Term
| What is the longest preferred number of days to have a catheter in? |
|
Definition
|
|
Term
| What are the 4 sizes of catheters? |
|
Definition
|
|
Term
| What are robinson catheters? |
|
Definition
|
|
Term
| What are foley catheters? |
|
Definition
|
|
Term
| ID and describe the 5 types of catheters |
|
Definition
| single lumen (straight), double lumen (foley), triple lumen (foley), suprapubic, external (condom) |
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|
Term
| When would a straight catheter be used? |
|
Definition
| empty distended bladder, collect urine sample, check residual urine amount, neurological issue |
|
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Term
| What procedure should be done prior to inserting a straight catheter? |
|
Definition
|
|
Term
| What should the residual amount of urine be post urination? |
|
Definition
|
|
Term
| Describe catheter irrigation |
|
Definition
| used to maintain flow of urine; fluid should flow in smoothly w/o resistance |
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|
Term
|
Definition
| continuous bladder irrigation; ususally done with 3 way cath, used for GU surgery to keep bladder clear of clots |
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|
Term
| What are some advantages of suprapubic catheters? |
|
Definition
| risk of urethral damage eliminated, fewer bladder spasms, more sanitary for the individual |
|
|
Term
| What is a complicatin of suprapubic catheters? |
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Definition
|
|
Term
| What are some things that cause pulse ox inaccuracies? |
|
Definition
| venous congestion, nail polish, bright overhead lights |
|
|
Term
| What are the 5 types of oxygen deliver devices? |
|
Definition
| nasal cannula, face mask, venturi mask, partial rebreather mask, nonrebreather mask |
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|
Term
| Describe the venturi mask |
|
Definition
| high flow o2 delivery system through a disposable mask |
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|
Term
| What is the purpose of a rebreather mask? |
|
Definition
| to retain the first 3rd of CO2 exhaled to stimulate respiration |
|
|
Term
| What every time item is prohibited with the use of oxygen? |
|
Definition
| petroleum based products: vaseline, chapstick |
|
|
Term
| What can cause inaccuracies in pulse ox readings? |
|
Definition
| reduced peripheral blood flow, nail polish, venous congestion, bright overhead lights |
|
|
Term
| What is the FiO2 of nasal cannula? |
|
Definition
|
|
Term
| What is the FiO2 of a face mask? |
|
Definition
| 35-50%; low flow system; final O2 concentration is variable/uncontrolled |
|
|
Term
| What is the FiO2 of a venturi mask? |
|
Definition
|
|
Term
| What is the FiO2 of a partial rebreather mask? |
|
Definition
|
|
Term
| What is the FiO2 of a non rebreather mask? |
|
Definition
|
|
Term
| What are the 10 rights of med administration? |
|
Definition
| drug, patient, time, dose, route, patient, documentation, education, refuse, assessment, evaluation, reason |
|
|
Term
| What are the 7 essential pieces of a MAR? |
|
Definition
| Full patient name, date and time order written, name of drug, dose, frequency, route, signature of provider |
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|
Term
|
Definition
|
|
Term
| Describe the process of administering NG meds |
|
Definition
| flush before with 30ml water; flush between with 10ml water; flush after 30-60ml water; if clogged flush 30ml tepid water |
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|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Where should eye drops be given? |
|
Definition
|
|
Term
| How do you administer ear meds? |
|
Definition
| instill drops 1 cm above ear canal, pt remains in position for 5-10mins and gently massage tragus |
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Term
| How long should you wait between giving different types of inhaled meds? |
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Definition
|
|
Term
| With inhalers, ___ should be given before ___ if used |
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Definition
|
|
Term
| Rectal meds are contraindicated in what kind of patient? |
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Definition
|
|
Term
| How are suspension meds prepared? |
