final Flashcards
where do we do a cap glucose measurement
side of the finger (pad)
why do we wipe away first drop of blood for glucose test
what is DKA
body can’t produce enough insulin, body begins to break down fat as fuel causing buildup of acids in bloodstream = ketones
what order do you draw up insulin
air in N (long acting), air in R (rapid acting), draw R, draw N
what are the kinds of insulin and how fast will they work
rapid = onset 15-30 mins, peak = 1-3hrs
short = onset 30-1hr, peak = 1-5hrs
intermediate = onset 1-2 hrs, peak = 6-14 hrs
long = onset 0.8-2 hrs, peak = peakless
what sites can you use for insulin and what angle injection
adipose tissue: upper arms, outer side of thigh, belly area
5cm tissue = 90 degrees
less than 5cm tissue = 45 degrees
what is heparin? what are contraindications to heparin adminsiteration
what is the correct size of subcutaneous syringe
what is the max amount of volume in the subcutaneous site
2mL
why do we do a TB skin test
where is the correct spot for TB?
what angle of insertion for TB
what other things might be given intradermal?
what is different b/w blunt fill and filter?
filter = prevent small glass fragments from entering syringe
blunt fill = used to draw up medication
which needle do you use for vial? an ampule?
vial = blunt
ampule = filter
what are some differences b/w vial and ampule
ampules = single dose medication, constricted neck must be snapped off to access medication, scored for easy break
vial = single or multi dose, rubber seal, closed system, air must be injected into vial to permit easy withdrawal
name the different parts of a syringe
plunger, barrel, needle hub
would you draw up from a vial or ampule first if you were mixing 2 medications?
how many litres would you put the O2 to for NP, simple face mask, non-rebreather
NP = 1-6mL
simple face mask = 5-8mL
non-rebreather = 10-15mL
what is a normal oxygen level? for a COPD patient
greater than 95%
88-92%
signs of hypoxia include?
what is difference b/w high and low flow oxygen delivery device
low = oxygen mixing with room air (NP, simple face mask)
high = deliver O2 rates above normal inspiratory flow rate
how would you explain an incentive spirometer
encourage voluntary deep breathing by providing visual feedback
suck in (inhale) until ball raises and you can’t inhale any longer, hold breath for 5 secs, exhale normally
name 2 breathing exercises that require no equipment and how would you explain them
pursed lips = breathe in slowly through nose for 2 counts, purse lips as if you are going to whistle, breathe out for 4
deep breathing & coughing = breathe in slowly through nose for 3 counts, keeping mouth close, exhale slowly through mouth and cough at end of exhale
explain how to admin NEBS
explain how to admin metered dose inhaler (MDI) with & without spacer
what time of the day is the best sputum sample
early in morning
3 elements to pronounce?
pulse, respiration, HR (VS) no response to shout and pain
under what circumstances can an RPN pronounce?
with a physicians order
2 nurses listen to apical HR for 1 min
rigor mortis, algor mortis, livor mortis
rigor = stiffening of body (couple hrs after death, peak 8 hrs, gone after 12hrs)
algor = cooling of body (1 degree per hr)
livor = settling of blood (red blood cells settle into skin, see on back)
what is the advantage of a subcutaneous butterfly & where do we put them
less injections with needle — provides more comfort
upper arm, thigh, abdomen
how would you prepare a subcutaneous medication for the first use of butterfly
what is the otic route
ear
what is the ophthalmic route
eye
what instructions do we give patients when taking sublingual medications
do not swallow, place under tongue and let dissolve slowly
what position for rectal medications
left side sims position
transdermal patches deliver medication how?
absorbing through the skin
what is difference b/w buccal & SL
buccal: cheek
SL: under tongue
what size syringe do we use for IM
3mL
name the 4 sites for IM and landmark, naming the appropriate anatomy
deltoid = expose upper arm, relax arm, palpate lower edge of acromion process, inject
ventrogluteal = nondominant hand, greater trochanter, iliac crest, iliac spine, heel of hand over greater trochanter, point thumb towards groin, index finger to anterior iliac spine, other fingers on iliac crest, inject in V
vastus lateralis = greater trochanter & top of knee, inject in middle — anterior lateral aspect of thigh
dorsogluteal = divide into quarter & inject upper outer quadrant
what is the max volume for each site
deltoid = 2mL
dorsogluteal = 4mL
ventrogluteal = 3mL
vastus lateralis = 3mL
what is the preferred site for adults? for children?
adults = ventrogluteal
children = vastus lateralis
why are women more prone to UTI
what are signs of UTI
pain and burning sensation, fever, chills, vomiting, urgency, hematuria, cloudy foul smelling, change of colour
define: polyuria, dysuria, oliguria, anuria, frequency, retention, neurogenic bladder
polyuria: large amount of urine
dysuria: painful urine
oliguria: small amount of urine
anuria: no urine
retention: holding onto urine
neurogenic bladder: lack bladder control due to brain, spinal cord or nerve problems
what is purpose of a bladder scanner
to determine how much urine is in the bladder
what is fecal occult blood test for
check stool samples for hidden (occult) blood
advantage of condom catheter over urinary catheter
what is C+S
what is surgical asepsis
procedures used to eliminate all microorganisms — complete removal
what is a nosocomial infection
infection that is acquired in a hospital setting
what are the 3 types of precautions in hospital & name an example
contact — MRSA
airborne — TB
droplet — rubella, mumps, influenza
what kind of equipment do you need for each precaution
contact = gown, gloves
airborne = respiratory protection device (N95)
droplet = mask
what is the order of donning and doffing
donning: hand hygiene, gown, mask, eye protection, gloves
doffing: gloves, hand hygiene, gown, hand hygiene, eye protection, hand hygiene, mask, hand hygiene
chain of infection what are the different elements
infectious agent (pathogen)
reservoir (source for the pathogen to grow — person, environment)
portal of exit of reservoir (sneeze)
mode of transmission (direct, indirect, vehicle, vector)
portal of entry into host (wound)
susceptible host
