Quiz 3 Flashcards by Courtney W

The study of distribution and determinants of disease and injuries in human populations; cause and effect, patterns of distribution of disease

Epidemiology

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The reproduction of an infectious microorganism, but there is no interaction between the body and microorganisms that would result in a detectable immune response

Colonization

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Person who is colonized but not ill/no symptoms

Carrier

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Ability of an infectious agent to cause clinical disease

Pathogenicity

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The severity of a clinical disease, morbidity, etc.

Virulence

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6 elements needed to transmit infection

Infectious agent
Reservoir/environment in which the pathogenic microbes can live and multiply
Portal from which to exit the reservoir
Means of transmission
Portal of entry into new host; ex: inhale, swallowing, injected, etc.
Susceptible new host

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Something that infiltrates another living thing

Infectious agent

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Any person, animal, plant, soil, or substance in which an infectious agent normally lives and multiples

Reservoir/environment

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Site through which microorganisms exit/enter the susceptible host and cause disease/infection; ex: mouth, nose, urinary tract, etc.

Portal

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Infectious agent moves from source to host

Transmission

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2 types of transmission

Direct

Indirect

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Disease causing microorganisms pass from actual contact with the infected individual; ex: someone sneezes on you

Direct transmission

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Susceptible person is infected from contact with a contaminated surface/object; ex: needle stick

Indirect transmission

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Minute, single-cell organism with no nucleus; contains RNA and DNA
Can adapt

Bacteria

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3 classifications of bacteria based on shape/appearance

Cocci
Bacilli
Spirilla

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Cocci

Spherical

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Bacilli

Oblong

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Spirilla

Spiral

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3 classifications of bacteria based on groups

Diplococci
Streptococci
Staphylococci

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Groups of two

Diplococci

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Streptococci

Chains

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Irregular clusters, hanging grape-like bunches

Staphylococci

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4 examples of bacteria

Diphtheria
Tuberculosis (TB)
Streptococcal infections
Chlamydia STD, etc.

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Some have both yeast and mold characteristics
Usually reproduce by budding/spores
Thrive in dark, damp areas
Can be harder to treat
Ex: thrush, vulvovaginitis, etc.

Fungi

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Vulvovaginitis

Yeast infection

2 forms of fungi

Yeast | Mold

Single cell fungi

Yeast

Miniature cell fungi

Mold

Live on or in other organisms at expense of host

Parasites

2 types of parasites

Protozoa | Helminths

More complex single-cell microorganisms, move by cilia action of flagella Usually in GI tract in people Ex: amebiasis, malaria from mosquitos, etc.

Protozoa

Infection of intestines by amoeba, usually dysentery from food or drink

Amebiasis

Parasitic worms that commonly affect intestinal tract; some can bee seen with naked eye Ex: ringworm, tapeworm, pinworm, etc.

Helminths

Minute microorganisms that cannot be visualized by normal microscope, smallest microorganism to infect man DNA or RNA Attack host cell, invades and reproduces, and lies dormant or spreads Once outside body = die immediately in dry form, wet form = die when exposed to heat, and in blood at 4°C = live a couple weeks Ex: influenza, common cold, mumps, measles, AIDS/HIV, hepatitis A, B, and C, etc.

Viruses

4 microorganisms

Bacteria Fungi Parasites Viruses

4 stages in the process of infection

Incubation period Prodromal Disease period Convalescence period

Pathogen enters body and microbes start reproducing; disease process beginning

Incubation period

More specific symptoms of disease starting, microorganisms increase, and disease is highly infectious

Prodromal

Signs and symptoms reach full extent, when disease is most communicable

Disease period

Symptoms diminish and disappear, can go latent and come back again; ex: herpes, malaria, TB, gonorrhea, etc.

Convalescence period

2 tiers of precautions from CDC (1996)

Tier 1: standard precautions | Tier 2: transmission based precautions

Treat every patient as though they're infected; use all the time, regardless of diagnosis Refers to blood, open wounds, secretions (not sweat)/body fluids, intact skin/abrasions, mucous membranes, etc.

