page 11-20 Flashcards by Jen R

Blood Administration

What must be received before a transfusion started?

Signed written consent

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Blood Administration

What blood type is considered universal & can be used for all other donors?

Type O Negative

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Blood Administration

What blood type is considered the universal recipient & can receive all blood?

Type AB Positive

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Blood Administration

What is the most common infection spread through blood transfusions?

Hepatitis B

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Blood Administration

In order to determine donor compatibility, what must be done?

Type & cross match

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Blood Administration

What must be done to determine a client’s baseline before starting the transfusion?

Take vital signs

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Blood Administration

What size IV gauge must the client have?

18G with a filter needle

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Blood Administration

How many nurses confirm the unit of blood?

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Blood Administration

How long after blood is removed from blood bank’s refrigerator do you have to start it?

30 minutes

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Blood Administration

How long must you stay with the client after transfusion is started?

15 minutes

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Blood Administration

How many mLs are in one unit of packed RBCs?

About 250 mL

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Blood Administration

What are the signs of an adverse reaction?

restlessness
nausea
hives
SOB
fever
chills
back pain

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Blood Administration

What do you do if an adverse reaction occurs?

STOP Blood & run the normal saline that hangs with blood
do vitals
notify physician & blood bank
make sure urine & blood cultures are done

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Blood Administration

Why must you run blood at a slow rate?

because running blood fast can cause fluid overload

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Blood Administration

What drug is also used to treat anemia because it increases red blood cell production?

Epoetin alfa

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Blood Administration

Clients taking Epoetin alfa should be monitored for what?

Hypertension & seizures

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Blood Pressure

What is Blood Pressure?

The force of blood flowing through the arteries.

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Blood Pressure

What is the recommended blood pressure?

120/80

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Blood Pressure

What are the top & bottom values?

Systolic & diastolic pressure

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Blood Pressure

Define the terms: systolic &diastolic pressure

Systolic
-pressure while heart beats

Diastolic
-pressure while heart rests

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Blood Pressure

Which value determines if a person has HTN?

Diastolic - if the pressure of the heart is elevated at rest, then HTN is present.

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Blood Pressure

What are the risk factors for hypertension?

African American
obesity
anxiety
diabetes
smoking

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Blood Pressure

What are the physical signs of hypotension?

Blurry vision
headache
chest pain
but remember that HTN is called a silent killer because most people don’t have symptoms

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Blood pressure

How can the size of the blood pressure cuff affect blood pressure reading?

If it is too small, the BP will be higher than it really is.

If it is too big, the BP will be lower than it actually is.

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Blood pressure What are some other factors that alter blood pressure?

Position, caffeine, anxiety, activity

Blood pressure What is pulse pressure?

The difference between systolic and diastolic numbers

Blood pressure what is the mean arterial pressure?

Diastolic pressure (+) 1/3 of pulse pressure; this value should be greater than 60.

Blood pressure Before you give a blood pressure medication, always check ______ and ______ .

Blood pressure and pulse rate

Blood pressure Hold the medication if systolic BP is less than _____ Or heart rate is less than _____.

100, 60

Blood pressure What classes of medications are used for HTN?

Diuretics, beta blockers, calcium channel blockers, vasodilators

Blood pressure Medications that end in “pril” are _____?

Ace inhibitors

Blood pressure Ace inhibitors correct heart failure by _____ afterload.

Decreasing They also promote vasodilation by inhibiting the production of angiotensin.

Blood pressure ____Is an adverse reaction seen with the use of ACE inhibitors.

Angioedema

Blood pressure Signs of angioedema are?

Swelling of the lips and mouth

Blood pressure Client may also have a persistent, nagging ______.

Cough

Blood pressure Which is more dangerous in angioedema: a cop or swelling of the lips and mouth?

Swelling of the lips and swelling mouth may indicate laryngeal angioedema. A compromise airway is the priority.

Blood pressure Medications that end in “olol” are______?

Beta blockers

Blood pressure Client who take anti—hypertensive medications should be taught what method to avoid falling?

Sit in a chair or at the bedside for 30 minutes after taking medication to adjust to a lower circulating blood pressure.

