Flashcards in Final, Super Important Only Deck (57):
serious safety error that causes death or serious injury like loss of limbs or function and needs to be further investigated for cause
Aim at base
What should you do if there is a fire alarm, but there is no smoke or fire in your unit?
Close hallway and patient doors
What is the chain of infection?
infectious agent, source, portal of exit, mode of transmission, portal of entry, host
What is MRSA treated with?
vancomycin (which may be very toxic to liver)
What is VRE treated with?
synercid and zyvox
Which diseases are airborne precautions?
TB, varicella, measles
Which diseases are droplet precautions?
pneumonia, meninjitis, flu
Which disease are contact precautions?
VRE, MRSA, C. Diff
What is enteric precautions?
What is strict precautions?
airborne AND contact
What is protective precautions?
Protects patient when they have low WBC counts
What do T-lymphocytes (cellular immunity) do?
Attack microbe at site of invasion and keep a memory of the antigen
What do B-lymphocytes (humoral immunity) do?
Produce antibodies which produce resistance
What is the first, second, and third lines of defense?
1. skin and fluid secretions (tears, oil)
2. inflammatory response
3. immune response
Besides UTIs, what are the other big HAIs?
surgical site, bloodstream, and respiratory
results from a procedure (UTI)
organism external to patient (c.diff)
part of normal flora, becomes pathogenic (streptococci, e. coli)
Prodromal stage of infection
nonspecific symptoms occur
Convalescence stage of infection
completes the progress of an infection- antibodies appear in the blood and body systems return to normal
What is normal ANC, and when does a patient need to be in protective isolation?
Normal is 1500, below 500 requires isolation
tensing a muscle, then releasing (quad exercises)
Which center controls voluntary movement? Involuntary?
Voluntary; cerebral cortex
What are the cardiovascular effects from immobility?
increased cardiac workload, orthostatic hypotension, increased HR, and decreased bp
Indications that a patient needs turned more than every 2 hours?
blanched or red areas, decreased cap refill
Right after injury- vasoCONSTRICTION and clot formation
1-3 days; vasoDILATION and phagocytosis
3-24 days; wound fills with granulation tissue
up to 2 years: collagen scar gains strength
Primary wound healing
clean wound caused by sharp object; edges CAN be brought together
Secondary wound healing
some pressure wounds; edges CANNOT be brought together, epithelium grows over scar
Tertiary wound healing
large, granulation tissue fills in, closure with a scar
5 Cardinal Signs of Injury/Infection
redness, heat, edema, pain, altered function
Normal Glucose Level
What effect might corticosteroids have during surgery?
bradycardia and hypotension
What effect might antihypertensives have during surgery
decrease body's ability to handle stress
What are the early signs of malignant hyperthermia?
jaw muscle rigidity, increased CO2 volume, ventricular dyrhythmia, tachypnea, cyanosis, unstable BP
What are the antagonists for moderate sedation?
naloxone or flumazenil
What is conscious sedation used for?
diagnostic tests (colonoscopy, biopsy)
How soon after surgery to respiratory complications occur?
First 48 hours
What are two signs of hemorrhage?
low BP and high HR
Besides hemorrhage, when do circulatory complications occur post op?
How soon after surgery do infections occur?
Difference between a-delta and c-fibers?
A-delta: sharp, localized pain w/ injury
C-fibers: dull, poorly localized pain after injury
What do prostaglandins do?
regulate smooth muscle contraction
What is modulation?
inhibition of the nocioceptive impulses in the CNS; after the brain perceives pain, it releases serotonin and NE to produce analgesia
What acts as a pain gate?
dorsal horn cells
What opens the pain gate? What closes the pain gate?
Open: a-delta and c-fibers
Close: alpha and betas fibers
What is acute pain associated with?
anxiety and fear, acute injuries
What is chronic pain associated with?
depression, frustration, and fear, prolonged tissue pathology
Manifestations of pain
INCREASED everything, including metabolism
Adjusting a drug's dose to a client's response
What is important to watch out for with Acetaminophen?
If a patient is on an opioid, how often must they have a BM?
every 3 days