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NRSG 302 > Final Exam Study Guide > Flashcards

Final Exam Study Guide Flashcards

1
Q

What is the indication for increasing circulatory blood post trauma?

A

To manage hemorrhage

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2
Q

What is the indication for increasing RBC in patients?

A

For people with anemias

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3
Q

What should be done in the event of a transfusion reaction?

A

Stop transfusion and disconnect blood from VAD

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4
Q

What should be administered to maintain systolic blood pressure over 90 during a transfusion reaction?

A

IV fluid

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5
Q

Who should be called in case of a transfusion reaction?

A

MRP/code team

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6
Q

What is a common cause of acute hemolytic reaction?

A

ABO incompatibility

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7
Q

What are the signs and symptoms of an acute hemolytic reaction?

A
  • Chills
  • Lumbar/IV site pain
  • Hypotension
  • Tachycardia
  • Tachypnea
  • Dyspnea
  • Nausea
  • Flushing
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8
Q

How soon do symptoms of an acute hemolytic reaction typically occur?

A

Within the first 25 mL of blood

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9
Q

What is anaphylactic reaction due to during a transfusion?

A

Sensitivity to some of the donor components

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10
Q

What are the signs and symptoms of an anaphylactic reaction?

A
  • Rash/hives
  • Itchiness
  • Flushed
  • Wheezing/resp distress
  • Swelling
  • Vomiting
  • Hypotension/tachycardia
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11
Q

When does a febrile reaction usually develop during a transfusion?

A

Later in the infusion

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12
Q

What are the signs and symptoms of a febrile reaction?

A
  • Temp higher than 38 or an increase of 1 degree from baseline
  • Sudden chills
  • Flushing
  • Malaise
  • Muscle pain
  • Headache
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13
Q

Who is at risk for fluid volume overload during transfusions?

A
  • Patients with renal impairment
  • Patients with heart failure
  • Frail elderly
  • Patients receiving lots of fluid quickly
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14
Q

What are the signs and symptoms of fluid volume overload?

A
  • Hypertension
  • Dyspnea
  • Bounding pulses
  • Moist breath sounds
  • Cough
  • JVD
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15
Q

What is a common complication with platelet infusions?

A

Bacterial sepsis

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16
Q

What is required before administering a blood transfusion?

A

Physician consent and order

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17
Q

What must the consent for a blood transfusion include?

A
  • Why the patient requires the product
  • The blood product or component being administered
  • The risks and benefits
  • Opportunity to ask questions
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18
Q

What should the order for a blood transfusion contain?

A
  • Patient identifiers
  • Date and time
  • Rate and duration of transfusion
  • Amount and type of blood products
  • Sequence of products if multiple
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19
Q

What should be done after blood transfusion is complete?

A

Flush VAD with 30-50 mL NS

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20
Q

What is the maximum time a blood transfusion should take from issue time?

A

4 hours

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21
Q

What is the purpose of a Jackson Pratt drain?

A

Active/suction system for fluid drainage

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22
Q

What is a Penrose drain?

A

An open/passive system that maintains an opening for fluid drainage

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23
Q

What is the procedure for removing JP & Hemovac drains?

A
  • Requires physician’s orders
  • Empty drain and leave uncharged
  • Cleanse wound first and then drain site
  • Stabilize skin over drain site
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24
Q

What is phlebitis?

