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PCC 2 > Final > Flashcards

Final Flashcards

1
Q

How do you use an IS?

A

Breathe in slow amend steady and hold it. Make a good seal on the mouthpiece, keep the ball in between two lines

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2
Q

Can a pt share an IS?

A

No

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3
Q

What is not allowed for an MRI?

A

Metal

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4
Q

List some things that are a safety risk for an MRI

A

Jewelry, med patches, implants

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5
Q

Is getting an MRI safe if a pt has a pacemaker?

A

They should have a medical implant card saying it is safe

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6
Q

If a pt has any kind of implant or hardware in the body, what should they carry for an MRI?

A

MRI safety card clearing them to get one- the metal is not a hazard

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7
Q

What should the nurse do if she cannot confirm a pt’s implant is safe for an MRI?

A

Reschedule the MRI until safety can be confirmed

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8
Q

What’s are the types of wound drainage?

A

Purulent, sanguinous, serous, and serosanguinous

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9
Q

Describe the appearance of serous fluid

A

Clear

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10
Q

Describe the appearance of sanguinous fluid

A

Bloody

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11
Q

Describe the appearance of purulent drainage

A

Thick, green/yellow (pus)- can be thick and have an odor- indicates infection

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12
Q

Describe the appearance of serosanguinous fluid

A

Clearish with a brown/red/pink tint- can be considered normal post-op

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13
Q

Describe slough

A

Sticky,stringy, yellow/green mostly covering the perimeter of a wound

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14
Q

Describe eschar

A

Black, leathery covering wound bed

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15
Q

What is granulation

A

Healing of the tissue and wound bed, good

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16
Q

What is the acronym for wound care

A

BED

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17
Q

What does BED in wound care stand for?

A

Bacteria, exudate, debridement

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18
Q

Do you need BED for all wounds?

A

Yes, the more information, the better the wound are will be

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19
Q

Do you have to use BED In order in wound care?

A

No

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20
Q

What kind of wound would you use hydrogel /hydrocolloid?

A

Dry

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21
Q

What kind of dressing would you use for a wet, draining wound

A

Alginate

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22
Q

What is the absorbance capability of alginate?

A

Absorbs up to 20 times it weight

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23
Q

Do you wet the alginate dressing before applying it?

A

No, it will inhibit the absorbent properties

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24
Q

What kind of dressing would you use for an infected wound?

A

Silver, it is an antimicrobial agent

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25
Q

What are the IV complications?

A

Thrombophlebitis, phlebitis, infiltration, extravasation

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26
Q

Describe infiltration

A

Area will be cold, puffy, pale, but not painful
Medication escaped vein into surrounding tissues

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27
Q

Describe phlebitis

A

The vein becomes irritated by an infusion- too fast, cold,etc
Area will look red, warm, and may have streaking
Phlebitis scale 0-4

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28
Q

Describe extravasation

A

Vesicant (damaging) mediation escapes the vein into the surrounding tissues causing necrosis
I.e. chemo, phenergren

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29
Q

Thrombophlebitis

A

A blood clot in a vessel that can result in dangerous events if not treated immediately (MI,CVA,etc)

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30
Q

What is the phlebitis scale?

A

0-no pain, no appearance changes
1- pink but no pain
2- pink and warm with some pain
3- red, painful,possible streaking-can be palpable
4- red, warm, painful, obvious streaking, palpable veinous cord >2.54 cm purulent drainage

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31
Q

Z-track method is used for

A

IM injection

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32
Q

Pushing an injection rate

A

1mL/10 sec

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33
Q

Infection sites for IM injections

A

Deltoid, vastus lateralis, ventrogluteal

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34
Q

How to locate injection site for the deltoid location

A

Find acromion process, 2-3 finger widths down

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35
Q

How to locate the injection site for the ventrogluteal injection site

A

Find the greater trochanter and iliac crest
Palm on greater trochanter , fingers towards umbilicus and iliac crest- in between the “V”

