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Blue Book > 2 > Flashcards

2 Flashcards

1
Q

If my blood pressure is 190/110, what is my pulse

pressure?

A

80 mm/hg

Systolic - diastolic (formula)

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2
Q

What blood test must be done before a transfusion?

A

Type and cross match

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3
Q

What does a type and cross match indicate?

A

Whether the client’s blood and donor blood are compatible.

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4
Q

What should the nurse measure before starting a transfusion?

A

Vital signs

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5
Q

With what solution should blood be transfused?

A

0.9 normal saline

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6
Q

How many nurses are required to check the blood?

A

2 nurses

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7
Q

What happens when blood is administered with Dextrose Is?

A

The cells clump together & don’t flow well.

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8
Q

If a transfusion reaction occurs what should the nurse do first?

A

Stop the blood flow & start running the saline.

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9
Q

How long can a unit of blood be on the unit before it must

be started?

A

Less than 1/2 hour

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10
Q

What should the nurse do with the IV line if transfusion reaction is suspected?

A

Keep it open with saline

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11
Q

If a transfusion reaction is suspected, what two samples

are collected and sent to the lab?

A

Urine & blood

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12
Q

If a unit of blood is infused through a central line it must be

A

Warmed

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13
Q

Which of the following are signs of transfusion reaction?

A

Bradycardia, Fever, Hives, Wheezing, increased Blood Pressure,
Low Back Pain: Low back pain, wheezing, fever, hives

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14
Q

What are three types of transfusion reactions that can occur?

A

Hemolytic, febrile, allergic

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15
Q

What would you do first if you suspected transfusion reaction?

A

Stop the blood and start the saline

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16
Q

What are the signs and symptoms of a hemolytic transfusion reaction?

A

Shivering, HA, low back pain, increased

pulse & respirations, decreasing BP, oliguria, hematuria.

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17
Q

What are the signs and symptoms of a febrile transfusion reaction?

A

Low back pain, shaking HA, increasing temperature, confusion, hemoptysis

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18
Q

What are the signs of symptoms of an allergic reaction to a transfusion?

A

Hives- uticaria, wheezing, pruritus, joint pain, (arthralgia)

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19
Q

Give three reasons for a blood transfusion

A

Restore blood
volume secondary to hemorrhage, maintain hemoglobin in
anemia, replace specific blood components.

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20
Q

What does blood-typing mean?

A

Check for surface antigen on the red blood cell.

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21
Q

When does typing and cross matching need to be done?

A

Whenever a client is to get a blood product. It is only good for
24 hours.

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22
Q

What does blood cross matching mean?

A

Mixing a little of

the client’s blood with the donor blood and looking for agglutination.

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23
Q

When are hemolytic transfusion reactions likely to occur?

A

In the first 10 to 15 minutes

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24
Q

When is a febrile reaction likely to occur?

A

Within 30 minutes of beginning the transfusion.

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25
Q

What test identifies Rh factor?

A

Coombs test detects antibodies to Rh

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26
Q

What is the difference between whole blood and packed cells?

A

Packed cells don’t have nearly as much plasma or volume as whole blood does

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27
Q

What would you do if the client had an increasing temperature and was to get blood?

A

Call the MD because

blood is often held with an elevated temperature

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28
Q

blood is often held with an elevated temperature

130. How long should it take for one unit of blood to infuse?

A

From one hour to three hours

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29
Q

What blood type is the universal recipient?

A

AB

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30
Q

What blood type is the universal donor?

A

O

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31
Q

What is the routine for vital sign measurement with a transfusion?

A

Once before administration
015 x2 after administration is begun
01 x1 after transfusion has stopped

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32
Q

What IV solution is hung with a blood transfusion?

A

0.9 normal saline (No glucose)

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33
Q

What gauge needle is used with a blood transfusion?

A

Large gauge, 18 gauge

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34
Q

What other things are appropriate after a reaction?

A

Call MD, get a blood sample, get urine sample, monitor vitals, send
blood to lab

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35
Q

Can blood be given immediately after removal from refrigeration?

A

No, it has to be warmed first for only about 20 to 30 minutes.

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36
Q

With what solution & when should a breast feeding mother cleanse the areola?

A

Plain water, before & after each feeding

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37
Q

For a woman who doesn’t have retracted nipples, is towel drying or air drying better?

A

Air drying of the nipples is best

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38
Q

The goal is for the infant to breast feed for

A

20 minutes per side.

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39
Q

How does the mother break the suction of the breast feeding infant?

A

She inserts her little finger into the side of the infant’s mouth

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40
Q

When should the breast feeding infant be burped?

A

After feeding from each breast

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41
Q

Assuming no mastitis, on which side should the breastfeeding begin?

A

Begin nursing on the side that the baby

finished on the last feeding.

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42
Q

How long can breast milk be refrigerated?

A

24 hours

43
Q

How long can breast milk be frozen?

A

6 months

44
Q

In what type of container should breast milk be stored?

A

Sealed plastic bags

45
Q

Can you microwave frozen breast milk in order to warm/thaw it?

A

Never

46
Q

Which two nutrients is breast milk lower in?

A

Fluoride and iron

47
Q

What should you tell a breast feeding mother about her milk supply when she goes home from the hospital?

A

Milk should come in postpartum day 3. Breastfeed every 2-3 hours
to establish good milk supply.

48
Q

Can a woman on oral contraceptives breastfed?

A

Should not use OCP during the first 6 weeks after birth because the
hormones may decrease milk supply. Estrogen is not recommended. Non-hormonal methods are recommended.
Remember, breastfeeding is an unreliable contraceptive.

49
Q

What is another name for Burger’s disease?

