Chapter 32: Vital Chapter 32: Vital SignsSigns

Bonnie M. Wivell, MS, RN, Bonnie M. Wivell, MS, RN, CNSCNS

VITAL SIGNSVITAL SIGNS TEMPERATURETEMPERATURE BLOOD PRESSUREBLOOD PRESSURE PULSEPULSE

APICALAPICAL RADIALRADIAL

RESPIRATIONSRESPIRATIONS PULSE OXIMETRYPULSE OXIMETRY PAIN SCALEPAIN SCALE

VITAL SIGNS ARE PART OF VITAL SIGNS ARE PART OF THE PHYSICAL ASSESSMENTTHE PHYSICAL ASSESSMENT

Delegation of Duties to UAPDelegation of Duties to UAP Unlicensed Assistive PersonnelUnlicensed Assistive Personnel

RN is Responsible to Manage Care RN is Responsible to Manage Care Based on Physical AssessmentBased on Physical Assessment Administering medicationsAdministering medications Communicating to other members of Communicating to other members of

the health care teamthe health care team Supervising delegated tasksSupervising delegated tasks

EQUIPMENTEQUIPMENT

RN is responsible for assuring RN is responsible for assuring equipment is functioning properlyequipment is functioning properly Appropriate equipmentAppropriate equipment

Must be appropriate to patient age sizeMust be appropriate to patient age size ThermometerThermometer Stethescope: Diaphragm (high-pitched Stethescope: Diaphragm (high-pitched

sounds); bell (low-pitched sounds)sounds); bell (low-pitched sounds) BP cuffBP cuff Pulse oximeterPulse oximeter

PATIENT HISTORYPATIENT HISTORY

RN must know patient medical RN must know patient medical history, including medicationshistory, including medications These facts can affect vital signsThese facts can affect vital signs

RN is responsible for knowing the RN is responsible for knowing the patient’s usual vital sign rangepatient’s usual vital sign range

FREQUENCY OF VITAL FREQUENCY OF VITAL SIGNSSIGNS

Physicians order the frequency of vital Physicians order the frequency of vital signssigns Could be ordered by protocol or policyCould be ordered by protocol or policy

The RN can increase the frequency based The RN can increase the frequency based on his/her assessmenton his/her assessment

VITAL SIGNS can be an early warning VITAL SIGNS can be an early warning sign that complications are developingsign that complications are developing

INDICATIONS FOR INDICATIONS FOR MEDICATION MEDICATION

ADMINISTRATIONADMINISTRATION

Many medications are administered Many medications are administered when the vital signs are within an when the vital signs are within an acceptable range. acceptable range.

Accurate VITAL SIGNS are required Accurate VITAL SIGNS are required in order to make treatment decisions.in order to make treatment decisions.

COMPREHENSIVE COMPREHENSIVE ASSESSMENT FINDINGSASSESSMENT FINDINGS

Compare VITAL SIGNS to Compare VITAL SIGNS to assessment findings and laboratory assessment findings and laboratory results to accurately interpret the results to accurately interpret the patient status.patient status.

Discuss your findings with peers and Discuss your findings with peers and charge RN before deciding on a plan charge RN before deciding on a plan of action. of action.

TEMPERATURETEMPERATURE Factors affecting body temp. (36-Factors affecting body temp. (36-

3838°C/96.8-100.4°F)°C/96.8-100.4°F) AgeAge

Infants: 95.9 – 99.5Infants: 95.9 – 99.5° F° F Elderly: Average temp is 96.8° F; Sensitive Elderly: Average temp is 96.8° F; Sensitive

to temp extremesto temp extremes ExerciseExercise Hormone levelsHormone levels Circadian rhythmCircadian rhythm StressStress EnvironmentEnvironment

TEMPERATURE TEMPERATURE ALTERATIONSALTERATIONS

AfebrileAfebrile Fever of unknown origin (FUO)Fever of unknown origin (FUO) Malignant hyperthermia: hereditary, Malignant hyperthermia: hereditary,

occurs during anesthesiaoccurs during anesthesia Heatstroke: medical emergencyHeatstroke: medical emergency Heat exhaustionHeat exhaustion HypothermiaHypothermia FrostbiteFrostbite

TEMPERATURE Cont’d.TEMPERATURE Cont’d.

