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NURSING INCO > RESPI AND URINARY PROCEDURES > Flashcards

RESPI AND URINARY PROCEDURES Flashcards

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1
Q

SUCTIONING RECOMMENDED POSITION; Conscious

A

Semi-fowlers

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2
Q

SUCTIONING RECOMMENDED POSITION; Unconscious

A

Side lying (prevent aspiration)

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3
Q

RECOMMENDED PRESSURE (WALL UNIT) Child

A

90 – 95

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4
Q

RECOMMENDED PRESSURE (WALL UNIT) Adult

A

100 – 120

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5
Q

RECOMMENDED PRESSURE (WALL UNIT) Infant

A

95 – 100

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6
Q

RECOMMENDED PRESSURE (PORTABLE) Adult

A

10 – 15

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7
Q

RECOMMENDED PRESSURE (PORTABLE) Adult

A

10 – 15

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8
Q

RECOMMENDED PRESSURE (PORTABLE) Infant

A

5 – 10

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9
Q

RECOMMENDED PRESSURE (PORTABLE) Child

A

2 – 5

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10
Q

APPROPRIATE SIZE OF SUCTION CATHETER; Adult

A

12 – 15

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11
Q

APPROPRIATE SIZE OF SUCTION CATHETER; Infant

A

8 – 10

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12
Q

APPROPRIATE SIZE OF SUCTION CATHETER; Child

A

5 – 8

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13
Q

LENGTH OF CATHETER

A

Measure from the tip of nose to the earlobe or about 13 cm (5-6 in) for adult

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14
Q

LUBRICATE CATHETER; Nasopharyngeal suction tip

A

Water soluble

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15
Q

LUBRICATE CATHETER; Oropharyngeal suction tip

A

Sterile water or NSS

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16
Q

Apply suction during removal to-

A

prevent trauma to mucous membrane

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17
Q

Apply suction for

A

5-10 secs, max = 15 secs

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18
Q

over suctioning

A

hypoxia and vasovagal stimulation

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19
Q

Hyperventilate client with oxygen before and after suctioning to

A

prevent hypoxia

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20
Q

Provide _____ and ______ hygiene

A

Provide oral and nasal hygiene

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21
Q

How to assess effectiveness of suctioning?

A

Auscultate breath sounds – absence of rales, crackles

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22
Q

Removal of fluid or air from the pleural cavity

A

THORACENTESIS

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23
Q

THORACENTESIS; Position

A

Sitting upright leaning forward

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24
Q

Thoracentesis: Instruct to remain still, avoid __________during insertion of needle

A

coughing

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25
Q

Normal due to infiltration of local anesthetic agent in thoracentesis

A

Pressure sensation

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26
Q

No more than_______ of fluid is removed

A

1000ml

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27
Q

Thoracentesis: Apply pressure to:

A

prevent bleeding

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28
Q

Thoracentesis: Position: After

A

Unaffected side (approximately 1 hour)

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29
Q

After Thoracentesis: Bed rest until VS become stable to?

A

prevent orthostatic hypotension

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30
Q

After Thoracentesis: Check for?

A

Expectoration of blood, Faintness, Vertigo, Tightness in chest, Blood-tinged frothy mucus and Signs of hypoxemia

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31
Q

Direct inspection and examination of the larynx, trachea, and bronchi

A

BRONCHOSCOPY

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32
Q

CARE BEFORE BRONCHOSCOPY: NPO 6 hours for?

A

clearer visualization

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33
Q

CARE BEFORE BRONCHOSCOPY: Pre-op med?

A

Atropine Sulfate (anticholinergic) – depress gag reflex

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34
Q

depress gag reflex

A

depress gag reflexAtropine Sulfate (anticholinergic)

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35
Q

CARE BEFORE BRONCHOSCOPY: Remove dentures and jewelry

A

prevent aspiration

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36
Q

CARE BEFORE BRONCHOSCOPY: Sprayed Local anesthesia/topical anesthesia

A

to numb area

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37
Q

a pre- op med to numb area

A

valium or diazepam – relax pt

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38
Q

CARE BEFORE BRONCHOSCOPY: Position:

A

Supine or sitting

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39
Q

CARE AFTER BRONCHOSCOPY: Position?

