FUNDA Flashcards

1
Q

NURSING THEORIES
1. Nature of nursing model (14 basic needs) dole in assisting sick/healthy individuals to gain independence in meeting the 14 basic needs
2. Defines nursing as service. Her theory is Patient Centered approaches to nursing model identifying the 21 nursing probs
3. Nursing as an interaction process of pt and nurse leading to GOAL ATTAINMENT

A
  1. Virginia Henderson
  2. Faye Abdellah
  3. Imogene King
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2
Q

NURSING THEORIES
1. each personal as a behavioral system composed of of 7 subsystem
2. Transcultural nursing model
3. 4 conservation principles

A
  1. Dorothy Johnson
  2. Madelain Leininger
  3. Myra Levine
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3
Q

NURSING THEORIES

  1. Concerning to response to stress (intrapersonal stressors, interpersonal stressors, extra-personal stressors)
  2. Self care and self care deficit nursing theory
  3. Psychodynamic (interpersonal RELATIONS) model
A
  1. Betty Neuman
  2. Dorothea Orem
  3. Hildegard Peplau
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4
Q

NURSING THEORIES

  1. Science of Unitary Human being (whole is greater than sum of its parts)
  2. Adaptation Model (integration)
  3. Core, Care, Cure Model
A
  1. Martha Rogers
  2. Sister Callista Roy
  3. Lydia Hall
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5
Q

NURSING THEORIES

  1. Dynamic Nurse-Patient Relationship Model (assistance to meet an immediate need of pt
  2. Human Caring Theory (caring as unifying focus of practice)
  3. Human becoming theory
A
  1. Ida Jean Orlando
  2. Jean Watson
  3. RoseMarie Parse
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6
Q
  1. accdg to __ nursing is the protection, promotion, optimization, alleviation of suffering, etc
  2. accdg to __ Health is state of complete physical, mental, social wellbeing ad not merely the absence of dse
  3. accdg to __ health is the ability to maintain homeostasis
A
  1. ANA
  2. WHO
  3. WALTER CANNON
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7
Q

4 scopes of N. Practice

A
  1. Promoting health and wellness
  2. Preventing illness
  3. Restoring health
  4. Caring for dying
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8
Q

7 expanded CAREER roles of Nurses

A
  1. Nurse midwife
  2. Nurse entrepreneur
  3. Nurse practitioner
  4. Nurse administrator
  5. Nurse educator
  6. Clinical nurse specialist
  7. Certified Nurse Anesthetist
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9
Q

PATRICIA BENNER’s STAGE OF NURSING EXPERTISE
1. W 2-3 yrs expi, focuses on client’s needs and wants
2. Demonstrates acceptable performance, focuses on theory and real life situations
3. Focuses on rules and regulations
4. No longer requires to maxims, uses instinct
5. 3-5 yrs expi, prioritize ABC, uses maxims, focus on long term goal and perceive situations a a whole rather than its parts

A
  1. Competent
  2. Adv Beginner
  3. Novice
  4. Expert
  5. Proficient
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10
Q

Type of Records
1. Traditional record, each person makes notations in separate sections
2. All data abt their prob

A
  1. SOMR/ Source Oriented Medical Record
  2. POMR/ Problem Oriented Medical Record
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11
Q

Provides concise method of recording data

A

KARDEX

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12
Q

Types of Fever
1. Alternates at regular intervals
2. Fluctuations more than 2 C for over 24h
3. Interpersed w periods of 1-2 days normal temp
4. Always remains above normal
5. Temp rises to fever rapidly ff normal tep then returns to normal within few hrs

A
  1. Intermittent
  2. Remittent
  3. Relapsing
  4. Constant
  5. Fever spike/ stair case
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13
Q

Most accurate site of assessing temp

A

Rectal

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14
Q

Normal CO

A

5L/min

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15
Q

Pulse sites:
1. used when radial is not accessible
2. Used during cardiac arrest in adults
3. used sa infants and < 3yo
4. Determine leg circulation

A
  1. Temporal
  2. Carotid
  3. Apical
  4. Femoral
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16
Q