Standard precautions

Restrictions used when called for; ex: TB, GI, etc.

Transmission based precautions

3 types of disease transmission by government and 2 more (5 total)

``` Air: government Droplet: government Contact: government Common vehicle Vector-borne (ex: mosquito) ```

5 recommended vaccines for health care workers

``` Hepatitis B Influenza Varicella/chickenpox Pertussis, tetanus, and diphtheria Measles, mumps, and rubella (MMR) ```

5 transmission routes

``` Contact Droplet Common vehicle Airborne Vectorborne ```

Most common transmission route, direct or indirect

Contact

Rapid transfer of infectious agent through air over short distance; ex: sneeze

Droplet

Inanimate object involved in transmission of disease; ex: food, water, medicines, equipment, supplies, etc.

Fomite | Common vehicle

Infectious agent disseminated through air over a long distance, 6 feet to miles away

Airborne

Vector transports infectious agent to host; ex: fly, mosquito, etc.

Vectorborne

Animal that carries and transmits a pathogen capable of causing disease

Vector

Needle sticks account for ___% of job-related acquired HIV; never __________

84%, never recap

8 techniques for infection control

``` Handwashing proper/best way to prevent disease; up to 40-60 seconds with aseptic technique Dress for the workplace: no jewelry, long or fake nails, etc. Hair short or pulled back Gloves Eye protection Laundry Cleaning and proper waste disposal Disinfection ```

Condition free from germs

Asceptic

Process that reduces microbial life forms | Process of cleaning, especially with a chemical, in order to destroy bacteria

Disinfection/-ants

10 parts of standard precautions

``` Hand hygiene Gloves Mask, eye protection, and face shield Gown Needlestick safety Patient care equipment Environmental control Linen Occupation health and bloodborne pathogens Respiratory hygiene/cough etiquette ```

6 isolation techniques used when a patient is known to have a disease that is contagious

``` Drainage-secretion precautions Enteric precautions Acid-fast bacillus (AFB) isolation Respiratory isolation Contact isolation Strict isolation ```

Prevent infections that are transmitted by direct or indirect contact with purulent patient material, drainage, or secretions from an infected site on the body such as abscesses, wound infections, and burns; ex: MRSA Gown, gloves, dressings bagged in proper containers, 3 minute hand scrubbing for asepsis, separate trash (incinerate infected object)

Drainage-secretion precautions

Prevent infections that are transmitted by direct or indirect contact with fecal material Bowel, colon, etc. Dysentery, cholera, etc. Private room/bathroom, gowns, and gloves

Enteric precautions

Help with privacy, used with pulmonary TB who currently have a positive sputum culture for acid fast bacilli or a chest x-ray that reflects active TB (airborne) Fitted mask, gowns if gross contamination, gloves, and private room with special ventilation closed door

Acid-fast bacillus (AFB) isolation

Isolation technique when spread by droplet contact as patient talks, coughs, or sneezes Meningitis, flu, measles, mumps, etc. Private room, masks, gowns, and gloves

Respiratory isolation

Used for diseases spread by close or direct contact, present microbes Indirect: infected person touches object or not infected person, fomite Acute respiratory infection pneumonia, etc/. Masks, gowns, gloves, and private room

Contact isolation

Used for patients with diseases transported by airborne or contact route, highly infectious and spread is hard to control Combination of protective and reverse isolation Pharyngeal diphtheria (throat), plaque, chickenpox, etc. Negative pressure room, mask, gown, gloves, hand washing and decontamination of items, and private room or with patient who has disease

Strict isolation

Isolation for immunocompromised patient | Negative pressure room

Reverse isolation

Process that destroys all microbial life forms including resistant spores, done by physical or chemical process

Sterilization

3 levels of disinfectants

High-level disinfection (HLD) Intermediate-level disinfection Low-level disinfection

Eliminates all microbial forms when there's a high level of bacterial spores, ex: anthrax

High-level disinfection (HLD)

