Midterm 1 Flashcards
Define low flow system
oxygen rates lower than the individual’s inspiratory demands
Define high flow system
ventilatory demand is met completely by the flow system
Adv of nasal cannula
easily transportable
are oxygen masks for long term or short term therapy
short term
how full does the reservoir bag have to be for nonrebreather masks
full
What 3 things should be assessed with a nasal cannula
Pt’s skin integrity, SpO2 value and pt level of understanding
What device to infants and small children receive their oxygen through
oxygen hoods
What are the two types of incentive spirometry
Flow oriented and volume oriented
Define flow oriented spirometry
chambers with coloured balls that rise and the pt inhales
Define volume oriented spirometry
measures volume that the pt inhales
What two assessments should be done prior to giving pt incentive spirometry
pain and LOC
Special considerations for geriatric and children using incentive spirometry
school aged children plus, gerontological- difficulty coordinating the use of IS and weakened respiratory muscles so takes longer to reach desired volume
How to measure oropharyngeal airway
lips to jawline
What mnfts cause the need for oropharyngeal airway
upper airway gurgling with breathing, absent cough or gag reflex, oral secretion, drooling, and clenched teeth
What things should be considered when choosing an oxygen devices for a pt?
age, developmental level, hospital or home, level of health orientation
Ex of high flow devices
venturi mask, large volume nebulizer, and blender masks,
Ex of low flow devices
nasal cannula, simple face mask, nonrebreather and partial rebreather
Flow rate range for nasal cannula
1-6L/min
Flow rate for oxygen conserving cannula
8L/min
Flow rate for simple face mask:
6-12L/min
Partial nonrebreather flow rate range
10-15L/min
what oxygen device is used for a pt that can’t tolerate a tight fitting mask
face tent
Which incentive spirometry is preferred for geriatrics?
volume IS
When are oropharyngeal devices inserted into a Pt?
when pt is unconscious
What is hypoxemia
decrease in arterial blood oxygen levels
Where is aseptic technique utilized in nursing
operating room, labor and delivery, major Dx areas
Principle 1 of sterile asepsis
- all items in a sterile field must be sterile
Principle 2 of sterile asepsis
- a sterile barrier that has been permeated by tears, punctures or moisture must be considered contaminated
Principle 3 of sterile asepsis
1 inch border around the edges is considered unsterile
Principle 4 of sterile asepsis
Only sterile at table level
Principle 5 of sterile asepsis
in any questions about sterility it is unsterile
Principle 6 of sterile asepsis
sterile items only contact sterile things
Principle 7 of sterile asepsis
movement in a sterile field must not compromise sterility
Principle 8 of sterile asepsis
a sterile object below waist is considered unsterile
Principle 9 of sterile asepsis
a sterile object is contaminated by prolonged exposure
List the sterile equipment in order for putting it on
gown, cap, mask, eyewear, gloves
List the sterile equipment in order for taking it off
gloves, eyewear, gown, mask, cap
What do you need to watch for with sterile gloves?
latex allergy
Do you glove dominant or non dominant hand first
dominant
When collecting a catheter specimen how long do you clamp before collecting
15min
How many mL need to be withdrawn for a culture collection from catheter
3mL
How many mL need to be withdrawn from catheter for routine analysis?
20mL
For a urinalysis, transfer urine from __ container to __ container for culture
clean to sterile
What is a nose and throat specimen collection used for?
Dx when signs and symptoms of an upper respiratory infection
Where do you swab for a throat specimen collection?
tonsil area careful not to touch other parts of the mouth
When collecting a nasal swab, where are you swabbing
inflamed area rotate swab quickly
Define asepsis
process for keeping away disease-producing microorganisms
What is medical asepsis
technique to reduce or prevent the spread of microorganisms
Define surgical asepsis
process to eliminate all microorganisms including spores from an object
What to not do when getting a needle stick injury
squeeze the wound, apply disinfectant
What is SESIP
sharps with engineered sharp injury prevention
what is the most ideal size for needle selection
want smallest gauge and shortest needle possible
What position of limb is most comfortable for injection
flexed
What site is best for IM injection
ventrogluteal
How long to wait before removing IM injection from limb
10 sec
___ injection sites to prevent abscess from forming
rotate
Define a luer-lock syringe
needle twists onto syringe and lock to prevent accidental removal of needle
Define a non-luer lock syringe
needles slip onto the top of the syringe
What size range do syringes come in
0.5mL-60mL
What size syringes are used for SC and IM injections
1-3mL
size of syringe is determined based on
dos of med, viscosity, gender and size of patient
3 parts to a needle
hub, shaft, bevel
What size needle is used for IM
1-1.5 inch
What size needle is used for SC inj
3/8 to 5/8 inch
What needle is used to draw up meds from ampules
filter tip needle
vials can be multi-use but __ pt
single
for dry vial, add __ to the vial
dissolvent
Do you expel air bubbles into ampule
no
where to dispose of extra fluid in syringe?
sink
What to write on label of multi-use vial
date, concentration of med and initials
What is intradermal inj used for
skin testing, potent meds to slow absorption
Risk of injecting a med too fasr
anaphylactic reaction
How much can you inject intradermally
0.01 to 0.1mL
What forms if intradermal inj went into the dermis
bleb
How far do you advance the needle for intradermal inj
3mm
How much med can be inj SC
0.5-1.5mL
How much med can be injected SC in pediatrics
0.5mL
What 4 locations are best for SC
abdomen, upper arms, anterior thigh, butt
What size needle is used for SC inj.
25 gauge, 16 or 12mm
If less than __ inches of skin pinch, inj at 45 degree angle
2
How much med can be injected IM into adult? child? infant?
2-5mL, 1mL, 0.5mL
What method is used for IM injection
Z track method
Why is ventrogluteal the best IM location
away from nerves and blood vessels
What 4 complications are associated with all sites for IM except ventrogluteal
fibrosis, nerve damage, abscess and tissue necrosis
Vastus lateralis is preferred site of what IM injections?
biologics in infants, toddlers and children
How much med can be inj IM in deltoid
2mL or less
When is deltoid used for IM inj
small doses, routine vaccinations toddler plus, when other sites are inaccessible
What are 5 adv to IV and vascular access therapy
parenteral nutrition, transfuse blood, hemodynamic monitoring, Dx testing, admin fluids/meds
What two types of meds are injected SC
one time infusion or IV push administration
What 5 clinical factors are assessed before IV therapy
body weight, vascular volume, interstitial volume, thirst, LOC
What is included when assessing vascular volume?
urine output, vitals, auscultation of lungs and distended neck veins
What makes up interstitial volume
skin turgor, dependent edema, oral mucous membrane
Grade 1 phlebitis symptoms
erythema at access site with or without pain
Grade 2 phlebitis
pain at access site, erythema or edema
Grade 3 phlebitis
pain at access site, erythema, streak forming
