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2016FA PATIENT CARE (R. Taylor) > EXAM #2 (9-22 → 9-29) > Flashcards

EXAM #2 (9-22 → 9-29) Flashcards

1
Q

If a line becomes displaced or removed, can it be life threatening?

A

yes

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2
Q

Does reinsertion of an accidentally removed device require another surgery or procedure?

A

yes

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3
Q

Patients are most vulnerable to accidental line removal during _____.

A

Patients are most vulnerable to accidental line removal during transport.

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4
Q

You should always be mindful of any tube, line and drain and take great precaution to maintain the integrity.

A

yes okay

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5
Q

Any _____ can be painful due to securing devices – i.e. a foley catheter is held in the bladder with an inflated balloon

A

Any tugging can be painful due to securing devices – i.e. a foley catheter is held in the bladder with an inflated balloon

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6
Q

Most tubes will have a _____ device to aid in keeping in place

A

Most tubes will have a securing device to aid in keeping in place

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7
Q

_____ must take place prior to MRI studies to assure compatibility with the magnet.

A

Screening must take place prior to MRI studies to assure compatibility with the magnet.

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8
Q

[IMPLANTED DEVICES]

Implanted
Surgically implanted under the _____

There IS OR ISN’T a presence externally

Example – ___________

A

Implanted
Surgically implanted under the skin

There may or not be a presence externally

Example – cardiac pacemaker

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9
Q

Percutaneous/peripheral
Placed in a _____ manner

Example – ______, _____

A

Percutaneous/peripheral
Placed in a minimally invasive manner

Example – nephrostomy tube, central venous catheters

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10
Q

When are endotracheal tubes used?

A

Used during general anesthesia to ventilate and provide oxygen delivery

For shock, disease that impairs gas exchanges, and upper airway obstruction

Impending gastric acid reflux or aspiration

To ventilate coma induced patients

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11
Q

When endotracheal tubes are used, what is done for short term and what is done for long term?

A

Intubation is achieved via laryngeal or nasal approach

For long term ventilation a tracheostomy is performed

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12
Q

Patients with endotracheal tubes and trachs often produce large amounts of _____

These _____ need to be _____ to maintain potency of the tube and prevent airway obstruction

Every imaging room should contain wall _____ and catheters to use in the event _____ is needed and/or a _____ machine must be very near by

Daily checks should always occur for the availability of emergency equipment

A

Patients with endotracheal tubes and trachs often produce large amounts of secretions

These secretions need to be suctioned to maintain potency of the tube and prevent airway obstruction

Every imaging room should contain wall suction and catheters to use in the event suctioning is needed and/or a suction machine must be very near by

Daily checks should always occur for the availability of emergency equipment

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13
Q

Why are Thoracostomy tubes used?

When _____ or _____ accumulation occurs in this space the lung fails to fully expand

Used to treat _____, ______, _____ and _____

Cause can be trauma, complication of a lung biopsy or central line placement, infection, rib fracture, rupture of an emphysema bleb

Always attached to a _____ or _____ valve

[*] Should the chest tube become dislodged a _____ dressing should be placed over the site to seal the puncture site

Always keep the pleuovac _____ than the chest to prevent reflux of drainage into the pleurospace

A

Used to re-establish negative pressure in the pleural cavity

When fluid or air accumulation occurs in this space the lung fails to fully expand

Used to treat pneumothorax, hemothorax, pleural effusion and empyema

Cause can be trauma, complication of a lung biopsy or central line placement, infection, rib fracture, rupture of an emphysema bleb

Always attached to a pleuovac or Heimlich valve

Should the chest tube become dislodged a Vaseline dressing should be placed over the site to seal the puncture site

Always keep the pleuovac lower than the chest to prevent reflux of drainage into the pleurospace

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14
Q

What is an NG tube

A

nasogastric tube

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15
Q

What is a PEG tube used for

A

used for feeding

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16
Q

[FOLEY]

Inserted into _____ via _____

Held in _____ with a _____

Attached to a _____ bag

Always kept level of drainage bag _____ the bladder level to prevent reflux back into bladder

A

Inserted into bladder via urethra

Held in bladder with a balloon

Attached to a drainage bag

Always kept level of drainage bag below the bladder level to prevent reflux back into bladder

17
Q

[SUPRAPUBIC TUBE]

Tube that is _____ placed into the _____

Attached to _____ bag – most commonly used after _____ surgery

Always keep bag _____ level of bladder to prevent reflux

A

Tube that is surgically placed into the bladder

Attached to drainage bag – most commonly used after prostate surgery

Always keep bag below level of bladder to prevent reflux

18
Q

[NEPHROSTOMY TUBE]

_____ inserted into the _____ of the kidney

Used to _____ kidney when an obstruction is present in the ureter – i.e. kidney stones
Attached to a drainage bag

Always keep bag _____ level of kidney to prevent reflux

A

Percutaneously inserted into the calyx of the kidney

Used to drain kidney when an obstruction is present in the ureter – i.e. kidney stones
Attached to a drainage bag

Always keep bag below level of kidney to prevent reflux

19
Q

[VASCULAR ACCESS CATHETERS]

Traditional ______ catheters – nearly every hospital inpatient has one which may or not be connected to IV fluids.

These lines are always covered with a _____ dressing, alert nurse should dressing be loose or fall off

_____ devices are always present to maintain integrity of line

There are a variety of other types of lines which are utilized to provide access for the administration of fluids, medications and blood in those patients where a peripheral intravenous line is unable to be established or maintained, or where the patient requires lines for treatment. The insertion site is always maintained with sterile technique.

  • PICC (peripherally inserted central catheter)
  • PORT
  • CVC’s (central venous catheters)
  • Arterial lines
A

Traditional intravenous catheters – nearly every hospital inpatient has one which may or not be connected to IV fluids.

