Skills Flashcards
at what point during oxygen administration does humidification need to be attached?
if the ordered flow rate is greater than 4L/min, humidification needs to be attached
what position promotes lung expansion and can help with breathing?
high-fowler’s or semi-fowler’s
a patient with COPD is having trouble breathing. what position could help them breath better?
have them lean over a bedside table with arms propped up
what position decreases orthopnea?
- supine with head supported by two pillows.
- can also raise head of bed to 30 degrees
how to do controlled coughing
1) have pt sit up with arms wrapped around a pillow over abdomen
2) take two deep breaths
3) on last breath hold it for three seconds, then cough three times without taking in a breath
4) take another deep breath and cough two or three more times forcefully
how to huff cough
- take deep breath and make a HA sound three times
- have pt do this three times then attempt to cough
what is the usual initial C-PAP setting?
4-8cm H2O
what is the usual Bi-PAP setting?
Inspiratory pressure:
10-15cm H2O
Expiratory pressure:
4-10cm H2O
what is PEFR used for?
peak flow is used to assess airway management interventions and help the patient know when to seek help
how to use peak flow
- take deep and blow through meter as hard and fast as possible.
- do this three times and record highest reading
describe zones of peak flow assessment
green zone: 80%-100%/no symptoms
yellow zone: 50%-80% possible attack and need for treatment
red zone: <50%/ medical alert, immediate need for medication and contact provider
how far do you insert the suctioning tube for nasotracheal suctioning?
- Adult: 20 cm
- older children: 18-20 cm
- infants and younger children: 8-14 cm
how far do you insert suctioning tube for nasopharyngeal suctioning?
- 16cm (adults)
- 8 - 12 cm (older children)
- 4 - 7.5 cm (infants and older children)
how do you reach left and right broncus during nasotracheal suctioning?
have pt turn head.
- turning head to right will help you get to the left broncus
- turning head to the left will help you get to the right broncus
how many nasotracheal suctioning passes can you perform consecutively?
no more than 2
what is the flow range for a nasal cannula?
1 - 6 L/min
what is the flow range for a reservoir nasal cannula or oxymizer?
1 - 15L/min
what is the flow range for a venturi mask?
4 - 12L/min
what is the flow range for a partial nonrebreathing mask?
10 - 12L/min
what is the flow range on a NRB mask?
15L/min
what is the flow range for a face tent?
8 - 12L/min
how do you clean an IV site?
- use a chlorhexidine antiseptic swab and wipe the area that will be covered for 30 seconds
- allow to dry completely
- if using an alcohol swab, clean in a circular motion working outward from the insertion site.
when should you start preparing a refrigerated IV bag?
at least an hour before you hang it, so it is room temp
what is the difference between a micro drip set and a macro drip set?
micro drip set infuses 60 gtts/mL; recommended for infusion rates of less than 100mL/hr
macro drip set infuses 10-20gtts/mL; used for infusion rates of 100mL/hr or more
0 on the phlebitis scale
no symptoms
1 on the phlebitis scale
redness at the access site with or without pain
2 on the phlebitis scale
pain at access site with redness and/or edema
3 on the phlebitis scale
pain at access site with redness, streak formation, and palpable venous cord
4 on the phlebitis scale
pain at access site with redness, streak formation, palpable venous cord >1 inch, and purulent drainage
what are some things to remember concerning PCA programming(3)?
1) deliver ordered type and dose of pain medication
2) provide lockout interval
3) maintain 1 or 4 hour dose limit
what are some events related to PCA requiring notification of nurse(5)?
1) side effects occurring
2) pain relief is inadequate
3) severity or location of pain changes
4) device alarm sounds
5) patient has a question
when you discontinue a PCA, what do you first document?
the amount of the medication used and the amount to be discarded
what position should the patient be in for diaphragmatic breathing exercises?
standing or fowler’s or semi-fowlers
if a CPN bag is a 2 in 1 solution, what should you inspect it for?
particulate matter or cloudiness
if a CPN bag is a 3 in 1 solution, what should you inspect for?
separation of fat into layers
if a CPN bag has been refrigerated, how long do you let it sit at room temp before administration?
one hour
for CPN without lipids, what filter do you attach to the setup?
a .2 micron filter
for a 3 in 1 CPN solution, what filter do you use?
1.2 micron filter
What should you not use a CPN access for?
only use it for CPN.
DO NOT USE FOR:
* IV meds
* blood transfusions
* blood samples
* venous pressure readings
CPN should not be interrupted for:
do not interrupt CPN for anything including:
* showers
* transportation
* transfusions
vegans lack complete proteins in single foods. how can they get sufficient protein?
by using complementary proteins from two or more foods
why are vegans at risk for vitamin b12 deficiency?
because vitamin b12 is only available from animal sources
