Exam #1
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| Lymphatic Vessels | show 🗑
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| Spleen Functions | show 🗑
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| Splenectomy procedure and risk | show 🗑
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| Thrombocytes | show 🗑
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| show | O-; can donate to all blood types
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| show | AB
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| show | NO...Rh- cannot receive + blood.
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| show | Yes.
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| Only IV fluid hung with blood products | show 🗑
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| Time for s/s to appear for a reaction to donated blood products. | show 🗑
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| show | Chills, Fever, SOB, Tachycardia, back pain, HA, chest pain, hypotension.
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| If s/s of hemolytic reaction occur when a patient is receiving blood transfusion... | show 🗑
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| show | 4 hrs. Must then discard. If greater duration is required or fluid overload occurs, may call blood bank and have unit split into smaller units.
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| show | RN will need to start another line. Additional fluids may NOT be piggybacked.
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| Pre-transfusion check | show 🗑
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| IV gauge for blood transfusion | show 🗑
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| show | Produces bile, Metabolizes, Synthesizes coagulation factors VII, IX, X, and prothrombin. Stores Vitamins and glycogen.
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| Lymph nodes to be concerned about | show 🗑
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| show | Blood chemistry, Hematologic studies, Bone marrow aspiration/biopsy, Coagulation studies, Bone scan, Schilling test.
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| When use of radioisotopes during diagnostic test is required, RN needs to assess for what type of allergy. | show 🗑
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| Hematocrit should be about __x greater than hemoglobin | show 🗑
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| show | 9
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| show | Patient's weight
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| show | 1-2; patient's with cardiac issues may be 2.5-3.5
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| Platelet normal value | show 🗑
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| show | Blood clot, affects on the cardiac and respiratory system due to higher blood viscosity.
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| Decrease in platelet value = | show 🗑
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| Primary blood dyscrasias | show 🗑
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| show | A cause other than defect in blood...i.e malnutrition, drugs, disease processes.
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| Sickle cell is more prevalent in... | show 🗑
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| show | Clots which lead to hypoxia which leads to tissue necrosis.
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| Anemia | show 🗑
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| Polycythemia | show 🗑
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| show | Iron or vitamin deficiency. Most common anemia.
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| Pernicious Anemia | show 🗑
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| show | Pregnant mother with Rh- blood, is exposed to baby's Rh+ blood. The mother produces antibodies and attacks fetus' blood. AKA hemolytic anemia
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| show | Caused by bleeding, trauma, leukemia, cancer, kidney disease.
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| Anemias caused by genetic factors | show 🗑
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| show | Caused by malfunctioning bone marrow.
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| show | Women then children, especially pregnant women.
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| show | Pregnant women, women, children, poor dietary intake, PUD, long term ASA use, colon cancer.
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| Signs and symptoms of anemia | show 🗑
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| show | Best on empty stomach, vitamin C increases absorption. SHOULD NOT be given with milk or antacid.
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| show | Vitamin C
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| Considerations when giving IV iron | show 🗑
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| Considerations when giving IM injection of iron | show 🗑
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| show | Dark green leafy vegetables, Beans and peas, dried fruits, eggs, nuts, raisin, seafood, spinach, whole grain
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| show | Eggs, meat, poultry, shellfish, milk and milk products.
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| show | Fruits and vegetables.
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| Dilantin use related to folate | show 🗑
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| show | Pts using dilantin, ETOH, or hemodialysis.
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| show | Removal of blood, IV fluids
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| show | Stroke, MI, embolism, infection (due to immature WBC), bleeding (platelets are immature), poor perfusion, stasis ulcers.
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| Hemophilia | show 🗑
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| show | Leukemia
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| Blasts | show 🗑
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| Decrease in WBCs | show 🗑
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| Increase or decrease in WBCs causes and increase in... | show 🗑
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| show | Decrease in neutrophils. Caused by cancer, immunosuppressive disease/therapy, HIV, Lupis
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| Leukopenia | show 🗑
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| show | Bacterial
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| show | Fungal or viral
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| show | Reverse isolation: no kids, keep in room as much as possible, no sick visitors or staff, wash fruits and veggies thoroughly (cooked is best), monitor temp every 4 hours, mask gown when leaving room.
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| show | No soap or lotion can be applied to area. Wash with warm water only.
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| show | Fever or night sweats, frequent infections, feeling weak or tired, headache, bleeding/bruising, bone and/or joint pain, swollen lymph nodes, weight loss
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| Blood tests for leukemia | show 🗑
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| Side effects for chemo | show 🗑
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| Monoclonal antibodies | show 🗑
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| show | Slows growth of cells. Mostly used for GI/Colon cancer
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| show | Rash/swelling at injection site, anemia, flu like symptoms. Not as severe as with chemo/radiation.
