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LCC nursing
jami dannels notes
| Question | Answer |
|---|---|
| what are the 3 injection sites for IM? | Deltoid, vastus lateralis, ventrogluteal |
| Give IM at what degree? | 90 |
| what is an air lock? | air bubble that is drawn into the syringe to help the medication all be expelled from the syringe. |
| what are the steps to giving the injection? | go in at 90 degrees pull back on plunger to make sure not into an artery inject |
| always apirate except? | heprin and novalin |
| how do you know where the deltoid is? | acromian process, three fingers below, inject |
| how do you know where the vastus lateralis? | divide leg in 1/2 in front and on the side. Put a hand on the knee and on the greater trochanter |
| how do you know where the ventrogluteal is? | palm of hand on greater trochanter and thumb toward the groin. index finger on the illiac creast. |
| when do you chart the meds in the MAR? | right after you administer them. |
| what are the routes of administration? | oral- sublingual, buccalparenteral- SQ, IM, IV, IDtopicalinhailantsitraocular |
| what is the key to avoiding med errors? | PREVENTION |
| How many identifiers do you use when administering meds and what are they? | 2 identifiers birthdate, ID number, and have Pt. state full name. |
| What are the six rights for med administration? | right med, dose, Pt., route, time, documentation. |
| compare label on meds how many times and when? | verify 3 times.before removing the med container, as you remove the amount of med, before returning the container to the cart. |
| what is the needle size for SQ | 3/8 to 5/8 |
| IM needle size | 1/4 to 3 inches |
| what will slow the absorption of IM and SQ injections | fat poor circulationedemashock |
| PC | 30 minutes after meals |
| AC | 30 minutes before meals |
| med orders need what | Pt full name date and time order written drug name dosage route time and frequency signature of prescriber |
| best way to measure liquid meds is | use a syringe |
| maximum ML in IM sites | 2 ML adults 1 ML child and infant |
| SQ maximum ML | 1 ML |
| urinary assessment includes what | hx patterns symptoms factors affecting |
| common urinary problems | urinary retentionUTIurinary incontinence |
| types of urinary incontinence | total functionalstressurge reflex |
| urinary diversions | urostomy |
| common urinary problem sx's | urgency, dysuria, frequency, hesitancy, polyuria, oliguria, nocturia, dribbleing, hematuria, retention, residual urine |
| urinary elimination physical assessment | skin and mucous membraneskidney flankbladderuretheral meatus I&Ourine characteristics |
| types of lab for Urinanalysis | UAclean catchsterile 24 hr urine |
| pH value | 4.6 to 8.0 |
| protien value | up to 8mg/100ml |
| glucose values | normally not present |
| ketones values | normally not present |
| blood values | up to 2 RBC |
| specific gravity values | 1.01 to 1.03 |
| when do you need to document medications | immediatly after giving |
| assessment nursing process med administration | medication hx medical hxdiet hx |
| nursing diagnosis use these while administering meds | anxiety, ineffective health maintenence, health seeking behaviors, deficient knowledge, noncompliance, effective therapuetic regimen managment, ineffective family therapuetic regimen managment |
| routes of med adm. | oral-sublingual, buccalparenteral-SQ, IM, IV, IDtopical inhalantsintraocular |
| how many times do you read med labels | 3 |
| how many Pt identifiers do you use | 2 |
| 6 rights for med adm. | right route, time, med, dose, Pt, documentation |
| what meds cant be crushed | enteracoatedtime releasedextended released |
| diagnostic tests non invasive and invasive | non invasive-KUB, IVPinvasive- endoscope, arteriogram |
| types of catheters | foley suprapubicstraightcondom |
| constipation | fewer dry and hard |
| impaction | results from constipation |
| diarrhea | increased frequency loose |
| elimination problems | incontinance flatulance hemorrhoidsbowel diversions |
| bowel elimination assessment | chewing food and fluid intake stress level normal is different for each person |
| physical assessment bowel assessment | inspect teeth and gums mucous membranes in mouth mobility anal sphincter functionpalpate abdomem |
| fecal characteristics | color odorconsistenctyfrequency amount shape constituents |
| health promotion activities | diet exercisefluids timing and privacy promotion of normal defecation |
| medications (laxatives) | stimulants saline or osmotic agents wetting or stool softeners bulk forming lubricants |
| enemas are given to | stretch rectal wallbreak up stoolstimulate peristalsis |
| enemas common uses | constipationfecal impaction removal cleanse for tests, surg, childbirthbeginning bowel training |
| enema types | cleansing high or low oil retention |
| types of cleansing enemas | tap water normal saline low volume hypertonic salinesoapsuds |
| Enemas til clear means | give 3 but no more than that |
| bowel training | normal routine time 1 hr p breakfast positionfluids diet exercisepossible glycerin supp. |
| ostomy care | pouch is wornskin barrierirrigate daily flatulance skin integrity |
| hemorrhoids watch what | diet fluids exercise |
| how do you relieve pain from hemorrhoids | heat sitzlub. jelly stool stofteners |
| causes of flatulance | gum carbonationstraws |
| treatment for flatulance | walk rectal tube watch foods |
| temp of water for enema | 95-102 |
| if cramping occurs during enema what do you do | stop flow |
| administer enemas at what height | 12-18 inches, hold for 5 min. |
| aluminum does what | neutralizes but constipates |
| magnesium does what | neutralizes but causes diarrhea |
| calcium does what | neutralizes but watch for kidney stone formation |
| antacids are known for what | they neutralize acid |
| therapuetic uses antacids | neutralize acid |
| side effects of antacids | diarrhea constipationhypercalcemia |
| antacid interactions | reduces absorption(chelation)drugs cant releasechemical inactivation(due to decreased acid in stomach)increased stomach pHincreased urinary pH |
| H2 antagonists | these drugs reduce acid secretion, works on preventing acid formatin in the body |
| H2 antagonists action | decreases the production of HCL |
| H2 antagonists drug effects | decreased production of acid doesnt allow histamine to bind |
| H2 antagonists therapeutic uses | decrease acid |
| proton pump inhibitors action | blocks all acid secretion |
| proton pump inhibitors drug effects | no gastric acid secretion |
| proton pump inhibitors therapeutic uses | GERDerosive esophagitis duidenal ulcer |
| proton pump inhibitors interactons | valium, dilantin, coumadin |
| sucralfate action | protective agent, binds to erosions and ulcers and form a barrier |
| carafate therapeutic uses | PUD |
| carafate interactions | some antiabsorption of tetracycline avoid this by taking on empty stomach |
| antidiarrheal categories | absorbents anti cholinergics intestinal flora modifiers |
| hypertension you have a risk factor for | strok CHFrenal failure PVDCAD |
| what is JNC-7 | individualized plan of care |
| HTN defined by what | cause |
| unknown cause of HTN is what % | 90 |
| secondary HTN | 10% |
| what are the 3 classifications of causes of HTN | essentialidiopathic primary |
| what + what = BP | cardiac output + systemic vascular resistance |
| what is the receptor for PSNS and SNS | nicotinic receptor |
Created by:
jdannels
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