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Critical Care > Exam #1 > Flashcards

Exam #1 Flashcards

1
Q

what should the charge nurse do in relation to staffing?

A

bed assignments, look at call ins, be aware of LPNs, is their staff being floated out?

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2
Q

what kind of listening should a charge nurse have?

A

active

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3
Q

what is active listening?

A

listening to what is being said and responding

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3
Q

what might a nurse have to tell a nurse about their perfomance?

A

that they are not doing their job

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4
Q

what are the steps in mediating conflict?

A

accept that conflict happens, be calm, active listening, analyze conflict, be neutral, separate the problems, and work together

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5
Q

when is it a bad time to educate a patient?

A

after giving bad news or after giving narcotics

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6
Q

what reading level should you break things down to when dealing with patietns?

A

8th grade

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7
Q

what can stress a nurse out?

A

inadequate knowledge, floating, death, environment, burnout

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8
Q

what behavioral changes are signs of burnout?

A

withdrawal, risk taking, impulsive, decreased productivity, career change, tardy, less time with patient

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9
Q

what physiological changes are signs of burnout?

A

fatigue, sleep problems, appetite changes

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10
Q

what psychological changes are signs of burnout?

A

blaming others and sterotyping

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11
Q

what cognitive changes are signs of burnout?

A

decreased judgment, lack of initiative, and forgetful

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12
Q

what emotional changes are signs of burnout?

A

apathy, anger, anxiety, bored, irritable,

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13
Q

what meds cant a LPN give?

A

vasoactive drugs

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14
Q

what does ABC stand for?

A

airway, breathing, cardiac

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15
Q

what is something that needs to be observed on the neck with chest truama?

A

ensuring that the trachea is midline

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16
Q

what is blunt force trauma?

A

trauma from hitting an object without penetration

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17
Q

what can blunt force chest trauma lead to?

A

hypoxemia, hemorrhage, pneumothorax, hemothorax, hypovolemia, and cardiac failure

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18
Q

how serious is blunt force trauma?

A

can be life threatening

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19
Q

what bone is commonly broken in blunt force trauma?

A

ribs

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20
Q

what are the most common places for ribs to break?

A

4-10

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21
Q

what lung disease can rib fractures lead to ?

A

pneumonia

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22
Q

what makes tenderness/muscle spasms worse in rib breaks?

A

coughing, moving, deep breathing

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23
Q

what are symptoms of rib/sternal breaks?

A

point tenderness, muscle spasms, bruising, swelling, crepitus, chest wall deformity, dyspnea XXXXXXXXXXXXXXXXXXXX

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24
Q

what is the treatment for a normal rib fracture?

A

not splinted, sternal wraps may be used light wraps, intercostal nerve blocks, NSAIDs, Opiods

25
Q

what is the preferred medication to treat normal rib fractures?

A

NSAIDs are preferred because they do not cause lowered RR or resp depression

26
Q

what device might rib fracture patients have for pain?

A

PCA

27
Q

can you push PCA button for rib fracture patients?

A

no

28
Q

when is a rib fracture considered flail chest?

A

when there are three of more ribs broken in a row and in two or more places in each rib

29
Q

what are the symptoms of a flail chest?

A

dyspnea, cyanotic, impaired gas exhange, sob, anxiety, low pulse ox, bruising, tachycardia, paradoxical chest movement

30
Q

what does paradoxical chest movement look like?

A

on inspiration the chest wall caves in, on expiration the chest wall exands, the patient will be in pain

31
Q

what should be done for both broken rib/flail chest?

A

TCDB

32
Q

when is a vent required in flail chest?

A

if they have severe dyspnea or a big drop in pulse ox

33
Q

what kind of vent setting will flail chest have?

A

peep

34
Q

what kind of lumen trach tube will flail chest have while intubated?

A

double lumen due to the different pressure in the chest

35
Q

what surgery might flail chest get?

A

stabilization surgery with pins/plates

36
Q

what should be monitored in rib fracture patients?

A

the vital signsXXXXXXXXXXXXXXXXXXX

37
Q

what is the pain management for flail chest?

A

IV pain med, epidural, nerve block

38
Q

what might be given to flail chest patients?

A

O2 and iv fluids

39
Q

what is a pulmonary contusion?

A

occurs when there is bruising/bleeding into the lungs between the alveoli….the tissue gets oversaturated with blood effecting gas exchange

40
Q

what causes pulmonary contusion?

A

any type of chest trauma

41
Q

what can a pulmonary contusion lead to?

A

respiratory distress

42
Q

what are the symptoms of pulmonary contusion?

A

decreased breath sounds, tachypnea, tachycardia, chest pain, hypoxemia, crackles, frank bleeding, bloody sputum, agitation, respiratory acidosis, decreased lung movement, fatigue, hemoptysis

43
Q

how do you manage mild pulmonary contusion?

A

IV or Oral fluids, O2 high flow, moderate fowlers, expansion techniques

44
Q

how do you manage moderate pulmonary contusion?

A

ventilation with PEEP, NG tube for GI distention, Bronchoscopy,

45
Q

how do you manage severe pulmonary contusion?

A

Vent, diuretic, fluid restriction and antibiotics

46
Q

what should you monitor for when giving fluids to pulmonary contusion patietns?

A

make sure they dont get hypervolemic

47
Q

what are signs of hypervolemia?

A

elevated BP, edema, weight gain, tachycardia, weak pulse

48
Q

what expansion techniques are used in moderate contusion?

A

draining, suction, cough, high flow o2

49
Q

what is a pneumothorax?

A

collapsed lung due to their being positive pressured air in the pleural space

50
Q

what can cause pneumothorax?

A

blunt, penetrating, bleb

51
Q

what causes a closed pneumothorax?

A

blunt force or a bleb

52
Q

what is occurring during a closed pneumothorax?

A

air is being trapped into the pleural space not due to penetration

53
Q

what is a bleb?

A

a air filled blister on the surface of the lung….when it pops the air then is trapped in the pleural space taking away from the negative pressure

54
Q

what can cause a bleb?

A

COPD, TB, CF, CVL, Bypass, Thoracentesis, biopsy

55
Q

what occurs during a open pneumothorax?

A

puncture of the skin, pleural space and lung that allows free movement of air

56
Q

what is commonly paired with open pneumo?

A

hemothorax

57
Q

what is a hemothorax?

A

damage to the vasculature of the chest causing build up of pressure on the lung eventually causing collapse

58
Q

what are symptoms of the pneumothorax?

A

cyanosis, accessory use, dyspnea, pain, reduced breath sounds, anxiety, tachypnea, tachycardia, bruising, unequal chest rising

59
Q

what are the interventions for pneumothorax?

A

chest tube or thoracostomy

60
Q

when is a thoracostomy used?

A

xxxx

61
Q
A

Critical Care (6 decks)

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