Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Surgery and other stuff > Reading material > Flashcards

Reading material Flashcards

1
Q

What is the order in which the blood tubes should be filled?

A
  1. Blood culture
  2. Tube withOUT additives (red tubes)
  3. Tubes WITH additives
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are red tubes used for?

A

Chemistries, amylase, Igs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are blue tops used for?

A

PT
PTT
INR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are green tops used for?

A

Ammonia

CPK isozymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are purple top tubes used for?

A

CBC

ABO types

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are gray top tubes used for?

A

Ethanol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are pink top tubes used for?

A

Cross matching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which colored tube does not have any additives?

A

Red

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

True or false: you should not draw blood on the side of the body that a mastectomy was performed

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

True or false: when drawing blood on the side of an arm with an IV in place, you should draw above the IV site

A

False– I don’t know why though

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What should you never do after cleaning a venipuncture site?

A

touch it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

True or false: you should gently invert or shake the tubes of blood in a blood draw

A

False– NEVER shake. But the inverting bit is a good idea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the landmarks that should be palpated before doing a cricoidotomy?

A

Thyroid and cricoid cartilage (between them in the cricothyroid ligament)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What direction should the needle face when performing a needle cricoidotomy? When should you stop advancing the needle?

A

45 degrees inferiorly

Stop when air is aspirated into the syringe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How long can adequate ventilation be achieved with a needle cricothyroidotomy?

A

30-45 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the age cutoff (lower bound) for surgical cricothyroidotomy?

A

12 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Central line placement for the IJV is on what side of the body? Subclavian?

A 
IJV = right side
Subclavian = left side
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the landmarks used for placing a central line into the subclavian? How should the hands be placed? How should the needle be inserted?

A

Thumb on the sternal notch
Index finger on the intersection between the clavicle and the first rib. Insert needle lateral to the thumb, and beneath the clavicle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the landmarks used for central line placement in the IJV?

A

Between the two heads of the SCM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What way should the tip of the J wire be inserted in an IJV central line?

A

Toward the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What must be monitored with a IJV central line placement? Why?

A

EKG for arrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the minimal amount of blood that can be seen on a CXR for a hemothorax?

A

300-500 ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What should you do if draining more than 1500 ml of blood from a chest tube?

A

Get to OR for thoracotomy to control bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the ribs that are used for landmarks for a chest tube placement with a pneumothorax? Where?

A

3 4 or 5 intercostal space along the anterior axillary line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Which intercostal spaces are used for chest tube placement with a hemothorax?

A

3 4 or 5 along the posterior or midaxillary line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the position the pt should be placed in for a chest tube placement?

A

arm over head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the area relative to the rib where you should place the chest tube?

A

On top of the lower rib in the intercostal space to prevent hitting the intercostal arteries/nerves that lie below the ribs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the tool used to make the puncture for a chest tube?

A

Hemostat (after making an incision with a scalpel)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Which way should a chest tube be inserted toward for a hemothorax? Pneumothorax?

A 
Hemo = down
Pneumo = up
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Widening of the mediastinum following a chest tube placement may indicate what?

A

Thoracic aorta dissection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is tidaling with chest tube placement?

A

Movement of the ball in the pleurivac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

True or false: except for checking for leaks, a chest tube should never be clamped off

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What should be done with a pneumo and hemothorax concurrently?

A

Chtes tubes place anterior and posterolaterally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What indicated that a chest tube was successful?

A

No more tidaling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is a laproscopic surgery?

A

Small tools + CO2 inflated peritoneum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are the spaces that an LP should be performed at?

A

L4-L5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Which way should the needle be driven in a LP?

A

toward the naval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the only position in which you are able to get an opening pressure with a LP?

A

Lateral recumbent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Why should you never introduce negative pressure with a LP?

A

will cause hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are the first three tubes that are used in the collection of CSF (in order)?

A
  1. cell count and differential
  2. Gram stain cultures
  3. Glucose, protein,
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What happens if you get a bloody tap?

A

May have hit the venous plexus, which will stop after you draw more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Name the mallampati score: clear visualization of the faucial pillar, soft palate, and uvula

A

I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Name the mallampati score: The uvula is masked by the tongue, but o/w clear visualization of the facial pillars and soft palate

A

II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Name the mallampati score: Only the soft palate is visualized

A

III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Name the mallampati score: Only the hard palate is visualized

A

IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Why should you not rock the laryngoscope?