A

Side-lying

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40
Q

Why pt. to side lie after bronchoscopy?

A

promote drainage of secretions, prevent aspiration

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41
Q

CARE AFTER BRONCHOSCOPY: NPO until?

A

cough and gag reflex return

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42
Q

CARE AFTER BRONCHOSCOPY: Offer ice chips and fluids when?

A

cough reflex is demonstrated

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43
Q

CARE AFTER BRONCHOSCOPY: WOF:

A

hypoxia, hypotension, tachycardia, dysrhythmias, hemoptysis, and dyspnea

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44
Q

CARE BEFORE BRONCHOGRAPHY:

A

o Secure written consent
o Check for allergies
o NPO 6 to 8 hours
o Anticholinergics and Valium
o Have oxygen ready

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45
Q

CARE AFTER BRONCHOGRAPHY: Position?

A

Side-lying

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46
Q

CARE AFTER BRONCHOGRAPHY:

A

-Side-lying
o NPO
o Cough and deep breath client
o Low grade fever

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47
Q

CARE AFTER BRONCHOGRAPHY: Cough and deep breath client- to?

A

promote airway clearance, expansion of lungs, cough of secretions

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48
Q

CARE AFTER BRONCHOGRAPHY: Low grade fever common

A

common irritate mucus membrane

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49
Q

Assess ventilation and Acid-base imbalance

A

ARTERIAL BLOOD GAS

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50
Q

ABG: Common site

A

radial artery, brachial and femoral

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51
Q

Done before withdrawing blood to determine adequacy of circulation or collateral circulation

A

Allen’s test

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52
Q

pinkish color should return within 6 secs, indicates?

A

good circulation

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53
Q

Amount of arterial blood obtained:

A

2mL in a 5-10 mL syringe

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54
Q

ABG Blood should sent to the lab within?

A

2 hours

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55
Q

Before sending ABG blood, place in a container with ice to?

A

prevent hemolysis – RBC breakdown)

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56
Q

Apply pressure over arterial site: To?

A

prevent bleeding

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57
Q

SPUTUM STUDIES

A

To identify pathogenic organisms and to determine whether malignant cells are present

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58
Q

SPUTUM STUDIES: Usual method:

A

expectoration (early morning)

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59
Q

Definitive test for TB

A

Acid Fast Bacilli

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60
Q

only tell exposure to bacteria but not active TB

A

Mantoux Test

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61
Q

Other names of Mantoux Test

A

Purified Protein Derivative or Tuberculin Skin Test

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62
Q

Mantoux test: Route?

A

Intradermal

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63
Q

Mantoux test: Induration

A

10 mm - mycobacterium tuberculae
5mm = HIV

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64
Q

mycobacterium tubercule is resistant to

A

rifampicin and isoniazid, mycobacterium africanum, mycobacterium bovis

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65
Q

determine the extent of lesion, parenchyma, determine if it is pulmonary or extrapulmonary

A

X-ray

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66
Q

In Sputum studies: Instruct to clear nose and throat and rinse mouth to

A

decrease contamination of sputum

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67
Q

In Sputum studies: After taking few deep breaths, patient ________ rather than spits using the __________ and expectorates into sterile container

A

Cough; Diaphragm

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68
Q

Deepest specimen from the base of the lungs: obtained in ________ after they have accumulated overnight

A

morning

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69
Q

Specimen delivered to the lab within 2hours: to?

A

prevents overgrowth of microorganisms

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70
Q

Offer oral hygiene after collection to?

A

decrease palatability of sputum

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71
Q

TB precaution

A

airborne (use N95) ;
Droplet (within 3 feet);
Contact = use gloves before and remove after

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72
Q

Detects fluids, tumors, foreign bodies, and other pathologic conditions

A

CHEST X-RAY

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73
Q

In Chest X-ray: Usually taken after ____________ or ____________.

