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fundamentals Flashcards

1
Q

right brain damage

A

left side weakness
spatial perceptual def
-impulsivness
-high risk for falls

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2
Q

rise from suttting (crtuches)

A

hold hand grips on borth crutches in the hand of the affacted side

  • move to chairs edge
  • hold armrest with the hand on the unaffected side
  • use crutces, armrest, and unaffected leg to support when rising
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3
Q

to sit

A

back up to the chair and move both of the crutches into the hand on the affected side and then holds arm rest with other hand and lowers body

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4
Q

before sitting the clien

A

back up to the chair till the unaffected leg touches the chair

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5
Q

caring for unconsious pt during admission

A

dont remove medical patches until consulting with HCP because clients are often prescribed transdermal patches for chronic conditions

  • remove contact lenses
  • tampons should be removed to prevetn toxic shock or infection
  • rings and jewlery should be removed to prevent constrictive injury if edema dev
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6
Q

absoulte contrindications for MRI

A

cardiac pacemaker

  • inplantable cardioverter defillator
  • choclear inplant
  • retained metallic forign body such as in the eye

relative contrindication:

  • metal pins
  • prostehtic heart value
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7
Q

med patches before MRI

A

should be removed but not contrindication but can cause burns so replace after MRI

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8
Q

when determining most app method of safetly transfer assess

A

wether the client can bear weight

-whether client is copperative

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9
Q

if client is cooperative and able to particallt bear weight

A

one person stand and pivot techniquie with gait belt

-

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10
Q

if client is copperative and can bear full weight

A

stand by

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11
Q

no weight bearing abilty but can follow commands

A

2 person stand assist lift

motoized assist device

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12
Q

no weight bearing and not following commands

A

2 person assit with full body sling

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13
Q

types of error

A

Diagnostic (delay in diagnosis, failure to employ indicated tests, failure to act on results of monitoring)
Treatment (error in performance of procedure, treatment, dose; avoidable delay)
Preventive (failure to provide prophylactic treatment, inadequate follow-up/monitoring of treatment)
Other (failure of communication, equipment failure, system failure)

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14
Q

trach tube in infalted cuff is used in clients

A

ho are at risk for apsiration (unconsous, mechanical ventilation)

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15
Q

the cuff is delated when

A

the client is iporving and not to be at risk for aspiration

-is awake

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16
Q

before cuff can be delated

A

the client is asked to cough to exporate secretions that is built above the inflated cuff
-then suction is applieid through the trach tube and then the mouth and it is then deflated

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17
Q

aditional interventions to deccrease the risk of aspiration

A

sit upright with chin flexed slightly toward chest

-mointor wet or garbled sound

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18
Q

hypextension of the neck

A

increases risk for aspiraiotion

it should be flexed toward the chest

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19
Q

if a client is up and awake and isnt at risk for apsiration

A

then deflate the cuff to prevent aspiration

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20
Q

droplet precaution

A 
mentigits
diphtherpia
MMR
pertussis
grpup a step (strep throat)
viral influenza
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21
Q

protective euq for dropley

A

surgical
provate
as needed for procedures with risk of splasm: gloves gown googles anf face shield (suctioning, wound care)
-equip should stay in room

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22
Q

sterile technique when

A

collecting urine sample

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23
Q

perineal hygeine

A

soap and water not antisepectic cleansers

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24
Q

irrgation of catherter

A

routine irrgation with atimicrobial soltiion or adm of atnimicrobials is not recommends

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25
Q

contact precaustions

A

MRSA
c diff
VRE (vancymycin resistant enteroccus)
scabies

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26
Q

compact precations include

A

private roomo (preffered) or cohoring clients with same infection

  • using dedicated equip
  • door notice for vistors
  • if xray is needed try to arrange for portable one
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27
Q

etoh hand rubs vs hand wash

A

MRSA and VRE- etoh

cdiff- soap

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28
Q

nitroglycerine

A

vasodilator and headache is expected so take ecta

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29
Q

felodipine

A

ca channel blocker and causes vasodilation

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30
Q

ca channel

A

vasodilation and causes peripheral edema and this si an expected freq side effect and not allergic reaction
-tell clients to elevate their legs when lying down and to use stockings

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31
Q

latex-

A

allegries can happen 3-4 days after

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32
Q

common latex

A

kiwi, banaa, avacoda, tomator, peaches, grapes,

  • baloon tupped catherers (arterial cath)
  • blowing up toy balloons
  • use of bottle nipples and pacifiers
  • confoms or diaphragmns
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33
Q

who is at risk for catherter related bloodstream infections

A

those with comprimised immune system

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34
Q

CLABSI risk

A

higher when using lower ext

-higher infection when using wrists or upper arm compared to hands

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35
Q

antecubial fossa

A

commly use in emergency sitautoiins due to its size and ease of cannulation
0but prob when longer termr needs because it is at the bend of the elbow
-bending of the arm can move cather and increase infection risk

