Clinical Nursing Skills

<h2>Table of Contents</h2> <p> </p> <h3>CHAPTER 1: ASSESSMENT</h3> <ul> <li>Chapter at a Glance</li> <li><strong>General Assessment</strong> <ul> <li>1.1 Appearance and Mental Status: Assessing</li> <li>1.2 Height: Newborn, Infant, Child, Adult, Measuring</li> <li>1.3 Newborn’s or Infant’s Head, Chest, and Abdomen: Measuring</li> <li>1.4 Weight: Newborn, Infant, Child, Adult, Measuring</li> </ul></li> <li><strong>Vital Signs</strong> <ul> <li>1.5 Blood Pressure: Newborn, Infant, Child, Adult, Obtaining</li> <li>1.6 Pulse, Apical and Peripheral: Obtaining</li> <li>1.7 Pulse Oximeter: Using</li> <li>1.8 Respirations: Newborn, Infant, Child, Adult, Obtaining</li> <li>1.9 Temperature: Newborn, Infant, Child, Adult, Obtaining</li> </ul></li> <li><strong>Physical Assessment</strong> <ul> <li>1.10 Abdomen: Assessing</li> <li>1.11 Anus: Assessing</li> <li>1.12 Breasts and Axillae: Assessing</li> <li>1.13 Ears: Hearing Acuity, Assessing</li> <li>1.14 Eyes: Visual Acuity, Assessing</li> <li>1.15 Genitals and Inguinal Area: Assessing</li> <li>1.16 Hair: Assessing</li> <li>1.17 Heart and Central Vessels: Assessing</li> <li>1.18 Mouth and Oropharynx: Assessing</li> <li>1.19 Musculoskeletal System: Assessing</li> <li>1.20 Nails: Assessing</li> <li>1.21 Neck: Assessing</li> <li>1.22 Neurologic Status: Assessing</li> <li>1.23 Nose and Sinuses: Assessing</li> <li>1.24 Peripheral Vascular System: Assessing</li> <li>1.25 Skin: Assessing</li> <li>1.26 Skull and Face: Assessing</li> <li>1.27 Thorax and Lungs: Assessing</li> <li>Critical Thinking Options for Unexpected Outcomes</li> <li>Review Questions</li> </ul></li> </ul> <h3>CHAPTER 2: CARING INTERVENTIONS</h3> <ul> <li>Chapter at a Glance</li> <li><strong>Bed Care and Activities of Daily Living (ADLs)</strong> <ul> <li>2.1 Bathing: Newborn, Infant, Child, Adult</li> <li>2.2 Bedmaking: Occupied, Unoccupied</li> <li>2.3 Eyes and Contact Lenses: Caring for</li> <li>2.4 Feet: Caring for</li> <li>2.5 Hair: Caring for</li> <li>2.6 Hearing Aid: Removing, Cleaning, and Inserting</li> <li>2.7 Mouth: Regular and for the Unconscious or Debilitated Patient, Caring for</li> <li>2.8 Perineal-Genital Area: Caring for</li> <li>2.9 Shaving: Male Patient</li> </ul></li> <li><strong>Medication and Administration Systems</strong> <ul> <li>2.10 Automated Dispensing System: Using</li> <li>2.11 Medication: Preparing and Administering</li> <li>2.12 Narcotic Control System: Using</li> </ul></li> <li><strong>Medication Preparation</strong> <ul> <li>2.13 Ampule Medication: Removing</li> <li>2.14 Calculating Dosages</li> <li>2.15 Mixing Medications in One Syringe</li> <li>2.16 Vial Medication: Removing</li> </ul></li> <li><strong>Medication Routes</strong> <ul> <li>2.17 Ear Medication: Administering</li> <li>2.18 Enteral Tube Medication: Administering</li> <li>2.19 Eye Medication: Administering</li> <li>2.20 Inhaler, Dry Powder Medication: Administering</li> <li>2.21 Inhaler, Metered-Dose Medication: Administering</li> <li>2.22 Nasal Medication: Administering</li> <li>2.23 Nebulized Medication, Nonpressurized Aerosol (NPA): Administering</li> <li>2.24 Oral Medication: Administering</li> <li>2.25 Rectal Medication: Administering</li> <li>2.26 Sublingual Medication: