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Adult 2 > Exam #1 > Flashcards

Exam #1 Flashcards

1
Q

What is immunity?

A

The bodies specific response to a foreign antigen or organism

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2
Q

What is the purpose of the immune system?

A

To fight off foreign bodies that can infect our body

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3
Q

What type of cells fight off infection?

A

WBC

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4
Q

What instances can raise WBC?

A

Infections or trauma

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5
Q

When a WBC response is triggered what is also triggered?

A

Inflammatory response

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6
Q

What type of diseases attack your own healthy tissues?

A

Autoimmune diseases

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7
Q

What occurs in the body with a hypersensitivity?

A

It is when your body has a inappropriate response to specific antigens

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8
Q

What are some examples of hypersensitivities?

A

Peanut, dog, cat, pollen, latex

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9
Q

What happens inside the body with a primary deficiency disesease?

A

Improper development of the immune system

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10
Q

How do you get a primary deficiency disease?

A

Through genetics/inheritance

Changing of genetic make up

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11
Q

What are some examples of primary deficiency diseases?

A

Sickle Cell, HIV/Aids

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12
Q

What is a secondary deficiency?

A

a disease that is developed later in life and is a result of a primary disease

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13
Q

What is an example of a secondary disease and how it develops?

A

A person with HIV has a supressed immune system gets Pneumonia

The pneumonia is the secondary disease

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14
Q

Can secondary diseases alter genetic make up?

A

Yes

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15
Q

What parts of the body do rheumatic diseases effect?

A

Muscles, bones, ligaments, and joints

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16
Q

In rheumatoid arthritis is inflammation primary or secondary?

A

Primary

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17
Q

In rheumatoid arthritis what happens if the inflammation of the body is controlled?

A

The patient will get relief because the inflammation is what is causing the problems in the first place

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18
Q

In degenerative diseases what happens to the patients condition if inflammation is controlled?

A

Swelling will go down but their underlying condition/symptoms will still be present

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19
Q

What is an autoimmune disease?

A

A disease that attacks your own healthy tissues

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20
Q

In what rheumatic disease is inflammation secondary?

A

Degenerative, osteoarthritis

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21
Q

In what diseases is inflammation primary?

A

Autoimmune rheumatic diseases such as lupus, MS and Rheumatoid arthritis

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22
Q

What are some examples of rheumatic degenerative disorders?

A

Osteoporosis and osteoarthritis

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23
Q

Is osteoarthritis and osteoporosis inflammatory or non inflammatory?

A

Non inflammatory

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24
Q

What occurs in the body in patients with osteoarthritis?

A

The Cartlidge that protects the joint and allows smooth movements is worn down to the point that bones are rubbing on each other

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25
Q

What occurs in the body for patient with osteoporosis?

A

Their body is not regulating calcitonin and estrogen properly which prevents their bones from keeping the calcium they need to be strong

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26
Q

What are the differences between rheumatoid arthritis and osteoarthritis?

A

RA is an inflammatory disease while OA is noninflammatory

RA is bilateral where OA can be unilateral

Morning stiffness for RA can take between 30 up to an hour to go away whereas OA is better in less than 30 minutes

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27
Q

What is happening to the cartilage and synovial membrane in RA?

A

Cartilage is still in tact but the synovial sac is inflamed

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28
Q

What is happening to the cartilage and synovial membrane in OA?

A

Thinned cartilage but the synovial membrane is fine

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29
Q

Does RA or OA have crepitus?

A

OA

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30
Q

Does RA improve or worsen with use?

A

May improve

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31
Q

Does OA improve or worsen with use?

A

Worsens

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32
Q

Is RA or OA systemic?

A

RA

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33
Q

What is RA?

A

A chronic progressive systemic inflammatory disease that affects tissues and joints

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34
Q

How does RA damage joints?

A

Inflammation in the synovial sacs form growths called pannus that narrow the joint space causing pain, damage, and decreased ROM

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35
Q

Where does RA typically start and where does it go from there?

A

Starts in hands first and then goes on the knee and spine

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36
Q

What are some non systemic symptoms of RA?

A

Bone erosion, erythema, immobilization, contractures, deformities

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37
Q

What is erythema?

