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68WM6 Ph 2 Test 2
Diagnostic Testing, Fluid Electrolytes, Managing the Pt with Pain, Complimentary
| Question | Answer |
|---|---|
| What is the LPN’s role in collecting specimens? | Patient preparation, Patient knowledge, Preparing supplies & equipment, Patient care during procedures, Post procedure care |
| What labs are found on a BMP? | BUN, CR, CA, Glucose, CO2, K, Cl, Na |
| What labs are found on a CMP? | BUN, CR, CA, Glucose, CO2, K, Cl, Na, AST, Albumin, ALP, Bilirubin, Total protein |
| What color stool would a patient have if they had an upper GI bleed? | Black, tarry feces indicate the presence of old blood and that the site of bleeding is higher in the GI tract. |
| What color stool would a patient have if they had an lower GI bleed? | Blood in the stool may be bright red, which indicates that the blood is fresh and that the site of bleeding is in the lower gastrointestinal (GI) tract. |
| What items need to be documented after a procedure? | Type of procedure, time, specimen obtained, patient response and teaching. Also, time specimen went to lab with appropriate requisition. |
| Which type of transportation in the body requires energy? | Active transport |
| What are signs of severe dehydration in the infant? | Sunken eyeballs & depression of the anterior fontanel |
| What does mEq/L stand for? | Milliequivalents per liter. The measure of chemical activity or chemical combining power of an ion |
| What is the chief intracellular ion? | Potassium |
| What electrolyte does water follow in the body? | Sodium |
| In what electrolyte imbalances are Chvostek & Trousseau signs positive? | hypocalcemia & hypomagnesemia |
| If a client who is hypervolemic gained 4.4 pounds, how much fluid volume excess would he have? | 2 liters |
| What is the most common cause of metabolic alkalosis? | Vomiting |
| Normal ABGs | pH 7.35-7.45, PaCO2 35-45 mmHg, PO2 80-100 mmHg, O2 saturation: 95-100%, HCO3 22-26 mEq/L |
| The client’s ABG values are: pH 7.30, PaCO2 25mmHg, O2 Sat 98%, PaO2 75mmHg, HCO3 20mmHg What acid-base disturbance might he be experiencing? | Metabolic acidosis |
| An examination in which the different kinds of white blood cells are counted and reported as percentages of the total examined or absolute (actual number) is called _________________ | Differential |
| A patient is receiving 2 units of packed RBCs for anemia. The nurse is aware that following the transfusion, the patient’s (all that apply):Hematocrit should increase, B12 should increase, Hemoglobin should increase, and/or Factor VIII should decrease | Hematocrit should increase, and Hemoglobin should increase |
| What product would you expect the physician to order if the client needed an increase in oxygen carrying capacity? | Packed RBCs |
| A teenage boy with hemophilia is having surgery. The doctor orders Cryoprecipitate to be given before his surgery. The nurse knows that Cryoprecipitate contains which factor to help with the blood clotting mechanism? | Factor VIII |
| Why should the IV tubing for the administration of blood products contain a filter? | Prevent infusion of clots |
| What is the minimum gauge a nurse must use to transfuse blood? | 20 gauge |
| What is the only solution blood can be infused with? | Normal Saline (0.9%) |
| How long should the nurse remain with the patient after initiating a blood transfusion? | 15 minutes |
| 20 minutes after blood transfusion began, the patient began having chills and itching. The nurse should do what? | Stop the transfusion immediately and infuse NS with new tubing, and notify the physician immediately |
| The nurse would premedicate the client with acetaminophen (Tylenol) according to protocol orders if the patient has a history of which of the following transfusion reactions? | Febrile Non-hemolytic |
| The nurse understands that this type transfusion reaction is due to sensitivity to foreign plasma proteins | Mild Allergic |
| What is the first thing the LPN should do if a transfusion reaction is suspected? | Immediately stop the transfusion |
| The following items should be sent to the lab after a transfusion reaction except: a. Blood container, the tubing, and labels b. Sample of the patient’s sputum c. Sample of the patient’s urine d. Transfusion record | Sample of the patient’s sputum |
| What should the nurse know about every drug prior to administration? | Generic/trade name, reason for use, dosage range, expected action, possible side effects, contraindications to administration, any special precautions. |
| How many times should you check pt identification before administration? | two |
| Which method of medication administration provides the fastest action? | Parenteral |
| What is the nasal route used for? | To shrink the mucosa or administer antibiotics. |
| Medications are contraindicated for clients who are vomiting or comatose via which route? | Oral |
| One of your client's medications is in a liquid form. You pour the medication with the container at eye level and read the meniscus at what point? | Low part of the curve |
| If a medication is ordered orally, and the client is NPO, which action do you take? | Consult the nurse in charge. |
| In an adult, gently pull the earlobe in what direction before instilling ear drops? | Upward and back |
| After a possible exposure to tuberculosis, a 25 year old health worker receives a TB skin test. The skin test will be given by the following type of injection | intradermal |
| Which site is preferred for intramuscular injections for infants and children? | Vastus Lateralis |
| Which injection site is well-defined by bony anatomic landmarks? | Ventrogluteal |
| What is the IM site (not visible to the client) that has the danger of injury if incorrect technique is used ? | Dorsogluteal |
| What’s the maximum amount of mls that can be administered subcutaneously? | 1 ml |
| Why must air be injected into vial prior to removal of desired medication amount? | To prevent the development of a vacuum |
| Why is a large central vein needed for the infusion of TPN? | The hypertonic solution in TPN is too harsh and can cause irritation to a peripheral vein |
| What are signs of fluid overload? | Anxiousness, dyspnea, weak and rapid pulse |
