GWCC Block 2 nursing
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| show | Malnutrition; Obesity; Cardiac complications; Blood coagulation disorders; Upper Respiratory/COPD; Renal disease; Diabetes mellitus; Uncontrolled neuro disease (seizures)
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| Why is obesity an increased surgical risk? | show 🗑
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| show | Regulation of body fluids, electrolyte, acid/base balance, excretion of drugs and toxins
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| Why does liver disease have increased surgical risk? | show 🗑
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| show | Delayed wound healing, predisposes patient for wound infection
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| show | anticoagulants; tranquilizers; cortocosteriods; diuretics
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| topical anesthesia | show 🗑
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| local anesthesia (infiltration) | show 🗑
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| nerve block | show 🗑
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| show | occlusion tourniquet is applied to prevent infiltration/aborption beyond the extremity. Used most for arms, hands & wrists.
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| spinal anesthesia (SAB- subarachnoid block) | show 🗑
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| show | injected med into epidural space, the area inside the spinal column but outside dura mater.
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| conscious sedation | show 🗑
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| show | On the side, face slightly down to allow drainage. No pillow. Elevate upper arm on pillow to allow maximum respiration. Artificial airway remains in place until client starts to gag/cough.
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| Patients are released from PACU when . . . | show 🗑
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| Post-op patient vital schedule | show 🗑
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| What do nurses assess post-operatively? | show 🗑
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| Pneumonia signs | show 🗑
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| show | dyspnea tachypnea, tachycardia, diaphoresis, anxiety, pleural pain, decreased chest wall movement, dull/absent breath sounds, decreased O2 sat, sudden chest pain, SOB, cyanosis, shock (tachycardia w/ low BP)
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| show | sudden chest pain, SOB, cyanosis, shock (tachycardia w/ low BP)
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| show | excess bleeding, increased pain, increased abdominal girth, swelling or bruising around incision
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| hypovolemic shock signs | show 🗑
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| show | inflammation of veins: aching, cramping pain, affected area swollen, red and hot to touch, vein feels hard, discomfort in calf when foot is dorsiflexed or when client walks (Homan's sign)
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| show | stationary clot
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| embolus | show 🗑
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| show | appearance (color, approximation of wound edges); size, drainage (color, consistency, odor, degree of bandage saturation); swelling; pain, drains or tube (security, placement, character of drainage, functioning of drainage apparatus)
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| Sequential signs of healing for primary intention (surgical) wounds | show 🗑
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| Guidelines for cleaning a wound with a penrose drain | show 🗑
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| When removing tape, pull the tape ____ the wound. | show 🗑
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| When changing bandages that involve a Penrose drain, | show 🗑
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| If using forceps to assist in cleaning a wound . . | show 🗑
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| show | suctioning the stomach of secretions. The larger lumen allows delivery of liquids or removal of secretions. The smaller lumen allows for airflow into the stomach, which prevents vacuum pressure in the stomach/adherence to the stomach wall.
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| show | a longer tube (longer than the NG tube) that is inserted into the top part of the small intestine.
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| show | measure from the tip of the nose to the tip of the earlobe, and then down to the tip of the xiphoid.
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| What position should the client's head be in when inserting an NG tube? | show 🗑
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| How should the NG tube be guided in? | show 🗑
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| show | Ask the client to tilt the head forward and encourage the client to drink and swallow. Tilting the head forward facilitates passage of the tube into the posterior pharynx and esophagus rather than the larynx.
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| show | 1 to 5. 6 or grater indicates the tube is in the respiratory tract or lower in the intestinal tract.
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| Before removing an NG tube: | show 🗑
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| show | use a syringe to deliver the formula
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| Define continuous feeding | show 🗑
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| Define cyclic feeding | show 🗑
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| Open systems of formula can hang for | show 🗑
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| show | 48 hours if sterile technique is used
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| If more than ___mL is aspirated when checking residuals before the next feeding, check with the nurse in charge or agency policy. | show 🗑
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| When using a prefilled bottle for tube-feeding, hang it on an IV pole about ___ inches above tube insertion point. | show 🗑
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| show | 4-8
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| show | 3-5 times before performing suction or trach care. Do not do this if the client has copious secretions, as it can cause the secretions to go further down in the airway.
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| show | 80-120
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| Hyperoxygenation of client on ventilator: | show 🗑
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| show | 5 inches, 2 cm (0.4 to 0.8 inches)
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| Allow ____ minutes between suctions to allow for client recovery. | show 🗑
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| Isotonic Solutions | show 🗑
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| show | metacarpal, basilic, cephalic
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| show | Basilic- pinky; Cephalic- thumb
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| show | subclavian or jugular vein, with distal tep resting in the superior vena cava just above the right atrium. Risks include hemothorax, pneumothorax, cardiac perforation, thrombosis, infection.
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| Peripherally inserted central venous catheters (PICC lines) are usually placed ____. The advantage of a PICC line is ___. | show 🗑
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| For routine hydration and intermittent therapies use a ___ gauge IV catheter. | show 🗑
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| For transfusion therapies use a ___ gauge IV catheter. | show 🗑
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| show | 24-27
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| The over-the-needle catheter should be inserted at __ angle. | show 🗑
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| show | date, time, size of catheter, and initials
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| show | blood flow.
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| show | fluid that accumulates in the pleural space of the lungs
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| pneumothorax | show 🗑
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| hemothorax | show 🗑
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| show | 14 F for uncomplicated cases, 18 F for thick secretions.
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| What do you ask the patient to do during removal of the chest tube? | show 🗑
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| When using a dry suction unit for chest tube collection, set the wall suction at ___ to achieve a -20 pressure on the unit. | show 🗑
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| show | crepitis, constant air flow in the unit (instead of normal tidal volume).
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| show | 100
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| If a chest tube becomes clotted, ___. | show 🗑
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| artifact | show 🗑
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| show | electrical problems with ECG unit
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| wandering baselines | show 🗑
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| P wave | show 🗑
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| show | depolarization of ventricles
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| T wave | show 🗑
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| Where is a specimen collected from a chest tube? | show 🗑
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| When the ___ , a pt with a chest tube is considered healed. | show 🗑
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| TKO | show 🗑
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| When prepping an area for IV/vein puncture ___. | show 🗑
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| show | up from the last site.
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| show | above
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| show | 2
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| show | 6 inches above the site. 2 minutes.
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| show | (volume/hour x drip factor on bag) divided by 60 min
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| How long can IV tubing last? | show 🗑
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| How long can bags hang (saline)? | show 🗑
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| How long can catheters last? | show 🗑
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| show | 24 hours
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| show | tube holders- standard; syringe- fragile veins; butterfly- large amt. of blood being taken, children, or difficult sticks.
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| show | put your finger above the needle!
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| show | 4th intercostal space to right of sternum
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| V2 | show 🗑
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| show | mid-clavicular line & 5th intercostal space
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| show | mid-axillary line, horizonal V4
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| V5 | show 🗑
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| V3 | show 🗑
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