fundamentals ch31,37,38
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| Pain may be accompanied by what other changes in vitals? | Increased heart rate, blood pressure, and respiratory rate
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| _________ pain may worsen in the presence of anxiety or fear | Acute
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| Cloths wrapped around a limb or body part are __________;they are effective in relieving pain associated with strains, sprains, and surgical incisions | Binders
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| What organization established standards related to pain that focus on the patient? | The Joint Commission
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| Regarding pain, patients have the right to what? | Appropriate assessment and management of pain
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| When is pain assessment performed? | It is considered the fifth vital sign
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| An aquathermia K-pad is used to help relieve ________. | Pain
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| What kind of patients have skin that is more sensitive to heat damage? | the very young and very old
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| What other patients are at risk for burns from heating pads? | Patients with altered level of consciousness, impaired movement and feeling, poor circulation (they may not be aware something is too hot)
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| What is another term for therapeutic suggestion? | Hypnosis
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| This trance-like state focuses on what? | Relaxation techniques
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| What technique is used to assist the patient to form mental images of a pleasant environment where they are comfortable and happy? | Guided imagery
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| Reading from a script that helps patient visualize a restful place is an example of what? | Guided imagery
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| A non-traditional therapy likely to help with back pain may include: | Chiropractic therapy
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| What non-traditional therapy does not involve machinery or equipment of any kind? | hypnosis
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| What techniques are often used for back pain? | chiropractic,acupuncture, and accupressure
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| What are some examples of narcotic pain medication? | Codeine, oxycodone, morphine
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| Continuous infusion of _______ is less effective at pain control and may more easily result in overmedication | Opiods
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| What are some benefits of the PCA pump? | Patients have greater control and less anxiety about pain control
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| When cleaning around an epidural catheter site, what technique should be remembered? | Cleanse in a circular motion, starting in the center and working out
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| For a patient with baseline vitals of B/P 120/80 and pulse of 72; what example of vitals may indicate a need for more pain medication? | B/P 140/90, pulse 90
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| The shortest analgesic effect will be medication given via which route? | Intravenously
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| Stage 3 of sleep presents what changes in the body? | Heart rate slows, respiratory rate slows, body become immobile
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| Regular exercise can help a person sleep, but should not be close to bedtime due to why? | It may over-stimulate and keep a person awake
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| What is the condition in which the person will stop breathing for brief periods during sleep? | Sleep apnea
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| How can eating patterns affect sleep? | Going to bed overly full or hungry can interfere with sleep
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| Many children patients may sleep better in the hospital if they have what from home? | favorite pillow or blanket
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| Lysis | removal or destruction of
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| Anastomosis | joining of two part
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| -ectomy | cutting out or off
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| -oma | tumor
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| -ostomy | creating an outlet
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| -plasty | revision,molding, or repair of tissue
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| -plexy | fixation,anchoring in place
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| What is very important for the calculations of anesthetic agents and medication dosages for the elderly? | Accurate height and weight
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| If the patient is a minor, who can sign the consent? | A legal guardian or parent
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| Can consents be given over the phone? | In an emergency, with two witnesses on extension lines
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| Prior to surgery, as you finish the preoperative checklist, what should you have the patient do first? | empty their bladder
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| Is shaving hair from the operative site recommended? | Usually just clip the hair
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| Can jewelry be worn into surgery? | All jewelry should be removed; if a wedding bad cannot be removed, it should be taped to the finger
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| When the patients goes to surgery, how should the nurse prepare the patients room? | connect oxygen and suctioning equipment and make sure it works;gather emesis basin, tissues, make the bed
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| Recovery time for same-day surgery usually takes how long? | 1-3 or 1-4 hours
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| Vital signs post-operatively should be done how often? | every 15 mins for 1 hour, every 30 mins for 2 hours, every hour for 4 hours, then every 4 hours until fully recovered
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| What is a priority measure to protect the patient? | Maintain an open airway