Administering</li> <li>2.27 Topical Medication: Applying</li> <li>2.28 Transdermal Patch Medication: Applying</li> <li>2.29 Vaginal Medication: Administering</li> </ul></li> <li><strong>Parenteral Routes</strong> <ul> <li>2.30 Injection, Intradermal: Administering</li> <li>2.31 Injection, Intramuscular: Administering</li> <li>2.32 Injection, Subcutaneous: Administering</li> <li>2.33 Injection, Subcutaneous Anticoagulant: Administering</li> <li>2.34 Injection, Z-Track Method: Using</li> <li>2.35 Insulin Injection: Using a Syringe, Pen, or Pump</li> <li>2.36 Intravenous Medication: Adding to Fluid Container</li> <li>2.37 Intravenous Medication, Intermittent: Using a Secondary Set</li> <li>2.38 Intravenous Medication, IV Push: Administering</li> <li>Critical Thinking Options for Unexpected Outcomes</li> <li>Review Questions</li> </ul></li> </ul> <h3>CHAPTER 3: COMFORT</h3> <ul> <li>Chapter at a Glance</li> <li><strong>Acute/Chronic Pain Management</strong> <ul> <li>3.1 Pain in Newborn, Infant, Child, Adult: Assessing</li> <li>3.2 Pain Relief: Back Massage</li> <li>3.3 Pain Relief: Complementary Health Approaches</li> <li>3.4 Pain Relief: Transcutaneous Electrical Nerve Stimulation (TENS) Unit, Using</li> <li>3.5 Patient-Controlled Analgesia (PCA) Pump: Using</li> <li>3.6 Sleep Promotion: Assisting</li> </ul></li> <li><strong>Heat and Cold Application</strong> <ul> <li>3.7 Cooling Blanket: Applying</li> <li>3.8 Dry Cold: Applying</li> <li>3.9 Dry Heat: Applying</li> <li>3.10 Moist Pack and Tepid Sponges: Applying</li> <li>3.11 Neonatal Incubator and Infant Radiant Warmer: Using</li> <li>3.12 Sitz Bath: Assisting</li> </ul></li> <li><strong>End of Life Care</strong> <ul> <li>3.13 Physiological Needs of the Dying Patient: Managing</li> <li>3.14 Postmortem Care: Providing</li> <li>Critical Thinking Options for Unexpected Outcomes</li> <li>Review Questions</li> </ul></li> </ul> <h3>CHAPTER 4: ELIMINATION</h3> <ul> <li>Chapter at a Glance</li> <li><strong>Assessment — Collecting Specimens</strong> <ul> <li>4.1 Bladder Scanner: Using</li> <li>4.2 Stool Specimen, Routine, Culture, Ova, Parasites: Obtaining</li> <li>4.3 Urine Specimen, Clean-Catch, Closed Drainage System for Culture and Sensitivity: Obtaining</li> <li>4.4 Urine Specimen, Ileal Conduit: Obtaining</li> <li>4.5 Urine Specimen, Routine, 24-Hour: Obtaining</li> </ul></li> <li><strong>Bladder Interventions</strong> <ul> <li>4.6 Bedpan: Assisting</li> <li>4.7 Bladder Irrigation: Continuous</li> <li>4.8 Bladder Irrigation: Providing</li> <li>4.9 Commode: Assisting</li> <li>4.10 Urinal: Assisting</li> <li>4.11 Urinary Catheter: Caring for and Removing</li> <li>4.12 Urinary Catheterization: Performing</li> <li>4.13 Urinary Diversion Pouch: Applying</li> <li>4.14 Urinary External Device: Applying</li> <li>4.15 Urinary Ostomy: Caring for</li> <li>4.16 Urinary Suprapubic Catheter: Caring for</li> </ul></li> <li><strong>Bowel Interventions</strong> <ul> <li>4.17 Bowel Routine, Develop Regular: Assisting</li> <li>4.18 Bowel Diversion Ostomy Appliance: Changing</li> <li>4.19 Colostomy: Irrigating</li> <li>4.20 Enema and Retention Enema: Administering</li> <li>4.21 Fecal Impaction: Removing</li> <li>4.22 Fecal Ostomy Pouch: Applying</li> <li>4.23 Rectal Tube: