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Practicum > Practicum > Flashcards

Practicum Flashcards

1
Q

Nasogastic Tube (NG tube)

A

is passed through the nostril down the esophagus and into the stomach. This type of feeding is generally used for short term feeding of 2 weeks at the most.

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2
Q

Gastric Feeding Tube (G-tube)

A

tube inserted through a small incision in the abdomen into the stomach and is used for long-term enteral nutrition. The G-tube is appropriate when difficulty swallowing is due to neurological disorders, and it decreases the risk of aspiration pneumonia

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3
Q

Percutaneous Endoscopic Gastrotomy (PEG tube)

A

type of gastric feeding: the feeding tube is inserted using an endoscope to visualize the stomach. Benefits of a PEG tube vs. a traditional gastronomy include: shorter surgery/recovery, less risky, cost less.

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4
Q

Jejunostomy (J-tube)

A

feeding tube placement in the jejunum (second part of the small intestine); usually chosen if the stomach is unsuitable for surgery/tube-placement

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5
Q

Enteral

A

administration that involves any part of the gastrointestinal tract and has a systemic effect; includes: oral, gastric feeding tubes, nasogastric feeding J-tubes, and rectal feeding

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6
Q

Parenteral

A

route other than the digestive tract; includes intravenous (TPN), intramuscular, subcutaneous, etc.

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7
Q

Total Parenteral Nutrition: TPN

A

used as only source of nutrition, needs a large vein in the neck or chest

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8
Q

Peripheral Parenteral Nutrition PPN

A

partial nutrition used when a person’s digestive system is blocked

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9
Q

Major Complications of ANH

A

Aspiration, hemorrhage, peritonitis and necrotizing fasciitis, 3-4% pts

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10
Q

Minor Complications ANH:

A

infection, stomal leakage, buried bumper, gastric ulcer& fistulous tracts and occur in 7-20% of patients

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11
Q

In re L.W (1992)

A

the Wisconsin Supreme Court noted that ANH was equivalent to a respirator and can be withheld or withdrawn liek any other medical procedure

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12
Q

Barber v. Superior Court (1983)

A

the first reported case in which not only was it held that withdrawal of ANH was allowed, but the court ruling stated explicitly that physicians are not criminally liable for following the wishes of surrogates of incompetent pts to discontinue ANH if the pt is unlikely to recover

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13
Q

Retricular Activating System (RAS)

A

loose network of neurons and fibers in the brainstem which receive input from sensory pathways and project to the entire cerebral cortex. Arousal is dependent on the adequate functioning of the RAS. Because arousal is purely a function of the brain stem, if a patient opens his or her eyes when you call their name it tells you that their RAS is functioning, but not if they are awake or aware

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14
Q

Consciousness

A

a state of general awareness of oneself and the environment. It is hard to measure but is estimated by observing how pts respond to stimuli. Involves Arousal (function of the brain stem) and Awareness (function of the cortex)

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15
Q

Brain death

A

an irreversible loss of cortical and brain stem function

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16
Q

Persistent Vegetative State

A

A coma-like unconcious state that lasts longer than a few weeks and includes the presence of sleep-wake cycles. After four weeks in VS the pt is classified as in persistent vegetative state after 1 year permanent vegetative state

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17
Q

Common causes of Disturbed Consciousness

A

decreased cerebral metabolism, drugs, hypotension, structural lesions

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18
Q

Common Neurological Tests

A

Mental status exam, cranial nerve exam, motor exams, deep tendon reflexes, sensation

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19
Q

Locked In Syndrome

A

a state of muscle paralysis, involving voluntary muscles, while there is preservation of full consciousness and cognition

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20
Q

Drowsy:

A

oriented when awake, but if left alone will sleep

21
Q

Confused

A

disoriented to time, place, person

22
Q

Stuporous

A

generally unresponsive except to vigorous stimulation, opens eyes to deep pain

23
Q

Comatose

A

unarousable & unresponsive, does not open eyes to deep pain

24
Q

Medical Hierarchy

A 
Medical director
Head of department
attending physician
fellow
chief resident
senior resident (3rd ear or above)
junior resident (2nd year)
Intern
Medical student
25
Q