Pulse sites:
1. Determine lower leg circulation
2. Determine foot circulation
3. used in cardiac arrest and shock
4. Use din cardiac arrest in infants

A
  1. Popliteal
  2. Posterior Tibia and Dorsalis Pedis
  3. Femoral
  4. Brachial
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17
Q

term to discrepancy between apical and radial pulse

A

Pulse deficit

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18
Q

Scale in Pulse assessment

  • 0
  • 1+
  • 2+
  • 3+
A
  • Absent
  • Weak
  • Normal
  • Bounding
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19
Q

Fire extinguisher class
1. Combustible cooking
2. Metals
3. Electrical
4. Flammable/ combustible liquids/ gas
5. Ordinary

A
  1. Class K
  2. D
  3. C
  4. B
  5. A
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20
Q

More Fall scale (MFS) high risk score and no rx score

A

> 50: high rx
0-24: no rx

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21
Q

Kelan ginagawa MFS

A

q shift

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22
Q

Percussions sounds
1. Solid organs like bone and muscle
2. Soft tissue like liver heart
3. Normal
4. air in lungs
5. air and fluids in stomach

A
  1. Flat
  2. Dull
  3. Resonance
  4. Hyperresonance
  5. Tympany
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23
Q

diff of bell and diaphragm in stet

A

DiapHragm- HigH pitch

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24
Q

Pattern of abdominal auscultation and how many mins pakikinig per quadrant

A

RLQ to RUQ to LUQ to LLQ
At least 5 mins

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25
Q

Normal number of bowel sounds per min

A

5-20 bowel sound/ min

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26
Q

<5 bowel sound/min means __
>20 bowel sound/min means __

A

hypoactive/ consti
Hyperactive/ diarrhea

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27
Q

Assessment Position
1. Respiratory assessment
2. Abd assessment

A
  1. Upright
  2. Dorsal recumbent
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28
Q

TYPES OF ENDOSCOPY
1. Resp
2. Upper GI
3. Lower GI

A
  1. Bronchoscopy and Laryngoscopy
  2. Esophagogastroduodenoscopy
  3. Colonoscopy
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29
Q

respiratory and Upper GI endoscopy (UPPER ENDOSCOPY) Prep “canva”

A
  1. Consent
  2. Atropine sulfate
  3. NPO post midnight 6-8h
  4. Valium (sedate)
  5. Anes spray- lidocaine
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30
Q

respiratory and Upper GI endoscopy (UPPER ENDOSCOPY) post procedure

A

Post procedure:
1. Gag reflex- tongue depressor
2. Compli ass

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31
Q

Compli of upper endoscopy

A
  1. Bleeding- freq swallowing or spit blood
  2. Perforation- severe abdominal pain and board like
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32
Q

Lower endoscopy- COLONOSCOPY prep “linis bituka goal”

A
  1. 1-3 days fiber
  2. NPO post midnight
  3. Laxative night before procedure
  4. Cleansing enema
  5. Left sims position (during procedure)
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33
Q

Lower endoscopy- COLONOSCOPY post procedure

A

Assess compli: Same with upper bleeding and perforation

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34
Q

Barium studies
1. Contraindicated kanino
2. conjoined w __ (series of x-ray) and for barium enema
3. conjoined w __ and for barium swallow

A
  1. Preg
  2. Colonoscopy
  3. Fluoroscopy
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35
Q

Choose if barium swallow or barium enema
1. For upper GI series
2. For lower GI series
3. Same w colonoscopy ang prep
4. NPO post midnight and assess barium allergy
5. Fowlers position during

A
  1. BS
  2. BE
  3. BE
  4. BS
  5. BS
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36
Q

After barium studies considerations

A

Goal to excrete barium (intestinal obstruction)
1. OFI
2. FIBER
3. LAXATIVE
4. INFORM STOOL IS WHITE
5. STOOL WITHIN 24-48h

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37
Q

BSE

A

Start sa: TAIL OF SPENCE
Most common are of tumor: UPPER OUTER QUADRANT

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38
Q

TSE
age:
Sino Mas lower sa side ng testicle:

A

age: 13
Sino Mas lower sa side ng testicle: LEFT

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39
Q

Postural drainage by virtue of gravity, how many mins

A

5

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40
Q

CPT
time:
Post procedure:

A

time: BEFORE MEALS, 2 H AFTER MEALS, AFTER NEBULIZATION
Post procedure: MOUTHCARE (suction)

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41
Q

SUCTIONING anong gloves
Oropharyngeal:
Naso:
Tracheal:

A

Oropharyngeal: ETO LANG CLEAN GLOVES
Naso: sterile
Tracheal: sterile

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42
Q

SUCTIONING POSITION
unconscious:
Conscious:
Apply suction during:
Hyperoxygenate:
Duration:
Interval:
Total suction time:

A

unconscious: S LYING
Conscious: FOWLERS
WITHDRAWAL
100% for 1 min
Duration: 5-10, max na ung 15 sec
Interval: 20-30 sec (suction in between suction)
Total suction time: 5 min

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43
Q

Tracheal length of insertion

A

Same w naso, just pull 1-2 cm

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44
Q

2TYPES OF SUCTION MACHINE ilang mmhg
1. Portable:
2. Wall-mounted:

A

10-15
100-120

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45
Q

Most accurate 02 device that has valve

A

Venturi (24-60%, 3-10 flow rate)

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46
Q

02 device na highest flow 30-60 and highest Fi02 na 100

02 device na lowest w 2-6% and 25-40 lang

A

High flow nasal cannula

nasal cannula

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47
Q

02 device na 2nd to the highest w 10-15 L/min and 80-90 Fi02

02 device na 2nd to the lowest w 6-10L/min and 35-50 Fi02

A

Non rebreather

Simple facemask

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48
Q

THORACENTESIS prep

A

Lidocainape allergy
PT
Xray
Consent

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49
Q

CTT
nabasag:
Disconnect:

A

Do not KINK, immerse sa NSS/water

Tape 3 sides w Dry gauze/ PETROLATUM gauze

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50
Q

3 parts of Tracheostomy and fxn

How to lock & unlock

A

Outer cannula
Inner cannula: ito ung nireremove pag naga suction na
Obturator: guide

Lock: cLOCKwise
unlock: coUNter cLOCKwise

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51
Q

Trach inner cannula is cleaned tuwing__ with__rinsed w__and dry w__

How abt trach ties kelan pinapalitan

A

Every shift
Hydrogen peroxide half strength
Water/NSS and brush/pipe cleaner
MESH gauze❌cotton gauze

Change WHEN NECESSARY

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52
Q

Trach ties is tied at?

A

Side of neck

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53
Q

Types of NGT
1. Single lumen-
2. Double lumen-
3. NasINTESRINAL tube-

Position:
While inserting instruct pt to:
Insertion length:

A

LEVIN
SALEM SUMP
MILLER-ABBOTT

semi/highfowlers while FLEX neck
swallow/sip thru straw
NEX

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54
Q

To ensure NGT PLACEMENT

A

Aspiration ng gastric content dat 1-4 pneumonia

Confirm: xray

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55
Q

FEEDING
position-
Residuals-
Hold _inch above Insertion
if percutaneous endoscopic gastrotomy ilan inch-
Flush with-

A

SEMI F
check ibalik <400 proceed pakain, >400 HOLD
12 inches
6 inch
Water/NSS 30-60 ml

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56
Q

Ileostomy location

Empty colostomy bag when

Foods that reduces odor

A

RLQ
1/3-1/2 full
PaBuYoCOT (parsley, buttermilk, yogurt, cranberry juice, Orange juice, Tomato juice)—mga acidic

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57
Q

RECTAL CATH
W Waterbased lubricant ilang inch submerge dito

Insert

Inch hawakan if low flow enema? Highflow enema?