Inserting</li> </ul></li> <li><strong>Dialysis</strong> <ul> <li>4.24 Dialysis, Peritoneal: Catheter Insertion, Assisting</li> <li>4.25 Dialysis, Peritoneal: Procedures, Assisting</li> <li>4.26 Hemodialysis: Central Venous Dual-Lumen Catheter, Caring for</li> <li>4.27 Hemodialysis: Procedures, Caring for, Assisting</li> <li>Critical Thinking Options for Unexpected Outcomes</li> <li>Review Questions</li> </ul></li> </ul> <h3>CHAPTER 5: FLUIDS AND ELECTROLYTES</h3> <ul> <li>Chapter at a Glance</li> <li><strong>Fluid Balance Measurement</strong> <ul> <li>5.1 Intake and Output: Measuring</li> </ul></li> <li><strong>Intravenous Therapy</strong> <ul> <li>5.2 Central Line Dressing: Changing</li> <li>5.3 Central Line: Infusing Intravenous Fluids</li> <li>5.4 Central Line: Managing</li> <li>5.5 Implanted Vascular Access Devices: Managing</li> <li>5.6 Infusion Device: Discontinuing</li> <li>5.7 Infusion Flow Rate Using Controller or IV Pump: Regulating</li> <li>5.8 Infusion Intermittent Device: Maintaining</li> <li>5.9 Infusion: Initiating</li> <li>5.10 Infusion: Maintaining</li> <li>5.11 Infusion Pump and “Smart” Pump: Using</li> <li>5.12 Infusion Syringe Pump: Using</li> <li>5.13 Percutaneous Central Vascular Catheterization: Assisting</li> <li>5.14 PICC Line Dressing: Changing</li> <li>5.15 Venipuncture: Initiating</li> <li>Critical Thinking Options for Unexpected Outcomes</li> <li>Review Questions</li> </ul></li> </ul> <h3>CHAPTER 6: INFECTION</h3> <ul> <li>Chapter at a Glance</li> <li><strong>Medical Asepsis</strong> <ul> <li>6.1 Hand Hygiene: Performing</li> </ul></li> <li><strong>Person Protective Equipment (PPE) and Isolation Precautions</strong> <ul> <li>6.2 Enteric Contact Precautions: Using</li> <li>6.3 Isolation, Attire: Donning and Doffing</li> <li>6.4 Isolation, Patient and Others: Caring for</li> <li>6.5 Isolation, Double-Bagging: Using</li> <li>6.6 Isolation, Equipment, Specimens: Removing</li> <li>6.7 Isolation, Transporting Patient Outside Room</li> <li>6.8 PPE, Clean Gloves: Donning and Doffing</li> <li>6.9 PPE, Face Masks: Donning and Doffing</li> <li>Critical Thinking Options for Unexpected Outcomes</li> <li>Review Questions</li> </ul></li> </ul> <h3>CHAPTER 7: INTRACRANIAL REGULATION</h3> <ul> <li>Chapter at a Glance <ul> <li>7.1 Glasgow Coma Scale: Using</li> <li>7.2 Intracranial Pressure: Monitoring and Caring for</li> <li>7.3 Lumbar Puncture: Assisting</li> <li>Critical Thinking Options for Unexpected Outcomes</li> <li>Review Questions</li> </ul></li> </ul> <h3>CHAPTER 8: METABOLISM</h3> <ul> <li>Chapter at a Glance</li> <li><strong>General</strong> <ul> <li>8.1 Endocrine Disorders: Assessing</li> <li>8.2 Endocrine Disorders: Complementary Health Approaches</li> <li>8.3 Paracentesis: Assisting</li> </ul></li> <li><strong>Diabetes Care</strong> <ul> <li>8.4 Capillary Blood Specimen for Glucose: Measuring</li> <li>8.5 Diabetes: Managing</li> <li>Critical Thinking Options for Unexpected Outcomes</li> <li>Review Questions</li> </ul></li> </ul> <h3>CHAPTER 9: MOBILITY</h3> <ul> <li>Chapter at a Glance</li> <li><strong>Balance and Strength</strong> <ul> <li>9.1 Body Mechanics: Using</li> <li>9.2 Range-of-Motion Exercises: Assisting</li> </ul></li> <li><strong>Moving and Transferring a