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36
Q

6 rights of medication administration

A

Right person, time, medication,dose, route, documentation

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37
Q

Degree of injection for an IM injection

A

90

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38
Q

What is the Z-track method

A

Displacing the skin to prevent leakage of irritating or discoloring meds into subcutaneous tissue and prevent leakeage into needle track; this also eliminates discomfort

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39
Q

Landmarks for vastus lateralis injection site

A

Hip and knee- go in between both joints

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40
Q

Best location for a large volume of medication in an injection

A

IM- ventrogluteal

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41
Q

Best locations for a viscous medication via injection

A

IM- ventrogluteal

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42
Q

Small amount of medication(i.e. flu vaccine), best location for injection?

A

Deltoid

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43
Q

What are the pt rights of medication administration?

A

Right to be informed about a medication, right to refuse a medication, right to be properly advised about experimental nature of medication, right to receive labeled meds safely, right to receive appropriate support therapy, right to not receive unnecessary medication, right to be informed if meds are part of a research study

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44
Q

Angle of injection for subcutaneous injections

A

45-90 degrees, changes based on client’s available adipose tissue

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45
Q

What kind of injections are given subcutaneously?

A

Insulin, blood thinnner (lovenox/enoxaparin), heparin

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46
Q

Do you z-track subcutaneous

A

No

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47
Q

Do you aspirate an injection?

A

No

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48
Q

Routes of medication administration

A

Oral(buccal and sublingual), parenteral (IV,IM,ID,SC), specialized (epidural, intractable, intraperitoneal, intrapleural, intraarterial), topical (skin and mucous membranes) inhalation, intraocular

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49
Q

Define topical medications

A

Skin and mucous membrane based administration of medications

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50
Q

What are the types of oral mediations

A

Sublingual and buccal (or swallowed whole)

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51
Q

What are the parenteral medication types?

A

ID,SC,IM,IV

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52
Q

Are eye drops clean or sterile?

A

Sterile

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53
Q

Are nasal sprays clean or sterile?

A

Clean

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54
Q

Are nasal drops clean or sterile?

A

Sterile

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55
Q

What kind of needle is used or ID injection?

A

Tuberculin

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56
Q

Which insulin do you inject air into first

A

NPH (cloudy)

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57
Q

Which insulin do you draw first ?

A

Regular (clear)

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58
Q

Who reports an error?

A

Anyone who finds it

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59
Q

Controlled med—> waste unused amount

A

Witness needed-another nurse (if you are licensed to give it, you can witness)

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60
Q

PRN order

A

When pt needs it, i.e. pain medication

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61
Q

Sharps go….

A

Into a sharps container

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62
Q

If the sharps container is mostly full,

A

Close it and find another one

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63
Q

STAT order

A

Immediately, emergency use

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64
Q

Where do you put a controlled med to waste

A

The designated container with a witness

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65
Q

Standing order

A

Certain time, there until the order is changed of d/c
I.e. BP med

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66
Q

One-Time order

A

One time for a specific reason i.e. anxiety meds before MRI

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67
Q

When would someone need a catheter? (Foley)

A

Acute Urinary retention, surgery(prolonged surgery/urologic surgery/adjacent structures), loss of continence with a sacral/perineal wound, hospice/comfort measures for end of life, require strict prolonged immobilization, acute bladder outlet obstruction, need for accurate measure of output in critically ill

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68
Q

How to prevent a CAUTI

A

Maintain a closed system, sterile aseptic technique insertion, standard precautions, proper peri care, using when appropriate indications are present, only using it as long as it is needed, maintain unobstructed urine flow, proper. Hand hygiene, change whole system Q 30 days, hang bag below bladder on unloveable part of bed

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69
Q

How often should the whole Foley catheter system be changed?

A

Every 30 days

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70
Q

When mixing meds in a vial and ampule, which med do you draw first?

A

VA
Vial then ampule

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71
Q

Do you shake the NPH solution to make sure the medication is dispersed?

