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Quiz 1 Flashcards

1
Q

What is done during the preoperative assessment?

A

medical hx
food/drug allergies
asses pt emotional state/readiness for sx
baseline data

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2
Q

If a pt has allergies to banana or kiwi, what can this indicate?

A

risk for reaction to latex

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3
Q

If a pt has allergies to eggs or soybean oil, what can this be a contradiction of?

A

contraindication to the use of propofol for anesthesia

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4
Q

If a pt has allergies to shellfish, what can this result in?

A

reaction to povidone-iodine

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5
Q

How long should a pt be NPO before surgery?

A

at least 8 hours (solid foods)
at least 2 hours (clear liquids)

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6
Q

What are the types of anesthesia techniques?

A

general anesthesia
local anesthesia
monitored anesthesia
regional anesthesia

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7
Q

Define general anesthesia

A

loss of sensation with loss of consciousness

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8
Q

Define local anesthesia

A

smaller area
loss of sensation without loss of consciousness

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9
Q

Define monitored anesthesia care (MAC)

A

decreased responsiveness, may need airway support

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10
Q

Define regional anesthesia

A

larger area
loss of sensation to region of body without loss of consciousness

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11
Q

What are examples of catastrophic events in intraoperative care?

A

anaphylactic reaction
malignant hyperthermia

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12
Q

What are manifestations of anaphylactic reaction?

A

hypotension + tachycardia = (bleeding somewhere)

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13
Q

What can an anaphylactic reaction reaction cause?

A

bronchospasm
pulmonary edema

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14
Q

What are the interventions for an anaphylactic reaction?

A

protect airway
give epinephrine

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15
Q

What are the manifestations of malignant hyperthermia?

A

increased HR
decreased BP
increased RR
muscle rigidity
hyperthermia (late sign)

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16
Q

What are the interventions of malignant hyperthermia?

A

stop anesthetic
protect airway (100% oxygen)
administer dantrolene
start iced IV 0.9% NaCl
initiate cooling measures

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17
Q

During postop care, what will be done for the pulmonary assessment?

A

encourage cough/deep breathing/incentive spirometer
suction prn
assess:
- airway
-respiratory pattern
- O2 sat

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18
Q

During postop care, what will be done for the circulatory assessment?

A

compare VS to baseline
assess:
- tissue perfusion
- fluid and electrolyte balance
- signs of bleeding

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19
Q

During postop care, what will be done for the neuro assessment?

A

assess:
- LOC
- reflexes
- movements

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20
Q

During postop care, what will be done for the urinary assessment?

A

monitor I&O

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21
Q

During postop care, what will be done for the gastrointestinal assessment?

A

assess:
- bowel sounds
- abdominal distention

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22
Q

During postop care, what will be done for the integument assessment?

A

assess:
- dressing
- amount of drainage

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23
Q

GCS less than 8….

A

you must intubate

cal rapid respone!

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24
Q

Describe the glasgow coma scale

A

EYE OPENING
4. spontaneous
3. to sound
2. to pain
1. never

MOTOR RESPONSE
6. obeys command
5. localizes pain
4. normal flexion (withdrawal)
3. abnormal flexion
2. extension
1. none

VERBAL RESPONSE
5. oriented
4. confused conversation
3. inappropriate words
2. incomprehensible words
1. none

