In each blank, try to type in the
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If your not sure what answer should be entered, press the space bar and the next missing letter will be displayed. When you are all done, you should look back over all your answers and review the ones in red. These ones in red are the ones which you needed help on. Question: Health problems that surgical riskAnswer: ; Obesity; Cardiac complications; Blood coagulation disorders; Upper Respiratory/COPD; Renal disease; Diabetes mellitus; Uncontrolled neuro disease (seizures) Question: Why is obesity an surgical risk?Answer: leads to hypertension, impaired cardio function, impaired respiration. Delayed healing b/c adipose tissue impedes circulation. Question: Why does disease have increased surgical risk?Answer: Regulation of body fluids, , acid/base balance, excretion of drugs and toxins Question: Why does disease have increased surgical risk?Answer: impairs ability to detoxify/metabolize meds. Liver makes proteins (prothrombin for and others for wound healing). Question: Why does diabetes have increased surgical risk?Answer: Delayed wound healing, predisposes patient for wound Question: The use of what meds can surgical risk?Answer: ; tranquilizers; cortocosteriods; diuretics Question: anesthesiaAnswer: applied to skin, mucous membranes, wounds. Xylocaine & benzocaine Question: anesthesia (infiltration)Answer: injected into a area. Lidocaine & tetracaine 0.1% Question: blockAnswer: anesthetic agent is injected around a nerve or group of . Major (brachial plexis - arm) and minor (facial) Question: intravenous (Bier) Answer: occlusion tourniquet is applied to prevent infiltration/aborption beyond the . Used most for arms, hands & wrists. Question: spinal anesthesia (SAB- block)Answer: lumbar puncture between L2 and S1. Low (saddle block- perineal/rectal); Mid (below umbilicus- hernia, appendectomies), High (reaching nipple line- ) Question: epidural (peridural) Answer: injected med into epidural space, the area the spinal column but outside dura mater. Question: conscious Answer: 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, reversal of effects. Question: Position during postanesthetic stage for an unconscious client.Answer: On the side, face slightly down to allow drainage. No pillow. Elevate upper arm on pillow to allow maximum respiration. Artificial airway in place until client starts to gag/cough. Question: Patients are from PACU when . . .Answer: conscious, oriented, able to breathe freely, cough, stable vital signs for 30 , protective reflexes (gag, swallow) intact, move all extremities, I&O 30ml/hr, afebrile, dressings dry/intact, no overt drainage Question: Post-op patient vital Answer: 15 minutes until vital signs stable; every hour for the next four hours; every 4 hours for the next 2 days. Question: What do assess post-operatively?Answer: LOC; vital signs; skin color/temp; comfort; fluid balance; dressing & bedclothes (for hemorrhage); drains and . Question: Pneumonia Answer: elevated temperature, cough, expectoration of blood-tinged or purulent , dyspnea, chest pain. Question: signsAnswer: dyspnea tachypnea, tachycardia, diaphoresis, anxiety, pleural pain, chest wall movement, dull/absent breath sounds, decreased O2 sat, sudden chest pain, SOB, cyanosis, shock (tachycardia w/ low BP) Question: pulmonary embolism Answer: sudden chest pain, SOB, cyanosis, (tachycardia w/ low BP) Question: hemorrhage Answer: excess bleeding, pain, increased abdominal girth, swelling or bruising around incision Question: shock signsAnswer: rapid, weak pulse, dyspnea, tachypnea, and anxiety, urine less than 30mL/hour, decreased BP, cool clammy skin, thirst, pallor Question: Answer: inflammation of veins: aching, cramping pain, affected area swollen, red and hot to , vein feels hard, discomfort in calf when foot is dorsiflexed or when client walks (Homan's sign) Question: Answer: stationary Question: embolusAnswer: clot that has dislodged Question: Assessing surgical (6)Answer: appearance (color, approximation of wound edges); size, drainage (color, consistency, odor, degree of saturation); swelling; pain, drains or tube (security, placement, character of drainage, functioning of drainage apparatus) Question: Sequential of healing for primary intention (surgical) woundsAnswer: 1. Absence of bleeding/formation of clot; 2. inflammation of wound edges for 1-3 days; 3. reduction in inflammation, bridge and in 7-10 days; 4. scar formation; 5. diminished scar over time Question: Guidelines for cleaning a wound with a drainAnswer: The Penrose drain is considered to be less clean than the surgical incision because of the drainage from the drain. Clean the main surgical incision first. Then clean the Penrose drain using different equipment/dressing/cleaning supplies. Question: When removing tape, pull the tape ____ the wound.Answer: Towards- to prevent straining the . Question: When changing bandages that involve a Penrose , Answer: make sure not to pull the off without making sure that the drain is not attached to the bandage! Sometimes the drain may stick to the bandage. Question: If using forceps to in cleaning a wound . . Answer: keep the forcep tips than the handles at all times to prevent contamination and fluid traveling up the handle and to the nurse's wrist, and back to the tips. Question: A -lumen NG tube is used for:Answer: suctioning the stomach of secretions. The larger lumen allows delivery of liquids or removal of secretions. The smaller lumen for airflow into the stomach, which prevents vacuum pressure in the stomach/adherence to the stomach wall. Question: What is a tube?Answer: a tube (longer than the NG tube) that is inserted into the top part of the small intestine. Question: How to measure an NG Answer: measure from the tip of the nose to the tip of the earlobe, and then down to the tip of the . Question: What position should the client's head be in when an NG tube?Answer: hyper-extend the neck to reduce the curvature of the junction. Question: How should the NG tube be in?Answer: direct the tube along the floor of the nostril and towards the ear on that side. This nasal turbinates along the lateral wall. Question: When placing an NG tube, and the client begins to gag and , what should the nurse do?Answer: Ask the client to tilt the head forward and encourage the client to drink and swallow. Tilting the head forward facilitates of the tube into the posterior pharynx and esophagus rather than the larynx. Question: pH should be at:Answer: 1 to 5. 