Unit 1 Flashcards
Sodium normal levels
135-145
Potassium normal levels
3.5-5.0
Calcium normal levels
8.5-10.5
Magnesium normal levels
1.3-2.1
Chloride normal levels
97-110
Phosphate normal levels
2.5-4.5
PH normal levels
7.35-7.45
PaO2 normal levels
80-100
CO2 normal levels
35-45
PaCO2 normal levels
35-45
Bicarbonate normal levels
24-30
Carbonic acid normal levels
2.4
BUN normal levels
8-25
Creatinine normal levels
0.6-1.5
GLucose normal level
65-110
Serum osmolality normal levels
280-300
Hematocrit % normal level
36%-52%
Isotonic fluids
5%dextrose in water
0.9% sodium chloride
Lactated Ringers
Water does not move into or out of cells
Hypertonic fluids
5% dextrose in 0.9% sodium chloride 5% dextrose in 0.45% sodium chloride 3% normal saline 5% dextrose in lactated ringers Corrects fluid, electrolyte and acid base imbalances Par enteral nutrition
Scope of medical surgical
Nurses promote, restore or maintain optimal health for patients
Promote health
Prevent illness/injury
Nurses must have broad knowledge base
Expanding knowledge and technology
Ensure pt. safety as priority
IOM- 44,000and 98,000 pt deaths result each year from preventable errors
100,000 lives campaign: effort to save lives
Rapid Response team- save lives; provide care before resp. Or cardiac arrest
6 core QSEN competencies
Provide patient centered care Implement EBP Use informatics in patient care Collaborate w/ HCT Use quality improvement in patient care
Provide patient centered care-Focus on
Communication Compassion Culture Patient education Empowerment Respect
SPEAK UP Campaign
Speak up Pay attention to care receiving Educate self Ask trusted family member Know medications you take Use hospital Participate in all decisions
Autonomy
Self- determination
Beneficence
Promotes positive actions
Veracity
Nurse obligated to tell truth to best of his/her knowledge
Teamwork and Collaboration
Planning
Implementation
Evaluating patient. Care together using ID plan of care
SBAR communication
Situation: what is happening
Background: relevant background info
Assessment: analysis of problem
Recommendations: needed or desired outcome
Quality Improvement
Monitor quality and effectiveness
Access and evaluate data
Recommend ways to improve care
Implement activities to improve care
Informatics: Information and tech used to
Communicate
Support decision making
Manage knowledge
Decrease errors
5 rights of delegation
Right task Right person Right supervision Right circumstances Right communication
Delegation
Transferring to a competent person of authority to perform a selected nursing task
The nurse is always
Accountable for the task that is delegated
Supervision
Guidance or direction, evaluation and follow up by the nurse to ensure task is done properly
Filtration
Movement of fluid through cell or blood vessel
Related to water volume pressing against confining walls
Hydrostatic pressure
Water-pushing pressure
Blood pressure
Edema: clinical significance
Diffusion
Free movements of particles across permeable membrane from higher to lower
Sodium potassium pump
Glucose cannot enter unless insulin present
Minimum urine amount needed to excrete toxic waste products
400-600 mL/day
Insensible water loss
Stool
Skin
Lungs
Dehydration care
Fluid intake does not meet body's fluid needs Effects: Cardio Respiratory Skin Neurological Renal
1L of water weighs
2.2 lb equal to 1 kg
Weight change of 1lb
Fluid volume change of about 500 mL
Fluid overload care
High
Older adults
At risk for fluid imbalance
Tearing of skin
Select higher in arm
Angle 10-15 degrees
Isotonic
Hypertonic
Hypotonic
Stay in vascular
Treats fluid overload
Treats dehydration
TPN has osmolarity
> 1400
Never be infused peripheral circulation
Peripheral IV therapy
Dwell for 72-96 hours then require a new insertion site
Veins cannot be used in patients with:
Mastectomy Auxiliary lymph node dissection Lymph edema Paralysis of upper extremities Dialysis graft or fistulas
CD recommends aseptic technique include:
Hand hygiene Clip hair; do not shave Ensure skin is clean Wear gloves Prepare skin with 70% alcohol
Midline catheter
3-8 inches Inserted through vein in upper arm Used for therapies 1-4 weeks Do not use vesicant drugs; can cause tissue damage Do not use to draw blood
Central IV. Therapy
Placed into the superior vena cava
Chest X-Ray to confirm placement
PICC (Peripherally Inserted Central Catheter)
18-29 inches
Chest X-Ray determines placement
Used for contrast injection
Nontunneled per cutaneous central venous catheter
Inserted through subclavian vein in upper chest or jugular vein May require insertion in femoral vein 7-10 inches Tip resides in SVC Chest X-Ray confirms placement
Implanted Port
Surgically created subcutaneous pocket houses the port body Placed in upper chest/extremity Not visible FLushing after each use ANd flushed at least once per month
Hemodialysis catheter
Catheters-related bloodstream infections
Vein thrombosis
Do not use for administering other fluids/medications
Change lipid tubing every
24 hours
Change blood tubing every
4 hours
Change propofol tubing every
6 to 12 hours
Interventions to reduce infection risk:
Clean needle less system connections before use for 30 seconds
Do not tape connections tubing sets
Hand hygiene
Steps of EBP process
Asking burning question
Find find the very best evidence available
Critically appraise and synthesize relevant evidence
MAke recommendations for practice improvement
Implement accepted recommendations
Evaluate outcomes
Qualitative
Focuses on meaning and interpretation of experience
Quantitative
Asks about relationship between defined measurable phenomena
Statistical analysis
PICOT format
Population Intervention Comparison Outcome Time
Level 1 of evidence
Book
Level 2 of evidence
Book
