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3040 Test 2

Medication/Documentation/Skin Integrity

QuestionAnswer
Intradermal (ID) injection (Max mL, Sites, types of testing, needle size, Degree, how to administer) MAX 0.1mL Sites- forearms, scapula, anterior chest Testing- Tb skin test and allergy testing Needle size- #25-#27 gauge; 1/4 to 5/8 inch 5-15 degrees Spread flat with fingers
Subcutaneous (SubQ) injection (Max mL, Sites, types of testing, needle size, Degree, how to administer) MAX 1mL Sites- abdomen, below scapula, outer aspect of upper arms, anterior aspect of thighs Testing- vaccines, insulin, and heparin Needle size- #25 gauge, 5/8-inch for 45 degrees (ADULT); 3/8-inch for 90 degrees (CHILD) Pinch an inch = 90 degrees
Intramuscular (IM) injection (Max mL, Sites, types of testing, needle size, Degree, how to administer) MAX 1mL (Deltoid); 3mL Sites- ventrogluteal, Vastus lateralis, dorsogluteal, rectus femoris, deltoid Needle size- #23 to #25, 1 inch for deltoid; #20 for more viscous solutions; 2 inches for obese clients; 1 inch for emaciated clients Z-track; Aspirate
Who regulates the production, prescription, distribution, and administration of drugs? Federal drug legislation
Generic name (of drug) given before a drug officially becomes an approved medication; generally used throughout the drug's lifetime
Trade name (of drug) name of drug given by the drug manufacturer; also known as the brand name
Who defines limits on the nurse's responsibilities regarding medications? Nursing practice acts
Therapeutic effect the primary effect effect intended of a drug; reason the drug is prescribed, also known as desired effect
Side effect the secondary effect of a drug that is unintended; usually predictable and may be either harmless or potentially harmful
Adverse effect more severe side effects that may justify the discontinuation of a drug
Drug toxicity the quality of a drug that exerts a deleterious effect on an organism or tissue ex: overdosage, ingestion of drug intended for external use, or cumulative effect
Cumulative effect buildup of the drug in the blood because of impaired metabolism or excretion
Drug allergy an immunologic reaction to a drug
Anaphylactic reaction a severe allergic reaction that usually occurs immediately after the administration of a drug
Drug tolerance a condition in which successive increases in the dosage of a drug are required to maintain a given therapeutic effect
Idiosyncratic effect a different, unexpected, or individual effect from the normal one usually expected from a medication; the occurrence of unpredictable and unexplainable symptoms
Drug interactions the beneficial or harmful interaction of one drug with another drug
Potentiating effect the increased effect of one or more drugs
Inhibiting effect the decreased effect of one or more drugs
Additive effect when two of the same types of drugs increase the actions of each other
Synergistic effect when two different drugs increase the action of one or another drug
Onset of action the time after administration when the body initially responds to the drug
Peak plasma level the highest plasma level achieved by a single dose when the elimination rate of a drug equals the absorption rate
Drug half-life the time required for the elimination process to reduce the concentration of the drug to one-half what it was at initial administration
Plateau a maintained concentration of a drug in the plasma during a series of scheduled doses
Medication orders include: Client’s full name; date and time the order is written; name of the medication; dosage, frequency, and route of administration; and signature of the ordering PCP or nurse
Stat order The medication is to be given immediately and only once
Single order Medication to be given once; also known as one-time order
Standing order An order that may be carried out indefinitely until another order is written to cancel it, or that may be carried out for a specified number of days
PRN order “as needed order”; permits the nurse to give a medication when, in the nurse’s judgment, the client requires it
Three important areas for medication reconciliation to occur are? on admission; during shift reports, transfers, and with new medication administration records; and at discharge
Preferred IM site for infant 1 year and younger? Vastus Lateralis
Preferred IM site for clients older than 7 months? Ventrogluteal
percutaneous through the skin
intentional body wounds trauma occurs during therapy
unintentional body wounds wounds are accidental; i.e. automobile collision
pressure ulcers injury to the skin and/or underlying tissue, usually over a body prominence, as a result of force alone or in combination with movement
friction a force acting parallel to the skin surface
shearing force a combination of friction and pressure
skin maceration tissue softened by prolonged wetting or soaking i.e. moisture from incontinence
skin excoriation area of loss of the superficial layers of the skin; also known as denuded area i.e. from feces, gastric tube drainage, and urea in urine
The Braden Scale for Predicting Pressure Sore Risk sensory perception, moisture, activity, mobility, nutrition, and friction and shear 23 total points; below 18 points is considered at risk
Norton's Pressure Area Risk Assessment Form Scale general physical condition, mental state, activity, mobility, and incontinence, and medications 24 total points; Scores of 15 and 16 are at risk
primary intention healing occurs where the tissue surfaces have been approximated (closed) and there is minimal or no tissue loss; it is characterized by the formation of minimal granulation tissue and scarring i.e. closed surgical incision
secondary intention healing a wond that is extensive and involves considerable tissue loss, and in which the edges cannot or should not be approximated i.e. pressure ulcer
tertiary intention wounds that are left open for 3 to 5 days to allow edema or infection to resolve or exudate to drain and are then closed with sutures, staples, or adhesive skin closures
inflammatory phase initiated immediately after injury and lasts 3 to 6 days.
