Patient Care 14, 15, 16, 18

Description

Flashcards on Patient Care 14, 15, 16, 18, created by Haley Cordova on 19/11/2015.
Haley Cordova
Flashcards by Haley Cordova, updated more than 1 year ago
Haley Cordova
Created by Haley Cordova over 8 years ago
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Resource summary

Question Answer
6 "rights" of medication adminstration Right dose Right medication Right patient Right time Right route Right documentation
1 cc = ? 1 mL
5 routes of medication administration Enteral Topical Inhalation Sublingual/buccal Parenteral
Enteral route Administration directly into GI tract (Oral, nasogastric, rectal)
6 parenteral routes Intradermal Subcutaneous Intramuscular Intra-arterial Intrathecal Intravenous
Intradermal injections are administered at what angle? 15°
What angle are subq injections given at? 45°
Angle for intramuscular injections 90°
Typical sites for IM injections Deltoid muscle (upper arm) Gluteal muscle (hip) Vastus lateralis muscle (lateral thigh)
Which IM injection site should be avoided in children under 5? Gluteal muscle
What is the preferred IM injection site for children under 5? Vastus lateralis
Locking device that holds needle by twisting Luer-Lok
SESIPs Sharps with Engineered Sharps Injury Protection
Rapid injection of a large dose of contrast medium to increase opacification of blood vessels Bolus injection
How high above vein should Standard Gravity Flow IV be? 18-24"
Code Red Fire
Code Blue Heart or respiration stopping
Code Orange Hazardous material spill or release
Code Grey Missing adult
Code Pink Missing infant or child
Code Yellow Mass casualty
Code Clear Situation resolved
Code Silver Active shooter
Normal flow rate for oxygen administration 1 to 6 L/min
Trauma flow rate for oxygen administration Up to 10 L/min
Maximum flow rate for oxygen administration 15 L./min
Normal oxygen concentration 24% to 45%
Simplest oxygen administration route Delivers 24% to 45% oxygen at a rate of 1 to 6 L/min Nasal cannula
Provides oxygen and humidity for short term use 40% to 60% oxygen at 1 to 10 L/min Simple oxygen face mask
100% oxygen in bag Non-rebreathing oxygen face mask
Provides different percentage of oxygen as needed 40% to 70% Partial rebreathing oxygen face mask
Allows precise control of oxygen percentage High-flow oxygen mask
Which type of oxygen administration is commonly used for patients with COPD? High-flow oxygen mask
High rate of oxygen and humidity, often used in pediatrics Oxygen tent
For long-term use with critical patients Life support Mechanical ventilator/respirator
Where should tip of endotracheal tube be located in a chest radiograph? Above the carina
Surgical opening through neck to trachea Tracheostomy
Asthma Difficulty breathing caused by bronchospasm
Pulmonary embolism Blood clot, fat, or air lodges in vessel restricting blood flow to lungs
Treatment for PE Heparin (anticoagulant)
Acute Coronary Syndrome Group of symptoms that indicate heart attack
Angina pectoris Chest pain due to decreased oxygen to the heart because of narrowing of coronary arteries
Treatment for angina pectoris Sublingual nitroglycerin
Cardiac arrest Heart stops If no pulse or respiration begin CPR
Lack of circulation will cause brain damage in ________ minutes 3 to 5 minutes
Minimal tissue damage to brain Temporary mild disruption of physiological activity Concussion
Contrecoup Injury on opposite side of trauma
Contusion Brain bruise
Signs and symptoms of increased cranial pressure (due to bleeding and swelling) Decreased level of consciousness Lethargy Decreased responsiveness Irritability Headache Nausea/vomiting Decreased pulse and respiration rate
4 levels of consciousness 1. Alert and conscious 2. Drowsy but responsive 3. Unconscious, but reactive to painful stimuli 4. Comatose
Blood in pleural space Hemothorax
Air in pleural space Pneumothorax
Opening in chest wall with tube inserted into pleural cavity Thoracostomy
Flail chest Multiple rib fractures, part of chest wall is separated Can cause atelectasis; life threatening
Bleeding into the pericardium causing increased pressure that compromises heart function Cardiac tamponade
When sutures break open Post-surgical wound dehiscence
First degree burn Epidermis only Red, swollen, painful