Kills TB bacteria, most viruses, fungi, but not bacterial spores

Intermediate-level disinfection

Sanitation; activates most bacteria, some viruses, and fungi, doesn't work against TB or bacterial spores

Low-level disinfection

Antimicrobial substance on skin surface

Antiseptic

4 vital/cardinal signs

Body temperature Pulse Respiration Blood pressure (BP)

Brain can't survive/function for ___-___ minutes without oxygen

4-5 minutes

Result from metabolic activity must be stable in order for the body's cellular and enzymatic activity to remain efficient

Temperature

Fever leads to increased pulse and respiration, general discomfort, achiness, flush, dry skin that feels hot, chills, loss of appetite, etc.

Pyrexia

Excessively high temperature of 105.8°F or 41°C

Hyperpyrexic

Temperature less than 34°C, death

Hypopyrexic

___-___°F for open heart surgery

92-92.5°F

Celsius (C) to fahrenheit (F) and fahrenheit to celsius conversion

``` C = (F-32)5/9 F = (9/5)C + 32 ```

Average temperature and variance, 3 months to 3 years, and 5 years to 13 years

Average and variance: 98.6°F or 37°C, most people vary by 0.5-1° 3 months to 3 years: 99-99.7°F 5 years to 13 years: 97.8-98.6°F

5 methods for temperature taking

``` Oral Axillary Rectal Tympanic Temporal ```

Average oral (time), axillary (time), rectal temperature

Oral: 37°C or 98.6°F, 3-5 minutes Axillary: 36.4-36.7°C or 97.6-96°F; 5-10 minutes, not as accurate Rectal: 37.5°C or 99.6°F

Most accurate temperature taking method in pelvic viscera

Rectal

Number of heart beats

Pulse

Normal pulse for men and women at rest, infants, and children 4-10 years old

Men and women at rest: 60-90 beats/minute Infants: 120 bpm Children 4-10 years old: 90-100 bpm

Fast/rapid heartbeat over 100 bpm

Tachycardia

Heartbeat under 60 bpm

Bradycardia

Most accurate point to get pulse for infants/kids | At apex of heart

Apical

9 pulse points

``` Apical Radial Carotid Femoral Popliteal Temporal Dorsals Post-tibial artery pulse Brachial artery pulse ```

Purpose is to exchange oxygen and carbon dioxide (CO2) between the environment and the circulating blood Look for quality of breath and symmetrical rise and fall of chest

Respiration

Normal respiration

12-20 breaths per minute

______ blood has oxygen; _______ lack oxygen and has carbon dioxide but _______ vein has oxygen

Arterial Venous Pulmonary

Amount of blood flow ejected from the left ventricle of the heart during systole and the amount of resistance the blood meets due to systemic vascular resistance, volume to resistance Blood loss due to hemorrhage = lower Generally lower in morning, men's usually slightly higher

Blood pressure (BP)

Normal, pre-hypertension, and stage 1 and 2 hypertension BP

Normal: less than 120/less than 80 mmHg Pre: 120-139/80-89 mmHg 1: 140-159/90-99 mmHg 2: 160 or more/100 or more mmHg

Difference between systolic and diastolic pressure

Pulse pressure

Normal systolic and diastolic pressure

Systolic: 110-140 mmHg, 120 or less Diastolic: 60-80 mmHg

BP when the heart is contracting, maximum arterial pressure Highest part reached, active/beating portion Top number over diastolic

Systolic

Minimum arterial pressure during relaxation and dilation of ventricles of heart when they fill with blood; resting, lowest point Minimum pressure exerted at arterial walls Bottom number under systolic

Diastolic

Volume of blood pumped from left ventricle per beat; 120/80 = 40

Stroke volume (SV)

3 pieces of equipment for BP

Sphygmomanometer BP cuff Stethoscope

Mercury more _______, digital more _______

Accurate, common

Helps patient who isn't getting enough oxygen The effectiveness of pulmonary function, the lungs ability to exchange oxygen and carbon dioxide efficiently, is most accurately measured by laboratory testing of arterial blood for the concentrations of oxygen, carbon dioxide, bicarbonate, acidity, and the saturation of hemoglobin with oxygen

Oxygen therapy

Using light, measures the proportion of oxygenated hemoglobin in blood in pulsating vessels, especially the capillaries of finger or ear

Pulse oximeter (ox)

5 methods of oxygen therapy delivery

