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fund test 2

What are the legal aspects of medication administration (8) Nurse must follow legal provisions when administering narcotics, responsible for 1) knowing action 2) dose, 3)therapeutic affects, 4) side effects, 5) adverse reactions, 6)drug interactions, 7) contraindications, 8) precautions
What are the parts of a medication order (6) 1. Name; 2) DOSE; 3) Frequency; 4) Route 5) dATE, 6) Signature
STAT Immediate administration of measure or med
NOW ASAP (usually within an hour or as soon as medication can be prepared BUT 90 MIN. AT OUTSIDE
PRN As needed by patient, (always should have cause)
Intramuscular works 3ML SYRINGE, 1-11/2" LONG 21-25 GAUGE
subcutaneous works 1 ml OR 50-100 UNIT 25-27 Ga 3/8-5/8" long
Intradermal works 1 Ml 25-27 GA 1/4-5/8 (tuberculin needle)
What are the 7 rights of medication administration Right drug, dose, patient, route, time, form, documentation,
Intramuscular sites Ventrogluteal, vastus laterallis, deltoid,
subcutaneous sites Outer aspects of upper arms, abdomen (avoid umbilicus) , anterior aspect of thighs, scapula, upper ventral or dorsogluteal areas
Intradermal sites Select area on inner aspect of forearm that is not heavily pigmented or covered with hair. Upper chest or upper back beneath the scapulae also are sites for intradermal injections.
Intramuscular administration Spread skin with fingers, or use Z track technique, inject at 90 degree angle, aspirate, if no blood, inject medication
subcutaneous administration Pinch skin together (around 2 inches) inject at 45 deg. Angle, do not aspirate,
Intradermal administration Inject at 5-15 deg. Angle. Should be able to seee needle tip. Inject, look for bleb
Opiods.what is the most important nursing assessment to perform before administration Respiration rate
What medication should be available in the event of adverse reactions to opiods Naloxone, 4 mg diluted in 4 ml of Saline
Describe types of pain Acute, chronic, referred, somatic, phantom, visceral
Acute pain Moderate to severe, rapid onset
Chronic pain Ongoing pain (arthritis) may be moderate to severe
Referred pain Pain in a part of the body separate from source of pain
Visceral pain Pain resulting from stimulation of internal organs
Phantom pain Pain from severed limb, brain centers initiate
Somatic pain Tissue, joint bone, localized
Pain assessment, objective data Limited range of motion, grimacing
Pain assessment, subjective data Patient pain assessment, scale
medication used to treat itching (common side affect of many drugs) Benydryl?
Pain scale 0-10, moderate, mild, severe 1-3, milds; 3-6, moderate, 7-10 severe
asepsis freedom from infection; the methods used to prevent the spread of microorganisms
medical asepsis (Noun) the practice of techniques and procedures designed to reduce the number of microorganisms in an area or on an object and to decrease the likelihood of transfer hand hygiene
surgical asepsis refer to destruction of organisms before they enter the body that can be carried by open wound or surgical procedures. Surgical technique
principles of surgical asepsis 1. Sterile to sterile, is sterile, 2) only sterile objects can be placed on a sterile field,3) out of site, not sterile,4) hands below waist, not sterile, 5) prolonged exposure, not sterile, 6) wet sterile not sterile, edges (1" border ) to sterile fiel
Chain of infection Agent, reservoir, Portal of entry, susceptible host, port of exit, mode of transmission
Systemic infection Fever, malaise, enlarged lymph nodes
Localized infection Localized swelling, pain, heat, edema
describe the infectious process Incubation, prodromal, illness
defenses against infection Normal flora, body defenses, tissue repair, inflammation, vascular and cellular responses
actions to reduce infection aseptic technique,
actions to reduce reservoir Bathing, hygiene, dressing changes, Bedside unit,
difference between systemic and localized infection Local/entire body
follow a client with skin problems through nursing process (ADPIE) Assess skin integrity, diagnose, plan , implement evaluate
Key points of standard precautions Hand washing, gloves, masks, gowns, clean equipment
Isolation Guidelines As ordered PPE changed after contact
transmission base precautions Airborn, droplet, contact, protective equipment
Range of motion activities for neck Chin to chest, tilt side to side, rotate (flexion, extentsion, hyperextension, lateral flex, rotation)