SitesSites Core temp is measured in pulmonary Core temp is measured in pulmonary

artery, esophagus, and urinary bladderartery, esophagus, and urinary bladder Mouth, rectum, tympanic membrane, Mouth, rectum, tympanic membrane,

temporal artery, and axillatemporal artery, and axilla Variety of types available – Variety of types available –

electronic and disposableelectronic and disposable Antipyretics = drugs that reduce Antipyretics = drugs that reduce

feverfever

PULSEPULSE

SitesSites Temporal, Carotid, Apical, Brachial, Radial, Temporal, Carotid, Apical, Brachial, Radial,

Femoral, Popliteal, Posterior Tibial, Dorsalis Femoral, Popliteal, Posterior Tibial, Dorsalis PedisPedis

Increases in HRIncreases in HR Short-term exercise, fever, heat, pain, anxiety, Short-term exercise, fever, heat, pain, anxiety,

drugs, loss of blood, standing or sitting, poor drugs, loss of blood, standing or sitting, poor oxygenationoxygenation

Decreases in HRDecreases in HR Long-term exercise, hypothermia, relaxation, Long-term exercise, hypothermia, relaxation,

drugs, lying downdrugs, lying down

PULSE Cont’d.PULSE Cont’d. Volume of blood pumped by the heart Volume of blood pumped by the heart

during 1 minute is the cardiac outputduring 1 minute is the cardiac output When mechanical, neural or chemical When mechanical, neural or chemical

factors are unable to alter stroke volume, factors are unable to alter stroke volume, a change in heart rate will result in a change in heart rate will result in change in cardiac output, which affects change in cardiac output, which affects blood pressureblood pressure HR HR ↑, less time for heart to fill, BP ↓↑, less time for heart to fill, BP ↓ HR ↓, filling time is increased, BP ↑HR ↓, filling time is increased, BP ↑

An abnormally slow, rapid, or irregular An abnormally slow, rapid, or irregular pulse alters cardiac outputpulse alters cardiac output

RESPIRATIONSRESPIRATIONS

Ventilation = the movement of gases Ventilation = the movement of gases in and out of lungsin and out of lungs

Diffusion = the movement of oxygen Diffusion = the movement of oxygen and CO2 between the alveoli and and CO2 between the alveoli and RBCsRBCs

Perfusion = the distribution of RBCs Perfusion = the distribution of RBCs to and from the pulmonary to and from the pulmonary capillariescapillaries

Factors Influencing Factors Influencing Character of RespirationsCharacter of Respirations

ExerciseExercise Acute PainAcute Pain AnxietyAnxiety SmokingSmoking Body PositionBody Position MedicationsMedications Neurological injuryNeurological injury Hemoglobin Hemoglobin

functionfunction

RESPIRATIONS Cont’d.RESPIRATIONS Cont’d.

Tachypnea = rapid breathingTachypnea = rapid breathing Apnea = cessation of breathingApnea = cessation of breathing Cheyne-Stokes = rate and depth Cheyne-Stokes = rate and depth

irregular, alternate periods of apnea irregular, alternate periods of apnea and hyperventilationand hyperventilation

Kussmaul’s = abnormally deep, Kussmaul’s = abnormally deep, regular, and increased in rate regular, and increased in rate (associated with DM)(associated with DM)

PULSE OXIMETERPULSE OXIMETER

Indirect measurement of oxygen Indirect measurement of oxygen saturationsaturation

Photodetector detects the amount of Photodetector detects the amount of oxygen bound to hemoglobin oxygen bound to hemoglobin molecules and oximeter calculates molecules and oximeter calculates the pulse saturationthe pulse saturation

Only reliable when SaO2 is over 70%Only reliable when SaO2 is over 70%

BLOOD PRESSUREBLOOD PRESSURE

Force exerted on the walls of an Force exerted on the walls of an artery by the pulsing blood under artery by the pulsing blood under pressure from the heartpressure from the heart

Systolic = maximum pressure when Systolic = maximum pressure when ejection occursejection occurs

Diastolic = minimum pressure of Diastolic = minimum pressure of blood remaining in the arteries after blood remaining in the arteries after ventricles relaxventricles relax

BLOOD PRESSURE BLOOD PRESSURE Cont’d.Cont’d.