A

NO- roll it

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72
Q

What insulins should never be mixed

A

Long acting
Lantus or levemir

glargine and detemir

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73
Q

What is a clean catch urine sample

A

“Midstream”
Used for C&S
Clean peri area, start to pee, stop, then pee and catch

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74
Q

Random specimen for urine sample

A

UA and Microanalysis, anytime

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75
Q

First morning specimen urine

A

8 hour urine collection
Most concentrated, higher elements of cellular components and protein if present

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76
Q

Most common reason for an 8 hour urine collection

A

Pregnancy tests

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77
Q

Timed specimen collection

A

24-hour urine collection
Empty bladder completely first and then start collecting EVERY DROP at “start time”,must start over if even a drop is lost

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78
Q

Timed specimen collection

A

Must be on ice in a biohazard bag before taken to the lab labeled

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79
Q

Steps for glucose monitoring

A

Hand hygiene
Identify client-2 identifiers
Gloves
Scan badge
Scan pt
Compare screen with bracelet
Cleanse pt finger (ask preference)
Let dry for 10 sec
Insert strip into glucometer
Prick outside of finger pad
Wipe waste away
Let blood run into test strip- lay glucometer flat
Hold pressure on clients finger
Bandaid if needed
Discard lancet and used supplies
Clean glucometer
Doff gloves
Hand hygiene

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80
Q

How do you evaluate sleep?

A

Subjective- ask the pt

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81
Q

Sleep apnea

A

Air passages relax when asleep-airflow blocked and breathing stops
S/s=excessive daytime sleepiness, snoring, headaches
Dx with sleep study
CPAP=tx
Use STOPBANG Assessment

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82
Q

Insomnia

A

Cannot fall asleep and stay Asleep
Medications are the last resort
Teach sleep hygiene first

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83
Q

Narcolepsy

A

Falls asleep uncontrollably- cataplexy=paralysis, no control
Meds can treat not cure
Helmets outside if severe
Worsens with strong emotions

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84
Q

CAP

A

Community acquired pneumonia
Risks=old age, immunocompromised,smoking, vaccination status, children

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85
Q

HAP

A

Healthcare associated pneumonia
Risks= ventilator, increased age, immunocompromised, aspiration

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86
Q

Oxygen safety

A

Avoid heat, smoking, and dropping it

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87
Q

Hypoxia

A

Early-agitation, restlessness, pallor
Late-cyanosis, LOC

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88
Q

Wound stages

A

Unstageable, 1-4, deep tissue injury

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89
Q

Stage 1 wound

A

erythema, non-blanchable skin intact

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90
Q

Stage 2 wound

A

erythema, partial thickness loss of epidermis

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91
Q

Stage 3 wound

A

partial thickness loss going into the dermis but no underlying structures exposed

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92
Q

Stage 4 wound

A

ful thickness skin loss past the dermis, bone, muscle, etc may be visible or palpable

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93
Q

Unstageable wound

A

cannotbe staged bc the wound bed is not visible- covered by eschar or slough

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94
Q

What kind of diet should a pt with a healing wound be on?

A

High protein

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95
Q

What are the drain types

A

J-Pratt, hemovac

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96
Q

What is important about a wound vac

A

Seal of occlusive dressing - promotes granulation of tissue and healing with neg pressure

97
Q

How do you remove staples and sutures

A

Clean
Start with 2nd one, remove every other one until done to avoid dehiscence
Cut stitch at knot and remove by pulling on the long part

98
Q

What happens if a wound dehisces?

A

Stop immediately and notify the provider that the wound has opened again and needs to be closed

99
Q

New ostomy education

A

How to clean- soap and water no alcohol
Avoid high fiber (ileostomy) and increase fluids (ileostomy)
No laxatives - occluded or dehydrated
Liquid/paste output-ileostomy
Colostomy output-solid

100
Q

What is a large issue with new ostomies?

