingredient

source of raw materials

batch yeild

equipment required

step by step procedures

expiry and storage conditions

QA testing results

Front 28

what does PCA stand for?

Back 28

Patient Controlled Analgesia

Front 29

what are medications commonly used in PCA syringes?

Back 29

Morphine

Meperidine (Demerol)

Fentanyl (Sublimase)

Hydromorphone (Dilaudid)

Front 30

where are epidural blocks administered?

Back 30

special catheters inserted to eipdural space of the spine.

Solutions must be preservative free.

Continuous infusion, or bolus injections are used.

Front 31

what does PCEA stand for?

Back 31

Patient controlled epidural analgesia

Front 32

what medicatio should not be administered in addition to epidural blocks?

Back 32

NO ORAL ANTICOAGULATION SHOULD BE TAKEN DURING EPIDURAL BLOCKS

Front 33

what are cassettes used in addition to?

Back 33

CADD pumps

Front 34

what are USP recommendations for CADD pumps and cassettes?

Back 34

*use barcodes on all PCA medicatiosn

*maintain the pump mechanism

*double check pump calibrations

*education staff about equipment

*use pre-printed forms and master formulas

*education patients and families about the pump

Front 35

what are the 4 types of syringe systems?

Back 35

1. syringe pumps

2. volume control chambers

3. gravity feed

4. intravenous push

Front 36

what is a piggy back system?

Back 36

Method of administrating drugs by adding drug to SVP or piggyback IV bag.

Connects secondary set to the primary IV set at the proximal y-site.

Piggyback bag placed higher than the primary IV bag causing gravity to run to patient vein before the primary bag

Front 37

what is a Minibag Plus?

Back 37

Container with standard diluent with an internal drug vial adapter.

Screw on or attached port for medications.

Swish NS or D5W between IV bag and vial of powdered medication.

Front 38

what is the ADD-Vantage system?

Back 38

Similar to the minibag plus.

Meds prepared quickly without needles, syringes or alcohol swabs.

Front 39

what two routes can TPN be administered?

Back 39

1. Directly to the subclavian vein

2. Peripherally through a vein in arm or back of feet or hands

*NOTE: Neonates go through the veins in scalp*

Front 40

what is another term for total parenteral nutrition?

Back 40

hyperalimentation

Front 41

what ingredients go into a TPN bag?

Back 41

1. Amino Acids

2. Dextrose

3. Water

4. Electrolytes

5. Vitamins

Front 42

what is the purpose of amino acids in TPN bags?

Back 42

two types:

1. Essential - cannot be synthesized by humans so you need them through the diet

2. Non-Essential- one of eleven amino acids that humans can synthesize.

They are types of proteins for cell repair, nutrient transport, immune function.

Front 43

that is the purpose of dextrose and water in TPN bags?

Back 43

Fluid and nutrient replenisher.

Usually comes in 50 or 70%.

Front 44

what are examples of electolytes in TPN bags? What are they used for?

Back 44

Calcium- needed for normal function of the heart, nerves, muscles

Magnesium- electrolyte replenisher and cathartic (bowel evacuation)

Sodium- chief component of extracellular body fluids

Potassium- chief component of intracellular body fluids

Chloride- electrolyte replenisher

Phosphate- cathartic action

Acetate- system and urinary alkalizer (pH buffer)

*All needed for metabolic requirements*

Front 45

what are examples of trace elements needed for in TPN bags?

Back 45

required for proper enzymatic reactions

Front 46

how many vitamins are added to TPN vitamins?

Back 46

12

Front 47

what are lipids used for in TPN bags?

Back 47

source of fuel and calories.

made from soy and corn

10 or 20%