ibis final Flashcards

1
Q

urine specific gravity lab value

A

1.010-1.030

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2
Q

would a patient with fluid volume deficit have a high or low urine specific gravity?`

A

high

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3
Q

safety measures for a patient with increased confusion?

A

place patient in room closest to nursing station

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4
Q

magnesium normal lab values

A

1.3-2.1

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5
Q

sodium normal lab values

A

135-145

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6
Q

potassium normal lab values

A

3.5-5

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7
Q

chrloride normal lab values

A

98-106

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8
Q

BUN normal range

A

10-20

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9
Q

what does a high BUN indicate

A

patient dehydrated

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10
Q

Physiological findings of a pt with N/V/D

A
dehydration
poor skin turgor 
fluid volume deficit
flat neck veins 
tachycardia 
low BP (hypotension)
electrolyte imbalance
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11
Q

fluid volume deficit means?

A

dehydration

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12
Q

Aspiration prevention for patient with NG tube?

A

30-45 degree bed elevation
flush
aspirate for gastric secretions (ph testing)
abdominal x-ray

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13
Q

instructions for flushing meds down NG tube

A

15-30 ml

put meds once at a time

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14
Q

explanation for why patient needs IV access even though they are drinking by mouth

A

for medications

for emergency access

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15
Q

Who do you refer a patient with pain and crepitus out of Temporomandibular joint (TMJ?

A

oral surgeon

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16
Q

signs of TMJ disorder

A

pain
popping
crepitus

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17
Q

who is responsible to obtain patient informed consent?

A

the surgeon (person performing surgery)

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18
Q

What tasks can you delegate to an AP for a post op patient

A

vitals
feeding
ambulation

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19
Q

Can an AP change dressings

A

No

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20
Q

Isolation precautions for airborne

A

N95 mask
TB
measles (rubeola)
varicella zoster

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21
Q

what precautions are there for rubella?

A

droplet

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22
Q

where do you put linen that has been soiled by feces

A

biohazard

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23
Q

proper linen handling

A
dont put on floor 
dont double bag 
wrap inward or use a tie 
dont shake 
dont leave extra linen inside room
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24
Q

what do you put at the foot of isolation patient bed

A

plastic bag

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25
Q

isolation patient will have their own?

A

linen disposal hamper

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26
Q

how to keep a sterile field

A

dont reach over
keep hands over elbows
open outwards
wash hands for 20 secs

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27
Q

Response for when family asks why you dont put restraints on patient who keeps pulling out IV

A

lowest form of restraints have to be used before
wrap IV site with acrylics
place IV in non-reachable area
try to resolve patient confusion if they are confused

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28
Q

what do you do before obtaining wound culture

A

irrigate site

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29
Q

difference between speaking to male patient and female patient

A

male patients are more direct

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30
Q

home safety for fall risk patient

A
bars in shower
non slip bathmat 
no carpet 
no clutter
night light 
non slip rug 
med alert 
shower chair
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31
Q

nursing actions for patient with partial hearing issues

A

make sure hearing aid is working
speak to patient face to face
clean hearing aid w/ non alcohol wipes or damp cloth

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32
Q

what does cold therapy do

A

constricts (less blood circulation)

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33
Q

what does hot therapy do

A

dilates (more blood circulation)

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34
Q

clean under patient nail with

A

orange stick

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35
Q

can a CNA cut a patients nail?

A

no

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36
Q

who cuts diabetic patients nails

A

podiatrist

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37
Q

clear liquid diet includes

A
black coffee
jello 
apple juice 
orange juice 
chicken broth
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38
Q

is sherbert included in a clear liquid diet?

A

no

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39
Q

what kind of liquid is apple sauce

A

full liquid

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40
Q

what do you ask a patient to do if they have adventitious lung sounds (abnormal)

A

cough (could be congestion)

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41
Q

interventions for patient with low o2 saturation

A

raise head of bed (opens up airways)

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42
Q

what is the limit of O2 COPD patient can receive?

A

2 L (they retain CO2)

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43
Q

patient with cardiac issues should be instructed not to do what when defecating

A

straining

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44
Q

what is the issue with a patient straining during defecation

A

can cause cardiac syncope (passing out)

stimulates cranial nerve 10

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45
Q

why dont you let cardiac patients go to the bathroom by themselves

A

morphine they were given for pain can cause constipation which could cause them to strain while defecating

46
Q

what do you give patient with constipation

A

stool softeners

47
Q

use a gait belt if patient is

A

unbalanced

weak

48
Q

what should you assess before ambulating a patient

A

if they can bear weight

49
Q

aspiration precaution for patient at home

A

sit up in chair (fowlers position)

50
Q

what to assess when patient is immobile for long period of time to see if theyre ready to ambulate

A

able to move all extremities

51
Q

what do you remove first

A

gloves (most dirty)

52
Q

first thing you put on

A

gloves

53
Q

next step if patient is still pulling out IV

A

put on mittens

54
Q

restraint process

A

get order within 24 hrs
easy tie knot
dont tie to side rails

55
Q

how often do you assess a restrained patient

A

every 2 hrs

56
Q

what do you assess when assessing restrained patient

A

circulation
ROM (remove restraints & perform ROM exercises)
if they need to use bathroom

