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nursing 2900 > Acute and Complex > Flashcards

Acute and Complex Flashcards

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1
Q

How often should you check pain scale after administration of tylenol

A

1 hour

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2
Q

how often should you check pain scale after administration of Toradol

A

15-30 mins

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3
Q

Implementation (interventions) For acute pain

A

Ice and heat
repositioning
distraction
essential oils

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4
Q

Implementation (interventions) for impaired physical mobility

A

encouragement physically and emotionally
pre-medicate

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5
Q

implementation (interventions) for nausea

A

alcohol pad
slow down drinking

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6
Q

Implementation (interventions) for constipation

A

Movement
fiber intake
coffee/prune juice
fluid intake

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7
Q

Name a couple nursing Evaluations for reducing pain

A

Client will reduce pain by blah blah blah
skin integrity, resp depression, PCA use, minimal side effects from analgesic, anxiety, mobility

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8
Q

independent vs collaborative interventions for mobility

A

independent interventions are what you can do before asking for other specialties (PT, Radiology, MD)

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9
Q

Implementation of strategies to modify stuff for mobility

A

Education and empower them to get their shit together

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10
Q

Rocephin cannot go in what fluid

A

LR

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11
Q

How much should you flush through an Saline lock

A

5 mL to 10 mL

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12
Q

Complications of IVs

A

Infiltration/extravasation
phlebitis/thrombosis
Hematoma
Cellulitis
Infection

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13
Q

What to Assess with IV

A

Improperly secured IV (pulled out)
Length of time device was in place (infection
erythema at site, redness or warmth
pain or burning at the site and/or along the length of vein
vein is hard, red and cordlike

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14
Q

What are Colloids

A

large protein molecules that dont pass semipermeable membranes.
* Remain in vascular system (no absorption
* Increase intravascular volume

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15
Q

Why are colloids awesome

A

used when people need volume expansion but they cant tolerate large infusions of crystalloids

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16
Q

Commonly used Colloids

A

Human Albumin, hetastarch or hespan, synthetic starches, blood products

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17
Q

What are crystalloids

A

Most like body fluids. They are easily mixed and dissolve in a solution.

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18
Q

What is crystalloid fluid used for?

A

increase the fluid volume in both interstitial and intravascular space.
* passes the semipermeable membrane so goes from blood stream into cells and body tissues

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19
Q

Three types of crystalloids

A

Isotonic
hypotonic
hypertonic

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20
Q

Isotonic

A
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21
Q

Hypotonic

A
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22
Q

Hypertonic

A
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23
Q

RN responsibilities for IV therapy

A

1 Know infusion orders and what is expected outcome
2. Evaluate if appropriate for pt
3. make sure orders are followed and communicate to oncoming RN
4. Document
4a. Where are the sites of the
IV and what are they

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24
Q

Indications for IV therapy

A

fluid: increase, replace. med admin, blood donation or need, nutrition

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25
Q

Good stuff about IVs

A

Bioavailability, maintenance, site for nutritional support

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26
Q

Bad stuff about IVs

A

no time to correct errors, once it’s in youre stuck

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27
Q

what is a central line

A

general term for IV cath that ends in a large blood vessel

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28
Q

Where does a central line absolutely need to terminate in vessel

A

SVC within 3-4 cm of the atrial superior vena cava junction (right above the enterence of the RA) Cant fucking kink. Confrimed with radiology (xray)

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29
Q

Where is a CVL usually placed?

A

EJ or IJ. Sometimes AC or subclavicular

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30
Q

procedure for putting in central line

A

sterile procedure, 1,2,3 lumen, made from a flex material and placed with a guide wire, Xray to confirm

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31
Q

What is a PICC

A

peripherally inserted cath line. can have 1,2,3 in a single line

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32
Q

Where is a PICC usually put

A

Upper arm. Really long and ends in a large vessel

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33
Q

can you give incompatible meds through PICC lines

A

yeah, different endings

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34
Q

what is the difference between Midline and PICC

A

where the tip of the catheter ends. Mid ends near the subclavian veins vs the vena cava

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35
Q

Indications for Central lines or PICC lines

A
  1. vesicant / hyperosmolar infusions or long term use
  2. frequent lab draws
  3. TPN
  4. Monitor RA pressures
36
Q

Contraindications for PICC or Central line

A

Immunosuppression, thin blood, fracture/trauma to area, anatomical issues, superior Vena cava syndrome (bad flow into the heart), local infection

37
Q

Situs inversus def

A

Where your organs develop as a mirror image on the opposite side

38
Q

Complications of central line

A

pneumo, infection, air or blood emboli, inflammation, equipment breakdown (broken cath, migration, blah blah), nerve or vascular injuries.

39
Q

Phrenic nerve is located where and what does it do?