|
Definition
|
|
Term
| TB syringes are used for what types of injections? |
|
Definition
|
|
Term
| Longer needles are used for what type of injection? |
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Definition
|
|
Term
| Describe how needle gauges are measured |
|
Definition
| smaller gauge= larger needle |
|
|
Term
| If mixing insulins in the same syringe, which one is drawn up first? |
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Definition
|
|
Term
| What are the two best sites for SQ injections? |
|
Definition
| back of the arm and abdomen |
|
|
Term
| rapid acting insulin should be given within __ minutes of a meal |
|
Definition
|
|
Term
| short acting insulin should be given within ___ minutes of a meal |
|
Definition
|
|
Term
| What pt lab value should be monitored if they're on heparin? |
|
Definition
|
|
Term
| where is heparin recommended to be given? |
|
Definition
| abdomen; can be given SQ or IV |
|
|
Term
| What are the preferred IM injection sites? |
|
Definition
| ventrogluteal or vastus lateralis if supine; deltoid |
|
|
Term
| What is the fluid limit for injections in the deltoid? |
|
Definition
|
|
Term
| What is the injection limit for intradermal? |
|
Definition
|
|
Term
| What is the injection limit for most muscle sites? |
|
Definition
|
|
Term
| What are the 3 rapid acting insulins? |
|
Definition
| humalog, novolog and apidra |
|
|
Term
| What is the onset of humalog? |
|
Definition
|
|
Term
| What is the peak effect of humalog? |
|
Definition
|
|
Term
| What is the duration of action for humalog? |
|
Definition
|
|
Term
| What is the onset for novolog? |
|
Definition
|
|
Term
| What is the peak effect of novolog? |
|
Definition
|
|
Term
| What is the duration of action for novolog? |
|
Definition
|
|
Term
| What is the onset, peak effect and duration of action for apidra? |
|
Definition
| 10-15 mins, 1-1.5 hrs; 3-5 hrs |
|
|
Term
| What is the onset, peak effect and duration of action for regular insulin (short acting)? |
|
Definition
| 30-60 mins, 1-5 hrs, 6-10 hrs |
|
|
Term
| What is the onset, peak effect, duration of action for NPH (intermediate acting insulin)? |
|
Definition
| 1-2 hrs; 6-14 hrs; 16-24 hrs |
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|
Term
| What are the two long acting insulins? |
|
Definition
|
|
Term
| What is the onset, peak effect and duration of action for lantus? |
|
Definition
|
|
Term
| What is the onset, peak effect and duration of action for levemir? |
|
Definition
| .8-2hrs; peakless; up to 24hrs |
|
|
Term
| What is the normal serum osmolarity for adults? |
|
Definition
|
|
Term
| What are the examples and risks of isotonic fluids? |
|
Definition
| NS and lactated ringers; fluid overload, especially CHF, hypertension and elderly |
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|
Term
| Describe and give examples of hypotonic IV fluids |
|
Definition
| move water into cells to help expand them; helpful with dehydration and hyperglycemia, can cause increased ICP; Dextrose |
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|
Term
| Describe hypertonic IV fluids |
|
Definition
| used to correct fluid, electrolyte and acid base imbalances by moving water out of cells and into blood stream; reduce edema, increase urine |
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|
Term
| What are 4 examples of hypertonic IV solutions? |
|
Definition
| 10% NS, blood products, albumin, parenteral nutrition |
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|
Term
|
Definition
| total parenteral nutrition; "food" delivered through central IV |
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|
Term
| Describe crystalloid solutions |
|
Definition
| clear fluid mix of water and electrolyte solutions; will cross semipermeable membrane |
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|
Term
| Describe colloid solutions |
|
Definition
| gelatinous solutions containing particles; don't form sediment under influence of gravity and can't cross semi permeable membrane; can interfere with coag factors |
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|
Term
| Where is venipuncture commonly performed? |
|
Definition
|
|
Term
| What are the 3 most critical complications for IV fluids? |
|
Definition
| infiltration (absence of blood return), extravasation (pain, burning, feeling of tightness below insertion), phlebitis |