Patient</strong> <ul> <li>9.3 Ambulating Patient: Assisting</li> <li>9.4 Hydraulic Lift: Using</li> <li>9.5 Logrolling Patient in Bed</li> <li>9.6 Moving Patient Up in Bed</li> <li>9.7 Positioning Patient in Bed</li> <li>9.8 Sitting on Side of Bed (Dangling): Assisting</li> <li>9.9 Transferring Patient Between Bed and Chair</li> <li>9.10 Transferring Patient Between Bed and Stretcher</li> <li>9.11 Transporting: Newborn, Infant, Toddler</li> <li>9.12 Turning Patient: Lateral or Prone Position in Bed</li> </ul></li> <li><strong>Patient Assistive Devices</strong> <ul> <li>9.13 Cane: Assisting</li> <li>9.14 Crutches: Assisting</li> <li>9.15 Walker: Assisting</li> </ul></li> <li><strong>Traction and Cast Care</strong> <ul> <li>9.16 Cast, Initial: Caring for</li> <li>9.17 Cast, Ongoing for Plaster and Synthetic: Caring for</li> <li>9.18 Traction, Skin and Skeletal: Caring for</li> <li>Critical Thinking Options for Unexpected Outcomes</li> <li>Review Questions</li> </ul></li> </ul> <h3>CHAPTER 10: NUTRITION</h3> <ul> <li>Chapter at a Glance</li> <li><strong>Healthy Eating Habits</strong> <ul> <li>10.1 Body Mass Index (BMI): Assessing</li> <li>10.2 Diet, Therapeutic: Managing</li> <li>10.3 Eating Assistance: Providing</li> <li>10.4 Mealtime: Complementary Health Approaches</li> <li>10.5 Nutrition: Assessing</li> </ul></li> <li><strong>Enteral Nutrition Using a Feeding Tube</strong> <ul> <li>10.6 Feeding, Continuous, Nasointestinal/Jejunostomy with a Small-Bore Tube: Administering</li> <li>10.7 Feeding, Gastrostomy or Jejunostomy Tubes: Administering</li> <li>10.8 Gastric Lavage: Performing</li> <li>10.9 Nasogastric Tube: Feeding</li> <li>10.10 Nasogastric Tube: Flushing and Maintaining</li> <li>10.11 Nasogastric Tube: Inserting</li> <li>10.12 Nasogastric Tube: Removing</li> </ul></li> <li><strong>Parenteral Nutrition Using Intravenous Infusion</strong> <ul> <li>10.13 Lipids, IV Infusion: Providing</li> <li>10.14 Total Parental Nutrition (TPN), IV Infusion: Providing</li> <li>Critical Thinking Options for Unexpected Outcomes</li> <li>Review Questions</li> </ul></li> </ul> <h3>CHAPTER 11: OXYGENATION</h3> <ul> <li>Chapter at a Glance</li> <li><strong>Assessment</strong> <ul> <li>11.1 Nose and Throat Specimen: Collecting</li> <li>11.2 Peak Expiratory Flow Rate: Measuring</li> <li>11.3 Sputum Specimen: Collecting</li> </ul></li> <li><strong>Interventions</strong> <ul> <li>11.4 Chest Physiotherapy: Preparing Patient</li> <li>11.5 Incentive Spirometer: Using</li> <li>11.6 Pursed-Lip Breathing</li> <li>11.7 Thoracentesis: Assisting</li> </ul></li> <li><strong>Supplemental Oxygen Therapy</strong> <ul> <li>11.8 Oxygen Delivery Systems: Using</li> <li>11.9 Oxygen, Portable Cylinder: Using</li> <li>11.10 Ventilator, Mechanical: Caring for Patient</li> </ul></li> <li><strong>Maintaining a Patent Airway</strong> <ul> <li>11.11 Airway, Nasopharyngeal: Inserting</li> <li>11.12 Airway, Oropharyngeal: Inserting</li> <li>11.13 Endotracheal Tube: Caring for</li> <li>11.14 Suctioning, Oropharyngeal and Nasopharyngeal: Newborn, Infant, Child, Adult</li> <li>11.15 Suctioning, Tracheostomy or Endotracheal Tube</li> <li>11.16 Tracheal Tube: Inflating the Cuff</li> <li>11.17 Tracheostomy: Caring for</li> </ul></li> <li><strong>Maintaining Lung