A

Warmth of the joint

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38
Q

What are some systemic symptoms of RA?

A

Anemia, anorexia, fatigue, depression, vasculitis, pericarditis, kidney disease, Sjögren’s syndrome, and Raynauds

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39
Q

What is anemia?

A

This occurs when you have a drop in your hemoglobin and hematocrit

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40
Q

Why is anemia bad?

A

Because you will not have enough hemoglobin to carry oxygen to your body

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41
Q

What are some symptoms of anemia?

A

Fatigue, weakness, SOB, pale skin, head ache, cold hands/feet, dizziness, irregular heartbeat, chest pain

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42
Q

What is vasculitis?

A

Inflammation of the blood vessels

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43
Q

What are symptoms of vasculitis?

A

Fever, headache, general body pain, hypertension, MI, stroke, nose bleeds, blood cough

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44
Q

What is pericarditis?

A

Inflammation around the heart

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45
Q

What does the patient feel when they have pericarditis?

A

Pain on inhalation but not on exhale

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46
Q

What can pericarditis be confused with?

A

heart attack / cardiac arrest

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47
Q

What should you in relation to the kidneys in RA patients?

A

Monitor creatinine, BUN, and urine output

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48
Q

What is Sjögren’s syndrome?

A

Any gland that produces xxxx goes dry….dry mouth and dry eyes

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49
Q

What is raynuads syndrome?

A

Blood vessels constrict in the hand and makes finger turn blue/pale and makes them numb

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50
Q

Why would a physician order an x ray for a RA patient?

A

To look for bone erosion and deformities

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51
Q

What labs are ran for a potential RA patient?

A

Rheumatoid factor, CBC, H and H, ESR, BMP, Liver enzymes

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52
Q

What does a rheumatoid factor show?

A

Looks for antibodies in the connective tissues

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53
Q

Why would a CBC test be ran on a RA patient?

A

Their immune systems are lowered so they are looking for possible infection

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54
Q

Why would physicians run a ESR on a potential RA patient?

A

to look for excessive inflammation

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55
Q

Why would a physician run a BMP on a potential RA patient?

A

To monitor for dehydration, electrolytes , BUN, and Creatinine

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56
Q

Why would a physician run a liver enzymes on a RA patient?

A

To get baseline numbers on to compare once starting RA medications….RA medications can affect the liver

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57
Q

What are goals of treatment for RA patients?

A

Decrease pain, inflammation, and slow the progression

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58
Q

What procedure can be done to help alleviate pain and restore function from RA?

A

Artherocentesis

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59
Q

What is a artherocentesis?

A

This a procedure where a physician will insert a large needle into a synovial sac and drain of the excess fluid

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60
Q

What medication is used during Arthrocentesis?

A

Lidocaine to numb the area

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61
Q

What is another term used for Arthrocentesis?

A

Joint aspiration

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62
Q

What education should you give to a post op Arthrocentesis patient?

A

Labs may be drawn, ice the site, don’t use heat, look for drainage, watch the swelling, and rest for 24 hours

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63
Q

What should RA patients do at home to improve their condition?

A

Take medications, rest, ROM exercises, ICE, heat, PT, OT, support groups, and self care

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64
Q

What are the risk factors for RA?

A

Women, age 30-60, having Epstein bar virus, genetics, physical / mental stress

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65
Q

What are you looking for in an immunity assessment in relation to physical assessment?

A

Hair and skin….rashes, lesions, erythema, hair loss, hair thinning, photosensitivity, dyshphagia, void patterns, stool or urine characteristics

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66
Q

What is lupus?

A

A chronic progressive system inflammatory autoimmune disease that causes organs and systems to fail due to remissions and exacerbations

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67
Q

What is occurring in relation to WBC in lupus?

A

The WBC are attacking healthy tissues

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68
Q

What are the risk factors for lupus?

A

Women, 30-45, African Americans, Asians, Hispanics, native Americans, native Hawaiians

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69
Q

Clinical manifestations of lupus?

A

Fever, pain in several joints (mimics RA?), fatigue due to anemia, weakness, amenorrhea, oliguria, anorexia, butterfly rash, photosensitivity, systemic issues

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70
Q

What can trigger lupus exacerbation?

