Part 3 Flashcards
How do you mix insulins in the same syringe
-CLEAR TO CLOUDY
- REGULAR TO NPH RNs draw up RN
-inject air into N first, then R and then draw up R then draw up N
NRRN
IM needle
-I looks like 1 pick answer w 1 in it for both gauge and length (ex 21 gauge)
SQ Lenght and gauge
S looks like 5
-pick 5 for both parts ( 25 and 5/8 of an inch)
Heparin
-Iv or subcutaneous
-Works immediately
-Cannot be given for longer than three weeks except for Lovenox
-antidote Protamin Sulfate (heParin)
-lab PTT
-CAN be used in pregnancy (class C)
Only tranquilizer that can be given to pregnant women
Haldol
Coumadin (warfarin)
-takes days to weeks to work
-can be on for life
-PO only
- antidote vitamin K Coumadin
-lab INR,PT
-CANT USE IN PREGNANCY
-class X (pregnancy)
Potassium wasting diuretics
-IF IT ENDS IN X IT Xs OUT K+ (plus diuril)
-otherwise it spares K+
Baclofen
-muscle relaxant
2 side effects= fatigue/drowsiness & muscle weakness
-pt teaching dont drink, drive, or operate heavy machinery
-if you’re on baclofen you’re on your back loafin
Flexeril
-muscle relaxant (FLEX)
Piagets 0-2
SENSORY MOTOR
-present oriented (only think abt now, teach while doing it, present tense)
-
Piagets 3-6 years
PRE OPERATIONAL (PREschool)
-fantasy (magical thinking, imaginative)
-can’t reason w a preschooler
-can teach before (morning of, 2 hours before
-teach what you are going to do
-learn through play
Piagets 7-11 years
-CONCRETE OPERATIONAL
-concreted 7 elevens
-rule orientated
-can’t think abstractly yet, rigid
- teach days ahead
-teach what you will do plus skills
-must be 7 to learn a skill
Piagets 12-15 years
-FORMAL OPERATIONAL (older so closer to going to a formal or dance)
-can think abstract, cause and effect
-education once a child turns 12 is the same as adults (can manage their own care) not severity of illness but rather age of child
How many hours is fresh postop?
-12 hours
-Highly prioritized
High priority temp
Above 105
Black tag in an unwitnessed event
-breathlessness
- Pulselessness
-fixed and dilated pupils
Tie breaker for priority
-the more vital the organ
-1st brain
-2nd lung
-3rd heart
-4th liver
-kidney
-pancreas
CANT DELEGATE TO LPN
-starting an IV
-hanging or mixing IV meds
- pushing IV push meds
- administer blood or mess with central lines (flushing or change dressing)
-plan care
-preform or develop teaching (but can reinforce what RN has taught)
- unstable pts
-to do the first of anything
LPNS CANNOT DO THE FOLLOWING ASSESSMENTS
-admission
-discharge
-transfer
- or first assessment after a change
What is pulmonary capillary wedge pressure
-it is an estimate of the left ventricular end diastolic pressure or preload of the heart
-PCWP higher then 18 mmHg suggests heart failure
Filgrastim
-drug used to treat neutropenia, nurse should monitor white blood cells after administration
What can’t be delegated to an UAP
-cannot document about pt, CAN document what they did
-can only administered OTC topical barrier creams
-can do vital signs and acu checks (neuro checks)
-no treatments besides enemas
- can do ADLS but never the first of anything
Location for auscultations heart valves
Order APETM
A- aortic 2nd intercostal at right sternal border
Pulmonic is the second intercostal space left border
Tri cuspid is fourth intercostal left sternal border
Mytrial is fifth intercostal space at mid curricular line ( where are the apical pulse is)
If a drug is PO and you have no idea what it is pick
-GI side effect
How to answer pediatric questions that you do not know
-Give me the child more time to grow and develop
-1. When in doubt, call it normal
-2. When in doubt pick the older age
3.when in doubt pick the easier task