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| show | Bone Marrow Transplant
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| Radiation therapy side effects | show 🗑
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| show | Talk to the radiologist before performing wound care.
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| Side effects of Bone Marrow Transplant | show 🗑
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| Hodgkin's lymphoma | show 🗑
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| Lymphatic cancer is usually... | show 🗑
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| Lymphoma signs and symptoms | show 🗑
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| PICC and central line dressing changes are... | show 🗑
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| show | Deficient number of platelets
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| show | ETOH, ASA, and NSAIDS
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| show | Sudden onset of petechiae, malaise, fatigue, general weakness.
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| show | Nose bleed
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| PICCS are usually used for about....weeks before changing. | show 🗑
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| Ferrous sulfate and antacids must be taken at least __ hours apart. | show 🗑
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| show | The surgeon/physician
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| Clinical signs of stress | show 🗑
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| show | Cognition, decision making, and coping skills. Pts will not learn while anxious.
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| Perhaps the strongest positive coping mechanism... | show 🗑
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| Pre-op assessment includes.. | show 🗑
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| Postoperative delirium can occur with... | show 🗑
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| show | They can affect airway management and anesthesia delivery.
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| show | Hypo/hyperglycemia, ketosis, cardiovascular alterations, delayed wound healing, infection.
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| Assessment for pts with diabetes mellitus prior to surgery.. | show 🗑
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| Drugs to check with doctor before giving the morning of surgery. | show 🗑
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| show | Addisonian crisis
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| show | May take meds with sip of water. Document appropriately.
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| IF a pt is NPO, the RN needs to double check to see if there is an order for... | show 🗑
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| Implications of obesity on surgical procedures. | show 🗑
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| show | May need to provide extra padding to prevent pressure ulcers.
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| show | Informed consent, signature for blood transfusion, advance directives and power of attorney.
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| If MPOA is approving a procedure over the phone... | show 🗑
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| show | VOID :)
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| show | 4-6 weeks
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| show | Avocados, bananas, peaches. Have asthma or hay fever.
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| Pre-op labs and diagnostic tests | show 🗑
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| show | Deep breathing, incentive spirometry, splint incision, turn, reposition (prevent atelectasis/pneumonia). Leg exercises and antiembolic SCDs.
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| show | Provides the surgeon with required instruments, sponges, drains, and other equipment, anticipating what will be needed. Prepares sterile tables prior to surgery.
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| show | Complete preoperative preparations
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| Circulating nurse | show 🗑
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| show | Sponges and instruments at the close of surgery.
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| One of the most significant potential hazards to the pt in the OR is... | show 🗑
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| Time out or procedural pause | show 🗑
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| show | Produces analgesia, relaxes muscles, results in a sleep-like state. Patient will be intubated.
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| Regional anesthetic | show 🗑
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| show | Depresses superficial peripheral nerves and blocks conduction of pain impulses from their site of origin.
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| show | Diazepam/Valium, Midazolam/Versed. Usually need RN present constantly during conscious sedation.
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| show | Cardiologist
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| Skin staples | show 🗑
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| show | Reaction to anesthesia. Ask pts prior to surgery if they have any family member who have experienced this. Without antidote, the pt dies.
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| S/S of malignant hyperthermia | show 🗑
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| PACU Care | show 🗑
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| show | May indicate obstruction of the airway, possibly from emesis, accumulated secretions, or patient positioning that allows the tongue to fall to the back of the throat.
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| If respiratory rate in decreased or O2 sats are 90-92... | show 🗑
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| show | Hemorrhage or shock
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| Sinus Bradycardia | show 🗑
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| show | All intervals of PQRST wave normal, just fast pulse. Monitor V/S. Assess pt for cause.
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| show | Atria contracting spontaneously, ventricles can contract normal part of the time. Atrial rate may appear to be 350-600 while ventricle rate is 100-160
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| show | V tach and V fib
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| show | DEADLY RHYTHM. Rapid uncoordinated firing of the ventricles. This rhythm does not generate a pulse. Interventions: Quickly check pulse, if no pulse, De-fibrillate immediately.
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| show | Assess for gag reflex.
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| show | 15 minutes for the first hour, every 30 minutes for 2 hours, every hour for 4 hours, then every 4 hours as needed.
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| If bleeding is noticed on a post-op bandage... | show 🗑
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| show | Be able to void and ambulate independently (or up to baseline), be alert and oriented, have minimal nausea and vomiting, have a person to accompany them home.
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| show | Get pt up and walking. Best way to prevent these issues.
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| show | Diet with significant amounts of protein and vit A and C help rebuild tissues and promote wound healing. Adequate carbs and fat are also needed to avoid depleting protein stores.
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| show | Within 6-8 hours. Janice gets nervous around 4 hours w/o voiding.
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| show | Hypovolemia, hemorrhage, electrolyte imbalance, inadequate circulation, hypoxia, or impending shock.