A

Inflammation of the vein

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25
What are the stages of phlebitis?
4 different stages
26
What is the proper insertion technique for IVs?
Insert needle bevel UP at 15-20 degrees
27
What are the signs and symptoms of infiltration?
* Swelling * Cool feeling skin * Slowed or stopped IV flow * Pain around site
28
What are hypertonic fluids used for?
Treatments of hypovolemia
29
What are isotonic fluids commonly used for?
Volume replacement
30
What is the purpose of NG tubes?
Decompress stomach, lavage, enteral feeding, instilling medication
31
What should be done to confirm the placement of an NG tube?
Placement MUST be confirmed by X-ray
32
What is a complication of PCA?
Respiratory depression
33
What is the preferred route for administering Narcan?
IV
34
What are the benefits of PCA?
* Better overall patient satisfaction * Patient has a sense of control over pain * Fewer post-op complications * Consistent serum drug concentration
35
What are the signs and symptoms of atelectasis?
* Poor color * Mild tachypnea * Mild tachycardia * Mild fever * Decreased air entry
36
What is a common post-op complication that can lead to fever?
Pneumonia
37
What are the signs of pneumonia?
* Productive cough * Fever * Pleuritic pain * Increased WBC
38
What is acute respiratory distress syndrome (ARDS)?
A condition characterized by rapid shallow breathing and severe hypoxemia
39
What are the signs of pulmonary edema?
* Crackles on lungs * Chest X-ray shows increased density on lungs
40
What is a common complication within 24-48 hours after surgery?
Airway obstruction ## Footnote This can be due to tongue obstruction if the patient is sedated, aspiration of emesis, or spasm of bronchi or larynx.
41
What can cause respiratory depression after surgery?
Changes in cardiovascular or neurological status ## Footnote Respiratory rate and function are often the first vital signs affected.
42
What are the signs and symptoms of pulmonary edema?
* Crackles on lungs * Chest X-ray shows increased density * Productive cough with clear to pink sputum * Decreased O2 saturation ## Footnote Pulmonary edema can be caused by fluid overload, left ventricle failure, or sepsis.
43
What interventions are used for pulmonary edema?
* Diuretics * Fluid restriction * Supplemental O2 ## Footnote These are aimed at reducing fluid overload and improving oxygenation.
44
What is pulmonary embolism?
When a thrombosis breaks off and blocks blood flow to the lung ## Footnote It usually breaks off from another part of the body.
45
What are the signs and symptoms of a pulmonary embolism?
* Tachypnea * Dyspnea * Chest/shoulder pain * Hypotension * Cough with frothy pink sputum * Decreased O2 ## Footnote Calf warmth, swelling, pain, or redness indicate DVT, which can lead to PE.
46
What interventions are required for a pulmonary embolism?
* Raise head of bed (HOB) * Anticoagulation * Clot busters like tPA (severe cases) * Supplemental O2 ## Footnote These interventions aim to restore blood flow and improve oxygenation.
47
What are risk factors for cardiovascular complications post-surgery?
* A-Fib * Blood thinners * Long surgical time ## Footnote These increase the likelihood of hemorrhage and related complications.
48
What are the signs and symptoms of hemorrhage?
* Increased pulse * Decreased blood pressure * Signs of shock ## Footnote These indicate a significant loss of blood volume.
49
What interventions should be taken if active bleeding is observed?
Apply pressure ## Footnote This is crucial to control the bleeding.
50
What is a hematoma?
Blood leaking out of the vascular space into surrounding tissue ## Footnote It usually occurs around the surgical site.
51
What are the signs and symptoms of a urinary tract infection (UTI)?
* Cloudy urine * Increased frequency * Burning during urination * Fever * Delirium in the elderly ## Footnote These symptoms help in diagnosing a UTI.
52
What interventions are appropriate for a UTI?
* Antibiotics * Encourage fluids ## Footnote These help to eliminate the infection and promote hydration.
53
What is the significance of dehiscence after surgery?
Opening of wound edges, usually occurs 7-10 days post-surgery ## Footnote It is a medical emergency that can lead to further complications.
54
What are risk factors for surgical dehiscence?
* Poor wound closure * Coughing or vomiting with an incision * Abdominal distention * Malnutrition * Obesity * Older age ## Footnote These factors increase the likelihood of wound failure.
55
What should be done in case of evisceration?
Cover the area with a normal saline soaked dressing and place the patient in bed with knees to chest ## Footnote This is a medical emergency requiring immediate attention.
56
What criteria must a patient meet before being transferred from the Post Anesthesia Recovery (PAR)?
* Can maintain own airway * Stable vital signs * Alert and oriented * Stable pain and nausea levels ## Footnote A complete ABCDEFGH assessment must also be performed.
57
What does the A in ABCDEFGH assessment stand for?
Airway ## Footnote This involves checking if the patient can breathe or talk and if their gag reflex is intact.
58
What does the C in ABCDEFGH assessment stand for?
Circulation ## Footnote This includes checking pulses, for bleeding, and ensuring IV is patent.
59
What is the significance of informed consent in surgery?
It must be voluntary, the patient must have mental capacity, and must be properly informed ## Footnote Life or limb emergency surgery may not require consent.
60
What are the three key elements for valid consent?
* Must be voluntary * Must have mental capacity * Must be properly informed ## Footnote Consent must be checked by the nurse for completeness.
61
What are indications for Total Parenteral Nutrition (TPN)?
* Paralyzed or non-functioning GI tracts * Conditions requiring GI rest * Bowel obstruction * Ulcerative colitis * Pancreatitis * Chronic diarrhea * Chronic malnutrition ## Footnote These conditions necessitate the use of TPN.
62
What complications can arise from TPN?
* Hyperglycemia * Hypoglycemia * Dehydration and electrolyte imbalances * Infection * Liver failure * Micronutrient deficiencies * Refeeding syndrome ## Footnote These complications require monitoring and intervention.
63
What is refeeding syndrome?
Occurs when a severely malnourished patient suddenly receives food, especially high carbs ## Footnote This can lead to dangerously low serum levels of potassium, magnesium, and phosphorus.
64
What is the difference between enteral and parenteral feeding?
Enteral feeding is cheaper, has a lower risk of infection, and helps maintain GI function, while parenteral feeding is more invasive, has a higher risk of infection, and does not require a functioning GI tract ## Footnote Enteral feeding is preferable when the GI tract is functional.
65
What are the signs of a tracheostomy complication?
* Abnormal bleeding * Tube dislodgement * Obstructed tube/mucus plug * Infection * Subcutaneous emphysema * Tracheoesophageal fistula ## Footnote Monitoring for these signs is crucial for patient safety.
66
What is the procedure for suctioning a tracheostomy?
* Elevate HOB to 45-90 degrees * Hyperoxygenate the patient * Use sterile gloves * Insert catheter without suctioning * Apply suction intermittently as you withdraw ## Footnote This procedure is essential to clear secretions safely.
67
What are complications of suctioning?
* Tracheal damage * Hypoxia * Dysrhythmias * Lung collapse * Infections * Bronchospasms * Low blood pressure ## Footnote These can arise from improper suctioning techniques.

NRSG 302 (6 decks)

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