``` Nasal cannula Nasal catheter Face mask Nonrebreathing mask Oxygen tent ```

Amount of oxygen delivered with nasal cannula (adults, kids, and percent oxygen), catheter, face mask, and nonrebreathing mask

Cannula: 1-6 liters (L)/min adults, 1/4-1/2 L/min; 21-60% Catheter: 1-6 L/min Face mask: no less than 5 L/min, shorter time periods Nonrebreathing mask: up to 100% oxygen by preventing CO2 from getting back into system

French-tipped catheter in pharynx, can get stomach distension if misplaced

Nasal catheter

Oxygen therapy for kids, preemies because lungs are last organs to develop in kids

Oxygen tent

___% oxygen in air

21%

2 hazards of oxygen administration

Fire: avoid sparks or flames Parenchymal lung damage if patient goes on 100% all the time, want to use lowest level possible; short-term (bronchitis, etc.) may be reversible

Scale of 3-15 helps identify patient's level of consciousness 7 or less means danger and if this happens, notify doctor and take patient to ER if necessary but never leave patient

Glasgow coma scale

On their own

Spontaneously

Physiological reaction due to sickness/illness, trauma, high stress emotional situation/disturbance, etc.; usually seen in young or elderly and can occur quickly

Shock

7 shock symptoms

``` Decreased temperature Weak pulse Rapid heartbeat Shallow respirations Hypotension Cyanosis Increased thirst ```

Sign of respiratory distress; bluish discoloration around mouth, gums, nailbeds, earlobes, etc. Skin turns blue/purple due to lack of oxygenated blood; usually seen in extremities, nail beds, etc.

Cyanosis

Shock gets worse if not taken care of

Shock continuum

3 stages of shock continuum

Compensatory Progressive Irreversible

First stage of shock, body's homeostatic mechanisms attempt to maintain CO2, BP, and tissue perfusion

Compensatory stage

Compensatory mechanisms begin failing to meet tissue metabolic needs, and the shock cycle is perpetuated/gets worse

Progressive stage

5 symptoms of the compensatory stage of shock continuum

``` Cold and clammy skin Decreased urine output Increased respirations and anxiety, may begin to be uncooperative Hypoactive bowel sounds Normal BP ```

7 symptoms of the progressive stage of shock continuum

BP falls Rapid and shallow respirations Acute respiration distress syndrome/shock lung Tachycardia results; increased heart rate may be 150 bpm Chest pain (CP) Mental status changes beginning with subtle behavior alterations such as confusion with progression to lethargy and loss of consciousness Renal, hepatic, GI, and hematologic problems

Shock becomes unresponsive to therapy; causes of shock can't be fixed, organs fail, and death occurs

Irreversible stage

3 symptoms of the irreversible stage of shock continuum

BP remains low Renal and liver failure result Release of necrotic tissue toxins (causes necrosis of tissue) and an overwhelming lactic acidosis

Severe pulmonary edema results from leakage of fluid from the pulmonary capillaries

Acute respiration distress syndrome/shock lung

Buildup of lactate in body, resulting in excessively low pH in bloodstream; blood becomes more acidic

Lactic acidosis

Shock caused by abnormally low volume of circulating blood in the body, blood/fluid loss 15-20% decrease or by a loss of 750-1300 mL of fluid Signs and symptoms may be placed into classes of I-IV Restlessness, thirst, cold, clammy skin, sweating, cyanotic lips and nails, rapid respirations, systolic pressure less than 60-90 mmHg, anuria, and cardiac and respiratory failure will follow Notify physician, make sure patient can breath, have emergency cart present, be ready to give oxygen, don't leave patient, don't give fluids unless doctor says to because examinations to see cause need empty stomach, etc.