|
|
Term
| What are some ways of preventing infiltration/extravasation? |
|
Definition
| avoid areas of flexion for puncture site, hypertonic fluids should not be infused peripherally, use smallest gauge appropriate |
|
|
Term
| What are the cons of using peripheral veins for IVs? |
|
Definition
| can collapse, difficult to cannulate, difficult to locate |
|
|
Term
| What types of veins should be used for IVs? |
|
Definition
|
|
Term
| IF possible you should insert the IV on the patient's _____ side |
|
Definition
|
|
Term
| What are the 3 common sites of Peripheral IV insertion? |
|
Definition
| antecubital fossa, forearm, and dorsal hand |
|
|
Term
| what're the 3 main veins for peripheral IV? |
|
Definition
| cephalic, basilic, median cubital |
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|
Term
|
Definition
| saline, administer medicine, saline |
|
|
Term
| What sites should be avoided for IVs? |
|
Definition
| burns, edema, injury, mastectomy and fistulas |
|
|
Term
| If a patient has diarrhea after a tube feeding, what does that mean? |
|
Definition
|
|
Term
|
Definition
| Nasogastric; for stomach depression and bowel rest; contraindicated in presence of facial trauma; complications include aspiration and tissue trauma |
|
|
Term
|
Definition
| for feedings longer than 6-8 weeks |
|
|
Term
|
Definition
| jejunostomy tubes; used when feedings will be long term and increased risk of aspiration from stomach |
|
|
Term
| Before giving a new feeding you should always check the ____ which should not be more than ____ |
|
Definition
|
|
Term
| What is the food concentration for tube feeding? |
|
Definition
|
|
Term
| Bolus feeds can only be given in the ___ |
|
Definition
|
|
Term
| Only what kinds of feeds can be given in the intestines? |
|
Definition
|
|
Term
| Open-canned feedings should be discarded after how long? |
|
Definition
|
|
Term
| how can tube feeding cause vomiting? |
|
Definition
| improper tube placement, feeding too fast, air in stomach, wrong position |
|
|
Term
| how can tube feeding cause diarrhea? |
|
Definition
| feeding too fast, concentration of formula, lactose intolerance |
|
|
Term
| how can tube feeding cause constipation? |
|
Definition
| no fiber in diet, inadequate fluid intake, drugs |
|
|
Term
| how can tube feeding cause dehydration? |
|
Definition
|
|
Term
| Describe fat emulsions as part of parenteral nutrition |
|
Definition
| for pts who need additional source of calories or fatty acids, provides non-protein energy source; piggy back to TPN below filter |
|
|
Term
| What is the main use of a whole blood transfusion? |
|
Definition
| massive transfusion; increase O2 carrying capacity of blood |
|
|
Term
| Platelets should not be given to patients with what? |
|
Definition
| heparin induced thrombocytopenia |
|
|
Term
| What is the purpose of an albumin transfusion? |
|
Definition
| maintains normal colloid oncotic pressure; replaces blood volume after acute loss (burns or signs of edema) |
|
|
Term
| What is the purpose of a PRBC transfusion? |
|
Definition
| increase oxygen carrying capacity of circulatory system in presence of blood loss; increase Hgb and Hct |
|
|
Term
| What is the purpose of FFP transfusion? |
|
Definition
| contains clotting factors and fibrinogen; corrects coag deficiencies, reverse warfarin effect, given for sickle cells crisis |
|
|
Term
| Describe the use of cryprecipitate |
|
Definition
| given to control bleeding by replacing clotting factors; should not be used as substitute for FFP |
|
|
Term
| What needle gauges should be used for blood transfusions? |
|
Definition
| at least 20, preferably 18 |
|
|
Term
| how long do you have to get PRBCs infused? how soon must it be hung? |
|
Definition
|
|
Term
| What are the 4 complications of transfusions? |
|
Definition
| volume overload (HTN, edema, crackles). transfusion reactions, iron overload, infections |
|
|
Term
| Describe acute hemolytic transfusion reactions |
|
Definition
| fever, chills, flank pain, tachycardia, hypotension, brown urine (ABO incompatibility) |
|
|
Term
| Describe febrile transfusion reactions |
|
Definition
| leukocyte incompatibility; fever, chills, warm, flushed, headache |
|
|
Term
| Describe allergic transfusion reactions |
|
Definition