Nursing Hierarchy

A 
Chief nursing executive
director of nursing
nurse manager/supervisor
Advanced nurse practitioner or clinical nurse specialist
charge nurse
staff or bedside nurse (RN)
Licensed Vocational or Practical nurse (LVN LPN)
Unlicensed assitive professional
26
Q

Administrative hierarchy

A 
Board of directors
President/CEO
Chief Medical Staff
Vice Presidents
Department Heads
27
Q

Baby Doe Regulations

A

all disabled infants get ANH and medically indicated treatment unless: infant is chronically and irreversibly comatose, merely prolong dying, virtually futile

28
Q

Sidney Miller Case (1990)

A

The Texas Supreme Court has ruled that doctors do not need to have parental permission before taking emergency measures to save the life of infants with disabilities.

29
Q

Baby Messenger (1994)

A

Michigan case where parents did want want 25 week old baby on LSMT, father pulled plug but was acquitted of manslaughter

30
Q

Common risks premature infants

A

neurological, cardiovascular, respiratory, GI and metabolic issues, anemia, jaundice, infections, vision and hearing problems

31
Q

Surfactant

A

a surface active lipoprotein in lungs that reduces surface tension to lungs can expand

32
Q

ECMO

A

extracorporeal membrane oxygenation

33
Q

Gestational age

A

most commonly used in obstetrics age in weeks since last menstrual period

34
Q

conceputal age

A

age in weeks since conception

35
Q

neonatal incubator

A

used for oxygeneation (head hod, nasal cannula or CPAP) protection from cold, infection, noise and germs; provision of nutrition

36
Q

mechanical ventilation

A

used to assist pts with breathing. ventilator tubing consists of two parts: one part delivers oxygen to the lungs and the other carries away the exhaled gas, including carbon dioxide. Can be invasive or non-invasive

37
Q

endotracheal intubation:

A

endotracheal intubation is necessary when pts can no longer cough and clear secretions or breathe on their own. An endotracheal tube (breathing tube) can be inserted through the mouth or through the nose then advanced into the airway

38
Q

tracheotomy tube

A

a small tube placed directly into a pt’s windpipe through the neck. The surgical procedure of inserting the trach tube is called a tracheotomy

39
Q

bi-level positive airway pressure (BiPAP)

A

form of temporary and noninvasive repiratory support for pts that have difficulty breathing. Each time the pt breathes, the BIPAP machien assists the pt by delivering both inspiratory positive airway pressure and expiratory positive airway pressure. (CPAP requires pt to exhale)

40
Q

Bronchoscopy

A

procedure performed to evaluate the windpipe and respiratory condition. The pt is sedated and the doctor inserts bronchoscope through the mouth or nose and into the trachea and small passageways of the lungs. It diagnoses blockage, infection or injury and sometimes lung secretions or biopsies of the trachea or lung are obtained.

41
Q

Pneumothorax

A

collapsed lung (treated with thoracostomy)

42
Q

hemothorax

A

blood collection in pleural cavity (treated with thoracostomy)

43
Q

pleural effusion

A

fluid colelciton in pleural cavity (treated with thoracentesis or thoracostomy)

44
Q

SOAP note

A

subjective, objective, analysis, plan

45
Q

9 key systems

A 
cardiovascular
central nervous system
endocrine
gastro-intestinal tract
hematolgoy
microbiology
peripheries
renal 
respiratory
46
Q

qualifications for hospice

A

be eligible for Medicare part A
be terminally ill, according to your doctor
sign a statement choosing hospice care instead of other medicare covered benefits
get care from a medicare-approved hospice program

47
Q

Elements of basic life support (or CPR)

A 
assessment
airway maintenance
rescue breathing
chest compression
defibrillation
48
Q

AND

A

allow natural death

49
Q

DNI

A

do not intubate

Practicum (1 decks)

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