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36
Q

using foot for IV

A

infection
thromphebitis
DVT

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37
Q

radial

A

severe pain
nerve dmage
infection

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38
Q

cellutis

A

inflammation of the subq tissues due to bacterial infection resulting from insect bite
cut
abrasion
open wound

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39
Q

cellutis characteristic

A

redness
edema
pain
fever

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40
Q

nursing care for cellutlist

A

ensure the affected ext is elevated when sitting or lying down
-flat or dependednt position can worsen edema
–protect cliients with weeping or draining woudnds from prolonged exposure to moist or soiled linens –>infection
-warm compresses promote circulation and reduce edema
-daily marking and dating
-

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41
Q

unsterile field

A

one inch margin at the edge

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42
Q

when tb client leaves room

A

surgical mask ONLY

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43
Q

scrub foley collection port

A

with elcholol or chlohexdine for 15 seconds before drawing sepecimens

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44
Q

middle east resp syndrome

A

viral resp illness caused by coronavirus

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45
Q

middle east resp syndrome symtoms

A

fever cough sob

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46
Q

precaution for midle east resp syndrome

A

standard
contact
aurborn (n95)
eye porection

47
Q

midle east resp sydrome spread through

A

resp sections

48
Q

hital hernia

A

abnormal movement of stomach into the chest due to weakness of the diaphrgmn

49
Q

signs of hital hernia

A

asymtoamic

  • heart burn
  • CP
  • dysphagia
  • SOB
  • intrabsominal pressure
50
Q

hital hernia management

A

lose weight by perfomraing LIGHT actv such as short walks

  • avoid actv that strain (weight lifting)
  • sit up for several hours afte meals
  • sleep with HOB elevated 6 in at least
  • surgical if home management fails
51
Q

gastric residual should be check

A

no less than every 4 hours

52
Q

when dose is outside range

A

ask HCP

53
Q

hydromorphone

A

5-10 X the strength

54
Q

before sugery

A

consent
assessment
clients staus
preop checklist

55
Q

conact precaution measures

A

nonsterile gown
gown
private room preferrred
hand hygenigene (cdiff)

56
Q

romberg test

A

assess clients preception of their head in spsace (vestibular function)
-body in space

57
Q

how to perform romberg test

A

stand with feet togegther and hands by side of the body

-close eyes

58
Q

inernal radiation inplant (bracytherpy)

A

emits radition in or near tumor to treat certain malignicies

59
Q

when caring for pt with brachyterpy mointor for

A

implant dislgement

60
Q

what should be kept in the room of t who had radiactive inplant

A

long hande forceps
lead lined container
in case of dislogement
WRapping the inplant in linens and placing it within bihazard bag does not reduce radiation

61
Q

restrints are tied to the

A

bed frame

62
Q

elbow restaints used to temporaily immoblize child (<30 mins)

A

not a restraint

63
Q

misconcccpetion of bed bugs

A

darn to dirty env

64
Q

bed bugs treatment

A

treat the entire house for bed bugs

  • washing a single pillowacse of blanket doesnt stop the infestations
  • get pest control
65
Q

bed bugs signs

A

rash that is itchy

-pets can get it and other hosehold memebers

66
Q

MRSA or drug resistant organisms are bathed in

A

premoistened cloths or warm water containg chlorihexindine

67
Q

app uses of indewlling catherter

A

n. Appropriate use includes urinary obstruction or retention, some perioperative circumstances, required prolonged immobilization, end-of-life comfort, and facilitating healing of an open perineal or sacral wound. Indwelling urinary catheters should not be used for convenience or as a substitute for nursing care

68
Q

needlestick injury

A 
remove gloves
wash hands wihth soap and water
-tell supervisor
-then go to employee health clinic
-ppost exposure prohalysix will be given
69
Q

postexposure prolhaxis for hiv infection most effective when

A

given within 2 hours of exposure incident

70
Q

which pt should get isloation room the most

A

airborne first then dropley

contact are only contagious if tyou touch them

71
Q

ebola precaution

A

standard
contact
droplet
airborne
(, impermeable gown/coveralls, N95 respirator, full face shield, doubled gloves with extended cuffs, single-use boot covers, single-use apro)
-vistors are probhited
-log everyone who enters and exits the room and all logged indv are mointored for symtoms
-procedures and use of sharps and needles are limited whenever possible

72
Q

treatment for ebola

A

no meds or vaccines apporved by FDA

PREVENTION is curcia;

73
Q

PPE removal process

A

strict mointoring byb trained observer
-outer gloves are first cleaned with dsiinfected and removed
the inner gloves are wiped bwtween removal of every subquent piece of PPE (resp and gown) and removed last

74
Q

highest risk for hospital acquired MRSA

A 
older adults
immunsupressed
long HX of abx
invasive tubes or lines (hemodialsys pt)
ICU pt
75
Q

PICC

A

longterm IV

mesd (parental, chemo)