A

Any stress to the body such as child birth, drugs, uv light

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71
Q

What systemic issues arise in lupus patients?

A

Alopecia,amonorhea pancytopenia, LOC, pleural effusion, lupus nephritis, pericarditis, raynauds syndrome

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72
Q

What is amenorrhea?

A

Irregular menstrual cycle

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73
Q

What is oliguria?

A

Decreased urine output

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74
Q

What does butterfly fly rash look like?

A

Dry, scaly, raised red rash on the face

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75
Q

What is alopecia?

A

Patchy hair loss

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76
Q

How can lupus cause changes in a patients LOC

A

Confusion, irritability, headaches, seizures, decrease sodium

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77
Q

What does pancytopenia mean?

A

Decrease in all blood cells which included anemia, neutropenia, thrombocytopenia

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78
Q

What is anemia?

A

Decreased RBC

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79
Q

What is neutropenia?

A

Decreased WBC

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80
Q

What is thrombocytopenia?

A

Decreased platelets

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81
Q

What is a pleural effusion?

A

Build of fluid between the lungs and heart

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82
Q

What does pleural effusion look like?

A

Wet cough, chest paints, SOB

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83
Q

What is lupus nephritis?

A

Damage to kidneys due to lupus effects

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84
Q

What are symptoms of lupus nephritis?

A

Fluid build up, decreased urine output, increased BP, increased creatinine, peripheral edema

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85
Q

What does pericarditis feel like for the patient?

A

Pain on inhalation but not on exhale

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86
Q

How is a diagnosis of lupus made?

A

Combination of H and P, skin biopsy, and labs

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87
Q

What skin is removed for testing?

A

The lesions or rashes

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88
Q

What labs are looked at for lupus?

A

Antinuclear antibody, rheumatoid factor, erhyrocyte sedimentation rate, basic metabolic panel, complete blood count, UA

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89
Q

What does the ANA/ antinuclear antibody lab show?

A

Shows the number of antibodies present for ????

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90
Q

What does the RF lab do in relation to lupus?

A

Helps determine if the patient has RA or Lupus

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91
Q

What does the UA look for in lupus patients?

A

Looks at BUN and creatinine levels to determine kidney function

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92
Q

What does the CBC look for in lupus patients?

A

WBC, H and H, and Platelets

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93
Q

What is the goal when treating lupus patients?

A

Prevent organ damage, reduce exacerbations, pain control, and reduce the disease effects that come with lupus

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94
Q

What education should be give to patients with lupus?

A

Inspect skin, avoiding prolonged sun exposure, wearing long sleeves, brimmed hats, sun block of 30 spf or higher, mild soaps with no perfume, avoid skin drying agents like make up and powders , and support groups

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95
Q

What does the antigen do on a blood cell?

A

It is the key for what can be accepted by that blood cell

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96
Q

What does the antibody do in a blood cell?

A

It prevents that blood type from being accepted by the body

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97
Q

What happens if a patient gets the wrong blood type?

A

Agglination

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98
Q

What happens during agglutination? ?

A

The persons receives the wrong combination for antigen and antibody….the body then clumps of these cells

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99
Q

Who is agglutination most common in?

A

Patients receiving many units of blood

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100
Q

What is a autologous infusion?

A

An infusion do with your own donated blood

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101
Q

What are some good medications to give pre transfusion to reduce the speed and effects of agglutination?

A

Benadryl, Tylenol,

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102
Q

What type of saline is used when transfusing blood?

A

Normal 0.9 saline

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103
Q

What is added to a IV line when infusing blood?

A

A filter

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104
Q

What should be done between infusing each unit of blood?

A

Changing the IV tubing????

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105
Q

What lab is run to determine patient blood type?

A

Type and screen

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106
Q

When would it be a good idea to use a transfusion warmer?

A

Patients with problems of thermoregulation or in patients that are receiving many units of blood

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107
Q

What is the max time a unit of blood can be infused for?

A

4 hours

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108
Q

What blood type is the universal donor?

A

O blood

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109
Q

What is the universal acceptor blood type?

A

AB

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110
Q

What are the types of blood transfusion reactions?

