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Accessing an Implanted Port
Activity
Activity, care related to
Adding Sterile Items to a Sterile Field
Administering a Blood Transfusion
Administering a Continuous Closed Bladder or Catheter Irrigation
Administering a Continuous Subcutaneous Infusion: Applying an Insulin Pump
Administering a Large-Volume Cleansing Enema
Administering a Nasal Spray
Administering an Ear Irrigation
Administering an Eye Irrigation
Administering an Intermittent Intravenous Infusion of Medication Via a Mini-Infusion Pump
Anatomy of the Genitourinary Tract
Assessing the Abdomen
Assessing the Neurologic, Musculoskeletal, and Peripheral Vascular Systems
Basic Principles of Medical Asepsis in Patient Care
Box - ANA Board of Directors Position Statement: Reduction of Patient Restraint and Seclusion in Health Care Settings
Box - Characteristics of Sputum and Potential Causes
Calculator - Fall Risk category - (Calc)
Calculator - FLACC Behavioral Scale - (Calc)
Caring for a Patient Receiving Epidural Analgesia
Caring for a Patient with a Cast
Comfort and Pain Management
Components of a Health History
Figure - Abdominal Quadrants and Underlying Organs
Figure - Palpating the Abdomen Lightly
Flowchart - Example of an Algorithm (Assessment Tool) to Aid in Decision Making Regarding Safe Patient Handling and Mobility to Reposition a Patient in Bed
Flowchart - Example of an Algorithm to Aid in Decision Making Regarding Safe Patient Handling and Mobility to Transfer a Patient from Bed to a Chair
Promoting Patient Comfort
Providing Range-of-Motion Exercises
Safety
Safety
Table - Adventitious Breath Sounds
Table - Arterial Blood Gas: Normal Values
I. Actions Basic to Nursing Care
1. Asepsis and Infection Control
1. Asepsis and Infection Control
1-1. Performing Hand Hygiene Using an Alcohol-Based Hand Sanitizer - Skills
1-2. Performing Hand Hygiene Using Soap and Water (Handwashing) - Skills
1-3. Using Personal Protective Equipment - Skills
1-4. Preparing a Sterile Field Using a Packaged Sterile Drape - Skills
1-5. Preparing a Sterile Field Using a Commercially Prepared Sterile Kit or Tray - Skills
1-6. Adding Sterile Items to a Sterile Field - Skills
1-7. Putting on Sterile Gloves and Removing Soiled Gloves - Skills
B - 1-1. Guidelines for Effective Use of PPE
F - 001-01. Applying the correct amount of product to the palm of one hand
F - 001-02. Ensuring use of the correct amount of product
F - 001-03. Rubbing hands together until dry
F - 002-01. Standing in front of sink
F - 002-02. Turning on the water at the sink
F - 002-03. Wetting hands to the wrist
F - 002-04. Lathering hands with soap and rubbing with firm circular motion
F - 002-05. Washing areas between fingers
F - 002-06. Washing to 1 inch above the wrist
F - 002-07. Using fingernails to clean under nails of opposite hand
F - 002-08. Rinsing hands under running water with water flowing toward fingertips
F - 003-01. Tying gown at neck and waist
F - 003-02. Applying mask over nose, mouth, and chin
F - 003-03. Putting on goggles
F - 003-04. Putting on face shield
F - 003-05. Putting on gloves, ensuring gloves cover gown cuffs
F - 003-06. Grasping the palm area of one glove and peeling off
F - 003-07. Sliding fingers of ungloved hand under the remaining glove at the wrist
F - 003-08. Peeling off the second glove, containing the first glove inside the other
F - 003-09. Removing goggles by grasping earpieces
F - 003-10. Touching only the inside of the gown, pull away from the neck and shoulders
F - 003-11. Keeping hands on the inner surface of the gown, pull gown from arms
F - 003-12. Turning gown inside out, rolling into a bundle
F - 003-13. Removing mask or respirator, grasping the neck ties or elastic, taking care to avoid touching the front
F - 003-14. Grasping the outside of the front of gown and pulling away from the body
F - 003-15. Rolling gown inside-out into a bundle
F - 003-16. Peeling off gloves as gown is being removed, touching only the inside of the gloves and gown
F - 003-17. Removing the goggles or face shield, grasping the headband or earpieces
F - 003-18. Removing the mask or respirator, grasping the bottom ties or elastic, and then the top ties or elastic
F - 004-01. Holding drape by corners and allowing it to unfold away from body and surfaces
F - 004-02. Positioning drape on work surface with the moisture-proof side down
F - 005-01. Opening outside cover of package
F - 005-02. Pulling top flap open, away from body
F - 005-03. Pulling open the first side flap
F - 005-04. Pulling open the remaining side flap
F - 005-05. Pulling open flap closest to body
F - 005-06. Positioning wrapper on work surface
F - 005-07. Outside wrapper of package is now sterile field
F - 006-01. Carefully peeling edges apart
F - 006-02. Dropping sterile item onto sterile field
F - 006-03. Opening bottle of sterile solution and placing cap on table with edges up
F - 006-04. Pouring solution into sterile container
F - 007-01. Pulling top layer of outside wrapper back
F - 007-02. Folding back side flaps
F - 007-03. Grasping cuff of glove for dominant hand
F - 007-04. Lifting glove from package
F - 007-05. Inserting dominant hand into glove
F - 007-06. Sliding fingers under cuff of glove for nondominant hand
F - 007-07. Sliding fingers of one hand under cuff of other hand and extending cuff down the arm
F - 007-08. Adjusting gloves as necessary
F - 007-09. Inverting glove as it is removed
F - 007-10. Sliding fingers of ungloved hand inside remaining glove
F - 007-11. Inverting glove as it is removed, securing first glove inside it
Fundamental Reviews - 1-1. Basic Principles of Medical Asepsis in Patient Care
Fundamental Reviews - 1-2. Basic Principles of Surgical Asepsis in Patient Care
Fundamental Reviews - 1-3. Standard Precautions
Fundamental Reviews - 1-4. Transmission-Based Precautions
2. Vital Signs
2. Vital Signs
2-1. Assessing Body Temperature - Skills
2-2. Regulating Temperature Using an Overhead Radiant Warmer - Skills
2-3. Regulating Temperature Using a Hypothermia Blanket - Skills
2-4. Assessing a Peripheral Pulse by Palpation - Skills
2-5. Assessing the Apical Pulse by Auscultation - Skills
2-6. Assessing Respiration - Skills
2-7. Assessing Blood Pressure Using an Automated, Electronic Oscillometric Device - Skills
2-8. Assessing Blood Pressure by Auscultation - Skills
B - 2-1. Normal Temperature Variations Based on Measurement Site
B - 2-2. Pulse Sites and Pulse Amplitude
B - 2-3. Considerations Related to Measurement of Blood Pressure
B - 2-4. Sources of Error in Blood Pressure Measurement
B - 2-5. Assessing for Orthostatic Hypotension
F - 001-01. Holding the device perpendicular from the patient's forehead
F - 001-02. Putting probe cover on the thermometer
F - 001-03. Placing thermometer under the tongue in the posterior sublingual pocket
F - 001-04. Holding probe in the patient's mouth
F - 001-05. Pushing button to dispose of cover
F - 001-06. Attaching the disposable cover onto the tympanic probe
F - 001-07. Thermometer in patient's ear canal with pinna pulled up and back
F - 001-08. Disposing of probe cover
F - 001-09. Placing the thermometer probe on the center of the forehead
F - 001-10. Sliding the probe across the forehead to the hairline
F - 001-11. Touching the probe behind the ear
F - 001-12. Exposing axilla to assess temperature
F - 001-13. Placing thermometer in the center of the axilla
F - 001-14. Removing appropriate probe and attaching disposable probe cover
F - 001-15. Lubricating thermometer tip
F - 001-16. Inserting thermometer into the anus
F - 002-01. Probe in place with foil cover
F - 002-02. Taking infant's axillary temperature
F - 003-01. Moving the Doppler tip until pulse is heard
F - 003-02. Turning the hypothermia blanket control unit on and checking the settings
F - 003-03. Positioning the hypothermia blanket under the patient
F - 004-01. Placing fingers over the artery
F - 004-02. Counting the pulse
F - 005-01. Inflating cuff while listening to artery pulsations
F - 005-02. The apical pulse is usually found at (A) the fifth intercostal space just inside the midclavicular line and can be heard (B) over the apex of the heart
F - 006-01. Assessing respirations
F - 007-01. The electronic oscillometric blood pressure monitor reports systolic and diastolic blood pressure as well as mean blood pressure
F - 007-02. Proper positioning for blood pressure assessment using brachial artery
F - 007-03. Centering the bladder of the cuff over the brachial artery
F - 007-04. Cuff tubing extending from the edge of the cuff nearer the patient's elbow
F - 007-05. Wrapping the cuff around the arm smoothly and snugly
