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Procedures Flashcards

0
Q

Regional anesthesia (spinal anesthesia)

A

Adequately hydrate to prevent hypotensive problems

Not NPO

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1
Q

Amniotomy

Artificial rupture of membranes

A

Increase efficiency of contractions

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2
Q

Appendectomy

A

Large amount of serosanguineous drainage so ask if tissue drain placed during surgery.
Complains of pain: after administering analgesic, elevate head of bed 30-45 degrees to reduce stress on suture line and provide comfort

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3
Q

Arteriogram

A

Injecting radiopaque contrast agent directly into vascular system to visualize vessels
Shows location of obstruction and collateral circulation

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4
Q

Biofeedback

A

Useful for reducing stress associated with physiologically based disorders

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5
Q

Prepare for breast feeding

A

Wash breasts with water and rub with a towel every day

The pill suppresses production of breast milk, pick another contraceptive

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6
Q

Bronchoscopy

A

Assess for respiratory distress from swelling due to procedure (tachypnea, tachycardia, respiratory strider and retractions)

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7
Q

Brudzinskis reflex

A 
Gently flex child's head and neck onto chest
Positive response (flexion of hips and knees) indicates meningeal irritation
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8
Q

Bucks traction

A

Patient with fractured femur keeps sliding down in bed: elevate the foot of the bed on blocks bc it will keep leg straight and counter the pull of the weights
Immobility leading cause of problems so turn client every 2 hrs to unaffected side
Head of bed 15-20 degrees
Strict bed rest
No footboard bc it would interfere with traction
No pins
Assess elastic bandages are not too loose or too tight to make sure circulation is not being compromised

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9
Q

Bulge test

A

Lie down and extend your legs

Confirms presence of fluid in knee

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10
Q

Cane

A

Sprained right ankle
Nurse should stand on client’s left side and slightly behind
Use gait belt to assist patient

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11
Q

Cardiac cath

A

Check pedal pulses after procedure every 15 min for 1 hr, then every 30 min for 2 hr, then every 4 hr
NPO after midnight
Bed rest 8 to 12 h after procedure with pressure dressing applied over catheter insertion site
May feel burning sensation when dye injected
May feel fluttery sensation when catheter passed into left ventricle

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12
Q

Cardioversion

A

Elective procedure to treat dysrhythmias; is a synchronized countershock
Conducting agent between skin and paddles
Call “clear” before discharging electrical current
Paddle placed directly on skin
Apply approx 20-25 lb of pressure on each paddle
Record the electrical current delivered and resulting rhythm
Administer versed for procedure

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13
Q

Cataract surgery

A

Immediate post op: position client on back or unaffected side with head slightly elevated to prevent trauma to surgical eye

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14
Q

Chest tube

A

If water-seal chamber doesn’t fluctuate - indicates re-expansion of lung, x-Ray will confirm
Keep water seal chamber with 2 mL of water to maintain negative pressure
Constant bubbling in water seal chamber would indicate air leak
Clamp tube if checking for air leaks or changing equip
Crackling under skin after chest tube removed yesterday describes subcutaneous emphysema which indicates pneumothorax

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15
Q

Cholecystectomy

A

Incision high on abdominal wall

Decreased breath sounds post op might indicate complication of pneumonia

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16
Q

Contractions stress test

A

Negative: normal

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17
Q

CPR

A

Depress sternum 2”
Reposition airway if chest wall fails to rise
4-6 min to respond to prevent permanent brain damage
100 compressions/min

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18
Q

Defibrillator

A

Check it every 8 hrs

Don’t touch bed when using to prevent accidental countershock

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19
Q

Ear irrigation

A

Warm the irrigant; if too cool it can elicit dizziness

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20
Q

ECT

A

General anesthesia-NPO after midnight

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21
Q

Enema

A

Hold irrigation set 12-18 inches above rectum
Insert irrigation tube 3-4 inches into rectum
Patient in sims position, descending colon at lowest point
Warm water to slightly higher than body temp (105)

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22
Q

EPS (electrophysiology studies)

A

Study hearts electrical system
Invasive procedure
Special wire is introduced into heart to produce dysrhythmia
NPO for 6-8 hrs before test
Antidysrhythmics held for at least 24 hrs
Sedation avoided since clients verbal response is extremely important