Physiology of arterial blood pressurePhysiology of arterial blood pressure Cardiac Output, Peripheral resistance, Cardiac Output, Peripheral resistance,

Blood volume, Viscosity, ElasticityBlood volume, Viscosity, Elasticity Factors influencing BPFactors influencing BP

Age, Stress, Ethnicity, Gender, Daily Age, Stress, Ethnicity, Gender, Daily Variation, Meds, Activity, Weight, Variation, Meds, Activity, Weight, SmokingSmoking

HypertensionHypertension HypotensionHypotension Orthostatic or postural hypotensionOrthostatic or postural hypotension

Chapter 34: INFECTION Chapter 34: INFECTION PREVENTION and PREVENTION and

CONTROLCONTROL

CHAIN OF INFECTIONCHAIN OF INFECTION

MODES OF MODES OF TRANSMISSIONTRANSMISSION

DIRECTDIRECT PERSON TO PERSON (FECAL-ORAL)PERSON TO PERSON (FECAL-ORAL)

HEPATITIS AHEPATITIS A STAPHSTAPH

INDIRECTINDIRECT CONTACT WITH CONTAMINATED CONTACT WITH CONTAMINATED

OBJECTOBJECT HEPATITIS B AND CHEPATITIS B AND C HIVHIV RSVRSV MRSAMRSA

MODES OF MODES OF TRANSMISSIONTRANSMISSION

DROPLET TRANSMISSIONDROPLET TRANSMISSION LARGE PARTICLESLARGE PARTICLES CAN TRAVEL UP TO 3 FEETCAN TRAVEL UP TO 3 FEET

INFLUENZAINFLUENZA RUBELLA (3-day/GERMAN MEASLES)RUBELLA (3-day/GERMAN MEASLES) BACTERIAL MENINGITISBACTERIAL MENINGITIS

SNEEZESNEEZE OR COUGHOR COUGH

MODES OF MODES OF TRANSMISSIONTRANSMISSION

AIRBORNEAIRBORNE DROPLETS SUSPENDED IN AIR AFTER DROPLETS SUSPENDED IN AIR AFTER

COUGHING AND SNEEZING OR CARRIED COUGHING AND SNEEZING OR CARRIED ON DUST PARTICLESON DUST PARTICLES

TBTB CHICKEN POXCHICKEN POX MEASLES (RUBEOLA)MEASLES (RUBEOLA) ASPERGILLUSASPERGILLUS

VECTORVECTOR EXTERNAL MECHANICAL TRANSFEREXTERNAL MECHANICAL TRANSFER MOSQUITO,, LOUSE, FLEA, TICK, FLYMOSQUITO,, LOUSE, FLEA, TICK, FLY

WEST NILE VIRUSWEST NILE VIRUS MALARIAMALARIA LYME DISEASELYME DISEASE

NORMAL DEFENSESNORMAL DEFENSES

INFLAMMATORY RESPONSEINFLAMMATORY RESPONSE NORMAL BODY FLORANORMAL BODY FLORA CILIA IN LUNGSCILIA IN LUNGS INTACT SKININTACT SKIN pH OF BODY FLUIDS pH OF BODY FLUIDS

ACIDIC GASTRIC SECRETIONSACIDIC GASTRIC SECRETIONS ALKALINE VAGINAL SECRETIONSALKALINE VAGINAL SECRETIONS

Types of InfectionsTypes of Infections Heath Care-Associated InfectionsHeath Care-Associated Infections (HAIs – (HAIs –

formerly called nosocomial): result from delivery formerly called nosocomial): result from delivery of health services in a health care facilityof health services in a health care facility

Iatrogenic:Iatrogenic: a type of HAI from a diagnostic or a type of HAI from a diagnostic or therapeutic procedure therapeutic procedure

Exogenous:Exogenous: an infection that is present outside an infection that is present outside the client, i.e. a post-op infectionthe client, i.e. a post-op infection

Endogenous:Endogenous: an infection that occurs when an infection that occurs when part of the client’s flora becomes altered or part of the client’s flora becomes altered or overgrowth results, i.e. C. Diff, vaginal yeast overgrowth results, i.e. C. Diff, vaginal yeast infectioninfection

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VIGNETTEVIGNETTE An older adult, hospitalized with a An older adult, hospitalized with a

GI disorder is on bedrest and GI disorder is on bedrest and requires assistance for uncontrolled requires assistance for uncontrolled diarrhea stools.diarrhea stools.

Following one episode of cleaning Following one episode of cleaning the patient and changing the bed the patient and changing the bed linens, the nurse went to a second linens, the nurse went to a second patient to provide tracheostomy patient to provide tracheostomy care.care.