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25
How can a nurse prevent respiratory complications?
positioning (semi-fowlers) O2 therapy incentive spirometer coughing and deep breathing hydration mucolytics
26
How can a nurse prevent neurologic or psychologic complications?
safety precautions fluid/electrolyte monitoring sleep pain management bowel/bladder function
27
How can a nurse prevent cardiovascular complications?
VS, LOC, I&O monitoring antiembolic stockings promotion of venous flow IV isotonic fluid to support BP early ambulation prophylactic anticoagulant
28
How can a nurse prevent gastrointestinal complications?
nausea: - oral care - antiemetic - NG tube to decompress stomach - comfort measures paralytic ileus: - ambulation - prokinetic agent (metoclopramide) - limiting opiods - NG tube to decompress stomach
29
How can a nurse prevent urinary retention?
bladder scan bedoan I&O monitoring no more than 6 hrs w/o pt voiding
30
What is done when there is wound dehiscence or evisceration?
- position to decrease tension @ suture line - sterile saline-soaked gauze - notify surgeon - no coughing or straining
31
What is the criteria for discharge?
aldrete score of 8-10 stable VS no evidence of bleeding return of reflexes (gag, cough, swallow) minimal to absent N/V wound drainage min-mod urine output at least 30 mL/hr
32
What is aldrete scoring?
5 factors (scored 0-2): - activity - consciousness - respiration - O2 sat - circulation 2 being back to normal
33
What is IV therapy used for?
administration of - medications - fluids - blood/blood products - radiologic constrast agents - nutritional support - repeated blood sampling
34
What are the types of IV therapy?
peripheral central venous access
35
Describe infiltration What are the interventions?
cool skin swelling at site stop tx, remove catheter, elevate extremity
36
Describe extravasation What are the interventions?
pain burning redness swelling stop tx, notify provider, infuse antidote
37
Describe phlebitis What are the interventions?
redness tenderness pain warmth red streak stop tx, remove cath, use warm compress
38
Describe a midline catheter
peripheral venous access doesn't last long good for multiple draws
39
Where are central venous access devices placed? How is this confirmed?
large blood vessels - subclavian vein - jugular vein Xray to confirm placement
40
What are examples of central venous access devices?
non tunneled or tunneled implanted infusion port peripherally inserted central cath (PICC) - single or multiple lumen
41
What is the interventions for an air embolism in a CVAD?
clamp cath admin oxygen place client on left side in trendelenburg
42
What should be assessed when looking at IVs?
insertion site integrity signs of complications connections solutions rate
43
What is the protocol for flushing the catheter?
flush w/ normal saline use push-pause technique with CVADs use 10 mL syringe
44
What are examples of complications of CVADs?
circulatory overload air embolism pneumothorax catheter-related bloodstream infection
45
What are the symptoms of circulatory overload?
shortness of breath crackles, cough hypertension
46
What are the interventions of circulatory overload?
slow iv rate elevate HOB monitor VS notify provider administer diuretic
47
What are the symptoms of an air embolism?
chest pain increased HR decreased BP decreased O2 sat
48
What are the interventions of an air embolism?
clamp cath position pt left lateral trendelenburg give O2 notify provider
49
What are the symptoms of pneumothorax?
dyspnea chest pain decreased breath sounds
50
What are the interventions for pneumothorax?
elevate HOB administer O2 discontinue cath notify provider chest tube insertion
51
What are the symptoms for catheter-related bloodstream infection?
redness tenderness warmth edema purulent drainage fever chills
52
What are the interventions for catheter-related bloodstream infection?
discontinue cath and apply warm compress culture tip of cath give antibiotic and antipyretic apply CRBSI prevention bundle
53
What does a complete blood count (CBC) include?
RBC Hgb Hct WBC Platelet
54
What is the normal range for RBC?
male 4.7-6.1 x10^12/L female 4.2-5.4 x10^12/L
55
What is the normal range for Hgb?
male 14-18 g/dL female 12-16 g/dL
56
What is the normal range for Hct?
male 42-52% female 37-47%
57
What is the normal range for WBC?
5,000-10,000 /mm^3
58
What is the normal range for platelet count?
150,000-400,000 /mm^3
59
How long is blood tubing good for?
4 hours
60
What do RBCs do?
carries oxygen
61
What does plasma do?
maintains blood pressure treats bleeding replaces fluid volume
62
What do platelets do?
helps clotting process treat thrombocytopenia
63
Type A blood can receive / donate to?
receive: A, O donate: A, AB
64
Type B blood can receive / donate to?
receive: B, O donate: B, AB
65
Type AB blood can receive / donate to?
receive: all types donate: AB
66
Type O blood can receive / donate to?
receive: O donate: all types
67
What is the nurse's responsibility before a blood transfusion?
- assess lab values/verify order/consent - type and cross match - initiate large bore IV access - assess VS and hx of transfusion - explain reason for transfusion - inspect blood product - prime blood administration set with 0.9% NaCl - verify client and compatibility with 2 nurses - infuse
68
What is a nurse's responsibility during a blood transfusion?
remain with client for first 15 min monitor VS complete transfusion
69
What is a nurse's responsibility after a blood transfusion?
obtain VS dispose of blood admin set monitor blood values complete transfusion documents document
70
What are examples of transfusion reactions?
acute hemolytic reaction febrile transfusion reaction allergic transfusion reaction circulatory overload
71
What are examples of isotonic IV fluids?
dextrose 5% in water 0.9% sodium chloride lactated ringers
72
What do isotonic IV fluids do?
replaces fluid losses
73
What are examples of hypotonic IV fluids?
0.45% NaCl 0.33% NaCl
74
Who do hypotonic IV fluids do?
rehydrates cells
75
What are examples of hypertonic IV fluids?
dextrose 10% in water 3-5% NaCl dextrose 5% in 0.9% NaCl dextrose 5% in 0.45% NaCl dextrose 5% in LR
76
What do hypertonic IV fluids do?
pulls fluid from cells
77
What are the expected ranges for sodium?
136-145
78
What are the expected ranges for potassium?
3.5-5
79
What are the expected ranges for calcium?
9-10.5
80
What are the expected ranges for magnesium?
1.3-2.1
81
What are the expected ranges for phosphorus?
3.0-4.5
82
What are the expected ranges for chloride?
98-106

Med Surg 1 (10 decks)

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