A

1-2 inch
3-4 inch
12 inch, 18 inch above

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58
Q

Urinary Cath
Single lumen-
Double lumen-
Triple lumen-

Male
position-
inch insertion-
Anchor-

FEMale
position-
inch insertion-
Anchor-

A

Single lumen-STRAIGHT CATH
Double lumen- FOLEY
Triple lumen-CYSTOCLYSIS OR CBI

Male
position-SUPINE
inch insertion- 6-9
Anchor- UPPER thigh/lower abdomen

FEMale
position- DORSAL RECUMBENT
inch insertion- 2-3
Anchor- INNER THIGH

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59
Q

CANE
__in. tabi ng affected leg
positioned sa?
hold on
going upstairs-
downstairs-

A

4-6
Hips/greater trochanter/ elbow crease
Strong side
Good—cane bad
Cane bad—good

60
Q

CRUTCHES
Inch ng tripod position-
how many fingerbreadth below axilla-

A

6-9 inch
2-3

61
Q

GAIT
4 pt gait-
2 pt gait-
3 pt gait-
Swing to-
Swing through-

A

4 pt gait-R crutch, R leg, L crutch, L leg

2 pt gait-R crutch + R leg, L crutch + L leg

3 pt gait- BOTH crutch + bad, good

Swing to- level of crutch
Swing through- beyond

62
Q

full bounding pulse and weak/thready pulse

A

PULSE VOL

63
Q

beats, can be dysrhythmia/arrhythmia

A

RHYTHM

64
Q

SHALLOW RESPI

A

HYPOVENTILATION

65
Q

VERY TO DEEP TO VERY SHALLOW BREATHING FOLLOWED BY TEMPORARY APNEA

A

CHEYNE STROKES

66
Q

RAPID DEEP LABORED BREATHING

A

KUSSMAUL’S

67
Q

SHRILL HARSH SOUND DURING INSPIRATION

A

STRIDOR

68
Q

SNORING/SONOROUS RESPI

A

STERTOR

69
Q

SHALLOW BREATHS INTERRUPTED BY APNEA

A

BIOT’S/CLUSTER RESPI

70
Q

ERROR IN BP NA ARM ABOVE LEVEL OF HEART

A

FALSE LOW (ITO LANG AT CUFF TO WIDE UNG FALSE LOW)

71
Q

NAG EXERCISE/SMOKE ALLOW ILANG MINS BAGO TAKE BP

A

30 MINS

72
Q

BP ARM POSITION? ARM PREFERED USED

A

LEVEL OF HEART, LEFT ARM

73
Q

ILANG IN ABOVE ANTECUBITAL SPACE WRAP CUFF SA BP

ilang mins iwait BEFORE MAKING FURTHER DETERMINATIONS

A

1

1-2 MINS

74
Q

__BP FIRST BAGO AUSCULTATORY BP

RELEASE THE BP VALVE _mmHg per sec

A

PALPATORY

2-3

75
Q

PERCUSSION SOUNDS
1. Muscle bone
2. Liver heart organs
3. Normal lung
4. Air/emphysematous lung
5. Air in stomach

A
  1. FLAT
  2. DULL
  3. RESONANCE
  4. HYPER RESONANCE
  5. TYMPANY
76
Q

POSITION WHEN EXAMINING
CHEST-
BACK-
Abd-
NECK-
Opthalmoscopy-

A

CHEST- SIT
BACK- STANDING
Abd- DORSAL RECUMBENT
NECK- NURSE stands behind the pt
Opthalmoscopy- darken room for illumination

77
Q

If babae pt iexamine ng male nurse gagawin

A

Female nurse must be in attendance

78
Q

VENIPUNCTURE
1. INFANT VEINS USED
2. When to use larger veins
3. Used for continuous or intermittent infusions
4. For long term IV or parenteral
5. Use __veins first
6. Y highly visible veins is avoided

A
  1. Scalp or dorsal foot
  2. Need rapid or if irritaing
  3. Metacarpal, basilic (loob), cephalic (left)
  4. Central venous cath
  5. Distal
  6. Maga roll away sa needle
79
Q

COMPLI OF IV INFUSION and mngt
1. out of vein, nag COLD/pallor
2. Na overuse, red/WARM
3. engorge neck veins dyspne
4. Sudden pain of DOB
5. Fever
6. IV push med rapidly w pounding headache

A
  1. Infiltration- stop, restart sa diff site, limit movt
  2. Thrombophlebitis- stop, restart sa diff site, warm moist compress din
  3. Circulatory overload- slow notify upright w feet dependent
  4. Air embolism- left S lying (trap), notify
  5. Infection- aseptic tech
  6. Speed shock
80
Q