F - 007-06. Noting the blood pressure reading
F - 008-01. Sphygmomanometer
F - 008-02. Positioning for blood pressure assessment using brachial artery
F - 008-03. Placing the blood pressure cuff on the upper arm
F - 008-04. Ensuring gauge starts at zero
F - 008-05. Palpating the brachial pulse
F - 008-06. Placement of diaphragm of stethoscope
F - 008-07. Noting the point on the gauge at which the first of at least two consecutive beats appears
F - 008-08. Noting the point at which the sound completely disappears
F - tbl004-01. Blood flow interrupted by inflated cuff
F - tbl004-02. As the pressure in the cuff is released, blood starts flowing again and Korotkoff sounds are audible
F - tbl004-03. Cuff is completely deflated after Phase V, restoring complete blood flow
Fundamental Reviews - 2-1. Age-Related Variations in Normal Vital Signs
Fundamental Reviews - 2-2. Techniques for Obtaining Vital Signs of Infants and Children
T - 2-1. Patterns of Respiration
T - 2-2. Categories for Blood Pressure Levels in Adults (Ages 18 and Older)
T - 2-3. Recommended Blood Pressure Cuff Sizes
T - 2-4. Korotkoff Sounds
3. Health Assessment
3. Health Assessment
3-1. Performing a General Survey - Skills
3-10. Assessing the Neurologic, Musculoskeletal, and Peripheral Vascular Systems - Skills
3-2. Using a Portable Bed Scale - Skills
3-3. Assessing the Skin, Hair, and Nails - Skills
3-4. Assessing the Head and Neck - Skills
3-5. Assessing the Thorax, Lungs, and Breasts - Skills
3-6. Assessing the Cardiovascular System - Skills
3-7. Assessing the Abdomen - Skills
3-8. Assessing the Female Genitalia - Skills
3-9. Assessing the Male Genitalia - Skills
B - 3-1. Methods for Palpating the Breasts
B - 3-2. Components of a Neurovascular Assessment
F - 001-01. Weighing patient using scale
F - 001-02. Measuring patient's height
F - 002-01. Using a bed scale
F - 003-01. Inspecting overall skin coloration
F - 003-02. Assessing skin temperature
F - 003-03. Assessing skin turgor
F - 003-04. Inspecting the scalp and hair
F - 004-01. Pupillary gauge measures pupils in millimeters (mm)
F - 004-02. Assessing pupillary reaction to light
F - 004-03. Assessing pupillary accommodation
F - 004-04. Assessing extraocular movements
F - 004-05. Assessing convergence
F - 004-06. Testing visual acuity with a Snellen chart
F - 004-07. Palpating the nose
F - 004-08. Palpating the sinuses
F - 004-09. Inspecting the mouth using a tongue blade and penlight
F - 004-10. Location of lymph nodes in neck
F - 004-11. Palpating lymph nodes
F - 004-12. Palpating (A) and auscultating (B) the carotid arteries
F - 004-13. Palpating to determine position of trachea
F - 004-14. Assessing the thyroid gland
F - 005-01. Inspecting the skin for abnormalities and variations
F - 005-02. Palpating the posterior thorax
F - 005-03. Palpating posterior thoracic excursion
F - 005-04. Auscultating the posterior thorax
F - 005-05. Palpating the anterior thorax
F - 005-06. Auscultating the anterior thorax
F - 006-01. Precordium cardiac landmarks
F - 006-02. Palpating the apical impulse in the mitral area
F - 006-03. Auscultating the mitral area
F - 007-01. Abdominal quadrants and underlying organs
F - 007-02. Auscultating the abdomen
F - 007-03. Locations to auscultate for vascular sounds
F - 007-04. Palpating the abdomen lightly
F - 008-01. External female genitalia
F - 009-01. External male genitalia
F - 010-01. Puffing out cheeks
F - 010-02. Assessing function of the spinal accessory nerve (CN XI) and muscular strength
F - 010-03. Moving each ear to the corresponding shoulder
F - 010-04. Assessing muscle strength of the upper extremities
F - 010-05. Palpating the wrist
F - 010-06. Testing grip
F - 010-07. Palpating (A) and auscultating (B) the femoral pulses
F - 010-08. Assessing for pitting edema in lower extremities
F - 010-09. Testing motor strength of upper leg
F - 010-10. A. Testing ankle flexion and dorsiflexion. The patient first pushes the balls of the feet against resistance of the nurse's hands.B. Then attempts to pull against nurse's resistance
F - 010-11. Testing heel to toe walking
F - 010-12. Positioning for the Romberg's test
Fundamental Reviews - 3-1. Components of a Health History
Fundamental Reviews - 3-2. Physical Assessment Techniques
Fundamental Reviews - 3-3. Brief General Physical Assessment
T - 3-1. Normal Breath Sounds
T - 3-2. Adventitious Breath Sounds
T - 3-3. Heart Sounds
4. Safety
4. Safety
4-1. Performing a Situational Assessment - Skills
4-2. Fall Risk and Fall-Related Injury Risk Reduction - Skills
4-3. Implementing Alternatives to the Use of Restraints - Skills
4-4. Applying an Extremity Restraint - Skills
4-5. Applying a Waist Restraint - Skills
4-6. Applying an Elbow Restraint - Skills
4-7. Applying a Mummy Restraint - Skills
B - 4-1. Patient Education for Preventing Falls in the Home
B - 4-2. ANA Board of Directors Position Statement: Reduction of Patient Restraint and Seclusion in Health Care Settings
F - 001-01. Observing the patient's behavior and affect
F - 002-01. Johns Hopkins fall risk assessment Tool
F - 002-02. Reviewing the results of the fall risk assessment and fall risk factors with the patient
F - 002-03. Low bed with floor mats
F - 002-04. Providing nonskid footwear
F - 002-05. Encouraging appropriate exercise
F - 002-06. Engaging bed locks
F - 002-07. Raising side rails on bed at the patient's request
F - 002-08. Patient wearing a personal alarm device
F - 004-01. Wrapping the restraint around the extremity with the soft part in contact with the skin
F - 004-02. Using a hand mitt, with cushion to the palmar aspect of hand
F - 004-03. Securing restraint on extremity
F - 004-04. Ensuring that two fingers can be inserted between the restraint and the patient's extremity
F - 004-05. Securing restraint to bed frame
F - 005-01. Positioning waist restraint
F - 005-02. Restraint secured behind chair, out of the patient's reach
F - 006-01. Child with elbow restraint secured in place
F - 007-01. Pulling blanket over right shoulder and chest and securing under patient's left side
F - 007-02. Securing blanket under right side of body
F - 007-03. Securing lower corner of blanket under each side of patient's body
Fundamental Reviews - 4-1. Preventing Accidents and Promoting Safety at Varying Developmental Stages
Fundamental Reviews - 4-2. General Guidelines for Restraint Use
T - 4-1. Recommended Fall-Prevention Strategies by Fall Risk Level
5. Medications
5. Medications
5-1. Administering Oral Medications - Skills
5-10. Administering Medications by Intravenous Bolus or Push Through an Intravenous Infusion - Skills
5-11. Administering Medications by Intravenous Bolus or Push Through a Medication or Drug-Infusion Lock - Skills
5-12. Administering a Piggyback Intermittent Intravenous Infusion of Medication - Skills
5-13. Administering an Intermittent Intravenous Infusion of Medication Via a Mini-Infusion Pump - Skills
5-14. Applying a Transdermal Patch - Skills
5-15. Administering Eye Drops - Skills
5-16. Administering an Eye Irrigation - Skills
5-17. Administering Ear Drops - Skills
5-18. Administering an Ear Irrigation - Skills
5-19. Administering a Nasal Spray - Skills
5-2. Administering Medications Via a Gastric Tube - Skills
5-20. Administering a Vaginal Cream - Skills
5-21. Administering a Rectal Suppository - Skills
5-22. Administering Medication Via a Metered-Dose Inhaler (MDI) - Skills
5-23. Administering Medication Via a Dry Powder Inhaler - Skills
5-24. Administering Medication Via a Small-Volume Nebulizer - Skills
5-3. Removing Medication From an Ampule - Skills
5-4. Removing Medication From a Vial - Skills
5-5. Mixing Medications From Two Vials in One Syringe - Skills
5-6. Administering an Intradermal Injection - Skills
5-7. Administering a Subcutaneous Injection - Skills
5-8. Administering an Intramuscular Injection - Skills
5-9. Administering a Continuous Subcutaneous Infusion: Applying an Insulin Pump - Skills
B - 5-1. Reducing Discomfort in Subcutaneous and Intramuscular Administrations
F - 001-01. Example of a specially designed vial that has the diluent and powder separated by a rubber stopper within the vial
F - 001-02. Measuring at eye level
F - 001-03. Comparing patient's name and identification number with eMAR
F - 001-04. Scanning bar code on patient's identification bracelet
F - 001-05. Remaining with patient until each medication is swallowed
F - 001-06. Recording each medication administered on eMAR
F - 001-07. Monoject⢠oral syringe
F - 002-01. Patient using insulin pen
F - 002-02. Scanning bar code on the patient's identification bracelet
F - 002-03. Pausing feeding pump
