Blue Book 2 Flashcards
When the terminology “the 3 phases of labor” is used, what does it mean?
If the statement refers to PHASES of labor, it means the 3-step process of latency, followed by active and transitional. (LAT order - just as its spelled in LATency)
Normal length of pregnancy is ____ to ____ days
240, 300
Pregnancy is divided into ____ trimesters
3
During the 1st trimester the woman experiences decreased or increased vaginal secretions?
increased
When are urine pregnancy tests positive?
At the time of the first missed period
Pregnancy tests test for the presence of what hormone?
HCG (human chorionic gonadotropin hormone)
Urine and blood pregnancy tests are enough evidence to be certain of pregnancy (T/F)?
false, these tests only suggest pregnancy
What is Hegar’s sign?
Uterine softening
What is Chadwick’s sign?
Blue-tint to the cervix
The first trimester goes from week ___ to week __
1-13
The second trimester goes from week ___ to week ___
14-27
Which week can mother first feel the fetus move?
16th-20th week, (the end of the 4th month into the 5th month)
What is the word used to ID the feeling that the mother experiences when the fetus moves?
quickening
The 3rd trimester goes from week ___ to week ___
28-40
In which trimester does the women most feel backache?
3rd
Which trimester is the fetus most susceptible to effects of outside agents?
1st
What is the name of the process in which outside agents cause birth defects in the fetus?
Teratogenesis
Which trimester is N&V most common?
1st
Which trimester do Braxton-Hicks contractions begin?
3rd
What are Braxton-Hicks?
Usually painless contractions that strengthen the uterus for labor
Which trimester does quickening occur?
2nd
Which trimester does venous congestion in the legs occur?
3rd
Which trimester does linea nigra appear?
2nd
What is linea nigra?
Single dark vertical line on the abdomen
Which trimester do striations occur?
2nd
What is chloasma?
Mask of pregnancy- pigmented area on face
Which trimester is constipation most common?
3rd
In addition to the nares, where else should the nurse assess for skin irritation when nasal cannulae are in use?
Behind and on top of the ears
What are two signs of hypoxia?
Restlessness and tachycardia
What is the highest flow rate appropriate for nasal cannulae?
6 L/min
How often should the nares of a client with O2 by nasal cannulae be assessed for skin breakdown?
Q 6-8hrs
What is the maximal O2 flow rate for the client with COPD?
2L/min
What are the signs of O2 toxicity?
confusion, HA
What can happen if the client with COPD is given a high flow rate of O2
they may stop breathing
respiratory depression
What is the problem with giving high flow rates of O2 by nasal cannulae?
dires mucous membranes
Can a client smoke in the room when the O2 is turned off?
No, the O2 delivery device must be removed from the wall or the tank out of the room before a client can smoke
When O2 is administered, it must be …
humidified
Masks deliver higher or lower concentrations of O2 than nasal cannulae?
higher
How often should the nurse check the flow rate of the O2?
at least once per shift
O2 is an explosive (T/F)?
False, it does not explode- it supports combustion
What structures in the brain are most affected in Parkinson’s
basal ganglia
The neurotransmitter imbalance that causes Parkinson’s is a ___ in _____ ______
Decrease, dopamine activity
What drugs can cause a Parkinson-like syndrome?
Haldol, major tranquilizers - drugs that end in “-azine”
What is the classic motor manifestation of Parkinson’s?
pill-rolling and tremors
What type of rigidity is typical of Parkinson’s?
Cogwheel - Cogwheel’ rigidity is a combination of leadpipe rigidity and tremor which presents as a jerky resistance to passive movement as muscles tense and relax
Parkinson’s patients move fast or slow?
slow
What type of gait is seen in Parkinson’s?
shuffling, slow
Patients with Parkinson’s have ___ speech
monotone
Patients with Parkinon’s tend to have constipation or diarrhea?
constipation
Name 4 drugs used to treat Parkinson’s
Levodopa, Sinement, Symmetrol, Cogentin, Artane, Parlodel
In what type of chair should Parkinson’s patients sit?
firm, hard backed
What time of day can be particularly dangerous for the Parkinson’s patient?
Mealtime, d/t choking
When a patient is taking Levodopa he should have assistance getting out of bed because…
Of orthostatic hypotension
What vitamin should patients on Levodopa avoid?
B6, pyridoxine - Vitamin B6 reduces the effectiveness of levodopa
Levodopa should be given with or without food?
with food
What might Levodopa do to patients urine?
make it very dark
The tremors of Parkinson’s will get better or worse when they purposefully move or perform a task?
Better, they tremor more when not performing an action
The client on a PCA pump is less likely to have post-op complications than the client w/o a PCA pump (T/F)?
True, b/c the comfortable pt moves around more and is less likely to get thrombophlebitis, pulmonary embolus, fatigue, ileus and pneumonia
Clients with COPD are not good candidates for PCA pumps (T/F)?
True, d/t the effects of narcotics on central respiratory control
Name the 3 most common uses of PCA techniques
Post-op pain, cancer pain, sickle-cell crisis pain
PCA pumps allow a more constant level of serum drug than conventional analgesia (T/F)?
ture
A major disadvantage of PCA pump is that the client can take too much medication (T/F)?
False. It is not possible for a client to OD d/t the lock-out feature
Clients on PCA pumps use more medication than those receiving IM injections (T/F)
False, they use less
A disadvantage of PCA pumps is that the client does not ambulate as early d/t the machine (T/F)
False, PCA clients ambulate earlier and they pull their machine with them
When d/c a PCA infusion it is acceptable to discard the drug cartridge (T/F)
False, the whole cartridge system must be returned to the pharmacy d/t federal narcotic control laws
Comfort range of relative humidity is…
30-60%
Which patients should be forbidden to smoke? Smoke alone?
Those with oxygen in the room, confused, sleepy, drugged patients
When applying restraints remember to…
Avoid bruising the skin, cutting off circulation, and accidental entangling
List ways to ensure privacy…
Use drapes and screens during care in semi-private rooms
Plastic pillow cases are _____ (disadvantage)
Hot and slippery
When using restraints with clients who object, dont forget about ____ ______
False imprisonment
Individuals who are ill are ____ sensitive to noise than individuals who are well
more
When you are not at the bedside the bed should always be…
In the lowest position
Can nurses be held liable for an accident resulting from a client not being told how to use the call light?
yes
Dangers associated with drafts are…
Circulation of micro-organisms on air currents
The first thing a nurse should do when a client objects to side rails is…
Explain why they are being used
The comfort range of temperature is …
68-74
Is having the client verbally ID himself considered adequate for safety?
No, only ID bands are acceptable
Bed side rails should be up for the following individuals…
Elderly clients, unconscious, babies, young children, restless, confused
The S&S of sensory overload and sensory deprivation are…
Fear, panic, depression, inability to concentrate, restlessness, agitation
If a family member asks to have the side rails down while they are in the room you should…
Remember that you are responsible for the client’s safety - not his family, it might be unwise to permit this
Pillows are sterilized between uses (T/F)
false
What is the common name for pediculosis?
lice
What is a common finding with pediculosis pubis?
Reddish-brown dust in the underwear
What common household solution is used to remove nits?
Vinegar. Nits are the eggs of lice that adhere to the hair shaft
What shampoo is used for lice?
kwell
Where are head lice most commonly found?
At the back of the head and behind the ears