A

Febrile, hemolytic, and allergic

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111
Q

What are the symptoms of a febrile blood reaction?

A

Chills, fever, headache, flushing, tachycardia, and increased anxiety

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112
Q

What are symptoms of an allergic reaction during a blood transfusion?

A

Mild…Hives, pruritis, facial flushing, SOB, bronchospasms, anxiety

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113
Q

What are the symptoms of a hemolytic transfusion reaction?

A

Low back pain, hypotension, tachycardia, fever, chills, chest pain, tachypnea, homoglobinuria, may be immoderate onset

114
Q

What should you do if patient exhibits any type of reaction to a blood transfusion?

A

Stop infusion, notify physician, change iv tubing, treat symptoms, administer o2, epi, and fluids as needed, recheck blood type being infused with type and screen results

115
Q

What should you do for blood transfusion reaction in relation to hemolytic reactions?

A

Obtain 2 blood samples distal to infusion site, obtain UA testing for hemoglobinuria, monitor fluid and electrolyte balance (BMP), evaluate serum calcium levels

116
Q

What is the purpose of priming blood infusion with saline?

A

If you do not prim tubing with saline the blood cells become shredded

117
Q

What is added to IV tubing during a blood transfusion to prevent clots from reaching the patient?

A

Filter chamber

118
Q

What is multiple sclerosis?

A

A chronic progressive autoimmune disease that causes demyelination of the myelin that surround the axon of the neuron

119
Q

What causes demyelination of the myelin in MS?

A

Inflammation

120
Q

Why is demyelination of the myelin bad?

A

It distorts the message from your brain telling your organs and muscles what to do

121
Q

What are risk factors for MS?

A

Genetics, developmental changes, environmental changes such as cold climates, women, ages 15 - 45

122
Q

What are the symptoms of MS?

A

Muscle weakness, spasticity, pain, fatigue, vision changes, spastic bladder, decreased sexual function, gait changes, intention tremors, parenthesis, dysarthria, dysphasia, cognitive changes

123
Q

What vision changes can someone with MS have?

A

Blurred vision, diplopia, scotomas, nystagmus

124
Q

What is diplopia?

A

Double vision

125
Q

What is scotomas?

A

Changes in peripheral vision

126
Q

What is nystagmus?

A

Involuntary eye movement

127
Q

What symptoms does someone with a spastic bladder have?

A

Incontinence

128
Q

What may MS patients have to do at home to relieve their bladder problems?

A

In and out catheter

129
Q

What gait changes may you suspect in a MS patient?

A

Not picking up their feet completely

130
Q

What are intentional tremors?

A

Tremors when the patient is trying to do something

131
Q

What is parenthesis?

A

Numbness and tingling

132
Q

What is dysarthria?

A

Slurred speech

133
Q

What is dysphagia?

A

Difficult swallowing

134
Q

What is someone with dysphagia at risk for?

A

Aspiration

135
Q

What is aspiration?

A

Inhaling foreign object into the airway

136
Q

What cognitive changes might you see in a patient with MS?

A

Depression, delirium, attention span issues, and early onset dementia

137
Q

How can you differentiate between MS and Parkinson’s?

A

When walking Parkinson’s patients shuffle their feet while MS patients drag them

138
Q

What are the differences between MS and ALS?

A

MS have episodes of remission and exacerbations

MS has muscle spasticity where as ALS has Muscle atrophy

MS does not impact the respiratory system where as ALS does

MS causes body tremors where as ALS causes facial/tongue twitching

139
Q

What happens when ALS reaches the lungs?

A

Death

140
Q

What can be done to help diagnose MS?

A

Lumbar puncture and MRI of brain and spine

141
Q

What do they do during a lumbar puncture?

A

The physician will remove some CSF from the low back and test the fluid

142
Q

What must a patient do after having a lumbar puncture done?

A

Lay flat until physician says its okay for them to sit up

143
Q

What should the nurse do if the patient experiences a headache upon sitting up after a lumbar puncture?

A

Lay them back down and notify the provider

144
Q

What does a headache mean after sitting up in lumbar puncture patients?