6 or grater indicates the tube is in the tract or lower in the intestinal tract. Question: removing an NG tube:Answer: instill 50mL of air into the tube to clear it of contents. Question: bolus feedingAnswer: use a to deliver the formula Question: continuous feedingAnswer: administered over a 24 hour period at a constant Question: Define cyclic Answer: continuous feeding that is administered in less than 24 (12 or 16 hours, usually overnight) Question: Open systems of formula can hang Answer: 8-12 Question: Closed systems of can hang forAnswer: 48 hours if sterile technique is Question: If more than ___mL is when checking residuals before the next feeding, check with the nurse in charge or agency policy.Answer: Question: When using a prefilled bottle for tube-feeding, hang it on an IV pole ___ inches above tube insertion point.Answer: 12 Question: For continuous feedings, residual every ___hours.Answer: 4-8 Question: with ambu bag:Answer: 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 . Question: What should the setting be when using ?Answer: 80-120 Question: of client on ventilator:Answer: turn it on 100% O2 for 2 minutes prior to /trach care Question: Insert the suction catheter ___ inches. Withdraw the catheter ___ cm before applying suction to prevent damage to bifurcation of .Answer: 5 inches, 2 cm (0.4 to 0.8 ) Question: Allow ____ minutes between suctions to allow for client recovery.Answer: 1 Question: SolutionsAnswer: Normal Saline (0.9% NaCl); Ringers; D5W (5% dextrose in water) Question: used for IV infusion in the hand/armsAnswer: metacarpal, basilic, Question: vein is on the __ side of the arm. The Cephalic vein is on the __ side of the arm.Answer: Basilic- ; Cephalic- thumb Question: A central venous catheter is usually placed in ___ and the end is__. include___.Answer: subclavian or jugular vein, with distal tep resting in the superior vena cava just above the atrium. Risks include hemothorax, pneumothorax, cardiac perforation, thrombosis, infection. Question: Peripherally inserted central venous catheters (PICC lines) are usually placed ____. The advantage of a PICC line is ___.Answer: in the basilic or vein just abouve or below the antecubital space of the right arm with tip resting in superior vena cava. Eliminates risk of pneumothorax. Question: For routine hydration and intermittent therapies use a ___ gauge IV .Answer: 20 (ideal) to Question: For therapies use a ___ gauge IV catheter.Answer: Question: For neonates or clients with fragile veins use ___ gauge IV .Answer: 24-27 Question: The over-the-needle catheter be inserted at __ angle.Answer: 15-30 degrees, with up Question: the IV site with:Answer: date, time, size of catheter, and Question: For a needle, insert it in the direction of ___.Answer: flow. Question: pleural Answer: that accumulates in the pleural space of the lungs Question: pneumothoraxAnswer: air in the space Question: Answer: blood in the space Question: What FR size is used for tubes?Answer: 14 F for cases, 18 F for thick secretions. Question: What do you ask the to do during removal of the chest tube?Answer: maneuver Question: When using a dry suction unit for chest tube collection, set the wall suction at ___ to achieve a -20 on the unit.Answer: at 80 Question: What does a nurse assess in a pt with a tube?Answer: crepitis, air flow in the unit (instead of normal tidal volume).
Question: If a pt with a tube gets more than ___mL/hr it is a hemorrhageAnswer: 100 Question: If a chest tube clotted, ___.Answer: contact the . Don't try to unclot it yourself. Question: artifactAnswer: during an ECG, when the patient is moving or when using electrodes that are too dry. reading. Question: 60-cycle Answer: electrical with ECG unit Question: wandering Answer: caused by breathing and electrodes too much during ECG Question: P waveAnswer: depolarization of (sinus node) Question: QRS Answer: depolarization of Question: T Answer: re-polarization of Question: Where is a specimen from a chest tube?Answer: Directly from the tube. Not from the unit. Question: When the ___ , a pt with a tube is considered healed.Answer: stops moving Question: TKOAnswer: "to keep open" referring to the order to keep the IV open and flow . Usually set to 20-30mL/hr for this purpose Question: When prepping an area for IV/vein ___.Answer: use a chloroprep to go back and forth. Question: Every time you an IV site, you have to move ___.Answer: up from the last site. Question: Do not draw ___ an IV site.Answer: above Question: When to get an IV placed, the RN should only try __ times before getting another RN.Answer: 2 Question: Place the ___. It should not be kept on longer than ___.Answer: 6 inches above the site. 2 . Question: What is the for calculating gtts/min?Answer: (volume/hour x drip factor on bag) by 60 min Question: How long can IV last?Answer: 2 Question: How long can bags hang (saline)?Answer: 24 Question: How long can last? Answer: 2-4 Question: How long can TPN hang?Answer: 24 Question: What kind of needle/catheter should be used for circumstance when drawing blood?Answer: tube - standard; syringe- fragile veins; butterfly- large amt. of blood being taken, children, or difficult sticks. Question: When a vein, do NOT ___.Answer: put your finger the needle! Question: V1Answer: 4th intercostal to right of sternum Question: Answer: 4th intercostal to left of sternum Question: V4Answer: mid-clavicular line & 5th space Question: Answer: mid-axillary line, V4 Question: Answer: between V4 & Question: V3Answer: between V4 & |
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