Questions from LABS

Question 1

Basic Life Support (BLS)

What are the criteria and expected time response for: A) Urgent Medical Review. B) MET Call. C) Code Blue.

Question 2

Basic Life Support (BLS)

Explain the steps of the resuscitation process (DRSABCD).

Answer 2

D - Danger
R - Response
S - Send for help
A - Airway
B - Breathing
C - Circulation
D - Disability
E - Exposure

Question 3

Basic Life Support (BLS)

What could be regarded as potential danger in the resuscitation process?

Answer 3

• Broken ribs from chest compressions
• internal organ damage
• pneumothorax
• cardiac tamponade
• brain damage due to lack of oxygen
• Infection
• Psychological trauma

Question 4

Basic Life Support (BLS)

How do you check for patient response?

Answer 4

1. Call out to them
2. gently shake them while talking to them
3. squeeze their shoulder for a pain response

Question 5

Basic Life Support (BLS)

What is the process for opening and maintaining an airway during basic life support?

Answer 5

Tilt their head and lift their chin.

Question 6

Basic Life Support (BLS)

What airway adjuncts may be required?

Answer 6

Oropharyngeal airway (OPA)
- inserted in the mouth

Nasopharyngeal airway (NPA)
- inserted through the nose

Bag valve mask
- delivers positive pressure ventilation

Question 7

Basic Life Support (BLS)

How so you assess for signs of breathing?

Answer 7

Look - is the chest rising and falling
Listen - put your ear near their mouth - can you hear them breathing?
Feel - for movement of air from the mouth and nose

Question 8

Basic Life Support (BLS)

What is the hand position for compressions on an Adult, Child and Neonate?

Answer 8

Adult
- One hand on tope of the other

Child
- One hand

Neonate
- two fingers

Question 9

Basic Life Support (BLS)

What is the rate and depth of cardiac compressions?

Answer 9

Cardiac chest compressions should be 100-120 compressions per minute.
Depth should be 1/3 of the depth of the chest

Question 10

Basic Life Support (BLS)

What is the rate of breathing to cardiac compressions for an adult?

Answer 10

30 compressions to 2 breaths

Question 11

Basic Life Support (BLS)

What are the differences for a child or neonate when performing basic life support? A) Airway? B) Breathing? C) Compressions?

Answer 11

Child
Airway - Open the airway by tilting the head back slightly (sniffing)
Breathing - Pinch the nose closed and blow air into their mouth
Compressions - Use one hand and compress 1/3 depth

Neonate
Airway - Keep head in a neutral position and support the lower jaw
Breathing - place your mouth over both nose and mouth of infant and puff breaths
Compressions - Use two fingers and compress 1/3 depth

Question 12

Basic Life Support (BLS)

When should the automated external defibrillator (AED) be connected to the patients chest during basic life support?

Answer 12

As soon as possible after confirming that the patient is unresponsive and not breathing normally, usually within the first few minutes of starting CPR

Question 13

Basic Life Support (BLS)

What are the precautions when applying AED pads to the patients chest?

Answer 13

• Ensure the chest is bare
• remove clothing or jewellery
• place pads in correct locations
• avoid moisture/water on the patient
• remove excess hair if possible

Question 14

Basic Life Support (BLS)

What are the steps when using an AED?

Answer 14

1. turn AED on and follow instructions
2. remove clothing and anything containing metal near the chest area
3. correctly place defib pads on bare chest
4. AED Analyses heart rhythm
5. Listen to AED instructions
6. If prompted by AED - deliver shock and stay clear of patient
7. After shock delivered, continue CPR until patient responds, breathing returns or paramedics take over
8. follow instructions from the AED incase a second shock is required.

Question 15

Basic Life Support (BLS)

When should the person maintaining the airway and the person doing the chest compressions switch over?

Answer 15

Roles should be switched every two minutes, or sooner if either person becomes fatigued and effective CPR cannot be maintained.

Question 16

Basic Life Support (BLS)

What needs to be documented? Examples include: Time started, ceased, outcome, number of shocks, time insertion of IV cannula, artificial airway, NOK contacted, debriefing to be scheduled, criteria for coroner?