BT types
1. Hemorrhage
2. O2 carrying
3. after elective surgery
4. bleeding disorder/⬇️platelet
5. Expands bv and provides clotting
6. Expander din w plasma protein
7. Clotting factor deficiency

A
  1. Whole blood
  2. Packed RBC
  3. Autologous RBC
  4. Platelet
  5. Fresh frozen plasma
  6. Plasma protein fraction and albumin
  7. Cryoprecipitate and clotting factors
81
Q

BT
1. Gauge
2. Sol
3. duration
4. Tubing changed after
5. Blood left at room temp not more than
6. Observe pt for
7. Ilang gtts/min for first 15 mins
8. Assess q

A
  1. 18-20
  2. NSS/.9 NCL only! (❌dextrose-hemolysis)
  3. 4 hrs
  4. 4-6 units per policy
  5. 30 mins
  6. 5-15 mins
  7. 10
  8. 30 mins
82
Q

Enema types
1. For dx test
2. Clean as much of the colon, left lateral to dorsal recumbent to right lateral paglipat position ng pt and 12-18 ibc above RECTUM
3. clean rectum and sigmoid only
4. Expel flatud w 60-80 ml sol
5. Oil/med to soften/lubricate rectum for 1-3 hrs
6. 100-200 ml fluid in and out of rectum done 5-6 times until flatus is expelled

A
  1. CLEANSING ENEMA
  2. HIGN ENEMA
  3. LOW ENEMA
  4. CARMINATIVE
  5. RETENTION
  6. RETURN FLOW
83
Q

BT reactions general mngt
BT reactions special mngt
1. Hemolytic anemia
2. Febrile reaction (sensitive sa plasma, WBC, platelet)
3. Allergic reaction (sensitive lang sa plasma)
4. Circulatory overload
5. Sepsis

A

Stop and notify
1. Send remaining blood, blood set, sample of clients blood sa lab
2. KVO w NSS
3. Antihistamine
4. Same w IV
5. KVO w NSS and Send remaining blood and tubing sa lab

84
Q

Moist heat/autoclave
Pressure:
Temp:

A

1 atm
121-123 Celcius

85
Q

Gas uses what chemical na for heat sensitive items

A

Ethylene oxide

86
Q

If airborne dse anong air pressure and mngt

A

Negative air pressure, icohort, ❌susceptible ppl

87
Q

Normal urine for 24 hrs
Odor
Ph

A

1200-1500
Faint aromatic
4.5-8

88
Q

Urinary cath french size

A

Male:16-18
Female: 12-14

89
Q

Taking care of death
1. placed under head and shoulders
2. Inserted to give face natural appearance
3. To take up any feces and urine
4. Remove all jewelry except this that is taped to the finger

A
  1. One pillow
  2. Dentures
  3. Absorbent pad under buttocks
  4. Wedding band
90
Q
  1. Stiffening of body
  2. Body temp falls 1 Celcius
  3. Discoloration of body
A
  1. Rigor mortis
  2. Algor mortis
  3. Livor mortis
91
Q

How to push stretcher to protect pt from collision

Stretcher in entering elevator

Wheelchair position on what side

A

Push from the end where pt’s head
Pt head 1st
Strong

92
Q

EVOL OF NURSING
MODERN

NIGHTINGALE

MIDDLE AGES, DARK PERIOD

MEDIEVAL NO FORMAL TRAINING

A

Contemporary
Educative
Apprentice
Intuitive

93
Q

1st CON-
1st offer 4 yr-
1st state university-
1st virtual lab-

A

1st CON-UST
1st offer 4 yr-MANILA CENTRAL
1st state university- UP
1st virtual lab-FEU

94
Q

Earliest hosp

A

Hosp Real de Mnla

95
Q

3 patron saints

A

St Claire
St Elizabeth
St Catherine

96
Q

Syringe and ml
1. IM:
2. Subq:
3. ID:

