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nursing 2900 > Acute and Complex > Flashcards

Acute and Complex Flashcards

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1
Q

How often should you check pain scale after administration of tylenol

A

1 hour

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2
Q

how often should you check pain scale after administration of Toradol

A

15-30 mins

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3
Q

Implementation (interventions) For acute pain

A

Ice and heat
repositioning
distraction
essential oils

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4
Q

Implementation (interventions) for impaired physical mobility

A

encouragement physically and emotionally
pre-medicate

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5
Q

implementation (interventions) for nausea

A

alcohol pad
slow down drinking

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6
Q

Implementation (interventions) for constipation

A

Movement
fiber intake
coffee/prune juice
fluid intake

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7
Q

Name a couple nursing Evaluations for reducing pain

A

Client will reduce pain by blah blah blah
skin integrity, resp depression, PCA use, minimal side effects from analgesic, anxiety, mobility

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8
Q

independent vs collaborative interventions for mobility

A

independent interventions are what you can do before asking for other specialties (PT, Radiology, MD)

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9
Q

Implementation of strategies to modify stuff for mobility

A

Education and empower them to get their shit together

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10
Q

Rocephin cannot go in what fluid

A

LR

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11
Q

How much should you flush through an Saline lock

A

5 mL to 10 mL

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12
Q

Complications of IVs

A

Infiltration/extravasation
phlebitis/thrombosis
Hematoma
Cellulitis
Infection

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13
Q

What to Assess with IV

A

Improperly secured IV (pulled out)
Length of time device was in place (infection
erythema at site, redness or warmth
pain or burning at the site and/or along the length of vein
vein is hard, red and cordlike

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14
Q

What are Colloids

A

large protein molecules that dont pass semipermeable membranes.
* Remain in vascular system (no absorption
* Increase intravascular volume

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15
Q

Why are colloids awesome

A

used when people need volume expansion but they cant tolerate large infusions of crystalloids

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16
Q

Commonly used Colloids

A

Human Albumin, hetastarch or hespan, synthetic starches, blood products

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17
Q

What are crystalloids

A

Most like body fluids. They are easily mixed and dissolve in a solution.

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18
Q

What is crystalloid fluid used for?

A

increase the fluid volume in both interstitial and intravascular space.
* passes the semipermeable membrane so goes from blood stream into cells and body tissues

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19
Q

Three types of crystalloids

A

Isotonic
hypotonic
hypertonic

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20
Q

Isotonic

A
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21
Q

Hypotonic

A
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22
Q

Hypertonic

A
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23
Q

RN responsibilities for IV therapy

A

1 Know infusion orders and what is expected outcome
2. Evaluate if appropriate for pt
3. make sure orders are followed and communicate to oncoming RN
4. Document
4a. Where are the sites of the
IV and what are they

