Shared Flashcard Set

Details

NUR 871
Exam 1
37
Nursing
Undergraduate 3
01/22/2011

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Cards

Term
What are the ranges of Hgb for male and female?
Definition
M (14-18) W (12-16)
Term
What are the ranges of Hct for male and female?
Definition
M (37-47) W (32-42)
Term
What are the Nursing Responsibilities for Hgb and Hct?
Definition
Explain the procedure and it's purpose
Term
What does Hgb reflect?
Definition
reflects amount of Hgb available for combination with oxygen. Venous blood is used.
Term
What does Hct reflect?
Definition
reflects ratio of blood cells to plasma. Increased hct (polycythemia) found in chronic hypoxemia. Venous blood is used.
Term
When looking at H&H labs that may be high or low, what is important to consider about the patient?
Definition
What is the patients trend (Are they usually high or are they usually low)
Term
When you see that a patient is receiving ABG's what is the first question you should ask and why?
Definition
Figure out why the person is receiving ABG's because they are uncommon to receive.
Term
What is perfusion? and why is it important?
Definition
The circulation of blood and oxygen and nutrients to an area. It is important because our tissue needs good perfusion to survive.
Term
What is it called if a persons 02 is dropping? and when should something be done about it?
Definition
If a persons 02 is dropping it is called desaturation and something needs to be done immediately.
Term
What are the Nursing Responsibilities of a person receiving an ABG test?
Definition
Indicate whether patient is using 02 (percentage, L/min), Avoid change in therapy or intervention (ex. suctioning, position change, etc.) for 20 min. before obtaining a sample, Assist with positioning, Collect blood into heparinized syringe.
Term
What can a nurse do to help ensure accurate results in an ABG test?
Definition
To ensure accurate results, expel all air bubbles, and place sample in ice, unless it will be analyzed in less than 1 minute.
Term
When someone is receiving ABG's, what can the nurse do to prevent hematoma?
Definition
Apply pressure to artery for 5 min. after specimen is obtained to prevent hematoma at the arterial puncture site.
Term
How are ABG's obtained and what do they assess for?
Definition
Arterial blood is obtained through puncture of radial or femoral artery or through arterial catheter. Performed to assess acid-base balance, ventilation status, need for oxygen therapy, or change in ventilator settings.
Term
How is a oximetry test obtained and what does it monitor?
Definition
An oximetry test monitors arterial or venous oxygen saturation. Probe attaches to the finger, toe, earlobe, and bride of nose for Sp02 or pulmonary artery catheter for Sv02.
Term
What are the Nursing Responsibilities for Oximetry Test?
Definition
Apply probe. When interpreting Sp02 and Sv02 values, first assess patient status and presence of factors that can alter accuracy of pulse oximetry reading. For Sp02 these include motion, low perfusion, cold extremities, bright lights, acrylic nails, dark skin color, carbon monoxide, and anemia. For Sv02 these include change in 02 delivery or 02 consumption.
Term
What is a culture and sensitivity test for and how is it performed?
Definition
A single specimen is collected in a sterile container. The purpose is to diagnose bacterial infection, select antibiotic, and evaluate treatment. Takes 48-72 hr for results.
Term
What are the Nursing Responsibilities for Culture and Sensitivity?
Definition
Instruct patient on how to produce a good specimen. If patient cannot produce specimen, bronchoscopy may be used.
Term
What are Gram Stain Test?
Definition
Gram Stain test are the staining of sputum, which permits classification og bacteria into gram-negative and gram-positive types. Results guide therapy until culture and sensitivity results are obtained.
Term
What are the Nursing Responsibilities for Gram Stain test?
Definition
Instruct patient to expectorate sputum into container after coughing deeply. Obtain sputum, not saliva. Obtain specimen early in the morning after mouth care because secretions collect during night. If unsuccessful, try inceasing oral fluid intake unless fluids are restricted. Collect sputum in sterile container (sputum trap) during suctioning or by aspirating secretions from trachea. Send specimen to laboratory promptly.
Term
What does a AFB test do?
Definition
Assess for acid-fast bacilli (Tuberculosis). A series of 3 early morning specimens.
Term
What are the Nursing Responsibilities for AFB?
Definition
Instruct the patient how to produce a good specimen. Cover specimen and send to laboratory for analysis.
Term
What does a cytology test do?
Definition
Determines presence of abnormal cells that may indicate malignant condition (cancer). Single sputum specimen is collected in special container with fixate solution.
