Exam 1 Flashcards
Contact Isolation
MRSA, C-diff, VRE, Scabies
Gloves & gown
Wash hands after
Don’t shave or reuse clothing or toiletries
Wash clothes and towels daily
Tx of sickle cell anemia
Oxygen
Hypotonic or isotonic fluids
Analgesic
NO frequent BPs
Encourage extension of arms
Warm compresses
Primary care
Planned care
Ex. Immunizations, education, smoking cessation
S/S of blood transfusion reaction
Sweating/ chills
Hives
Headache
Back pain
Pruritis
SOB
Nausea
S/S of sickle cell anemia
Severe pain
Dizziness
SOB/ hypoxia
Fatigue
S/S of B12 deficiency
Tingling/numbing in hands
Glossitis
Trouble walking
Tx of psoriasis
Biological agents (etanercept)
Always report fever
Loose cotton clothing
Warm weather helps
S/S of iron deficiency
Irritable
Brittle nails
Anorexia
Glossitis
Fissures in corner of mouth
Iron rich foods
Spinach
Red meats
Liver/organ meats
Fish/seafood
Raisins
Poultry
Iron deficiency
From low intake of iron rich foods, alcoholism, and loss of blood
NO WHEAT- binds to iron making it unavailable for absorption
S/S of anemia
Fatigue
Pale
SOB
hypoxemia
Skin cool to touch
High HR
Low BP
Murmurs
Psoriasis and its trigger
Autoimmune disease
Over proliferation of skin cells and scaling
Trigger: abts and stress
Signs of dehiscence
Purulent/foul smelling drainage
Increase in drainage
Change in drainage (serous to sanguineous)
Non-tunneled central line
For short term
Accessed through IJ or subclavical
Inserted by Dr
CXR to avoid pneumothorax
Universal donor
O-
Serrosanguinous drainage
Yellow/red
Sanguineous drainage
Red
Removal of central lines
Supine or trendelenburg position
Valsalva maneuver (bearing down)
Universal receiver
AB+
TPN
Via central line ONLY
Complications- infection, high or low BS
Don’t change rate or turn off
Jackson-Pratt drains
Tube in wound with bulb outside of body to collect drainage
Squeeze and replace bulb to reset
Taken out of drainage <25ml
Vitamin B12 deficiency
B12 is from animal sources
Vegans need B12 shots
TPN education
Monitor weight daily
Albumin checked everyday
BS q6hrs
If bag runs out, hang 10% dextrose ONLY
Not for people who have good or intact GI function
Blood transfusion equipment
Large bore IV (min. 20gauge) In non-dominant arm
Y tubing with ONLY 0.9% saline
Blood transfusion rate
2ml/min for first 15 min
Infuse each unit over 4 hrs
Highest concern with pain meds
Overmedication
Respiratory depression
Sickle cell anemia
Abnormal shaped cells
Don’t flow well and blocks passages in arteries/veins
Blood transfusion Vital sign schedule
q15 min x2
q30min x2
qhr until finished
Herpes zoster
Shingles
Contagious until lesions crust over
HEPA mask (N95)
Immobility can cause
Atelectasis
Constipation
Urinary stasis
Muscle atrophy
Contractures
Most at risk for febrile (non-hemolytic) reaction
People who have gotten transfusions in the past
TENS unit
Electrodes to painful area
Should feel pins and needles sensation
Affective immediately
May be repeated
Interventions for immobility
Reposition q2hrs
Float heels
Pillows/wedges on bony prominences
Pressure offloading devices
High tops to prevent foot drop
Ankle flexion exercises
Cellulitis
Infection
Redness (erythema)
Fever
Enlarged lymph nodes
NO ITCHING/BURNING
Dehiscence
Higher risk if taking NSAIDS/steroids or diabetic
Evisceration (wound opens) possible
Common side effects of opioids
Sedation/drwsiness
Constipation
Respiratory depression
Urinary stasis
Rash
N/V
Itching
Hypotension
If reaction to blood transfusion
Return tubing and bag to blood bank
Disconnect blood tubing and replace with new IV tubing with 0.9% saline running
Secondary care
Screenings
TB test
PAP smears
Breast/testes exams
Tunneled central line
Long term (years)
Mainly for dialysis
Inserted through IJ or subclavical by DR
CXR to confirm
Tertiary care
After disease/improving life
Ex. Cardiac rehab, speech therapy, chemo
Opioid antidote
Naloxone
Going upstairs with ambulatory aid
Up with good leg first, down with bad leg first
High risk for infection
Immunocompromised (chemo, HIV, steroid use, transplant pts)
Malnourished
ETOH
Labs for wound healing
Albumin (shows nutrition status)
How to walk with ambulatory aid
Aid on strong side
Move cane with weak side
Pruritis
Itchiness
Urticaria
Hives
Pre op care of pt
Pacemaker/electrical devices interfere with electric cauterizer
Ask if any hx or family hx with anesthesia (malignant hyperthermia)
Allergy to preop abts?
Check for abnormal labs (coag or electrolytes)
Shave with electrical shaver ONLY
NPO- No insulin
Airborne Isolation
Negative pressure room
HEPA mask(N95)
Visitors wear masks
Implanted port
Central line
Assessed with Huber 90 degree non-coring needle
Confirmed with blood return
Inserted by DR
Negative pressure wound vacs
Not for pts on anticoagulants
ONLY Intermittent suctioning
Monitor drainage q2hrs
Fresh frozen plasma
To replace clotting factors
Reverses INR
Anemia causes
Bleeding
Iron deficiency
Bone marrow
Genetic diseases
Intra-op care
Extra padding for decreased circulation
Time out procedure- go over all information before surgery
Donning PPE
Putting on
Reverse alphabetical order except mask is 2nd
Gown
Mask
Goggles
Gloves
Doffing PPE
Taking off
alphabetical order
Gloves
Goggles
Gown
Mask
Wash hands
Droplet iso
Mask within 3ft
Gloves/gown if contact with fluids
Sepsis/scarlet fever
Parvovirus
Influenza
Diphtheria
Epiglottitis
Rubella
Mumps/meningitis
ANdenovirus
Post-op day 1 (day after surgery)
Foleys removed
D/c prophylactic abts within 24hrs
Monitor for dehiscence
NPO-advance diet as ordered
TCDB + IS 5-10x an hour
No corticosteroids (delays healing)
VS of bleeding
Hypotension
Tachycardia
Tachypnea
Hypoxemia
Serous drainage
Yellowish