A

That their is leak of CSF somewhere in the spine

145
Q

What is the goal of treatment in patients with MS?

A

Delay progression, manage symptoms, and treat exacerbations

146
Q

What education should be given to a MS patient?

A

Avoid rigorous activity, avoid extreme temps, plan activities, alternate eye patch??, toileting schedule, PT, OT, ST, eliminate things that could cause falls

147
Q

Why should you alternate eye patch in MS patients?

A

To help treat the diplopia

148
Q

What is perioperative nursing?

A

Nursing that starts from scheduling and sometimes after discharge

149
Q

What is considered pre operative?

A

From scheduling to transfer to surgical suite

150
Q

What is considered intraoperative?

A

Entering to the surgical suite up until the transfer to post anesthesia care unit (PACU)

151
Q

What is considered post operative?

A

From PACU to surgeons release..sometimes extending past discharge

152
Q

What is considered the number one priority in the perioperative setting?

A

Safety

153
Q

What are patients at risk for while in a perioperative setting?

A

Infection, impaired skin, ineffective thermoregulation, self care deficit, DVT, cardiac events

154
Q

What considerations should you have for a surgical patient?

A

Comfort, nutrition, sensory, interaction, education

155
Q

What nutritional considerations should you keep in mind for surgical patients?

A

NPO status, hydration status, eating enough to promote healing

156
Q

What elimination considerations should you keep in mind for surgical patients?

A

Surgery often slows down elimination for both urine or stool

157
Q

What sensory considerations should you keep in mind for surgical patients?

A

Nerve blocks, lidocaine, opioid high

158
Q

What human interaction considerations should you keep in mind for surgical patients?

A

Anxiety and disturbed body image

159
Q

What learning considerations should you keep in mind for surgical patients?

A

They may not be fully informed or educated about procedure, their condition, and what post surgery will be like

160
Q

What are the “reasons” for an operation?

A

Diagnostic, Curative, restorative, palliative, and cosmetic

161
Q

What is considered a curative surgery?

A

Removal of cancer mass or removal of a problematic organ

162
Q

What is considered a diagnostic surgery?

A

When a biopsy is taken

163
Q

What is considered a restorative surgery?

A

Something that can improve functional ability but does not cure the issue

164
Q

What is considered a cosmetic surgery

A

something done to help only with appearance

165
Q

What is considered a palliative surgery?

A

Reduce suffering or support quality of life….how does this differ from restorative???

166
Q

What are the different level of urgency for surgeries?

A

Elective, urgent, emergent

167
Q

What is an elective procedure?

A

A procedure that a patient may need but does not threaten their life

168
Q

What is an urgent procedure?

A

A procedure than can wait until the patient is medically stable …

169
Q

What is an emergent procedure?

A

A procedure that must be done or the patient will die

170
Q

What is the degree of risk for operations?

A

Minor or major

171
Q

What are the extents of surgery?

A

Simple, radical, or minimally invasive

172
Q

What is a minimally invasive surgery?

A

A procedure that uses specialized instruments that either go into a natural orifices or use very small incisions

173
Q

What is a simple procedure?

A

Only removing part of an organ

174
Q

What is a radical procedure?

A

Removing all of the organ

175
Q

How far out must patients not have solids from surgical procedure?

A

8 hours

176
Q

How far out must patients not have liquids?

A

2 hours

177
Q

What is on the pre op check list?

A

Accurate patient identifiers, last know oral intake, psychosocial support, 18 gauge preferred or 20 gauge IV, base line imaging is done, base line labs are done, patient voids before giving pre op meds, consent is signed before giving any mental altering meds, the DR has marked the correct procedure site, OR check list is complete in the front of chart, pre op meds are given, and side rails up

178
Q

What should be removed before a patient goes into surgery?

A

Jewelry, dentures, bridges, nail polish, clothing, contact lenses,

179
Q

What should be done to the skin before surgery?

A

Chlorhexidine aka CHG bath

180
Q

When should on the call to OR meds be given?

A

When the CRNA/Anesthesiologist calls…it will be 30 minutes before the procedure will begin

181
Q

What are advance directives?

A

A legal document that the patient has made stating what they wish to be done if they can not make decisions for themselves

182
Q

What status should be noted before procedures?

