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RSPN Final 091711

QuestionAnswer
Differentiate between subjective and objective data subjective data is given to you, objective data is observed by the nurse
Why do we complete a Health History and Physical Assessment? To determine patient's level of functioning in order to make clinical judgement
Why do we complete an admission assessment? 1- to evaluate health status and 2-To identify health problems
What are the main concerns of an Emergency Assessment? Focus on respiratory, circulatory, neuro, or emergency psychosocial situations
List some of the purposes of documentation to keep chronological source of data, accessible, baseline establishment for diagnoses, source of data for new diagnoses, determine teaching goals, reimbursement, legal record, accredittaion
What are the phases of the Health History Interview? Preparatory phase, introductory phase, working phase, summary and closing phase
List some types of non-verbal communication appearance, demeanor, attitude, facial expression, listening, silence
What types of data require validation? any discrepancy between subjective and objective data, between patient statements at different times, and between patient and family reports- as well as abnormal and or inconsistend data
what are the 7 steps to interpret data using Diagnostic reasoning skills? ID abnormal data and strenghts, cluster data, draw inferences, propose possible nursing Dx, check for defining characteristics, confirm or rule out nursing dx, and document conclusions
What are some of the pitfalls of Diagnosing (2 sets)? In the assessment phase: too many or too few data, unreliable or invalid data, insufficient number of cues; in analysis phase: clustering of unrelated cues
Identify and explain the acronmy that assists in analyzing symptoms COLDSPA- Character, Onset, Location, duration, Severity, Pattern, Associated factors
Define: neonate birth to 28 days
Define: PTL pre term labor
Define: LGA Large for gestational age
Define: SGA Small for gestational age
Define: ROM, PROM, PPROM Rupture, premature rupture, or preterm premature rupture of membranes
Define: IUGD Intrauterine Growth Delay
What is RDS? Respiratory Distress syndrome
Nasal flaring, retractions, tachypnea, and cyanosis in a neonate are sx of what? RDS
Complications of RDS include Respiratory failure, BPD, PDA, ROP, IVH, ICH
Are short periods of apnea normal for neonates? yes
What is it called when a neonate/preemie has a 20 sec period of apnea Apnea of Prematurity
The nurse is documenting A's and B's, giving gentle stimulation, possible caffeine, blow by O2, and monitoring closely, Why? Preemie indicates AOP
Why use whole blood during transfusion? increase volume
Why use Packed RBC's during transfusion? anemia, hypoxia, patient has good volume but poor o2 carrying capacity
Why use albumin during transfusion? to expand volume
Why use plasma / FFP during transfusion? for clot factor problems
Why use cryoprecipitateduring transfusion? for hemophilia / factor VIII
Plasma Volume Expander: Crystalloid: List 2 normal saline, lactated ringers
When is a crystalloid used? to expand volume in VASCULAR space (low bp)
Plasma Volume Expander: Colloid:List 4 albumin, plasma, dextran, hetastartch
When is a colloid used? when volume is needed -THIS QUESTION NEEDS RESEARCHED
During surgery, my own blood was used. What is this called? autologous / intraoperative blood salvage if collected AND used during surgery
Universal needle/cath/venipuncture/blood draw 20 gauge
When do most blood transfusion reactions happen? within first 15 minutes
What is the *only* fluid used with blood administration? NS
What rate do you start infusion at? 10gtt/min
If blood has been hanging for more than ____ hours, you must stop it 4
During transfusion, patient develops fever and chills- what type of reaction is this? febrile
During transfusion, patient develops urticaria and/or hives or anaphylaxis- what type of reaction is this? allergic
During transfusion, this type of reaction is emergent and requires swift intervention hemolytic
Which type of reaction occurs 4-8 days later after blood transfusion? Delayed hemolytic
True or false: if you suspect a reaction, you remove the intravenous access false
True or false: if you suspect a reaction, you must stop the transfusion true
True or False: This class seems easy sometimes but it's really hard!! true :-D
True or False: If a resident is a DNR, you will not intubate the patient false- not necessarily- there are different kinds of advance directives
True or False: Some meds may be given via ETT true
What meds may be given via ETT? NAVEL - Narcan, Atropine, Vasopressin, Epinephrine, Lidocaine
True or False: you must shock a PEA (Pulseless Electrical Activity) False
The team leader is looking for the underlying cause during a code. Know the 5 ____ and 6 ____'s 5 T's and 6 H's
What are the 5 T's the team leader will look for during a code? Tamponade(cardiac), Tension pneumothorax, toxins, thrombosis, trauma
What are the 6 H's the team leader will look for during a code? Hypoxia, H-ion excess(acidosis), Hypovolemia, Hyper/Hypokalemia, Hypothermia, Hypoglycemia
Call for help or begin CPR first when you establish unresponsiveness CALL FOR HELP FIRST
Who is responsible for safety of all team members when a shock is advised? the person initiating the shock
What are some risks of a PICC line? pneumothorax/lung puncture, infection
What is the max pressure of infusion and what size syringe is the minimum to keep below that pressure? <25psi, 10ml syringe or greater
True or False: A clamped PICC line (Hickman/Hohn) requires Heparin True
True or False: An unclamped PICC line (Groshong) requires Heparin False - only requires NS flush
True or False: You should always maintain positive pressure when flushing a PICC True
In order to use a PCA pump, the patient must: BE ALERT and ABLE to both physically AND mentally comply with PCA procedures
When an epidural is removed, what 2 things were identified in notes as being most important? INSPECT TIP and cover with DSD
Epidural injections are contraindicated in patients who have a spinal defect, increased ICP, or are on anticoagulant therapy
True or False: A patient on Coumadin is OK to receive an epidural False
When starting a PCA at RRMC, you should monitor VS how often? Q15minx4, Qhrx2, Q4h thereafter
True or False: It is acceptable for the patients brother to hit the PCA button for a dose if the patient cannot False
Created by: 100002387598309
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