Range of motion activities for shoulder
Range of motion activities for elbow Flexion, extension, hyperextension
Range of motion activities for forearm Pronation, supination
Range of motion activities for wrist Flexion, extension, hyperextension, adduction, abduction
Range of motion activities for fingers Flex, ext, hyper, ad, ab
Range of motion activities for hip Flex, exte, hyp, ab, ad, internal rot external rotation, circumduction
Range of motion activities for knee Flex, extend
Range of motion activities for ankle Plantar flex, dorsal flex
Range of motion activities for foot Inver, evert, flex, extend, ab, ad
Passive ROM assisted
Active rom unassisted
EFFECTS OF IMMOBILITY ON MUSCULOSKELETAL SYSTEM Atrophy of muscles and stiffening of joints
EFFECTS OF IMMOBILITY ON CARDIOVASCULAR Circulation to periphery is compromised
EFFECTS OF IMMOBILITY ON gi System Bowel blockages,
EFFECTS OF IMMOBILITY ON Integumentary Pressure ulcers
Assessment for vision Subjective: vision difficulties, pain, strabismus or diplopia, reddness. Objective: Snellen, cardinal, confrontation light reflex, accommodation
diplopioa Double vision
Snellen 2o feet away,
Confrontation Measures peripheral vision, cover one eye pring object in from side
Light reflex Darken room and bring light across, look for equal and reactive response of pupils to light
accomodation Focus on distant object then close
Cardinal position of gaaz Muscle weakness, hold finger 6-12" go out and back
Assessment for hearing Subjective data, earache, tinnitis, verigo, discharge, hearing loss. Objective, tuning fork, Webber test rinne test
Weber test Tuning fork on head (side to side differential)
Rinne Test Tuning fork next to ear then on bone (air vs. solid) count
assessment for head Subjective: headaches, injuries, Dizziness, neck pain, lumps: Objective, palpate determine size, shape, t
assessment for neck Assess rom, check lymph nodes look for tracheal shifts
flexion Bending at joint
extension Straightening at joint
abduction Moving limb away from body
adduction Moving limb into body
pronation Turning forearm palm down
supination Turning forearm palm up
Circumduction moving arm in a circle around shoulder
inversion Moving sole of foot toward ankle
eversion Moving sole of foot outwards at ankle
rotation Moving head around a central axis
protraction Forward and parallel to ground
retraction Backwards and parallel
elevation raising
depression lowering
assessment for nose
assessment for throat
assessment for musculoskeletal
assessment for skin hair nails
method to apply sterile gloves
performing dry sterile dressing
applying wet to dry sterile dressing
Wound staging for pressure ulcers
Stage 1 characteristics Intact skin with non-blanchable redness of a localized area usually over a bony prominence. Darkly pigmented skin may not have visible blanching; its color may differ from the surrounding area.
stage 2 characteristics Partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without slough. May also present as an intact or open/ruptured serum-filled blister. 
stage 3 characteristics Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunneling. 
stage 4 characteristics Full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present on some parts of the wound bed. Often include undermining and tunneling.
risk factors for developing pressure ulcers Impaired sensory perception, Alteration in LOC, impaired mobility, shear, friction, moisture
types of wounds
wound color
wound healing
exudates Serous, sanguineous, serosanguinous, purulent
Serous exudate Yellow clear
Sanguinous exudate red
Serosanguinous exudate Pale red
Purulent Yellow greeniush, pussy
and complications
closure designation for suterued, stapled, taped wound Primary intention
closure designation for pressure ulcer Secondary intention
complications of wound healing
dihiscence Total disintegration of mechanical bonding of wound brought about by influences not totally understood.
evisceration An organ protruding through a wound site
what to do if evisceration is discovered by nurse Call doctor, medical emergency
methods to reduce effects of shearing force or skin trauma on pt when moving pt confined to bed
Nursing action to promote wound healing and preventing pressure ulcers
what are types of wound dressing
what are the functions of different wound dressings Protect,
Created by: jrjct1