final

Question 1

where do we do a cap glucose measurement

Answer 1

side of the finger (pad)

Question 2

why do we wipe away first drop of blood for glucose test

Question 3

what is DKA

Answer 3

body can’t produce enough insulin, body begins to break down fat as fuel causing buildup of acids in bloodstream = ketones

Question 4

what order do you draw up insulin

Answer 4

air in N (long acting), air in R (rapid acting), draw R, draw N

Question 5

what are the kinds of insulin and how fast will they work

Answer 5

rapid = onset 15-30 mins, peak = 1-3hrs

short = onset 30-1hr, peak = 1-5hrs

intermediate = onset 1-2 hrs, peak = 6-14 hrs

long = onset 0.8-2 hrs, peak = peakless

Question 6

what sites can you use for insulin and what angle injection

Answer 6

adipose tissue: upper arms, outer side of thigh, belly area

5cm tissue = 90 degrees
less than 5cm tissue = 45 degrees

Question 7

what is heparin? what are contraindications to heparin adminsiteration

Question 8

what is the correct size of subcutaneous syringe

Question 9

what is the max amount of volume in the subcutaneous site

Answer 9

2mL

Question 10

why do we do a TB skin test

Question 11

where is the correct spot for TB?

Question 12

what angle of insertion for TB

Question 13

what other things might be given intradermal?

Question 14

what is different b/w blunt fill and filter?

Answer 14

filter = prevent small glass fragments from entering syringe

blunt fill = used to draw up medication

Question 15

which needle do you use for vial? an ampule?

Answer 15

vial = blunt

ampule = filter

Question 16

what are some differences b/w vial and ampule

Answer 16

ampules = single dose medication, constricted neck must be snapped off to access medication, scored for easy break

vial = single or multi dose, rubber seal, closed system, air must be injected into vial to permit easy withdrawal

Question 17

name the different parts of a syringe

Answer 17

plunger, barrel, needle hub

Question 18

would you draw up from a vial or ampule first if you were mixing 2 medications?

Question 19

how many litres would you put the O2 to for NP, simple face mask, non-rebreather

Answer 19

NP = 1-6mL
simple face mask = 5-8mL
non-rebreather = 10-15mL

Question 20

what is a normal oxygen level? for a COPD patient

Answer 20

greater than 95%

88-92%

Question 21

signs of hypoxia include?

Question 22

what is difference b/w high and low flow oxygen delivery device

Answer 22

low = oxygen mixing with room air (NP, simple face mask)

high = deliver O2 rates above normal inspiratory flow rate

Question 23

how would you explain an incentive spirometer

Answer 23

encourage voluntary deep breathing by providing visual feedback

suck in (inhale) until ball raises and you can’t inhale any longer, hold breath for 5 secs, exhale normally

Question 24

name 2 breathing exercises that require no equipment and how would you explain them

Answer 24

pursed lips = breathe in slowly through nose for 2 counts, purse lips as if you are going to whistle, breathe out for 4

deep breathing & coughing = breathe in slowly through nose for 3 counts, keeping mouth close, exhale slowly through mouth and cough at end of exhale

Question 25

explain how to admin NEBS

Question 26

explain how to admin metered dose inhaler (MDI) with & without spacer

Question 27

what time of the day is the best sputum sample

Answer 27

early in morning

Question 28

3 elements to pronounce?

Answer 28

pulse, respiration, HR (VS) no response to shout and pain

Question 29

under what circumstances can an RPN pronounce?

Answer 29

with a physicians order 2 nurses listen to apical HR for 1 min

Question 30

rigor mortis, algor mortis, livor mortis

Answer 30

rigor = stiffening of body (couple hrs after death, peak 8 hrs, gone after 12hrs) algor = cooling of body (1 degree per hr) livor = settling of blood (red blood cells settle into skin, see on back)

Question 31

what is the advantage of a subcutaneous butterfly & where do we put them

Answer 31

less injections with needle — provides more comfort upper arm, thigh, abdomen

Question 32

how would you prepare a subcutaneous medication for the first use of butterfly

Question 33

what is the otic route

Answer 33

ear

Question 34

what is the ophthalmic route

Answer 34

eye

Question 35

what instructions do we give patients when taking sublingual medications

Answer 35

do not swallow, place under tongue and let dissolve slowly

Question 36

what position for rectal medications

Answer 36

left side sims position

Question 37

transdermal patches deliver medication how?

Answer 37

absorbing through the skin

Question 38

what is difference b/w buccal & SL

Answer 38

buccal: cheek SL: under tongue

Question 39

what size syringe do we use for IM

Answer 39

3mL

Question 40

name the 4 sites for IM and landmark, naming the appropriate anatomy

Answer 40

deltoid = expose upper arm, relax arm, palpate lower edge of acromion process, inject ventrogluteal = nondominant hand, greater trochanter, iliac crest, iliac spine, heel of hand over greater trochanter, point thumb towards groin, index finger to anterior iliac spine, other fingers on iliac crest, inject in V vastus lateralis = greater trochanter & top of knee, inject in middle — anterior lateral aspect of thigh dorsogluteal = divide into quarter & inject upper outer quadrant

Question 41

what is the max volume for each site

Answer 41

deltoid = 2mL dorsogluteal = 4mL ventrogluteal = 3mL vastus lateralis = 3mL

Question 42

what is the preferred site for adults? for children?

Answer 42

adults = ventrogluteal children = vastus lateralis

Question 43

why are women more prone to UTI

Question 44

what are signs of UTI

Answer 44

pain and burning sensation, fever, chills, vomiting, urgency, hematuria, cloudy foul smelling, change of colour

Question 45

define: polyuria, dysuria, oliguria, anuria, frequency, retention, neurogenic bladder

Answer 45

polyuria: large amount of urine dysuria: painful urine oliguria: small amount of urine anuria: no urine retention: holding onto urine neurogenic bladder: lack bladder control due to brain, spinal cord or nerve problems

Question 46

what is purpose of a bladder scanner

Answer 46

to determine how much urine is in the bladder

Question 47

what is fecal occult blood test for

Answer 47

check stool samples for hidden (occult) blood

Question 48

advantage of condom catheter over urinary catheter

Question 49

what is C+S

Question 50

what is surgical asepsis

Answer 50

procedures used to eliminate all microorganisms — complete removal

Question 51

what is a nosocomial infection

Answer 51

infection that is acquired in a hospital setting

Question 52

what are the 3 types of precautions in hospital & name an example

Answer 52

contact — MRSA airborne — TB droplet — rubella, mumps, influenza

Question 53

what kind of equipment do you need for each precaution

Answer 53

contact = gown, gloves airborne = respiratory protection device (N95) droplet = mask

Question 54

what is the order of donning and doffing

Answer 54

donning: hand hygiene, gown, mask, eye protection, gloves doffing: gloves, hand hygiene, gown, hand hygiene, eye protection, hand hygiene, mask, hand hygiene

Question 55

chain of infection what are the different elements

Answer 55

infectious agent (pathogen) reservoir (source for the pathogen to grow — person, environment) portal of exit of reservoir (sneeze) mode of transmission (direct, indirect, vehicle, vector) portal of entry into host (wound) susceptible host