Appendicitis

Question 1

Patho?

Answer 1

Related to low fiber diet

Question 2

Number 1 thing to worry about?

Answer 2

Rupture

Question 3

Pain

Answer 3

Generalized pain initially

*eventually localizes in the RLQ (McBurney point)

Question 4

GI

Answer 4

Rebound tenderness
NV
Anorexia

Question 5

Diagnosis?

Answer 5

WBC increased
UC
CT

Question 6

Do we give enemas or laxatives ?

Answer 6

No, worried about rupturing!

Question 7

Treatment?

Answer 7

Surgery

Question 8

After any abdominal surgery, what is the position of choice?

Answer 8

Semi-Fowlers

*never want pressure on a suture line

Question 9

TPN aka ?

Answer 9

Hyperalimentation

Question 10

TPN

How to store

Answer 10

Keep refrigerated
Warm for administration
Let sit out for a fe minutes prior to hanging

Question 11

TPN

What line

Answer 11

Central line (anything more than 10% needs central line)

Question 12

TPN

What is needed?

Answer 12

Filter needle

Question 13

TPN

Can anything else go through the line?

Answer 13

Dedicated line for TPN so no

Question 14

TPN

Discontinue gradually to avoid?

Answer 14

Hypoglycemia

Question 15

TPN

Daily ?

Answer 15

Weight

Question 16

TPN

May have to start taking ?

Answer 16

Insulin

Question 17

TPN

BG monitoring every ?

Answer 17

6 hr

Question 18

TPN

Check urine for?

Answer 18

Ketones and glucose

Question 19

TPN

T/F: Do not mix ahead

Answer 19

T

*mixture changes everyday according to electrolytes

Question 20

TPN

How long can it be hung for?

Answer 20

24 hours

Question 21

TPN

T/F: Change tubing with each new bag

Answer 21

T

Question 22

TPN

IV bag may be covered with dark bag. Why?

Answer 22

To prevent chemical breakdown

Question 23

TPN

Need to be on a ?

Answer 23

Pump

Question 24

TPN

Home TPN–emphasize ?

Answer 24

Hand washing

Question 25

TPN Most frequent complication?

Answer 25

Infection

Question 26

TPN Protein can't leak through the glomerulus unless?

Answer 26

Kidney damage

Question 27

Central line assisting Have what?

Answer 27

Saline available for flush Do not start fluids until positive confirmation of placement (CXR)

Question 28

Central line assisting Position?

Answer 28

Trendelenburg to distend veins

Question 29

Central line assisting If air gets in the line, what position?

Answer 29

Left side trendelenburg (then go to cath lab to get air out)

Question 30

Central line assisting When an air embolus is suspected in the heart, the client may be taken where?

Answer 30

To cath lab for removal of air

Question 31

Central line assisting When you are changing the tubing, how can you avoid getting air in the line?

Answer 31

Clamp it off alsalva Take a deep breath and HUMM

Question 32

Central line assisting Why is an x-ray done post insertion?

Answer 32

Check for placement | Make sure client doesnt have a pneumothorax