A
  1. IM: 2-5 ml, 21-23g
  2. Subq: 1-3 ml, 25-27g
  3. ID: 1 ml, 26/27g (tuberculin syringe)
97
Q

Postural drainage
- Elevate the—

A

AFFECTED - ex. RIght affected, position on left S Lying

98
Q

Indications
- FWB:
- PRBC:
- Platelet:
- FFP:
- Albumin:

A
  • FWB: surgery
  • PRBC: anemia
  • Platelet: bleeding
  • FFP: shock (vol expander=⬆️circ blood volume)
  • Albumin: RAPID Vol Expander
99
Q

Edema diet

A
  1. Low NA- only prevent further edema
  2. ✅High CHON (EGG WHITE, soybeans like tofu, milk)
100
Q

Normal Urine ph:

Paracentesis— position and—

A

4.6-8
sitting empty bladder

101
Q

After lumbar puncture position

A

supine for 1-2 hrs then flat without pillow, or prone for 4-12h

102
Q

After suctioning, ABG is done after— mins

Obtain sputum- — as best natural mucolytic

A

20-30
Water

103
Q

cracking of lips

Cheeselike substance in male genitalia-

A

Cheilosis

SMEGMA (infxn)

104
Q

Coughing/resistance felt during suctioning- dt natamaan carina —then suction na

Suction—- suction while— cath in— motion

A

atras onti
INTERMITTENT WITHDRAWING circular

105
Q

“skin RIPPED off”

Partial rebreather- COLLAPSE—, if not=—

A

Laceration

ALL THE TIME
Leak

106
Q

Obtaining stool culture:— (clean) only for routine dapat STERILE so—

A

Tongue blades
rectal swab

107
Q

Pag “every __hrs” that’s a—

Asking pt’s name <—

A

standard written order
ID band

108
Q

Obtaining CSF fluid via lumbar puncture:
-: pedia
-: adult

A

L4-L5
L3-L4

109
Q

Checking of bleeding time
- Warfarin:
- Heparin:

A

INR & PT
PTT

110
Q

Bone marrow aspiration: use flat bone, ❌—

A

long bones

111
Q

Handwashing di pede bumaba ng—
—: total time of handwashing

A

20 sec
40-60 sec

112
Q

Anti-embolic stocking measurement
1. Knee length:
2. Thigh-
✅Remove at least— times per day
✅Apply while—

A
  1. Knee length: popliteal to foot
  2. Thigh- gluteal fold to foot

2 supine

113
Q

Trashcans
-Green:
- Black:
- Orange:
- Yellow:

A

-Green: biodegradable
- Black: general wastes (paper)
- Orange: radioactive
- Yellow: infectious

114
Q

Suction wall pressure
- Pedia:
- Adult:

A
  • Pedia: 80-120 mmhg
  • Adult: 150 mmhg
115
Q

Heparin- nakakaHematoma, ❌—

A

aspirate/massage

116
Q

Rectal tube insert— cm

CTT- below—

A

3-4
chest level

117
Q

Order of bed sheet “brad top bottom pa”

A
  1. Bottom sheet
  2. Rubber sheet
  3. Draw sheet
  4. Top sheet
  5. Blanket
  6. Pillow case
118
Q

2 pt gait: wt bearing on —legs,— stable, faster.

A

BOTH less
R crutch and L foot, then L crutch R foot

119
Q

4 pt gait: wt bearing on— legs, most—, slow.

A

Both stable R crutch, L foot, L crutch, R foot

120
Q

3 pt gait: NON wt bearing on— leg.

A

One, Both crutches and affected, then strong

121
Q

Swing to:
Swing through:

A

level of crutch or “AS FAR AS”
“FORWARD/BEYOND”

122
Q

⬆️60% TBSA

A

low chance of survival

123
Q

negative peripheral pulse post cardiac catheterization- Femoral cut down so ✅— on femoral artery. If (-) pulse means—