Answer 16

• time started and ended
• Initial patient assessment
• number of chest compressions given
• presence of absence of a pulse
• medications administered
• patients response
• reason for stopping
• people performing CPR
• Defib used - how many times

Question 17

Respiratory Assessment and Patient Care:

Name three types of artificial airways and describe the indications for each

Question 18

Respiratory Assessment and Patient Care:

Describe the differences in the types of tracheostomies available

Question 19

Respiratory Assessment and Patient Care:

Why, how and when would you measure trache

Question 20

Respiratory Assessment and Patient Care:

Describe the various techniques that a nurse may need to communicate with a patient with a tracheostomy

Question 21

Respiratory Assessment and Patient Care:

What monitoring of the stoma and neck should occur during therapy?

Question 22

Respiratory Assessment and Patient Care:

What criteria would determine the need for stoma care?

Question 23

Respiratory Assessment and Patient Care:

List the equipment needed for a tracheostomy dressing

Question 24

Respiratory Assessment and Patient Care:

How would you determine frequency and the solutions to be used in a tracheostomy stoma care?

Question 25

Respiratory Assessment and Patient Care: Why is it important that another nurse assists when a tracheostomy tube or tracheostomy tapes require changing?

Question 26

Respiratory Assessment and Patient Care: How do you ensure that tracheostomy tapes are not too tight or too loose?

Question 27

Respiratory Assessment and Patient Care: What is the difference between humidification and nebulization?

Question 28

Respiratory Assessment and Patient Care: Why is humidification used with an artificial airway?

Question 29

Respiratory Assessment and Patient Care: What observations of the client with a tracheostomy would indicate the need for suctioning?

Question 30

Respiratory Assessment and Patient Care: How should the client be prepared prior to suctioning? Provide rationale

Question 31

Respiratory Assessment and Patient Care: Why might hypoxia occure during or following the suction procedure?

Question 32

Respiratory Assessment and Patient Care: How much of the catheter is inserted into the artificial airway and how is this determined?

Question 33

Respiratory Assessment and Patient Care: Why would you not reinsert a catheter that had first been used for oral pharyngeal suctioning into the tracheal tree?

Question 34

Respiratory Assessment and Patient Care: What data would support that the lower and upper airways were clear of secretions?

Question 35

Respiratory Assessment and Patient Care: What modifications to the suctioning procedure would you make if a cuffed tracheostomy tube was in situ and the cuff was to be deflated?

Question 36

Respiratory Assessment and Patient Care: List the emergency bedside equipment needed for a patient with a tracheostomy

Question 37

Respiratory Assessment and Patient Care: What are the complications that may occur in a patient with a tracheostomy and what are the interventions/managemenmt for them?

Question 38

Respiratory Assessment and Patient Care: What are the indications for commencing nasal humidification for a patient?

Question 39

Respiratory Assessment and Patient Care: What are the contraindications for commencing HFNP?

Question 40

Respiratory Assessment and Patient Care: What are the benefits of nasal humidification delivery systems?

Question 41

Assessment of Advanced Pain Management Modalities Identify the importance of using a structured assessment tool for assessing a patients pain.

Question 42

Assessment of Advanced Pain Management Modalities Identify the various methods of analgesic administration and give examples of their use and/or the type of medications that can be used for pain relief with this modality: - Intravenous - Inhalation - Nerve Blocks - Spinal/Epidural - TENS Machine - Implantable nerve stimulators

Question 43

Assessment of Advanced Pain Management Modalities Why might a patient require an epidural - give an example

Question 44

Assessment of Advanced Pain Management Modalities Where is an epidural placed (use medical terms)

Question 45

Assessment of Advanced Pain Management Modalities What assessments must a nurse perform whilst caring for a patient with an epidural (give rationales)

Question 46

Assessment of Advanced Pain Management Modalities What are the common medications used for epidural analgesia?

Question 47

Assessment of Advanced Pain Management Modalities What is the purpose of a sedation scale? Do all patients require this assessment?

Question 48

Assessment of Advanced Pain Management Modalities If the patient has a high level of sedation which medication would you ask the doctor to prescribe?

Question 49

Assessment of Advanced Pain Management Modalities What other invasive line etc must be in situ in a patient with an epidural infusion?

Question 50

Assessment of Advanced Pain Management Modalities What other item must be inserted if a patient has an epidural? Why?

Question 51

Assessment of Advanced Pain Management Modalities What position should a patient be in with an epidural? Why?

Question 52

Assessment of Advanced Pain Management Modalities What is the lockout period in a PCA? What amount of time is it usually set at?