A

Will break teeth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Is it every okay to let go of the ET tube?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Each time the patient is moved with a ETT in, what is the chance that it will dislodge?

A

10-15%

49
Q

What is the Selleck manuver?

A

Applying pressure to the cricoid cartilage during an intubation

50
Q

Should you try to intubate through a glottis that is closed d/t a laryngeal spasm?

A

Never

51
Q

What are the four regions assessed during a FAST exam?

A
  1. Pericardial (Pericardial effusion)
  2. RUQ (spleen)
  3. LUQ (kidneys)
  4. Pelvic (pouch of douglas)
52
Q

Hyperechoic appears what color on the screen? Hypoechoic?

A 
Hyper = white
Hypo = black
53
Q

What does red flow indicate? Blue?

A 
Red = toward you
Blue = away from you
54
Q

What is the size of the urinary catheter that should be used for adults? What if they have gross hematuria?

A

16-18 french

22-24 for patients with gross hematuria

55
Q

What is the only absolute contraindication for urinary catheterization?

A

Trauma to the urethra (e.g. pelvic fracture)

56
Q

When are triple lumen catheters used?

A

For patients with clots or obstruction

57
Q

What way should the penis be held when doing a cath?

A

Perpendicular to the body

58
Q

What should you do prior to inflating the foley cath balloon?

A

Check for urine return

59
Q

Name two relative contraindications for urethral catheterization (3 are given)

A

Urethral stricture
Recent urethral/bladder surgery
Combative patient

60
Q

Name two contraindications to performing an LP.

A 
Cardiorespiratory compromise
Cerebral herniation
Focal neurological signs
Bleeding diathesis
Previous lumbar surgery
61
Q

What gauge needle is usually used for an LP?

A

20-22

62
Q

What should you do first if there is no flow from an LP?

A

Rotate the needle 90 degrees, since a nerve rootlet may be obstructing the flow

63
Q

What should you do if there is blood in an LP needle?

A

get a new needle and enter a new interspace, since you do not want it to clog

64
Q

Over what mmH2O is concerning in a spinal tap

A

20

65
Q

Why should you never aspirate a LP?

A

May cause a herniation

66
Q

What is the size of the triple lumen catheter that should be used for central lines? What about for fluid resuscitation?

A

7 french

11.5 if resuscitation

67
Q

What are the contraindications to tracheal intubation?

A 
Trauma
Burns
Tumor
Edema
Infection
68
Q

What does gauge measure? What does a high gauge needle mean?

A

Measures the diameter of a needle.

Larger gauge means smaller needle size

69
Q

What does bore size indicate?

A

size of the lumen (inside diameter)

70
Q

What are the three layers of a vessel, and what is the important part of each?

A

Outer layer = tunica adventitia (supporting vasculature)
Middle layer = tunica media (muscular layer)
Inner layer = tunica intima (elastic layer)

71
Q

How often should peripheral IV catheters be changed?

A

every 72 hours

72
Q

When is it appropriate to give D5W to a patient IV?

A

Never– will raise glucose levels too fast, and cause osmotic diuresis

73
Q

What type of fluids do you want to use when replacing volume: hypotonic, isotonic, or hypertonic

A

isotonic

74
Q

What are the electrolyte concentrations in NS? pH?

A

154 Na and Cl

pH is 4-5

75
Q

What are the electrolyte concentrations in LR? pH?

A

130 Na
110 Cl
4 K
100 H2O

7ish pH

76
Q

What are the electrolyte concentrations in D5W? D10W?

A 
D5 = 50 gm glucose
D10 = 100 gm glucose

both have 1000 ml of water

77
Q

What are the electrolyte concentrations in 3% NS?

A

513 Na

513 Cl

78
Q

What is the rule for choosing an IV rate per hour?

A

4 ml/kg for first 10 kg
2 ml/kg for next 10 kg
1 ml/kg for each kg thereafter

79
Q

What is the angle of the injection that should be done with SQ administration of a drug? IM?

A 
SQ = 45 degrees
IM = 90 degrees
80
Q

What are the sites of injection of IM meds?

A

Anterior/posterior forearms, tricep area, chest, or shoulder blade area

81
Q

What is the preferred site of injection for heparin?

A

Lower abdominal fat pad, beneath the umbilicus

82
Q

Under what age should the dorsogluteal muscle not be used?

A

3 years of age

83
Q

When injecting into the gluteal area, how do you ensure that you are in the correct area?

