Nursing Interventions and Procedures
Nursing Interventions and Procedures
This domain tests safe technique and verification for common bedside procedures: aseptic dressing changes, urinary catheter insertion and care, nasogastric tube placement, oxygen delivery, suctioning, specimen collection, and pressure-injury prevention. The exam focuses on the step that prevents a serious complication, not on ritual.
Core rules
- Aseptic technique for invasive procedures (catheter, central line, wound packing); clean technique for intact skin and some chronic wounds.
- Verify NG tube placement with aspirate pH (typically ≤5.5) and documented tube marking; auscultation of injected air is unreliable.
- Use the smallest catheter and remove urinary catheters as soon as no longer indicated; maintain a closed drainage system below bladder level.
- Oxygen is a drug: document device, flow rate, and target saturation; titrate to the ordered target.
- Suction only when indicated, limit duration, and preoxygenate when tolerated.
- Prevent pressure injury with risk assessment, repositioning, surface selection, moisture management, and nutrition.
Worked example
A nurse inserts an NG tube for enteral feeding. The patient has a history of facial trauma. Before insertion, the nurse checks for basal skull fracture signs and confirms the order. After insertion, the nurse obtains aspirate with pH 4, confirms the centimeter marking, and documents both. The nurse does not use the whoosh test because air insufflation can be misleading. If pH were >5.5 or aspirate unavailable, the nurse would obtain an X-ray before feeding.
Traps
- Confirming NG placement by auscultating air over the epigastrium.
- Inserting an NG tube in a patient with suspected basal skull fracture without escalation.
- Securing a catheter or tube before verifying correct placement.
- Using a larger urinary catheter to prevent leaks instead of addressing the cause.