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fund exam 3
fundamentals exam #3 ch 12, 13 & 19
| Question | Answer |
|---|---|
| ad lib | as desired or if patient desires |
| ASAP | as soon as possible |
| bid | twice a day |
| cath | catheter |
| CBC | complete blood count |
| c/o | complaint of |
| CVA | cerebrovascular accident (stroke) |
| DX or Dx | diagnosis |
| GI | gastrointestinal |
| h/o | history of |
| pr | per rectum |
| H&P | history and physical |
| ht | height |
| Tab | tablet |
| HTN | hypertension |
| hyper | above or high |
| hypo | below or low |
| I&O | intake and output |
| IV | intravenous |
| mL | milliliter |
| N/V/D | nausea - vomiting - diarrhea |
| NKA or NKDA | no known allergies or no known drug allergies |
| NG | nasogastric |
| ac | before meals |
| NGT | nasogastric tube |
| NPO | nothing by mouth |
| pc | after meals |
| pt | patient |
| q | every |
| qam | every morning |
| qh | every hour |
| qid | four times a day |
| r/o or R/O | rule out |
| RX or rx | treatment or prescription |
| stat | immediately |
| tid | 3 times a day |
| vs | vital signs |
| WBC | white blood count |
| What is the proper way of collecting urine for patient without a catheter? | Midstream |
| What is the proper way of collecting urine for patient with a catheter? | Clamp just below catheter port for about 30 minutes. Return in 30 minutes; clean port with alcohol prep. Insert needle into port at 30-degree angle and withdraw 5 to 10 mL of urine for a specimen.place in sterile cup and unclamp catheter |
| What is residual urine and how do we obtain it? | residual urine is urine left in the bladder after voiding can be measured at the time of catheterization. catheterization is performed within 10 minutes |
| What do we instruct patients whom we have to secure 24 hour urine collection? | patient void when the 24-hour specimen collection is to begin; discard this voiding. Save all urine for the 24-hour period; place each voided specimen into the larger container with preservative.Place labeled container on ice if required |
| What is the characteristic of the stool if the probable cause is bleeding of the upper GI track? | black or tarry color |
| What is the characteristic of the stool if the probable cause is bleeding of the lower GI track? | the color is bright red |
| How do we collect a sputum specimen? | Have patient breath deep and cough from within. |
| When is the right time to collect a sputum specimen and it's rationale? | Early morning and before breakfast so that the collection is uncontaminated and the patient has not yeat cleared respiratory passages |
| Pre-procedural nursing care for a patient who will undergo CT scan | Assess for allergies to iodine. Inform patient that wigs hairpins or clips and partial denture plates must be removed if scan will include head.Maintain NPO status 4 hours before oral contrast medium is administered except in emergencies |
| Pre-procedural nursing care for a patient who will undergo Colonoscoy | Bowel prep and NPO after midnight |
| Post-procedural care for patient who underwent liver biopsy | pt on right side observe for hemmorage (dressing site for bleeding low b/p high h/r) |
| Post-procedural care for patient who underwent lumbar puncture. | Place patient in the prone position with a pillow under the abdomen to increase intraabdominal pressure. Notify physician if any unusual findings from puncture site occur |
| Normal values of blood glucose ac | 80-120 |
| What instructions do we give to patient who needs a blood culture x2 and when is the best time to collect it? | explain procedure to pt that we'll be drawing 4 bottles of blood and best time is when pt's temp is elevated or with fever and must be ordered by doctor. |
| ac | before meals |
| pc | after meals |
| ad lib | as desired |
| qd | every day |
| bid | 2 times per day |
| qid | four times a day |
| IV | intravenous |
| IM | intramuscular |
| sc/sq | subcutaneous |
| po | per oral |
| pr | per rectum |
| Tab | tablet |
| supp | suppository |
| gtt | drops |
| prn | as needed |
| stat | immediately |
| ASAP | as soon as possible |
| NS | normal saline |
| q | every |
| What are the three processes of wound healing | Primary intention - surgical wound edges are cleansecondary intention - wound edges are not closed and purelent dicharge is presenttertiary intention - wound is infected and is left open and suturing is delayed |
| Identify the different exudates and their characteristics. | Serous - clear watery plasma Purulent - thick yellow green tan or brownSerosanguineous - pale red watery: mixture of serous and sanguineous Sanguineous - Bright red: indicates active bleeding |
| What is expected during the Hemostasis phase of wound | Bleeding stops and begins to clot. |
| Rationale of wet to dry dressing | Mechanical debridment |
| Basic concept of wound irrigation | Cleanest to dirtiest. position patient so it can drain properly |