24
Q

Hemodynamic monitoring

Swan-ganz catheter

A

Indirectly measures the pressure in the ventricles

25
Ileostomy
Laxatives (miralax) contraindicated | Enteric coated contraindicated
26
Intravenous pyelogram (IVP)
Ask client about allergies, iodine | May experience hot feeling and my skin may feel flushed and nausea caused by dye injection
27
Lumbar puncture
Remain flat in bed for 8 hrs after test to prevent post-lumbar headache No general anesthetic Fluids not restricted before test
28
Guthrie blood test
Evaluates neonate for PKU | Give lofenalac formula bc it is low in Phenylalanine
29
NG tube
Check pH Large barreled syringe to aspirate Flush with 30 mL of air before aspirating Tube feeding at room temperature Check tube placement prior to giving medication If stomach contents draining from the air vent, insert 30 ml of air to reset abolish proper suction
30
Incentive spirometer
Quantifiable method of assessing respiratory effort with deep breathing exercises Mouthpiece in mouth, exhale normally, seal lips around mouthpiece, inhale slowly and deeply, keep balls or cylinder elevated 2-3 sec, exhale
31
Position for Liver biopsy
Supine with arms raised above head | On right side with small pillow under puncture site for 3 hrs after procedure
33
Knee gatch post surgery
Knee gatch: don't use bc would compromise circulation and predispose to thrombus formation Two pillows behind knee: don't because it would compress the vessels behind the knee
34
Total laryngectomy
Communicate in writing initially then by artificial larynx or esophageal speech Feeding tube: Requires nutritional support for 10 days until wound heals, then gradually resumes oral intake Will require laryngectomy tube to prevent scar tissue contracture May develop some difficulty with taste and smell after surgery Cough and deep breath after surgery Suction: client to take several deep breaths before suction catheter is inserted Not able to sing, whistle or laugh using laryngeal communication
36
Paracentesis
Client to void before procedure to prevent puncture of bladder NPO not needed Bowel prep not needed
36
Radium implant
Evaluate position of applicator every 8 hrs Strict bed rest High fluid intake Low residual diet to decrease bowel movements (BMs can dislodge it)
37
MRI
nitroglycerine patch to be removed before test
38
Peritoneal dialysis
Cloudy or opaque dialysate output is earliest sign of peritonitis
39
Non-stress test
Reactive: normal
39
Myelogram
Dye injected into subarachnoid space before x-Ray of spinal cord and vertebral column to assist in identifying spinal lesions Drink extra fluids after test to replace CSF lost during test NPO 4-6 hrs Bed rest after for as long as 24 hrs HOB 30 degrees for 24 hrs
41
Pacemaker
Avoid lifting post-op arm above shoulder for 1 wk Takes 2 mo for full range of motion to return Microwaves don't interrupt Avoid heavy lifting until approved by HCP Any time the pulse rate drops below the preset rate on the pacemaker, the pacemaker is malfunctioning; the pulse should be maintained at a minimal rate set on the pacemaker
43
Packed cells
1 Obtain history of transfusion reactions 2 Start IV gauge 19 3 Obtain blood product 4 Begin transfusion
45
Rombergs sign
Have the child stand with his eyes closed, his arms at his sides, and his feet and knees close together. Assesses equilibrium and cerebellar functions
46
Subclavian triple lumen catheter
Supine with the clients head low and turned away from the insertion site. This produces dilation of neck and shoulder vessels, making entry easier and preventing air embolus
47
Systemic desentization
Form of behavior modification for learned disorders | Best for phobic disorders, learned disorder
48
Sengstaken Blakemore tube
If patient in respiratory distress, cut the balloon ports and remove the tube.
49
Fractured right femur Thomas splint and Pearson attachment Weights on floor Feet touching foot of bed
Steady traction and ask child to bend the left leg and push up in bed Don't release weights Don't pull on weights
50
Suppository
Pt to breath through mouth to relax for insertion Inserted 3-4 in into rectum Positioned to touch wall of rectum Lubricant applied to tip of suppository prior to insertion
52
Tracheostomy
Suction 90-120 mm Hg #12 or #14 French catheter Hyper oxygenate If it dislodges, immediately replace to secure airway
52
Thyroidectomy
Monitor for signs of respiratory distress every hour Head of bed elevated Check trousseau's and chvostek's in case parathyroid was damaged
52
Tonsillectomy
Observe for frequent swallowing indicating post op hemorrhage
52
Transcutaneous electrical nerve stimulation (TENS)
Place electrodes over, above or below painful area Apply Conducting gel to electrodes Client turns up voltage until feels prickly pins and needles sensation Client adjusts voltage based on relief of pain experiences
53
Transcutaneous pacing
Non-invasive temporary means of pacing a patient's heart during a medical emergency. It is accomplished by delivering pulses of electric current through the patient's chest, which stimulates the heart to contract. 3 electrodes, 2 pads
54
Wound irrigation
Sterile field that includes the irrigating equip | Wash hands, prepare sterile field and remove soiled dressing
54
Uterine relaxed
Put infant to breast
54
Transition phase of 1st stage of labor
Shallow respirations during contractions (pant breathing)
55
Crutches
Strong leg lead the way going upstairs; when going downstairs, the crutches are advanced to the lower step, the weak leg is advanced, and then the strong leg follows
56
Suctioning
80-120 mm Hg

NCLEX (8 decks)

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