Blood pressure What the herbal medication is used to lower BP?

Garlic

Blood pressure Clients taking antihypertensives should avoid hot showers, baths, and weather . True or false?

True. These things can cause dizziness.

Blood pressure What is the best diet for a hypertensive client?

Low Sodium, low-fat DASH diet Dietary approaches to stop HTN

Breast-feeding Breast-feeding moms will often feel what while feeding the baby?

Abdominal cramps

Breast-feeding This is due to the release of?

Prolactin and oxytocin

Breast-feeding What is the best way to burp a baby?

While he or she is sitting up

Breast-feeding What are the benefits of breast-feeding?

Passive immunity Quicker weight loss in mother after birth Increase in bonding Economically low cost

Buerger’s Disease (Thromboangitis Obliterans) This disease is the obstruction and inflammation of blood vessels mainly where?

Hands and feet

Buerger’s disease (Thromboangitis Obliterans) Clients presents with what symptoms?

Pale, blue, cold hands and feet; they may tingle or be painful.

Buerger’s disease (Thromboangitis Obliterans) Who is most At risk for this disease?

Males who smoke or chew tobacco

Buerger’s disease (Thromboangitis Obliterans) What are the treatment goals?

There is no cure, only symptom control | Teach trying to Stop smoking, dress appropriately for the weather and try to reduce life stressors.

Bulimia Nervosa What is the eating cycle involved?

Eating binges followed by purging.

Bulimia Nervosa Will you be able to see physical changes or weight loss?

Client usually remains at a normal weight.

Bulimia Nervosa Besides purging, what other methods are used to loose weight?

``` Vomiting Enemas Drugs (speed) Diuretics Diet’s Pills ```

Bulimia Nervosa What are the medical complications associated with bulimia nervosa?

tooth decay electrolyte imbalances ulcers cardiac arrhythmias

Bulimia Nervosa Safety is a concern in clients with bulimia nervosa because of______.

Suicidal thoughts

Bulimia Nervosa List the treatment goals.

1. Encouraging talking, safety and assessing suicidal potential 2. Establishing a diet plan 3. Supervision during meal time 4. Antidepressants may be prescribed

Burns What are the two age groups most at risk for suffering a burn injury?

Children and elderly

Burns What are the types of burns?

Chemical, electrical, thermal, radiation

Burns If the face/neck has been burned, what is the nursing priority?

Airway obstruction

Classification of burns First degree (Superficial partial thickness)

Skin pink/red, painful (sunburn)

Classification of burns Second- degree (deep partial thickness)

Skin red/white, blisters, swelling

Classification of burns Third- degree (full thickness)

Skin black/brown, edema, all layers of skin burned, grafting needed

Classification of burns What is the formula used to determine fluid replacement for the first 24 hours?

Parkland formula

Classification of burns What is the Parkland formula?

4 ml of LR x wt. (kg) x % of body burn

Classification of burns How much of this fluid do you give in the first 8 hours?

1/2 of the total volume

Classification of burns How much fluid do you give for the second eight hours?

1/4 of total volume

Classification of a Burns How much fluid do you give for the third eight hours?

1/4 of total volume

Classification of burns Should you burst a blister?

Classification of burns What is the best route for pain meds?

Classification of burns What diet is appropriate for burn patients?

High calorie, high-protein

Classification of burns What is a common electrolyte problem in clients with burn?

Hypokalemia or hyper kalemia; both can be seen in clients with burns.

Classification of burns Due to prolong stressed, clients are at risk for what type of ulcers?

Curling’s ulcers

Classification of burns What medication should be given before dressing changes?

Pain medication

Cancer True or false? Cancer is an abnormal growth of cells.

True-growth of cells is uncontrolled.

Cancer When the cancer cells travels from the original location to a new place, what is it called?

Metastasis

Cancer What acronym is used to describe the warning signs of cancer?

CAUTION

Cancer What do the letters CAUTION stand for?

``` Change in bowel or bladder Any store that does not heal Unusual bleeding/discharge Thickening in breast Indigestion Obvious change in wart Nagging cough or hoarseness ```

Cancer What are the two ways to describe a tumor?