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24
Q

Indications for IV therapy

A

fluid: increase, replace. med admin, blood donation or need, nutrition

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25
Good stuff about IVs
Bioavailability, maintenance, site for nutritional support
26
Bad stuff about IVs
no time to correct errors, once it's in youre stuck
27
what is a central line
general term for IV cath that ends in a large blood vessel
28
Where does a central line absolutely need to terminate in vessel
SVC within 3-4 cm of the atrial superior vena cava junction (right above the enterence of the RA) Cant fucking kink. Confrimed with radiology (xray)
29
Where is a CVL usually placed?
EJ or IJ. Sometimes AC or subclavicular
30
procedure for putting in central line
sterile procedure, 1,2,3 lumen, made from a flex material and placed with a guide wire, Xray to confirm
31
What is a PICC
peripherally inserted cath line. can have 1,2,3 in a single line
32
Where is a PICC usually put
Upper arm. Really long and ends in a large vessel
33
can you give incompatible meds through PICC lines
yeah, different endings
34
what is the difference between Midline and PICC
where the tip of the catheter ends. Mid ends near the subclavian veins vs the vena cava
35
Indications for Central lines or PICC lines
1. vesicant / hyperosmolar infusions or long term use 2. frequent lab draws 3. TPN 4. Monitor RA pressures
36
Contraindications for PICC or Central line
Immunosuppression, thin blood, fracture/trauma to area, anatomical issues, superior Vena cava syndrome (bad flow into the heart), local infection
37
Situs inversus def
Where your organs develop as a mirror image on the opposite side
38
Complications of central line
pneumo, infection, air or blood emboli, inflammation, equipment breakdown (broken cath, migration, blah blah), nerve or vascular injuries.
39
Phrenic nerve is located where and what does it do?
Rooted in Cervical spine 3-5. A plays a role in skeletal movement while breathing
40
What are some causes of IV occlusions
clotted off, kinked, pulled, drugs fat deposits
41
Steps to fix occlusion in IV
facility policy, never force flush, use 10 mL syringe, Call doc (tPA or PLAT)
42
what is tPA
43
site management of transparent dressing for Central lines
7 days for Tecaderm, caps every 72 hours flushing: masking for everyone, gloves, scrub hub chlorohexidine 15 seconds, 10 mL pulsing flush before and after meds,
44
Blood draws
45
Port or portacath are what
placed under the skin in chest by hubert and ends in large vein close to the heart and connected port. Needle can stay in for 7 days
46
What are tunneled catheters?
used in ches and threaded through a tunnel of tissue until it enters vein.
47
How long can tunneled catheters stay in?
Can stay in for >6 weeks
48
Where should TPN always be run through
Central line
49
Feeding regimen related to electrolyte balances
hypoglycemia, hypokalemia, hypocalcemia
50
how much should someone gain in 24 hours from tpn
1 lbs
51
Nursing considerations with TPN
I&O (EVERYTHING) BGL status of dressing and site condition if you can see it
52
TPN tubing need to be changed how often
every 24 hours (prevents bacteremia in tubing)
53
What other medications are able to run in TPN
ONLY LIPIDS!!
54
TPN is always run through a filter. T or F
True
55
Lipids are usually run for how long?
12 hours
56
Schizophrenia brain changes
Enlargement of lateral and third ventricles reduction in frontal lobe, temporal and amygala
57
Schizophrenia in US are how much more likely to die in the US
2-3
58
Risk factors for schizophrenia
Childhood trauma (predisposed to stress), malnutrition, cannabis, vitamins, old man sperm,
59
Positive symptoms of Schizophrenia
Hallucinations - see touch command, touch, feel Delusions - paranoid, grandiose, referential, somatic Disorganized speech and thinking - neologism, word salad, derailment, echolalia, tangentiality
60
Negative symptoms of schizophrenia
Affect flat anhedonia apathy and avolition (no motivation) Alogia (poor speech) anxiety and avoids social interaction Catatonia (motionless)
61
Treatment goals for schizophrenia
Safety induce remission prevent exacerbation improve behaviors and psychosocial and cognitive function
62
ECT
electro convulsive therapy
63
PHQ9 is for what
patient health questionnaire for suicidal ideations
64
AIMES
extrapyramidal side effects1
65
difference between borderline and bipolar
borderline makes conscious decisions for moods bipolar doesn't know and their emotions are changing and last for longer
66
anxiety vs anxiety disorders
Anxiety is situationally based Anxiety disorder impairs your life.
67
schizophrenia vs schizoeffective
Schizoaffective has another mood disorder along with the schizophrenic hallucinations
68
Is tardive dyskinesia permanent?
if you catch it early, otherwise they're stuck acting like Bardy crouch JR.
69
If your on steroids for long periods of time what can happen
Reduce your immune system
70
Which med classification should be noted before surgery due to electrolyte imbalance?
Diacritics
71
special considerations during preoperative period
Fatties, Disabilities, Ambulatory and emergency surgery
72
BGL under what allows you to heal the fastest
150.
73
Uterine atony
soft and weak uterus after delivery.
74
Uterine trauma
damage to the vagina, cervix, uterus, or perineum causes bleeding. Forceps vacuum extraction can increase the risk
75
Hematoma can form in a concealed area and cause
bleedign hours or days after delivery
76
retained placental tissue
The entire placenta doesnt separate from the uterine wall
77
5Ts of PPH
tone tissue trauma thrombin traction
78
Signs and symptoms of post partum hemorrhage
Tachycardia anxiety hypotension hypotension decreased RBC Pale or clammy skin basically hypovolemia for fuck sakes
79
Modifiable risk factor for PPH
Prolonged labor vaginal laceration fetal malposition labor induction uterine atony cesarean deliver (VBAC) intrauterine fetal death placental previa
80
Non modifiable risk factor for PPH
Female old fetal macrosomia primigravida grand multiparity history of PPH Large for gestational age
81
TOLAC
82
How would you describe the Romburg test
The nurse should inform the client that the Romberg test will be performed once with eyes open and once with eyes closed. A Romberg test is performed to assess balance and motor function.
83
for a client in hepatic coma, which outcome would be the most appropriate?
The client is A&Ox 4
84
85
pruritus. Which nursing intervention would be included in care plan for the client
Keep fingernails short and smooth
86

nursing 2900 (3 decks)

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