F - 002-04. Pinching (or clamping) gastric tubing to prevent backflow of gastric drainage and opening medication administration port
F - 002-05. Pouring water into syringe inserted in gastric tube
F - 002-06. Pouring medication into syringe inserted in gastric tube
F - 003-01. Tapping stem of the ampule
F - 003-02. Twisting wrist quickly while holding ampule vertically
F - 003-03. Using a snapping motion to break top of ampule
F - 003-04. Withdrawing medication from upright ampule
F - 003-05. Withdrawing medication from inverted ampule
F - 004-01. Injecting air with vial upright
F - 004-02. Example of a needleless system to access a medication vial
F - 004-03. Positioning needle tip in solution
F - 004-04. Withdrawing medication at eye level
F - 005-01. Lubricating suppository
F - 005-02. Inserting suppository into vagina
F - 005-03. Withdrawing prescribed amount of unmodified insulin
F - 005-04. Withdrawing modified insulin
F - 006-01. Holding the MDI 1 to 2 inches from the mouth
F - 006-02. Inserting needle almost flat against the skin
F - 006-03. Observing for wheal while injecting medication
F - 007-01. Body sites where subcutaneous injections can be given
F - 007-02. Scanning bar code on the patient's identification bracelet
F - 007-03. Cleaning injection site
F - 007-04. Pinching up the skin and underlying fatty tissue
F - 007-05. Inserting needle
F - 007-06. Sites for administration of enoxaparin
F - 008-01. Sites for intramuscular injections
F - 008-02. Scanning bar code on the patient's identification bracelet
F - 008-03. Identifying the appropriate landmarks
F - 008-04. Z-track or zigzag technique is recommended for intramuscular injections
F - 008-05. Darting needle into tissue
F - 008-06. Applying gentle pressure at injection site
F - 009-01. Insulin pump utilizing infusion tubing and a small needle-insertion device
F - 009-02. Insulin pump utilizing a wireless patch-pump system
F - 009-03. Scanning bar code on patient's identification bracelet
F - 009-04. Removing cap from syringe or insulin cartridge
F - 009-05. Placing syringe or cartridge in compartment according to the manufacturer's directions
F - 009-06. Programming pump according to prescribed insulin dosing following manufacturer's guidelines for the device
F - 009-07. Cleansing area around injection site with antimicrobial swab
F - 009-08. Insulin pump in place
F - 010-01. Closing the clamp on the administration set
F - 010-02. Removing the passive disinfection cap
F - 010-03. Inserting the saline flush syringe into the injection port
F - 010-04. Pulling back on the plunger to aspirate for a blood return
F - 010-05. Injecting medication at the recommended rate
F - 010-06. Attaching a passive disinfection cap
F - 011-01. Scanning bar code on patient's identification bracelet
F - 011-02. Removing the passive disinfection cap from the access port
F - 011-03. Inserting the saline flush syringe into the access port
F - 011-04. Releasing the clamp on the extension tubing
F - 011-05. Pulling back on the plunger to aspirate for a blood return
F - 011-06. Injecting the medication at the recommended rate
F - 011-07. Clamping the extension tubing
F - 011-08. Attaching a passive disinfection cap to the access port
F - 012-01. Lowering the primary IV fluid container to position the piggyback container higher than primary IV fluid container
F - 012-02. Vigorously scrubbing the access port
F - 012-03. Connecting piggyback administration set to access port
F - 012-04. Setting rate for secondary infusion on infusion pump
F - 012-05. Using roller clamp on primary infusion tubing to regulate gravity flow
F - 013-01. Inserting syringe into mini-infusion pump
F - 013-02. Removing the passive disinfection cap from the access port closest to IV insertion site
F - 013-03. Connecting secondary infusion tubing the access port
F - 013-04. Programming mini-infusion pump
F - 014-01. Scanning bar code on patient's identification bracelet
F - 014-02. Removing protective covering on patch
F - 014-03. Applying patch to patient's skin
F - 015-01. Scanning bar code on patient's identification bracelet
F - 015-02. Cleaning eyelids and eyelashes from the inner toward the outer canthus
F - 015-03. Turning head slightly to affected side
F - 015-04. Applying pressure downward over bony cheek prominence to expose lower conjunctival sac
F - 015-05. Squeezing container to administering drops into conjunctival sac
F - 015-06. Applying gentle pressure over inner canthus
F - 016-01. Tilting head toward affected eye
F - 016-02. Cleaning eyelids and eyelashes from inner canthus to outer canthus
F - 016-03. Placing basin to catch irrigating fluid
F - 016-04. Exposing lower conjunctival sac and holding upper lid open
F - 016-05. Holding irrigation syringe 3 to 4 cm but no more than 5 cm from eye
F - 017-01. Cleaning external ear
F - 017-02. Positioning patient on unaffected side
F - 017-03. Removing the cap from the medication bottle
F - 017-04. Pulling the pinna up and back and placing dropper tip above auditory canal
F - 017-05. Applying pressure to tragus
F - 017-06. Inserting cotton ball into ear canal
F - 017-07. Pulling pinna up and back for a child older than age 3 years
F - 017-08. Pulling pinna down and back for an infant or child younger than age 3 years
F - 018-01. Pulling pinna up and back to straighten the ear canal
F - 018-02. Instilling irrigation fluid
F - 018-03. Placing cotton ball in ear
F - 018-04. Pulling pinna up and back for child older than age 3 years
F - 018-05. Pulling pinna down and back for an infant or child younger than age 3 years
F - 019-01. Scanning bar code on the patient's identification bracelet
F - 019-02. Inserting tip of bottle into one nostril
F - 020-01. Scanning bar code on patient's identification bracelet
F - 020-02. Performing perineal care
F - 020-03. Filling vaginal applicator with cream
F - 020-04. Positioning applicator in vagina for administration of medication
F - 021-01. Scanning bar code on patient's identification bracelet
F - 021-02. Applying lubricant to rounded end of suppository
F - 021-03. Inserting suppository round end first along rectal wall
F - 022-01. Scanning bar code on patient's identification bracelet
F - 022-02. Placing spacer with MDI into mouth
F - 023-01. Scanning bar code on patient's identification bracelet
F - 023-02. Patient with teeth over and lips sealed around DPI mouthpiece
F - 024-01. Putting medication into nebulizer
F - 024-02. Inhaling slowly and deeply through the mouth
Fundamental Reviews - 5-1. Know Your Medications
Fundamental Reviews - 5-2. The Three Checks
Fundamental Reviews - 5-3. Rights of Medication Administration
Fundamental Reviews - 5-4. Nursing Responsibilities for Administering Drugs
Fundamental Reviews - 5-5. Needle/Syringe Selection
T - 5-1. Intramuscular Injection Needle Length
T - 5-2. Intramuscular Site Selection
T - 5-3. Patient Positioning
6. Perioperative Nursing
6. Perioperative Nursing
6-1. Teaching Deep-Breathing Exercises, Coughing, and Splinting - Skills
6-2. Teaching Leg Exercises - Skills
6-3. Providing Preoperative Patient Care - Skills
6-4. Providing Preoperative Patient Care: Day of Surgery - Skills
6-5. Providing Postoperative Care - Skills
6-6. Applying a Forced-Air Warming Device - Skills
B - 6-1. The I Cough Multidisciplinary Program
F - 001-01. Assisting patient to semi- or high-Fowler's position
F - 001-02. Having patient splint chest or abdominal incision by holding a folded bath blanket or small pillow against the incision
F - 001-03. Telling patient to take a deep breath and hold for 3 seconds
F - 001-04. Encouraging patient to cough out three short times after holding breath
F - 002-01. Assisting patient to semi-Fowler's position
F - 002-02. Extending lower portion of the leg and holding for a few seconds
F - 002-03. Lowering entire leg to bed
F - 002-04. Pointing toes of both feet toward foot of bed
F - 002-05. Pulling toes toward chin
F - 002-06. Having patient make circles with both ankles, first one way and then the other
F - 003-01. Identifying needs of patient and answering questions
F - 003-02. Helping patient to roll over to her right side while she pushes with left bent leg and pulls on the side rail
F - 004-01. Obtaining preoperative vital signs
F - 004-02. Postoperative bed, ready for patient's return
F - 005-01. Obtaining postoperative oxygen saturation level
F - 005-02. Checking dressings for color, odor, and amount of drainage
F - 006-01. Forced-air blanket on patient, plastic side up, with air hose inlet at foot of bed
Fundamental Reviews - 6-1. Nursing Assessment and Intervention Before Surgery
Fundamental Reviews - 6-2. Preoperative Information for Outpatient/Same Day Surgery