A

DNR, DNI, Full code

183
Q

What should you not do once you give hypnotics to a patient?

A

Leave them alone

184
Q

Why would baseline imaging be done before a procedure?

A

To see what needs to be operated on and have something to compare to after surgery to see if there is improvement or not post op

185
Q

Why would baseline labs be done before a surgery?

A

To see if they will have delay clotting times or have something to compare WBC with in relation to infection

186
Q

What labs will be run before a procedure?

A

CBC, CMP or BMP, Type and Screen, Clotting Factors, and UA

187
Q

What does a CBC lab show?

A

RBC, WBC, Platelets

188
Q

Why would a CBC be ran before a procedure?

A

To look a their RBC, WBC, and platelets

189
Q

Why would you need to know what a patients RBC is before a procedure?

A

RBC shows hemoglobin and hematocrit….if these value are low then you know if they need a blood transfusion before or if they will need the transfusion during the procedure

190
Q

Why do you need to know WBC count before a procedure?

A

You need the WBC count first determine if they have a infection prior to surgery but also have a baseline number to compare to post surgery

191
Q

Why would you need to know a platelet count before surgery

A

Your platelets are responsible for clotting and if you do not have enough platelets then you run the risk of bleeding out

192
Q

Why would you run a BMP/CMP before a procedure?

A

To determine their kidney/liver function, blood sugar, electrolyte, and hydration status

193
Q

Why is kidney/liver function important to know before surgery?

A

The anesthesiologist or CRNA needs to know the level of function of these organs because these organ metabolize the anesthetics

194
Q

Why would you need to know a patients blood sugar before a procedure?

A

Having a controlled blood sugar helps the body fight off infection also your patients most likely will not have eaten anything which will likely have their blood sugar low

195
Q

What should you take into consideration with diabetic patient at are NPO and schedule insulin?

A

Check their blood sugar before giving the insulin…the patient is fasted therefore will likely have a normal blood sugar level..if the patient is coming the day of surgery make sure that their blood sugar is in a acceptable range because they may have taken their scheduled insulin while fasted and put their blood sugar below an acceptable level

196
Q

What medications should you be most concerned about before a patient comes to have their procedure done?

A

Anti diabetic medications, anticoagulants, antiplatelets, antihypotensives

197
Q

Why would a type and screen be run before a procedure?

A

So that the patients blood type is known just in case of an emergency during the procedure where they need an immediate transfusion

198
Q

What are the clotting studies that are ran?

A

INR, APTT, Anti Xa

199
Q

Why are clotting studies ran before a procedure?

A

To determine their ability to clot up and stop bleeding….if their ability to stop bleeding is hindered too much they run the risk of bleeding out during a procedure

200
Q

Why is a chest x ray done before a procedure?

A

Do look at overall lung health and to check for pneumonia

201
Q

Why is an EKG/ECG performed before a procedure?

A

Surgery is stressful on the body and a abnormal heart function could lead to cardiac arrest also to have a baseline to compare to post op

202
Q

In what patient population is a ekg/ecg performed before surgery?

A

Patients over 40 or patients with a past heart history

203
Q

Why would a UA be done before a procedure?

A

To see if a women is unknowingly pregnant….anesthesia and the operation could harm the child

204
Q

How far out from the procedure should patients stop taking Antiplatelets and anticoagulation medications?

A

2-3 days before the procedure

205
Q

What do you do if you feel like the patient is not adequately informed about their procedure?

A

Call the provider and chart it.

206
Q

What if you discover a critical or out of range lab result?

A

Call the prover and chart it

207
Q

What does adequate disclosure of diagnosis mean?

A

The patient should know the purpose, risk, probability of success, and prognosis before treatment

208
Q

What does understanding and comprehension mean?

A

The patient must understand the procedure and be drug free when signing the consent

209
Q

What does consent given voluntarily mean?

A

The patient was not persuaded into doing the procedure

210
Q

How old must you be to sign a consent?

A

18

211
Q

When can parent sign for their children?

A

When the child is dependent on them

212
Q

What two mental states should the patient be to sign consent?

A

AAO and competent

213
Q

When can a consent be bypassed?

