1. Usually taken to assess the blood's normal cells and other components.
2. To determine the presence of abnormalities of disease organisms.

1. Median Cubital Vein 
2. Cephalic vein
3. Basilic vein

1. Remove protective cap
2. Clean rubber stopper with alcohol prep 
3. Add amount of air into syringe equal to amount of medication that will be withdrawn from vial.
4. Insert needle into rubber stopper, inject air into vial
5. Pull plunger back to the desired ml mark.
6. Verify correct dosage by holding syringe at eye level and ensuring forward edge of plunger is exactly on prescribed ml mark

1. Lightly tap the uprightampule to force any trapped medication out of the ampule neck and top.
2. Clean neck of ampule with alcohol prep pad. Wrap neck of ampule with same prep pad.
3. Grasp the neck and pad and snap the neck bending it away from the break line.  BREAK AWAY FROM YOU AND OTHERS.
4. Hold ampule to light, inspect for glass particles.  If glass is present, discard ampule and replace.
5. Hold ampule vertical and withdraw med.
6. Check syringe for air bubbles.

1. Deltoid Muscle (only up to 2 ml)
2. Gluteus Maximus (5ml of med)
3. Vastus Lateralis (5ml)

Note: Vastus Lateralis is the outer thigh

1. Upper Arm (0.5 ml)
2. Vastus Laeralis (2 ml)
3. Abdomen (varies)

1. Inner forearm is primary site
2. Free of hair, tattoos, and scars
3. NOT over a vein or bony area

1. Fever greater than 101 F
2. Shortness of breath
3. Abnormal breath sounds: rhonci, rales, wheezing
4. Abnormal pulse ox (less than 95%)
5. Accessory muscle use

1. Inspect and palpate
2. Note rate, rhythm, and effort of breathing 
3. Auscultate bilaterally

1. Productive cough with purulent sputum
2. Chest pain, worse with cough
3. SOB at rest
4. Malaise, lethargy
5. Poor appetite 
6. Fever occasionally with shaking chills
7. Tachycardia
8. RHONCHI AND RALES MAY BE PRESENT

1. Emotional Upsets
2. Physical Exertion
3. Cold Weather
4. Upper Resp Infection
5. Allergens: pollen,mold,dust, etc

1. Inhaled bronchodilators  - MDI or nebulizer
2. IV fluids
3. Supplemental 02

1. Intolerable pain not responsive to tx
2. Open fx, deformities, and neuro compromised extremities
3. Trauma with neuro changes, muscle weakness, or a deteriorating exam in the affected extremity
4. Ay hot, swollen joint or inability to fully extend or flex the extremity
5. Any suspected fx

1. RICE
2. NSAIDs or acetominophen
3. Activity modification
4. Splint or brace

If you think it is a fx, then to as one.  Give them crutches and refer to MO

1. Extent of the injury
2. Type of injury
3. Infection
4. Pt's nutritional status
5. Age of the pt
6. Obesity
7. Impaired oxygenation
8. Smoking
9. Drugs

1. Serous - clear and watery
2. Sanguinous - bloody
3. Serosanguonous - serum and blood
4. Purulent - pus

0.5 ml

If wounded, pt needs it if they haven't received the shot in the last 5 yrs.

Every 10 yrs if no injuries occur.

How often should adults receive tetanus boosters?

Every 10 years.

5 years if the pt receives an open wound.

1. Gauze
2. Transparent
3. Hydrocolloid

Open Drains (tube in wound, uses gravity to drain)

Closed/suction drains (suction units)

Jackson Pratt Drain

Hemovac

• Liver
• Gallbladder
• Head of the pancreas
• Part of the colon
• Small intestine
• Abdominal aorta
• Right kidney
• Right renal artery

• Stomach
• Spleen
• Tail of the pancreas
• Part of colon
• Small intestine
• Left kidney
• Left renal artery

1. Inspect
2. Auscultate
3. Palpate

1. Progressive, severe pain w/o improvement over 6 hrs
2. Severe pain with rebound tenderness in RLQ
3. Hx of ABD surgery within last 6 mo
4. ABD  pain with associated fever
5. ABD withtachycardia 
6. blood in stool or black stool
7. Emesis containing blood or coffee grounds

1. Fluid resuscitation
2. Anti diarrheal medication - Pepto Bismol or Kaopectate
3. Antibiotic therapy
4. Liquid to bland diet

Imodium (loperamide)

Pepto-Bismol

Kaopectate

Kidney infection

Normally occurs in females as a progression of cystitis (UTI)

UTI - Urinary Tract Infection

An infection of the urinary bladder

1. Sclera - white of the eye
2. Conjunctiva - pink membrane that lines eyelid
3. Retina - Rods and cones that make images
4. Cornea - covers pupil and lens
5. Lens - filled with jelly like substance; focuses
6. Iris - colored part; controls amout of light entering eye
7. Pupil -circle in iris
8. Lacrimal glands - tear ducts

• Chemical irritation
• Infections
• Allergies

Tympanic Membrane

AKA: Ear Drum

Separated externaland middle ear, see through membrane, pearly gray or amber in color.

1. Malleus (hammer)
2. Incus (anvil)
3. Stapes (stirrup)

1. Cerumen Impaction - wax buildup
2. Otis Externa (OE) - swimmer's ear
3. Otis Media (OM) - middle ear infection

• Hearing loss
• Pain usually not present
• TM can't be seen during exam due to wax

1. Temp 101 F or higher
2. Object embedded in ear

A head cold

Results in mucous buildup in the Eustachian Tube, possibly causing some hearing loss during course of infection.  

Mainly viral but can be bacterial.

Sore throat and feeling stuffed up.

Upper Respiratory Infection

1. Significant lymph gland enlargement of the neck
2. Shaggy, white-purple tonsillar exudate
3. ABD Pain may indicate INFLAMMATION OF THE SPLEEN.