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cp 2 > dee final cards > Flashcards

dee final cards Flashcards

1
Q

Where do we do a capillary glucose measurement?

A

On the side of the finger; less nerve endings

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2
Q

Why do we wipe away the first drop of blood?

A
  • to avoid contamination by alcohol
  • it might be mixed w/ interstitial fluid
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3
Q

What is DKA?

A
  • diabetic ketoacidosis
  • caused by insulin deficiency
  • body can’t absorb sugar so it begins to break down fats leading to excess ketones
  • characterized by fruity breath, excessive thirst and frequent urination
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4
Q

What order do you draw up Insulin R and Insulin NPH?

A
  • ISSI
  • air into I, air into S, draw up S, draw up I
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5
Q

What sites are used for a subcutaneous injection?

A
  • posterior aspects/lateral outer of arms
  • lower abdomen at least 2 in away from umbilicus
  • anterior aspects of thighs
  • upper ventral gluteal area
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6
Q

What angle is used for subcutaneous injections?

A
  • average-sized pt: 45-90 degrees
  • obese pt: 90 degrees
  • always “pinch an inch”
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7
Q

What is heparin? What are the contraindications for heparin?

A
  • anticoagulant AKA blood thinner
  • contraindications:
  • active bleeding
  • uncontrolled hypertension
  • thrombocytopenia
  • NSAIDs
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8
Q

What is the correct size of subcutaneous syringe?

A
  • use a tuberculin syringe
  • syringe calibrated in sixteenths of a minim and in hundreths of a mm
  • capacity of 1 mL
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9
Q

What is the maximum volume for subcutaneous injection?

A
  • 1.5 mL
  • can go up in certain cases
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10
Q

Why do we do a TB test?

A
  • test for tuberculosis
  • TB is very contagious w/ high mortality rate
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11
Q

Where is the correct spot for a TB test?

A
  • 3-4 finger widths below antecubital space and hand width above the wrist
  • if necessary, sites for subcu injections can be used
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12
Q

What is the angle of insertion of intradermal injections?

A
  • 15 degrees
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13
Q

How do we read a TB test?

A
  • 48 hrs after injection
  • inspect injection site
  • in healthy person: 15 mm or more of swelling and/or blisters indicates positive
  • in unhealthy person: greater than 5 mm of swelling
  • those who received BGG vaccine will be positive
  • measure the BUMP not the redness
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14
Q

What other things might be given intradermally?

A
  • allergy tests
  • lidocaine
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15
Q

What is the difference between a blunt fill and filter needle?

A
  • blunt fill: used when drawing up from vials to prevent contamination or damage to the needle, also mitigates risk of needle-stick injuries
  • filter needle: used when drawing up medication from an ampule to filter out particles and glass
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16
Q

What are some differences between a vial and an ampule?

A
  • vial: usually multi-dose, req. air injection to displace pressure, fill needle, inverted
  • ampule: single-dose, no air injection req., req. use of filter needle, usually kept upright
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17
Q

Name the different parts of the syringe:

A
  1. barrel: where the medication is stored
  2. plunger: used to inject medication
  3. tip: where the needle is screwed into
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18
Q

Do you draw up from vial or ampule first?

A
  • vial
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19
Q

Name the different parts of the needle:

A
  1. hub: where it connects to the syringe
  2. shaft: length of the needle
  3. bevel: angled exit portal of needle (always inject bevel up!)
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20
Q

What is the formula for desired dose?

A

desired dose/dose on hand x amount

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21
Q

What syringe size do we use for IM?

A

3 mLs

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22
Q

Four sites for IM:

A
  • deltoid:
  • ventrogluteal: preferred site
  • dorsogluteal: often preferred by pts but not my nurses b/c of risk of hitting sciatic nerve, contraindicated in children
  • vastus lateralis: lacks major nerves and vessels, facilitates rapid absorption, used in infants and children
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23
Q

Landmarking deltoid:

A

find acromion process, 2 fingers down, triangle

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24
Q

Landmarking ventrogluteal:

A

find greater trochanter, point index finger towards anterior aspect of iliac crest, spread second finger making a V, inject in between knuckles

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25
Q

Landmarking dorsogluteal:

A

find greater trochanter, find posterior aspect of iliac crest, draw imaginary line over two bones, top outer corner of X

26
Q

Landmarking vastus lateralis:

A
  • outer middle third of anterior aspect of thig
27
Q

What is the max vol. for each IM site?

