Term
| What is insertion of needle into pleural space to drain fluid or instill meds? |
|
Definition
|
|
Term
| What is pleural sclerosis? |
|
Definition
| thickens pleura to decrease effusion |
|
|
Term
| What type of procedure doesn't need informed consent? |
|
Definition
|
|
Term
| How is a patient positioned for a Thoracentesis? |
|
Definition
| Arms resting on pillows, overbed table or sidelying with HOB up-side to be "tapped" at edge of mattress |
|
|
Term
| What are the Pre-procedure Assessments for Thoracentesis? |
|
Definition
| VS, Lung sounds, O2 sats, symmetry of chest movement, check labs: CBC, PT/PTT, obtain equipment |
|
|
Term
| What is the main concern with Thoracentesis? |
|
Definition
|
|
Term
| What are the s/s of pneumothorax? |
|
Definition
| SOB, pallor, tachycardia, c/o dizziness & chest pain |
|
|
Term
| What are the s/s of medial sternum shift? |
|
Definition
| bleeding within 1h, coughing up bloody sputum, VS critical fast=hypotension and tachycardia |
|
|
Term
| What are the Post-procedure Assessments for Thoracentesis? |
|
Definition
| VS-should be stable q 15"x4, Lung sounds, O2 sats, RR, chest expansion, client should be able to breath easier, CXR |
|
|
Term
| How long should the patient be watched after a Thoracentesis? |
|
Definition
|
|
Term
| What procedure is the insertion of a needle into the peritoneal space to drain fluids? |
|
Definition
|
|
Term
| How is a patient positioned for a paracentesis? |
|
Definition
| dangle at bedside, HOB at 45 degrees |
|
|
Term
| What are the Pre-procedure Assessments for a Paracentesis? |
|
Definition
| Abdominal Girth-mark in cm where measurement done, wt, have client void if no foley in place, check labs: CBC, PT/PTT,BMP, obtain equipment |
|
|
Term
| How much fluid is normally removed during a paracentesis? |
|
Definition
|
|
Term
| What is caused if too much fluid is removed? |
|
Definition
|
|
Term
| What are the post-procedure assessments for a paracentesis? |
|
Definition
| VS, wt, abdominal girth at same level |
|
|
Term
| What is the main problem with a paracentesis? |
|
Definition
|
|
Term
| What procedure has a needle inserted into subarachnoid space? |
|
Definition
|
|
Term
| Which area of the spine is the Lumbar puncture done? |
|
Definition
| between L3 & L4 or L4 & L5 |
|
|
Term
| What are the 4 reasons to do a Lumbar puncture? |
|
Definition
Spinal Menegitis
Obtain measurements when blockage is suspected
Myleogram-ruptured discs
To instill medicine-antibiotics, chemo, lidicane or predisone |
|
|
Term
| What is the position for the patient for a lumbar puncture? |
|
Definition
| side-lying knees to chest, side of bed support arms with overbed table, backwards on chair |
|
|
Term
| What are the Pre-procedure Assessments for a Lumbar puncture? |
|
Definition
| VS, Ability of pt to cooperate and tolerate positioning, obtain equipment |
|
|
Term
| What is the normal pressure for Lumbar puncture? |
|
Definition
|
|
Term
| What is the specific gravity for Lumbar puncture? |
|
Definition
|
|
Term
| What is the glucose for lumbar puncture? |
|
Definition
|
|
Term
| What is the CBC for lumbar puncture? |
|
Definition
|
|
Term
| What is the WBC for lumbar puncture? |
|
Definition
|
|
Term
| Which tube cannot be tested for cell count? |
|
Definition
|
|
Term
| There are 4 tubes for lumbar puncture-what do they collect? |
|
Definition
| C&S, Glucose, Protein, Cell Count |
|
|
Term
| What does clear fluid mean in a lumbar puncture? |
|
Definition
|
|
Term
| What is the compostion of the fluid from a lumbar puncture for Bacterial menegitis? |
|
Definition
|
|
Term
| What is the Post-procedure Assessment for a lumbar puncture? |
|
Definition
| VS, MD will specify how long client must lie flat |
|
|
Term
| Why must a pt lie flat after a lumbar puncture? |
|
Definition
| Allows clot to seal puncture site, prevents leaking of CSF through puncture, prevents HA |
|
|
Term
| What is the insertion of a needle into the liver? |
|
Definition
|
|
Term
| What is the position of the patient during a liver biopsy? |
|
Definition
| generally supine with R side near edge of mattress-30 degrees |
|
|
Term
| What are the Pre-procedure Assessments for a liver biopsy? |
|
Definition
| VS, Lung sounds, O2 sats, labs-CBC, PT/PTT, INR, obtain tray thru central supply or brought by pathology tech |
|
|
Term
| What is the #1 complication with a lumbar puncture? |
|
Definition
|
|
Term