| Complications of wound healing and your nursing care if presented by the patient | Abscess - Cavity containing pus and surrounded by inflamed tissue Adhesion- Band of scar tissue that binds together two anatomic surfaces normally separated Cellulitis - Infection of the skin characterized by heat pain erythema and edema Dehiscence - Sepa |
| When is the best time to remove staples/ suture | 7 - 10 days |
| Rationale of drainage system and the several methods | to monitor drainage and to assist gravity in removing exudate from the cavity. Closed drainage is a system of tubing and other apparatus attached to the body to remove fluid in an airtight circuit that prevents contaminants from entering the wound |
| What are the different infectious agents | bacteria - tuberculosis viruses - cold sores HIV fungi - ringworm protozoa - malaria |
| What is that specialized structure that is found when conditions are not favorable for the bacterial growth | Spores - spores have a high degree of resistance to heat and disinfectants. Sterilization refers to methods used to kill all microorganisms including spores. |
| What are the different types of precautions? | Standard - airborne - droplet - contact and neutropenic |
| What is a standard precaution | Wash hands before and after patient contact - wear gloves when touching blood - body fluids - secretions - excretions and contaminated items. Wear a mask and eye protection/face shield during procedures likely to generate droplets of blood - body fluid |
| What are Airborne Precautions | Standard Precautions plus: Place the patient in a private room that has monitored negative air pressure - a minimum of six air changes/hour - and appropriate filtration of air before it is discharged from the room. Wear respiratory protection when enter |
| What are Droplet Precautions | Standard Precaution plus: Place the patient in a private room or cohort them with someone with the same infection. If not feasible maintain at least 3 feet between patients. Wear a mask when working within 3 feet of the patient. Limit movement and trans |
| What are Contact Precautions | Standard Precautions plus: Place the patient in a private room or cohort them with someone with the same infection if possible. Wear gloves when entering the room. Change gloves after contact with infective material. Wear a gown when entering the room i |
| What are neutropenic precautions? | precautions for the immunocompromised patient. They are generally at increased risk for bacterial - fungal parasitic - and viral infections from both endogenous and exogenous sources. The use of standard precautions for all patients and transmission-based |
| Samples of when to use Standard Precautions | Standard precautions are employed in the care of ALL patients |
| Sample of when to use Airborne Precautions | Measles - Varicella - Pulmonary - Tuberculosis - smallpox - |
| Sample of when to use Contact precautions | MRSA - VRE - Clostridium difficile - RSV - parainfluenza - enteroviruses - enteric infections in the incontinent host skin infections ( lice - scabies) conjunctivitis - Viral Hemorrhagic |
| Samples of when to use Droplet Precautions | flu - pneumonia - mumps - pertussis |
| What is the method of destroying pathogens including spores | sterilization |
| When blood is present in the stool but cannot be seen without the use of a microscope it is referred to as what? | Occult Blood |
| What test detects occult blood in feces? | Hemoccult |
| What are secretions from the lungs? | Sputum |
| What are Aerobic organisims? | organisms that grow in superficial wounds exposed to the air |
| How do you collect an aerobic wound specimen? | Insert a sterile swab from the culturette tube into wound secretions - return the swab to the culturette tube - cap the tube and crush the inner ampule so that the medium for organism growth coats the swab tip |
| How do you collect an anaerobic wound specimen? | Use a sterile syringe tip to aspirate visible drainage from the inner wound - expel any air from the syringe and inject the syringe contents into a special vacuum container with culture medium. In some institutions the nurse may place a cork over the need |
| What are anaerobic organisms? | organisms that tend to grow within body cavities where they are not exposed to air |
| What does the color indicate on the rubber stoppers on blood collection tubes? | The color signals the different type of additive - amount of blood to draw and the recommended tests |
| Where are the most common venipuncture sites? | The basilic and cephalic veins in the inner arm |
| What purpose does the tournequet serve? | A tourniquet is a constricting device applied to control bleeding. It prevents arterial blood flow to the part below the tourniquet and prevents venous blood from returning to the heart. The veins fill with blood and distend which makes them firmer and |
| What is Aspesis? | free of pathogenic microorganisms |
