final Flashcards
(335 cards)
1
Q
3 things in nutrition to help woh wound healing
A
Protein, Vitamin C, Zinc
2
Q
Antibiotic therapy is vigorously initiated if blood cultures verify a __________ condition.
A
septicemia
3
Q
this is the remedy for what type of Incontinence
Follow the prescribed schedule for emptying the bladder either through voiding or by intermittent catheterization.
Supply urine-containment products: condom catheter, undergarments, pads, briefs. Monitor for signs and symptoms of urinary retention and UTI.
Monitor for autonomic dysreflexia
A
Reflex Incontinence
4
Q
Modes of Transmission where
- Contaminated items
- Water
- Drugs, solutions
- Blood
- Food (improperly handled, stored, or cooked; fresh or thawed meats)
A
Vehicles
5
Q
Pre-filled syringe
Do not expel air bubble prior to administration
A
lovenox
6
Q
type of IV Solution that
Uses
Intracellular/cellular hydration
Fluid management for a patient who is both volume-depleted and hyperosmolar
A
Hypotonic
7
Q
is a disorder characterized by the lack of airflow through the nose and mouth for periods of 10 seconds or longer during sleep. There are three types central, obstructive, and mixed
A
Sleep apnea
8
Q
What is the normal blood pressure range for adult
A
<120/80 B/P (mmHg)
9
Q
Loss of continence because of causes outside the urinary tract. Usually related to functional deficits such as altered mobility and manual dexterity, cognitive impairment, poor motivation, or environmental barriers
A
Functional Incontinence
10
Q
stage of pressure ulcer where
nonblanchable erythema of intact skin
A
1
11
Q
less concentrated than plasma
action:fluid shifts from plasma into the cells
A
hypotonic
12
Q
4 late Respiratory Signs and Symptoms of Hypoxia
A
Dyspnea at rest
Use of accessory muscles
Retractions on inspiration
Pause for breath between sentences, words
13
Q
normal pH for urine
A
4.6-8.0
14
Q
_________ disease is the infectious disease transmitted from one person to another.
A
Communicable
15
Q
A patient is experiencing some problems with joint stability. The doctor has prescribed crutches for the patient to use while still being allowed to bear weight on both legs. Which of the following gaits should the patient be taught to use?
- Four-point
- Three-point
- Two-point
- Swing-through
A
-Four-point
16
Q
type of Medications Long-term use
alters metabolism of anesthetic agents.
A
Anticonvulsants
17
Q
is a symptom that patients experience when they have chronic difficulty falling asleep, frequent awakenings from sleep, and/or a short sleep or nonrestorative sleep
A
Insomnia
18
Q
6 cause of Hypokalemia
A
Diuretics
- Diarrhea
- Vomiting
- Gastric suction
- Steroid administration
- Bulemia
D- drugs (steroids, diuretics, laxatives)
I- inadequate intake (nothing by mouth, anorexic)
T- too much (water, base, insulin)
C- Cushing syndrome
H- heavy fluid loss (suctioning)
19
Q
Provide 60-80% concentrations of O2
A
Non-rebreather Face Mask with reservoir bag
20
Q
Oral suctioning is performed with a ____ device.
A
Yankauer
21
Q
______ determines if there is actual tissue damage v. reactive hyperemia.
A
Blanch test
22
Q
Infiltration Score where
blanching, cool to touch, edema > 6 inches, Mild to moderate; numbness
A
3
23
Q
Wound is left open to heal “from the ground up”—as in a contaminated wound
Takes longer time to heal, leaves bigger scar, greater risk for infection, can be more difficult for patient both physically and psychologically
A
Secondary intention:
24
Q
Central Lines watch for what 6 things
A
Watch for: SOB, chest pain, cough, hypotension, tachycardia, anxiety after or during insertion
25
Clinical Manifestations :
- Anorexia, N/V
- Weakness
- Lethargy
- Confusion, headache
- Muscle cramps/twitching
- Seizures
- Coma
Hyponatremia
26
Type of Cleansing Enema that
Distends the colon
Stimulates peristalsis
Softens feces
Isotonic (Normal saline)
27
Oxygen Capability 24-48%
Nasal cannula
28
```
Clinical Presentation:
Tachycardia
Pulmonary Edema
Tachypnea
Confusion
Coma
```
Metabolic Acidosis
29
Regulates amount of water in the body
Helps with electrical signals in the brain, nervous system and muscles
Sodium
30
Scraping or rubbing away of epidermis; may result in localized bleeding and later weeping of serous fluid.
Abrasion
31
Soft, pink, fleshy projections of tissue that form during the healing process in a wound not healing by primary intention.
Red and moist, viable
granulation tissue
32
is a problem many patients experience as a result of dyssomnia. Causes include symptoms (e.g., fever, difficulty breathing, or pain) caused by illnesses, emotional stress, medications, environmental disturbances
Sleep deprivation
33
Provide 40-60% concentrations of O2
simple face mask
34
Provides 24%-60% oxygen
Venturi Mask
35
developed after prolonged intake or when a medication accumulates due to impaired metabolism
Toxic Effect
36
a flaring of moderate to severe pain despite therapeutic doses of analgesics
breakthrough pain
37
FLUID SPACING
Normal
Between
ICF & ECF
1st
38
Calcium (Normal Value: )
9-10.5 mEq
39
Clinical presentation:
Numbness
Muscle twitches
Seizures
Respiratory alkalosis
40
Injection locations
up to 3 ml
Vastus lateralis
41
nursing diagnosis
K
E
S
A
knowledge
experience
standards
attiudes
42
Specific gravity for urine
(1.0053-1.030),
43
an adaptive state characterized by a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response
tolerance
44
6 things that are on the Braden scale for prediction of PU Development
```
Sensory Perception
Moisture
Activity
Mobility
Nutrition
Friction and Shear
```
45
(protrusion of visceral organs through a wound opening) occurs.
Evisceration.
46
4 General rules of body mechanics
Assess the situation CAREFULLY before acting!
Use the large muscle groups whenever possible.
Work at appropriate height!
Use mechanical lifts
47
Sodium (Normal Value: )
135-145 mEq
48
wound drainage that is
Bright red; indicates active bleeding
Sanguineous
49
The nurse evaluates that the NAP has applied a patient’s sequential compression device (SCD) appropriately when which of the following is observed? (Select all that apply.)