Second degree burn Dermal layer Extensive blistering
Third degree burn AKA Full thickness Nerve endings destroyed Charred, white appearance Requires skin grafts
When radiographing burn patients what type of isolation should be employed? Reverse isolation (Protect the patient from your germs)
Most accurate indicator of shock BP 30 mm/Hg below baseline systolic or below 50 mm/Hg diastolic
Hypovolemic Shock Large blood or fluid loss (hemorrhage, vomiting) Treated with fluid replacement and oxygen
Septic Shock Occurs from massive infection Blood pressure drops rapidly Treated with antibiotics
Neurogenic shock Caused from injury to nervous system, head/spinal trauma Decreased BP
Cardiogenic shock Interference with heart function (MI or PE)
Shock Failure of circulation Blood pressure drops too low to support oxygen to vital tissues
How to treat shock Stop the procedure Lay patient on back Elevate feet to increase blood flow to brain Check BP and be ready for CPR Call code
Syncope Fainting Mild form of shock, help patient to ground without injury
Psychological Shock Now known as PTSD Caused by psychological stress
Common, normal side effects of contrast injection Warm, flushed feeling Sensation of urination Metallic taste
Mild reaction to contrast Nausea, vomiting Help patient to lateral recumbent, provide basin and monitor
Intermediate reaction to contrast Erythema, urticaria, bronchospasm, dyspnea Notify radiologist immediately, stay with patient as symptoms can progress to anaphylactic shock Benadryl or epinephrine to treat
Anaphylaxis/Severe allergic reaction to contrast Dysphagia (difficulty swallowing), warmth, tingling, itching, feeling of doom Can lead to seizures, cardiac arrest Call code Treat with epinephrine
Vasovagal reaction Non-allergic, contrast stimulates vagus nerve Hypotension, bradycardia, diaphoresis Treat with atropine
Diabetes Insipidus Caused by kidney or pituitary disorder and characterized by polyuria and extreme thirst
Diabetes Mellitus Inability to metabolize blood glucose Not enough insulin or cells stop responding to insulin
DM Type I Insulin deficiency Juvenile (Under age 25) Abrupt onset
DM Type II Non-insulin dependent Can be insulin deficiency or unreceptiveness Age 40+, overweight Gradual onset
Hyperglycemia Increased blood glucose levels due to insufficient insulin
Diabetic ketoacidosis Insufficient insulin causes liver to begin to break down fat for fuel creating ketones
Hypoglycemia Low blood sugar Give candy or OJ PO
Cerebrovascular accident Stroke Caused by interruption of blood flow to brain due to hemorrhage or clot
Warning signs of CVA Slurred speech Dizziness Severe headache Muscle weakness Blurred vision Temporary loss of consciousness
Grand mal Major motor seizure Violent convulsions, loss of consciousness
Petit mal Partial, focal seizure Uncontrollable tremors
Absence seizure Brief loss of consciousness Patient stares into space, eyes flutter
Epistaxis Nose bleed Have patient squeeze septum but do not lie down, blow nose, tilt head back or talk
Medical asepsis Reducing pathogenic microorganisms in the environment and intervening in their spreading
Surgical asepsis Process of creating and maintaining an area that is completely free of pathogens
Chemical sterilization Uses chemicals Difficult to determine effectiveness as it depends on immersion time, solution strength, temperature Not recommended for surgical asepsis
Autoclaving Steam sterilization Most common For objects that can stand up to 275° and moisture
Conventional gas sterilization Heated mixture of gases Used for items that cannot be autoclaved Effective but gases are poisonous and it is time consuming
Gas plasma sterilzation Safer and more cost-effective than conventional gas sterilization Not good for linens or objects with long, narrow lumens
Dry heat Most popular and effective Vacuum chamber with infrared heating element, up to 329° to 338° Cheaper than autoclave, but time consuming and not good for objects that cannot withstand heat
How far up arms do you scrub during surgical hand scrub? 2" past elbows
How long should you scrub hands during surgical hand scrub? 1 minute per hand
Closed gloving method With sterile gowning
Open gloving method Without sterile gowning
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