A

When the circumstance are life threatening and the patient can’t sign or if the person that can sign is not present

214
Q

What are some symptoms of a latex allergy?

A

Urticaria,rhinorrhea , bronchospasms, compromised respiratory system

215
Q

What allergies common correlate with latex allergy

A

Bananas, kiwi, avocado

216
Q

What does Urticaria mean?

A

Rash or hives

217
Q

What does rhinorrhea mean?

A

Runny nose

218
Q

What allergy other than latex should you be aware of prior to surgery?

A

Drug and iodine?

219
Q

What allergy is correlated with iodine allergy?

A

Shell fish

220
Q

Who’s at most risk for a latex allergy?

A

Spina bifida, urogenital issues, spinal cord injury, health care providers, people who under go many operations

221
Q

What is spina bifida?

A

The spine protruding from the skin

222
Q

What is the urogenital system?

A

Organs of the reproductive and urinary system

223
Q

Why should post op teaching be done during pre op?

A

Because the patient is sober and not under any drugs at that point

224
Q

What pre op teaching might you talk about?

A

The surgery, sensations, pain management, ambulation, TCDB, Spirometer, and exercises

225
Q

When should vitals be done pre and post op?

A

Xxx

226
Q

When do severe reactions usually take place when administering blood?

A

Within the first 15 minutes or 50mL

227
Q

How long should blood take to infuse?

A

Between 2 and 4 hours

228
Q

what is a timeout?

A

correct patient, site, surgery, allergy, and surgical site marked

229
Q

types of sedation…429 and 430 moderate sedation

A

xxxxx

230
Q
A
231
Q

What are the human needs considerations for perioperative care?

A

Comfort, nutrition, elimination, sensory, human interaction, and learning

232
Q

What is dehiscence?

A

When the wound has separated and is exposing layers under the skin

233
Q

What is evisceration?

A

Viscera is exposed or intestines are showing

234
Q

What is the acronym coach used for?

A

charting body fluids

235
Q

What does the acronym COACH stand for?

A

Color, Odor, Amount, Consistency, How is the patient tolerating

236
Q

What is the acronym REEDA used for?

A

Assessing the surgical site

237
Q

What does REEDA mean?

A

Redness…Edema…Ecchymosis…Drainage…Approximation

238
Q

What is a pulmonary embolism?

A

A clot that is found in one of the pulmonary arteries

239
Q

What are the symptoms of a PE?

A

Chest pain, dyspnea, tachycardia, anxiety, diaphoresis, blood gas changes, increases respiration rate, increased anxiety, decreased BP, decreased orientation

240
Q

What is urinary retention?

A

When you are holding excessive amounts of urine

241
Q

What are symptoms of urinary retention?

A

Unable to urinate for 8-10 hours post op

Palpable bladder

Frequent small voids

Pain in the suprapubic area

242
Q

What is pneumonia?

A

Fluid in the alveoli

243
Q

What are the symptoms of pneumonia?

A

Rapid shallow respirations, fever, wet breath sounds, asymmetrical chest movement, productive cough, hypoxia, tachycardia

244
Q

What is atelectasis ?

A

Dyspnea, tachypnea, decreased breath sounds, aysmetrical chest movement, tachycardia, increased restlessness

245
Q

What is gastric dilation?

A

Sudden and severe distention caused by a build up of fluid and gas

246
Q

What are the symptoms of gastric dilation?

A

Nausea and vomiting and

Abd distention

247
Q

What is a paralytic ileus?

A

condition where the motor activity of the bowel is impaired, usually without the presence of a physical obstruction

248
Q

What are paralytic ileus symptoms

A

Decreased bowel sounds, no stool, no gas, nausea, vomiting, abd distention, abd tenderness

249
Q

What to do if patient is having a PE?

A

Sit them up, apply oxygen, reassure client, call rapid response

250
Q

How frequently are vitals done on a patient after surgery and when does the spacing between sets increase?

A

Q15 until patient wakes up and then every 4 hours after that

251
Q

What is malignant hypothermia?

A

A condition that is set off by anesthesia where the patients body temperature increases up to 107 degrees

252
Q

What are risk factors for malignant hyperthermia?