A. Initial patient measurement is made around the calves
B. Inflation pressure averages 40 mm Hg
C. Patient’s leg placed in SCD sleeve with back of knee aligned with popliteal opening on the sleeve.
D. Stockings are removed every 2 hours during application.
E. Yellow light indicates SCD device is functioning.
Patient’s leg placed in SCD sleeve with back of knee aligned with popliteal opening on the sleeve.
Inflation pressure averages 40 mm Hg
50
What is the normal pulse range for adult
60-100 HR/minute
51
PaCO2 normal range
34-45
52
Body measures of height, weight, and skinfolds to evaluate muscle atrophy.
anthropometric measurements
53
Provides 5-10L of O2
Minimum of 5L/min O2 required to prevent client from re-breathing exhaled carbon dioxide
Simple Face Mask
54
Loss of more water than sodium
Hypertonic imbalance
Water deficit
ECV Deficit + Hypernatremia
Gastroenteritis (Severe N&V)
clinical dehydration
Hypovolemia
55
smart goal means
```
S: specific
M: measurable
A: Achievable
R: Relevant
T: Time Bound
```
56
Type of Enema that
- lubricates and softens stool
Oil Retention
57
3 Hypokalemia interventions
Interventions:
-Administer potassium supplement
PO can have a bad taste and be irritating to the GI tract
IV must be well diluted and NEVER given as a bolus
- Assess renal status (UOP) prior to giving supplemental potassium
- Encourage foods rich in potassium
58
3 late Central Nervous System Signs and Symptoms of Hypoxia
* Combativeness
* Coma
* confusion
59
clinical manifestations
```
Thready pulse
Decreased BP, Increased HR, Increased RR
Decreased Cap Refill, cool clammy skin, poor skin turgor
Hypoxia
Weak, dizzy
Decreased Weight
Increased thirst
Decreased urine output
Confusion, changes in LOC, lethargy (seizures, coma)
```
Hypovolemia
60
Involuntary loss of urine occurring at somewhat predictable intervals when patient reaches specific bladder volume related to spinal cord damage between C1 to S2
Reflex Incontinence
61
size of catheter for
Most medical/surgical patients, daily use
20-24 gauge
62
Type of Cleansing Enema that
Irritate mucosa
Distends the colon
Soap suds
63
A nurse is instructing a patient who has decreased leg strength on the left side how to use a cane. Which action indicates proper cane use by the patient?
- The patient keeps the cane on the left side of the body.
- The patient slightly leans to one side while walking.
- The patient keeps two points of support on the floor at all times.
- After the patient places the cane forward, he or she then moves the right leg forward to the cane.
The patient keeps two points of support on the floor at all times.
64
By using known criteria in conducting an assessment such as reviewing with a patient the typical characteristics of pain, a nurse is demonstrating which critical thinking attitude?
- Curiosity
- Adequacy
- Discipline
- Thinking independently
Discipline
65
causes
Intake
Decreased PO intake
Decreased Na intake
Inability to drink/express thirst
Output
Diarrhea, vomiting
Profuse sweating, drainage
Hemorrhage
Drugs
Diuretics, laxatives
Diseases
Renal disease
Third spacing: burns
Hypovolemia
66
Accidental administration of a non-vesicant solution into subcutaneous tissues.
The severity of the swelling is measured an a standardized scale
Infiltration
67
Immunizations are often given _______
Intramuscular (IM)
68
wound drainage that is
| Clear, watery plasma
Serous
69
Provides 6-10 L of O2 per minute
rebreathe first third of exhaled air in conjunction with O2.
Patient is still taking in room air.
Partial Non-rebreather with a reservoir bag
70
Infiltration Score where
blanching, cool to touch, edema >6 inches pitting, Moderate to severe pain, Circulatory impairment
4
71
A patient has been on bed rest for over 4 days. On assessment, the nurse identifies the following as a sign associated with immobility:
A. Decreased peristalsis
B. Decreased heart rate
C. Increased blood pressure
D. Increased urinary output
Decreased peristalsis
72
Modes of Transmission where
• Personal contact of susceptible host with contaminated inanimate object (e.g., needles or sharp objects, dressings, environment)
Indirect
73
What is your role as a nurse during a fire? (Select all that apply.)
- Help to evacuate patients
- Shut off medical gases
- Use a fire extinguisher
- Single carry patients out
- Direct ambulatory patients
- Help to evacuate patients
- Shut off medical gases
- Use a fire extinguisher
- Direct ambulatory patients
74
```
Clinical Manifestations:
- + Chvostek’s sign
- + Trousseau’s sign
Numbness/tingling
Muscle twitch
Cramping
Hyperactive reflexes
Tetany
Seizures
```
Hypocalcemia
75
stage of pressure ulcer where
full-thickness tissue loss; not involving underlying fascia. SC fat may be visible. May include tunneling and undermining.
3
76
one of a group of analgesics that act on higher centers of the brain and spinal cord to modify perceptions of moderate to severe pain
opioid
77
Respiratory alkalosis cause
Deep and Fast Breathing!
78
A nurse is evaluating a patient who is in soft wrist restraints. Which of the following activities does the nurse perform? (Select all that apply.)
- Check the patient's peripheral pulse in the restrained extremity
- Evaluate the patient's need for toileting
- Offer the patient fluids if appropriate
- Release both limbs at the same time to perform range of motion (ROM)
- Inspect the skin under each restraint
Check the patient's peripheral pulse in the restrained extremity
Evaluate the patient's need for toileting
Offer the patient fluids if appropriate
- Inspect the skin under each restraint
79
Type of Anesthesia where
Administration of drugs by inhalation, intravenous, rectal, or oral route
a patient loses all sensation, consciousness, and reflexes, including gag and blink reflexes.
involves major procedures with extensive tissue manipulation
General
80
(the movement of gases in and out of the lungs)
VENTILATION
81
treatment approaches used to complement conventional medical treatments
complimentary therapies
82
Syringe (1 to 3 mL) and needle (25- to 27-gauge, 3/8- to 5/8-inch)
when injecting, If you can grasp 2 inches insert at a 90-degree angle; (1 inch) of tissue, 45-degree
Subcutaneous:
83
Clinical Manifestations:
- F: fever/flushed dry skin
- R: restless
- I: Increased fluid retention
- E: Edema
- D: Decreased urine output
- Seizures
- Irritability/hallucinations
- Thirst, sticky mucus membranes
Hypernatremia
84
Worst possible score = __
Best possible score = __
braden scale
6
23
85
This is required for tests of renal function and urine composition
If urine is accidentally discarded or contaminated or the patient is incontinent, restart the time period.
