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Med/Surg-Lab
| Question | Answer |
|---|---|
| Purpose of a chest tube | -Remove air, fluid, or blood -Reestablish negative pressure -Facilitate lung expansion -Restore normal intrapleural pressure |
| air in pleural space? | pneumothorax |
| blood in pleural space? | hemothorax |
| abnormal accumulation of fluid (lungs)? | pleural effusion |
| pus in pleural space (infection, lung abscess) | pulmonary empyema |
| dry suction: is there a water column to control suctioning? | no; suction controlled by suction monitor bellows (bellows balances wall suction ) |
| advantages of dry suction? | -higher suction pressure -no water evaporation -no bubbling water in suction control chamber |
| water seal chamber: ____ occurs when patient inhales/exhales | tidaling |
| water seal chamber: constant bubbling indicates? | air leak |
| drainage chamber: document what hourly? | output and color |
| drainage chamber: excessive drainage is how much? | >100mL/hour |
| chest tubes: keep what at bedside at all times? | sterile water |
| chest tubes: if tubing is dislodged from patient, do what? | -apply a sterile dry 4x4 dressing -ONLY tape 3 sides of the dressing |
| removing a chest tube | -administer pain med -instruct the patient to take a deep breath, exhale, and bear down (Valsalva maneuver) -apply airtight sterile petroleum jelly gauze dressing -apply tape on all 4 sides -obtain a chest x-ray -monitor site for S/Sx of infection |
| first big three things to check with giving blood | -verify order -informed consent -verify if there is an order for pre-transfusion medications |
| only fluid that is given with blood | normal saline |
| how many (and who) prior to blood transfusion? | two RNs |
| two RNs verify what at pt's bedside prior to blood transfusion? | Verify: Order Consent Pre-transfusion meds Pt’s Name DOB and/or ID/Medical Record # Donor # Blood Type Expiration Date |
| blood product transfusion: obtain baseline vital signs when? | before beginning transfusion |
| blood product transfusion: obtain VS how often? | every 5-mins x 3 (at start of infusion), then every 15-mins for 1st hour, then every 30-mins after 1st hour until transfusion complete, once infusion is done, then every 30-mins after transfusion done |
| blood product transfusion: observe pt for what during transfusion? | infiltration, flushing, dyspnea, itching, hives, rash, any usual comments |
| when should you administer pretransfusion med(s)? | ~30-mins before initiating blood transfusion |
| ask pt what before initiating blood transfusion? | previous experience(s) w/transfusion and any reactions |
| pt to report what during blood transfusion? | chills, itching, rash, unusual symptoms |
| blood product transfusion: max. time for transfusion | 4-hours |
| blood product transfusion: increase infusion rate when? | after observation period (first 15-mins of transfusion) |
| blood product transfusion: what do you do for transfusion reaction? | stop transfusion, quickly replace tubing with new set for normal saline (at 40-50mL/hr), obtain VS, notify ordering provider and blood bank |
| blood product transfusion: monitor and assess pt for what after transfusion? (you would also instruct pt on this) | delayed transfusion reaction |
| universal blood donor? | O- |
| universal blood recipient? | AB+ |
| blood: Rh factor matters when mom is Rh what and baby is Rh what? | mom Rh- baby Rh+ |
Created by:
nurse savage
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