Clinical Flashcards
Before a pt goes to surgery, what should their blood glucose be kept above?
150
What is the purpose of BIS (bispectral index) monitoring during anesthesia?
To assess pt’s depth of consciousness
Red-tinged drainage
Sanguineous
Clear or yellowish drainage
Serous
Where is the tip of a central line located?
Superior vena cava
What is a hub used for?
For flushing IV or admin of IV push meds
What is vented tubing used for?
Meds in glass containers
How often should a saline lock be flushed?
Every 12 hours
How often should IV sites be examined?
Every 4 hours and as needed if pt has discomfort or complications
Irritating fluids in tissue area around IV
Extravasation
Non vesicant fluids leaking around IV site
Infiltration
How to avoid nerve damage to the median nerve
Do not start an IV within 4 inches of the wrist
When do 10 mL syringes NEED to be used
When doing anything with a midline or PICC line
Common syringe size for Intradermal injections
1 mL
Common needle gauge and length for Intradermal injections
26-29 gauge
0.5 inch
Max volume for Intradermal injection site
0.1 mL
Common syringe size for subcutaneous injections
1-3 mL
Needle gauge and length for subcutaneous injections
25-31 gauge
0.5 - 1 inch (only 1 if the person is very obese)
Max volume for a subcutaneous injection
1 mL
Common syringe size for intramuscular injections
3 mL
Needle gauge and length for intramuscular injections
21-23 gauge
1-2 inch (2 inch is rare)
Max volume for intramuscular injections
3 mL for Ventrogluteal and Vastus lateralis
1 mL for deltoid
What type of insulin as Aspart?
Rapid
Onset of action for Aspart
10-20 mins
Peak for aspart
1-3 hours
Duration of action for Aspart
3-5 hours
What type of insulin is Regular?
Short acting
Onset of Regular insulin?
30-60 minutes
Peak of Regular insulin
1-5 hours
Duration of Regular insulin
6-10 hours
What type of insulin is Detemir?
Long acting
Onset of Detemir
60-120 minutes
Peak of Detemir
None
Duration of Detemir
12-24 hours
What should you do if you pt’s accu check is <70 and they can swallow?
Admin 15 g carbohydrate every 15 mins until glucose level is >70
(3 glucose tabs or 4 oz soda)
What should you do if pt’s accu check is <70 and they cannot swallow?
Administer 25 mL (1/2 amp) of D50W (50% dextrose)
What should you do if your pt’s accu check is <70 and they cannot swallow and do not have an IV?
Administer 1 mg glucagon IM and turn pt onto left side
What should you do after you’ve administered/fed glucose to pt?
Recheck glucose after 15 mins. If it is not >70 after 30 min of tx if still not >70
When it is >70, provide protein/carb snack like 2 tbsp PB & 3 saltine crackers or 8oz milk
CN 1
Olfactory
Use alcohol pad to assess
CN II
Optic
PERRLA
CN III
Oculomotor
Follow finger or penlight with eyes only
CN IV
Trochlear
Follow finger or penlight with eyes only
CN V
Trigeminal
Clench jaws, use light touch test
CN VI
Abducens
Follow finger or penlight with eyes only
CN VII
Facial
Smile, frown, make funny faces, taste sugar or salt?
CN VIII
Vestibulocochlear
Determine distance or loudness of sounds
CN IX
Glossopharyngeal
Gag reflex or swallowing (can assess when giving meds or a drink of water)
CN X
Vagus
Pt says “ahh”, watch for uvula movement
CN XI
Accessory
Pt shrugs shoulders and turns head against force
CN XII
Hypoglossal
Pt sticks tongue out