.
24-Hour Urine Specimen
86
6 Hyperkalemia interventions
Interventions:
- Eliminate parenteral potassium
- Kayexalate
- Monitor EKG
- Administer calcium gluconate to protect the heart
- IV loop diuretics
- Renal dialysis
87
wound drainage that is
Thick, yellow, green, tan, or brown
Purulent
88
3 early Central Nervous System Signs and Symptoms of Hypoxia
apprehension
restlessness or irritability
confusion, poor concentration and lethargy
89
3 late Cardiovascular Signs and Symptoms of Hypoxia
Dysrhythmias
Cyanosis
Cool, clammy skin
90
type of Medications cause adrenal atrophy, reducing the ability of the body to withstand stress. Before and during surgery, dosages are often increased
Corticosteroids
91
Potassium (Normal Value: )
3.5-5.0 mEq
92
What is the correct order of steps for removal of protective barriers after leaving an isolation room?
1. Remove gloves.
2. Perform hand hygiene.
3. Remove eyewear or goggles.
4. Untie top and then bottom mask strings and remove from face.
5. Untie waist and neck strings of gown. Remove gown, rolling it onto itself without touching the contaminated side.
-1, 3, 5, 4, 2
93
____________ heals by forming new tissue, a process that can take longer
Involves granulation
full-thickness wound
94
What is the normal respiratory range for adult
12-20
95
—fruits and vegetables, bran, chocolate, alcohol, coffee
Foods with laxative effect
96
—cheese, lean meat, eggs, pasta
Constipating foods
97
______ or workplace bullying between colleagues sometimes occurs and includes behaviors such as withholding information, backbiting, making snide remarks or put downs, and nonverbal expressions of disapproval such as raising eyebrows or making faces.
Lateral violence
98
Interval between entrance of pathogen into body and appearance of first symptoms (e.g., chickenpox, 14 to 16 days after exposure; common cold, 1 to 2 days; influenza, 1 to 4 days; measles, 10 to 12 days; mumps, 16 to 18 days; Ebola 2 to 21 days
Incubation Period
99
, considered one of the most tolerated and safest analgesics available, is available in a variety of over-the-counter (OTC) oral medications (e.g., cold and flu remedies) or rectal forms and in an intravenous (IV) preparation (Ofirmev).
Acetaminophen (Tylenol)
100
FLUID SPACING
Abnormal
Trapped, cannot be easily exchanged with the ECF
ACITES
EDEMA (a/w burns, trauma, sepsis)
3rd
101
Which is the correct gait when a patient is ascending stairs on crutches?
- A modified two-point gait (The affected leg is advanced between the crutches to the stairs.)
- A modified three-point gait (The unaffected leg is advanced between the crutches to the stairs.)
- A swing-through gait
- A modified four-point gait. (Both legs advance between the crutches to the stairs.)
A modified three-point gait (The unaffected leg is advanced between the crutches to the stairs.)
102
_______ wound extends into the subcutaneous layer, and the depth and tissue type varies, depending on body location
A full-thickness
103
```
Clinical Manifestations:
- Muscle weakness
- Constipation
- Anorexia, N/V
- Dysrhythmias
- Neurosis
Diminished reflexes
Renal calculi (flank pain)
```
Hypercalcemia
104
Pain at access site with erythema or edema
is a grade __ on the Phlebitis Scale
2
105
Decrease pressure times- limit pressure every___ hours whether sitting in a chair, lying in bed, laying on a bony prominence
2
106
Which type of personal protective equipment are staff required to wear when caring for a pediatric patient who is placed into airborne precautions for confirmed chicken pox/herpes zoster? (Select all that apply.)
- Disposable gown
- N 95 respirator mask
- Face shield or goggles
- Surgical mask
- Gloves
Disposable gown
N 95 respirator mask
Gloves
107
type of Medications such as beta blockers and calcium channel blockers interact with anesthetic agents to cause bradycardia, hypotension, and impaired circulation. They inhibit synthesis and storage of norepinephrine in sympathetic nerve endings
Antihypertensives
108
size of catheter for
Small children, Older adults, small vein access
22-24 gauge
109
```
Clinical Manifestations:
- Muscle weakness
- Bradycardia
Dysrhythmias
Flaccid paralysis
Intestinal colic
Tall T waves on EKG
```
```
M-muscles weakness
U- urine output decreased
R- respiratory failure
D- decreased cardiac contractility
E- early muscle twitching
R- rhythem changes
```
Hyperkalemia
110
Type of Anesthesia where
Used for short-term procedures, diagnostic, and therapeutic procedures that do not require complete anesthesia but rather a depressed level of consciousness
Conscious sedation
111
Pain at access site with erythema and edema, streak, palpable cord>1 inch in length & purulent drainage
is a grade __ on the Phlebitis Scale
4
112
A patient who has been isolated for Clostridium difficile (C. difficile) asks you to explain what he should know about this organism. What is the most appropriate information to include in patient teaching? (Select all that apply.)
The organism is usually transmitted through the fecal-
oral route.
- Hands should always be cleaned with soap and water versus alcohol-based hand sanitizer.
- Everyone coming into the room must be wearing a gown and gloves.
-While the patient is in contact precautions, he cannot
leave the room.
-C. difficile dies quickly once outside the body.
The organism is usually transmitted through the fecal-
oral route.
- Hands should always be cleaned with soap and water versus alcohol-based hand sanitizer.
- Everyone coming into the room must be wearing a gown and gloves.
113
A nurse enters a 72-year-old patient’s home and begins to observe her behaviors and examine her physical condition. The nurse learns that the patient lives alone and notices bruising on the patient’s leg. When watching the patient walk, the nurse notes that she has an unsteady gait and leans to one side. The patient admits to having fallen in the past. The nurse identifies the patient as having the nursing diagnosis of Risk for Falls. This scenario is an example of:
- Inference.
- Basic critical thinking.
- Evaluation.
- Diagnostic reasoning
Diagnostic reasoning
114
A healthy adult patient tells the nurse that he obtained his blood pressure in "one of those quick machines in the mall" and was alarmed that it was 152/72 when his normal value ranges from 114/72 to 118/78. The nurse obtains a blood pressure of 116/76. What would account for the blood pressure of 152/92? (Select all that apply.)
