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NUR 4512 > Final Exam > Flashcards

Final Exam Flashcards

1
Q

What are the steps to a central line dressing change?

A
  1. hand hygiene & PPE (if indicated)
  2. put patient into comfortable position
  3. apply mask for self & patient
  4. put on clean globes & assess site through old dressing
  5. perform hand hygiene again & put on sterile gloves
  6. apply new antimicrobial dressing
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2
Q

What do you document after changing a central line dressing?

A
  • time
  • date
  • location of site
  • assessment of site
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3
Q

How often are central line dressings changed?

A

once a week

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4
Q

What’s used to flush a central line?

A

normal saline (NS) & heparin

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5
Q

What lines can labs be drawn from?

A

Mid lines & central lines
- NO peripheral IVs or PICC lines

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6
Q

Use the _______ line first when drawing blood from a central line and the _______ line when administering meds w/ multiple lumen

A
  • distal
  • proximal
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7
Q

When removing a central line, the patient should be laying ________

A

flat

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8
Q

When are vital signs taken for a blood transfusion?

A
  • before administering blood
  • 15 minutes after
  • one hour after
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9
Q

Blood can run for _____ hours

A

4 hours

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10
Q

What are the steps for a blood transfusion?

A
  1. cover filter w/ NS
  2. clamp NS
  3. unclamp blood & roller clamp
  4. connect patient to blood
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11
Q

What interventions are given when you notice a patient having a reaction during a blood transfusion?

A
  • STOP transfusion
  • get new tubing
  • run NS
  • obtain labs (test blood)
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12
Q

S&S of blood transfusion reaction

A
  • fever/chills
  • flank pain
  • hypotension
  • tachycardia
  • feeling of impending doom
  • hives
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13
Q

What diuretic should you monitor electrolytes with?

A

Furosemide (Lasix)

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14
Q

What diuretic is potassium sparing?

A

Spironolactone (Aldactone)

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15
Q

MOA of antiplatelets

A
  • inhibit platelet aggregation
  • prevents cells sticking together & forming clots
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16
Q

Examples of calcium channel blocker (CCB) meds

A
  • Verapamil
  • Diltiazem
  • Amlodipine
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17
Q

Examples of anticoagulant & antiplatelet meds

A
  • ANTICOAG = Warfarin (Coumadin), Eliquis, Heparin
  • ANTIPLATE = Aspirin, Plavix, Brilinta
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18
Q

Examples of angiotensin II receptor blockers (ARBs) – sartans

A
  • Losartan (Cozaar)
  • Valsartan (Diovan)
  • Olmesartan (Benicar)
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19
Q

Examples of ACE inhibitor meds – prils

A
  • Quinapril
  • Lisinopril
  • Ramipril
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20
Q

What lab value is monitored for Warfarin?

A

INR – tells you how long it takes the body to clot

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21
Q

What is the reversal agent for Warfarin?

A

Vitamin K

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22
Q

What is the reversal agent for Heparin?

A

Protamine sulfate

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23
Q

What lab is monitored for Heparin?

A

PTT (partial thromboplastin time) – measures time it takes for a clot to form

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24
Q

What is the reversal agent for opioids?

A

Naloxone (Narcan)

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25
Q

What is the reversal agent for benzodiazepines?

A

Flumazenil (Romazicon)

26
Q

What meds are given for V-tach, V-fib, and asystole?

A
  • Amiodarone
  • Epinephrine
27
Q

What med can be given for bradycardia?

A

Atropine

28
Q

Tx for increased ICP

A
  • Mannitol
  • craniotomy
29
Q

What is a normal GCS indicating no head injury?

A

15

30
Q

What GCS score indicates MTN needs to be contacted?

A

< 8

31
Q

What does GCS measure?

A
  • Eye opening
  • Verbal response
  • Motor response
32
Q

What does CPP stand for & what is the normal range?

A
  • Cerebral perfusion pressure
  • 60 - 100
33
Q

What is the formular for finding the CPP?

A

CPP = MAP - ICP

34
Q

What does MAP stand for?

A

Mean arterial pressure

35
Q

What’s considered a normal MAP?

A

60-65 and higher

36
Q

What does ICP stand for & what is the normal range?

A
  • Intracranial pressure
  • 5 - 15
37
Q

What is the formula for finding the MAP?

A

MAP = (DBP x 2) + SBP/3

38
Q

What is the normal PR interval?

A

0.12 - 0.20 seconds

39
Q

What does the PR interval measure?

A

Time from start of atrial depolarization to start of ventricular depolarization

40
Q

What is a normal QRS interval?

A

< 0.12 seconds

41
Q

What does the QRS complex represent?

A

ventricular depolarization

42
Q

What does an elevation of ST indicate?

A
  • Myocardial infarction (MI)
  • STEMI (ST elevated MI)
43
Q

What is a normal QT interval?

A

< 0.43
0.35 - 0.45

44
Q

An issue with the P wave indicates an issue with the _______

A

atria

45
Q

An issue with the QRS complex or T wave indicates an issue with the ___________

A

ventricle

46
Q

What is the difference between a PVC and a PAC?

A

Ventricular vs. Atrial

47
Q

If there is a pacer mark before the P wave, this means the _______ is being paced

A

atria

48
Q

If there is a pacer mark before the QRS, this means the __________ is being paced

A

ventricles
- the complexes will also be inverted
(upside down)

49
Q

What would you do if a chest tube is pulled out?

A

Put on sterile water and a petroleum gauze dressing

50
Q

What do you do if the atria falls for a chest tube?

A

Get a new one

51
Q

T/F: the atrium connected to a chest tube going into the pleural space should be hung at the end of the bed.

A

False –>always down (gravity) and on a flat surface (floor)

52
Q

What is the first intervention if the ventilator is giving you a high pressure alarm?

A

Suctioning

53
Q

What could be causing a high pressure alarm on vented patients?

A
  • blocked airway
  • coughing
  • biting the tube
  • tension pneumothorax
54
Q

What should you check for if the ventilator has a low pressure alarm going off?

A
  • check for chest rise
  • check for an air leak or disconnected tubing
55
Q

What keeps the alveoli open on the ventilator?

A

PEEP

56
Q

Open suctioning is _________ when closed suction is _________

A
  • sterile
  • aseptic
57
Q

What would you do before suctioning or changing a trach?

A

hyperventilate

58
Q

Indications for NG tubes

A
  • intake requirements
  • decompress the stomach
  • aspirate gastric contents
59
Q

How should you position a patient during an NG tube insertion?

A
  • sitting up (High Fowler’s)
  • tuck the chin in
60
Q

What would you instruct the patient to do while inserting an NG tube?

A

swallow

61
Q

What does coughing during NG tube insertion indicate?

A

You are in the lungs – immediately remove while patient holds breath

62
Q

What does gagging indicate during an NG tube insertion?

A

This is a normal finding

NUR 4512 (2 decks)

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