SKILLS LAB #1
VS Measurement, Patient Identification, Standard Precautions,
Handwashing, Blood Glucose Monitoring
Objectives
◦ Identify methods used to correctly identify a patient.
◦ Identify techniques to foster patient communication.
◦ Discuss standard precautions and techniques used to implement standard precautions
including hand hygiene and use of personal protective equipment (PPE).
◦ Demonstrate and discuss techniques utilized to perform T, P, R & BP measurement.
◦ Verbalize understanding of blood glucose monitoring procedures.
Identifying the patient
◦ 2 identifiers
◦ Name
◦ Date of birth
Patient Communication
STANDARD
PRECAUTIONS
Standard Precautions (Source: www.osha.gov)
◦ The CDC recommends Standard Precautions for the care of all patients,
regardless of their diagnosis or presumed infection status.
◦ Standard precautions are designed to reduce the risk of transmission of
microorganisms from both recognized and unrecognized sources of
infection in hospitals.
Standard Precautions
◦ Apply to:
◦ 1) blood
◦ 2) all body fluids, secretions, and excretions, except sweat, regardless of whether or not they
contain visible blood
◦ 3) non-intact skin, and
◦ 4) mucous membranes
◦ Includes the use of:
◦ Hand hygiene, use of personal protective equipment (PPE) such as gloves, gowns, masks and
eye protection whenever touching or exposure to patients' body fluids is anticipated
HAND HYGIENE
5 Moments of Hand
Hygiene
1) Before touching a
patient
2) Before a clean or
aseptic
procedure
3) After body fluid
exposure or risk
4) After touching a
patient
5) After touching a
patient’s
surroundings
* World Health
Organization (WHO)
HANDWASHING
VITAL SIGN
MEASUREMENT
Assessing Temperature
Methods of Measurement
ORAL, TYMPANIC, TEMPORAL, RECTAL & AXILLARY
EQUIPMENT USED FOR ASSESSING
TEMPERATURE
ELECTRONIC
OR DIGITAL
TYMPANIC
MEMBRANE
AUTOMATED
MONITORING
DISPOSABLE
TEMPORAL
ARTERY
ORAL
◦ WAIT 15 MINUTES AFTER LIQUIDS, SMOKING OR
CHEWING GUM
TYMPANIC
◦ APPROXIMATELY = TO ORAL READING
◦ Adult → pull pinna of ear up and back
TEMPORAL
AXILLARY
◦ Add 1 ̊ F to get oral equivalent
RECTAL
◦ Subtract 1 ̊ F to get oral equivalent
◦ Pt in side-lying position
◦ Lubrication needed
◦ Insert probe 1.5 inches for adults
◦ Caution → Vagal nerve stimulation
Assessing Respirations
Pulse Sites
Pulse Measurement
Doppler Use
Stethoscope 101
Apical Pulse Assessment
Assessing Blood Pressure
Sphygmomanometer
ADDITIONAL METHODS FOR
MEASUREMENT
◦ AUTOMATED
◦ DOPPLER
◦ DIRECT ELECTRONIC (PRIMARILY IN ICU)
◦ PALPATION
KOROTKOFF SOUNDS
◦ SERIES OF SOUNDS HEARD WHEN
BLOOD FLOWS AFTER RELEASE OF BP
CUFF
SITES TO AVOID
◦ ARM WITH AN IV, IF POSSIBLE
◦ PLACE SIGN ABOVE BED IF PATIENT HAS THE
FOLLOWING AND AVOID USING AFFECTED SIDE FOR
BP MEASUREMENT
◦ AV FISTULA OR SHUNT
◦ MASTECTOMY OR AXILLARY LYMPH NODE REMOVAL
Cuff Placement for Brachial BP
Measurement
Locating the Brachial Pulse
Stethoscope Placement for Brachial BP
Alternate
Site/Method
◦ POPLITEAL ARTERY
◦ PALPATING PRESSURE
BLOOD GLUCOSE
MONITORING
EQUIPMENT NEEDED
◦ Blood glucose meter
◦ Sterile lancet
◦ Cotton balls or gauze squares
◦ Testing strips for meter
◦ Nonsterile gloves
◦ PPE, as indicated
◦ Skin cleanser and water, or alcohol swab
Procedure
◦ Perform hand hygiene
◦ Identify the patient
◦ Apply gloves
◦ Prepare lancet
◦ Prepare meter
◦ Test strips
◦ Select site and prep
Procedure (continued)
◦ Cleanse skin
◦ Have patient wash hands with skin cleanser and warm water. Dry thoroughly.
◦ Or, cleanse the skin with alcohol swab. Allow skin to dry completely.
◦ Puncture finger
◦ Wipe away first drop of blood with a cotton ball
Procedure (continued)
◦ Gently touch next drop of blood to the test strip
◦ Apply pressure to puncture site with a cotton ball or dry gauze. Do not use alcohol wipe.
◦ Read results on meter
Procedure (continued)
◦ Turn off meter and remove strip
◦ Wipe meter clean
◦ Dispose of strip, lancet, gloves, alcohol swab, cotton ball
◦ Perform hand hygiene
◦ Record results