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FPCC > Final Exam > Flashcards

Final Exam Flashcards

1
Q

Fluid output

A

2200-2700 mL/day

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2
Q

GI feces output

A

100-200 mL/ day

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3
Q

Kidneys Urine output

A

1500 mL/day

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4
Q

Insensible Skin output

A

300-600 mL/day

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5
Q

Fluid distribution

A

intacellular- inside the cell. 2/3 of body fluids
extracellular- outside the cell. 1/3 of body fluids

interstitial-around the cells
intravascular- in arteries, capillaries, & veins

isotonic- equal balance
hypertonic- cells shrink
hypotonic- cells swell

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6
Q

Goals for prevention and controlling of infections

A

Prevent exposure
Early detection
Eliminate or reduce the infection
Educate in infection prevention and control

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7
Q

Primary defense mechanisms

A 
Skin
Respiratory Tract
Eye
Mouth
Gastrointestinal
Genitourinary
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8
Q

Medical Asepsis:

A

Reducing number and preventing transfer of organisms

AKA “Clean technique”
Hand hygiene
Clean environment
Barrier techniques

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9
Q

Standard Precautions

A

Prevent contact with blood, body fluids, secretions, non-intact skin, and mucous membranes with ALL clients.

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10
Q

PPE

A

Gown
Gloves
Mask
Goggles

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11
Q

Droplet illnesses

A

Influenza (flu)
Mumps
Pertussis (whooping cough)

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12
Q

Droplet Barrier protection

A

Private or cohort room
Surgical mask w/in 3 feet
Patient leaves the room only if necessary
Mask on patient when transporting

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13
Q

Airborne illnesses

A

Measles
Chickenpox
Disseminated herpes zoster
Tuberculosis

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14
Q

Airborne barrier precautions

A 
Private room
Negative airflow pressure
Door closed except entering and exiting
Ultraviolet irradiation or air filter
Mask (N95)
Patient leaves the room only if necessary
Mask on patient when transporting
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15
Q

Contact indications

A

MDROs- c. diff, MRSA, VCEs

Wound infections

Skin infections

Eye infections

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16
Q

Contact barrier precautions

A

Private room or cohort patient

Gloves and gown

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17
Q

Protective indications

A

Transplant
Chemotherapy
Immunocompromised
Burns

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18
Q

Protective enviroment

A

Private room
Positive airflow
No plants or fresh fruits
Full PPE

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19
Q

Surgical Asepsis

A

Eliminating microorganisms

Sterile technique
Sterile equipment and supplies
Sterile environments

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20
Q

Principles of Surgical Asepsis

A
  • A sterile object remains sterile only when touched by another sterile object.
  • Only sterile objects may be placed on a sterile field.
  • A sterile object or field out of the range of vision or an object held below a person’s waist is contaminated.
  • A sterile object or field becomes contaminated by prolonged exposure to air.
21
Q

Factors that increase susceptibility (Risk Factors)

A
  • Break in primary defenses
  • Acute illness and chronic disease
  • Some medications
  • Invasive procedures
  • Tobacco use
  • Substance abuse
  • Multiple sex partners
  • Environmental conditions
22
Q

Local infection

A 
Specific to the location
Examples
Wound
Respiratory
Urinary
Gastrointestinal
Eyes/Ear/Throat
23
Q

Systemic Infections

A 
Fever, chills, diaphoresis
Increased HR and RR
Malaise
Anorexia
Enlarged lymph nodes
Organ failure
24
Q

Healthcare Associated Infections (HAIs)

A 
“Infection not present on admission”
Results in increased:
Patient stay
Discomfort
Cost
25
Q

Peripheral placement iV

A

Short term use

Ease of insertion

26
Q

Central placement IV

A 
Purpose
Long term use
Large amounts
Irritating substances
Poor peripheral sites
Types
PICCs
Tunneled
Nontunneled
Implanted ports
27
Q

Isotonic Solution

A

0.9% Sodium Chloride (NS)
Lactated Ringer’s (LR)
Dextrose 5% in Water (D5W)

Expands ECV (vascular and interstitial); does not enter cells

28
Q

Hypotonic solution

A
  1. 45 % Sodium Chloride (1/2 NS)
  2. 225% Sodium Chloride (1/4 NS)

Expands ECV and rehydrates cells

29
Q

Hypertonic Solutions

A

3% or 5% Sodium Chloride
Dextrose 5% in 0.45% NaCl (D5 ½NS)
Dextrose 5% in 0.9% NaCl (D5NS)
Dextrose 5% in LR (D5LR)

Sodium replacement
Draws water from cells

30
Q

Isotonic fluid is used for

A

Hypotension, hypovolemia

31
Q

Hypotonic fluid is used for

A

Hyperglycemic, conditions (diabetes ketoacidosis)

32
Q

Hypertonic fluid is used for

A

Stabilize BP,
^ urine output, and reduce edema
Usually after loss or blood or plasma such as burns or hemorrhaging pts

33
Q

16g to 18g is used for ?

A

rapid infusion, thick fluids, surgical or trauma pts

34
Q

20g

A

adult blood transfusions

35
Q

20g to 22g

A

adult peripheral transfusion

36
Q

How many times should you attempt to initiate an IV?

A

No more than two tries, if you miss the first, go above the initial site or opposite extremity

37
Q

Primary and secondary IV administration sets should be changed how often?

A

No more frequently than 96 hours, at least every 7 days

38
Q

Intermittent administration sets should be changed how often?

A

Every 24 hours

39
Q

What is the preferred type of dressing for an IV site? AND WHY?

A

Transparent semipermeable so you can see the site and permits evaporation or moisture and provide a secure anchor

40
Q

How will you select a site for a peripheral IV?

A

age (adults = veins in hand or arm, child = scalp or foot)

  • solution type (use large veins for < irritation when using hypertonic, viscous or irritating substances)
  • infusion speed (the faster = larger vein and Iv cath
  • duration (change peripheral IV 72-96 hours)
  • presence of disease or previous surgery (avoid scarring or impaired circulation)
41
Q

Infiltration

A

inadvertent administration of a nonvesicant (non tissue damaging) solution or medication into

42
Q

Infiltration CMs

A

swelling, tenderness, pallor, hardness, and coolness at site, and burning sensation.

Nursing response: stop infusion Immediately, restart infusion in different vein, elevate affected arm on a pillow to promote absorption of excess fluid.

43
Q

Extravasation

A

inadvertent infiltration of vesicant solution or medication into surrounding tissue

*if these happen don’t pull out catheter, stop infusion first, talk to pharmacist bc there might be an antidote to put through the catheter.

44
Q

Extravasation CMs

A

pain, burning, swelling, and coolness of surrounding skin, blistering is a late sign.

treatment depends on severity, stop infusion immediately, administer an antidote, apply cold compresses, and elevate the extremity.

45
Q

Phlebitis

A

inflammation of the vein, can result from the chemical part of fluid going into it or mechanical meaning the inside of catheter is damaging the vein.

46
Q

Phlebitis CMs

A

redness, warmth, tender, may be palpable.

Nursing Response: discontinue iv infusion and restart in new location, apply cold compresses, assess for circulatory impairment, consult HCP.

47
Q

Thrombophlebitis

A

clot forming in addition of the phlebitis that happened. Discontinue infusion and take out catheter, elevate extremity, apply warm compresses 3-4x a day, restart infuse in a different extremity.

48
Q

Thrombophlebitis nursing response

A

discontinue iv infusion, and restart in opposite extremity apply warm compresses, consult HCP.

FPCC (15 decks)

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