A

full inspiration or deep breath

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74
Q

In Chest X-ray: Instruct to remove ________, ___________ and other materials that contains metal

A

jewelries, dentures,

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75
Q

An airway clearance technique (ACT) to drain the lungs

A

CHEST PHYSIOTHERAPY

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76
Q

CPT; Main goal:

A

remove or drain tracheobronchial secretions

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77
Q

In CPT it includes:

A

percussion (clapping), vibration, deep breathing, and huffing or coughing

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78
Q

In CPT: Not done for patients with

A

airborne infections

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79
Q

In CPT: Patient should _________ tight clothing, jewelry, buttons, and zippers around the neck, chest, and waist

A

remove

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80
Q

In CPT: Light, soft clothing, such as a T-shirt, may be________.

A

worn

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81
Q

Do not do CPT on_______.

A

bare skin

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82
Q

Length of CPT:

A

20-40 mins (ave = 30 mins)

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83
Q

Best time to perform chest physiotherapy:

A

a. Upon awakening
b. Before meals
c. 30 mins – 2 hours after meals (prevent possible aspiration)
d. At bedtime

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84
Q

CPT Classification:

A

POSTURAL DRAINAGE
PERCUSSION
VIBRATION

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85
Q

Involves positioning a person with the assistance of gravity to aid the normal airway clearance mechanism

A

POSTURAL DRAINAGE

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86
Q

POSTURAL DRAINAGE :Length of time to hold:

A

3-15 mins

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87
Q

Put 2 or 3 pillows over stomach for support.

A

Sitting Positions

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88
Q

Place a small pillow under head. Put 2 pillows under bent knees.

A

Trendelenburg Position

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89
Q

In PD: Breathe in through nose and out through mouth. Remember: always to breathe out for _________than breathe in.

A

longer- This allows lungs to empty as much as possible

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90
Q

Put 2 or 3 pillows under stomach so that chest is lower than hips

A

Prone

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91
Q

Place a small pillow under head and 2 or 3 pillows under hips.

A

Side-lying Position

92
Q

Also referred to as cupping, clapping, and tapotement

A

PERCUSSION

93
Q

This is accomplished by rhythmically striking the thorax/chest wall with a cupped hand or mechanical device directly over the lung segment (s) being drained

A

PERCUSSION

94
Q

PERCUSSION: Length:

A

2-3 minutes (3-5 minutes)

95
Q

Special attention must be taken to not clap over the?

Hint: SBSL

A

Spine
Breastbone
Stomach
Lower ribs or back

96
Q

Involves the application of a fine tremorous action/ rapid vibratory impulse.

A

VIBRATION

97
Q

Vibration: Length:

A

approximately 15 seconds

98
Q

Highly infectious chronic disease caused by tubercle bacilli

A

PULMONARY TUBERCULOSIS

99
Q

tuberculosis among children

A

Primary Complex

100
Q

PULMONARY TUBERCULOSIS; Causative Agents:

A

Mycobacterium tuberculae
Mycobacterium africanum
Mycobacterium bovis

101
Q

TB: Mode of transmission

A

Airborne
Droplet
Direct Invasion – rare
Ingestion of unpasteurized milk or dairy products

102
Q

Pasteurized?

A

63°C = 30 mins;
71.6◦C = 15 secs

103
Q

What is Incubation Period?

A

s/s not yet specific = from entrance to appearance of s/s

104
Q

TB Incubation Period

A

2-8 weeks

105
Q

PERIOD OF COMMUNICABILITY

A

-While bacillus in the sputum
-Good compliance to regimen – not contagious 2-4 weeks’ after

106
Q

Enclosed space (3 months)

A

Close Contact

107
Q

Closed environment (prison)

A

High Risk Group

108
Q

with AIDS, HIV, DM, Renal failure
(immunocompromised)

A

High Risk Clinical Group

109
Q

5 CARDINAL SIGNS OF PTB

A

C
NS
WL
A
H
LGF-PM

110
Q

DSSM

A

DIRECT SPUTUM SMEAR MICROSCOPY

111
Q

Early morning sputum collection

A

Conventional Strategy (Spot)

112
Q

3 times of sputum collection

A

Spot-Spot
o One Spot – turkak now
o Second Spot – turkak after 1 hour
o Third Specimen – turkak early morning tomorrow

