nursing practice

Question 1

WSC
What is supposed to be seen in the B chamber? What if it is not seen (possible problems) + next nursing action

Answer 1

Fluctuations when the patient is breathing
1. dislodgment of catheter from pt eg. being pulled out
- (if air leak) sterile dressing taped on 3 sides to let air out
- (if no air leak) place sterile occlusive dressing and monitor signs of respiratory distress

2.disconnection of chest tube from chest tube connector
- use a kelly clamp to prevent air from coming out
- submerge the distal end of the tube in a container of sterile water
- inform HCP

Question 2

WSC
What is supposed to be seen in the C chamber?

Answer 2

Intermittent bubbling for patient with pneumothorax
if no bubble is seen, pleural space has sealed

Question 3

WSC
potential side effects? how does it occur?

Answer 3

subcutaneous emphysema (SCE)
when air is trapped in the subcutaneous tissues in the face, neck or chest
presenting sign: edema and crackling sensation under the skin during palpitations

Question 4

Respi
how does a cpap work?

Answer 4

single set pressure
pressure relief during exhale

Question 5

Respi
how does a bipap work?

Answer 5

two distinct pressures to aid in breathing
depending on the pressure when breathing

Question 6

Respi
patients with COPD

Answer 6

• ABG (every 4 hours)
• nasal canula (between 90-93%)/ venturi mask
• albuterol (bronchodilator) & methylprednisolone (to relieve steroids: inflammation)

Question 7

Respi
When is non-invasive mechanical ventilators used?

Answer 7

-severe dypsnea
- respiratory acidosis (<7.35) or PaCO2 > 45mm Hg

Question 8

diabetes
Lines of treatment for hypoglycemia

Answer 8

1st line: 1/2 sachets of glucose in <100mls water
2nd line: 1/2 sachets of dextrose in <100mls water
3rd line: 100mls IV dextrose 10%, prepare 40mls IV dextrose 50% for doctor
4th line: 100mls IV dextrose 50% bolus stat

Question 9

diabetes
What to look out for in DKA treatment?

Answer 9

sodium, potassium, insulin and sodium carbonate (for pH lvls of the blood)
insulin will cause K to be transported into the cells, instead of staying int he blood which can cause hypokalemia in the patient

Question 10

medsurg
what is the diff between arterial and venous clots?

Answer 10

arterial clots
- stroke
- MI
- gangrene, if extreme, it will be painful and cold

venous clots
- pulmonary embolism (clot in the pulmonary vein)
- DVT

Question 11

medsurg
presenting symptoms of PE & DVT?

Answer 11

PE
- SOB, chest pain, cough, bloody sputum

DVT
- swelling, pain, warmth, blue-purple discolouration

Question 12

blood
what to give in the case of an emergency transfusion?

Answer 12

• Inj Histamine (anti-allergy)
• Inj Steroid (anti-inflammatory)
• Inj Paracetamol (antipyretic) like fever
• Inj Furosemide (Diuretics- prevent cardiac overload)

Question 13

blood
how long does the group and cross match validity last?

Answer 13

72 hours before transfusion

Question 14

blood
what size cannula to be given?