- Cuff too small
- Arm positioned above heart level
- Slow inflation of the cuff by the machine
- Patient did not remove his long-sleeved shirt
- Insufficient time between measurements
Cuff too small
- Insufficient time between measurements
115
size of catheter for
Trauma, large volume at a rapid rate
14-16 gauge
116
Nuts, beans
Canned entrees
Frozen bread, meals
Smoked/cured/canned meat and poultry
are all rich in ______
Sodium
117
size of catheter for
Surgical patient, rapid administration of fluids and blood products
18 gauge
118
________ wound heals by regeneration;
Involves epithelialization.
A partial-thickness
119
PaO2 normal range
80-100
120
type of IV Solution that
Examples:
0.9%NS
Lactated Ringers (LR)
D5W (note: D5W is the low end of isotonic, this can also be considered hypotonic)
Isotonic
121
type of Medications potentiate electrolyte imbalances (particularly potassium) after surgery.
Diuretics
122
- Visual examination of the tracheobronchial tree through a narrow, flexible fiberoptic bronchoscope
- Performed to obtain fluid, sputum, or biopsy samples; remove mucus plugs or foreign bodie
Bronchoscopy
123
4 Hyponatremia interventions
Interventions:
- Restrict fluid intake (if that is the cause of the hyponatremia)
- Replace sodium
- Hypertonic IV fluids (infuse slowly)
- Seizure precautions
124
Keep O2 delivery systems ___ feet from open flames
10
125
Nurses signature on informed consent indicates what 2 things
1. Patient signed without coercion
| 2. Patient was alert &; aware (competent)
126
absence of sensitivity to pain
analgesia
127
Urine is collected after voiding is initiated (midstream) and before voiding is completed
Midstream urine specimen
128
2 early Respiratory Signs and Symptoms of Hypoxia
Tachypnea
| Dyspnea on exertion (DOE)
129
When an incision fails to heal properly, the layers of skin and tissue separate. This most commonly occurs before collagen formation (3 to 11 days after injury).
Dehiscence
130
three types of analgesics:
nonopioids, including acetaminophen and nonsteroidal antiinflammatory drugs
opioids (traditionally called narcotics); and
adjuvants or co-analgesics, a variety of medications that enhance analgesics or have analgesic properties that were originally unknown
131
Blood Transfusion Reactions
Anaphylactic Reaction is promptly treated with
_______,_____________ & _______________
antihistamines, steroids, and epinephrine
132
aspect of critical thinking where you must
Be open-minded as you look at information about a patient.
Do not make careless assumptions.
Does the data reveal a problem or trend that you believe is true, or are there other options?
Analysis
133
Which of the following actions by the nurse comply with core principles of surgical asepsis? (Select all that apply.)
- Set up sterile field before patient and other staff come to the operating suite.
- Keep the sterile field in view at all times.
- Consider the outer 2.5 cm (1 inch) of the sterile field as contaminated.
- Only health care personnel within the sterile field must wear personal protective equipment.
- The sterile gown must be put on before the surgical scrub is performed.
- Keep the sterile field in view at all times.
| - Consider the outer 2.5 cm (1 inch) of the sterile field as contaminated.
134
7 things that must be on a medication order
```
patients full name
date and time order is written
medication name
dosage
route
time and frequency of administration
signature of health care provider
```
135
During early stages of hypoxia the blood pressure is _______ unless the condition is caused by shock. As the hypoxia worsens, the respiratory rate _____ as a result of respiratory muscle fatigue.
elevated
declines
136
, chronic pain that persists in the absence of a detectable cause.
idiopathic pain
137
- typically are used for skin testing
| - injection is 5 to 15 degrees
Intradermal (ID)
138
6 Hyperkalemia causes
- Hemolyzed serum sample (in lab)
- Oliguria
- Acidosis
- Renal failure
- Addison disease
- Multiple blood transfusions
139
4 Interventions for Hypernatremia
- Restrict sodium intake in diet
- Increased water intake
- Dietary education: beware of hidden sodium in foods
- Seizure precautions-
140
Prevents medication from leaking back into the tissues
Reduces pain and discomfort
Good for elderly patients who have decreased muscle mass
Z-track Technique
141
Type of Enema that
- to relieve flatus (gas)
Return-flow/Carminative/Cathartics
142
type of grief that
| when the individual cannot openly grieve.
Disenfranchised Grief:
143
Communication:
S―What is going on with the patient?
B―What is the clinical background or context?
A―What do I think the problem is?
R―What would I recommend?
Situation
Background
Assessment
Recommendation
144
begins and lasts from 3 to 24 days. The main activities during this phase are the filling of a wound with granulation tissue, wound contraction, and wound resurfacing by epithelialization
proliferative phase
145
Interval from onset of nonspecific signs and symptoms (malaise, low-grade fever, fatigue) to more specific symptoms.
(During this time microorganisms grow and multiply, and patient may be capable of spreading disease to others.)
For example, herpes simplex begins with itching and tingling at the site before the lesion appears
Prodromal Stage
146
Fire safety
P
A
S
S
* Pull pin
* Aim at base of fire
* Squeeze handles
* Sweep from side to side to coat area evenly
147
To prevent complications of immobility, what would be the most effective activity on the first postoperative day for a patient who has had abdominal surgery?
A. Turn, cough, and deep breathe every 30 minutes while awake
B. Ambulate patient to chair in the hall
C. Passive range of motion 4 times a day
D. Immobility is not a concern the first postoperative day
Ambulate patient to chair in the hall
148
State of extreme dryness, or the process of extreme drying
desiccation
149
It is a drug delivery system that allows patients to self-administer opioids (usually morphine, hydromorphone, or fentanyl) with minimal risk of overdose.