Expansion</strong> <ul> <li>11.18 Chest Tube Drainage: Maintaining</li> <li>11.19 Chest Tube Insertion: Assisting</li> <li>11.20 Chest Tube Removal: Assisting</li> </ul></li> <li><strong>Life Threatening Situations</strong> <ul> <li>11.21 Airway Obstruction: Clearing</li> <li>11.22 Cardiac Compressions, External: Performing</li> <li>11.23 Rescue Breathing: Performing</li> <li>Critical Thinking Options for Unexpected Outcomes</li> <li>Review Questions</li> </ul></li> </ul> <h3>CHAPTER 12: PERFUSION</h3> <ul> <li>Chapter at a Glance</li> <li><strong>Maintaining Blood Volume</strong> <ul> <li>12.1 Blood Products: Administering</li> <li>12.2 Blood Transfusion: Administering</li> <li>12.3 Direct Pressure: Applying</li> <li>12.4 Pressure Dressing: Applying</li> </ul></li> <li><strong>Antiembolism Devices</strong> <ul> <li>12.5 Antiembolism Stockings: Applying</li> <li>12.6 Pneumatic Compression Device: Applying</li> <li>12.7 Sequential Compression Devices: Applying</li> </ul></li> <li><strong>Electrical Conduction in the Heart</strong> <ul> <li>12.8 Automated External Defibrillator (AED): Adult, Using</li> <li>12.9 ECG, 12-Lead: Recording</li> <li>12.10 ECG, Leads: Applying</li> <li>12.11 ECG, Strip: Interpreting</li> <li>12.12 Pacemaker, Insertion: Assisting</li> <li>12.13 Pacemaker, Permanent: Teaching</li> <li>12.14 Pacemaker, Temporary: Maintaining</li> <li>12.15 Temporary Cardiac Pacing, Transvenous, Epicardial: Monitoring</li> </ul></li> <li><strong>Arterial Line</strong> <ul> <li>12.16 Allen Test: Performing</li> <li>12.17 Arterial Blood Pressure: Monitoring</li> <li>12.18 Arterial Blood Samples: Withdrawing</li> <li>12.19 Arterial Line: Caring for</li> <li>Critical Thinking Options for Unexpected Outcomes</li> <li>Review Questions</li> </ul></li> </ul> <h3>CHAPTER 13: PERIOPERATIVE CARE</h3> <ul> <li>Chapter at a Glance</li> <li><strong>General</strong> <ul> <li>13.1 Preoperative Patient Teaching</li> <li>13.2 Surgical Hand Antisepsis and Scrubs</li> <li>13.3 Surgical Site: Preparing</li> </ul></li> <li><strong>Using Sterile Technique</strong> <ul> <li>13.4 Sterile Field: Maintaining</li> <li>13.5 Sterile Gown and Gloves: Donning (Closed Method)</li> <li>13.6 Surgical Patient: Preparing</li> <li>Critical Thinking Options for Unexpected Outcomes</li> <li>Review Questions</li> </ul></li> </ul> <h3>CHAPTER 14: REPRODUCTION</h3> <ul> <li>Chapter at a Glance</li> <li><strong>Antepartum Care</strong> <ul> <li>14.1 Amniocentesis: Assisting</li> <li>14.2 Antepartum, Maternal and Fetal: Assessing</li> <li>14.3 Antepartum Pelvic Examination: Assisting</li> <li>14.4 Deep Tendon Reflexes and Clonus: Assessing</li> <li>14.5 Fetal Well-Being, Nonstress Test and Biophysical Profile: Assessing</li> <li>14.6 Rh Immune Globulin: Administering</li> </ul></li> <li><strong>Intrapartum Care</strong> <ul> <li>14.7 Amniotomy (Artificial Rupture of Membranes): Assisting</li> <li>14.8 Epidural: Assisting and Caring for Patient</li> <li>14.9 Fetal External Electronic: Monitoring</li> <li>14.10 Fetal Heart Rate: Auscultating</li> <li>14.11 Fetal Internal Scalp Electrode Placement: Monitoring</li> <li>14.12 Induction of Labor with Oxytocin and Other Agents: Assisting and Caring for Patient</li> <li>14.13 Intrapartum, Maternal