GWCC Block 2 nursing
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| Health problems that increase surgical risk | show 🗑
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| Why is obesity an increased surgical risk? | show 🗑
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| Why does renal disease have increased surgical risk? | show 🗑
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| Why does liver disease have increased surgical risk? | show 🗑
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| Why does diabetes mellitus have increased surgical risk? | show 🗑
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| show | anticoagulants; tranquilizers; cortocosteriods; diuretics
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| show | applied directly to skin, mucous membranes, wounds. Xylocaine & benzocaine
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| local anesthesia (infiltration) | show 🗑
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| nerve block | show 🗑
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| intravenous (Bier) block | show 🗑
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| spinal anesthesia (SAB- subarachnoid block) | show 🗑
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| epidural (peridural) anesthesia | show 🗑
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| show | minimal depression of LOC so client can retain patent airway and respond to commands. IV narcotics: fentanyl, diazepam (valium), Versed. Induces amnesia and higher pain threshold, prompt reversal of effects.
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| Position during immediate postanesthetic stage for an unconscious client. | show 🗑
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| Patients are released from PACU when . . . | show 🗑
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| show | every 15 minutes until vital signs stable; every hour for the next four hours; every 4 hours for the next 2 days.
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| show | LOC; vital signs; skin color/temp; comfort; fluid balance; dressing & bedclothes (for hemorrhage); drains and tubes.
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| Pneumonia signs | show 🗑
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| show | dyspnea tachypnea, tachycardia, diaphoresis, anxiety, pleural pain, decreased chest wall movement, dull/absent breath sounds, decreased O2 sat, sudden chest pain, SOB, cyanosis, shock (tachycardia w/ low BP)
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| pulmonary embolism signs | show 🗑
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| show | excess bleeding, increased pain, increased abdominal girth, swelling or bruising around incision
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| show | rapid, weak pulse, dyspnea, tachypnea, restlessness and anxiety, urine less than 30mL/hour, decreased BP, cool clammy skin, thirst, pallor
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| thrombophlebitis | show 🗑
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| show | stationary clot
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| embolus | show 🗑
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| show | appearance (color, approximation of wound edges); size, drainage (color, consistency, odor, degree of bandage saturation); swelling; pain, drains or tube (security, placement, character of drainage, functioning of drainage apparatus)
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| show | 1. Absence of bleeding/formation of clot; 2. inflammation of wound edges for 1-3 days; 3. reduction in inflammation, bridge and closed in 7-10 days; 4. scar formation; 5. diminished scar over time
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| Guidelines for cleaning a wound with a penrose drain | show 🗑
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| show | Towards- to prevent straining the incision.
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| When changing bandages that involve a Penrose drain, | show 🗑
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| If using forceps to assist in cleaning a wound . . | show 🗑
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| A double-lumen NG tube is used for: | show 🗑
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| What is a nasoenteric tube? | show 🗑
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| How to measure an NG tube | show 🗑
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| What position should the client's head be in when inserting an NG tube? | show 🗑
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| show | direct the tube along the floor of the nostril and towards the ear on that side. This avoids nasal turbinates along the lateral wall.
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| When placing an NG tube, and the client begins to gag and retch, what should the nurse do? | show 🗑
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| show | 1 to 5. 6 or grater indicates the tube is in the respiratory tract or lower in the intestinal tract.
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| Before removing an NG tube: | show 🗑
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| show | use a syringe to deliver the formula
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| Define continuous feeding | show 🗑
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| Define cyclic feeding | show 🗑
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| show | 8-12 hours
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| Closed systems of formula can hang for | show 🗑
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| If more than ___mL is aspirated when checking residuals before the next feeding, check with the nurse in charge or agency policy. | show 🗑
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| When using a prefilled bottle for tube-feeding, hang it on an IV pole about ___ inches above tube insertion point. | show 🗑
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| show | 4-8
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| show | 3-5 times before performing suction or trach care. Do not do this if the client has copious secretions, as it can cause the secretions to go further down in the airway.
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| show | 80-120
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| show | turn it on 100% O2 for 2 minutes prior to suction/trach care
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| Insert the suction catheter ___ inches. Withdraw the catheter ___ cm before applying suction to prevent damage to bifurcation of trachea. | show 🗑
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| Allow ____ minutes between suctions to allow for client recovery. | show 🗑
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| show | Normal Saline (0.9% NaCl); Lactated Ringers; D5W (5% dextrose in water)
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| Veins used for IV infusion in the hand/arms | show 🗑
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| Basilic vein is on the __ side of the arm. The Cephalic vein is on the __ side of the arm. | show 🗑
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| show | subclavian or jugular vein, with distal tep resting in the superior vena cava just above the right atrium. Risks include hemothorax, pneumothorax, cardiac perforation, thrombosis, infection.
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| Peripherally inserted central venous catheters (PICC lines) are usually placed ____. The advantage of a PICC line is ___. | show 🗑
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| For routine hydration and intermittent therapies use a ___ gauge IV catheter. | show 🗑
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| For transfusion therapies use a ___ gauge IV catheter. | show 🗑
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| For neonates or clients with fragile veins use ___ gauge IV catheter. | show 🗑
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| show | 15-30 degrees, with bevel up
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| Label the IV site with: | show 🗑
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| For a butterfly needle, insert it in the direction of ___. | show 🗑
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| pleural effusion | show 🗑
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| pneumothorax | show 🗑
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| hemothorax | show 🗑
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| show | 14 F for uncomplicated cases, 18 F for thick secretions.
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| What do you ask the patient to do during removal of the chest tube? | show 🗑
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| show | at least 80
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| What does a nurse assess in a pt with a chest tube? | show 🗑
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| If a pt with a chest tube gets more than ___mL/hr it is a hemorrhage | show 🗑
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| If a chest tube becomes clotted, ___. | show 🗑
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| show | during an ECG, when the patient is moving or when using electrodes that are too dry. Abnormal reading.
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| 60-cycle interference | show 🗑
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| show | caused by breathing and electrodes moving too much during ECG
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| show | depolarization of atria (sinus node)
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| show | depolarization of ventricles
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| T wave | show 🗑
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| Where is a specimen collected from a chest tube? | show 🗑
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| show | tidal stops moving
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| show | "to keep open" referring to the order to keep the IV open and flow moving. Usually set to 20-30mL/hr for this purpose
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| show | use a chloroprep to go vigorously back and forth.
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| show | up from the last site.
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| show | above
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| show | 2
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| Place the tourniquet ___. It should not be kept on longer than ___. | show 🗑
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| show | (volume/hour x drip factor on bag) divided by 60 min
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| show | 2 days
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| How long can bags hang (saline)? | show 🗑
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| How long can catheters last? | show 🗑
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| show | 24 hours
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| show | tube holders- standard; syringe- fragile veins; butterfly- large amt. of blood being taken, children, or difficult sticks.
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| When puncturing a vein, do NOT ___. | show 🗑
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| show | 4th intercostal space to right of sternum
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| V2 | show 🗑
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| V4 | show 🗑
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| show | mid-axillary line, horizonal V4
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| V5 | show 🗑
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| show | between V4 & V2
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