NS1222 Flashcards by Chloe Baxter

Subcutaneous medication administration

Needle size :25/26 g
Needle length:16mm 45 degree angle
9mm-90degrees
Don’t aspirated

Common meds given : vaccines, insulin, clexane

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Intramuscular medication administration

Common meds: analgesia,antemetics, 
Needle size: 25-38mm 90 degrees
Ventro: 3ml
Deltoid:1ml
Vastus:3ml
Aspirate

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Factors to consider when selecting a needle to administer an IM injection of metaclopramode

Persons weight-amount of muscle mass/adipose tissue
Site of injection
Viscosity of the medication

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Glasgow coma scale

Eye response (4)
Verbal response (5)
Motor response (6)

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Alpha cells

Produce the hormone glucagon
Stimulates breakdown of glycogen into glucose
Breaks down fat and protein into the intermediate metabolites that are converted into glucose

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Beta cells

Secrete the hormone insulin in response to a rising level of circulating glucose

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Insulin

Stimulates the skeletal muscles to uptake glucose and convert it to glycogen and uptake amino acids from the blood and convert them to a protein

WATCH VID

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People at risk of type 2 diabetes

People with impaired glucose tolerance (IGT)

People with a history of a cardiovascular event

People aged 35 and over
Indigenous peoples
Hypertension,BMI over 30
Woman with polycystic ovary syndrome who are obese

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Elective surgery

Surgery that is performed to prove life or patient well-being but is not for immediate life threatening conditions

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Emergency surgery

Necessary to prevent death or risk of permanent dysfunction of the body and it’s process

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Cosmetic surgery

To improve function or appearance

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Pre op considerations

Tape rings/remove jewellery
Remove mail polish
Remove make-up
Nil by mouth
TEDS
Vitals are normal
Valid consent

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Post op care

Immediate post op observations
Wound and drains
Pain levels
Fluid status, how much has gone in, how much has gone out

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How to prevent deep vein thrombosis

TEDS
LEG EXERCISES
EARLY MOBILISATION
FLUID INTAKE

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How to prevent atelectasis or respiratory compromise

Deep breathing and coughing
Mobilisation
Positioning

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If the patient become SOB, tachypnoeic and hypoxic what can you do?

Reposition (high-Fowlers)
Encourage deep breathing and coughing
Conduct respiratory assessment
Vitals

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Criteria for discharge from post anaesthetic care (PACU)

Vitals must be stable
Pain score must be minimal
Dressings must be dry and intact
GCS should be 15

Dehiscence

When a wound ruptures along a surgical incision

Evisceration

When surgical excision opens and abdominal organs protrude from the incision

Wound healing

PRIMARY

When the tissue surfaces have been approximated

E.g. A wound closed with sutures

Wound healing

SECONDARY

When wound edges cannot or should not be closed and allowed to heal gradually
E.g. Ulcer

Wound healing

TERTIARY

Initially cleaned and then closed after 4-5 days - considered for highly contaminated wounds

Chain of infection

Infectious agent
Reservoirs 
Portal of exit
Means of transmission 
Portal of entry 
Susceptible host

Wound ooze

SEROUS

Watery clear fluid

E.g. Blister

Wound ooze Haemoserous (sanguinous)

Consists of large amounts of red blood cells and looks like blood mixed with clear fluid

Wound ooze PURULENT

Thicker consistency, varies from yellow, green, brown | Result of tissue debris and bacteria, often unpleasant odour

Discharge planning

Should commence as part of the persons initial assessment (within 24 hours)

Health education

Is about assessing the needs of the person first. It's about what they want and need, not what we think is best

Factors to consider when discharging a person

How they are getting home Are they performing their ADL's independently Is their house appropriate When is their follow up appointment Who is with them at home Do they have discharge medications, do they understand the Meds How they are having their wound dressing done Do they need or want any services to help them at home

Respiratory inspection

``` Tachypnoea Nadal flaring Use of accessory muscles Tracheal deviation SOB Colour ```

Respiratory auscultation

Crackles Wh is as Rhonchi

Respiratory percussion and palpitation

Tympany Tactile Fremitus Respiratory excursion

Nursing interventions for a person with altered respiratory symptoms

``` Reposition Deep breathing and coughing Applying oxygen Vital signs Respiratory assessment ```

How to position someone for a cardiovascular assessment

Supine Upright Lateral Semi-Fowlers

How to ensure patient comfort during a CA

``` Provide a gown so not exposed Ensure curtains are pulled Make sure they don't need the toilet No visitors Ask if they would like someone present Make sure they are pain free ```

Beginning of systole closure of mitral and tricuspid valves

The end of the systole/beginning of diastole; closure of aortic and pulmonic valves

Assessing apical pulse

You palmate the point of maximal impulses and if it is difficult to find, you can ask the person to roll on their left side

When collecting a cardiovascular health history

Family medical history -specifically close fam Are they on any medications for their heart or blood Have they ever experience chest pain What does it feels like, where the pain is, does it move or radiate, 0-10 pain, how long it's lasted, what makes it stop, what brings it on

What values are you listening to during a cardiovascular examination

Aortic 2nd right sterns border pulmonary 2nd left sternal border Tricuspid 4th/5th left sternal border Mitral 5/6th mid clavicular line