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NCLEX > Cardiac/ chest tubes/ infection precautions > Flashcards

Cardiac/ chest tubes/ infection precautions Flashcards

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1
Q

calcium channel blockers (CCB) are like a

A

depressant

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2
Q

uses of CCB

A
  • they are negative inotropics, negative dromotropics, and negative chromotropics meaning they calm the heart
  • weakens, slows down, and depresses the heart
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3
Q

what do CCB treat

A
  • A, AA, AAA
  • anti hypertensive (relaxes heart and blood vessels = decreased BP)
  • anti angina = Decreases 02 demand by relaxing heart
  • anti atrial arythmia: treats everything atrial related (including SVT- s= above, v= ventricles, T = tachycardia)
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4
Q

side effects of CCB

A
  • headache due to the vasodilation in the brain
  • hypotension
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5
Q

CCB names

A
  • dipine
  • your dipping in the calcium channel
  • verapamil and cardizem (continous IV drip)
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6
Q

what to watch when on CCB

A
  • BP
  • monitor intermittenly
  • if systolic is below 100 hold
  • if on a drip and systolic is 98 you would titrate it down
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7
Q

normal sinus rhythm

A
  • evenly spaced top of the QRS
  • P for every QRS
  • P wave evenly spaced
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8
Q

V fib

A
  • this is number one priority
  • no pattern (chaotic and lethal)
  • there is no CO= no brain perfusion
  • you need to d fib
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9
Q

V tach

A
  • potentially life threatening (especially with a pulse) but they still have CO and brain perfusion
  • if a pulse cardiovert them
  • pattern, bizzarre
  • amioderone
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10
Q

A flutter

A
  • saw tooth
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11
Q

a systole

A
  • # 1 priority
  • flat line (lack of QRS)
  • no cardiac perfusion = no brain perfusion
  • lethal, flat, give Epi
  • epi then atropine if epi doesnt work (give in this order)
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12
Q

SVT

A
  • TX: ABCD’s
  • Adenosine- push fast (normal to see asystole but they will come out of it you just have to wait and see)
  • Beta blockers: “lol”- these are just like CCB with same treatment and same side effects
  • CCB: better for arrhythmia’s
  • Digoxin/digitalis (aka lanoxin)
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13
Q

PVC

A
  • never high priority
  • moderate priority if you have a bunch of PVC’s (its like a short run of v tach): if more than 6 PVC’S in a minute or row and/ or if PVC falls on the t wave of the previous beat
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14
Q

QRS depolarization always means

A
  • ventricular
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15
Q

P wave always means

A
  • atrial
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16
Q

lack of p wave

A
  • answer is always ventricular
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17
Q

chaotic =

A

fibrillation

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18
Q

bizarre =

A
  • tachycardia
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19
Q

potentially life threatening

A
  • v tach with a pulse
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20
Q

lethal priority

A
  • this will kill you in 8 minutes or less
  • asystole, no pulse
  • v fib, no pulse
21
Q

ventricular use

A
  • lidocaine or amioderone
22
Q

Atrial use

A
  • ABCD
23
Q

v fib use

A
  • d fib
24
Q

asystole use

A
  • epi and atropine
25
Q

what do chest tubes do

A
  • reestablish negative pressure in pleural space so the lung can expand when the chest wall moves
26
Q

Pneumothorax

A
  • chest tube that removes air
  • report no bubbling in 2 locations
27
Q

hemothorax

A
  • chest tube that removes blood
  • report no drainage
28
Q

pneumohemothorax

A
  • chest tube that removes blood and air
29
Q

chest tube location for air

A
  • apical (up high)
30
Q

chest tube location for blood

A
  • basilar (bottom of lung)
31
Q

placement of chest tubes

A
  • place apical and basilar on the same side of surgery
  • always assume chest injury is unilateral unless specified as bilateral
32
Q

troubleshooting chest tube: what if its knocked down

A
  • set it back up and tell the pt to take a deep breath
  • not an emergency
33
Q

troubleshooting chest tube: water seal broken

A
  • EMERGENCY
    1. clamp the water seal
    2. cut it away
    3. submerge in sterilized water
    4. unclamp because we reestablished the water seal
34
Q

troubleshooting chest tube: chest tube dislodged (pulled out)

A
  • cover it!
  • FIRST: cover with gloved hand
  • BEST: cover with vaseline gauze
35
Q

troubleshooting chest tube: bubbling`

A
  1. ask yourself where and when
    a. water seal: intermittent bubbling good so document it, continuous bubbling is bad and there is a leak so tape it (if you have a good seal it shouldnt always bubble)

b. suction chamber: intermitent is bad (turn suction higher), continuous is good so document it

36
Q

rules for clamping tubes

A
  • never clamp for more than 15 seconds w/o DR order
  • use rubber tip double clamps
37
Q

if heart defect starts with T

A
  • TROUBLE
38
Q

what congenital heart defects are bad

A
  • ones that start with a T (this is a right to left shunt so there is cyanosis- blue)
39
Q

what congenital heart defects are not bad

A
  • anything that doesnt start with A T: these are Left to right shunts and there isnt an oxygen issue
40
Q

tetralogy of fallout

A

” VarieD PictureS OF A RancH”
1. ventricular defect
2. pulmonary stenosis
3. overriding aorta
4. right hypertrophy

41
Q

why is right to left shunt bad

A
  • the right side of the heart has deoxygenated blood and needs to go to the lungs
  • if it bypasses the lungs and goes to the left side of the heart, this deoxygenated blood will get pumped to the body (no use for it because it isn’t oxygenated)
  • this is bad and needs surgery to live, short life expectancy, delayed growth and development, exercise intolerance, financial difficulties, pediatric cardiologist
42
Q

All heart defects have

A
  • murmor and echo done
43
Q

IV drip rate formula

A

volume x drop factor divided by time in minutes

44
Q

Contact precautions

A
  • anything enteric
  • C DIFF
    -Hep (anything with vowel comes from bowel)
  • herpes
  • staph
  • RSV (TRANSMITTED DROPLET BUT ON CONTACT)
  • needs private room
  • PPE: gloves, gown, disposable supplies
45
Q

Droplet precautions

A
  • PIMP (pertussis, influenza, meningitis, pneumonia)
  • sneezing/coughing
  • H-flu
  • private room
  • lumbar puncture for cultures for meningitis
  • PPE: gown, gloves, mask, goggles, disposable supplies, pt wear mask when leave room
46
Q

Airborne precautions

A
  • MTV
  • Measles
  • Mumps
  • rubella
  • TB
  • Varicella
    -private room
  • gloves, N95, gown, negative airflow room
47
Q

Don PPE

A
  • outside the room
  • reverse ABC
  • gown, mask, goggles, gloves
48
Q

Doff PPE

A
  • inside room except for mask
  • gloves, goggles, gown, mask
  • ABC order or reversed from don

NCLEX (15 decks)

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