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LPN week 1 > PPO lab 1 > Flashcards

PPO lab 1 Flashcards

1
Q

when to wash hands

A

before & after patient contact
before clean or aseptic procedures
after actual or presumed contact with body fluids
after touching patient surroundings
when moving hand from contaminated body site to clean site
after glove removal

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2
Q

hands that are not visibly dirty should be ____ because_____

A

cleaned with alcohol based hand rub
takes less time, is more effective, less irritating to the hands

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3
Q

soap and water should be used when ___

A

hands are visibly dirty, before eating, after using restroom and after known exposure to bacteria

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4
Q

handwashing equipment

A

easy to reach sink, with warm running water
antimicrobial or regular soap
paper towel
disposable nail cleaner (optional)

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5
Q

what is antiseptic hand rub ?

A

alcohol based waterless antiseptic

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6
Q

natural tips of nails should be no longer than ?

A

0.625 cm

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7
Q

hand washing steps

A

apply waterless antiseptic to hands
rub hands thoroughly
turn on water
lather hands thoroughly (15 sec) (5 times circular motion)
wash fingernails
rinse hands and wrists thoroughly keeping hands down and elbows up
dry hands from fingers to wrists with paper towel

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8
Q

Personal protective equipment (PPE)

A

gloves, gowns, caps, masks, eyewear

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9
Q

vital signs include ..?

A

temperature, pulse, respirations, & blood pressure
+ pain assessment

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10
Q

what do vital signs indicate ?

A

ability of the body to regulate body temperature, oxygenate body tissues, maintain blood flow

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11
Q

temperature acceptable ranges

A

36-38 c (96.8- 100.4 F)

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12
Q

acceptable temp. ranges for
*oral/ tympanic
*rectal
*axillary

A

*37.0 c (98.6 F)
*37.5 c (99.5 F)
*36.5 c (97.7 F)

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13
Q

Pulse normal range (adult)

A

60-100 beats/min
*strong & regular

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14
Q

normal respirations (adult)

A

12-20 breaths/min
*deep & regular

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15
Q

normal range for blood pressure

A

systolic < 120 mm Hg
diastolic <80 mm Hg

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16
Q

normal range for pulse pressure

A

30-50 mm Hg

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17
Q

pulse oximetry normal range

A

SpO2: 95%- 100%

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18
Q

the change from lying to standing causes a ______ in ____ blood pressure of <15 mm Hg

A

decrease, systolic

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19
Q

electronic thermometer

A

separate probes available for oral, axillary (blue tip) and rectal (red tip)

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20
Q

tympanic thermometer

A

otoscope like speculum with infrared sensor tip that detects heat radiated from tympanic membrane of the ear

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21
Q

temporal artery thermometer

A

sweep across forehead and just behind ear

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22
Q

chemical dot single-use or reusable thermometers

A

thermometer consists of thin strip of plastic with a temperature sensor at one end that contains impregnated dots formulated to change color to reflect temperature reading

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23
Q

what factors can affect temperature

A

hormones (women are more prone to temp changes due to menstrual cycle/menopause & have a thicker layer of fat)

stress

environmental temperature (infants & older adults are more prone)

medications (drugs can impair or promote sweating, vasoconstriction, vasodilation or interfere with hypothalamus ability to regulate temp)

daily fluctuations (body temp changes from 0.9 to 1.8 F in 24 hr period, morning is lowest , 5-7pm is max then gradually falls back down )

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24
Q

diaphragm of stethoscope

A

placed firmly and securely to hear high pitched lung and bowel sounds

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25
Q

the bell of stethoscope

A

placed lightly on the skin to hear low pitched vascular and heart sounds

26
Q

factors that influence heart rate

A

age (birth 100-160 b/m, 2Y 70-120 b/m, 60-90 b/m adolescence +)
exercise

position changes (lying to sitting or standing can increase HR)

medications (varies from medication can either increase or decrease HR)

temperature (fever increases HR, hypothermia reduces HR)

sympathetic stimulation (emotional stress, anxiety, fear stimulates sympathetic nervous system and increase HR)

27
Q

bradycardia

A

pulse rate is less than 60 beats/min

28
Q

tachycardia

A

pulse rate is greater than 100 beats/min

29
Q

where do you get a pulse in adults ? in children ?

A

radial pulse in adults
brachial pulse in infants

30
Q

risk factors that can alternate pulse

A

history of heart disease
cardiac dysrhythmia
onset of sudden chest pain
invasive cardiovascular diagnostic tests
surgery
large volume of IV fluid
internal or external hemorrhage
administration of medications that alter cardiac function

31
Q

if patient has been active wait __ to __ minutes before assessing pulse

A

5 to 10 minutes

32
Q

if patient has been smoking or ingesting caffeine wait __ minutes before assessing pulse

A

15 minutes

33
Q

if pulse is regular count rate for __ seconds and ___ by __

A

30 seconds, multiply by 2

34
Q

inspiration

A

diaphragm contracts, abdominal organs move downwards, chest cavity expands

35
Q

expiration

A

diaphragm relaxes upward, ribs and sternum return to the relaxed position

36
Q

factors that influence respirations

A

fever (increases oxygen demand, respiration increases in rate & depth)

exercise (increase in rate & depth due to additional oxygen and rid of carbon dioxide)

anxiety (due to sympathetic nervous system stimulation)

disease/ trauma chest wall or muscles (can affect expiration and/or inspiration)

constrictive chest, presence of chest tube, abdominal incisions/ dressing (can make it harder to breathe comfortably )

acute pain (pain increases oxygen demand & alters rate and rhythm)

smoking (increased respiratory rate at rest due to change in pulmonary airways)

medications ( medicines can either decrease or increase rate & depth)

body position (slumped or laying positions impairs or prevents full chest expansion)

neurological injury ( damage to brainstem impairs respiratory center & inhibits rate & rhythm)

anemia, decreased hemoglobin (lower amount of oxygen carried in blood, which increases rate & depth)