Hypovolemic shock

Absence of urine

Anuria

Blood loss of 15%

Class I hypovolemic shock

5 symptoms of class I hypovolemic shock

``` BP within normal limits Heart rate less than 100 bpm Slightly anxious patient Respiration range from 14-20 per minute Urine output within normal limits ```

Blood loss of 15-30%

Class II hypovolemic shock

5 symptoms of class II hypovolemic shock

BP within normal limits Heart rate greater than 100 bpm (exceeds normal limits) Increasingly anxious patient Respiration range from 20-30 per minute (exceeds normal limits) Urine output decreases

Blood loss of 30-40%

Class III hypovolemic shock

5 symptoms of class III hypovolemic shock

``` BP decreases to below normal limits Heart rate greater than 120 bpm Anxious and confused patient Respiration increases up to 30-40 per minute Urine output is greatly decreased ```

Blood loss of more than 40%

Class IV hypovolemic shock

5 symptoms of class IV hypovolemic shock

Systolic BP decreases from 90 to 60 mmHg Heart rate greater than 140 bpm with weak and thready pulse (hard to find because heart beating so fast to get fluid to body and heart overworking itself) Confused and lethargic patient Respiration greater than 40 per minute Urine output further diminishes or ceases

Caused by a failure of the heart to pump an adequate amount of blood to the vital organs Usually in patients with myocardial infarction (MI), cardiac tamponade, or pulmonary embolus Chest pain, restlessness, decreasing BP, cyanosis, irregular and slow pulse, and rapid changes in level of consciousness Call for assistance, notify physician, place them in Fowler's position, keep warm and quiet, vitals, no food or drink, oxygen, don't leave patient alone, possible IV fluids and medications (physician), and be ready for CPR

Cardiogenic shock

Compression of heart by an accumulation of fluid in the pericardial sac

Cardiac tamponade

Feet about 45-60° lower than head

Fowler's position

Abnormal distribution of blood flow in the smallest blood vessels results in pooling of blood in vessels and inadequate supply of blood to body's tissues and organs

Distributive shock

3 types of distributive shock

Neurogenic Septic Anaphylactic

Occurs when concussion, spinal cord injury, psychic trauma, or spinal anesthesia causes abnormal dilation of the peripheral blood vessels; causes fall in BP as blood pools in veins, mental disorder, aggravating emotional situation, etc. Vasodilators stop contracting Hypotension, warm dry skin, visible signs of poor tissue perfusion, cool extremities, and diminishing peripheral pulses Notify physician, assistance, keep patient flat, monitor vitals every 5 minutes, don't move if there's a spinal injury, oxygen, IV fluids and medications, etc.

Neurogenic shock

Caused by severe systemic infections and bacteria; caused by gram negative bacteria (most common), gram positive bacteria, and viruses Body's immune system responds and releases chemicals Place patient supine/flat, calm and quiet, don't leave alone, cover patient if they feel warm, give oxygen, IV fluids and medications, etc.

Septic shock

2 phases of septic shock

Early/first phase | Late/second phase

6 symptoms of early/first phase septic shock

``` Warm and flushed skin Urine output normal to excessive Increased heart and respiratory rate Nausea and vomiting (N&V) Possible confusion ```

6 symptoms of late/second phase septic shock

``` Abrupt decrease in level of consciousness Decrease in urine output Cold and clammy skin Seizures Cardiorespiratory failure Rapide heart and respiratory rate ```

Similar to neurogenic shock; result of exaggerated hypersensitivity reaction to an antigen that was previously encountered by the body's immune system, drug reaction Varies with time of onset: mild within two hours, moderate more rapid, and severe = abrupt Mild to severe: tightness in chest, itching at site of injection, nasal congestion, sneezing, choking, decreasing BP, dilated pupils, seizures, and respiratory and cardiac arrest Keep emergency cart available, get history (allergies, GFR, creatinine, BUN, etc.), etc.