A

clot formation
clot formation

124
Q

Aspirin only causes Reye’s syndrome (damaged liver and brain) if

A

VIRAL

125
Q
  1. Intermittent-
  2. Remittent-
  3. Relapsing-
  4. Constant-
A
  1. Intermittent- fluctuates from N to fever in “24h” (on and off fever); mc in meningitis
  2. Remittent- fluctuates but “NEVER” naga N in 24h; mc in bacterial endocarditis
  3. Relapsing- fluctuates from N to fever in 2-3 “DAYS”; mc in dengue & Lyme dse
  4. Constant- cont. high fever 40-41 C unresponsive to antipyretics; mc in Kawasaki dse
126
Q

Irrigation in adm oral care-use?? , or soft bristled toothbrush, or swab q “4h” apart —pede

A

hydrogen peroxide “half strength” c NSS
lemon-glycerin swabs

127
Q

Fecal impaction leads to fecalith and pen pike or ribbon like stools and if severe— nalang dadaan. Mngt:—

A

oozing liquid stool
manual extraction

128
Q
  • inflammation of skin around nail tutuklap balat
  • Linear cracks
A

Paronychia Fissure

129
Q

Sanguineous-
Serous-Sanguineous-
Serous-
Purulent-

A

Sanguineous- red
Serous-Sanguineous- pink
Serous- clear
Purulent- yellow

130
Q

flat nonpalpable colored
solid elevated circumscribed filled with serous fluid <1 cm but if >1cm (—-)
pus filled
serous fluid

A

Macule
Papule (Plaque)
Pustule
Vesicle

131
Q

Light palpation
— in indenting the skin (1.3-1.9 cm)

no diamond shape bet palms —clubbing

A

1/2-3/4 in
Schamioth window test

132
Q

Edema grading

A

1+ 0-2mm
2+ 2-4
3+ 4-6
4+ 6-8

133
Q

PULSE
- reg or irregular
-apical minus radial pulse
- aka amplitude
- 0
- +1
- +2
- +3
- +4
- no. of pulse

A

Pulse rhythm-
Pulse def-
Pulse vol-
- 0 absent
- +1 weak and thready
- +2 Normal
- +3 full
- +4 strong bounding
Pulse rate-

134
Q

what gauze in applying pressure to IV site after IV cath

A

Sterile gauze

135
Q

Highly sensitive and most painful site of venipuncture

A

Inner aspect of hand

136
Q

1st later of dressing at CTT in INSERTION site? Removal?

A

Insertion- sterile petrolatum jelly gauze
Removal- dry sterile gauze

137
Q

Rectal tip insert in— but directs towards midline w/c is—

A

rectum umbilicus

138
Q

Waiting time prior taking temp
Axilla:
Rectum:
Newborn:
Oral:

A

Axilla: 7-9 min
Rectum: 5 min
Newborn: 1 min
Oral: 2-3 mins

139
Q

Insert rectal temp— in

A

0.5-1.5

140
Q

Hot/cold exposure before Oral temp wait for

A

30 mins

141
Q

How to BP

A
  1. Lagay bp cuff
  2. Palpatory
  3. Inflate hanggang mawala
  4. Add 30
  5. Lagay stet
  6. Deflate
    ✅Arm above heart and loose eto lang false low ng BP
    ✅Not a diff of 10 mmhg on the other arm of pt if maga repeat ka on other arm
142
Q

ENEMA:

  • soften stool
  • absorb water and swell
A

Emollient
Bulk

143
Q

Enema first before barium swallow kc if not

A

icloud nya colon

144
Q

Enema
—- in above—
- Insert 3-4 inch (rectal tip)
- Left sims
- Low flow/small vol enema: —ml sol sa sigmoid and rectum
- High flow enema: —mlsa large intestine

A

12-18 anus/rectum
500
1k

145
Q

TPN
- ⬆️glucose (CHO, CHON, Fats that contains eggs)
- ❌allergy to—
- Via— (central lines)
- ✅ —pump
- SE:
- Compli: Infxn, ⭐️—, Cardiac Overload
- Instruct— ⬆️Intrathoracic pressure wala pumasok air
- use— if wala pa prepared na TPN para di mag rebound hypogly

A

egg
subclavian or brachial
infusion
Hypergly
Embolism
deep breath, hold, bear down to
D10

146
Q

Convertion
1. C to F
2. F to C

A

F= C x 1.8 + 32
C= (F-32) / 1.8