Fundamental Reviews - 6-3. Sample Preoperative Teaching: Activities and Events for In-Patient Surgery Preoperative Phase
Fundamental Reviews - 6-4. Nursing Interventions to Meet Psychosocial Needs of Patients Having Surgery
II. Promoting Healthy Physiologic Responses
10. Comfort and Pain Management
10. Comfort and Pain Management
10-1. Promoting Patient Comfort - Skills
10-2. Giving a Back Massage - Skills
10-3. Applying and Caring for a Patient Using a Transcutaneous Electrical Nerve Stimulation Unit - Skills
10-4. Caring for a Patient Receiving Patient-Controlled Analgesia - Skills
10-5. Caring for a Patient Receiving Epidural Analgesia - Skills
10-6. Caring for a Patient Receiving Continuous Wound Perfusion Pain Management - Skills
B - 10-1. Guidelines for Safe and Effective Use of Patient-Controlled Analgesia
B - 10-2. Guidelines for Safe Implementation of Authorized Agent-Controlled Analgesia
F - 002-01. Using light, gliding strokes to apply lotion
F - 002-02. Stroking upward to shoulders and back downward to the buttocks
F - 002-03. Kneading the patient's back
F - 002-04. Using long strokes with lessening pressure
F - 003-01. TENS unit
F - 003-02. Applying TENS electrodes
F - 003-03. Turning on TENS unit
F - 004-01. Checking label on prefilled drug syringe with patient identification
F - 004-02. Placing syringe/reservoir into PCA device
F - 004-03. Programming PCA device
F - 004-04. Reinforcing the need to press button to administer pain medication
F - 005-01. Placement of an epidural catheter for long-term use
F - 005-02. Assessing the epidural catheter exit site
F - 006-01. Wound perfusion pain management system consists of a balloon (pump), filter, and catheter that deliver a specific amount of prescribed local anesthetic at the rate determined by the prescribing health care provider
Fundamental Reviews - 10-1. General Guidelines for Pain Assessment
Fundamental Reviews - 10-2. Pain Assessment Tool
Fundamental Reviews - 10-3. Pain Assessment Scales
Fundamental Reviews - 10-4. FLACC Behavioral Scale
T - 10-1. Pasero Opioid-Induced Sedation Scale (POSS)
11. Nutrition
11. Nutrition
11-1. Assisting a Patient with Eating - Skills
11-2. Confirming Placement of a Nasogastric Tube - Skills
11-3. Administering a Tube Feeding (Open System) - Skills
11-4. Caring for a Gastrostomy Tube - Skills
B - 11-1. Special Considerations and Interventions for Assisting Patients with Dementia or Other Alterations in Cognition with Eating
B - 11-2. Special Considerations and Interventions for Assisting Patients with Dysphagia With Eating
B - 11-3. Monitoring for Tolerance of Enteral Nutrition
F - 001-01. Prefilled tube feedings in plastic containers and ready-to-use feeding in a can
F - 002-01. Measuring the length of the exposed nasogastric tube
F - 002-02. Aspirating gastric contents
F - 002-03. pH test strips to measure pH of aspirated fluid
F - 003-01. Cleaning top of feeding container with alcohol before opening it
F - 003-02. Attaching feeding administration set to NG tube
F - 003-03. Pouring water into feeding bag
F - 003-04. Capping NG tube after it is clamped
F - 003-05. Removing plunger from a 60-mL syringe
F - 003-06. Pouring formula into syringe
F - 003-07. Pouring water into almost-empty syringe
F - 003-08. Setting infusion rate on pump
F - 004-01. Wiping gastric tube site with cotton-tipped applicator and sterile saline
F - 004-02. Cleaning site with skin cleanser, water, and washcloth
Fundamental Reviews - 11-1. Clinical Observations for Nutritional Assessment
Fundamental Reviews - 11-2. Factors that May Affect Nutritional Status
T - 11-1. Modified Consistency and Selected Therapeutic Diets
12. Urinary Elimination
12. Urinary Elimination
12-1. Assisting with the Use of a Bedpan - Skills
12-10. Administering a Continuous Closed Bladder or Catheter Irrigation - Skills
12-11. Emptying and Changing a Stoma Appliance on a Urinary Diversion - Skills
12-12. Caring for a Suprapubic Urinary Catheter - Skills
12-13. Caring for a Peritoneal Dialysis Catheter - Skills
12-14. Caring for a Hemodialysis Access (Arteriovenous Fistula or Graft) - Skills
12-2. Assisting with the Use of a Urinal - Skills
12-3. Assisting with the Use of a Bedside Commode - Skills
12-4. Assessing Bladder Volume Using an Ultrasound Bladder Scanner - Skills
12-5. Applying an External Urinary Sheath - Skills
12-6. Applying an External Urine Collection Device (Female Genitalia) - Skills
12-7. Catheterizing the Urinary Bladder of a Patient with Female Genitalia - Skills
12-8. Catheterizing the Urinary Bladder of a Patient with Male Genitalia - Skills
12-9. Removing an Indwelling Urinary Catheter - Skills
B - 12-1. Guidelines for Care of the Patient with an Indwelling Catheter
B - 12-2. Patient Intermittent Self-Catheterization
B - 12-3. Guidelines for Care of the Patient with a Urinary Diversion
F - 001-01. Rolling patient on side to place bedpan
F - 001-02. Placing waterproof pad under patient's buttocks
F - 001-03. Assisting patient to raise hips upward and positioning the bedpan
F - 001-04. Placing call bell within patient's reach and handing patient toilet tissue
F - 002-01. Urinal
F - 002-02. Positioning urinal
F - 003-01. Bedside commode
F - 004-01. Two-piece appliances
F - 004-02. Gently pressing faceplate to skin
F - 004-03. A. Placing ultrasound gel about 1 to 1.5 inches above symphysis pubis.B. Gel pad
F - 004-04. A. Positioning scanner head with directional icon toward patient's head and aiming the scanner head toward the bladder.B. Scan button
F - 004-05. Centering image on crossbars
F - 005-01. Unrolling sheath onto penis
F - 005-02. Connecting external urinary sheath to drainage setup
F - 006-01. External urine collection device in place, secured to the suprapubic region
F - 006-02. External urine collection system (female genitalia)
F - 007-01. A. Indwelling urethral catheter.B. Intermittent urethral catheter
F - 007-02. Patient in dorsal recumbent position and draped properly
F - 007-03. Demonstration of side-lying position
F - 007-04. Patient with fenestrated drape in place over perineum
F - 007-05. Using dominant hand to separate and hold labia open
F - 007-06. Exposing urinary meatus with patient in side-lying position
F - 007-07. Wiping perineum with cotton ball held by forceps
F - 007-08. Inserting catheter with dominant hand while nondominant hand holds labia apart
F - 007-09. Inflating balloon of indwelling catheter
F - 007-10. Attaching catheter to drainage bag
F - 007-11. Catheter secured to leg
F - 008-01. Patient lying supine with fenestrated drape +over penis
F - 008-02. Lifting penis with gloved nondominant hand and cleaning meatus with cotton ball held with forceps in gloved dominant hand
F - 008-03. Inserting syringe into urethra and instilling lubricant
F - 008-04. Inserting catheter using dominant hand
F - 009-01. Removing fluid from balloon
F - 010-01. A triple-lumen catheter
F - 010-02. A continuous bladder irrigation (CBI) setup
F - 010-03. Inserting tubing into solution bag
F - 010-04. Removing air from irrigation tubing
F - 010-05. Attaching irrigation tubing to irrigation port on catheter
F - 010-06. Regulating irrigation flow rate using flow clamp
F - 011-01. Emptying urine into graduated container
F - 011-02. Gently removing appliance faceplate from skin
F - 011-03. Pushing skin from appliance rather than pulling appliance from skin
F - 011-04. Cleaning stoma with cleansing agent and washcloth
F - 011-05. Placing one or two gauze squares over stoma opening
F - 011-06. Cutting the faceplate opening 1/8 inch larger than stoma size
F - 011-07. Applying faceplate over stoma
F - 012-01. A suprapubic catheter positioned in bladder
F - 012-02. Cleaning area around catheter site with skin cleanser and water
F - 012-03. Using a sterile cotton-tipped applicator for cleaning
F - 012-04. Applying small drain sponge around catheter
F - 012-05. Forming a loop in tubing and taping to abdomen
F - 013-01. Position of catheter in peritoneal space
F - 014-01. Central catheter for hemodialysis
F - 014-02. Arteriovenous fistula for hemodialysis
F - 014-03. Arteriovenous graft for hemodialysis
F - 014-04. Palpating access site for thrill
Fundamental Reviews - 12-1. Anatomy of the Genitourinary Tract
Fundamental Reviews - 12-2. Factors Affecting Urinary Elimination
13. Bowel Elimination
13. Bowel Elimination
13-1. Administering a Large-Volume Cleansing Enema - Skills
13-10. Removing a Nasogastric Tube - Skills
13-2. Administering a Small-Volume Cleansing Enema - Skills
13-3. Administering a Retention Enema - Skills
13-4. Digital Removal of Stool - Skills
13-5. Applying an External Anal Pouch - Skills
13-6. Emptying and Changing an Ostomy Appliance - Skills