By grading or staging

Cancer What is the difference between Grading or staging?

Grading describes tumor By the cells. Staging describes the progression of a tumor by the clinical symptoms

Cancer What are the three types of radiation treatment?

1. External and unsealed 2. Internal sealed 3. Internal

Cancer What precautions must be taken for a client receiving radiation treatment?

Private room/bathroom Limit visitors Rotate nursing staff who provide care Place sign at door and bedside

Cancer What is the most dangerous type of radiation?

Sealed internal radiation because a solid radio active implant is placed inside tumor

Cancer What additional precautions must be taken for clients receiving sealed internal radiation?

All body fluids are radioactive; use hazardous clean up gloves/gown.

Cancer If a client’s sealed internal implant falls out. e.g. cervical implant, what should you do?

Pick it up with a long handle forceps and put it in a lead container.

Cancer Chemotherapy works by destroying the cell_______.

Wall

Cancer What are the side effects of chemo therapy?

``` Nausea Anorexia Alopecia Sterility Decrease bone marrow and platelets ```

Cancer Why is Reglan (metoclopramide) given?

To reduce nausea

Cancer Is alopecia from chemotherapy permanent?

No it is temporary.

Cancer is alopecia from chemotherapy permanent?

No, it is temporary.

Cancer Is the sterility From chemotherapy permanent?

Yes

Cancer Client with the cancer will also need____.

Neutropenic precautions

Cancer What are the neutropenic precautions?

``` Strict handwashing No visitors who are sick No children No raw food, no Live plants No free standing water ```

Cancer What is Filgrastim?

Drug used to treat neutropenia; monitor WBCs

Cancer When is the best time to do a breast self exam?

Once a month however these are no longer recommended.

Cancer When is the best time to do a self-testicular exam?

The same day each month.

Cancer If a client has had a mastectomy, can you take a blood pressure on the affected side?

No IV or BP

Cancer List some other post-mastectomy client education tips.

Elevate affected extremity No initial exercise after surgery Encourage discussion for positive self-image

Cataracts What are the signs of Cataracts?

Milky/white lens | Painless, blurred vision

Cataracts How are they treated ?

No treatment until vision is severely impaired

Cataracts During surgery, what is done?

The cataracts Are removed and a new lens may be implanted.

Cataracts After surgery, will vision be corrected?

Only if a new lens is placed. | If no lens is placed, the client will need glasses/contacts.

Cataracts After surgery, what is the main concern?

To check for hemorrhage of the eye. | Please client in semi Fowler’s position.

Cataracts What do you tell clients to avoid?

Coughing, sneezing, bending over at the waist, straining, rubbing, or crying. No lifting greater than 5 pounds.

Cataracs How should the post-op client sleep?

Sleep on Unaffected side or if surgery was on both eyes, sleep on back. Use eye shield at night to protect eye.

Celiac disease Foods containing______must not be eaten.

Gluten(This is a protein)

Celiac disease In celiac’s disease, malabsorption of____a curse.

Fats

Celiac disease What foods contain gluten?

BROW Barley Rye Oats Wheat

Celiac disease The client’s abdomen is often______.

Distended

Celiac disease What does the client’s stool look like?

Smelly, pale, bulky; expect lots of gas with some diarrhea.

Celiac disease The best food substitutes are___and_____.

Corn, rice

Celiac disease Can a client on a gluten-free diet have cookies, spaghetti, or waffles?

No all these products have grain in them.

Celiac disease What is another name for celiac disease?

Celiac sprue

Cerebrovascular Accident (CVA) Define the term CVA.

Reduction of cerebral blood flow and oxygen causing brain cell damage.

Cerebrovascular Accident (CVA) The three most common causes of CVA are?