Term
What are the Nursing Responsibilities for a cytology?
Definition
Send specimen to laboratory promptly. Instruct patient on how to produce a good specimen. If patient cannot produce specimen, bronchoscopy may be used.
Term
What is a Chest X-Ray (CXR) test used for?
Definition
Used to screen, diagnose, and evaluate changes in respiratory system. Most common views are anterior-posterior (AP) and lateral.
Term
What are the Nursing Responsibilities for Chest X-Ray (CXR)?
Definition
Instruct patient to undress to waist, put on gown, and remove any metal between head and neck.
Term
What is a Computed Tomography (CT) Test done for?
Definition
Performed for diagnosis of lesions difficult to assess (ex. mediastinum, hilum, pleura) by conventional x-ray studies. Common types are helical or spiral CT (contrast media is usually used) and high resolution CT scan (contrast media is not used). Spiral CT used to diagnose a pulmonary embolism.
Term
What are the Nursing Responsibilities for Computed Tomography (CT) Test?
Definition
Same as for Chest X-ray. Contrast media may be given IV. Evaluation of BUN and serum creatinine is done before contrast to assess renal function. Assess if patient is allergic to shellfish (iodine) as the contrast is iodine based. Be sure the patient is well hydrated before and after procedure (to excrete contrast). Know that contrast injection may cause a feeling of being warm and flushed. Instruct the patient that he or she will lie very still on a hard table and the scanner will revolve around the body with clicking noises.
Term
What is the Ventilation-Perfusion (V/Q) Test done for?
Definition
Used to assess ventilation and perfusion of lungs. IV radioisotope given to asses perfusion. For the ventilation portion, the patient inhales a radioactive gas (xenon or krypton), which outlines the alveoli. Normal scans show homogeneous radioactivity. Diminished or absent radioactivity suggest lack or perfusion or airflow. Ventilation without perfusion suggest a pulmonary embolus.
Term
What are the Nursing Responsibilities for Ventilation-Perfusion (V/Q)?
Definition
Same as for Chest X-ray. No precautions needed afterward because the gas and isotope transmit radioactivity for only a brief interval.
Term
What is the Bronchoscopy test for?
Definition
A flexible fiberoptic scope is used for diagnosis, biopsy, specimen collection, or assessment of changes. It may also be done to suction mucous plugs, lavage the lungs, or remove foreign objects.
Term
What are the Nursing Responsibilities for a Bronchoscopy Test?
Definition
Instruct patient to be on NPO status for 6-12 hours before the test. Obtain signed permit. Give sedative if ordered. After procedure, keep patient NPO until gag reflex returns and monitor for laryngeal edema, monitor for recovery from sedatives. Blood tinged mucous is not abnormal. If biopsy was done, monitor for hemorrhage and pneumothorax.
Term
What is the Thoracentesis test?
Definition
Used to obtain specimen of pleural fluid for diagnosis, to remove pleural fluid, or to instill medication. Chest X-ray is always obtained after procedure to check for pneumothorax.
Term
What are the Nursing Responsibilities for a Thoracentesis?
Definition
Explain procedure to patient and obtain signed permit before procedure, which is usually performed in the patient's room. Position patient upright with elbows on an overboard table and feet supported. Instruct the patient not to talk or cough, and assist during procedure. Observe for signs of hypoxia and pneumothorax and verify breath sounds in all fields after procedure. Encourage deep breaths to expand lungs. Send labeled specimens to laboratory.
Term
What is the purpose of a Pulmonary Function Test?
Definition
Used to evaluate lung function. Involves use of spirometer to assess air movement as patient performs prescribed respiratory maneuvers.
Term
What are the Nursing Responsibilities for Pulmonary Function Test?
Definition
Avoid scheduling immediately after mealtime. Avoid administration of inhaled bronchodilator 6 hr before procedure. Explain procedure to patient. Assess for respiratory distress before procedure and report. Provide rest after the procedure.
Term
What is the Nursing Care for an Anterior Nose Bleed (Epistaxis)?
Definition
Anterior: Position upright/lean forward, Reassure (calm), Lateral pressure/Ice, Loose packing, Teaching (Avoid blowing nose)
Term
What is the Nursing Care for a Posterior Nose Bleed (Epistaxis)?
Definition
Posterior: (Emergency/Hospitalization). Posterior packing, Assess respiratory status, Humidification, Oxygen, Bedrest, Pain control, Oral care, Teaching (Saline spray/humid. Avoid aspirin/NSAIDS, Avoid strenuous activities.)
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