A

Men and genetics

253
Q

What are symptoms of malignant hyperthermia?

A

Temp up to 107 degrees F
Dyspnea
Tachycardia
Tachypnea
Hypotension
Restlessness
Metabolic Acidosis
Elevated Ca and K
Cyanosis
Muscle rigidity in jaw and upper chest
Skin mottling

254
Q

What are the interventions for Malignant Hyperthermia?

A

Dantrolene Sodium, cooling blanket, and ice applied to groins, armpits, etc

255
Q

What labs will be looked at for a malignant hypothermia patient?

A

ABG….pH level, CO2, and O2

BMP for Ca and K

256
Q

When can Malignant Hyperthermia happen?

A

From the surgical suite up to 24 hours post op

257
Q

What are symptoms of OD?

A

Xxxx

258
Q

What is a JP drain?

A

A bulb like drain that sits deeper in the wound and uses negative pressure to pull internal drainage out

259
Q

What is a hemavac drain?

A

A spring loaded circular drain that pulls blood using negative pressure

260
Q

What is a Penrose drain?

A

Soft flexible latex tube that drains fluid away from wound

261
Q

How to brace your incision?

A

Brace against a pillow or push hands toward the incision reducing stretch on the incision site

262
Q

How to breath for TCDB exercise?

A

3 slow breaths in through nose and on third breath cough to remove secretions

263
Q

What does a circulatory nurse do?

A

Deals with patient advocacy and privacy

Sterile Continuity

Padding Boney proms

Traffic control

In charge of time out

Verifies consent

264
Q

What does the scrub nurse do?

A

Sterile

Hands items to surgeon

Instrument count

Setting up sterile field

Pays attention to irrigation, urine, and blood lose

265
Q

What is sanguineous drainage?

A

Bloody and normal for 1-2 days

266
Q

What is serousanguineous?

A

Blood and water which is normal for 2 to 5 days

If it last longer Than 5 days the patient may be dehiscing

267
Q

What is serous?

A

Clear drainage

268
Q

What is purulent drainage?

A

Thick, yellow, creamy

269
Q

What are symptoms of pulmonary embolism?

A

Anxiety, SOB, Cyanosis, Chest Pain, increased RR, Increased HR, decrease in SPO2, decrease in BP

270
Q

How can you prevent PE?

A

Blood thinners, smoking cessation, exercise, ambulation, not sitting for prolonged periods, hydration, healthy, weight, not using oral contraceptives

271
Q

What are symptoms of DVT?

A

Swelling, pain in the area of the clot, erythema, discoloration of skin around the site of the clot

272
Q

What are the risk factors for DVT and PE?

A

Obesity, Age, Cancer, oral contraceptives, pregnancy, smoking, diabetes, HF, varicose veins, hypertension

273
Q

What do you do if patient is having PE?

A

Raise head of bead, apply oxygen, encourage slow deep breaths and call rapid response

274
Q

How to prevent respiratory complications?

A

Monitor vitals, TCDB, coughing, Incentive spirometry, turning in bed, getting out of bed, early ambulation, hydration, and monitoring response to analgesics

275
Q

What post op assessments should be performed immediately after surgery/

A

Vital signs, pulse ox monitoring, tele monitoring, skin color, temperature, LOC, Position, surgical site

276
Q

How long will the patient be NPO after surgery?

A

Until bowel sounds are auscultated

277
Q

What meds can be given in pre op?

A

Hydroxyzine, lorazepam, midazolam, atropine

278
Q

What are signs and symptoms of opioid OD?

A

Loss of consciousness, pinpoint pupils, breathing difficulty, respiratory arrest, choking, cyanosis, unresponsive to loud/shaking/painful stimuli

279
Q

What are symptoms of benzodiazepine overdose?

A

Impaired mental status, confusion, slurred speech, slow breathing, respiratory arrest, coma

280
Q

What shoulda nurse do during a OD?

A

Once a OD is determined, call rapid response, administer antidote, apply oxygen, suction airway of secretions if needed, monitor vital signs, apply cardiac monitor, keep patient on their side to decrease risk of aspiration, monitor fluid and electrolytes,

Adult 2 (4 decks)

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