| What are the Post-procedure Assessments for a lumbar puncture? |
|
Definition
| Client positioned on R side- for 2h so don't bleed, VS q 30", Assess Bx site q 30", assess lung sounds-risk of diaphragmatic puncture |
|
|
Term
| What is a bone marrow Bx obtained for? |
|
Definition
|
|
Term
| What is the position for a bone marrow Bx? |
|
Definition
if taken through the Sternum or Anterior iliac-Supine
If taken through the Posterior Iliac-Prone |
|
|
Term
| What is put on the puncture site if bone marrow is taken from the supine position? |
|
Definition
|
|
Term
| How is the patient to be if the bone marrow was taken prone? |
|
Definition
|
|
Term
| What is the recovery time for a bone marrow Bx? |
|
Definition
|
|
Term
| What are the Post-procedure Assessments for a bone marrow Bx? |
|
Definition
| VS, apply pressure to puncture site, assess puncture site q 30" |
|
|
Term
| What fiberoptic procedure lets the MD see the esophagus, stomach and duodenum? |
|
Definition
|
|
Term
| What fiberoptic procedure scopes backwards to the gallbladder and pancreas? |
|
Definition
|
|
Term
| What fiberoptic procedure is prepped for the day before? |
|
Definition
|
|
Term
| What fiberoptic procedure lets the MD view the larynx, trachea, and bronchial tree? |
|
Definition
|
|
Term
| What is the #1 complication of a fiberoptic procedure? |
|
Definition
|
|
Term
| What is the #2 complication of a fiberoptic procedure? |
|
Definition
|
|
Term
| What must the patient do after a fiberoptic procedure before they can go home? |
|
Definition
| re-establish their gag reflex |
|
|
Term
| What is the Pre-op Assessments for a fiberoptic procedure? |
|
Definition
| VS, IV access, NPO, bowel prep for colonoscopy |
|
|
Term
| What meds does the client receive for a fiberoptic procedure? |
|
Definition
| Versed, Demerol, or Propofol |
|
|
Term
| What is the Post-procedure care after a fiberoptic procedure? |
|
Definition
| recover in PACU until fully awake, for scopes through the mouth-client must have gag reflex before po fluids are allowed |
|
|
Term
| What is observed for in EGD? |
|
Definition
|
|
Term
| What is to be observed for after a Bronchoscopy? |
|
Definition
|
|
Term
| What is observed for after a colonoscopy? |
|
Definition
|
|
Term
| What is a s/s of perforation after an EGD? |
|
Definition
| chest pain, abdominal pain, fever |
|
|
Term
| What is a s/s of perferation after a Bronchoscopy? |
|
Definition
| dyspnea, diminished or absent breath sounds, decreasing O2 sats, fever |
|
|
Term
| What are the s/s of perferation after a colonoscopy? |
|
Definition
| abdominal pain, rigidty, fever |
|
|
Term
| What are normal post procedure findings after an EGD? |
|
Definition
|
|
Term
| What is normal post procedure finding after bronchoscopy? |
|
Definition
| sore throat/mouth, slight hoarseness, blood streaked sputum |
|
|
Term
| If hoarseness gets worse or inability to speak after a bronchoscopy what does this signal? |
|
Definition
|
|
Term
| What are normal post procedure findings after a colonoscopy? |
|
Definition
| abdominal soreness, flatus/mild cramping, blood streaked mucus |
|
|
Term
| What is some discharge teaching for fiberoptic procedures? |
|
Definition
| Expected course, complications (s/s what to report), when to expect results if Bx were done-usually 48h for official results |
|
|
Term
|
Definition
| continuous bladder irrigation |
|
|
Term
|
Definition
| after bladder/prostate surgeries |
|
|
Term
| What can be used to control hematuria? |
|
Definition
|
|
Term
| What are the ports on a 3 way cath? |
|
Definition
| saline, middle-foley cath, fluids |
|
|
Term
| How many cc's are used for the irrigation fluid in a 3 way cath? |
|
Definition
|
|
Term
| What color is active bleeding? |
|
Definition
|
|
Term
| What color is slowing bleeding? |
|
Definition
|
|
Term
| What color is more drainage than bleeding? |
|
Definition
|
|
Term
| Rapid rate of flow may cause what during a CBI? |
|
Definition
|
|
Term
| If rapid rate causes bladder spams, what could a slow rate cause? |
|
Definition
|
|
Term
| How to calculate the actual urine output... |
|
Definition
| amt of irrigant - total drainage= actual urine output |
|
|
Term
| What is the use of mechanical filtration to remove liquid waste products? |
|
Definition
|
|
Term
|
Definition
| pts with renal failure, posioning and sepsis |
|
|
Term
| What labs are done for dialysis? |
|
Definition
|
|
Term
