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2015 DMU BSMS > LAB #1 > Flashcards

LAB #1 Flashcards

1
Q

How often does a butterfly needle need to be changed?

A

q24 hrs

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2
Q

How often does an over the needle IV catheter need to be changed?

A

q72 hrs

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3
Q

What does the IV needle/catheter gauge refer to?

A

Diameter of the cannula

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4
Q

What does the IV bore size refer to?

A

Diameter of the needle

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5
Q

What is the most common complication of an IV catheter?

A

Thrombophlebitis

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6
Q

Outline the contents of NS (0.9%).

A 
Na+= 154 mEq 
Cl-= 154 mEq

pH= 4-5

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7
Q

Outline the contents of LR.

A 
Na+= 130 mEq 
Cl-= 110 mEq
K+= 4 mEq 
Lactate= 28 mEq 
Ca++= 3 mEq

pH= 6.57-7.0

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8
Q

What is the only IV solution to contain K+?

A

LR

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9
Q

Outline the contents of D5 1/2 NS.

A 
Na+= 77 mEq 
Cl-= 77 mEq 
Glucose= 50 gm

pH=4

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10
Q

What is the daily K+ requirement?

A

40-100 mEq

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11
Q

How much K+ should you add to D5 1/2 NS for a maintenance infusion?

A

20 mEq/L

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12
Q

What is the normal UOP for an adult?

A

1/2 mL/kg/hr

Therefore, a 70kg adult should output ~35 mL per hour

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13
Q

What is the formula to calculate maintenance IV fluids?

A
  • 100 mL/kg for the first 10kg
  • 50 mL/kg for the 2nd 10kg
  • 20mL/kg for the rest of the bodyweight

Thus, a 70kg adult would require 2,500 mL/24 hours

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14
Q

How much K+ should be added to the normal adult maintenance fluids?

A
  • 2.5L per 24 hours
  • 20 mEq/L

Therefore, 50 mEq of K+

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15
Q

What are the two types of NG tubes? Which is used for suction and which is not?

A

Levin and Salem

*Remember, Salem Sucks

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16
Q

What are two indications for a urine catheter?

A

1) Acute retention

2) Irrigation of blood clots

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17
Q

What are the contraindications for a urine catheter?

A

1) Acute prostatitis
2) Trauma
3) Severe urethral stricture

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18
Q

What size urinary catheter is used for adults?

A

16 French

Note that kids get 5-12 French

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19
Q

How far do you insert a urinary catheter in a male?

A

To the flanged area

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20
Q

How far you insert a urinary catheter in a female?

A

Till urine return +1-2 inches

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21
Q

When do you inflate the balloon when inserting a Foley catheter?

A

AFTER urine return

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22
Q

How often should urinary catheters be replaced?

A

q72 hrs

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23
Q

What size suture is commonly used for general skin closure?

A

3-0, 4-0, and 5-0

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24
Q

What size suture is commonly used for skin closure on the face?

A

5-0 or 6-0

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25
Q

What size suture is used to close the abdomen of fascia?

A

0 or #2

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26
Q

What are the commonly used absorbable sutures?

A

Monocryl
Vicryl
Vetacryl

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27
Q

What is the commonly used non-absorbable suture?

A

Prolene

This is a nylon monofilaments that goes by various names

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28
Q

What suturing technique can only be used to close clean surgical incisions?

A

Running subcuticular

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29
Q

What is the Metzenbaum never used for?

A

Cutting suture

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30
Q

What could you use a #20 blade for?

A

Digital amputation

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31
Q

What is the purpose of Poole Abdominal Suction?

A

Removing large amounts of fluid from the abdominal cavity

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32
Q

What is a Rake used for?

A

Retracting tissues in shallow incisions

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33
Q

What is a Goelet Retractor used for?

A

Skin and subQ retraction

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34
Q

What is a Parker Retractor used for?

A

Retracting tissue is shallow incisions

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35
Q

When would you use a Ribbon/Malleable Retractor?

A

Special circumstances that require a unique shape

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36
Q

What is a Deaver Retractor for?

A

Deep cavity tissue retraction

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37
Q

What is a Richardson Retractor for?

A

Retracting tissue during incision

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38
Q

What is a Gelpi Retractor for?

A

Retracting heavy tissue i.e. muscle

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39
Q

What is a Balfour Abdominal Retractor for?

A

Retracting wound edges and organs during abdominal procedures

40
Q

What is Weitlaner Retractor for?

A

Retracting tissue in shallow areas

41
Q

What is a Bookwalter Retractor for?

A

Retracting wound edges and internal organs in abdominal surgery

42
Q

What is a Right Angle for?

A

Clamping hard to reach vessels

43
Q

What is a Babcock for?

A

Grasping/holding tissue of the GI tract

44
Q

What is Kocher for?

A

Grasping heavy tissue such as fascia or muscle

45
Q

What are Sponge Forceps for?

A

Holding sponges securely

46
Q

What are DeBakey Tissue Forceps for?

A

Grasping delicate tissue, organs, and vessels

47
Q

What are Ferris Smith Tissue Forceps for?

A

Fascia closure

48
Q

What Tissue Forceps With Teeth for?

A

Fascia closure

49
Q

In what area are Russian Tissue Forceps most commonly used?

A

OB/GYN

50
Q

What is the Kraske position?