These lines are always covered with a protective dressing, alert nurse should dressing be loose or fall off

Securing devices are always present to maintain integrity of line

There are a variety of other types of lines which are utilized to provide access for the administration of fluids, medications and blood in those patients where a peripheral intravenous line is unable to be established or maintained, or where the patient requires lines for treatment. The insertion site is always maintained with sterile technique.

  • PICC (peripherally inserted central catheter)
  • PORT
  • CVC’s (central venous catheters)
  • Arterial lines
20
Q

_____ are very commonly used for patients receiving chemotherapy

A

Ports are very commonly used for patients receiving chemotherapy

21
Q

When are PICCS used?

A

Used where peripheral IV access is difficult or not possible

Placed when long term IV access is needed

22
Q

[Arterial line (aka art line) ]

When are they used?

As a line for drawing of frequent _____ _____

Should line become dislodged direct constant _____ is required over puncture site

A

Used mainly for monitoring

As a line for drawing of frequent blood gases

Should line become dislodged direct constant pressure is required over puncture site

23
Q

What are tissue drains used for?

Often placed after _____ to prevent the collection of fluid or blood within a wound

A

Used to drain collections of fluid, blood or infectious matter

Often placed after surgery to prevent the collection of fluid or blood within a wound

24
Q

What are pain balls used for?

A

provide a continuous infusing to a wound for pain control

25
Q

What are Pacemakers & Internal Defibrillators used for?

Some _____ pace the heart

Others are on _____ when the heart rate falls below a given rate – i.e.. Less than 50

_____ defibrillators used to shock the heart when it goes into a dangerous irregular rhythm

Must use caution in _____ environment

A

Implanted device used to maintain a constant regular heart rate

Some constantly pace the heart

Others are on demand when the heart rate falls below a given rate – i.e.. Less than 50

Internal defibrillators used to shock the heart when it goes into a dangerous irregular rhythm

Must use caution in MRI environment

26
Q

[Greenfield filter (IVC filter) ]

Placed in the _____ to _____ and prevent them reaching the heart and lungs

Inserted through the _____ vein and placed just below the kidneys, usually in an _____ _____ setting

Caution must be taken for patient having an _____

A

Placed in the inferior vena cava to trap blood clots and prevent them reaching the heart and lungs

Inserted through the femoral vein and placed just below the kidneys, usually in an interventional radiology setting

Caution must be taken for patient having an MRI

27
Q

What is coding

A

Prospective Payment System (PPS)

Diagnostic Related Groups (DRGs)

Conversion of diagnoses and procedures into a numerical classification system

Conversion to these codes must be accurate

Used for reimbursement from Medicare,
Medicaid and other insurance payers

28
Q

What is ICD -10

A

used to code diseases, signs and symptoms, abnormal findings, complaints, social circumstances and external causes of injury/disease.

29
Q

Health Record content (general to know)

A

Med reconciliation = complete list of medications taken

Patient Identification

Medical history - chief complaint, present illness or injury, relevant family and social history, inventory of body systems

Report of relevant physical exam

Diagnostic and therapeutic orders

Clinical observations, including results of therapy

Reports of diagnostic and therapeutic procedures and tests as well as results

Evidence of appropriate informed consent

Conclusions at termination of hospitalization or evaluation of treatment, including any pertinent instructions for follow up care

30
Q

In radiology, you need to review patient’s _____ _____ prior to performing the particular study

A

In radiology, you need to review patient’s clinical history prior to performing the particular study

31
Q

[Health record in radiology]

Must have a radiology _____ or request for service

Must include patient demographic information (what’s going on with patient)

Specific procedure requested

Physician ordering

A

Must have a radiology order or request for service

Must include patient demographic information (what’s going on with patient)

Specific procedure requested

Physician ordering

32
Q

If something isn’t documented, then it wasn’t done!

A

If something isn’t documented, then it wasn’t done!

33
Q

What’s an ABN?

A

advances beneficiary notice, a person signs to say if their payer doesn’t pay, then they’re responsible for the bill

34
Q

Entries to medical record

A

If paper record, must be in ink

Only approved abbreviations can be use

Must be dated & timed

Signature with printed name (may use stamper) and legal title

EMR – date, time and signature are auto entered

35
Q

Mammography Quality Standards Act (MQSA)

A

Mammography Quality Standards Act (MQSA)

must keep mammo for 10 years

36
Q

When you talk with the patient, you should listen, first for what he wants to tell, secondly for what he does not want to tell, thirdly for what he cannot tell.L.J Henderson

A

When you talk with the patient, you should listen, first for what he wants to tell, secondly for what he does not want to tell, thirdly for what he cannot tell.L.J Henderson

37
Q

objective vs subjective data

A

objective = realism

subjective = perceived by the person only, individualized, idealism

38
Q

What are the Sacred Seven and what are they?

A
  1. Localization - precise area for the patient’s complaint - can use touch with the patient’s permission - touch for emphasis and touch for palpation
  2. Chronology - time element - duration since onset, frequency, course of the symptoms
  3. Quality - character of the symptoms - examples - color, consistency of body fluids, presence of clots or sores, size of lumps or lesions, type of cough, is pain constant or come and go
    Pain can have descriptors such as dull, aching, burning, radiating, crushing, pressure
    Pain is probably the most common complaint encountered as it usually drives patients to seek care
  4. Severity - describes the intensity, the quality, or extensiveness of the problem
  5. Onset - what patient was doing when condition began
  6. Aggravating or Alleviating factors - circumstances that makes problem worse or modifies problem
  7. Associated Manifestations - do other symptoms accompany the chief complaint

2016FA PATIENT CARE (R. Taylor) (5 decks)

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