| What are the 6 rights of medication administration? | Right patient, right medication, right dose, right time, right route, right documentation |
| 3 types of pain? | Acute, chronic, and referred |
| Which type of pain floods the body with epinephrine causing a fight or flight response? | Acute pain |
| What are some nursing interventions to modify pain perception based on the gate control theory? | Backrub, warm compress, ice application, auditory/visual distraction |
| : You are collecting information on a patient with Fibromyalgia at the pain clinic. She complains of chronic pain 6/10. This is an example of? | Subjective data |
| When a nurse ask a patient to mark a spot on a horizontal line in order to measure pain intensity, he is using the? | Visual Analog scale |
| The type of pain scale most likely used in a pediatric setting is? | Wong-Baker Faces pain rating scale |
| The goal for pain therapy is to provide pain relief measures before pain becomes severe. The nurse would correctly implement this by? | Offer PRN medications on schedule before the patient starts having severe pain. |
| What are 3 techniques of pain control? | Physical, psychological and medication |
| What should be documented in the patient record after a patient dies? | Time of death and a description of actions taken. |
| What agency requires a death certificate be prepared for each person that dies? | Local Health Department |
| Why is an autopsy performed? | Death due to an/a accident, suicide, homicide, illegal therapeutic practice |
| If an autopsy if scheduled, the nurse should remove the drainage tubes? T/F | False |
| What is the role of the nurse in caring for the family of the deceased? | Express words of sympathy, help notify the mortician, emotional support |
| Which Central Venous Access Device requires access with a Huber Needle? | Surgically implanted venous access device |
| How often should a central line dressing with an air occlusive dressing be changed? | Every 7 days or when it becomes damp, loosened, soiled, or after inspection of the site |
| What does SASH stand for? | Saline- flush with saline Administer- administer medication Saline- flush medication with saline Heparin- flush port with heparin |
| Your patient has a vascular access device and you suspect he’s developing an infection. What will be used to determine if the patient has an infection related to the device? | Obtain blood cultures and cultural the cite as ordered |
| What is the difference between complementary & alternative therapy? | Complementary therapy is used in addition to conventional treatment whereas alternative therapy replaces conventional therapy |
| Do herbal remedies have standardized doses? | No |
| Does the chiropractic doctor prescribe medications? | No, they use other treatment modalities to include hot and cold packs and gentle manipulation to put an area back in alignment. |
| Can acupuncture be performed by a licensed practical nurse? | No, only by a properly trained professional |
| What is the purpose of a therapeutic massage? | To manipulate the soft tissues of the body and assist with healing |
| What is the purpose of specific scents that are used in aromatherapy? | Specific scents are thought to relax or stimulate, improve digestion, increase hormone production & improve circulation or memory |
| State three actions that magnetic therapy should do. | Increase circulation, increase energy & decrease pain |
| Identify two ways in which imagery therapy can be performed. | Self-directed or guided |
| State two benefits of yoga. | Tone the muscles & increase flexibility of the spine |
| Can a patient with a pacemaker use magnet therapy? | No |
| IM angle of injection and needle length | 90 degrees; 1 to 1 1/2 inch |
| Sub-Q angle of injection and needle length | 45 degrees; 1/2 to 5/8 inch |
| ID angle of injection and needle length | 15 degrees; 3/8 to 5/8 inch |
| Insulin needle length | 5/16 to 1/2 inch |
| Percutaneous routes | topical, instillation, inhalation |
| Enteral routes | PO, tubal, suppository, enema, vaginal |
| Routes of medication administration | Enteral, percutaneous, parenteral |
| Definition of metabolite | Substance produced by metabolic action resulting in the breakdown of a drug |
| Fried's rule | (Age in months/150)x Avg Adult dose=child's dose *used for infants <2 yr old |
| Clark's rule | (lb/150)x Avg Adult dose=child's dose *uses chil's weight to determine dosage |
| Young's rule | (age/age+4)x Avg Adult dose=child's dose *for children up to age 12 but > 2 |
| Define dimensional analysis (DA) | calculates dosages using 3 factors: drug label factor, conversion factor, and drug order factor |
| Define enteric-coating | a candylike coated shell that encases tablets to keep them from being absorbed in the stomach instead of the small intestine |
| Define idiosyncratic | unexpected reaction to a medication that is pt specific |
| Define potentiation | when one drug increases the action or effect of another drug; also called synergism |
| What are the electrolytes | Sodium (Na+), Potassium (K+), Calcium (Ca++), Magnesium (Mg++), Chloride (Cl-), Bicarb (HCO3-), Sulfate (SO4-), Hydrogen phosphate (HPO4-) |
| Transcutaneous electric nerve stimulation (TENS) | utilizes the gate theory by using cutaneous stimulation to close the gate of pain |
| Define referred pain | radiating pain |
| Gate control theory of pain | when pain impulses are regulated or blocked by mechanism located along the CNS |
| Common CNA analgesic drug of choice | morphine; contraindicated for renal failure |
| An opiod no longer used because of toxic complications such as seizures? | meperdone (Demerol) |
| An inflammatory mediator released when cells are damaged to carry pain signals; depressed when drugs are used to releave pain | prostaglandin |
| two or more things working together to achieve an otherwise unlikely/impossible effect | synergistic |
| injurious to physical health | noxious |
| Common opioids | morphine (Avina, Kadia), meperidine (Demerol), hydromorphone (Dilaudid), fentanyl (Actiq, Duragesic), oxycodone (Combunox) |
| Common non-opioids | Acetaminophen, NSAIDs (aspirin, ibuprofen, naproxen sodium) |
| Created the most widely accepted definition of pain | International Association for the Study of Pain (IASP) |
Created by:
princess3734
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