Anaphylactic shock

4 major types of diabetes mellitus

Type 1 Type 2 Diabetes mellitus associated with or produced by other medical conditions or syndromes Gestational diabetes

Disease in which the body's ability to produce or respond to insulin hormone impaired

Diabetes mellitus

Insulin-producing beta cells are destroyed by autoimmune process; pancreas produces little or no insulin Usually under 30, abrupt onset Must receive insulin injections Not preventable or curative

Type 1 diabetes mellitus/insulin-dependent

Inherited metabolic disorder characterized by hyperglycemia with resistance to ketosis Usually over 40, gradual onset Results from an impaired sensitivity to insulin or from a decreased production of insulin Controlled by diet, exercise, and weight loss Can be cured/fixed

Type 2 diabetes mellitus

Occurs in later months of pregnancy and is caused by hormones secreted by the placenta that prevent the action of insulin, treatment with diet but may need insulin

Gestational diabetes

3 diabetic emergencies

Hypoglycemia Ketoacidosis Hyperosmolar nonketotic syndrome

Low blood sugar, high insulin; sugar less than 50-60 mg/deciliter (dL) Occurs when persons who have diabetes mellitus have an excess amount of insulin in their bloodstream, an increased rate of glucose, or inadequate food intake with which to use the insulin Mild tremors, sweating, dizziness, headache, disorientation, and impaired motor function (drastic)

Hypoglycemia

Normal sugar levels, what happens when it's less than 40 mg/dL (3), and over 90 mg/dL (3)

Normal: 70-90 mg/dL <40: kidney disease, hypopituitarism and -insulinism, etc. >90: diabetes mellitus with high blood sugar and hyperthyroid- and -pituitarism

Occurs when there's an insufficient insulin in the body, associated with hyperglycemia Body breaks down/uses stored fats and muscle instead of glucose Weakness, drowsiness, sweet odor to breath, warm dry skin, flushed face, tachycardia, and coma Check chart for diagnosis of diabetes, notify physician, call for assistance, monitor vitals, don't leave patient, administer oxygen and IV, etc.

Ketoacidosis

High sugar, low insulin

Hyperglycemia

Occurs due to the loss of effective insulin, leading to diuresis and loss of fluid and electrolytes Insulin not working; secondary to acute illness, ex: NPO for a long time period Often appear to be drunk or have had a stroke, dehydration, dry skin, hypotension, tachycardia, mental confusion, seizures, and stroke Call for assistance

Hyperosmolar nonketotic syndrome

Caused by an occlusion of one or more pulmonary arteries by a thrombus or thrombi that originates in the venous circulation Usually associated with trauma, surgery, pregnancy, and immobility Sudden onset of symptoms: CP, dyspnea, tachypnea, tachycardia, syncope, coma Moves = death Blood thinners, call for help, notify physician, monitor vitals, and don't leave them alone

Pulmonary embolus

Inadequate gas exchange by respiratory system; many causes by obstruction such as tongue, vomit, injury, etc.

Respiratory failure

Heart stops beating

Cardiac arrest

3 steps of CPR (get help)

Circulation Airway: make sure it's clear Breathing

Tilt chin up to open airway and watch for bilateral rise and fall of chest; mouth to mouth, mask, or bag

Breathing

Compressions on hard, flat surface; 1.5-2 inches deep

Circulation

CPR: ___ compressions and ___ breaths

30, 2

Caused by occlusion or rupture of the cerebral blood supply directly into the brain tissue or into the subarachnoid space Severe headache, eye deviation, difficult speech, ataxia, loss of consciousness, N&V, stiff neck, and paralysis on one side of body Call for aid, put patient in resting position with head slightly elevated, monitor vitals, ready to give IV, oxygen and CPR if patient stops breathing, etc.