patient-controlled analgesia
150
Apply to contact with blood, body fluid, non-intact skin, and mucous membranes from all patients
Standard precautions
151
Provide concentrations of O2 at 4-8L/m
Face Tent
152
Provides 10L/min of O2
prevent room air and client’s exhaled air from entering the bag so only O2 in bag is inspired
Non-rebreather Face Mask with reservoir bag
153
are sleep problems that are more common in children than adults. Some have hypothesized that sudden infant death syndrome (SIDS) is thought to be related to apnea, hypoxia, and cardiac arrhythmias caused by abnormalities in the autonomic nervous system that are manifested during sleep
The parasomnias
154
: Difference between the systolic and diastolic
| •Normal for Adult = 30-50mmHg
Pulse Pressure
155
Normal Values for
| Arterial carbon dioxide tension (PaCO2) is
35-45 mm Hg
156
wound drainage that is
Pale, pink, watery; mixture of clear and red fluid
Serosanguineous
157
Lab Values:
- Decreased serum osmolality
- Decreased urine specific gravity
Hyponatremia
158
In blood pressure
•The second number; represents the pressure within the artery between beats
Diastolic
159
Injection locations
recommended for volumes greater than 2 mL
Ventrogluteal
160
Bowel Diversion
Injuries: Gunshot, MVA
Familial Polyposis
Cancer
Inflammatory Diseases
Ulcerative colitis
Crohn’s Disease
Ileostomy
161
generally well-localized pain that results from activation of peripheral pain receptors without injury to the peripheral nerve or central nervous system, such as musculoskeletal pain
Comes from bone, joint, muscle, skin, or connective tissue; is usually aching or throbbing in quality and well localized
somatic pain
162
determine the hours of care and number of staff required for a given group of patients every shift or every 24 hours.
acuity ratings
163
are enteric-coated or extended release tabs or caps crushable
no
164
Type of Medicated Enema that
Not for stool, but to remove potassium rapidly!
Kayexalate
165
the ability of a drug to achieve its desired effect
efficacy
166
3 Major sites for HAI infection
Surgical or traumatic wounds
Urinary and respiratory tracts
Bloodstream
167
Pain at access site with erythema or edema plus streak formation and palpable cord
is a grade __ on the Phlebitis Scale
3
168
the expected or predicted physiological response of the medication
Therapeutic effect:
169
stage of pressure ulcer where
full-thickness tissue loss with extensive destruction. Exposed bone, tendon or muscle.
4
170
6 causes of Hypercalcemia
- Increased calcium intake
- Decreased kidney excretion
- Prolonged immobilization
- Hyperparathyroidism
- Decreased calcitonin
- Bone disease
171
Clinical Presentation:
Seizures
Headache
Dysrhythmias
Metabolic Alkalosis
172
interventions
```
Restrict Na & H2o
Promote excretion
Strict I&O
Daily weight
Assessment (including vital sign, respiratory and skin)
Raise HOB
Skin care: protect edematous tissue
Monitor labs
Patient teaching
```
HYPERVOLEMIA
173
Interval when patient manifests signs and symptoms specific to type of infection. For example, strep throat is manifested by sore throat, pain, and swelling; mumps is manifested by high fever, parotid and salivary gland swelling.
Illness Stage
174
- Specimen of plural fluid obtained for cytological examination
- Results may indicate an infection or neoplastic disease
Thoracentesis
175
Posture that decrease pulse rate
Laying
176
type of grief that
| This type of grief is to expect, await, or prepare oneself for the loss
Anticipatory Grief:
177
Type of Medicated Enema that
before colon surgery
Neomycin
178
type of grief that
| dysfunctional grief, the grieving person has a prolonged or significantly difficult time moving forward after a loss
Complicated Grief:
179
type of IV Solution that
Caution:
Should be used with extreme caution
Used cautiously in patients with cardiac and renal failure
Hypertonic
180
type of IV Solution that
```
Uses:
Correct fluid volume deficit in the vascular system
Treatment of vascular dehydration
Fever
Labor
Running
```
Isotonic
181
is being self-directed and independent in accomplishing goals and advocating for others.
Autonomy
182
stage of pressure ulcer where
partial-thickness skin loss
2
183
Signs and Symptoms:
| Change in Vital Signs, fever, chills, rash, hypotension, shock
Blood Transfusion Reactions
184
when Giving a medication through a feeding tube
| Flush tube with _____ before medication, in between medications, and when done
water
185
the dose of a particular drug beyond which additional amounts of the same drug do not increase the analgesic effect
analgesic ceiling
186
```
Clinical Manifestations:
- Fatigue
- Anorexia, N/V
- Muscle weakness
- Decreased GI motility
Dysrhythmia
Parasthesia
Flat T waves on EKG
```
Hypokalemia
187
6 Biggest indicators that someone will fall?
MORSE FALL SCALE
1. History of falling within the last 3 months
2. Secondary Diagnosis
3. Ambulatory aid
4. IV/Saline lock
5. Gait/transferring
6. Mental status
188
Thick layer of dead, dry tissue that covers a pressure ulcer or thermal burn. It may be allowed to be sloughed off naturally, or it may need to be surgically removed.
Black or brown; hard,necrotic
eschar
189
Phase of General Anesthesia
—starts when patient comes from anesthesia and is ready to leave operating room
Emergence
190
4 things to lok for when assesing a pressure ulcer
Size of wound
Depth of wound
undermining,
tunneling, or sinus tract
191
A patient is diagnosed with methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. Which type of isolation precaution is most appropriate for this patient?
- Reverse isolation
- Droplet precautions
- Standard precautions
- Contact precautions
Droplet precautions
192
Nursing intervention for
Musculoskeletal weakness, contractures, ↓ muscle tone and strength, ↓ROM
Mobilize patient, splint, PT, active and passive ROM, positioning, exercise program
193
Soft white or yellow, stringy
| wound
Slough
194
________ wounds that involve total loss of the skin layers (epidermis and dermis).
full-thickness
195
the point at which a person feels pain
pain threshold
196
Bowel Diversion
Injuries
Cancer
Perforated Diverticulitis
Fistulas
Colostomy
197
```
Hot, dry, flushed skin
•Headache
•Thirst
•Loss of appetite (anorexia)
•Malaise
```
these are signs and symptoms of
fever
198
(the distribution of red blood cells to and from the pulmonary capillaries
PERFUSION
199
Injection into a vein 25 degree angle
Intravenous (IV):
200
interventions
Replace fluids!!!
Assess, assess, assess!
```
Hypovolemic:
Isotonic solution (stays in the vessels to increase BP)
```
Clinical Dehydration:
Oral or IV replacement (Hypotonic solution because of hemoconcentration)
Hypovolemia
201
3 levels of critical thinking starting with lowest to highest
basic
complex
commitment
202
Loss of water and electrolytes
OR
Isotonic Loss
Fluid Volume Deficit decrease in ECF
Hypovolemia
203
Classic Signs
| Erythema, warmth, edema, drainage, and discomfort
IV site infection
204
5 Hypernatremia causes
- Increased salt intake
- Hypertonic IV solutions
- Decreased renal excretion
- Corticosteroids
- Water loss
205
Deflating the BP cuff too slowly will result in a false-high ________ blood pressure.
diastolic
206
type of Medications (e.g., ibuprofen) inhibit platelet aggregation and prolong bleeding time, increasing susceptibility to postoperative bleeding.
