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Nursing Level 2 > Nursing techniques Midterm One > Flashcards

Nursing techniques Midterm One Flashcards

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1
Q

What are four situations which IVs may be used?

A

1) Medications to be rapidly infused
2) Repleace fluid loss volume
3) TPN
4) NPO status
5) blood transfusions

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2
Q

What are two disadvantages to IV therapy?

A

direct invasion to the body, difficult to find vein, cannot be reversed if wrong dose given

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3
Q

What are localized complications of IV therapy?

A

Phlebitis, infiltration, infection and cellulitis

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4
Q

How often should IV tubing be changed?

A

q72h

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5
Q

How high should the bag be above the patient’s heart

A

3 feet

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6
Q

What types of catheter are most likely to have air embolism?

A

Central lines

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7
Q

What patients are at risk of fluid fluid overload?

A

ELderly, heart or kidney disease

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8
Q

Why is healing by primary intention preferable to secondary intention?

A

Primary - edges are closed, healing occurs quickly and decreases risk of infection
Secondary - wound remains open until scar tissue forms. Requires longer to heal thus more chance of infection

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9
Q

What are factors which delay wound healing?

A

1) Nutritional deficiencies
2) Inadequate blood supply
3) Corticosteroid drugs
4) Diabetes Mellitus
5) Anemia
6) Friction on wound, poor health

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10
Q

What is well approximated?

A

Incision line is closed with no gaps or leaking fluid.

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11
Q

What are factors which promote wound healing?

A

proper nutrition, proper wound care, moist, warm environment, keeping blood sugars normal, proper Hgb and oxygenation

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12
Q

When does deheiscence occur?

A

POD 4-8

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13
Q

Which side do you stand for dressing changes?

A

Drain side

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14
Q

What is min TKVO rate? Normal?

A

10-15ml/hr - 30-50ml/hr

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15
Q

How long can IV be clamped for?

A

2 mins before vein loses patency

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16
Q

What is the appropriate site for intradermal injections? Sub Q? IM?

A

Intradermal: Forearm, 3-4 fingers below elbow, one handbredth above wrist or upper back

SQ: Vascular areas of upper arm, abdo from costal margins to illiac crest, ant aspect of thighs

IM: Ventrogluteal, vastus lateralis & deltoid

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17
Q

What is the most important precaution when giving injections?

A

DOn’t recap needle

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18
Q

What IM site is no longer recommended?

A

Dorsogluteal - irritation of the sciatica nerve

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19
Q

Why is the Z track method used?

A

To ensure medication remains in deep muscle to prevent irritation

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20
Q

What needle length and gauges are required for intradermal injections, SQ injections and IM injections?

A

ID: 3/8 - 5/8th inch, 25 - 27 gauge
SQ: 1/2 - 5/8th inch, medium gauge
IM: 1 - 11/2 inch, 22-27 gauge

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21
Q

Where should SQ arm injection be given

A

3 inches below shoulder

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22
Q

What injections do you aspirate?

A

IM only

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23
Q

How long are SQ butterflies good for?

A

3-7days

24
Q

What is the max amount of medication that can be injected IM in the deltoid? Gluteal?

A

1 ml

3ml

25
Q

S&S of hypoglycemia?

A

Irritability, slurred speach, tachycardia, diaphoresis, confusion, fatigue, restlessness, tremors, clammy, unsteady gait, mood changes

26
Q

What can cause hypoglycemia in a hospital patient?

A

Missed meals dt tests, too much insulin given, nutritional deficienct dt N&Vm physiological stress rseponse, new medications, over exertion

27
Q

Common S&S of hyperglycemia?

A

Frequent urination, increase thirst and hunger, drowsiness, blurred vision, altered LOC, weakness, smelly urine

28
Q

When should you do BGM?

A

before meals

29
Q

Normal blood sugars?

A

5-9mmol

30
Q

What should be given to a hypoglycemia patient?

A

If just <4, 15g of carbs (juice, jello, apply sauce), cheese, PB

31
Q

What values should the RN double check?

A

20

32
Q

What is a normal blood sugar POD 1?

A

8-13mmol

33
Q

How much air should be put in a NG tube before it is rmeoved?

A

20cc

34
Q

How long do you have before a specimen is sent to the lab?

A

15 mins

35
Q

Reasons for hypotension in post op patient?

A

blood loss from surgery, decreased circulatory volume, SE of anesthetic, dt preop medication

36
Q

Major complicatoins from not ambulating?

A

Paralytic illeus, DVT, pneumonia

37
Q

When should a hemovac be removed?

A

After 1-3 days and the wound is draining <50cc/hr

38
Q

What proportion of fluid is in the intracellular fluid? extracellular fluid?

A

ICF: 2/3 ECF 1/3

39
Q

What is Osmolality?

A

number or osmoles/ L of solute + solvent

40
Q

What is TOnicity?

A

relative osmolality of a solution compared to the body

41
Q

What is osmotic pressure?

A

Force which draws H2O through a semi-permeable membrane

42
Q

What is the third shift?

A

When fluid moves from the intravascular space to a 3rd body (lumen which shouldn’t support circulation

43
Q

What are examples of internal fluid losses?

A

Internal hemmorhage, long bone fractures, spleen ruptures

44
Q

What are examples of external fluid loss?

A

hemorrhage, vomitting, diarrhea

45
Q

Which factors increase fluid needs?

A

restlessness, fever, high ambient temperatures

46
Q

What causeas decreased fluid requirements?

A

hypothermia, increased humidity, increased ICP, decreased LOC

47
Q

What are the osmolalities of hypotonic, isotonic and hypertonic therapies?

A

Hypo: 400

48
Q

What are the different types of fluid therapies

A

Crystalloids, Colloids, lbood components

49
Q

What is normal human osmolality?

A

275-300

50
Q

What are crystalloids?

A

Fluids which can pass through a semi-permeable membrane (vascular, interstitial & intracellular spaces)

51
Q

When are isotonic solutions given? What are examples? What do you need to monitor for?

A

Given to expand extravascular volume (in cases of diarrhea, vomitting, loss of fluid during surgery, waiting for surgery)
ie NaCl .9%, Lactate Ringers
Monitor for fluid overload

52
Q

When are hypotonic solutions given? What are examples? What do you need to monitor for?

A

Used to replace intracellular fluid (in cases of hyponatremia, cellular dehydration.
Can cause vascular depletion and increased ICP. Do not use with stroke, head trauma, severe burns, malnutrition or liver disease patients.
ie .45%NS & 2.5% NS w/wo D5Q

53
Q

When are hypertonic solutions given? What are examples? What do you need to monitor for?

A

Given to increased ECF. Used in acid-base imbalances and electrolyte imbalances
Incrreases risk of fluid overload.
Do not use in diabetic patients, cardiac or renal conditions
ie. D5NS, 3%NaCl, D10W

54
Q

WHat is special about >500 mosm (D10W)

A

Must be admnistered in central line

55
Q

WHat are colloids? Why are they given

A

Hypertonic products which contain undissolved particles - protein, sugar etc. Last longer than hypertonic solutions.
Expand plasma. Used in acute situations such as massive bleeding from trauma, shock or surgery
ie. albumin, dextran

Nursing Level 2 (6 decks)

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