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ATI > ATI FINAL > Flashcards

ATI FINAL Flashcards

1
Q

ABCDE FRAMEWORK

A

AIRWAY-OPEN FOR BREATHING
BREATHING- NECESSARY FOR OXYGENATION
CIRCULATION- OXYGEN TO REACH TISSUES
DISABILITY- EVALUATION OF SURVIVAL POTENTIAL
EXPOSURE- SAFETY AND RISK REDUCTION

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2
Q

CONSIDERATIONS FOR ABC FRAMEWORK

A

LEAST RESTRICTIVE
LEAST INVASIVE
EBP
ACUTE VS CHRONIC
URGENT VS NONURGENT
STABLE VS NONSTABLE

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3
Q

ADVANCE DIRECTIVES

A

ASK ALL AT ADMISSION
SHOULD GIVE WRITTEN INFO
PURPOSE IS TO COMMUNICATE EOL WISHES
HCPOA- PROXY MUST BE COMPETENT AND PSYCH MUST DETERMINE PT CANNOT MAKE DECISIONS

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4
Q

WHEN WOULD CPR NOT BE INITIATED

A

ONLY IF DNR OR AND IS ON FILE

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5
Q

NASAL CANNULA USE

A

FiO2 OF 24-44%
FLOW RATE OF 1-6 L/MIN
SAFE, SIMPLE, COMFORTABLE
EXTENDED USE CAN LEAD TO BREAKDOWN
USE HUMIDIFICATION IF FLOW RATE >4 L/MIN

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6
Q

BEST PRACTICES FOR OXYGEN THERAPY

A

DETERMINE INDICATION LIKE ASTHMA OR HYPOXIA
RISK OF OXYGEN TOXICITY, COMBUSTION, OR OXYGEN INDUCED HYPOVENTILATION
WEAR/USE COTTON
ENCOURAGE DEEP BREATHING, MONITOR O2, PLACE IN FOWLERS OR SEMIFOWLERS, MONITOR O2 AND ABGS

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7
Q

TRACH SUCTIONING

A

INDICATED WITH SIGNS OF HYPOXEMIA. GOAL IS CLEAR PATENT AIRWAY. COMPLICATIONS ARE DISLODGEMENT OR HYPOXEMIA. SHOULD BE IN FOWLERS OR HIGH FOWLERS. ENCOURAGE DEEP BREATH AND COUGH. PRESSURE NO HIGHER THAN 120-150. NO LONGER THAN 10-15 SECONDS AND 2X OVER 5 MINUTES. INTERMITTENT SUCTION ON REMOVAL. CATH SHOULD BE LESS THAN 1/2 INTERNAL DIAMETER AND NO LARGER THAN 16 FRENCH WITH 8MM TRACH. HYPEROXYGENATE 100% O2 BVM PRIOR

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8
Q

PRIMARY PREVENTION

A

VACCINES, FITNESS, CAR SEAT, NUTRITION, EDUCATION

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9
Q

SECONDARY PREVENTION

A

SCREENING, EARLY DETECTION

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10
Q

TERTIARY PREVENTION

A

AFTER ONSET, SLOW PROGRESS, PREVENT COMPLECATIONS

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11
Q

APPLICATION OF SCD

A

Q8H SKIN ASSESSMENT
NO MASSAGING OR PRESSURE IF POTENTIAL DVT OR EMBOLISM. INFLATE 10-15 SEC AND DEFLATE 45-60 SEC. MEASURE LARGEST PART OF THIGH. POSITION OPENING AT KNEE

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12
Q

IV THERAPY

A

FLUSH Q8H
MONITOR SITE Q1H
CHANGE Q72H
16G TRAUMA, 16-20G SURGERY, 20-24G OTHER
CHECK COMPATABILITY, CLARITY, LEAKS, EXPIRATION, SIGNS OF COMPLICATIONS