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| How should the surgical dressing be handled post op? | Keep it dry; if it is stained, the area is outlined with pen and the time noted so bleeding can be assessed later. If bleeding has saturated the dressing, reinforce with more dressings;check each hour for 4 hours;excessive bleeding is reported to surgeon
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| What position is best for maintaing airway for a patient who has just returned from surgery? | Side lying
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| Coughing and deep breathing is import post op to prevent stasis of secretions and expand lungs when would coughing be contradicted? | for PTs who have had hernia repair, eye, ear, or brain surgery
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| SCD's do what for the legs? | alternate compression and release, squeezing the vessels and propelling blood along them
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| What instructions would a nurse give post surgically for preventing respiratory complications, for a patient who had surgical removal of a brain tumor? | Deep breathing and incentive spirometer
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| When monitoring urine output post op, what amount should be reported to the surgeon? | <60mL over a 2 hour period
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| After surgery, post op patients can be offered a few ice chips or water unless what? | there is an order to maintain NPO status
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| A newly arrived post-surgical patient is after for water, what should the nurse do first? | Check for a physicians order
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| What is the term for a skin opening described as: the traumatic scraping away of surface layers of skin? | Abrasion
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| What is the first phase of wound healing and how long does it last? | The inflammatory phase begins immediately after injury and lasts about 4 days
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| Clinical signs of inflammatory process are what? | Swelling or edema of the injured part, erythema (redness), heat, pain
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| What is the second stage of wound healing and how long does it last? | Proliferation stage begins on the third and fourth day after injury and lasts 2-3 weeks
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| What is the final stage of wound healing? | The final stage of healing is maturation,beginning about 3 weeks after injury
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| A wound with little tissue loss such as a surgical incision, heals by what intention? | First (closure); the edges of the wound approximate
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| If a wound is left open and fills with scar tissue, it heals by what intention? | Second; (such as torn ragged laceration or a pressure ulcer)
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| What intention of wound healing is known or delayed or secondary closure? | Third intention
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| If internal hemorrhage is extensive, hypovolemic shock may occur; signs would be: | Fall in B/P, rapid thready pulse, increased resp rate, restlessness, diaphoresis, and cold clammy skin
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| What is the best way to prevent wound infection? | To maintain strict asepsis when performing wound care; used sterile equipment, meticulous hand washing, keep hair for swinging forward
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| What term for the spontaneous opening of an incision involves the separation of layers beneath the skin as well; pt may state "something has given way" | Dehiscence
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| What term describes the protrusion of an internal organ through incision | Evisceration
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| What is the first thing nurse should do is she is ambulating a pt in the hallway and the pt says " I think something just let go" | Have patient lay down in a supine position
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| If evisceration occurs, what should the nurse do? | Notify surgeon, prepare for pt to go back to operating room
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| What technique is used when emptying closed wound drainage unit? | Clean the pouring spout and plug using separate alcohol sponge for each
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| What type of dressing has a shiny,non-adherent surface on one side that is applied to the wound? | Telfa
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| What is transparent dressing that does not require the use of tape and is less bulky than a gauze dressing? | Opsite
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| What types of wound could opsite be used for? | Iv catheter sites, stage 1 pressure ulcer
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| Why are thin film dressing used on stage 1 ulcers? | to protect from shearing forces and keep them moist
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| What kind of bandage or tapes would be useful for a dressing that needs to be changed frequently, to help prevent skin irritation from removing and reapplying tape? | Montgomery straps
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| What is another term for bruise? | Ecchymosis
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| When removing tape from dressing over a wound, what techniques should be used? | Pull the tape towards the wound while stabilizing the skin with the other hand
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| When applying a hydrocollid dressing, what tip will help with adhesion? | Use skin prep around the edges of the skin to make the skin tachy
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| What technique will help make sure staple removal is pulled free of the skin? | Press the handles of the staple remover together all the way to depress the center of the staple
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| When a soak is ordered, the part to be treated is submerged in warm water or solution for how long? | 15-20 minutes
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| A hypothermia blanket is used to do what? | Lower body heat for patients who are running a persistently high fever
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| Chilling to the point of shivering should be avoided because of what? | Shivering causes the temperature to rise.
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