NSAIDs
207
A patient is admitted for dehydration caused by pneumonia and shortness of breath. He has a history of heart disease and cardiac dysrhythmias. The nursing assistant reports his admitting vital signs to the nurse. Which measurements should the nurse reassess? (Select all that apply.)
- Right arm BP: 118/72
- Radial pulse rate: 72 and irregular
- Temporal temperature: 37.4° C (99.3° F)
- Respiratory rate: 28
- Oxygen saturation: 99%
Radial pulse rate: 72 and irregular
Respiratory rate: 28
- Oxygen saturation: 99%
208
the level of pain a person is willing to endure
pain tollerence
209
4 Respiratory Acidosis causes
- Insufficient ventilation
- Impaired gas exchange
- Impaired neuromuscular function
- Dysfunction of brainstem respiratory contro
210
Adequate fluid intake per day
(2000-2500mL)
211
4 reasons for NG tube
1) Decompression 2) Enteral feeding 3) Compression 4) Lavage
212
3 Hypocalcemia interventions
- Increased calcium and Vitamin D
- Seizure precautions
- Quiet environment
213
2 Advance Directives
Living wills
Durable power of attorney
214
nursing interventions for patients who are receiving IV potassium:
Patient should receive no more than __mEq/hr
20
215
Clinical Manifestations
```
Increased pulse
Increased BP
Increased RR
JVD
SOB, crackles, cough, hypoxia (Pulmonary Edema)
Increased weight
Increased edema
Muscle weakness
Confusion, lethargy, change in LOC (seizures, coma)
```
HYPERVOLEMIA
216
Incentive Spirometry Correct use:
exhale normally then slowly and deeply inhale as much as possible, hold 3 seconds and exhale, repeat 10X every hour while awake
217
: unintended, undesirable and unpredictable severe responses
Adverse effect
218
HCO3 normal range
22-26
219
Drugs that decrease pulse rate
Beta blockers
| Calcium blockers
220
A patient is receiving 5000 units of heparin subcutaneously every 12 hours while on prolonged bed rest to prevent thrombophlebitis. Because bleeding is a potential side effect of this medication, the nurse should continually assess the patient for the following signs of bleeding: (Select all that apply.)
```
A. Bruising
B. Pale yellow urine
C. Bleeding gums
D. Coffee ground–like vomitus
E. Light brown stool
```
Bruising
Bleeding gums
Coffee ground–like vomitus
221
Eye: Avoid instilling any form of eye medications directly onto the _____
cornea
222
The body alignment of the patient in the tripod position includes the following: (Select all that apply.)
- An erect head and neck
- Straight vertebrae
- Extended hips and knees
- Axillae resting on the crutch pads
- Bent knees and hips
An erect head and neck
- Straight vertebrae
- Extended hips and knees
223
Provide 30-50% concentrations of O2
face tent
224
2 Metabolic Alkalosis causes
Increase of bicarbonate
| Loss of metabolic acid
225
is a system of organizing documentation to place the primary focus on patients' individual problems.
problem-oriented medical record (POMR)
226
Lab Values for ________
- Increased serum osmolality
- Increased specific gravity
Hypernatremia
227
```
Clinical presentation:
Altered LOC
Tachycardia
Diaphoresis
Headache
```
Respiratory Acidosis
228
Surgical diversion of the drainage of urine such as a ureterostomy.
urinary diversion
229
. If GRV is ___ mL or less, return aspirated contents to stomach. If GRV is greater than ____ mL, hold medication
250
230
this is the remedy for what type of Incontinence
Avoid bladder irritants (e.g., caffeine, artificial sweeteners, alcohol).
instruct patient in pelvic muscle exercises, in , urge-inhibition exercises, and/or in bladder training
Urge Incontinence
231
damaged tissue and mast cells secrete histamine, resulting in vasodilation of surrounding capillaries and movement/migration of serum and white blood cells into the damaged tissues.
4 to 6 days
inflammatory stage
232
Injection locations
recommended for 2ml or less
Deltoid
233
is one-on-one interaction between a nurse and another person that often occurs face to face. It is the level most frequently used in nursing situations and lies at the heart of nursing practice. It takes place within a social context and includes all the symbols and cues used to give and receive meaning.
Interpersonal communication
234
Erythema at access site with or without edema
is a grade __ on the Phlebitis Scale
1
235
6 parts to the chain of infection
```
infections agent or pathogen
Reservoir or source for pathogen growth
Portal of exit
Mode of transmission
Portal of entry
Susceptible host
```
236
Restraints should only be left for ____ hours and should be checked every _____ hours
8
2
237
(the movement of oxygen and carbon dioxide between the alveoli and the red blood cells
diffusion
238
Wound that is left open for several days; then wound edges are approximated is healing by ______
Tertiary Intention
239
Provide 40-70% concentrations of O2
Partial Non-rebreather with a reservoir bag
240
Normal Values for
Partial pressure of arterial oxygenation: (Pa02) is
60-100mm Hg
241
You are caring for a patient who frequently tries to remove his intravenous catheter and feeding tube. You have an order from the health care provider to apply a wrist restraint. What is the correct order for applying a wrist restraint?
1. Be sure that patient is comfortable with arm in anatomic alignment.
2. Wrap wrist with soft part of restraint toward skin and secure snugly.
3. Identify patient using two identifiers.
4. Introduce self and ask patient about his feelings of being restrained.
5. Assess condition of skin where restraint will be placed.
- 4, 3, 5, 1, 2
- 4, 3, 1, 5, 2
- 3, 4, 1, 5, 2
- 3, 4, 5, 1, 2
- 3, 4, 1, 5, 2
242
Closing a wound
Edges touch— APPROXIMATED
Heals more quickly, makes less of a scar
Primary intention:
243
Lab Values
Decreased HGB & HCT
Decreased Na
Decreased Serum Osmolality
Decreased BUN
Fluid Volume Excess
HYPERVOLEMIA
244
is a powerful form of communication that you use as a professional nurse. This level of communication is also called self-talk. People's thoughts and inner communications strongly influence perceptions, feelings, behavior, and self-esteem.