Question 53

Assessment of Advanced Pain Management Modalities Can a nurse administer PCA medication to a patient?

Question 54

Assessment of Advanced Pain Management Modalities Why is urinary retention an issue with epidurals or PCAs?

Question 55

Assessment of Advanced Pain Management Modalities What determines the frequency of performing PCA assessments? What assessments are made?

Question 56

Assessment of Advanced Pain Management Modalities Would pupils be constricted or dilated if the opioid dose was too high? why?

Question 57

Nutrition assessment and enteral feeds What are the contraindications to insertion of a nasogastric tube?

Question 58

Nutrition assessment and enteral feeds What assessments and documentation must be made after inserting a fine-bore nasogastric tube prior to starting feeding?

Question 59

Nutrition assessment and enteral feeds When would you insert a fine bore nasogastric tube rather than a wide bore one?

Question 60

Nutrition assessment and enteral feeds What patient assessments must be performed each shift (or more frequently) for a patient who is being fed enterally?

Question 61

Nutrition assessment and enteral feeds What position should the patient be in if receiving nasogastric/enteric feeding?

Question 62

Nutrition assessment and enteral feeds What are the complications of feeding via a fine bore nasogastric tube?

Question 63

Nutrition assessment and enteral feeds What are the complications of PEG feeding?

Question 64

Nutrition assessment and enteral feeds What do you do if the PEG tube becomes dislodged?

Question 65

Nutrition assessment and enteral feeds What general assessments must be made on any patient who is enterally fed?

Question 66

Nutrition assessment and enteral feeds Why is blood glucose monitoring necessary for a patient who is receiving TPN? How often?

Question 67

Nutrition assessment and enteral feeds What type of infusion access is preferred for a patient receiving TPN? Why is it a central access?

Question 68

Nutrition assessment and enteral feeds What type of documentation is necessary for a patient receiving either enteral or parenteral feeling?

Question 69

Nutrition assessment and enteral feeds What are some of the possible complications of a patient receiviing TPN?

Question 70

Nutrition assessment and enteral feeds What pathology and radiology tests are ordered for the person with enteral feeds ordered?

Question 71

Nutrition assessment and enteral feeds What are the roles of the ward nurse, doctor or nurse practitioner, pharmacist, dietician in the assessment of nutrition and hydration for the person receiving TPN?

Question 72

Central Venous Access Devices Where are CVCs located?

Question 73

Central Venous Access Devices What are the indications for use of a - CVC - PICC - Portacath - Hickman?

Question 74

Central Venous Access Devices What radiology test confirms the CVAD is correctly located?

Question 75

Central Venous Access Devices What is meant by a closed system?

Question 76

Central Venous Access Devices How long does it take to generate a result from blood cultures?

Question 77

Central Venous Access Devices What is the patient position for removal of a CVC? Why?

Question 78

Central Venous Access Devices Patient and family education must include what key points?

Question 79

Chest drainage systems What are the indications for a chest drainage and underwater seal drainage (UWSD)?

Question 80

Chest drainage systems How does the UWSD system work?

Question 81

Chest drainage systems What are the safety considerations for a patient with an UWSD? Where is the drain positioned, the purpose of Kelly clamps, why the bedside requires 2 wall suction outlets?

Question 82

Chest drainage systems Describe the assessments you would need to undertake of the patient with an UWSD system?

Question 83

Chest drainage systems Describe the respiratory assessment and frequency of assessment required for a patient with a UWSD?

Question 84

Chest drainage systems What documentation is required after assessing a patient with a chest drain and UWSD?

Question 85

Chest drainage systems What are the special precautions required to transport a patient with an UWSD?

Question 86

Chest drainage systems Indications for a chest drainage dressing change?

Question 87

Chest drainage systems What is subcutaneous emphysema? What is the cause and what is the risk if it is present?

Question 88

Chest drainage systems If an ICC is accidentally dislodged, what is the immediate care required?

Question 89

Chest drainage systems Where is the UWSD positioned in relation to the persons chest?

Question 90

Chest drainage systems Why is tension pneumothorax life threatening?

Question 91

Chest drainage systems Describe the 3 basic components of an UWSD?

Question 92

Chest drainage systems What is Tidaling? in what chamber is this expected to be seen?

Question 93

Chest drainage systems What indicates that a leak may be present in the UWSD or chest?

Question 94

Chest drainage systems How far below the patients chest should the chest drain system by positioned?