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13
Q

IV INFILTRATION

A

SECURE CATHETER. S/S: PALLOR, SWELLING, COOL SKIN TEMP, DAMP DRESSING, SLOWED INFUSION RATE. STOP INFUSION AND REMOVE. ELEVATE EXTREMITY AND ENCOURAGE ROM. APPLY WARM/COLD COMPRESS. RESTART PROXIMAL OR ON ANOTHER EXTREMITY
*EXTRAVASATION MAY NEED ANTIDOTE ADMIN PRIOR TO DISCONTINUING

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14
Q

COMPLICATIONS OF TRACH CARE

A
  1. ACCIDENTAL DECANNULATION- VENTILATE WITH BVM AND CALL FOR HELP
  2. TRACHEA DAMAGE- CUFF PRESSURE 14-20 AND CHECK Q8H, NO PULLING ON TUBING. CHANGE PARTS Q6WK, REPOSITION Q2H, MINIMIZE DUST, POSITION UPRIGHT AND CHIN TO CHEST FOR MEALS
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15
Q

BEDSIDE REQUIREMENTS FOR TRACH

A

2 EXTRA TRACH TUBES (1 SAME SIZE AND 1 SIZE SMALLER)
OBTURATOR FOR EXISTING TUBE
O2 SOURCE
SUCTION CATHS
SUCTION
BVM
METHODS OF COMMUNICATION
EMERGENCY CALL SYSTEM
HUMIDIFICATION
HYDRATION
CARE Q8H
ORAL CARE Q2H

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16
Q
A
17
Q

S/S OF FLUID OVERLOAD

A

DISTENDED NECK VEINS
INCREASED BP
SOB
TACHYCARDIA
LUNG CRACKLES
EDEMA

18
Q

INTERVENTIONS FOR FLUID OVERLOAD

A

DECREASE IV FLOW RATE
RAISE HOB
MEASURE VS AND O2
ADMIN DIURETICS

19
Q

POTENTIAL IV THERAPY COMPLICATIONS

A

INFILTRATION
EXTRAVASATION
PHLEBITIS
THROMBOPHLEBITIS
*STOP THE INFUSION

20
Q

INTERVENTIONS FOR CONSTIPATION

A
  1. START WITH FIBER AND FLUID INCREASE
  2. USE BULK FORMING BEFORE SOFTENERS, STIMULANTS OR SUPPOSITORIES
  3. ROUTINE ABDOMEN EXAMINATION
  4. PERFORM DIGITAL RECTAL EXAM WITH KNEES FLEXED, LEFT SIDE, RIGHT LEG FORWARD
  5. MONITOR FOR VAGUS NERVE STIMULATION CAUSING BRADYCARDIA
  6. ENEMAS ARE LAST RESORT
  7. ENEMAS INSERTED 3-4 INCHES
21
Q

PARALYTIC ILEUS

A

PROLONGED CONSTIPATION FROM SURGERY, ELECTROLYTE IMBALANCE, WOUND INFECTION OR MEDS

22
Q

WOUND VAC

A
  1. ADEQUATE HYDRATION, PROTEIN, AND CALORIE NEEDS (2500 ML/DAY, MEAT, FISH, EGGS, BEAN, NUTE, AT LEAST 1500 KCAL/DAY)
  2. CLEAN IN TO OUT
  3. 5-8 PSI –> 30-60 ML SYRINGE WITH 19 G NEEDLE
  4. GENTLE FRICTION
  5. NO COTTON BALLS
  6. USUALLY ISOTONIC
  7. NOTE ALBUMIN BELOW 3.5
  8. MAY NEED TO ADMIN ANALGESICS
23
Q

WHY WOUND VAC

A

SPEEDS TISSUE REGENERATION
DECREASE SWELLING
ENHANCE HEALING IN A MOIST AND PROTECTED ENVIRONMENT
USED IN PROLIFERATIVE STAGE TO SPEED REPLACEMENT WITH CONNECTIVE OR GRANULATED TISSUE WITH COLLAGEN

24
Q
A

ATI (10 decks)

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