and Fetal: Assessing</li> <li>14.14 Intrapartum Pelvic Examination: Assisting</li> <li>14.15 Prolapsed Cord: Caring for Patient</li> </ul></li> <li><strong>Postpartum Care</strong> <ul> <li>14.16 Breastfeeding: Assisting</li> <li>14.17 Lochia: Evaluating</li> <li>14.18 Postpartum, Maternal: Assessing</li> <li>14.19 Postpartum, Perineum: Assessing</li> <li>14.20 Uterine Fundus, After Vaginal or Caesarean Birth: Assessing</li> </ul></li> <li><strong>Newborn Care</strong> <ul> <li>14.21 Apgar Score: Assessing</li> <li>14.22 Circumcision: Caring for</li> <li>14.23 Newborn: Assessing</li> <li>14.24 Newborn, Initial Bathing</li> <li>14.25 Newborn Thermoregulation: Assisting</li> <li>14.26 Phototherapy, Newborn, Infant: Providing</li> <li>14.27 Umbilical Cord Clamp: Caring for</li> <li>Critical Thinking Options for Unexpected Outcomes</li> <li>Review Questions</li> </ul></li> </ul> <h3>CHAPTER 15: SAFETY</h3> <ul> <li>Chapter at a Glance</li> <li><strong>Patient Safety</strong> <ul> <li>15.1 Abuse: Newborn, Infant, Child, Older Adult, Assessing for</li> <li>15.2 Fall Prevention: Assessing and Managing</li> <li>15.3 Seizure Precautions: Implementing</li> <li>15.4 Suicide: Caring for Suicidal Patient</li> </ul></li> <li><strong>Environmental Safety</strong> <ul> <li>15.5 Environmental Safety: Healthcare Facility, Community, Home</li> <li>15.6 Fire Safety: Healthcare Facility, Community, Home</li> <li>15.7 Thermal and Electrical Injuries: Preventing</li> </ul></li> <li><strong>Immobilizers and Restraints</strong> <ul> <li>15.8 Bed or Chair Alarm, Exit Monitor Device: Applying</li> <li>15.9 Immobilizer, Mummy: Applying</li> <li>15.10 Immobilizer, Papoose Board: Applying</li> <li>15.11 Restraints and Alternatives: Caring for</li> <li>15.12 Restraints, Torso and Belt: Applying</li> <li>15.13 Restraints, Wrist and Ankle: Applying</li> <li>Critical Thinking Options for Unexpected Outcomes</li> <li>Review Questions</li> </ul></li> </ul> <h3>CHAPTER 16: TISSUE INTEGRITY</h3> <ul> <li>Chapter at a Glance</li> <li><strong>Assessment</strong> <ul> <li>16.1 Wound Drainage Specimen: Obtaining</li> </ul></li> <li><strong>Dressings and Binders</strong> <ul> <li>16.2 Abdominal Binder: Applying</li> <li>16.3 Closed Wound Drains: Maintaining</li> <li>16.4 Dressing, Dry: Changing</li> <li>16.5 Dressing, Sterile: Changing</li> <li>16.6 Dressing, Venous Ulcer: Changing</li> <li>16.7 Dressing, Wet-to-Moist: Applying</li> <li>16.8 Elastic Bandage: Applying</li> <li>16.9 Surgical Wound: Caring for</li> </ul></li> <li><strong>Wound Care</strong> <ul> <li>16.10 Dressing, Alginate: Applying</li> <li>16.11 Dressing, Hydrocolloid: Applying</li> <li>16.12 Dressing, Transparent: Applying</li> <li>16.13 Electrical Stimulation: Using</li> <li>16.14 Negative Pressure Wound Therapy: Using</li> <li>16.15 Pressure Injury: Preventing and Caring for</li> <li>16.16 Staple and Suture: Removing</li> <li>16.17 Stump: Positioning and Exercising</li> <li>16.18 Stump: Shrinking and Molding</li> <li>16.19 Wound: Irrigating</li> <li>Critical Thinking Options for Unexpected Outcomes</li> <li>Review Questions</li> </ul></li> </ul> <h3>Appendix A: Answers to Review Questions</h3> <h3>Appendix B: Guidelines for Laboratory and Diagnostic Assessment</h3> <p></p>