| What is a machine that pumps out arterial blood, cleans it then returns blood to pt via vein? |
|
Definition
|
|
Term
| What "accesses" are clients given with hemodialysis? |
|
Definition
|
|
Term
| How many days is the dialysis cath in place? |
|
Definition
|
|
Term
| How often are dialysis dressings changed? |
|
Definition
|
|
Term
| What is the most common complication with hemodialysis? |
|
Definition
|
|
Term
| What is assessed for dialysis? |
|
Definition
| daily wt-dry vs wet, lung sounds, edema, I&O, special renal diet, monitor electrolytes-creatinine K+ |
|
|
Term
| What is assessed each shift and immediately after dialysis treatment? |
|
Definition
| bruit, thrill and bleeding |
|
|
Term
| What meds are not to be given to dialysis unless ok'd by the nurse? |
|
Definition
|
|
Term
| Why may the pt be confused before dialysis Tx? |
|
Definition
|
|
Term
| What makes the pt hypetensive after dialysis tx? |
|
Definition
| rapid fluid shifts-disequilibrium syndrome |
|
|
Term
| What is given if the dialysis pt becomes hypertensive? |
|
Definition
| Procardia- 30 mg under tongue |
|
|
Term
| What is dialysis is used with pts who are more stable and able to follow complicated regime? |
|
Definition
|
|
Term
| How long is a Peritoneal Dialysis? |
|
Definition
|
|
Term
| How often is a peritoneal dialysis given? |
|
Definition
|
|
Term
| What is a SE of peritoneal dialysis? |
|
Definition
|
|
Term
| Where is the peritoneal bag placed on pt? |
|
Definition
|
|
Term
| What should the bag weigh after a peritoneal dialysis? |
|
Definition
|
|
Term
| If the bag of a peritoneal dialysis weighs less or the same as before the procedure what should the nurse do? |
|
Definition
|
|
Term
| What is the fluid for the peritoneal dialysis called? |
|
Definition
|
|
Term
| What temp is the Dialysate instilled at? |
|
Definition
|
|
Term
| What are the s/s for peritonitis? |
|
Definition
|
|
Term
| What should the dialysate look like coming out? |
|
Definition
|
|
Term
| If the dialysate is smoky, pink or red tinge coming out this means____? |
|
Definition
|
|
Term
| What is the most common type of cast? |
|
Definition
|
|
Term
| What is the drying time for a plaster cast? for a fiberglass cast? |
|
Definition
24h-plaster
1h-fiberglass |
|
|
Term
| What is assessed for CMS? |
|
Definition
circulation-cap refill, color, skin temp, pulses
motor-able to wiggle fingers/toes
sensory-is there any numbness/tingling |
|
|
Term
| How often is CMS assessed? |
|
Definition
|
|
Term
| What is a common problem with casts? |
|
Definition
|
|
Term
| How often is a fiberglass cast changed? |
|
Definition
|
|
Term
| What is a hole called that is put into the cast to relieve pressure? |
|
Definition
|
|
Term
| What is an open area around an abrasion area in a cast called? |
|
Definition
|
|
Term
| If there is itching while the cast is being put on...there may be an __________? |
|
Definition
|
|
Term
| What is a system that utilizes weights and counterweights to correct and maintain bone alignment? |
|
Definition
|
|
Term
| What is the primary use for Traction? |
|
Definition
|
|
Term
| What is traction used for in PT? |
|
Definition
|
|
Term
| How often is CMS assessed during traction? |
|
Definition
|
|
Term
| What is the pin that is attached to the inside during traction? |
|
Definition
|
|
Term
| What holds the wires out during traction? |
|
Definition
|
|
Term
| If traction is to be applied to the cervical area, what is this type called? |
|
Definition
|
|
Term
| How often is pin care assessed? |
|
Definition
|
|
Term
| What is the #1 complication for traction? |
|
Definition
|
|
Term
| What is assessed during nursing care? |
|
Definition
| insertion sites for warmth and drainage, client for osteomyelitis-fever/chills and fat embolism-confustion/petechia |
|
|
Term
| What does a Trapeze bar do for a pt? |
|
Definition
| increases mobility and increases imdependence |
|
|
Term
| How is constipation prevented from traction immobility? |
|
Definition
| stool softener, exercise, fiber, FF, laxative-PRN |
|
|
Term
| How is a UTI prevented from traction immobility? |
|
Definition
| FF, remove cath, enforce cranberry juice, reg toileting, bladder scan |
|
|
Term
| How is renal calculi prevented from traction immobility? |
|
Definition
| FF, cranberry juice, assess urine |
|
|
Term
| How is skin breakdown prevented from traction immobility? |
|
Definition
| check q shift, special bed |
|
|
Term