13-7. Irrigating a Colostomy - Skills
13-8. Inserting a Nasogastric Tube - Skills
13-9. Irrigating a Nasogastric Tube Connected to Suction - Skills
B - 13-1. Guidelines for Ostomy Care
F - 001-01. Two-piece appliances
F - 001-02. Gently press faceplate to skin
F - 001-03. Applying appliance pouch to faceplate
F - 001-04. Clamping tubing before removing
F - 001-05. Offering toilet tissue to patient on bedside commode
F - 002-01. Removing cap from prepackaged enema solution container
F - 002-02. Inserting tube into rectum, directing toward umbilicus
F - 002-03. Compressing container
F - 003-01. Inserting tube into rectum, directing toward umbilicus
F - 003-02. Compressing container
F - 004-01. Inserting lubricated forefinger of dominant hand into anal canal
F - 004-02. Gently working finger around to break up stool mass
F - 004-03. Cleaning anal area with washcloth and skin cleanser
F - 005-01. Removing paper backing from adhesive of rectal device
F - 005-02. Applying device over anal opening
F - 005-03. Attaching connector of fecal device to tubing of drainage bag
F - 005-04. Hanging drainage bag below level of patient
F - 006-01. Removing clamp, getting ready to empty pouch
F - 006-02. Emptying contents of appliance into a measuring device
F - 006-03. Wiping lower 2 inches of pouch with paper towel
F - 006-04. Gently removing appliance
F - 006-05. Using toilet tissue to remove excess stool from the stoma
F - 006-06. Assessing stoma and peristomal skin
F - 006-07. Using measurement guide to measure size of stoma
F - 006-08. Tracing the same-sized circle on back and center of skin barrier
F - 006-09. Cutting the opening 1/8 inch larger than stoma size
F - 006-10. Removing paper backing on faceplate
F - 006-11. Easing appliance over stoma
F - 006-12. Using clip to close bottom of appliance
F - 007-01. Irrigation sleeve and bag
F - 007-02. Positioning of irrigation sleeve on abdomen
F - 007-03. Colostomy irrigation
F - 008-01. Double-lumen nasogastric tube with a one-way antireflux valve in the airflow lumen
F - 008-02. Beginning insertion with patient positioned with head slightly flexed back
F - 008-03. Advancing tube after patient drops chin to chest and while swallowing
F - 008-04. Example of a commercially prepared securement device
F - 008-05. Making a 2-inch cut into a 4-inch strip of tape
F - 008-06. Applying tape to patient's nose
F - 008-07. Wrapping split ends around NG tube
F - 008-08. NG tube attached to wall suction
F - 008-09. Patient with Salem sump tube (NG) secured
F - 008-10. Example of a commercially prepared nasal bridle
F - 009-01. Preparing syringe with 30 mL of irrigation solution
F - 009-02. Clamping nasogastric tube while disconnecting
F - 009-03. Keeping both tubes upright to prevent leakage of gastric fluid
F - 009-04. Gently instilling irrigation
F - 010-01. Placing towel or disposable pad across patient's chest
F - 010-02. Flushing NG tube with 10-mL water
F - 010-03. Doubling tube on itself
F - 010-04. Measuring the amount of nasogastric drainage in collection device
Fundamental Reviews - 13-1. Anatomy of the Gastrointestinal Tract
Fundamental Reviews - 13-2. Factors that Affect Bowel Elimination
T - 13-1. Commonly Used Enema Solutions
14. Oxygenation
14. Oxygenation
14-1. Using a Pulse Oximeter - Skills
14-10. Suctioning an Endotracheal Tube: Closed System - Skills
14-11. Securing an Endotracheal Tube - Skills
14-12. Suctioning a Tracheostomy: Open System - Skills
14-13. Providing Care of a Tracheostomy Tube and Site - Skills
14-14. Providing Care of a Chest Drainage System - Skills
14-15. Assisting with Removal of a Chest Tube - Skills
14-16. Using a Manual Resuscitation Bag and Mask - Skills
14-2. Teaching a Patient to Use a Peak Flow Meter - Skills
14-3. Teaching a Patient to Use an Incentive Spirometer - Skills
14-4. Administering Oxygen by Nasal Cannula - Skills
14-5. Administering Oxygen by Mask - Skills
14-6. Caring for a Patient Receiving Noninvasive Continuous Positive Airway Pressure - Skills
14-7. Suctioning the Oropharyngeal and Nasopharyngeal Airways - Skills
14-8. Inserting an Oropharyngeal Airway - Skills
14-9. Suctioning an Endotracheal Tube: Open System - Skills
B - 14-1. Tips to Address Common Problems Patients Encounter When Using Cpap and Possible Interventions
B - 14-2. Methods to Determine Suction Catheter Depth
F - 001-01. Yankauer suction device
F - 001-02. Assessing pulse
F - 001-03. Assessing capillary refill
F - 001-04. Attaching probe to patient's finger
F - 001-05. Connecting sensor probe to unit
F - 001-06. Checking alarms
F - 001-07. Oximetry probe on infant's toe
F - 002-01. Example of a commercially available peak flow meter
F - 002-02. Patient placing meter in mouth
F - 002-03. Patient blowing out has hard and fast as they can in a single blow
F - 003-01. Measuring nasopharyngeal airway
F - 003-02. Lubricating nasopharyngeal airway
F - 003-03. Inserting nasopharyngeal airway
F - 003-04. Nasopharyngeal airway inserted until the rim is touching the naris
F - 004-01. Rotating inner cannula while stabilizing outer cannula
F - 004-02. Removing inner cannula for cleaning
F - 004-03. Using brush to clean inner cannula
F - 004-04. Replacing inner cannula
F - 004-05. Pulling tape through faceplate opening alongside old tie until ends are an even length
F - 004-06. Cleaning cannula, when indicated
F - 005-01. Types of oxygen masks
F - 005-02. Connecting face mask to oxygen source
F - 005-03. Allowing oxygen to fill bag
F - 005-04. Applying face mask over nose and mouth
F - 005-05. Adjusting elastic straps
F - 005-06. Adjusting flow rate
F - 006-01. Examples of CPAP face mask/nosepiece
F - 006-02. Placing the CPAP machine on a stable surface near the bed
F - 006-03. Attaching the CPAP hose and mask/nosepiece
F - 006-04. CPAP mask/nosepiece properly fitted on the patient's face
F - 007-01. Adjusting wall suction
F - 007-02. Connecting suction catheter to tubing
F - 007-03. Dipping catheter into sterile saline
F - 007-04. Inserting catheter into naris
F - 007-05. Rotating the catheter as it is withdrawn to suction the nasopharynx
F - 007-06. Rinsing catheter
F - 008-01. Measuring for oropharyngeal airway
F - 008-02. Inserting airway with curved tip pointing toward the roof of the mouth
F - 008-03. Rotating the airway so the tip points down
F - 008-04. Auscultating breath sounds
F - 009-01. Turning suction unit to appropriate pressure
F - 009-02. Inserting suction catheter into endotracheal tube
F - 009-03. Withdrawing suction catheter and intermittently occluding Y-port with thumb to apply suction
F - 010-01. Closed suction device
F - 010-02. Turning suction device to appropriate pressure
F - 010-03. Grasping the catheter through the protective sheath and inserting into endotracheal tube
F - 010-04. Depressing suction button
F - 010-05. Removing suction catheter by pulling back into sheath
F - 011-01. Commercially available endotracheal tube holder
F - 011-02. Ensuring endotracheal tube is stabilized and removing old tape
F - 011-03. Moving endotracheal tube to other side of mouth
F - 011-04. Removing excess adhesive on cheeks from tape
F - 011-05. Placing the top-half of the tape under the patient's nose
F - 011-06. Applying pressure to the tape on the endotracheal tube to ensure the tape is secure
F - 012-01. Patient in semi-Fowler position
F - 012-02. Turning suction unit to appropriate pressure
F - 012-03. Putting on goggles and mask
F - 012-04. Connecting suction catheter to suction tubing
F - 012-05. Moistening catheter in saline solution
F - 012-06. Occluding Y-port to check for proper suction
F - 012-07. Intermittently occluding the Y-port on the catheter to apply suction while withdrawing catheter
F - 012-08. Removing gloves while keeping catheter inside
F - 013-01. Carefully opening package with new disposable inner cannula
F - 013-02. Releasing lock on inner cannula
F - 013-03. Locking new inner cannula in place
F - 013-04. Cleaning from stoma site, outward
F - 013-05. Securing tabs on tracheostomy holder
F - 013-06. Reapplying oxygen source
F - 014-01. Chest drainage system
F - 014-02. Assessing dressing at chest tube insertion site
F - 014-03. Drainage marked on device
F - 014-04. Padded clamps on chest tube
F - 014-05. Unrolling foam tape
F - 014-06. Carefully cutting foam tape
F - 014-07. Inserting the end of the new drainage system into the chest tube
F - 014-08. Heimlich valve connected to chest tube
F - 016-01. Connecting mask to bag-valve device
F - 016-02. Connecting oxygen tubing on bag to oxygen source
F - 016-03. Squeezing the resuscitation bag with mask sealed on face
Fundamental Reviews - 14-1. Factors Affecting Oxygenation and Perfusion
