Summer Session
Skills Review
(
Review your Fundamental Book and Your Skills Notes/book
and Health Assessment Material)
Vital Signs:
Know the “normal” range for Temp, B/P, Pulse and Resp for age groups. Understand why a value
may be out-of-range.
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Know how to properly take a blood pressure (placement of cuff, two step method,
locations to take a blood pressure, when/where NOT to take a blood pressure)
Know how and where to take a pulse- landmarks, trouble shooting
Know how and where to take a temp and any adjustments needed for the location of
the temp. Be able to do conversions of temperatures.
Med administration:
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Rights in med administration. (6-10 rights depending on your source. These top 6 are
the most common you will see and hear.)
o Right patient
o Right medication
o Right dose
o Right route
o Right time
o Right documentation
o Right to education
o Right to patient refusal
o Right to assessment
o Right to evaluation
Checking patient ID—Ask the patient to identify themselves by having them state name,
birthday while checking their ID band. This is done each time an assessment,
intervention or evaluation is completed.
ALWAYS check for allergies!
ONLY recap a CLEAN UNUSED needle if you need to go from the medication room to the
patient’s room. Use the one hand sweep.
NEVER recap a USED needle!!
Medication should be taken to the patient’s room and opened at the bedside when the
five rights are complete.
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Wear gloves when working with topicals and patches. Inspect the area, rotate areas,
clean previous area with soap/water to remove residual medications.
Never shave hair- clip if needed.
Nasal spray is done best if the patient can do it themselves and lean slightly forward
Eyedrops—hyperextend the head, pull down to expose conjunctival sac and place the
prescribed number of drops, hold gentle pressure for 30-60 sec on nasolacrimal duct.
Wait 5 min between eye drops if in the same eye.
Ear—children younger than 3 (pull down and back) for children 4 to adult (pull up and
outward). May apply gentle pressure to tragus.
Inhaler- make sure patient “rinse and spit” after inhalers. Wait 5min between each
inhaler.
Rectal: Left Sims positions, lubricates, Suppository against mucosa and not in stool, go
past internal rectal sphincter. Enema; have commode available, slow down flow if
cramping.
Enema: Left Sims position. Review procedure for EACH TYPE of enema. Know height of
enema bag, know how to assess and interventions when patient complains.
Liquid medications—pour and measure on a flat surface. Base of meniscus should be
level to the desired dose. Use special oral syringes if needed.
Know the difference between Sublingual (under tongue) and buccal (against mucous
membrane in cheek.)
Not all oral pill/tablets/capsules, etc. can be crushed or opened.
Injections:
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Use a filter needle if drawing up medication from a glass vial and then change out
needle before use.
Know the type of injection being given: SQ, ID, IM
o How to landmark each one.
o Types of medications that are administer in appropriate locations
(immunizations in deltoid, Heparin in abd, etc..)
o Some may come in pre-filled syringes.
Know needle and syringe size based on the type of injection
o insulin (units) syringe; needle 5/8-1/2 inch with 25G-31G
 Review mixing insulin: (RN) cloudy, clear, clear (Regular), cloudy(NPH)
 Review normal BGM levels. Fasting less than 100.
 Roll- Don’t shake bottle.
o ID 1 mL syringe (TB syringe); needle 5/8-1/2 inch with 25G-27G
o IM 3mL syringe; Needle 1-2inch with 18G-25G (depends on medication, age and
size of person for selection of proper equipment). Utilize the “Z” track method.
Know preferred site of injection for medication and/or type of injection
o Ventrogluteal is the PREFERED site for 4 years to adult
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Vastus Lateralis is another large muscle that can be used safely and preferred
for infants.
Deltoid is for SMALL volume such as immunizations—NOT a preferred site.
Intravenous:
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Know the difference between Phlebitis and Infiltrate.
Understand rates: controller vs gtt/min
Review where to connect piggyback tubing vs doing IVP in existing line.
Learn terminology for Isotonic, Hypertonic, Hypotonic IV fluids and what IVF fall into
those categories along with Crystalloids vs Colloids.
Blood transfusions: know the difference between reactions and adverse effects (what
are you assessing for when transfusing blood?), use NS with blood transfusion, #20 G or
larger to infuse, Monitor VS and patient every 5min for 15min when blood reaches
patient.
Review compatibilities and check/balance/protocol of hanging blood. (two nurses at the
bedside, ect..)
Review central lines: dressing change, flushing, and medication administration
Understand evaluation of medication administration and antidotes, treatment for patient with adverse
effects.
Understand what to assess and reevaluate for after giving a medication.
Isolation/Infection Control
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HAND WASHING
Know that every concept has potential risk for infection control issues.
Understand the difference between clean, aseptic, sterile, surgical, medical technique
when dealing with infection control and when it is appropriate to use them.
Differentiate between the different isolation protocols, which type of isolation would be
appropriate for the disease process and what equipment should be used by the
healthcare worker. (ex: contact=gown and gloves)
Review order of PPE (see handout from CDC)
Review how to handle and concepts of a sterile field.
Wound Care:
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How to obtain and when to obtain a culture from a wound
Measurement and vocabulary of documenting wounds.
o Drainage, type of wound (stage, dehiscence, evisceration, etc.)
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o Tools used to assess wounds and those at risk.
o Maceration, undermining, tunneling
Equipment and medications used in wound care. (date/times)
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Age appropriate size of equipment.
Different types of foley catheters and when each is appropriately used.
How and what to assess for before, during and after foley insertion.
How to care, clean and empty a foley catheter.
Review principles of CBI and calculating I+O
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Different types of NG and reasons for
Technique of insertion
Tubefeeding: what to assess, risk, benefits
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Suctioning
Cleaning
What to assess before, during and after care.
Foley:
NG:
Trach care:
Restraints:
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All other resources should be attempted before using restraints.
Assess your patient and possible needs that may be causing the behavior
Follow facility and state policy and procedures on restraint use
Know the difference between chemical and physical restraints
Circulation should be checked every 15min
Care is offered every 2hrs (toileting, feeding and range of motion
Behavior restraints should have continuous in-person observation
Mittens not secured to an object is not a restraint.
Vests should never be used.
Don’t forget to review concepts that you will use in the clinical setting from your other courses:
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Delegation- don’t delegate what you can eat (Evaluate, Assess, Teach)
o Know job descriptions and what you can delegate to whom
Professional issues (Consents, POA, Living Will, etc.)
Legal- Always follow policy and procedure
o Job duties
o Delegation
o Changing tubing, how long something is good for {saline bottle, tubing, how
long blood can hang, etc.), dressing, patches, discarding items, etc.
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Communication concepts-- documentation
Assessment—Steps to an assessment (inspect, auscultate, percuss, and palpate [abd]);
neuro, head-to-toe, etc.)
Stages of pressure ulcer. (use the nursing process: how it occurs, what to do, ect.)
How to obtain specimens: Foley, clean catch, sputum, fecal, etc.
Review math calculations.
o Temperature
o Heparin
o Pitocin
o Basic math (PO; mg; mL; ggt/mL; mL/hr; mg/kg/day
Review abbreviations and know the “DO NOT USE” abbreviations.
Have working understanding of the nursing process.
Prioritize patient’s needs
ALWAYS assess your patient first.
Review most recent CPR guidelines