113
Q

SPUTUM ANALYSIS: 2 positive

A

Positive

114
Q

SPUTUM ANALYSIS: 1 positive and 1 negative

A

for X-RAY

115
Q

Never been diagnosed and taken anti TB drugs (last 2 months)

A

NEW

116
Q

Treated but diagnosed again (positive)

A

RELAPSE PATIENTS

117
Q

Undergone treatment but treatment failure

A

TREATMENT AFTER FAILURE PATIENTS

118
Q

Loss contact

A

TREATMENT AFTER LOSS TO FOLLOW-UP PATIENTS

119
Q

o No known treatment
o Return after default

A

OTHER PREVIOSULY TREATED PATIENTS

120
Q

Does not fit to 5 categories

A

PATIENTS WITH UNKOWNS PERVIOUS TB TREATMENT HISTORY

121
Q

DOTS

A

DIRECTLY OBSERVED TREATMENT SHORT COURSE

122
Q

DOTS: Intensive phase

A

2 months

123
Q

DOTS: Maintenance Phase

A

4 months (C2 = 5 months)

124
Q

MAINTENANCE phase: Meds?

A

HRZES

125
Q

Extensive parenchyma lesions, (+) smear, newly diagnosed, seriously ill

A

C1

126
Q

C1 Drug: Intensive Phase

A

2HRZE

127
Q

C1 Drug: Maintenance Phase

A

4HR

128
Q

Relapse, treatment failure, return after default, others

A

C2

129
Q

C2 Drug: Intensive Phase

A

2 HRZES

130
Q

C2 Drug: Maintenance Phase

A

5HRE

131
Q

New TB but minimal parenchyma lesions, not seriously ill

A

C3

132
Q

C3 Drug: Intensive Phase

A

2HRZ

133
Q

C3 Drug: Maintenance Phase

A

4HR

134
Q

Chronic PTB, (+) TB and (+) Sputum smear after supervised treatment

A

C4

135
Q

SECOND LINE DRUGS (INJECTABLES)

A

AMINOGLYCOSIDES & FLUROQUINALONESS

136
Q

AMINOGLYCOSIDES

A

Amikacin
Kanamycin
Capreomycin

137
Q

FLUROQUINALONESS

A

Ciprofloxacin
Moxifloxacin
Levofloxacin

138
Q

SE of Rifampicin, Isoniazid, Pyrazinamide, Ethambutol

A

Jaundice

139
Q

SE of Ethambutol

A

Visual Impairment

140
Q

SE of Streptomycin

A

Tinnitus and hearing impairment

141
Q

SE of Rifampicin, Isoniazid

A

Oliguria and albuminuria

142
Q

SE of Isoniazid

A

Psychosis and Convulsion

143
Q

SE of Rifampicin

A

Thrombocytopenia and anemia

144
Q

DR – TB

A

Isoniazid

145
Q

MDR – TB

A

Isoniazid and Rifampicin

146
Q

XDR – TB

A

Isoniazid, Rifampicin, Fluoroquinalones

147
Q

XXDR – TB

A

Isoniazid, Rifampicin, Fluoroquinalones

148
Q

TDR - TB

A

Isoniazid, Rifampicin, Fluoroquinalones

149
Q

Treatment pf choice for renal failure = particularly oliguria or anuria

A

DIALYSIS

150
Q

Remove the end products of protein from metabolism from the blood

A

DIALYSIS

151
Q

Maintain safe levels of electrolytes

A

DIALYSIS

152
Q

DHN: Serum Osmolality?

A

High

153
Q

High Serum Osmolality activate?

A

Thirst Mechanism in Hypothalamus

154
Q

thirsty: Increase?

A

ADH

155
Q

ADH; High?

A

Water Reabsorption

156
Q

High h2o reabsorption leads to?