Embolism Hemorrhage Thrombus

Cerebrovascular Accident (CVA) What are the signs of a CVA?

``` Client complaints of: headache, nausea, nuchal rigidity, HTN, slow bounding pulse, Cheyne- Stokes respirations, speech changes, facial droop ```

Cerebrovascular Accident (CVA) What is the difference between CVA and transient ischemic attack (TIA)?

TIA Is it temporary period of neurological deficit. It has similar signs as a CVA, but the symptoms will all resolve.

Cerebrovascular Accident (CVA) What is agnosia?

Inability to use an object correctly.

Cerebrovascular Accident (CVA) Expressive aphasia occurs when_____.

Client cannot communicate properly (Aphasia can be expressive or receptive)

Cerebrovascular Accident (CVA) If the left hemisphere is affected, you will see weakness on the ____side.

Right side

Cerebrovascular Accident (CVA) If the right hemisphere is affected, you will see weakness on the___side.

Left

Cerebrovascular Accident (CVA) Remember the place the client’s belongings on the_____side.

Unaffected

Cerebrovascular Accident (CVA) The tests used to determine CVA are?

CT, EEG, Cerebral arteriography

Cerebrovascular Accident (CVA) Patient with hemorrhagic stroke are at increased risk for which complication?

Seizures due to possible bleeding in the cerebral cortex.

Cerebrovascular Accident (CVA) What are the nursing assessments?

``` Monitor vital signs, Neuro checks, Watch for seizures, monitor for increase in intracranial pressure, check ability to swallow ```

Cerebrovascular Accident (CVA) What complications of the eyes can a client with a CVA have?

Corneal abrasions (lacrimal glands will not produce secretions)

Cerebrovascular Accident (CVA) What is the activity level for this client?

Strict bed rest

Cerebrovascular Accident (CVA) How should the room environment be?

Quiet, peaceful, with objects within reach on unaffected side.

Cerebrovascular Accident (CVA) How do you position the CVA client?

Turn every two hours on unaffected side 20 minutes on affected side Make sure to elevate affected extremities

Cerebrovascular Accident (CVA) Why would a thrombolytic be given?

To dissolve a clot

Cerebrovascular Accident (CVA) Do not give thrombolytics if the cause is ______.

Hemorrhage

Cerebrovascular Accident (CVA) What other medications may be prescribe to treat a CVA?

Anti-hypertensive, anti-coagulant (not for hemorrhage stroke!) anticonvulsants

Cerebrovascular Accident (CVA) Do anticoagulants like Coumadin and aspirin dissolve clots?

No, they only thin the blood; they do not dissolve clots.

Chronic obstructive pulmonary disorder COPD What are the three disorders that make up COPD?

Asthma Bronchitis Emphysema

Chronic obstructive pulmonary disorder COPD What are the signs/symptoms of COPD?

SOB with activity Wheezing Productive cough Cyanosis

Chronic obstructive pulmonary disorder COPD What would the ABG of a client with COPD show?

Hypoxemia

Chronic obstructive pulmonary disorder COPD What does the chest of a client with COPD look like?

Barrel chest

Chronic obstructive pulmonary disorder COPD What would the fingers of a client with COPD look like?

Clubbed

Chronic obstructive pulmonary disorder COPD Due to SOB with activity clients may experience______because of difficulty eating.

Weight loss

Chronic obstructive pulmonary disorder COPD Why must you access the amount of O2 your COPD client receives?

COPD’ers Keep a high level of CO2 in their blood; breathing is controlled by this fact.

Chronic obstructive pulmonary disorder COPD A client with a COPD should not receive 02 by NC greater than____.

2 LPM

Chronic obstructive pulmonary disorder COPD To control SOB, the____technique should be taught.

Pursed lip breathing

Chronic renal failure Chronic renal failure is progressive and irreversible. True or false?

True

Chronic renal failure What are possible causes of CRF?

Hypertension Frequent infections DM 2 Renal/urinary obstruction

Chronic renal failure what signs/symptoms would clients show?

Decrease urine output Hypertension Decreased urine specific gravity Fluid overload

Chronic renal failure What is uremic frost?

Urea crystals that come through the skin with perspiration

Chronic renal failure What are the nursing interventions for chronic renal failure?

Modification of diet Give diuretics Antihypertensives, monitor BUN and creatinine Daily weight

Chronic renal failure Where would you see uremic frost?

Face, Underarms, groin Teach client to wash skin with plain water

Chronic renal failure Client may need____to assist with waste removal.

Dialysis

page 11-20 Flashcards

(147 cards)