A

Thrombo angiitis obliterans

50
Q

Which extremities are affected by Burger’s disease?

A

Lower extremities

51
Q

Which sex does it affect the most often? (Burger’s disease)

A

Males

52
Q

The group with the highest incidence of Burger’s disease is:

A

Smokers

53
Q

Upon walking the patient with Burger’s experiences

A

Intermittent Claudication

54
Q

What is intermittent claudication?

A

Pain in calf upon walking

55
Q

A first degree burn is pale or red?

A

Red

56
Q

First degree burn has vesicles? T or F

A

False

57
Q

A second-degree burn is pale or red?

A

Red

58
Q

A second-degree burn is dull or shiny?

A

Shiny

59
Q

A second-degree burn has vesicles?

A

True

60
Q

A third-degree burn is white or red?

A

White

61
Q

A third-degree burn is wet or dry?

A

Dry

62
Q

A third degree burn is hard or soft?

A

Hard

63
Q

Of first, second and third degree burns which has less

pain? Why?

A

Third degree burns, nerve damage has occurred

64
Q

For what purpose do you use the rule of nines?

A

To estimate the percentage of body surface burned; is NOT used
for children.

65
Q

What is the only IM given to a burn patient?

A

Tetanus toxoid- if they had a previous immunization; tetanus antitoxin-
if they have never been immunized before (or immune
globulin)

66
Q

In the emergent phase do you cover burns?

A

(in the field):

Yes, with anything clean and dry.

67
Q

Should you remove adhered clothing?

A

No

68
Q

Name the 3 phases of burn:

A

Shock, diuretic, recovery

69
Q

Fluid moves from the bloodstream to the interstitial:

A

in the SHOCK phase.

70
Q

The shock phase lasts for the

A

first 24 to 48 hours after a

burn.

71
Q

During shock phase of a burn is potassium increased or

decreased? Why?

A

Increased, because of all the cells damaged-

the K+ is released from damaged cells.

72
Q

What acid-base disorder is seen in the shock phase of a burn?

A

Metabolic Acidosis

73
Q

What is the #1 therapy in the shock phase?

A

Fluid replacement/resuscitation

74
Q

What is the simple formula for calculating fluid replacement needs in the first 24 hours?

A

3cc X Kg X%

burned per day

75
Q

What blood value will dictate IV flow rate?

A

The hematocrit

76
Q

How will you know the patient has entered the fluid mobilization or diuretic phase?

A

The urine output will Increase

77
Q

How long does the fluid mobilization or diuretic phase of a burn last?

A

2 to 5 days

78
Q

In the diuretic phase, K+ levels fall or rise?

A

Fall- remember diuresis always causes hypokalemia

79
Q

If the nurse accidentally runs the IVs at the shock phase rate during the diuretic phase the patient will experience?

A

Pulmonary edema

80
Q

The burn patient will be on hourly urine output and daily weight.

A

The burn patient will be on hourly urine output and daily weight.

81
Q

Sulfamyon cream is used for

A

Burns

82
Q

Silver nitrate cream

A

Stains the skin

83
Q

Pain medications should be administered

A

30 minutes before wound

84
Q

When using silver nitrate, the dressings must be kept

A

Wet

85
Q

What is Curlings ulcer? Why is it a problem in burn

patients? What drug prevents it?

A

It is a stress Gl ulcer, you
get these with any severe physical stress. Tagamet, Zantac,
Pepcid (any H2 receptor antagonist), Protonix Prilosec

86
Q

Abruptio Placenta usually occurs in (prima/multi) gravida over the age of

A

Multigravida, 35 (HTN, trauma, cocaine)

87
Q

How is the bleeding of Abruptio Placenta different from that in placenta previa?

A

usually pain; bleeding is more

voluminous in previa

88
Q

If you are the nurse starting the IV on the client with

Abruptio Placenta, what gauge needle should you use?

A

18 (in preparation to give blood if necessary)

89
Q

How often should you measure the vital signs, vaginal

bleeding, fetal heart rate during Abruptio Placenta?

A

Q5-15
minutes for bleeding and maternal VS, continuous fetal
monitoring, deliver at earliest sign of fetal distress

90
Q

How is an infant delivered when Abruptio Placenta is present?

A

Usually C-section

91
Q

Is there a higher or lower incidence of fetal death with Abruptio Placenta compared to Placenta Previa?

A

Higher

92
Q

In what trimester does Abruptio Placenta most commonly occur?

A

Third

93
Q

At what age are accidental poisonings most common?

A

2 years old

94
Q

If a child swallows a potentially poisonous substance, what should be done first?

A

call medical help

95
Q

Should vomiting be induced after ingestion of gasoline?

A

No- not for gas or any other petroleum products

96
Q

When taking a child to the ER after accidental poisoning

has occurred what must accompany the child to the ER?

A

the suspected poison

97
Q

An elderly client is a (high/low) risk for accidental

poisoning? What about a school age child?:

A

high - due to poor eyesight, high

98
Q

What types of chemicals cause burns to oral mucosa when ingested?

A

Lye, caustic cleaners

99
Q

Children at highest risk for seizure activity after ingestion are those who have swallowed

A

drugs and Insecticides.

100
Q

Can impaired skin integrity ever be an appropriate nursing

diagnosis when poisoning has occurred?

A

Yes, when lye or caustic agents have been ingested

101
Q

What is the causative organism of acne?

A

Propionibacterium acnes

102
Q

What structures are involved in acne vulgaris?

A

The sebaceous glands

103
Q

Name 3 drugs given for acne?

A

Vitamin A, Antibiotics, Retinoids

104
Q

Dietary indiscretions and uncleanliness are causes of acne?

A

False

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