Cerebrovascular attack/stroke

Loss of coordination

Ataxia

Caused by insufficient supply of blood to the brain; heart disease, hunger, poor ventilation, fatigue, emotional shock are all causes Cold clammy skin, tachycardia, dizzy, nausea, pallor, hyperpnea Trendelenburg

Fainting/syncope

Increased depth and rate of breathing

Hyperpnea

Loss of pigmentation/color

Pallor

Head lower than feet

Trendelenburg

Unsystematic discharge of neurons of the cerebrum that results in an abrupt alteration in brain function in brain function Can be caused by infectious disease, high fever, extreme stress, head trauma, and brain tumors No driving

Convulsive seizures

Whole body convulses and the patient loses consciousness for a period of minutes Muscles become rigid, eyes open, jerky body movement, vomiting, frothy saliva, urinary or fecal incontinence, usually fall asleep following seizure because muscles are tense the entire time

Grand mal

May be restricted to a specific part of the brain, patient is not responsive to the environment although appears to be awake Lasts 1-4 minutes Lip smacking, chewing and facial grimacing, patting, picking, and rubbing one's clothing, and confusion for several minutes following seizure

Partial seizure

2 types of convulsive seizures

Grand mal/generalize seizure | Partial seizure

Partial seizure that is so brief that an observer may not be aware that it has occurred, harder to control medically; rare in adults A brief loss of awareness, blank stare, eye blinking, mild body movements, and sudden loss of all muscle tone resulting in afall

Petit mal/absence seizure

Have hollow lumen so secretions and air may be evacuated/suctioned or medications, nourishment, or contrast agents may be administered Made of polyurethane silicone rubber Placed in nose or mouth Must be in place before any medication, for, water or contrast is given

Nasogastric (NG) and nasoenteric (NE) tubes

Short-term tube that can be placed by nurse

Nasogastric (NG) tube

Allows peristalsis to pass through into duodenum and small intestine Long-term, weeks to months Placed by physician

Nasoenteric (NE) tube

3 ways to tell if Nasogastric (NG) and nasoenteric (NE) tubes are properly placed

Radiographic film Fluoroscopy Aspirate gastric contents and test on litmus paper, gastric contents are acidic; pH less than 7

Max suction on adults, older kids, and infants

Adults: 110-150 mmHg Kids: 100-120 mmHg Infants: 50-95 mmHg

Temporary or permanent tube that is directly into the stomach through an incision Usually when esophagus is blocked or cannot go through nose or mouth Patient sedated and endoscope used to verify placement

Gastrostomy tube

An opening into the trachea created surgically either to relieve respiratory distress caused by obstruction of the upper airway or to improve respiratory function by permitting better access of air to the lower respiratory tract Usually plastic or metal Disease in head and neck Difficulty speaking or fear of choking; keep in Fowler's position

Tracheostomy

2 signs for emergency suctioning

Audible rattling or gurgling sounds coming from the patient's throat Gagging or breathing with difficulty

Usually used for hemothorax, pneumothorax, or pleural effusion Tube inserted into the pleural cavity and attached to water-sealed drainage to remove air and fluid from intrapleural space

Chest tube

Blood in pleural cavity doesn't allow lung to expand

Hemothorax

Air/gas in cavity between lung and chest wall, causing lung to collapse

Pneumothorax

Excess fluid/water that accumulates in pleural cavity

Pleural effusion

Component of chest tube that keeps atmospheric air from getting back into lung

Water seal

Clamp ______________ tube when transporting patient, never clamp ________________

Nasogastric (NG) and nasoenteric (NE) tubes | Chest tube

Drains placed at or near wound sites or operative sites when large amounts of drainage are expected, done due to fluid interfering with healing process because the fluid is absorbed slowly by body Place with aseptic technique to prevent infection Ex: hip and spine surgery

Tissue drains

4 examples of tissue drains

T-tube for gallbladder surgery attached to common bile duct Penrose Jackson-Pratt Hemovac

Drain placed in wound after mastectomy, neck surgery, etc. and allows gravity to pull fluid

Penrose drain

3 diseases requiring airborne precautions

Measles Varicella (including disseminated zoster) TB

6 diseases requiring droplet precautions

``` Diphtheria Pertussis Pneumonic plague Mumps Rubella Influenza ```

Quiz 3 Flashcards

(193 cards)