| How is pneumonia prevented from traction immobility? |
|
Definition
| deep breath, cough, assess lung sounds, incentive spirometer q4h |
|
|
Term
| How is DVT prevented from traction immobility? |
|
Definition
| AES on opposite leg, assess pulse, Holmens sign |
|
|
Term
| How is contracture prevented from traction immobility? |
|
Definition
| PT on opposite extremities |
|
|
Term
| How is foot drop prevented from traction immobility? |
|
Definition
|
|
Term
| What is a combination of interventions which helps mobilize respiratory secretions? |
|
Definition
|
|
Term
| What makes up the Pulmonary Toilet? |
|
Definition
| Postural drainage, percussion, vibration |
|
|
Term
| When is Pulmonary toilet done? |
|
Definition
| either 1h ac or 2h pc to avoid N/V and possible aspiration |
|
|
Term
| What is used to administer anesthesia or to allow mechanical ventilation? |
|
Definition
|
|
Term
| Who can perform ET placements? |
|
Definition
| MD, CRNA, specially trained RT and RN, Paramedics |
|
|
Term
| What is the normal sizes for ET tubes? |
|
Definition
|
|
Term
| What blocks the trachea to maintain air flow on an ET tube? |
|
Definition
|
|
Term
| How is the ET tube placed? |
|
Definition
| via laryngoscope thru vocal cords and into trachea |
|
|
Term
| What is given for CS for ET tube placement? |
|
Definition
|
|
Term
| What should the nurse check on the ET tube before procedure? |
|
Definition
| light on laryngoscope and balloon on ET tube |
|
|
Term
| What is to be listened for to make sure placement is correct? |
|
Definition
|
|
Term
| What kind of procedure is the Trach in the hospital? |
|
Definition
|
|
Term
| How long is the sutures in place for a Trach? |
|
Definition
|
|
Term
| What guides the trach in and should be left at the bedside in a sterile cup? |
|
Definition
|
|
Term
| How often should the trach be cleaned? |
|
Definition
|
|
Term
| Why is a chest tube inserted? |
|
Definition
| to maintain/reestablish negative pressure within thoracic cavity |
|
|
Term
| What is the most common procedure to put in a chest tube? |
|
Definition
|
|
Term
| How often is respiratory assessment done for a chest tube? |
|
Definition
|
|
Term
| If there is no oscillation (bubbling) inside the chamber for chest tube what must the nurse check? |
|
Definition
| connections and if pneumothorax is resolved |
|
|
Term
| If there is constant bubbling in the water seal chamber what must the nurse check for? |
|
Definition
|
|
Term
| What will increase pleural pressure? |
|
Definition
| clamping, milking or stripping the tube |
|
|
Term
| What sounds/feels like bubble wrap and will drown the pt in fluid? |
|
Definition
|
|
Term
| What must be kept by the bedside while the pt has a chest tube? |
|
Definition
|
|
Term
| What is a short term vent used for? long term? |
|
Definition
|
|
Term
| When the vent tube bypasses the normal humidifying effect what is the pt at risk for? |
|
Definition
| Mucus plug #1 complication vent pts die from |
|
|
Term
| What is the setting for FiO2? |
|
Definition
22-100%
usually start at 40% |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| if pt doesn't take a breath, machine will give |
|
|
Term
|
Definition
| mimics normal respiration |
|
|
Term
|
Definition
| Tidal Volume- amt of air per cc per respiratory cycle |
|
|
Term
|
Definition
|
|
Term
|
Definition
| alarm indicates need for suction |
|
|
Term
|
Definition
| positive pressure-keeps alveoli open |
|
|
Term
| What is the earliest sign of hypoxia? |
|
Definition
|
|
Term
| What monitor is a continuous heart rate/rhythm? |
|
Definition
|
|
Term
| What monitor is worn at home and keeps a journal of activities/symptoms for 24h? |
|
Definition
|
|
Term
| What monitor is worn for 30 days, for irregular arhythmias, allowed to take off for showers? |
|
Definition
|
|
Term
| What is a temp pacemaker for? |
|
Definition
| bradycardias and 3rd or 4th heart blocks |
|
|
Term
|
Definition
| lowest sensitivity that causes the SA node to fire |
|
|
Term
| What is the threshold rate set at? |
|
Definition
|
|
Term
| What type of pacer is where the wire is in either the SA node or the AV node? |
|
Definition
|
|
Term
| What type of pacer is in both the SA and AV node? |
|
Definition
|
|
Term
| Dual chamber pacer will only fire if under________? |
|
Definition
|
|
Term
| What type of pacer has 3 chambers-SA and AV node and has a third wire in the left ventricle? |
|
Definition
|
|