A

This is the “bend over and take it” position

*Used for renal and rectal surgery

51
Q

What is a clean wound?

A

Surgical wound with scrub and no break in technique or complications

1.5-5% infection risk

52
Q

What is a clean/contaminated wound?

A

Clean wound WITH minor break in technique or entry into non-infected organ system

7% infection risk

53
Q

What is a contaminated wound?

A
  • Traumatic wound
  • Entry into viscus or gross spillage of colon contents
  • Major break in surgical technique

10-15% infection risk

54
Q

What is a dirty/infected wound?

A

Severely contaminated would from trauma or pre-op infection

14-40% infection risk

55
Q

What is healing by primary intention?

A

Suturing closed immediately

56
Q

What is healing by secondary intention?

A

Leaving the wound open

57
Q

What is healing by tertiary intention?

A

Leaving the wound open for a few days and then suturing closed

*Generally better result than secondary intention

58
Q

When should sutures and staples generally be removed?

A

7-10 days post

59
Q

How long does it take for a wound to epithelialize? What are the implications?

A

~48 hours

1) Dressing removed POD #2
2) Shower on POD #2

60
Q

What are the two amide local anesthetics?

A

1) Bupivicaine (12-18 hours)

2) Lidocaine (60-90 min)

61
Q

What are the two ester local anesthetics?

A

1) Chlorprocaine (60-90 min)

2) Procaine (60 min)

62
Q

How many mg/mL of anesthetic are in a 0.5, 1.0, and 2.0% solution?

A
  1. 5= 5mg/mL
  2. 0= 10 mg/mL
  3. 0= 20 mg/mL
63
Q

What is the purpose of adding epi to local anesthetics?

A

1) Increase duration of action

2) Decrease systemic toxicity

64
Q

Where should epi NOT be used?

A

1) Nose
2) Fingers
3) Penis
4) Toes

*or any area with end-arteries or poor circulation

65
Q

What immunization do you need to check on for an I and D?

A

Tetanus

66
Q

How soon after the procedure should the patient come back to the office?

A

2-3 days for re-eval

67
Q

Write the format for recording blood gases.

A

pH/PaCo2/PaO2/HCO3/O2 sat/BE

68
Q

What is the order of blood tubes for a venous blood draw?

A

1) Blood cultures
2) Red–no additives
3) Blue
4) Green
5) Purple
6) Gray
7) Pink

69
Q

What is the use of the red tube?

A

Chemistry and amylase

70
Q

What is the use of the blue top?

A

PT, PTT, and INR

71
Q

What is the use of the green top?

A

Ammonia, CPK isozymes

72
Q

What is the use of the purple top?

A

CBC, ABO type

73
Q

What is the use of the gray top?

A

Ethanol

74
Q

What is the use of the pink top?

A

Cross-match

75
Q

Write the template for a blood count, [PT, PTT, and INR] and BMP (with Ca++).

A

p. 192

76
Q

Which type of cricothyroidotomy is contraindicated in a pediatric patient?

A

Surgical

77
Q

What is the desired site for a subclavian central line?

A

LEFT

78
Q

What is the desired site for an IJ central line?

A

RIGHT

79
Q

What patients are likely to poorly tolerate the Trendelenburg position needed for central line?

A

1) CHF

2) Elevated ICP

80
Q

What is the proper way to wash your hands for a central line?

A

1) Medical scrub
2) Dry hands
3) Surgical gel

81
Q

S/p tube thoracotomy, what are the indications for thoracotomy?

A

1) Initial 1,500 mL

2) 2,000+ mL/hr

82
Q

What is Tube 1 for in LP?

A

Cell count and diff.

83
Q

What is Tube 2 for in LP?

A

Gram stain, bacterial, and viral cultures

84
Q

What is Tube 3 for in LP?

A

Glucose, protein, protein electrophoresis

85
Q

What is Tube 4 for in LP?

A

Optional/special tests

86
Q

What should you NEVER do in LP?

A

Aspirate CSF

87
Q

What are the four positions on the FAST exam?

A

1) Pericardial (Subxiphoid)
2) RUQ (Morrison’s pouch)
3) LUQ (Perisplenic)
4) Pelvic (Douglas/ Suprapubic)

88
Q

What is the the mnemonic for writing admit orders?

A

ADC VAAN DIMLE

A= admit 
D= diagnosis 
C= condition 
V= vitals 
A= allergy 
A= activity 
N= nursing 
D= diet 
I= IV 
M= meds 
L= labs 
E= extra
89
Q

How is Tylenol ordered for a fever?

A

325mg 1 tab PO q6 hr PRN for fever

90
Q

How is oral Percocet ordered?

A

5/325 mg 1-2 tabs PO q 6 PRN for pain

91
Q

How is morphine ordered?

A

2-5 mg IV q2 hr PRN pain

92
Q

How is Dilaudid ordered?

A

0.5-2mg IV q1 hr PRN pain

93
Q

How is Phenegran ordered?

A

12.5-25mg IV q6 PRN nausea

94
Q

How is Zofran ordered?

A

4-8mg IV q6 PRN nausea

95
Q

How is Benadryl ordered?

A

20-50mg IV or PO q6 PRN itching or insomnia

96
Q

What are the 5W’s for a post-op fever?

A

1) Wind
2) Water
3) Walk
4) Wounds
5) Wonder drugs

2015 DMU BSMS (1 decks)

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