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Flashcards in unit 5 Deck (136)
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1

in a chest tube acts as a one way valve

air goes out - none in

water seal chamber

2

in a chest tube, the drainage system should be kept __

and the insertion site should be _____-

always be kept below the level of the chest

insertion site covered with air tight dressing

3

most common mechanism of injury. Injuries may not be easily noted; requires expert clinical judgment to diagnose.

Blunt trauma-

4

first 60 mins where a critically injured trauma patient must recieve life saving care

golden hour

(when primary survey is done)

5

3 interventions for problems with disability

Spinal stabilization
Monitor for neurogenic shock
Maintain perfusion

6

musculoskeletal injuries what 5 things

Bone
Soft tissue
Muscle
Nerves
Surrounding blood vessles

7

cardiac tamponade is diagnosed by _____

fast ultrasound

8

with a blood transfusion it is important to remember to remain with client for _______

Remain with patient 1t 15-30 miN

9

in the fluid remobilization phase:

H&H:
Na:
K:
WBC:
glucose:
ABG's:
protein & albumin:

H&H: decreased
Na: decreased
K: decreased
WBC: decreased
glucose: elevated
ABG's: met.acidosis
protein & albumin: decreased

10

5 P's

pain - early sign
pallor
pulse -late sign
paraesthesia - early sign
paralysis

11

Fat globules from the long bones are released into the circulation and may lodge in the pulmonary system resulting in severe hypoxemia

May occur from fracture to the long bones and pelvis.

fat embolism

12

in a disaster situationclients that: have life threatening injuries that need immediate care

pneumothorax - tracheal deviation
chest bruising - flail chest
paradoxical breathing

Emergent

13

Crush injuries to the pelvis and/or both lower extremities or a prolonged entrapment often require

amputation

14

with a burn phase: begins with injury and continues for 24 to 48 hrs.

Resuscitative phase

15

Occurs when air escapes from injured lung into the pleural space, resulting in partial or complete collapse of the lung.

Pneumothorax

16

in the Resuscitative phase 6 things to remember with treatment

Stop the burning process
Take off jewlery (nonadherant)
Cool water - no ice or cold water
Brush off chemical
Prophalatic intubation
FIO2 100%

17


Findings are usually mild and include itching, urticaria, and flushing.

The client can develop an anaphylactic transfusion reaction resulting in bronchospasm, laryngeal edema, and shock.

allergic blood transfusion reaction

18

5 interventions to remember with the acute phase of burns

Pain management - IV opioids
Promote wound healing
Prevent infection (protective isolation)
Parental or TPN feedings
Physical therapy

19

3 interventions for problems with circulation

2 large gauge IV with isotonic solution

Transfusion of blood - warm blood

Fast scan - small ultrasound machiene for no missed bleeding

20

3 nursing interventions for a bacterial blood transfusion reaction

Stop the transfusion.

Administer antibiotics and an IV infusion of 0.9% sodium chloride using new tubing.

Send a blood culture specimen to the lab for analysis.

21

burn where Destruction of all skin layers, extends to muscle, tendon, and bones

Black, eschar hard and inelastic

Insensate (no pain)

Deep Full thickness

22

mechanism of injury where the patient:

struck with an object
skin still intact but may be serious injury underneath
evaluated with ultrasound

blunt trauma

23

IV fluid resuscitation is instituted for patients with greater than __% TBSA

20

24

3 complications from organ donation

rejection
infection
post transplan malignancies

25

type of burn where

skin exposed to a caustic agent acids, bases, and organic compounds.

Contact
Inhalation of fumes
Ingestion or injection

(lye or oven cleaner)

Chemical burn

26

Findings include crackles, dyspnea, cough, anxiety, jugular vein distention, and tachycardia. Manifestations can progress to pulmonary edema.

circulatory overload blood transfusion reactions

27

2 treatments of Pneumothorax-

needle decompression
chest tube

28

Healthy individuals offer organs to a client with end-organ disease.

Examples of organs donated by living donors are kidneys, lung lobes, part of a pancreas

Living Donors

29

monitor chest tube drainage every ___ hours
unless fresh from surgery, then __ hours

4, 1

30

one who does not meet brain death criteria but has an illness from which no recovery is expected

Circulatory Death-