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NPTE > Safety and protection > Flashcards

Safety and protection Flashcards

1
Q

What are medications that affect the brain and increase the risk of falls?

A
  1. anxiolytics/sedative-hypnotics
  2. antipsychotics
  3. antidepressants
  4. anticonvulsants/mood stabilizers
  5. opioid anelgesics
  6. BP medications/antihypertensives
  7. blood sugar altering medications
  8. diuretics
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2
Q

How do antipsychotics increase fall risk?

A
  1. syncope
  2. sedation
  3. slowed reflexes
  4. LOB
  5. impaired psychomotor function
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3
Q

How do antidepressants increase the risk of falling?

A

can cause hyponatremia (low sodium)

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4
Q

How do anti-hypertensives cause an increase in fall risk?

A

Can cause or worsen a drop in BP/postural hypotension

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5
Q

How can diuretics increase fall risk?

A

causes dehydration = orthostatic hypotension

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6
Q

How can urinary catheters cause autonomic dysreflexia?

A

Bladder distention caused from an overfilled collection bag, a locked/twisted/kinked tube, or a UTI

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7
Q

What is a chest tube used for?

A

evacuating air, fluid, and/or other material following a pneumothorax, cardiothoracic surgery, pleural effusion, and other conditions

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8
Q

Where must the chest tube be placed once it is secured into the chest wall?

A

Must remain below the level of the patient’s chest as the water seal is often on the floor

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9
Q

What devices are contraindicated when a chest tube is present?

A

positive pressure devices

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10
Q

What must you do if a patient’s chest tube becomes disconnected from the patient?

A

Have the patient fully exhale and place a gloved hand and gauze over the defect at the end of exhalation

– Call for medical help

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11
Q

What is a peripheral IV used for?

A

Short term infusion of fluids (electrolytes, blood, medications)

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12
Q

(true/false) the UE with a peripheral IV may be raised higher than the level of the IV medication bag.

A

FALSE - backflow can occur

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13
Q

What can possibly form if an IV solution is low?

A

Air embolism

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14
Q

What is a central venous catheter (Central line) used for?

A

Venous access for 6+ days

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15
Q

What are the possible veins that a central line can be administered into?

A
  1. SVC
  2. Jugular
  3. subclavian
  4. femoral
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16
Q

What structure does a PICC line give direct access to when administered into the UE?

Peripherally Inserted IV catheter

A

SVC

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17
Q

What movement is contraindicated when a femoral line is placed?

A

hip FLX > 45 degrees

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18
Q

What arteries do central arterial catheters use?

A
  1. radial
  2. brachial
  3. femoral
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19
Q

What are central arterial catheters used for?

A

Monitoring intra-arterial BP and ABG samples

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20
Q

(true/false) Central arterial catheters are used for medication administration

A

FALSE

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21
Q

What is a Swan-Ganz Catheter used for?

(Pulmonary artery catheter)

A

Monitor pulmonary artery pressure, cardiac output, and oxyhemoglobin saturation

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22
Q

What must you do if an arterial line becomes dislodged?

A

Provide immediate, firm pressure on or above the arterial insertion site to try and control the bleeding

–call for medical assistance

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23
Q

Are tracheal tubes taped or sutured in place?

A

sutured

Endotracheal and nasotracheal tubes are taped into place

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24
Q

A peaked inspired pressure (PIP) _____ cm H2O can indicate a kinked tube, need for patient suctioning, and/or bronchospasm

A

> 30 cm H2O

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25
Q

What level of PaO2 is indicative for supplemental oxygen?

A

< 55 mmHg

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26
Q

During CPR, untrained rescuers can only do what?

A

Chest compressions

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27
Q

Describe parameters for rescue breathing.

Pulse present but is not breathing

A

1 breath every 5-6 seconds
OR
10-12 breaths per minute

Check pulse every 2 minutes

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28
Q

What is the optimal number of chest compressions per minute when performing CPR?

A

120 bpm

no less than 110, no more than 120

Do not lean on chest in between compressions- allows for heart to completely fill before the next compression

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29
Q

How deep should CPR compressions be for an adult?

A

2+ inches

30
Q

How deep should CPR compressions be for a child?

A

approx. 2 inches

1/3 of AP depth

31
Q

How deep should CPR compressions be for an infant?

A

approx. 1.5 inches

1/3 of AP depth

32
Q

(Heat or cold pack) What is most appropriate for strains, sprains, and muscle contusions? Why?

A

Cold pack because it can decrease hemorrhage, edema, pain, and disability

Heat application is CONTRAINDICATED

33
Q

If an injured extremity is blue or extremely pale, what can you possibly do to help reduce neurovascular compromise?

A

Gently straighten the limb

34
Q

What causes Fat Embolus Syndrome (FES)?

definition: fat globules are released into the bloodstream.

A

Significant trauma

35
Q

What are symtoms that may indicate the beginning of FES leading to emergency?

A

Respiratory distress

36
Q

Persons with mild concussions have no LOC and symptoms that last how long?

A

Less than 15 minutes

37
Q

Persons with moderate concussion have no LOC and symptoms that last how long?

A

Longer than 15 minutes

38
Q

What does BE FAST stand for in regards to stroke recognition?

A

B- balance and coordination
E- eyes

F- Face drooping
A- Arm weakness
S- Speech difficulty
T- Time

Other possible symptoms:
- sudden N/T in the LEs
- sudden confusion or trouble understanding
- dizziness
- sudden severe HA with no known cause

39
Q

What are immediate signs of possible concussion after injury?