A

Rooted in Cervical spine 3-5. A plays a role in skeletal movement while breathing

40
Q

What are some causes of IV occlusions

A

clotted off, kinked, pulled, drugs fat deposits

41
Q

Steps to fix occlusion in IV

A

facility policy, never force flush, use 10 mL syringe, Call doc (tPA or PLAT)

42
Q

what is tPA

A
43
Q

site management of transparent dressing for Central lines

A

7 days for Tecaderm, caps every 72 hours

flushing: masking for everyone, gloves, scrub hub chlorohexidine 15 seconds, 10 mL pulsing flush before and after meds,

44
Q

Blood draws

A
45
Q

Port or portacath are what

A

placed under the skin in chest by hubert and ends in large vein close to the heart and connected port. Needle can stay in for 7 days

46
Q

What are tunneled catheters?

A

used in ches and threaded through a tunnel of tissue until it enters vein.

47
Q

How long can tunneled catheters stay in?

A

Can stay in for >6 weeks

48
Q

Where should TPN always be run through

A

Central line

49
Q

Feeding regimen related to electrolyte balances

A

hypoglycemia, hypokalemia, hypocalcemia

50
Q

how much should someone gain in 24 hours from tpn

A

1 lbs

51
Q

Nursing considerations with TPN

A

I&O (EVERYTHING)
BGL
status of dressing and site condition if you can see it

52
Q

TPN tubing need to be changed how often

A

every 24 hours (prevents bacteremia in tubing)

53
Q

What other medications are able to run in TPN

A

ONLY LIPIDS!!

54
Q

TPN is always run through a filter. T or F

A

True

55
Q

Lipids are usually run for how long?

A

12 hours

56
Q

Schizophrenia brain changes

A

Enlargement of lateral and third ventricles
reduction in frontal lobe, temporal and amygala

57
Q

Schizophrenia in US are how much more likely to die in the US

A

2-3

58
Q

Risk factors for schizophrenia

A

Childhood trauma (predisposed to stress), malnutrition, cannabis, vitamins, old man sperm,

59
Q

Positive symptoms of Schizophrenia

A

Hallucinations - see touch command, touch, feel
Delusions - paranoid, grandiose, referential, somatic
Disorganized speech and thinking - neologism, word salad, derailment, echolalia, tangentiality

60
Q

Negative symptoms of schizophrenia

A

Affect flat
anhedonia
apathy and avolition (no motivation)
Alogia (poor speech)
anxiety and avoids social interaction
Catatonia (motionless)

61
Q

Treatment goals for schizophrenia

A

Safety
induce remission
prevent exacerbation
improve behaviors and psychosocial and cognitive function

62
Q

ECT

A

electro convulsive therapy

63
Q

PHQ9 is for what

A

patient health questionnaire for suicidal ideations

64
Q

AIMES

A

extrapyramidal side effects1

65
Q

difference between borderline and bipolar

A

borderline makes conscious decisions for moods bipolar doesn’t know and their emotions are changing and last for longer

66
Q

anxiety vs anxiety disorders

A

Anxiety is situationally based
Anxiety disorder impairs your life.

67
Q

schizophrenia vs schizoeffective

A

Schizoaffective has another mood disorder along with the schizophrenic hallucinations

68
Q

Is tardive dyskinesia permanent?

A

if you catch it early, otherwise they’re stuck acting like Bardy crouch JR.

69
Q

If your on steroids for long periods of time what can happen

A

Reduce your immune system

70
Q

Which med classification should be noted before surgery due to electrolyte imbalance?

A

Diacritics

71
Q

special considerations during preoperative period

A

Fatties, Disabilities, Ambulatory and emergency surgery

72
Q

BGL under what allows you to heal the fastest

A

150.

73
Q

Uterine atony

A

soft and weak uterus after delivery.

74
Q

Uterine trauma

A

damage to the vagina, cervix, uterus, or perineum causes bleeding. Forceps vacuum extraction can increase the risk

75
Q

Hematoma can form in a concealed area and cause

A

bleedign hours or days after delivery

76
Q

retained placental tissue

A

The entire placenta doesnt separate from the uterine wall

77
Q

5Ts of PPH

A

tone
tissue
trauma
thrombin
traction

78
Q

Signs and symptoms of post partum hemorrhage

A

Tachycardia
anxiety hypotension
hypotension
decreased RBC
Pale or clammy skin
basically hypovolemia for fuck sakes

79
Q

Modifiable risk factor for PPH

A

Prolonged labor
vaginal laceration
fetal malposition
labor induction
uterine atony
cesarean deliver (VBAC)
intrauterine fetal death
placental previa

80
Q

Non modifiable risk factor for PPH

A

Female old
fetal macrosomia
primigravida
grand multiparity
history of PPH
Large for gestational age

81
Q

TOLAC

A
82
Q

How would you describe the Romburg test

A

The nurse should inform the client that the Romberg test will be performed once with eyes open and once with eyes closed. A Romberg test is performed to assess balance and motor function.

83
Q

for a client in hepatic coma, which outcome would be the most appropriate?

A

The client is A&Ox 4

84
Q
A
85
Q

pruritus. Which nursing intervention would be included in care plan for the client

A

Keep fingernails short and smooth

86
Q
A

nursing 2900 (3 decks)

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