The nurses hands were not washed The nurses hands were not washed before assisting the second patientbefore assisting the second patient

VIGNETTE ANALYSISVIGNETTE ANALYSIS

INFECTIOUS INFECTIOUS AGENTAGENT

RESERVOIRRESERVOIR PORTAL OF EXITPORTAL OF EXIT MODE OF MODE OF

TRANSMISSIONTRANSMISSION PORTAL OF PORTAL OF

ENTRYENTRY SUSCEPTIBLE SUSCEPTIBLE

HOSTHOST

EESCHERICHIA SCHERICHIA COLICOLI

LARGE LARGE INTESTINESINTESTINES

FECESFECES NURSE’S HANDSNURSE’S HANDS

TRACHEOSTOMY TRACHEOSTOMY OLDER ADULT OLDER ADULT

WITH WITH TRACHEOSTOMYTRACHEOSTOMY

NURSING PROCESSNURSING PROCESS ASSESSMENTASSESSMENT

PATIENTPATIENT CLIENT SUSCEPTIBILITY CLIENT SUSCEPTIBILITY

Status of DEFENSE MECHANISMS (smoker?)Status of DEFENSE MECHANISMS (smoker?) AGE – very young and very oldAGE – very young and very old NUTRITIONAL STATUS – decreased protein NUTRITIONAL STATUS – decreased protein

intake reduces the body’s defenses against intake reduces the body’s defenses against infection and impairs wound healinginfection and impairs wound healing

STRESS – lowers immunitySTRESS – lowers immunity DISEASE PROCESS – HIV, Leukemia, DISEASE PROCESS – HIV, Leukemia,

LymphomaLymphoma

LABORATORY DATALABORATORY DATA CLIENT NEEDS RELATED TO CLIENT NEEDS RELATED TO

DISEASE STATUSDISEASE STATUS

NURSING PROCESSNURSING PROCESS

NURSING DIAGNOSISNURSING DIAGNOSIS

RISK FOR INFECTION R/T RISK FOR INFECTION R/T COMPROMISED DEFENSE COMPROMISED DEFENSE

MECHANISM AS EVIDENCED BY MECHANISM AS EVIDENCED BY PRESENCE OF TRACHEOSTOMYPRESENCE OF TRACHEOSTOMY

NURSING PROCESS NURSING PROCESS

PLANNINGPLANNING GOALGOAL

PATIENT WILL REMAIN FREE FROM PATIENT WILL REMAIN FREE FROM INFECTIONINFECTION

EXPECTED OUTCOMEEXPECTED OUTCOME PATIENT WILL REMAIN AFEBRILEPATIENT WILL REMAIN AFEBRILE CLIENT WILL HAVE NO CLIENT WILL HAVE NO

SIGNS/SYMPTOMS OF INFECTIONSIGNS/SYMPTOMS OF INFECTION

NURSING PROCESSNURSING PROCESS

IMPLEMENTATIONIMPLEMENTATION STANDARD PRECAUTIONS WILL BE STANDARD PRECAUTIONS WILL BE

FOLLOWED FOR ALL PATIENT FOLLOWED FOR ALL PATIENT CONTACTCONTACT

NURSING PROCESSNURSING PROCESS

EVALUATIONEVALUATION DID PATIENT REMAIN DID PATIENT REMAIN

INFECTION FREE?INFECTION FREE? YESYES – GOOD JOB! – GOOD JOB! NONO – – - REASSESS PATIENT AND - REASSESS PATIENT AND

ENVIRONMENT TO DETERMINE ENVIRONMENT TO DETERMINE WHERE THE CHAIN OF INFECTION WHERE THE CHAIN OF INFECTION WAS BROKENWAS BROKEN

Break The Chain!Break The Chain!

Implement Implement ASEPSISASEPSIS: absence of : absence of disease-producing microorganisms; disease-producing microorganisms; refers to practices/procedures that refers to practices/procedures that assist in reducing the risk of assist in reducing the risk of infectioninfection

2 Types2 Types Medical (clean technique)Medical (clean technique) Surgical (sterile technique)Surgical (sterile technique)

MEDICAL ASEPSISMEDICAL ASEPSIS

A clean technique that A clean technique that limits the number of limits the number of pathogenspathogens that could cause infections that could cause infections

Aseptic technique: practices/procedures that assist in Aseptic technique: practices/procedures that assist in reducing the risk for infectionreducing the risk for infection

3 components 3 components to the technique: to the technique: Hand washing, Hand washing, Barriers of PPE (gloves, gowns, mask, protective Barriers of PPE (gloves, gowns, mask, protective

eyewear) eyewear) Routine environmental cleaningRoutine environmental cleaning

Contaminated area: one suspected of Contaminated area: one suspected of containing pathogens eg. used bedpan, wet containing pathogens eg. used bedpan, wet gauze, soiled linen, laboratory specimens, etcgauze, soiled linen, laboratory specimens, etc