hemostasis the cessation of bleeding
phagocytosis macrophages engulf microorganisms and cellular debris
proliferative phase extends from day 3 or 4 to about day 21 post injury fibroblasts begin to form collagen; epithelial cells proliferate over connective tissue or dried plasma cells and dead cells form
maturation phase begins on about day 21 and can extend 1 or 2 years after the injury collagen fibers reorganize themselves , the wound is remodeled and contracted, and the scar becomes stronger
exudate fluid and cells that has escaped from blood vessels during the inflammatory process and is deposited in tissue or on tissue surfaces
serous consists of serum (the clear portion of blood) i.e. blister from a burn
purulent presence of pus, which consists of leukocytes, liquefied dead tissue debris, and dead and living bacteria vary in color such as blue, green, or yellow
sanguineous consists of large amounts of red blood cells, indicating damage to capillaries
serosanguineous consisting of clear and blood-tinged drainage; commonly seen in surgical incisions
purosanguineous consisting of blood and pus; often seen in a new wound that is infected
suppuration process of pus formation
hemorrhage massive bleeding
hematoma a localized collection of blood underneath the skin that may appear as reddish blue swelling (bruise)
infection microorganisms colonizing the wound multiply excessively or invade tissues; may cause fever and elevated WBC count
dehiscence the partial or total rupturing of a sutured wound; i.e. an abdominal wound in which the layers below the skin also separate
evisceration protrusion of the internal viscera through an incision
RYB color code protect (cover) red, cleanse yellow, and debride black
rebound phenomenon occurs at the time the maximum therapeutic effect of the hot or cold application is achieved and the opposite effect begins
range of motions the maximum movement that is possible for that joint
proprioception describes awareness of posture, movement, and changes in equilibrium and the knowledge of position, weight, and resistance of objects in relation to the body
cerebral cortex initiates voluntary motor activity; directs arm to pick up coffee; coordinates moves not muscles
cerebellum coordinates the motor activities of movement; blends and coordinates the muscles involved in voluntary movement
basal ganglia maintains posture
degrees of head movement 45 degrees MAX
degrees of shoulder movement 50 degrees (adduction, hyperextension) 180 degrees (abduction, extension, flexion) 360 degrees (circumduction)
degrees of elbow 150 degrees (flexion, extension) 90 degrees (rotation for supination, rotation for pronation)
degrees of wrist 90 degrees (flexion, extension, hyperextension) 0-20 degrees (radial flexion) abduction 30-50 degrees (ulnar flexion) adduction
degrees of hand and fingers 90 degrees (flexion, extension) 30 degrees (hyperextension) 20 degrees (abduction, adduction)
degrees of thumb 90 degrees (flexion, extension) 30 degrees (adduction, abduction)
degrees of hip 90-120 degrees (flexion, extension) 30-50 degrees (hyperextension, abduction) 20-30 degrees (adduction) 360 degrees (circumduction)
degrees of knee 120 degrees (flexion, extension)
degrees of ankle 20 degrees (extension) 45-50 degrees (flexion) 5 degrees (eversion, inversion)
degrees of toes 35-60 degrees (flexion, extension)
degrees of trunk 70-90 degrees (flexion) 20-30 degrees (hyperextension) 35 degrees (lateral flexion) 30-45 degrees (rotation)
Parts of body with pivot joint neck
Parts of body with ball-and-socket joint shoulder, hip
Parts of body with hinge joint elbow, knee, ankle, toes
Parts of body with condyloid joint wrist
Parts of body with saddle joint thumb
Parts of body with gliding joint trunk
Created by: landonmc