A
  • change in LOC (dazed, stunned,etc)
  • anterograde or retrograde amnesia
  • confusion
  • clumsy
  • answers questions slowly
  • shows mood change
40
Q

What are symptoms of concussion

A
  • HA/head pressure
  • N/V
  • impaired balance, vision, or increased dizziness
  • light and noise sensitivity
  • feeling sluggish, hazy, foggy, or groggy
  • confusion, concentration, or memory problems
41
Q

What indicates an immediate call to 911 in regards to concussions?

A
  • LOC >30 seconds
  • one pupil larger than the other
  • Repeat n/v, convulsions, or Sz
  • Progressive HA
  • slurred speech, numbness, decreased coordination
  • confusion, disorientation, amnesia
42
Q

What are signs and symptoms of Sz?

A
  • altered consciousness
  • convulsions, involuntary contractions, rhythmic jerking of extremities
  • sensory phenomena
  • autonomic phenomena: sudden anxiety, tachycardia, sweating, piloerection, loss of bladder control
  • cognitive phenomena: sudden failure to communicate/comprehend, hallucinations, intense feelings
43
Q

What is status epilepticus?

A

Seizures that lasts longer than 5 minutes
OR
when seizures occur close together w/o regaining consciousness

44
Q

What are the classic signs of MI?

A
  • chest pain/discomfort/pressure
  • pain in other parts of the body (unilateral Arm, shoulder blades, back, neck, jaw)
  • SOB
  • nausea
  • sweating
  • lightheadedness/dizziness
45
Q

(Men/Women) can present with “silent symptoms” of MI

A

Women

  • chest pressure
  • SOB
  • sweating
  • nausea
  • lightheadedness w/o exertion
46
Q

What is shock?

A

Failure of the circulatory system to perfuse vital organs

blood is normally shunted from the periphery to maintain vital organs and core temperature

47
Q

If HR and rhythm are affected due to shock, what can occur?

A

Can progress to cardiac death and rest

48
Q

What are s/s of shock?

A
  • pale, grey, or blue skin
  • cool skin
  • increased and weak pulse
  • increased RR
  • decreased BP
  • drowsiness, diminished LOC, irritability, or restlessness
  • N/V
49
Q

How should you position a person who is in shock if they are responsive and breathing normally?

A

Supine

–> if no evidence of trauma or injury, person’s LEs can be elevated 6-12 inches (30-60 degrees) to help improve vital signs

DO NOT raise feet if the position and/or movement causes pain

50
Q

What is vasovagal syncope?

A

Fainting with sudden drop in HR and BP

51
Q

What are s/s of vasovagal syncope?

A
  • pale skin
  • lightheadedness
  • tunnel vision
  • nausea
  • feeling warm
  • cold/clammy sweating
  • blurred vision
  • slow, weak pulse
  • dilated pupils
  • jerky abnormal movements
52
Q

What must you do if a person is experiencing vasovagal syncope?

A

Lie down with legs elevated until symptoms resolve
OR
Person can sit with their head in between their knees until symptoms resolve

Symptoms resolve typically within 15-30 minutes

getting up too soon puts the person at risk for fainting again.

53
Q

What medications may prolong clotting?

A
  • NSAIDS (nonsteroidal anti-inflammatory drugs)
  • aspirin

Minor bleeds clot within 10 minutes

54
Q

What do you observe with arterial bleeds?

A
  • Blood is coming from the wound under high pressure
  • bright red blood
55
Q

What do you observe with venous bleeding?

A
  • low pressure bleeding with a steady flow
  • dark red/maroon blood
56
Q

What do you observe with capillary bleeds?

A
  • low pressure bleed
  • oozing
  • dark red blood
57
Q

(true/false) When managing bleeding, you should have the part of the body elevated above the heart until bleeding stops

A

true

58
Q

What pressure points/arteries should NOT be utilized when trying to manage an arterial bleed?

A

Femoral and brachial artery

use a torniquet

59
Q

What is normally the cause of internal bleeding?

A

blunt trauma rupturing a blood vessel or an organ

60
Q

What are s/s of internal bleeding?

A
  • ecchymosis/bruises
  • swelling (possible rebound tenderness)
  • pale, gray, moist, or cold skin
  • increased RR and HR
  • Weak pulse
  • decreased BP
  • possible n/v
  • possible anxiety/restlessness
  • possible decline in Level of consciousness
61
Q

After administration of an EpiPen, if the person does not respond to the initial dose in ___-___ minutes, a second dose may be administered

A

10-15 minutes

62
Q

What are signs of heat stroke?

A
  • nausea
  • dizziness
  • cramps
  • feeling faint
  • fatigue
  • heavy sweating
  • dizziness
  • syncope
  • confusion
  • Sz

Same s/s as heat exhaustion with the addition of CNS s/s

63
Q

What are s/s of heat exhaustion?

A
  • nausea
  • dizziness
  • cramps
  • feeling faint
  • fatigue
  • heavy sweating
64
Q

What is the average length of stay in an acute care hospital?

A

4-5 days

65
Q

What does primary care consist of?

A

Prevention, wellness, and treatment for common pt concerns

Personnel: RN, PCP, PA, NPs

Setting: outpatient

66
Q

What does secondary care consist of?

A

Specialized care

Personnel: medical specialists (cardiologists, dermatologist, etc)

Often requires inpatient hospitalization or same-day surgery

67
Q

(primary, secondary, tertiary) what care environment does PT/OT/SLP commonly work in?

A

secondary

68
Q

What is tertiary care?

A

Highly specialized, technology based medical services (transplants, major surgery)

Personnel: highly specialized physicians in a hospital setting

69
Q

What is a SNF?

A

Facility that skilled nursing services, rehab, and other healthcare services are given continuously on a daily basis –> requirement: services needed on a daily basis

  • must be certified by medicare
  • 24 hour nursing coverage
70
Q

What is the avg. length of stay in an inpatient rehab hospital?

A

13 days

3 hrs of PT everyday

NPTE (20 decks)

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