A

Client acceptance

101
Q

Complications of ostomies

A

Necrosis, candidiases, caput medusae, prolapsed, collapsed

102
Q

Ice counts as

A

1/2 cup

103
Q

How many mL is in an ounce?

A

30mL

104
Q

How many ounces are in one mL?

A

1 oz

105
Q

Foods high in potassium

A

Bananas, avocados, white potatoes

106
Q

Foods high in sodium

A

Canned/processed foods

107
Q

Foods high in magnesium

A

Nuts, seeds, fatty fish , dark chocolate

108
Q

What two signs indicate hypocalcemia?

A

Chovstek and trousseau

109
Q

Chovstek sign

A

Tap cheek, if twitch, calcium is low
Positive test= hypocalcemia
Negative test=no imbalance

110
Q

Trousseaus sign

A

Carpal spasm
BP cuff or tourniquet and watch for spasm, dont need to keep inflating once spasm occurs

111
Q

How do you treat ascites?

A

Sit them up, increase fluids (if dehydrated), thoracentesis and paracentesis

112
Q

S/S FVO

A

Thready pulses, HTN, edema, crackles in the lungs, weak peripheral pulses,JVD, excessive weight gain

113
Q

S/S FVD

A

Poor skin turgor, flat neck veins, dry mucous membranes, bounding pulses,tachycardia, hypotension

114
Q

Delegation

A

The act of dividing tasks to other people while still maintaining responsibility/accountability for the outcomes

115
Q

What should be kept in mind while delegating?

A

Is this the safest person for the skill?
Scope of practice
Trained for this task?
Experience
Client AND worker safety

116
Q

Pain scales

A

Wong-baker, FLACC, numeric

117
Q

Wong-baker scale

A

Pain scale using faces for children or those with difficulty verbally expressing

118
Q

FLACC scale

A

Face, legs, activity, cry, consolability

119
Q

Who is the FLACC scale used for?

A

Unconscious

120
Q

What is the greatest determinant of pain?

A

The pt

121
Q

Chronic pain is always psychological

A

False

122
Q

Chronic pain always leads to addiction and abuse of meds

A

False

123
Q

Breakthrough pain

A

Occurs after controlled med wears off (i.e. morphine/opioids), can be treated with “lighter” meds like NSAIDs

124
Q

Do long-term meds always lead to addiction?

A

No

125
Q

Addiction

A

Physical dependence on a medication or substance- an individual will put themselves, loved ones, or family in harms way intentionally for a substance or the effect

126
Q

Dependence

A

Body produces symptoms without given substance

127
Q

Clients who abuse substances overreact to discomforts

A

False

128
Q

The amount of tissue damage in an injury does not accurately indicate pain intensity

A

True

129
Q

If a client cannot speak, they cannot feel pain

A

False

130
Q

What are the characteristics of pain

A

Onset & duration
Location
Intensity
Quality
Pattern
Relief measures
Contributing symptoms
Effects of pain on the client

131
Q

Two mnemonics for pain assessment

A

OLD CART and PQRST
Onset, location, duration, characteristics, aggravated factors, radiation, tx

Provoked, Quaity, Region/ radiation , Severity, Timing

132
Q

Pain scales determine the ______ of pain, not the _______

A

Presence, intensity

133
Q

what is an NG tube

A

Nasogastric tube
Can be placed bedside

134
Q

indications for enteral feeding

A

Cannot eat bc of surgery, injury, disease process
Nutritional deficit from reduced food digestion, even when physically capable of eating
Impaired swallowing/gag reflex

135
Q

What is a contraindication for having enteral feeding?

A

Tube in the brain - a brain shunt (drains in back of throat, tube feeding will harm pt)
Facial deformities (facial fractures)

136
Q

What is a bolus feeding

A

“All at once”orders tell volume and time- aspiration risk!
Make sure client sits up for an hour after feeding for gravity to help with aspiration risk
given thru G tubes

137
Q

Who does the nutritional needs assessment?