Intrapersonal communication
245
2 Metabolic Acidosis causes
Increase of metabolic acids
| Loss of bicarbonate
246
type of grief that
| is a complex response with emotional, cognitive,social, behavioral and spiritual components
Normal Grief:
247
3 early Cardiovascular Signs and Symptoms of Hypoxia
Tachycardia
Mild elevated BP
Dysrhythmias
248
lab values
```
Increased Na
Increased HGB & HCT
Increased serum osmolality
Increased BUN
Increased urine specific gravity
```
Hypovolemia
249
Type of Enema that
To relieve constipation or impaction, to empty for surgery, to clear out for exams, to establish bowel function during training
Cleansing
250
a type of pain usually felt as burning or tingling and resulting from direct stimulation of nerve tissue of the peripheral or central nervous system
neuropathic pain
251
________ wounds are shallow in depth, moist, and painful; and the wound base generally appears red
Partial-thickness
252
type of IV Solution that
```
Examples
0.2% NS
0.45% NS
D5W
0.33NS
```
Hypotonic
253
Humidification is necessary for clients receiving O2 therapy >__L/min
4
254
type of IV Solution that
Examples:
3% NS
D5W/0.9%NS
D5W/LR
Hypertonic
255
type of surgery tht
Restores function lost or reduced as result of congenital anomalies
Constructive
256
Fire safety
R
A
C
E
* Rescue & remove those in immediate danger
* Activate the alarm
* Contain/confine the fire by closing doors/windows and turning off O2 and electrical equipment.
* Extinguish the fire.
257
When should a nurse wear a mask? (Select all that apply).
- The patient’s dental hygiene is poor.
- The nurse is assisting with an aerosolizing respiratory procedure such as suctioning.
- The patient has acquired immunodeficiency syndrome (AIDS) and a congested cough.
- The patient is in droplet precautions.
- The nurse is assisting a health care provider in the insertion of a central line catheter.
- The nurse is assisting with an aerosolizing respiratory procedure such as suctioning.
- The patient is in droplet precautions.
The nurse is assisting a health care provider in the insertion of a central line catheter
258
What is the normal temperature range?
96.8-100.4 F
259
5 Factors Affecting Wound Healing
```
Desiccation
Maceration
Edema
Infection
Necrosis
```
260
Type of Anesthesia where
Anesthetic agent injected near a nerve or nerve pathway or around operative site. No sedation.
protect a patient's limbs from injury until sensation returns.
results in loss of sensation in an area of the body by anesthetizing sensory pathways
Regional
261
Wound is not sutured or stapled closed
Heals from bottom and sides
Takes time, but does work with right factors in place
Secondary Intention Healing
262
The action of pulling or tearing away
Avulsion
263
any of a group of drugs that reduce pain, fever, and swelling (inflammation), including aspirin
nonsteroidal anti inflammatory drug
264
type of IV Solution that
Uses:
Treat intravascular dehydration with interstitial or cellular over-hydration
Third spacing
Hypertonic
265
after Catheter removal, client should void within ____ hours
6-8
266
the final stage of healing, sometimes takes place for more than a year, depending on the depth and extent of the wound
Maturation
267
A patient has an indwelling urinary catheter. Why does an indwelling urinary catheter present a risk for urinary tract infection? (Select all that apply.)
- It allows migration of organisms into the bladder.
- The insertion procedure is not done under sterile conditions
- It obstructs the normal flushing action of urine flow.
- It keeps an incontinent patient's skin dry.
- The outer surface of the catheter is not considered sterile.
-It allows migration of organisms into the bladder.
It obstructs the normal flushing action of urine flow
268
causes
INTAKE
Increased fluid intake
Rapid isotonic IV fluids
Increase consumption of salty foods
Output
Increased retention of H2O or H2O+ salt
Kidney Disease
Aldosterone
Drugs
Corticosteroids
Diseases
Kidney, heart and liver failure
Fluid Volume Excess
HYPERVOLEMIA
269
The effects of immobility on the cardiac system include which of the following? (Select all that apply.)
```
A. Thrombus formation
B. Increased cardiac workload
C. Weak peripheral pulses
D. Irregular heartbeat
E. Orthostatic hypotension
```
Thrombus formation
Increased cardiac workload
Orthostatic hypotension
270
Type of Cleansing Enema that
Draws water into colon
Hypertonic (Fleet phosphate)
271
Modes of Transmission where
• Large particles that travel up to 3 feet during coughing, sneezing, or talking and come in contact with susceptible host
Droplet
272
type of Medications such as warfarin (Coumadin) or aspirin alter normal clotting factors and thus increase risk of hemorrhaging. Discontinue at least 48 hours before surgery.
Anticoagulants
273
more concentrated than plasma
action: fluid shifts from the cells into the plasma
hypertonic
274
- calibrated in sixteenths of a minim and hundredths of a milliliter and has a capacity of 1 mL
The tuberculin syringe
275
Infiltration Score where
blanching, cool to touch, edema 1-6 inch
2
276
6 (+1) Rights of Medication Administration
```
Right Patient
Right Medication
Right Amount (dose & volume)
Right Route
Right Time
Right Documentation
Right Reason
Remember: PMART DR
```
277
Infiltration Score where
blanching, cool to touch, edema < 1 inch
1
278
steps of diet progression
- clear liquid
- full liquid
- thickened/ pureed liquids (dysphagia)
- mechanical soft
- soft/low residue
- high fiber
- low sodium
- low cholesterol
- diabetic
- gluten free
- regular
279
Post-Op Stoma Care requires
Low-______ diet first few weeks
fiber
280
6 Hypocalcemia causes
- Renal failure
- Hypoparathyroidism
- Malabsorption: ie chronic diarrhea, steatorrhea
- Pancreatitis
- Alkalosis
- Thyroid surgery (parathyroids removed or damaged)
281
or acute confusional state, is a potentially reversible cognitive impairment that often has a physiological caus
Delirium
282
IV where
```
Used for:
Long Term Therapy
All IV Therapies
Blood Draws
Bad peripheral veins
Large fluid volumes
Total parenteral nutrition (only IV nutritional supplement)
```
Central Lines
283
: Injection into the dermis just under the epidermis
Intradermal (ID)
284
nutrition
Used with patients who have un functional GI tract
Parenteral
285
In blood pressure
| •The higher number; represents the ventricles contracting
Systolic
286
Modes of Transmission where
• Person-to-person (fecal, oral) physical contact between source and susceptible host (e.g., touching patient feces and then touching your inner mouth or consuming contaminated food)
Direct
287
with enteral feeding If residue volume is >____ml HOLD TUBE FEEDING
200
288
What is normal Pulse Oximetry Range?