| What are the 2 Asepsis categories? | Medical Asepss and Surgical Asepsis |
| Define Medical Asepsis | Medical asepsis is also known as clean technique and is used in many daily activities such as handwashing and changing patients' bed linen. Principles of medical asepsis are commonly followed in the home - as in the case of washing hands before preparing |
| Define Surgical Asepsis | destroys all microorganisms and their spores. known as sterile technique and is used in specialized areas or skills such as care of surgical wounds urinary catheter insertion invasive procedures and surgery |
| What are the six elements in the infection process and in the correct order? | 1. Infectious agent - a pathogen 2. Reservoir - where the pathogen grows 3. Exit from the reservoir 4. Method of transport such as exudate - feces - air - hands 5. Entrance through skin - mucous lining or mouth 6. Host - another person or animal |
| What is a VECTOR? | A living carrier for transmission of microorganisms |
| What is a FOMITE? | Nonliving material such as bed linens stethoscope needles and many other objects that may host and transfer pathogenic microorganisms |
| What is an infection that is acquired at least 12 hours after admission while in a hospital or other health agency | Nosocomial |
| What are the signs of inflammation | redness- edema - heat - pain or tenderness and loss of function |
| What is an infection caused by microorganisms from another person? | Exogenous infection |
| What is an infection caused by the patient's own normal microorganisms becoming altered and overgrowng or being transferred from one body side to another? | Endogenous infection |
| What is the most important and basic preventive technique for interrupting the infectious process? | Handwashing |
| What is an area that is free of microorganisms and is prepared to receive sterile items? | Sterile field |
| What does disinfection NOT destroy? | Spores |
| What are the two types of sterilization methods? | physical and chemical |
| What is Physical Sterilization? | process that uses heat or radiation |
| What is Chemical Sterilization? | The use of gas Gas (ethylene oxide) or chemicals such as iodine - alcohol and chlorine bleach compounds |
| How often should surgical wound dressings be inspectec after surgery? | Every 2-4 hours for the first 24 hours |
| On the day of surgery what type of exudate can we expect? | Sanguineous |
| As exudate subsides it becomes what type of exudate? | serous |
| What type of dressing would be best for a wound with little exudate? | Dry dressing |
| What type of dressing is a synthetic permeable membrane that acts a second skin? | Transparent Dressing |
| What are the advantages of a transparent dressing? | Serves as a barrier to external fluids and bacteria yet still allows the wound to breathe - speeds cell growth permits a visual of the wound |
| What is the separation of a surgical incision or rupture of a wound closure | Dehiscence |
| What is the protrusion of an internal organ through a wound or surgical incision? | Evisceration |
| What is infection of the skin characterized by heat - pain - erythema and edema? | Cellulitis |
| What is a cavity containing pus and surrounded by inflamed tissue formed as a result of suppuration in a localized infection? | abscess |
| What is passage or escape into the tissues; usually of blood - serum or lymph? | Extravasation |
| What type of dressings should be placed over a wound area that has dehiscence? | Warm - moist - sterile dressings |
| More than how many ml of drainage within the first 24 hours would be considered ABNORMAL? | more than 300 ml is ABNORMAL |
| What can be used to support an incision or secure dressings without the use of adhesive materials? | Binder or Bandage |
| When washing hands for medical asepsis are the hands help above or below the elbow? | Below |
| When washing hands for Surgical Asepsis are the hands kept above or below the elbows? | Above |
| What may make a patient subject to psychologic and emotional deprivation because of the restricted environment | Isolation |
| What are the major sites for nosocomial infections? | urinary, catheter, respiratory tracts - bloodstream - and surgical or traumatic wounds |
| What do most invasive diagnostic tests require? | Informed Consent |
| The nurse is aware that for patients who cannot expectorate sputum from deep in the bronchial tree the specimen must by collected by what method? | tracheal suctioning |
| The nurse is aware that having Ms. G. hold her arm at her side for 30 seconds before obtaining a blood sample to measure glucose will ??? | increase blood to the site |
| The physician has ordered a stool specimen for blood that cannot be seen by the naked eye. This examination is for?? | Occult Blood |
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bsmymicareo
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