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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
What size suture is used to close the abdomen of fascia?
0 or #2
26
What are the commonly used absorbable sutures?
Monocryl Vicryl Vetacryl
27
What is the commonly used non-absorbable suture?
Prolene *This is a nylon monofilaments that goes by various names*
28
What suturing technique can only be used to close clean surgical incisions?
Running subcuticular
29
What is the Metzenbaum never used for?
Cutting suture
30
What could you use a #20 blade for?
Digital amputation
31
What is the purpose of Poole Abdominal Suction?
Removing large amounts of fluid from the abdominal cavity
32
What is a Rake used for?
Retracting tissues in shallow incisions
33
What is a Goelet Retractor used for?
Skin and subQ retraction
34
What is a Parker Retractor used for?
Retracting tissue is shallow incisions
35
When would you use a Ribbon/Malleable Retractor?
Special circumstances that require a unique shape
36
What is a Deaver Retractor for?
Deep cavity tissue retraction
37
What is a Richardson Retractor for?
Retracting tissue during incision
38
What is a Gelpi Retractor for?
Retracting heavy tissue i.e. muscle
39
What is a Balfour Abdominal Retractor for?
Retracting wound edges and organs during abdominal procedures
40
What is Weitlaner Retractor for?
Retracting tissue in shallow areas
41
What is a Bookwalter Retractor for?
Retracting wound edges and internal organs in abdominal surgery
42
What is a Right Angle for?
Clamping hard to reach vessels
43
What is a Babcock for?
Grasping/holding tissue of the GI tract
44
What is Kocher for?
Grasping heavy tissue such as fascia or muscle
45
What are Sponge Forceps for?
Holding sponges securely
46
What are DeBakey Tissue Forceps for?
Grasping delicate tissue, organs, and vessels
47
What are Ferris Smith Tissue Forceps for?
Fascia closure
48
What Tissue Forceps With Teeth for?
Fascia closure
49
In what area are Russian Tissue Forceps most commonly used?
OB/GYN
50
What is the Kraske position?
This is the "bend over and take it" position *Used for renal and rectal surgery
51
What is a clean wound?
Surgical wound with scrub and no break in technique or complications 1.5-5% infection risk
52
What is a clean/contaminated wound?
Clean wound WITH minor break in technique or entry into non-infected organ system 7% infection risk
53
What is a contaminated wound?
- Traumatic wound - Entry into viscus or gross spillage of colon contents - Major break in surgical technique 10-15% infection risk
54
What is a dirty/infected wound?
Severely contaminated would from trauma or pre-op infection 14-40% infection risk
55
What is healing by primary intention?
Suturing closed immediately
56
What is healing by secondary intention?
Leaving the wound open
57
What is healing by tertiary intention?
Leaving the wound open for a few days and then suturing closed *Generally better result than secondary intention
58
When should sutures and staples generally be removed?
7-10 days post
59
How long does it take for a wound to epithelialize? What are the implications?
~48 hours 1) Dressing removed POD #2 2) Shower on POD #2
60
What are the two amide local anesthetics?
1) Bupivicaine (12-18 hours) | 2) Lidocaine (60-90 min)
61
What are the two ester local anesthetics?
1) Chlorprocaine (60-90 min) | 2) Procaine (60 min)
62
How many mg/mL of anesthetic are in a 0.5, 1.0, and 2.0% solution?
0. 5= 5mg/mL 1. 0= 10 mg/mL 2. 0= 20 mg/mL
63
What is the purpose of adding epi to local anesthetics?
1) Increase duration of action | 2) Decrease systemic toxicity
64
Where should epi NOT be used?
1) Nose 2) Fingers 3) Penis 4) Toes *or any area with end-arteries or poor circulation
65
What immunization do you need to check on for an I and D?
Tetanus
66
How soon after the procedure should the patient come back to the office?
2-3 days for re-eval
67
Write the format for recording blood gases.
pH/PaCo2/PaO2/HCO3/O2 sat/BE
68
What is the order of blood tubes for a venous blood draw?
1) Blood cultures 2) Red--no additives 3) Blue 4) Green 5) Purple 6) Gray 7) Pink
69
What is the use of the red tube?
Chemistry and amylase
70
What is the use of the blue top?
PT, PTT, and INR
71
What is the use of the green top?
Ammonia, CPK isozymes
72
What is the use of the purple top?
CBC, ABO type
73
What is the use of the gray top?
Ethanol
74
What is the use of the pink top?
Cross-match
75
Write the template for a blood count, [PT, PTT, and INR] and BMP (with Ca++).
p. 192
76
Which type of cricothyroidotomy is contraindicated in a pediatric patient?
Surgical
77
What is the desired site for a subclavian central line?
LEFT
78
What is the desired site for an IJ central line?
RIGHT
79
What patients are likely to poorly tolerate the Trendelenburg position needed for central line?
1) CHF | 2) Elevated ICP
80
What is the proper way to wash your hands for a central line?
1) Medical scrub 2) Dry hands 3) Surgical gel
81
S/p tube thoracotomy, what are the indications for thoracotomy?
1) Initial 1,500 mL | 2) 2,000+ mL/hr
82
What is Tube 1 for in LP?
Cell count and diff.
83
What is Tube 2 for in LP?
Gram stain, bacterial, and viral cultures
84
What is Tube 3 for in LP?
Glucose, protein, protein electrophoresis
85
What is Tube 4 for in LP?
Optional/special tests
86
What should you NEVER do in LP?
Aspirate CSF
87
What are the four positions on the FAST exam?
1) Pericardial (Subxiphoid) 2) RUQ (Morrison's pouch) 3) LUQ (Perisplenic) 4) Pelvic (Douglas/ Suprapubic)
88
What is the the mnemonic for writing admit orders?
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
How is Tylenol ordered for a fever?
325mg 1 tab PO q6 hr PRN for fever
90
How is oral Percocet ordered?
5/325 mg 1-2 tabs PO q 6 PRN for pain
91
How is morphine ordered?
2-5 mg IV q2 hr PRN pain
92
How is Dilaudid ordered?
0.5-2mg IV q1 hr PRN pain
93
How is Phenegran ordered?
12.5-25mg IV q6 PRN nausea
94
How is Zofran ordered?
4-8mg IV q6 PRN nausea
95
How is Benadryl ordered?
20-50mg IV or PO q6 PRN itching or insomnia
96
What are the 5W's for a post-op fever?
1) Wind 2) Water 3) Walk 4) Wounds 5) Wonder drugs

2015 DMU BSMS (1 decks)

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