T - 14-1. Oxygen Delivery Systems
T - 14-2. Comparison of Chest Drainage Systems
15. Perfusion and Cardiovascular Care
15. Perfusion and Cardiovascular Care
15-1. Performing Cardiopulmonary Resuscitation - Skills
15-2. Performing Emergency Automated External Defibrillation - Skills
15-3. Performing Emergency Manual External Defibrillation (Asynchronous) - Skills
15-4. Obtaining an Electrocardiogram - Skills
15-5. Applying a Cardiac Monitor - Skills
15-6. Using a Transcutaneous (External) Pacemaker - Skills
15-7. Removing a Peripheral Arterial Catheter - Skills
B - 15-1. Special Situations Related to Automated External Defibrillation
B - 15-2. Electrocardiograph Complex
F - 001-01. Using correct body alignment for chest compressions
F - 001-02. Alternate hand position for chest compressions
F - 001-03. Using the head tilt-chin lift method to open the airway
F - 001-04. Using the jaw-thrust maneuver to open the airway
F - 001-05. A. Using a one-way valve mask.B. Using a handheld resuscitation bag
F - 001-06. Recovery position
F - 002-01. Automated external defibrillator (AED)
F - 002-02. AED electrode pad placement
F - 002-03. Stating a âClear the patientâ message
F - 003-01. External defibrillator
F - 003-02. Anterolateral placement of self-adhering electrode pads
F - 003-03. Anteroposterior placement of self-adhering electrode pads
F - 004-01. Electrocardiogram (waveform) strip
F - 004-02. 12-lead ECG lead placement
F - 004-03. Applying limb electrode
F - 004-04. A. Applying chest electrode.B. Applying chest lead
F - 004-05. Completed application of 12-lead ECG
F - 004-06. Observing tracing quality
F - 004-07. 12-Lead ECG configuration
F - 005-01. Electrode positions for 3- (left) and 5-lead (right) systems
F - 005-02. Applying the electrodes
F - 006-01. Transcutaneous pacemaker pads in place
F - 015-01. Cardiac anatomy
F - 015-02. Cardiac conduction system
F - 015-03. Cardiac landmarks: Reference lines
Fundamental Reviews - 15-1. Electrical Therapy Devices
16. Fluid, Electrolyte, and Acid-Base Balance
16. Fluid, Electrolyte, and Acid-Base Balance
16-1. Initiating a Peripheral Intravenous Catheter Access and Intravenous Infusion - Skills
16-10. Removing a Peripherally Inserted Central Catheter - Skills
16-2. Monitoring an Intravenous Site and Infusion - Skills
16-3. Changing an Intravenous Solution Container and Administration Set - Skills
16-4. Changing a Peripheral Venous Access Device Site Dressing - Skills
16-5. Capping for Intermittent Use and Flushing a Peripheral Venous Access Device - Skills
16-6. Administering a Blood Transfusion - Skills
16-7. Changing the Dressing and Flushing Central Venous Access Devices - Skills
16-8. Accessing an Implanted Port - Skills
16-9. Deaccessing an Implanted Port - Skills
B - 16-1. Regulating Intravenous Flow Rate
B - 16-2. Phlebitis Scale
B - 16-3. Recommended Administration Set Change Schedule
B - 16-4. Needleless Connectors
F - 001-01. Infusion sites
F - 001-02. Basic administration set for gravity/free-flow infusion
F - 001-03. Closing clamp on administration set
F - 001-04. Inserting administration set spike into entry site of IV fluid container
F - 001-05. Squeezing drip chamber to fill at least halfway
F - 001-06. Priming administration set
F - 001-07. Inserting administration set into electronic infusion device
F - 001-08. Applying tourniquet
F - 001-09. Stretching skin taut and inserting needle
F - 001-10. Venous access site with labeled dressing
F - 001-11. Inserting administration set into the end cap of venous access device
F - 001-12. Initiating IV fluid infusion
F - 001-13. Inspecting insertion site
F - 001-14. Attaching a passive disinfection cap to each access site
F - 002-01. Checking infusion device settings
F - 002-02. Checking drip chamber and timing drops
F - 002-03. Checking tubing for anything that might interfere with flow rate
F - 002-04. Inspecting IV site
F - 003-01. Scanning the bar code on container
F - 003-02. Removing administration spike from old IV fluid container
F - 003-03. Inserting administration set spike into entry port of new IV fluid container
F - 003-04. Reopening clamp and adjusting flow rate
F - 003-05. Inserting the end of the administration set into the needleless connector or end cap
F - 003-06. Making sure clamp is open on new tubing, with short extension tubing taped in place
F - 004-01. Carefully removing old dressing
F - 004-02. Cleansing the site with an antiseptic solution
F - 004-03. Applying skin protectant to site
F - 004-04. Applying transparent dressing to site
F - 004-05. Site dressing with label and anchored tubing
F - 005-01. Using an antimicrobial swab to disinfect the connection surface and sides of the needleless connector or end cap on the extension tubing
F - 005-02. Flushing venous access device
F - 006-01. Squeezing the drip chamber to saturate the filter
F - 006-02. Assessing vital signs after 15 minutes
F - 007-01. Placement of peripherally inserted central catheter (PICC)
F - 007-02. Placement of triple-lumen, nontunneled percutaneous central venous catheter
F - 007-03. Tunneled percutaneous central venous catheter
F - 007-04. Inspecting CVAD insertion site
F - 007-05. Applying antimicrobial dressing
F - 007-06. Applying site dressing
F - 007-07. Attaching a passive disinfection cap to each access site
F - 008-01. An implanted port with catheter inserted in subclavian vein and noncoring needle inserted into port
F - 008-02. Stabilizing port with nondominant hand
F - 008-03. Inserting needle through skin into port
F - 008-04. Noncoring (Huber) needle in place
F - 008-05. Aspirating for blood return
F - 008-06. Removing gripper from needle
F - 008-07. Attaching a passive disinfection cap
F - 009-01. Flushing port with saline
F - 009-02. Pulling needle from port with autoengagement of needle guard
F - 010-01. Removing PICC in small increments, using a smooth and constant motion
Fundamental Reviews - 16-1. Average Adult Daily Fluid Sources and Losses
Fundamental Reviews - 16-2. Selected IV Solutions
Fundamental Reviews - 16-3. Complications Associated with Intravenous Infusions
T - 16-1. Blood Products
T - 16-2. Transfusion Reactions
17. Neurologic Care
17. Neurologic Care
17-1. Applying a Two-Piece Cervical Collar - Skills
17-2. Employing Seizure Precautions and Seizure Management - Skills
17-3. Caring for a Patient with a Halo External Fixation Device (Halo Traction) - Skills
17-4. Caring for a Patient with an External Ventriculostomy (Intraventricular Catheter-Closed Fluid-Filled System) - Skills
17-5. Caring for a Patient with a Fiberoptic Intracranial Catheter - Skills
B - 17-1. Signs and Symptoms of Increased Intracranial Pressure in Adults
B - 17-2. Interpreting ICP Waveforms
F - 001-01. Cervical collar in place
F - 001-02. Sliding the flattened back portion of the collar under the patient's head
F - 001-03. Securing the front and back halves of the cervical collar
F - 002-01. Protecting patient from injury
F - 003-01. Examining halo vest for stability, secure connections, and positioning
F - 003-02. Cleansing pin sites
F - 004-01. Transducer leveled with tragus
F - 004-02. Sutured external ventriculostomy catheter
F - 005-01. Fiberoptic catheter in ventricle
Fundamental Reviews - 17-1. Fundamental Review 17-1
Fundamental Reviews - 17-2. Brief Neurologic Exam
Fundamental Reviews - 17-3. Glasgow Coma Scale
Fundamental Reviews - 17-4. The Full Outline of Unresponsiveness (Four)
18. Laboratory Specimen Collection
18. Laboratory Specimen Collection
18-1. Obtaining a Nasal Swab - Skills
18-10. Obtaining a Venous Blood Specimen for Culture and Sensitivity - Skills
18-11. Obtaining an Arterial Blood Specimen for Blood Gas Analysis - Skills
18-12. Obtaining a Blood Sample From a Central Venous Access Device - Skills
18-13. Obtaining an Arterial Blood Sample From an Arterial Catheter - Skills
18-2. Obtaining a Nasopharyngeal Swab - Skills
18-3. Collecting a Sputum Specimen for Culture - Skills
18-4. Collecting a Urine Specimen (Clean Catch, Midstream) - Skills
18-5. Obtaining a Urine Specimen From an Indwelling Urinary Catheter - Skills
18-6. Testing Stool for Occult Blood - Skills
18-7. Collecting a Stool Specimen - Skills
18-8. Obtaining a Capillary Blood Sample for Glucose Testing - Skills
18-9. Using Venipuncture to Collect a Venous Blood Sample - Skills
B - 18-1. Characteristics of Sputum and Potential Causes
F - 001-01. Suction trap for sputum collection
F - 002-01. A. Observing the nasopharynx and inserting swab.B. Nasopharyngeal swab inserted to the posterior wall of the nasopharynx
F - 003-01. Instructing patient to expectorate into the collection container