Disinfection/SterilizationDisinfection/Sterilization Disinfection = the process that eliminates Disinfection = the process that eliminates

many or all microorganisms, with the many or all microorganisms, with the exception of bacterial spores, from exception of bacterial spores, from inanimate objectsinanimate objects Disinfection of surfacesDisinfection of surfaces High-level disinfectionHigh-level disinfection

Alcohols, chlorines, glutaraldehydes, hydrogen Alcohols, chlorines, glutaraldehydes, hydrogen peroxideperoxide

Sterilization = complete elimination or Sterilization = complete elimination or destruction of all microorganism, including destruction of all microorganism, including sporesspores Steam under pressure, ethylene oxide gas Steam under pressure, ethylene oxide gas

(ETO)(ETO)

CDC GUIDELINESCDC GUIDELINES

Standard PrecautionsStandard Precautions apply to: apply to: BloodBlood All body fluids and secretions (feces, All body fluids and secretions (feces,

urine, mucus, wound drainage) urine, mucus, wound drainage) except sweatexcept sweat

Non-intact skin Non-intact skin Mucous membranesMucous membranes Respiratory secretions Respiratory secretions

STANDARD STANDARD PRECAUTIONSPRECAUTIONS

TIER 1TIER 1 Hand Hygiene: Hand Hygiene: see next slidesee next slide Gloves:Gloves: for touching blood, body fluids, for touching blood, body fluids,

secretions, excretions, non-intact skin, secretions, excretions, non-intact skin, mucous membranes or contaminated areasmucous membranes or contaminated areas

Masks, Eye Protection or Face Shields:Masks, Eye Protection or Face Shields: if if in contact w/ sprays or splashes of body fluidsin contact w/ sprays or splashes of body fluids

Gowns:Gowns: to protect your clothing to protect your clothing Contaminated Linen:Contaminated Linen: place in leak-proof place in leak-proof

bag so no contact with skin or mucous bag so no contact with skin or mucous membranesmembranes

Respiratory Hygiene/Cough Etiquette:Respiratory Hygiene/Cough Etiquette: provide client with tissues and containers for provide client with tissues and containers for disposal; stand ~3 feet away from coughing; disposal; stand ~3 feet away from coughing; use masks prnuse masks prn

Hand HygieneHand Hygiene Number one defense against infectionNumber one defense against infection Soap and water if hands are visibly soiledSoap and water if hands are visibly soiled

Friction for 15 secondsFriction for 15 seconds After 3-5 uses of hand gelAfter 3-5 uses of hand gel

Alcohol-based hand products are accepted Alcohol-based hand products are accepted if hands not visibly soiledif hands not visibly soiled Before and after providing client careBefore and after providing client care Before eatingBefore eating After contact with body fluids or excretaAfter contact with body fluids or excreta After contact with inanimate objects in After contact with inanimate objects in

immediate area of the clientimmediate area of the client Before proceduresBefore procedures After removing glovesAfter removing gloves Is NOT effective against C-DiffIs NOT effective against C-Diff

ISOLATION PRECAUTIONSISOLATION PRECAUTIONSTIER 2TIER 2

ContactContact = private room or cohort clients, = private room or cohort clients, gloves and gownsgloves and gowns MDRO, C-Diff, RSVMDRO, C-Diff, RSV

DropletDroplet = private room or cohort clients, = private room or cohort clients, mask is requiredmask is required Strept, pertusis, mumps, fluStrept, pertusis, mumps, flu

AirborneAirborne = private room, negative airflow, = private room, negative airflow, hepa filtration; N95 respirator mask hepa filtration; N95 respirator mask requiredrequired TB, chickenpox, measlesTB, chickenpox, measles

Protective EnvironmentProtective Environment = private room, = private room, positive-pressure room; hepa filtration; positive-pressure room; hepa filtration; gloves, gowns, mask (controversial); NO gloves, gowns, mask (controversial); NO flowers or potted plantsflowers or potted plants Stem cell transplantStem cell transplant

STANDARD STANDARD PRECAUTIONSPRECAUTIONS

HANDWASHINGHANDWASHING GLOVES (PPE)GLOVES (PPE) MASKS (PPE)MASKS (PPE) EYE PROTECTION (PPE)EYE PROTECTION (PPE) GOWNS (PPE)GOWNS (PPE) LEAKPROOF LINEN BAGSLEAKPROOF LINEN BAGS PUNCTURE PROOF CONTAINERSPUNCTURE PROOF CONTAINERS

IN A YEAR YOU WILL HAVE IN A YEAR YOU WILL HAVE SWALLOWED 14 INSECTS WHILE SWALLOWED 14 INSECTS WHILE

SLEEPINGSLEEPING

WHERE ARE WE IN THE WHERE ARE WE IN THE CHAIN OF INFECTION?CHAIN OF INFECTION?