57
Q

what is your priority assessment for a patient in vest restraints

A

respiration

58
Q

priority assessment for patient in mittens

A

skin integrity

circulation

59
Q

how do you prevent patients nails from digging into their palms when in mittens

A

place towel or cotton in hands

60
Q

where do you document a telephone order

A

in patients chart

61
Q

what do you do with left over medication

A

throw away

62
Q

how to prevent skin breakdown in immobile patient

A

barrier cream
clean & check often
reposition every 2 hrs

63
Q

best solution to use when inserting IV into patient

A

chlorhexidine

64
Q

phlebitits is

A

blood vessel inflammation

65
Q

signs of phlebitis

A

warmth
burning sensation
redness
tenderness

66
Q

what is infiltration

A

medication leaking into tissue

67
Q

infiltration makes skin

A

cold
swollen
discolored

68
Q

physiological changes in old people

A
lower metabolic rate 
increased pain threshold 
decreased cardiac output 
decreased gastric motility
decreased skin turgor
69
Q

first thing to do when removing NG tube

A

check order

70
Q

recommendation for patient with circulation issues, cold feet and trouble sleeping

A

put on socks

71
Q

is suction input or output

A

output

72
Q

proper way to put anti embolic stockings on

A
no wrinkles (preserve skin integrity)
make sure theyre not too tight
73
Q

where to put padding on restraints

A

over bony prominences

74
Q

patients that are at risk for aspiration

A
NG tube pts
dysphagia pts 
throat cancer pts (head and neck)
stroke pts 
post op pts on general anesthesia
75
Q

low sodium/fat/cholesterol patients cant have

A
packaged food (high sodium)
cheese (high fat and sodium)
red meat
dairy products (cant have low fat milk either)
chicken skin 
animal products (high cholesterol)
76
Q

high calcium food

A

salmon (high in calcium)
milk
oranges
citrus products

77
Q

TUMS are also called

A

calcium carbonate antacid

78
Q

what do calcium carbonate antacids cause

A

constipation

79
Q

antacids

A

milk of magnesia

aluminum hydroxide

80
Q

what does milk of magnesia cause

A

diarrhea

81
Q

what does aluminum hydroxide cause

A

constipation

82
Q

what do you give for constipation

A

fluids and fiber

83
Q

where do you test skin turgor on young patients

A

on hand

84
Q

where do test skin turgor on old patients

A

on collar bone

85
Q

vitamin d production gets triggered by

A

the sun

86
Q

foods high in vitamin c

A

oranges
cabbage
green pepper
strawberries

87
Q

you risk breaching EHR & EMR confidentiality when

A

some else documents for you
you give your password out
leave computer open
going into chart you arent assigned to

88
Q

patient statements are

A

subjective

89
Q

is vomiting subjective or objective

A

objective (you see i.t)

90
Q

is nausea objective or subjective

A

subjective

91
Q

what do you do first after collecting a stool sample

A

send to lab immediately

92
Q

patient needs to be catheterized if

A
incontinent 
immobile 
going to surgery 
urinary retention
open perineal wound 
residual urine (unable to empty bladder even after urinating)
93
Q

wipe from front to back to prevent

A

ecoli contamination

94
Q

first step if patient hasnt urinated after catheter is removed

A

assess with bladder scan

95
Q

normal gastric secretion ph

A

1-3

96
Q

can you use gastric tube if ph is near range (ex. ph of 4)

A

yes

97
Q

proper action for patient with cleansing enema

A

sims position
bag 12-18 in (30-45 cm)
hold solution to help gravity flow
insert 2 in to anus (lubricate tip)

98
Q

orthodox jewish patient diet

A

kosher
meat and dairy eaten hrs from each other
no pork

99
Q

islamic patient diet

A

no pork

100
Q

what kind of liquid is grape juice

A

clear liquid

101
Q

sublingal medication for patient that has NG tube what do you do?

A

place under patients tongue (always give med how i.ts supposed to be given)

102
Q

education for patient who has difficulty swallowing or stroke

A

soft foods
nectar liquids
sit up to eat and lean forward

103
Q

pulses locations

A
  1. temporal
  2. carotid
  3. brachial
  4. radial
  5. apical/pmi/mitral
  6. femoral
  7. popliteal
  8. dorsalis pedis
  9. posterior tibial
104
Q

what to do if patient has irregular heart beat

A

assess for full minute

105
Q

why dont you assess both carotid pulses at same time

A

could drop BP

106
Q

steps if patient has infiltration

A
assess
stop infusion
remove IV 
put sterile dressing 
elevate extremity (fluid gets reabsorbed)
apply warm (if fresh)
apply cold (after 24 hrs)
107
Q

during BP reading patients arm should be

A

at level of heart

108
Q

instructions for patient getting BP reading

A

no talking
keep legs uncrossed
keep feet flat
sit upright

109
Q

what gender is more likely to have scoliosis

A

female

110
Q

should incident reports be put in patients chart?

A

no

111
Q

fall risk patient care plan should include

A

in reach call bell
lowered bed position
fall mats

112
Q

what to do if ambulating patient and they begin to fall

A

help patient slide down or help fall against wall with gait belt