F - 003-02. Labeling specimen container
F - 003-03. Placing specimen container in biohazard bag
F - 004-01. Instructing patient about urine collection procedure
F - 004-02. Cleaning female perineum
F - 004-03. Cleaning male perineum
F - 005-01. Attaching the syringe to the needleless aspiration port and slowly withdrawing urine specimen
F - 006-01. Using a wooden applicator to transfer stool specimen to window of testing card
F - 006-02. Applying developer to card windows
F - 006-03. Observing windows on card for blue areas
F - 006-04. Observing for pink color on test (T) line and the control (C) line
F - 007-01. Plastic specimen collection receptacle in toilet to catch stool
F - 007-02. Transferring stool to specimen container
F - 007-03. Placing specimen container in biohazard bag
F - 008-01. Piercing patient's finger with lancet
F - 008-02. Applying blood to test strip
F - 009-01. Blood vessels in the arm typically used for venipuncture
F - 009-02. Cleaning the patient's skin at the venipuncture site
F - 009-03. Reapplying the tourniquet
F - 009-04. Inserting the needle at a 15-degree angle, with the bevel up
F - 009-05. Observing blood flowing into the collection tube
F - 010-01. Applying the tourniquet
F - 010-02. Aligning the butterfly needle with the chosen vein
F - 010-03. Inserting the needle with the bevel up at a 15- to 30-degree angle
F - 010-04. Stabilizing the butterfly needle and pushing the Vacutainer onto the aerobic collection bottle, keeping the bottle upright while filling
F - 010-05. Placing a label on specimen container
F - 010-06. Placing specimen containers in biohazard bag
F - 011-01. Performing Allen's test
F - 011-02. Observing blood backflow into syringe
F - 012-01. Removing the passive disinfection cap or nonvented cap from the end of the lumen
F - 012-02. Inserting the flush syringe into the needleless connector
F - 012-03. Pulling back on the syringe to aspirate for positive blood return
F - 012-04. Connecting the needleless adapter of the Vacutainer to the connector or end cap on the CVAD lumen
F - 012-05. Inserting the blood sample tube to collect discard blood volume
F - 013-01. Pressure monitoring system
F - 013-02. Closed blood collection/withdrawal system
Fundamental Reviews - 18-1. Characteristics of Urine
Fundamental Reviews - 18-2. Characteristics of Stool
T - 18-1. Arterial Blood Gas: Normal Values
7. Hygiene
7. Hygiene
7-1. Assisting with a Shower or Tub Bath - Skills
7-10. Making an Unoccupied Bed - Skills
7-11. Making an Occupied Bed - Skills
7-2. Providing a Bed Bath - Skills
7-3. Assisting the Patient with Oral Care - Skills
7-4. Providing Oral Care for the Dependent Patient - Skills
7-5. Providing Denture Care - Skills
7-6. Removing Contact Lenses - Skills
7-7. Shampooing a Patient's Hair in Bed - Skills
7-8. Assisting the Patient to Shave - Skills
7-9. Providing Nail Care - Skills
B - 7-1. Meeting the Bathing Needs of Patients with Dementia
B - 7-2. Meeting the Oral Hygiene Needs of Patients with Cognitive Impairments
F - 001-01. Performing female perineal care
F - 001-02. Performing male perineal care
F - 002-01. Commercial self-contained bathing system
F - 002-02. Exposing the far arm and washing it
F - 002-03. Washing the abdomen, with perineal and chest areas covered
F - 002-04. Washing and drying far leg, keeping the other leg covered
F - 002-05. Washing the back
F - 003-01. Centering lens
F - 003-02. Gently pulling outer corner of eye toward ear
F - 003-03. Receiving lens as patient blinks
F - 003-04. Spreading eyelids
F - 003-05. Pressing lower lid up against bottom of lens
F - 003-06. Sliding lens out between lids
F - 004-01. Placing warmed shampoo cap on the patient's head
F - 004-02. Massaging the hair and scalp
F - 004-03. Using suction to remove excess fluid
F - 004-04. Example of a suction toothbrush
F - 005-01. Grasping side edge of sheet and lifting off the bed
F - 005-02. Laying sheet on top of bed to make triangular, flat fold
F - 005-03. Tucking the loose part of the sheet under the mattress
F - 005-04. Picking up the top of the triangular fold to place down over the side of the mattress
F - 005-05. Tucking the loose portion of triangular fold under mattress
F - 005-06. Tucking remaining sheet snugly under mattress
F - 006-01. Retracting lower lid with one hand and using pad of index finger of other hand to move lens down to the sclera
F - 006-02. Using the pads of thumb and index finger to grasp lens with a gentle pinching motion to remove it
F - 006-03. Storage cases are marked L and R, designating left and right lenses
F - 007-01. Placing protective pad under patient's head
F - 007-02. Placing patient's head on shampoo board
F - 007-03. Positioning drain container for shampoo board
F - 007-04. Pouring warm water over patient's head
F - 007-05. Rinsing shampoo from patient's head
F - 007-06. Patting patient's hair dry
F - 008-01. Applying shaving cream to face
F - 008-02. Shaving face
F - 008-03. Using a wet washcloth to remove remaining shaving cream
F - 009-01. Gently cleaning under nails
F - 009-02. Trimming straight across nails with clipper
F - 009-03. Gently pushing cuticles back off nail
F - 009-04. Drying hand thoroughly
F - 010-01. Bundling soiled linens in bottom sheet and holding them away from clothing
F - 010-02. Pushing the bottom sheet open to the center of the mattress
F - 010-03. Placing lifting/repositioning sheet on bed
F - 010-04. Mitering corner of top sheet and blanket
F - 010-05. Cuffing top linens
F - 011-01. Removing top linens from under bath blanket
F - 011-02. Moving soiled linen as close to patient as possible
F - 011-03. Pulling the bottom sheet over the corners at the head and foot of the mattress
F - 011-04. Pushing the bottom sheet toward the center of the bed, positioning it under old linens
F - 011-05. Tucking lifting/repositioning or friction-reducing sheet tightly
F - 011-06. Removing soiled bottom linens from other side of bed
F - 011-07. Removing bath blanket from under top linens
Fundamental Reviews - 7-1. General Skin Care Principles
T - 7-1. Cleaning and Skin Care Products
8. Skin Integrity and Wound Care
8. Skin Integrity and Wound Care
8-1. Preventing Pressure Injury - Skills
8-10. Removing Surgical Staples - Skills
8-11. Applying an External Heating Pad - Skills
8-12. Applying a Warm Compress - Skills
8-13. Assisting with a Sitz Bath - Skills
8-14. Applying Cold Therapy - Skills
8-2. Cleaning a Wound and Applying a Dressing (General Guidelines) - Skills
8-3. Performing Irrigation of a Wound - Skills
8-4. Collecting a Wound Culture - Skills
8-5. Caring for a Penrose Drain - Skills
8-6. Caring for a Jackson-Pratt Drain - Skills
8-7. Caring for a Hemovac Drain - Skills
8-8. Applying Negative-Pressure Wound Therapy - Skills
8-9. Removing Sutures - Skills
B - 8-1. Risk Factors Contributing to Development of Pressure Injuries
B - 8-2. Risk Factors for Medical Adhesive-Related Skin Injury
B - 8-3. Cleaning a Wound
F - 002-01. Loosening dressing tape or adhesive edge
F - 002-02. Noting characteristics of drainage on dressing that has been removed
F - 002-03. Cleaning the skin surrounding the wound
F - 002-04. Applying skin protectant to skin surrounding the wound
F - 002-05. Applying prescribed wound care product
F - 002-06. Applying cover dressing to site
F - 003-01. Drawing up solution into irrigation syringe
F - 003-02. Applying pressure to basin to form seal
F - 003-03. Irrigating wound with a stream of solution
F - 003-04. Drying around wound, not in wound, with gauze pad
F - 003-05. Applying wound contact material
F - 004-01. Checking culture label with the patient's identification band
F - 004-02. Removing cap from culture tube
F - 004-03. Rotating swab several times over wound surface
F - 004-04. Placing swab in culture tube
F - 004-05. Labeled culture tube in biohazard bag
F - 005-01. Cleaning drain site in circular motion toward periphery
F - 005-02. Placing pre-split dressing around Penrose drain
F - 005-03. Applying gauze pads over drain
F - 006-01. Jackson-Pratt drain
F - 006-02. Emptying contents of Jackson-Pratt drain into collection container
F - 006-03. Compressing Jackson-Pratt drain and replacing cap
F - 006-04. Compressed drain bulb
F - 007-01. Hemovac drain
F - 007-02. Emptying Hemovac drain into collection container
F - 007-03. Compressing Hemovac and securing cap
F - 008-01. Principles of negative pressure wound therapy
F - 008-02. Examples of components of an NPWT system
F - 008-03. Single-use NPWT (sNPWT)
F - 008-04. Cutting wound contact material (foam) to shape and measurement of wound
F - 008-05. Placing transparent adhesive drape to cover the wound
F - 008-06. Cutting a hole in the drape