PORTAL OF EXITPORTAL OF EXIT

SUSCEPTIBLE HOSTSUSCEPTIBLE HOST

RESERVOIRRESERVOIR

CRITICAL THINKING!!CRITICAL THINKING!!

Surgical AsepsisSurgical Asepsis Sterile technique that prevents Sterile technique that prevents

contamination of an open wound, serves to contamination of an open wound, serves to isolate the operative area from the unsterile isolate the operative area from the unsterile environment, and maintains sterile field for environment, and maintains sterile field for surgerysurgery

Includes procedures used to eliminate all Includes procedures used to eliminate all microorganisms, including pathogens and microorganisms, including pathogens and spores from an object or areaspores from an object or area

Used in the following situations:Used in the following situations: Procedures requiring perforation of the skinProcedures requiring perforation of the skin When the skin’s integrity is broken as a result of When the skin’s integrity is broken as a result of

trauma, surgery or burnstrauma, surgery or burns During procedures that involve insertion of During procedures that involve insertion of

catheters or surgical instruments into sterile catheters or surgical instruments into sterile body cavitiesbody cavities

Principles of Surgical Principles of Surgical AsepsisAsepsis

A sterile object remains sterile only when touched A sterile object remains sterile only when touched by another sterile objectby another sterile object

Only sterile objects may be placed on a sterile fieldOnly sterile objects may be placed on a sterile field A sterile object or field out of the range of vision or A sterile object or field out of the range of vision or

an object held below a person’s waist is an object held below a person’s waist is contaminatedcontaminated

A sterile object or field becomes contaminated by A sterile object or field becomes contaminated by prolonged exposure to airprolonged exposure to air

When a sterile surface comes in contact with a wet, When a sterile surface comes in contact with a wet, contaminated surface, the sterile object or field contaminated surface, the sterile object or field becomes contaminated by capillary actionbecomes contaminated by capillary action

Fluid flows in the direction of gravity so a sterile Fluid flows in the direction of gravity so a sterile object becomes contaminated if gravity causes a object becomes contaminated if gravity causes a contaminated liquid to flow over the object’s surfacecontaminated liquid to flow over the object’s surface

The edges of a sterile field or container are The edges of a sterile field or container are considered to be contaminated – a 1 inch border considered to be contaminated – a 1 inch border around the drape is considered contaminatedaround the drape is considered contaminated

LAB Practice: Isolation LAB Practice: Isolation PrecautionsPrecautions

Demonstrate donning Isolation Gown, Demonstrate donning Isolation Gown, Mask, Gloves, Eyewear Mask, Gloves, Eyewear

Demonstrate removing Isolation Demonstrate removing Isolation Gown, Mask, Gloves, Eyewear Gown, Mask, Gloves, Eyewear

Demonstrate proper disposal of PPE Demonstrate proper disposal of PPE beforebefore leaving Isolation Room leaving Isolation Room

When performing care/treatments use When performing care/treatments use hospital provided stethoscope and hospital provided stethoscope and leave in the roomleave in the room

Lab Practice Cont’d.Lab Practice Cont’d. Practice pretending you are entering Practice pretending you are entering

patient room (use curtains) and give patient room (use curtains) and give Complete Bed Bath and do Bed Linen Complete Bed Bath and do Bed Linen Change wearing PPE (gown, mask, Change wearing PPE (gown, mask, gloves)gloves)

Remember to dispose of PPE Remember to dispose of PPE INSIDEINSIDE the the patient’s room before you leavepatient’s room before you leave

Practice bringing in all the supplies you Practice bringing in all the supplies you need so you can stay in the room & not need so you can stay in the room & not have to leave (de-gown etc) and come have to leave (de-gown etc) and come back in (re-gown etc)back in (re-gown etc)

LAB Practice: Sterile LAB Practice: Sterile ProceduresProcedures

Opening sterile packagesOpening sterile packages Preparing a sterile fieldPreparing a sterile field Pouring sterile solutions – label to Pouring sterile solutions – label to

palm, “lip” itpalm, “lip” it Donning sterile gown and glovesDonning sterile gown and gloves