| reaction to plasma proteins; flushing, rash w/ or w/o itching, severe dyspnea, stridor, chest pain, decreased O2 sat |
|
|
Term
| Describe circulatory overload transfusion reactions |
|
Definition
| cardiac or renal insufficiency; dyspnea, hypotention, crackles JVD |
|
|
Term
| What clinical signs indicate a need for suctioning? |
|
Definition
| restlessness, gurgling during respiration, pallor, decrease O2 sat |
|
|
Term
| Suctioning should last less than ___ secs |
|
Definition
|
|
Term
| There should be ____ between each suction |
|
Definition
| intervals; wait 20-30 sec between attempts for oral/nasopharyngeal and 2-3 mins for tracheal |
|
|
Term
| Suctioning in total should last less than ____ |
|
Definition
|
|
Term
| What are the complications of suctioning? |
|
Definition
| contamination, increased ICP, cardiac arrhythmias |
|
|
Term
| What type of suction device is used for the oral airway? |
|
Definition
|
|
Term
| What is the positioning for nasopharyngeal suctioning of a conscious person? |
|
Definition
|
|
Term
| What is the position for suctioning an unconscious person? |
|
Definition
| lateral, facing the care provider (vomit risk) |
|
|
Term
Id tracheostomy tube:
inflatable cuff that creates seal between tube and trachea |
|
Definition
|
|
Term
Id tracheostomy tube:
used to distribute low even pressure against trachea to reduce risk of necrosis |
|
Definition
|
|
Term
Id tracheostomy tube:
Used in children with resilient airways |
|
Definition
| uncuffed tracheostomy tube |
|
|
Term
| The pressure in a tracheostomy tube should never exceed what? |
|
Definition
|
|
Term
| How do you know what size suction tube to use for tracheostomy? |
|
Definition
|
|
Term
| What is the main sign of a pneumothorax? |
|
Definition
| air in pleural space; lungs will not move symmetrically |
|
|
Term
T/F:
bubbling in a wet chest tube system is an abnormal finding |
|
Definition
| false; as long as its not in water seal chamber |
|
|
Term
|
Definition
| instilling some substance into pleural space through chest tube to weld pleura together |
|
|
Term
| Partial thickness wounds do NOT have what color tissue? |
|
Definition
|
|
Term
| Partial thickness wounds damage what layers of skin? |
|
Definition
|
|
Term
| Purple coloring in a wound indicates what? |
|
Definition
| trauma, high levels of bacteria |
|
|
Term
| Define induration in regards to wound description |
|
Definition
|
|
Term
| Describe granulation tissue |
|
Definition
| new tissue that replaces dead tissue; beeft red |
|
|
Term
| What does it mean if a wound base color is pale pink? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What 7 things should be included in wound documentation? |
|
Definition
| size, location, tissue type, exudate, odor, surrounding tissue, pain |
|
|
Term
|
Definition
| catheter taht ends at or close to the heart or in one of the great vessels; used for infusion or withdrawing blood or hemodynamic monitoring; should not be left in >2days |
|
|
Term
| Describe non tunneled percutaneous central catheter |
|
Definition
| inserted through subclavian or jugular in neck; tip is in superior vena cava; placement confirmed by chest x ray;high infection risk |
|
|
Term
| What are the advantages and disadvantages of CVL? |
|
Definition
| eliminates need for needle sticks, long term IV therapy, TPN; pneumothorax, CRBI |
|
|
Term
| What does PICC stand for? |
|
Definition
| peripherally inserted central catheter |
|
|
Term
|
Definition
| Basilic vein preferred; less complications than CVL; catheter thrombosis if tip is in mid clavicular area and not SVC; can be used for months |
|
|
Term
| Describe a tunnled central catheter |
|
Definition
| used for frequent long term infusion therapy, less chance of infection; used when PICCs are not a good choice |
|
|
Term
| Describe a dialysis catheter site and usage |
|
Definition
| contain large doses of heparin and should not be used for anything else unless it's an emergency |
|
|
Term
| Hypertonic solutions should not be given where? |
|
Definition
|
|
Term
| Describe circulatory overload |
|
Definition
| elevation in blood pressure from an increase in blood volume; can lead to heart failure or pulmonary edema |
|
|
Term
|
Definition
| sudden adverse reaction to IV meds or drugs given too quickly; flushed face, headache, tight feeling in chest, irregular pulse |
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