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| show | Very painful, usually responds to TX with an NG tube, bowel rest, and IV.
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| If PO meds are crushed and inserted into NG tube... | show 🗑
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| Hemo-vac output measured every ... | show 🗑
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| Programming of PCA pumps need to be verified by... | show 🗑
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| show | Newborn or infant
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| show | Toddler
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| show | Preschool
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| Industry vs Inferiority | show 🗑
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| Identity vs Role Confusion | show 🗑
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| Intimacy vs Isolation | show 🗑
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| show | Middle-age
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| show | Old age
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| show | 10x every hour
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| show | Every hour
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| show | Supine
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| Antidote for malignant hyperthermia | show 🗑
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| S/S of shock | show 🗑
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| Drugs that turn urine red. | show 🗑
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| Drugs that turn urine orange or orange-red | show 🗑
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| Drugs that turn urine green or blue-green color | show 🗑
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| show | Injectable iron
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| show | To instill medication and to flush out old blood and clots (post TURP, injury, or bladder surgery.
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| show | Transurethral resection of the prostate.
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| show | Transurethral resection for bladder tumor.
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| Monitoring irrigation fluid in I&O. | show 🗑
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| show | Avoid bony prominences and fatty areas.
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| show | 6 second strip that can be printed from a monitor normally in lead II
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| show | V1-V6
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| Limb Leads | show 🗑
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| Isoelectric line | show 🗑
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| The normal running speed for EKG | show 🗑
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| show | Look to see if patient is moving or jerking, if there is muscle tremors. If there is a loose cable or lead.
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| What position should a pt be in prior to EKG | show 🗑
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| When can magnets be placed over pace-maker for EKG. | show 🗑
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| Electrodes in good condition may be reused within... | show 🗑
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| The limb electrodes may be placed on... | show 🗑
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| show | Goal is to obtain 12 lead EKG within 5 minutes of admission to ED or per hospital policy. This is in place to increase door-to-ballon times and improved patient care.
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| show | Normal rate, normal rhythm
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| show | Abnormal heart rhythm
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| How to determine heart rate from 6 sec strip | show 🗑
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| show | HR less than 60
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| show | HR more than 90
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| Atrial Fibrillation. | show 🗑
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| Ventricular Fibrillation | show 🗑
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| show | AKA Flatline. No rhythm and no pulse=legally dead.
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| MI on EKG | show 🗑
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| Myocardial ischemia on EKG | show 🗑
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| show | Perform CPR. Electrical activity is occurring but no heart beat.
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| show | To expand the lung to normal negative intrathoracic pressure.
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| show | Pressure builds in pleural space = shrinks lung.
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| show | Open (sucking chest wound) and Closed.
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| show | Closed. It allows pressure to build and will eventually cause a tension pneumothorax.
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| show | Blood in pleural space.
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| Pleural effusion | show 🗑
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| Tension Pneumothorax | show 🗑
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| show | Decreased BP, Increased Pulse, JVD, Deviated trachea
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| S/S of Pneumothorax | show 🗑
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| show | Needle Decompression using a large bore IV catheter. After decompression it will be a sucking wound and will need a chest tube.
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| show | Insertion of chest tube and drainage system. Drainage system does not need to be sterile but the chest tube does.
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| Always keep the chest tube ....the level of the pt. | show 🗑
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| Chest tubes need to be.... after placement. | show 🗑
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| show | Immediately apply a Vaseline gauze. It should be taped to the bed.
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| CDI | show 🗑
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| show | Blood cultures are always first. Then Blue, Red, Green, Purple, Grey.
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| show | CBC, Blood counts, blood sugar
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| Diagnostic tests for Light Blue | show 🗑
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| show | Ammonia, troponin, iSTAT
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| Diagnostic tests for Gray top | show 🗑
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| show | CMP (chemistry)
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| Gray tops are drawn after what type of prep is used.. | show 🗑
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| Gray top tubes are kept....after blood is drawn. | show 🗑
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| show | Must immediately go on ice, hold manual pressure for at least 5 minutes, and should be hand delivered to the lab.
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| show | Ammonia (green), lactate or lactic acid (green), ionized calcium (green), ABG (syringe)
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| If patient has a vagal reaction when drawing blood.... | show 🗑
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| show | Lavage stomach, assess for GI bleed, Decompress stomach.
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| show | 4-6 hours.
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| show | Drugs that are designed so that their 1st metabolite is the active form of the drug. If this drug is given IM or IV it will take longer to get a therapeutic effect.
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| show | Time in which half of original dose is removed. It takes about 5 half-lives to remove a drug.
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| Additive effect | show 🗑
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| show | Less effective than each alone
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| Synergistic effect | show 🗑
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| show | Causes Fetal deformities
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| show | Mutates DNA
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| Carcinogenic | show 🗑
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