A

Decrease UO

157
Q

water moves from___________ concentration to____________ concentration

A

low solute; high solute

158
Q

D5LRS; Shrink cells

A

Hypertonic

159
Q

0.45 NaCl;
Swell/bursts cells

A

Hypotonic

160
Q

IV fluid: Do not give to DHN

A

Hypertonic

161
Q

IV fluid: for DHN

A

Hypotonic

162
Q

NSS
0.9 NaCl

A

Isotonic

163
Q

Correct acidosis and replenish the blood bicarbonate system

A

DIALYSIS

164
Q

Remove excess fluid from the blood

A

DIALYSIS

165
Q

Purpose of Dialysis

A

RMCR

166
Q

PERITONEAL DIALYSIS; Site of insertion:

A

2 inches below umbilicus

167
Q

PERITONEAL DIALYSIS; Area:

A

avascular

168
Q

PERITONEAL DIALYSIS: Weigh patient before and after the procedure

A

best indicator of hydration

169
Q

Have patient_______ just before dialysis begins

A

void- for comfort

170
Q

The dialysate solution should be ______ at body temperature

A

warm

171
Q

The dialysate solution should be warm at body temperature

A

for the capillary permeability of peritoneum, prevent abdominal discomfort

172
Q

Cycle of peritoneal dialysis

A

Infusion time
Dwell time
Drainage time

173
Q

Infusion time

A

= 10 minutes

174
Q

Dwell time

A

= 4-6 hours

175
Q

Drainage time

A

= 30 minutes

176
Q

In peritoneal dialysis: First few bottles of drainage will normally be___________.

A

pink-tinged

177
Q

In peritoneal dialysis: If drainage stops,

A

turn client to the sides

178
Q

If drainage stops, turn client to the sides because?

A

colon may just be occluding the lumen of catheter

179
Q

Peritoneal Dialysis: Observe for_________, ___________, and _____________, _______________.

A

Observe for fluid leaks, signs of hypovolemia, and hyperglycemia, disequilibrium syndrome

180
Q

disequilibrium syndrome

A

rapid removal of waste products from the blood than brain

181
Q

S/SX of disequilibrium syndrome

A

headache, HPN, dec LOC, irritable, confusion

182
Q

Following dialysis, apply__________ and observe site for _________.

A

dressing; drainage

183
Q

board-like or rigid abdomen

A

Peritonitis

184
Q

Watch out after Peritoneal Dialysis

A

Peritonitis and Respiratory Difficulty

185
Q

S/Sx of Peritonitis

A

board-like or rigid abdomen, fever, ↑WBC, ↑body temp, chills, abdominal pain and tenderness

186
Q

When in Respiratory Difficulty?

A

Introduce fluid to compress diaphgram

187
Q

Position after Peritoneal Dialysis

A

Semi-fowlers to promote Lung expansion

188
Q

Requires vascular access

A

HEMODIALYSIS

189
Q

HEMODIALYSIS; Duration:

A

2-3 hours per day

190
Q

HEMODIALYSIS; Frequency:

A

3-4 times a week

191
Q

HEMODIALYSIS; 4 SITES

A

AV fistula
AV graft
AV shunt
Femoral vein catheterization

192
Q

Before and During Hemodialysis:

A

-Have client void
-Chart client’s weight
- VS q5mins
-Inform client that headache and nausea may occur
-Ensure bed rest
- Monitor for signs of bleeding

193
Q

Length of time for initial hemodialysis:

A

30 mins

194
Q

Arm precaution

A

No BP taking on affected

195
Q

No BP taking on affected because?

A

disrupt AV fistula patency = pale, arm pain

196
Q

In Hemodialysis : Assess for patency by auscultating _______and palpate for ________.

A

Bruit; thrill

197
Q

Assess for steal syndrome, this includes:

A

hand numbness, pain, coldness and weakness

198
Q

In Hemodialysis: Blood transfusion should be administered ________the procedure

A

during

199
Q

In Hemodialysis: ________________meds are omitted.

A

Anti-hypertensive (↓BP)

200
Q

o Adherence to well-balanced diet
o Importance of periodic blood chemistries
o Daily weights

A

CONTINUOUS AMBULATORY PERITONEAL DIALYSIS

201
Q

BENEFITS OF DIALYSIS
Improves the following problems:

Hint: 4E

A

-Edema
-Elevated BUN, serum creatinine
-Elevated electrolytes
-Elevated blood pressure

202
Q

HEMODIALYSIS MEDS

A

o Insulin
o Dextrose (glucose)
o Calcium gluconate
o Sodium bicarbonate
o Kayexalate
o Aluminum hydroxide

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NURSING INCO (9 decks)

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