95% to 100%
289
Oxygen Capability at 1-6L/min
Nasal Cannula
290
FLUID SPACING
Abnormal
Accumulation in the interstitial spaces
EDEMA
2nd
291
Wound that is closed is healing by ____
Primary Intention
292
Significant Results: 40 pulse beats up; BP 30mmHg down
For ___________ pulse and blood pressure
Orthostatic
293
Wound edges not approximated is healing by ___
Secondary Intention
294
pain that results from activating the pain receptors of organs in the thoracic, pelvic, or abdominal cavities and is felt as a generalized aching or cramping sensation sometimes referred to the surface of the body
visceral pain
295
Type of Cleansing Enema that
Distends the colon
Stimulates peristalsis
Softens feces
Hypotonic (tap water)
296
is the ability to produce disease.
Virulence
297
: begins after discarding first specimen and ends with a final voiding at the end of the time period
Timed Urine Specimen
298
nutrition
| Used with patients who have functional GI tract
Enteral
299
Syringe 2 to 3 mL
90-degree angle
Intramuscular (IM)
300
type of Medications (e.g., beta blockers) can reduce cardiac contractility and impair cardiac conduction during anesthesia.
Antidysrhythmics
301
: predictable and often unavoidable secondary effect of the medication
Side Effect
302
Ear: instill eardrops at ______ to prevent vertigo, dizziness, or nausea.
roomtemp
303
_________ wounds that involve only a partial loss of skin layers (the epidermis and superficial dermal layers)
Partial-thickness
304
causes:
| vein has ruptured allowing vesicant to seep into surrounding tissues
Extravasation
305
is an assessment and communication technique that allows nurses to better understand and perceive the emotions of themselves and others.
Emotional intelligence (EI)
306
Normal urine Output per 24 Hours:
1200 mL-1500 mL
307
Type of Anesthesia where
involves loss of sensation at the desired site by inhibiting peripheral nerve conduction
commonly used in ambulatory surgery
can also be used in addition to general or regional anesthesia
patient experiences a loss in pain and touch sensation and motor and autonomic activities
Local anesthesia
308
aspect of critical thinking where you must
Be orderly in collecting data about patients.
Apply reasoning while looking for patterns to emerge.
Categorize the data (e.g., nursing diagnoses.
Gather additional data or clarify any data about which you are uncertain.
Interpretation
309
6 Hypercalcemia interventions
- Decreased calcium intake (no antacids)
- Increased fluid intake
- Weight bearing exercises
- Tx constipation
- Renal dialysis if severe
- Give calcitonin to decrease calcium level
310
Signs and Symptoms
| Fever, chills, prostration, pain, headache, nausea, and vomiting
Septicemia
311
* Drop in BP and dizziness with position change
* Due to peripheral vasodilation accompanied by no increase in cardiac output
* Occurs: in the elderly; with bedrest; post-operatively; with dehydration, blood loss; with cardiac, BP, sedative or narcotic medications.
Orthostatic Hypotension
312
is a dysfunction of mechanisms that regulate sleep and wake states. Excessive daytime sleepiness is the most common complaint associated with this disorder. During the day a person suddenly feels an overwhelming wave of sleepiness and falls asleep
Narcolepsy
313
type of Medications that enhance action of anesthetic agents. If taken within 2 weeks before surgery, aminoglycosides (gentamicin, neomycin, tobramycin) may cause mild respiratory depression from depressed neuromuscular transmission.
Antibiotics
314
is a communication technique that makes an older adult more aware of time, place, and person.
Reality orientation
315
Symptoms: swelling, redness, pain, blisters
Extravasation
316
How can tempature be measured
Tympanic, oral, rectal, Axillary, Temporal artery, Esophageal, Pulmonary artery, Urinary bladder
317
charting where
a patient meets all standards unless otherwise documented.
charting by exception (CBE)
318
Softening and breaking down of skin from prolonged exposure to moisture.
maceration
319
Interval when acute symptoms of infection disappear. (Length of recovery depends on severity of infection and patient's host resistance; recovery may take several days to months.)
Convalescence
320
Injection into tissues just below the dermis of the skin
Subcutaneous:
321
Modes of Transmission where
• Droplet nuclei or residue or evaporated droplets suspended in air during coughing or sneezing or carried on dust particles
Airborne
322
or sudden muscle weakness during intense emotions such as anger, sadness, or laughter, occurs at any time during the day.
Cataplexy,
323
Incontinence caused by medical conditions that in many cases are treatable and reversible
Transient Incontinence
324
the process of gradually adjusting the dose of a medication until the desired effect is achieved
titration
325
Try to ________ to see if urinary retention is present before proceeding with an invasive procedure (urinary catheterization)- Decrease the risk of infection!
bladder scan
326
a process that eliminates many or all microorganisms, with the exception of bacterial spores, from inanimate objects
Disinfection:
327
Venturi Mask
_L=24-28%
_L=35-40%
_L=50-60%
4
8
12
328
5 Hyponatremia causes
causes:
- Diuretics
- GI fluid loss
- Hypotonic tube feedings
- Hypotonic IV fluids
- Diaphoresis
329
A patient with a right knee replacement is prescribed no weight bearing on the right leg. You reinforce crutch walking knowing that which of the following crutch gaits is most appropriate for this patient?
- Two-point gait
- Three-point gait
- Four-point gait
- Swing-through gait
- Three-point gait
330
is an alternative approach to communication with an older adult who is confused.
accepts the description of time and place as stated by the older adult.
Validation therapy
331
Involuntary passage of urine often associated with strong sense of urgency related to an overactive bladder caused by neurological problems, bladder inflammation, or bladder outlet obstruction
Urge Incontinence
332
type of IV Solution that
Caution (do not use in)
Cerebral/peripheral edema
Hypotonic
333
IV where
Therapy will continue for 1 month or more
Therapy includes administration of a vesicant infusion or long-term antibiotic therapy
Peripherally inserted central catheter (PICC)
334
dilated, engorged veins in lining of rectum
Internal or external, painful
needing treatment as to not interfere with normal bowel habits
Hemorrhoids
335
Phase of General Anesthesia
—from incision to near completion of procedure
Maintenance
