Skills

Question 1

at what point during oxygen administration does humidification need to be attached?

Answer 1

if the ordered flow rate is greater than 4L/min, humidification needs to be attached

Question 2

what position promotes lung expansion and can help with breathing?

Answer 2

high-fowler’s or semi-fowler’s

Question 3

a patient with COPD is having trouble breathing. what position could help them breath better?

Answer 3

have them lean over a bedside table with arms propped up

Question 4

what position decreases orthopnea?

Answer 4

• supine with head supported by two pillows.
• can also raise head of bed to 30 degrees

Question 5

how to do controlled coughing

Answer 5

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

Question 6

how to huff cough

Answer 6

• take deep breath and make a HA sound three times
• have pt do this three times then attempt to cough

Question 7

what is the usual initial C-PAP setting?

Answer 7

4-8cm H2O

Question 8

what is the usual Bi-PAP setting?

Answer 8

Inspiratory pressure:
10-15cm H2O

Expiratory pressure:
4-10cm H2O

Question 9

what is PEFR used for?

Answer 9

peak flow is used to assess airway management interventions and help the patient know when to seek help

Question 10

how to use peak flow

Answer 10

• take deep and blow through meter as hard and fast as possible.
• do this three times and record highest reading

Question 11

describe zones of peak flow assessment

Answer 11

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

Question 12

how far do you insert the suctioning tube for nasotracheal suctioning?

Answer 12

• Adult: 20 cm
• older children: 18-20 cm
• infants and younger children: 8-14 cm

Question 13

how far do you insert suctioning tube for nasopharyngeal suctioning?

Answer 13

• 16cm (adults)
• 8 - 12 cm (older children)
• 4 - 7.5 cm (infants and older children)

Question 14

how do you reach left and right broncus during nasotracheal suctioning?

Answer 14

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

Question 15

how many nasotracheal suctioning passes can you perform consecutively?

Answer 15

no more than 2

Question 16

what is the flow range for a nasal cannula?

Answer 16

1 - 6 L/min

Question 17

what is the flow range for a reservoir nasal cannula or oxymizer?

Answer 17

1 - 15L/min

Question 18

what is the flow range for a venturi mask?

Answer 18

4 - 12L/min

Question 19

what is the flow range for a partial nonrebreathing mask?

Answer 19

10 - 12L/min

Question 20

what is the flow range on a NRB mask?

Answer 20

15L/min

Question 21

what is the flow range for a face tent?

Answer 21

8 - 12L/min

Question 22

how do you clean an IV site?

Answer 22

• 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.

Question 23

when should you start preparing a refrigerated IV bag?

Answer 23

at least an hour before you hang it, so it is room temp

Question 24

what is the difference between a micro drip set and a macro drip set?

Answer 24

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

Question 25

0 on the phlebitis scale

Answer 25

no symptoms

Question 26

1 on the phlebitis scale

Answer 26

redness at the access site with or without pain

Question 27

2 on the phlebitis scale

Answer 27

pain at access site with redness and/or edema

Question 28

3 on the phlebitis scale

Answer 28

pain at access site with redness, streak formation, and palpable venous cord

Question 29

4 on the phlebitis scale

Answer 29

pain at access site with redness, streak formation, palpable venous cord >1 inch, and purulent drainage

Question 30

what are some things to remember concerning PCA programming(3)?

Answer 30

1) deliver ordered type and dose of pain medication
2) provide lockout interval
3) maintain 1 or 4 hour dose limit

Question 31

what are some events related to PCA requiring notification of nurse(5)?

Answer 31

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

Question 32

when you discontinue a PCA, what do you first document?

Answer 32

the amount of the medication used and the amount to be discarded

Question 33

what position should the patient be in for diaphragmatic breathing exercises?

Answer 33

standing or fowler’s or semi-fowlers

Question 34

if a CPN bag is a 2 in 1 solution, what should you inspect it for?

Answer 34

particulate matter or cloudiness

Question 35

if a CPN bag is a 3 in 1 solution, what should you inspect for?

Answer 35

separation of fat into layers

Question 36

if a CPN bag has been refrigerated, how long do you let it sit at room temp before administration?

Answer 36

one hour

Question 37

for CPN without lipids, what filter do you attach to the setup?

Answer 37

a .2 micron filter

Question 38

for a 3 in 1 CPN solution, what filter do you use?

Answer 38

1.2 micron filter

Question 39

What should you not use a CPN access for?

Answer 39

only use it for CPN.
DO NOT USE FOR:
* IV meds
* blood transfusions
* blood samples
* venous pressure readings

Question 40

CPN should not be interrupted for:

Answer 40

do not interrupt CPN for anything including:
* showers
* transportation
* transfusions

Question 41

vegans lack complete proteins in single foods. how can they get sufficient protein?

Answer 41

by using complementary proteins from two or more foods

Question 42

why are vegans at risk for vitamin b12 deficiency?

Answer 42

because vitamin b12 is only available from animal sources