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RSPN Final 091711
| Question | Answer |
|---|---|
| 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 |
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