A

Dietician / practitioner

138
Q

Continuous feedings

A

XML/hr for 24 hours
PUMP needed
30 degrees minimum HOB

139
Q

What is the difference between Dobbhoff and NG

A

Dobbhoff has a guide wire and is weighted to go through stomach sphincter and anchor in jejunum
NG ends in stomach

140
Q

PEG and PEJ are….

A

Long-term solution, surgically implanted

141
Q

NG and Dobbhoff tubes are

A

Short-term solutions

142
Q

G tubes-ending in stomach can be used for

A

Bolus or continuous feeds

143
Q

With jejunum lines, nutrition is

A

Continuous feeds bc there is no “holding tank” or digestive enzymes/ secretions in jejunum

144
Q

What color bag, syringes, and tubing mean enteral nutrition

A

Purple

145
Q

Tube-feeding formula should be kept at

A

Room temperature to avoid cramping and bloating

146
Q

What technique do you use to prepare and hang feeding formula

A

Aseptic technique

147
Q

What is the maximum hang time for formula in an open system, why?

A

8 hours, increased risk of bacterial colonization bc of high sugar

148
Q

When do you check gastric residual volume for each feeding

A

Bolus-right before next bolus, intermittent- before next feeding, and every 4-6 hours initially for continuous

149
Q

How do you check for gastric residual?

A

Draw up 30 mL of air into syringe and connect it to the feeding tube,listenfor air, pull back slowly, and aspirate the total amount of gastric contents
Return aspirated contents to stomach unless the volume exceeds 250mL or other specified amount

150
Q

When do you hold a feeding?

A

If gastric residual is 250mL or greater - hold for one 1hr and recheck, if still over 250mL, do not give second feed, report to HCP and expect continuous feeding order - not tolerating bolus

151
Q

For immunocompromised pts, what is used to flush tubes

A

Sterile water

152
Q

What do you flush feeding tubes with

A

30mL of tap water, unless specified otherwise

153
Q

Bolus feeding

A

Feed 30 min-1hr
Sit up for 1 hr after
Never put more than 8 hrs of feed in a bag
8 hr tubing

154
Q

Continuous feeding

A

24 hrs
30 degree HOB
Change tubing and feed q 24hrs

155
Q

Open feeding system

A

Disconnected tubing or add anything
Good for 8 hours
Pour feed into bag (open)

156
Q

Closed feeding system

A

Closed canister and spike
24 hrs then change

157
Q

Any questions about TF tubing dates, times, etc

A

Replace it

158
Q

Administering medications through an enteral tube

A

Flush tube with at least 15mL of sterile water using 60mL syringe
Draw up mediation in 60 mL syringe
Push meds or allow gravity free flow
Administer each med SEPARATELY followed by 15-30mL water
After all meds administered, flush tube with 30-60mL water
Restart feed in when appropriate

159
Q

How can you prevent cramping with enteral feedings

A

Room temp feeding, rate change (bolus to continuous if needed), no overfeeding

160
Q

what do you check for with catheter insertion after verifying the client’s identity

A

Allergies to betadine or iodine

161
Q

24 hour urine collection must

A

Be on ice at all times, “start time” and “end time” without a single DROP missing!

162
Q

what is a huge concern for enteral nutrition

A

Hyperglycemia (high in glucose), infection and bacterial growth

163
Q

when does REM begin?

A

90 min after stage 1

164
Q

What is the REM stage

A

Real resting phase-best sleep
Absent muscle tone, increased gastric secretions, vivid dreaming , difficult to arouse

165
Q

How can you promote sleep?