A

Place hand so that the 2nd finger is on the ASIS, and spread your fingers. Inject between the space formed by digits 2 and 3.

84
Q

What is meant by the “Z” track injection?

A

Pulling the skin back when injecting, thus creating a non-linear path for blood to flow out when the needle is removed and the skin released

85
Q

What are the indications for an NG tube? Contraindications?

A

Acute gastric dilatation/distention
Gastric outlet obstruction
Ileus

Contraindications:

  • recent esophageal surgery
  • absence of gag reflex
  • facial or nasal trauma
86
Q

True or false: esophageal varices are a contraindication to placing an NG tube

A

False

87
Q

What are the indications for a needle cricothyroidotomy?

A

Complete airway obstruction

Trauma to the face

88
Q

What are the two complications of a needle or surgical cricothyroidotomy?

A

Asphyxia

Aspiration

89
Q

What are the two contraindications to a surgical cricothyroidotomy?

A

Children under 12

There is a less radical means of establishing an airway

90
Q

What are the indications for a central line placement?

A

TPN

Long term infusion of drugs

91
Q

What are the contraindications for a central line placement?

A

Morbidly obese
Infection over insertion site
Pneumo/hemothorax on the ipsilateral side

92
Q

What are the two pre-procedure bits prior to doing a central line placement?

A

Consent and timeout

93
Q

What is the position the patient should be placed in for a central line placement?

A

Trendelenburg

94
Q

What gauge needle should be used when performing a subclavian or IJV central line placement?

A

18

95
Q

In what order should the scalpel, dilator, J wire, 18 gauge needle, and catheter be introduced in a central line placement?

A 
Needle/catheter
J wire
scalpel
dilator
Central catheter
96
Q

What should you do after placing a central line?

A

Check all ports for blood return

97
Q

What size tube should be used for pneumothorax in a child/adult? Hemo?

A

Pneumo: 22ish or 11ish
Hemo: 22 ish or 15ish

98
Q

True or false: when suturing, you should always select the smallest diameter suture that can adequately hold the tissue edges together.

A

true

99
Q

What size of suture should be used for regular skin closures?

A

3-0, 4-0, or 5-0

100
Q

What size of suture should be used for skin closure on the face?

A

5-0 or 6-0

101
Q

What size of suture should be used on abdominal fascia closure?

A

2 or 0

102
Q

What are the two types of points to a suture needle?

A

taper point

Cutting point

103
Q

What is a #10 blade used for? #11? #12? #15? #20?

A 
#10 - large incisions
#11 - stabs
#12 - ENT/GYN
#15 - small incision
#20 -Digit amputations
104
Q

What is the universal size for catheters?

A

16 french

105
Q

When do indwelling catheters need to be changed?

A

Every 72 hours

106
Q

What should you note in the medical record for a urine cath placement? (6)

A 
Indication
Size/type
Fluid injected
Urine output
Your name
Complications
107
Q

What drug needs to be in the syringe when doing an ABG?

A

heparin

108
Q

What are the pertinent findings in an ABG? (6)

A 
pH
PaCO2
PaO2
HCO3
O2
BE
109
Q

Are you oxygenating the patient, or ventilating them when performing a cricothyrotomy?

A

Oxygenating them

110
Q

In a needle cricothyroidotomy, what type of needle should be used?

A

12 or #14

111
Q

In a needle cricothyroidotomy, how many seconds do you oxygenate the patient by the tubing?

A

Occlude 1 second and release for 4

112
Q

How long can chest tubes stay in?

A

24-48 hours

113
Q

How can you check for air leaks in a chest tube?

A

Look at water seal chamber and if bubbles present = air leak

114
Q

When do you see tidaling with a chest tube placement?

A

When pleuravac is taken off suction; fluid in chamber should move with respiration and ventilation

115
Q

When should you obtain x-rays with a chest tube placement?

A

Beforehand, after insertion, serial during stay, and after pull out

116
Q

What is the purpose of undermining tissue?

A

Undermining = separation of superficial tissues (epidermis/dermis) from deeper tissues (SC tissue) in order to achieve better tissue approximation during suturing

117
Q

What is the most common cause of post-op fever? treatment?

A

Atelectasis

Spirometry

118
Q

What are the 5 W’s of post surgical infection?

A 
Wind (atelectasis)
Water (UTIs)
Walking (DVTs)
Wounds (duh)
Wonder drugs (rxn)
119
Q

What is the daily requirement for K?

A

40-100 mEq

Surgery and other stuff (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions