Stuff I wanna know final Flashcards
max amt for IM
4-5 but only 2=3 well absorbed
max for butterfly
2-3
max for child sub Cut
0.5
max for sub cut
0.5-1.5
Systemic complications for SPC
Septicemia
cirulatory overload
embolism
Local complications because of
Poor insertion inappropriate size bad stable ph or osmolarity 900+ poor assess incort or infrequent dress changes
how often dress change
5-7 days for semi perm. 2 for gauze
what to label on IV dress
date & time applied
Size, type of device & insertion date
when to change IV site
4 days
when to change IV tube
4 day for continuous of 24 hour for intermittent
seniors & children IV gauge
22-24
25 gauge for?
sub cut
22 gauge?
IM
affects the rate
vasospasm venous trauma manipulation of device flexion occlusion
mirror drops
60 per mill for less than 100 ml an hour
where IV container go
30 inches above site or 76.2 cm. Piggy back 6 inch higher
LISPRO HUMALOG
ONSET 15-30 minutes
Peak 60-90 minutes
DURATION 3-6 hours (2-5)
Give 15 before meal
ASPART
ONSET 10-20
Duration 3-6 hours
GIVEN 5-10 BEFORE MEAL
Regular insulin
onset 30-60
peak 1-5
Duration 10
GIVE 30 MINUTES BEFORE MEAL
NPH
1-2 hr onset
6-12 hr peak
18-24 hr
when sterilestips
any separtation greater then 2 seiches / staples apart
snsure to cut 4-5 cm or 1.5-2 in on each side of wound
how much can JP drain hold
100-200 ml/24 hr
how much can hemovac hold
500 ml/hr
how often check drainage
hourly
when to remove sutures & staples
usually 7-14 days
when to remove retention sutures
usually 14-21 days
when are drains usually removed
24-48 hour
what does skin do
thermoreg, metabolism, immunity, fluid balance regulation
outermost layer - stratum corneum
prevent dehydration, physical burial & topical med
inner most layer - stratum germinative
basal layer single keratinocytes
how do partial thickenesss heal
by regeneration (only epidermis & partial dermis)
how do full thickness wounds heal
SCAR FORM
Phases of wound healing
1) Hemostasis = Control blood loss
2) Inflammatory = control inflame & clean wound bed
3) Proliferative = epithelial cells layer down within 24-48 hours - contraction- HEALING RIDGE BY 5-9 D
4) Maturation & remodel = collagen is remodelled - stronger
Factors that negatively impact wound healing
Hypovolemia, hypotension, vasoconstriction, edema, hypoxia , nutrition, DM, Corticosterioid, advanced age
how long is terry left open
3-5 d
Neg pressure wound therapy
Edema & fluid removed, contraction, optimized blood flow new BP, moist environ
clean
always start @ suture line “cleanest
infection
microorganism form wound surface penetrate into wound tissue
when does dehiscence occur
5-8 days post op
when does Infection occur
3 days post op but if you put somethingg in the 1 yr
what contributes to dehiscence
anemia, malnutrition obesity or steroids
new dressing label
has date, time & initials on it
TIME ACCRONYM
TISSUE MANAGMENT (BIOBURDEN) INFLM/INFECT
MOISTURE
EDGE (goal is proliferative
Key principles of physiological wound environment
adequate moisture
temp control
ph
control bacterial burden
Polyurethane film dressing
surgical infection
gauze dressing
not for granulating - change 2-3x a day
transparents/ waterproof
shallow, minimal exudate, partial thickness, easy view may cause maceration, hard to removed.
Change every 3-4 days
hydrocolloids
gel semi occlusive
full thick, not einfected
Maceration
change 2-5 days
hydrogel
Partial or full thick, light exudate, clean base, decreases pain increases autolysis, onfoms to wound
change 3x a week
alginates
highly obsorbent, trump, leg ulcer, nonaderence, emocculsive, 24-48 hours
foam dress
All! good for the really bad onesssss
24 hours change
dry
protect from injury, sped heal, not interact with wound tissues
wet to dry
not good it derbies
wet to moist
not good - hypertonic - pulls fluid out - dries out
moist environment
favours epithelial cell migration, promote extracellular maxtrix, drerease fibrosis, decreases infection
full thickness wounds
inflame 3 days
proliferation is 3-24 days
remodel is 2 years
epithelial resurface
7-10 days
hemorrhage
greatest risk 24-48 hours
infection
all chronic wounds considered infected
what is a fistula
abnormal passage between 2 o4gan or organ & body
poor wound healing
infection, lyte imbalance, breakdown
Purpose of dress
Not contaminated aid hemostasis patient can't seee support thermal insulation moist environment