A

Cluster care, environment control, save invasive procedures for the daytime

166
Q

Ostomy complication- necrosis

A

Most common post-op
Stoma is black- surgical fix

167
Q

candidiases ostomy complication

A

Moisture and bacterial growth (host immunosuppression)
Keep it dry
Porous tape
Antifungal powder

168
Q

Caput medusae Ostomy complication

A

Liver disease pts
Hypervascularity
No tape-Vaseline for adhesive
Soft pouching system
Risk for bleeding

169
Q

Who qualifies for colostomy irrigation

A

Increase quality of life , scheduled timing
Anyone with no GI or mental issues

170
Q

pts with an ileostomy are at high risk for

A

Occlusion bc lumen=narrow
Chew well and avoid high fiber foods for 6 weeks then intro one at a time
dehydration

171
Q

Normal color for ostomy stomas

A

Red, “beefy”
Like the rolled end of a sock

172
Q

Mucocutaneous separation ostomy complication

A

Skin and fat separating, bacteria seeps into gaps-infection
Causes-malnutrition, steroids, infection, radiation
Tx=surgical, fillers

173
Q

Stomal retraction

A

Stoma pulled in sided out
Weight gain, or too tight surgically (thick abd wall)

174
Q

Stomal stenosis

A

Lumen collapse
Stool softeners, may require surgical intervention

175
Q

Stoma hernia

A

Additional bowel loops trapped
Surgical technique, poor stomach placement
Age (elderly)
Hernia support belt, flexible pouching system, d/c irrigation

176
Q

Prolapsed stoma

A

“dangling out”
One piece pouncing system needed
Reduce with cool packs and Lying on back, not painful but pouching-difficult
Reduce abd pressure

177
Q

Weartime for ostomy bags

A

3-14 days unless leaking, soiled, hurting, bleeding—>Change it

178
Q

Pectin skin barrier

A

Short time wear, not used for urostomies bc urine dissolves it

179
Q

Skin barrier paste for ostomies

A

Paste is NOT an adhesive, it IS a caulk
More is NOT better-> contains alcohol=drying to skin
Not used on premature babies bc of high alcohol content

180
Q

Skin barrier powder

A

Only used on eroded, moist skin
D/c after skin heals

181
Q

Odor elimination for ostomies

A

DO NOT USE ASPIRIN TAB= excess gas production and bag explodes
Drops when pouch is emptied
Spray in room
Filters with charcoal

182
Q

Exudate management

A

Maintaining or providing a moist wound environment while controlling excess wound drainage

183
Q

Transparent film dressing helps to

A

Maintain or provide moisture to a wound

184
Q

Ex of transparent film

A

Tegaderm

185
Q

Wound care products to absorb wet wounds

A

Alginate (most absorbent)
Foam
NaCl dressing
Wound drainage collector
Wound vac (neg pressure therapy)

186
Q

How to keep a wound “balanced”, not wet or dry

A

Moist saline gauze
Tegaderm

187
Q

How often do you change dressings

A

Q 12 hrs- 3 days unless saturated then change

188
Q

Autolytic debridement

A

Occlusive dressing, wound enzymes clean itself

189
Q

Mechanical debridement

A

Flushing and cleaning by hand

190
Q

Enzymatic debridement

A

Introduce wound wash to help as we clean to breakdown things

191
Q

Sharp/excisional

A

Surgical debridement

192
Q

Bio debridement

A

Maggot therapy; aseptically grown in lab, short life span
Only for difficult healing wounds

193
Q

STOPBANG assessment

A

Snoring?(loud?)
Tired?(during day)
Observed?(witness stop breathing)
Pressure?(HTN?)
BMI?(>35)
Age?(>50)
Neck size?(men=>17in fem=>16)
Gender? (Male=risk)

194
Q

STOPBANG risk levels

A

Low= yes to 0-2
Intermediate= yes to 3-4
High= yes to 5-8

195
Q

Biotes breathing

A

Brain issues

196
Q

Kussmaul’s breathing

A

DKA

197
Q

describe Biote’s breathing pattern

A

Apnea, rapid breathing, apnea

198
Q

Describe kussmaul’s breathing pattern

A

Maximum inhalation and maximum exhalation at a rapid rate

199
Q

Describe Cheyne stokes breathing pattern

A

Apnea, gradual increase, gradual decrease, apnea

200
Q

Cheyne stokes

A

Cardiac issues
MI, HF

201
Q

ABCDE of pain management

A

A- ask about pain regularly
B-believe the client abt pain
C-choose pain control appropriately
D- deliver interventions timely logical and coordinated fashion
E-Empower clients and families to control course to greatest extent