A
  • 3 mLs everywhere except deltoid
  • deltoid = 2 mLs
28
Q

Preferred IM site for children vs adults:

A
  • children: vastus lateralis
  • adults: ventrogluteal
29
Q

What are signs of UTI?

A
  • chills
  • fever
  • back pain
  • dysuria
  • urgency
  • delirium in older adults
30
Q

What does polyuria mean?

A
  • excessive urination
31
Q

dysuria

A

painful voiding

32
Q

oliguria

A

decreased output

33
Q

anuria

A

no output

34
Q

neurogenic bladder

A

lack of nerve supply to bladder
person can’t feel when baldder is full
must use catheter to voif

35
Q

What is the purpose of a bladder scanner?

A
  • to screen post-void residual and the amount
36
Q

What is a fecal occult blood test?

A
  • tests for hidden blood in stool
37
Q

What is the advantage of condom catheter?

A
  • more comfortable
  • less invasive/less damage
  • lower risk of infection
  • simpler and non-sterile procedure
38
Q

What is C+S?

A
  • culture and sensitivity test
  • cultures to determine type of organism
  • sensitivity to test antibiotic effectiveness
39
Q

What is surgical asepsis?

A
  • sterile technique: eliminates all microorganisms
40
Q

What is a nosocomial infection?

A

hospital acquired infection

41
Q

Common examples of nosocomial infections:

A

c diff, mrsa

42
Q

3 types of precautions in the hospital and examples:

A
  1. contact: MRSA, C. diff, major wound infections
  2. airborne: measles, chickenpox, TB
  3. droplet: diptheria, rubella, flu, pertussis, mumps, sepsis
43
Q

What kind of equipment do you need for contact precautions?

A
  • gown and gloves
44
Q

What kind of equipment do you need for droplet precautions

A
  • mask and eye shield worn w/i 2 m of pt
  • gown and gloves
45
Q

What kind of equipment do you need for airborne precautions?

A
  • n95 mask
  • gown and gloves
46
Q

What is the order of donning?

A

gown, mask, goggles, gloves

47
Q

What is the order of doffing?

A

gloves, goggles, gown, mask, hand hygiene b/t each step

48
Q

What is the chain of infection?

A

infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host

49
Q

What are the three elements to pronounce death?

A
  1. no response to noxious stimuli
  2. absence of apical/carotid pulse and respirations for one minute
  3. no pupillary reaction
50
Q

Under what circumstances can the RPN pronounce?

A
  • by DRs orders
  • needs 2 nurses
51
Q

What is rigor mortis?

A
  • stiffening of the body after death
  • peaks at 8 hours
  • goes away after 12 hours
52
Q

What is algor mortis?

A
  • cooling of the body
  • cools for about 1 hr until reaches room temp
53
Q

What is livor mortis?

A
  • settling of the blood
  • causes area to turn purple
54
Q

What is the advantage of a subcutaneous butterfly?

A
  • allows for medication to be administered regularly without re injecting the client
  • usually analgesics and anticholinergic medications to reduce respiratory secretions
55
Q

What are the sites for subcutaneous butterflies? Angle of insertion?

A
  • upper arm, thigh, abdomen
  • 30 degree angle, aspirate
56
Q

What is the otic route?

A

ear

57
Q

opthalmic

A

eye

58
Q

What instructions do we give pts when taking SL meds?

A
  • hold under tongue, don’t swallow
  • refrain from drinking water, eating, or smoking until the med is dissolved
59
Q

What position for rectal medications?

A
  • SIMs
  • laying on left side with right hip and knee bent
60
Q

How do transdermal medications work?

A
  • slowly penetrates the layers of the skin and is circulated by bloodstream
61
Q

Buccal vs SL:

A
  • buccal: cheek
  • SL: under tongue

cp 2 (6 decks)

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