37
Q

symptoms of respiratory alterations

A

blue or cyanotic nail beds, lips, mucous membranes, & skin
restlessness, irritability, confusion, reduced level of consciousness
pain during inspiration
labored or difficult breathing
orthopnea
use of accessory muscles
abnormal breath sounds (wheezing etc.)
copious sputum (thick mucus that’s coughed up)

38
Q

orthopnea

A

difficulty breathing when lying down

39
Q

arterial blood gases (ABGs) normal ranges

A

pH, 7.35- 7.45 (blood pH)
PaCO2, 35-45 mm Hg (blood level of carbon dioxide)
HCO3 22-28 mEq/L (bicarbonate)
PaO2 80-100 mm Hg (blood level of oxygen)
SaO2 95% - 100% (oxygen saturation)

40
Q

complete blood count (CBC) normal ranges

A

hemoglobin males 14-18 g/100mL
hemoglobin females 12-16 g/100mL
hematocrit males 42%- 52%
hematocrit females 37%-47%
RBC males 4.7-6.1 million/mm3
RBC female 4.2-5.4 million/mm3

41
Q

bradypnea

A

respiratory rate is below 12 breaths/min

42
Q

tachypnea

A

respiratory rate is above 20 breaths/min

43
Q

korotkoff phases

A

phase 1 - a sharp thump
phase 2 - a blowing or whooshing sound
phase 3 - crisp intense tapping
phase 4 - a softer blowing sound that fades
phase 5 - silence

44
Q

risk factors for blood pressure alterations

A

history of cardiovascular disease
renal disease
diabetes mellitus
circulatory shock
acute or chronic pain
rapid IV infusion or blood products
increased intracranial pressure
postoperative status
toxemia of pregnancy

45
Q

symptoms of BP alterations

A

headaches (usually occipital)
flushing of face, nosebleed, fatigue ( usually older adults)
hypotension ( dizziness, mental confusion, restlessness, pale & cool skin

46
Q

factors that influence BP

A

age (older patients BP increases due to presence of provider)

gender (during or after menopause BP is higher than age group)

daily *diurnal variation ( highest during the day 10am - 6pm, lowest early in the morning )

position (BP falls when person moves from lying to sitting or standing position)

exercise (increase in O2 increases BP)

weight (predictor of hypertension (high BP)

sympathetic stimulation (pain, anxiety, fear increase BP)

medications ( can lower BP)

smoking (rise BP)

ethnicity (higher BP in african american at young age, more severe, twice the risk, high related deaths)

temperature (cold exposure increase systolic BP)

47
Q

if the upper extremities are not available you can use the lower extremities for blood pressure.
True or false?

A

true

48
Q

proper cuff size for electronic monitor :
small adult, adult, large adult, thigh

A

small adult : 17-25cm
adult: 23-33 cm
large adult: 31-40 cm
thigh 38-50 cm

49
Q

indication of diastolic pressure in adults vs children

A

beginning of fifth sound in adults
distinct muffling sounds in children

50
Q

signs and symptoms of alterations in oxygen saturation

A

altered respiratory rate, depth rhythm
adventitious breath sounds
cyanotic, nails, lips, mucous membrane, skin,
restlessness
difficulty breathing

51
Q

factors that influence the measurement of oxygen saturation

A

oxygen therapy
respiratory therapy (postural drainage & percussion)
hemoglobin level
hypotension
temperature
nail polish (black or brown)
medications (ex: bronchodilators)

52
Q

average respiratory rate for newborns, toddlers (2y) and children

A

newborn: 30 to 60 breaths/min
toddlers: 24- 40 breaths/min
children: 18-30 breaths/min

53
Q

assess respiratory rate before other vital signs and temperature last for children
true or false

A

true

54
Q

equipment for blood glucose

A

antiseptic swab
cotton ball
lancet device (self activating or button activating)
blood glucose meter
blood glucose test strips
clean gloves
paper towel

55
Q

steps for using glucose meter

A

load test strip into meter
prick side of finger with lancet
gently squeeze puncture site until drop of blood forms
touch test strip to blood drop
results appear on meter screen

56
Q

Pasero opioid sedation scale (POSS)

A

S : sleep, easy to arouse
1: awake & alert
2: slightly drowsy, easily aroused
3: frequently drowsy, arousable, drifts off to sleep during convo
4: somnolent, minimal or no response to physical touch

57
Q

PQRSTU

A

Provocative/palliative factors : “what makes pain better or worse” (identifies nature and source of pain & what patient uses to reduce pain)

Quality: “tell me what your pain feels like” (helps determine underlying pain mechanism)

Region/radiation “show me everywhere your pain is” identifies location of pain

Severity “on a scale of 1 to 10 how much does it hurt” (may be determined by a numerical scale, categorical scale or pictorial scale)

Timing “how long, how often, is it constant, does it increase or decrease ?” (may reveal source of pain and if its chronic or acute)

U “how is pain affecting you and your day to day activities, relationships, enjoyment of life? (provides baseline info to see how interventions make an effect)

58
Q

splinting decreases movement and subsequent pain during activity true or false

A

true

59
Q

relaxation and the power of the mind

A

progressive muscle relaxation
breathing exercises
music relaxation
visual imagery
yoga

60
Q

put your body to work

A

exercise
pacing
conserving energy
body mechanics

61
Q

spirituality and reflection

A

engaging in religious practices
humor
setting aside time to focus on what is
talk about your stress with others
journaling
praying

62
Q

what to do when pain flares

A

cold & hot therapies
hand & foot massage
herbals

LPN week 1 (5 decks)

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