202
Q

Reversal agents

A

Opioids-Naloxone
Benzos-flumazenail
Malignant hyperthermia-dantrolene

203
Q

Types of anesthesia

A

Local (site), general (out out), conscious sedation (maintain airway themselves, be ready to stabilize if needed)

204
Q

informed consent

A

Over 18, right mind, not under influence , disabilities (if still in right mind ) can consent, we accommodate to them

205
Q

Role of circulating RN

A

Maintain safety of client
Sterile filed, monitors

206
Q

Periopertive complications

A

DVT, paralytic ileum, post op PNA

207
Q

Tx DVT

A

TEDS, SCDs, lovenox

208
Q

Tx paralytic ileus

A

Bowel sounds x4–> 5 min listen, gas? BM? Surgical

209
Q

Tx post-op PNA

A

IS, deep breathing and coughing exercises, early ambulation

210
Q

Classifications of surgery

A

Urgent, elective, emergent
Minor/major

211
Q

Score on aldrete tool for ICU discharge

A

8 or higher

212
Q

Aldrete tool

A

Scoring pt to discharge from ICU to PACU

213
Q

Delirium vs dementia

A

Delirium- short term, after surgery
Dementia- progressive, long-term condition

214
Q

Difference between delirium and dementia

A

Speed of onset

215
Q

Hypertensive crisis

A

Over 180/100

216
Q

Isotonic solution

A

NS (0.9 NaCl)
LR
D5W(in bag)

217
Q

Hypertonic solutions

A

D10
2% NaCl
3% NaCl

218
Q

Hypotonic solutions

A

0.45% NaCl
0.33% NaCl

219
Q

Isotonic solutions effect on cell

A

Same, even transfer of fluid

220
Q

Hypotonic solution effect on cell

A

Cell swells

221
Q

Hypertonic solution effect on cell

A

Cell shrinks

222
Q

What patient conditions are contraindicated for LRs

A

Liver and renal failure pts

223
Q

What condition can isotonic fluids be used for

A

LR for burns and electrolyte imbalances

224
Q

What condition can hypertonic fluids be used for

A

increased intracranial pressure (ICP) bc it pulls fluid out of the cell

225
Q

What condition can hypotonic solution be used for

A

Extreme dehydration, pulls fluid into the cell

226
Q

IV site selection

A

Start low and go up, do not use hand for vesicant medications , avoid limbs with fistulas, past mastectomy or lymphectomy, stroke unilateral weakness

227
Q

Hypoglycemia s/s

A

Weakness, dizziness, shakiness,clammy

228
Q

What do you do if TPN tube falls to floor or did not arrive on time?

A

Abruptly d/c current and/or use new tubing and run D10 while waiting for the new mix

229
Q

Hyperglycemia s/s

A

Polydipsia, polyuria, polyphagia

230
Q

Contents of TPN

A

Vitamins, electrolytes, sugar, minerals

231
Q

TPN looks like

A

Lemon lime Gatorade

232
Q

TPN is given at

A

Room temp, take out of fridge 1 hr before administration

233
Q

How is TPN given

A

Through a central line (terminates in a great vessel), sterile

234
Q

Lipids for TPN look like

A

Milk in a bag

235
Q

Do you give lipids through a central line?

A

Yes, but also though a peripheral line

236
Q

Lipids have

A

Essential fatty aids, calories

237
Q

Can you shake lipids to mix bc it looks separated or “cracked”

A

No, get a new bag

238
Q

Complications with TPN infusion

A

Infection: fever, increased WBC, redness, drainage
Blood glucose: monitor for hyperglycemia (high in sugar), if stopped abruptly- hypoglycemia risk, start D10

239
Q

What electrolytes are in LR

A

Magnesium, sodium, potassium, calcium

PCC 2 (3 decks)

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