F - 008-07. Applying the connecting pad over the hole
F - 008-08. Dressing is collapsed, shrinking to wound contact material and skin
F - 009-01. Incision with sutures
F - 009-02. Using forceps to pull up on a suture and cutting suture with sterile scissors
F - 009-03. Applying adhesive closure strips on incision
F - 010-01. Incision with surgical staples
F - 010-02. Grasping staple remover
F - 010-03. Firmly closing the staple remover, bending the staple in the middle, pulling the edges up out of the skin
F - 011-01. External heating pad electronic unit
F - 011-02. Attaching pad tubing to electronic unit tubing
F - 011-03. Applying heating pad to the prescribed area
F - 012-01. Applying compress to the intended area
F - 012-02. Covering site with clean dry bath towel
F - 013-01. Disposable sitz bath in place in toilet
F - 014-01. Filling ice bag with ice
F - 014-02. Covering ice bag with cover
F - 014-03. Positioning ice bag on the intended area and securing in place
Fundamental Reviews - 8-1. General Wound Assessment
Fundamental Reviews - 8-2. Measuring Wounds and Pressure Injuries
Fundamental Reviews - 8-3. Pressure Injury Stages
Fundamental Reviews - 8-4. Clean (Nonsterile) Technique and Wound Care
Fundamental Reviews - 8-5. Examples of Wound Dressings/Products
9. Activity
9. Activity
9-1. Assisting a Patient with Repositioning in Bed - Skills
9-10. Applying and Removing Graduated Compression Stockings - Skills
9-11. Applying Pneumatic Compression Devices - Skills
9-12. Applying a Continuous Passive Motion Device - Skills
9-13. Applying a Sling - Skills
9-14. Applying a Figure-Eight Bandage - Skills
9-15. Assisting with Cast Application - Skills
9-16. Caring for a Patient with a Cast - Skills
9-17. Applying Skin Traction and Caring for a Patient in Skin Traction - Skills
9-18. Caring for a Patient in Skeletal Traction - Skills
9-19. Caring for a Patient with an External Fixation Device - Skills
9-2. Transferring a Patient From the Bed to a Stretcher - Skills
9-3. Transferring a Patient From the Bed to a Chair - Skills
9-4. Transferring a Patient Using a Powered Full-Body Sling Lift - Skills
9-5. Providing Range-of-Motion Exercises - Skills
9-6. Assisting a Patient with Ambulation - Skills
9-7. Assisting a Patient with Ambulation Using a Walker - Skills
9-8. Assisting a Patient with Ambulation Using Crutches - Skills
9-9. Assisting a Patient with Ambulation Using a Cane - Skills
B - 9-1. Safe Handling of Patients with Dementia
B - 9-2. Principles of Effective Traction
F - 001-01. Example of an algorithm (assessment tool) to aid in decision making regarding safe patient handling and mobility to reposition a patient in bed
F - 001-02. Example of a repositioning sheet for use with a lift
F - 002-01. Example of an algorithm to aid in decision making regarding safe patient handling and mobility to transfer a patient from bed to stretcher
F - 002-02. Example of an air-assisted transfer device
F - 002-03. Using sheet to roll patient away from stretcher
F - 002-04. Positioning transfer device under patient
F - 002-05. Transferring patient onto stretcher
F - 002-06. Patient on stretcher
F - 003-01. Example of an algorithm to aid in decision making regarding safe patient handling and mobility to transfer a patient from bed to a chair
F - 003-02. Powered stand-assist device
F - 003-03. Example of a stand-assist aid
F - 003-04. Wrapping gait belt around patient's waist
F - 004-01. Rolling patient to one side and placing rolled sling underneath patient
F - 004-02. Rolling patient to opposite side and pulling sling under patient
F - 004-03. Widening stance of lift base
F - 004-04. Lowering lift arms
F - 004-05. Connecting lift straps
F - 004-06. Raising patient 6 inches above bed
F - 004-07. Positioning patient in sling over chair
F - 004-08. Lowering patient in sling into chair
F - 005-01. Moving patient's chin down to rest on chest
F - 005-02. Holding patient's head upright and centered
F - 005-03. Moving patient's head to one shoulder
F - 005-04. Moving patient's chin toward one shoulder
F - 005-05. Holding patient's arm at side
F - 005-06. Lifting patient's arm above patient's head
F - 005-07. Moving patient's arm laterally to an upright position above patient's head
F - 005-08. Moving arm across patient's body as far as possible
F - 005-09. Raising patient's arm until upper arm is in line with patient's shoulder, with elbow bent
F - 005-10. Bending patient's elbow, lower arm, and hand upward toward shoulder
F - 005-11. Rotating patient's lower arm and hand so palm is up
F - 005-12. Moving patient's hand downward toward inner aspect of forearm
F - 005-13. Returning hand to neutral position
F - 005-14. Bending patient's fingers to make a fist
F - 005-15. Straightening out patient's fingers
F - 005-16. Spreading patient's fingers apart
F - 005-17. Assisting patient to touch thumb to each finger on hand
F - 005-18. Extending and lifting patient's leg
F - 005-19. Lifting patient's leg laterally away from body (abduction)
F - 005-20. Returning leg back toward other leg and trying to extend it beyond midline, if possible
F - 005-21. Turning patient's foot and leg toward opposite leg to rotate it internally
F - 005-22. Turning patient's foot and leg outward, away from opposite leg, to rotate it externally
F - 005-23. Bending patient's leg and bringing heel toward back of leg
F - 005-24. Returning leg to a straight position
F - 005-25. At the ankle, moving patient's foot up and back until toes are upright
F - 005-26. Moving patient's foot with toes pointing down
F - 005-27. Turning sole toward midline
F - 005-28. Turning sole outward
F - 005-29. Curling patient's toes downward
F - 005-30. Straightening patient's toes
F - 005-31. Spreading patient's toes apart
F - 005-32. Bringing patient's toes together
F - 006-01. Example of an algorithm to aid in decision making regarding safe patient handling and mobility to assist a patient with ambulation
F - 006-02. Nurse positioned to side and slightly behind patient while walking, supporting patient by gait belt or waist
F - 007-01. Setting walker in front of a seated patient
F - 007-02. Assisting patient to walk with walker
F - 008-01. Assisting patient to stand erect facing forward in tripod position
F - 009-01. Nurse stands slightly behind patient
F - 010-01. Pulling graduated compression stocking inside-out
F - 010-02. Putting foot of stocking onto patient
F - 010-03. Ensuring heel is centered after stocking is on foot
F - 010-04. Pulling stocking up leg
F - 010-05. Pulling stocking up over thigh
F - 011-01. PCD machine at foot of bed
F - 011-02. Wrap the PCD sleeve snugly around the patient's leg
F - 011-03. PCD sleeves around patient's legs with sleeve tubing connected to device
F - 012-01. Placing patient's leg into CPM machine
F - 012-02. Adjusting footplate to maintain patient's foot in a neutral position
F - 012-03. Using two fingers to check fit between straps and leg
F - 013-01. Placing patient's arm into canvas sling
F - 013-02. Fastening the strap to the sling
F - 013-03. Placing padding between strap and patient's neck
F - 013-04. Patient with sling in place
F - 014-01. Wrapping bandage around patient's limb twice, below joint, to anchor it
F - 014-02. Using alternating ascending and descending turns to form a figure eight
F - 014-03. Overlapping each turn of bandage by one half to two thirds strip width
F - 014-04. Wrapping bandage around patient's limb twice, above joint, to anchor it
F - 015-01. Stockinette in place
F - 015-02. Casting material being applied
F - 015-03. Using palms to handle casted limb
F - 016-01. Assessing skin and neurovascular function, comparing with noncasted extremity
F - 016-02. Marking any breakthrough bleeding on cast, indicating date and time
F - 017-01. Applying traction boot with a compression stocking in place on leg
F - 017-02. Applying weight for skin traction
F - 017-03. Assessing distal pulses
F - 017-04. Assessing capillary refill
F - 017-05. Skin traction in place
F - 018-01. Skeletal traction in place, weights hanging freely
F - 018-02. Cleaning around pin sites with normal saline on an applicator
F - 019-01. External fixation device in place
F - 019-02. Cleaning around pin sites with normal saline on an applicator
Fundamental Reviews - 9-1. Effects of Immobility on the Body
Fundamental Reviews - 9-2. Guidelines for Safe Patient Handling and Movement
Fundamental Reviews - 9-3. Sphm Equipment and Devices
Fundamental Reviews - 9-4. Bedside Mobility Assessment Tool (Bmat 2.0)
III. Integrated Case Studies
Appendix A.Guidelines for Delegation Decision Making
Appendix B.Equivalents
Appendix C.Adult Laboratory Values*
Front Matter