76
Q

PICC line managemnt

A
  • sterile dressing changes every 48 hours with guaze dressing or 7 days with tranparent semiperamible dressing (biopatch) as well as immediately if dressing is loose/torn, soiled, or damp
  • flush line before and after med
  • bp and venipuncutre should not be perfomred on the affected arm as compression of the vein can alter its integrity
  • all infusing meds except vasopressors must be paused before drawing blood form picc line to prevent false intrepertation
  • scrub the hub with etoh or clorhexdine for 10-15 sedconds
77
Q

AMA

A

inform HCP

  • remove IV
  • client cannot be held against his or her will if the client refuses to sign an AMA
78
Q

nosocomial infection occur

A

occur 48 hours after admission

or up to 90 says after

79
Q

noscoomial clients who are at risk

A

young children
elderly
compromised immune systems

80
Q

most common noscomial infection

A

UTI
INFECTION
PNEUMONIA
BLOODSTREAM INF

81
Q

netrophill count

A

2200-7700

82
Q

nursing resp prior to surgery

A

informed consent and place the signed document in the clients chart

  • void before surgeyr
  • NPO
  • witness site marked
83
Q

treating bed bug

A

Laundering clothing in hot water and using the highest temperature setting on a dryer will kill any bed bugs attached to clothes. The clothing should then be stored in tightly sealed plastic bags to prevent additional infestation

84
Q

steps to operate fire extinguisher

A

PASS

dqueeze and sweeep

85
Q

colonized MRSA client

A

contact precaution

private room

86
Q

hep c precaustion

A

CDCCCC

87
Q

restraint care

A 
skin care
ROM
-skin integrity, neuro status
-pad bony prominseces
-determine need for cotined restraint by releasing restraints briefly and assessing clients reaction
88
Q

restrant straps should be attached to areas

A

that move with bed frame (hob)

89
Q

dont tie restaints to

A

base or side rails, the frame should never be used

90
Q

poistioning for restraint

A

never shoud be supine because of apsiration risk

-side lying or semi

91
Q

chemical restraints are

A

meds (benzo or psychotrpics)

92
Q

use of pscychotrops is not considered

A

standard treatment for clients with hx of falls

93
Q

benzo are considered standard treatment to

A

control agitationi in etoh withdrawl

94
Q

anitpsychotics are app for

A

schizo

95
Q

profol is standard treatment

A

to sedate client reciving mech ventaltion

96
Q

preggo women are no to be exposed to

A

TORCH (Toxoplasmosis, Other [VZV/parvovirus B19], Rubella, Cytomegalovirus, Herpes simplex virus

97
Q

airbrone diseases

A

shingles (herpes zoster)

rubeola (measels)

98
Q

isloation for airborn

A

negative pressure with hepa filters
n95

gown is only needed if you suscpt body fluid splash not routine care such as meds or assessments

99
Q

sleep hygiene clients should avoid

A

non sleep elated actv (reading, television, working) other than sex

100
Q

relaxed reading before bed is helpfult o stimulate sleep but

A

should not occur in bed and should be in another setting

101
Q

healthy sleeping habits

A

avoid caff, nictonie, and etoh within 4-6 hours of sleep

  • excercise daily but avoid excercise or strenous actv within 4-6 hours of sleep
  • avoid going to bed hungry or eating heavy meal just before bed
  • practice relaxation tech (deep brethhing) if stress is causing isomnia
  • avoid naps and naps should only be 20-30 mins
  • room should be kept slightly coolm quiet and dark
  • same bedtime and wake up time everyday
102
Q

donning

A

gown
mask
goggles
gloves

103
Q

central venous lumen require

A

anticogulation in heprain flush to maintain patency and prevent clotting when not in use

104
Q

dose for CVC flush

A

. Doses of 2–3 mL containing 10 units/mL–100 units/mL are the standard of care for flushing a CVC.
—doses of Doses of 1000–10,000 units are given for cases of venous thromboembolism; therefore, this prescription is an error and should be clarified by the nurse.

105
Q

what is a high alert med

A

heprain

106
Q

tpn should be adm though

A

CVC bc of its high viscoity and high glucose lips electro minerals
-PICC

107
Q

occuslive dressing should be changed every

A

7 days

108
Q

what port shuld be used for CVP measure

A

distal port of the trupple lumen CVC

109
Q

key feature of petusssis

A

rapid coughing that lead to vomiting

110
Q

impeigo not congeious after

A

24 hours after ABX

111
Q

posion ivy

A

not congeious and canot spread person to person

112
Q

HIV pt

A

stadard precation

  • wear gloves when exposure to blood and body fluids
  • isoltation gown when splashing body fluids
  • googles if spalshing possiblity
113
Q

safety when using crutches

A
  • look forward not at feet when walking to maintain upright poistion
  • use small backpack , fanny pack or shoulder bag to hold personal items
  • wear RUBBER or nonskd soled slipper shoes with leaves
  • rest curtches upside down on axilla crutch bads
  • keep crutch rubber tips dry and replace if worn out

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