Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
54 Cards in this Set
- Front
- Back
|
What are the contraindications for nasogastric tube placement?
|
obstructed path
damaged structures chronic atresia facial trauma/basilar skull fx esophageal stricture, atresia, burn Zenker diverticulum recent abd or esophagus surgery H/O gastrectomy |
|
|
______ flexion of the c-spine facilitates passage of the NG tube
|
anterior
|
|
|
What is the average size of the NG tube in non-emergency situations?
|
3 Fr- 18 Fr
(26-32 Fr = oral emergency) |
|
|
How do you determine the length of NG tube needed?
|
measure from tip of nose to ear lobe, then to xiphoid
-add 15-20cm if tube is to be placed below stomach |
|
|
What is the procedure for venipuncture?
|
apply tourniquet
select site release tourniquet cleanse site order of draw perform procedure label tubes ck pts arm/bandage |
|
|
Failure to obtain blood during a venipuncture proceudre may be due to ________
|
position of tube or problem w/vacuum
bevel against vein wall needle position needle through the vein collapsed vein |
|
|
A red or red/gray topped tube contains ________
|
no additives
|
|
|
A gold or red/black topped tube contains ________
|
clot activator & gel for serum separation
|
|
|
A purple topped tube contains ______
|
EDTA - preserves cell morphology for CBC
|
|
|
A green topped tube contains __________
|
Heparin - used for plasma determinations in chemistry (CK, troponin, ammonia)
|
|
|
A light blue topped tube contains _______
|
Sodium Citrate - used for PT, PTT and coagulation testing
|
|
|
A gray topped tube contains _______
|
Potassium Oxalate, Sodium Fluoride, Lithium Idoacetate
|
|
|
A yellow topped tube contains ______
|
SPS - it is sterile and used for bone marrow
|
|
|
What is the order of the draw for evacuated tube system?
|
Sterile - yellow
Red Light Bue Green Lavender Gray |
|
|
What is the order of the draw for a syringe system?
|
Sterile- yellow
Light Blue Lavender Green Gray Red (silly ladies love green & gray roses) |
|
|
Where should you draw blood for a pediatric venipuncture?
|
antecubital vein or dorsal hand vein
|
|
|
Which tests cannot be performed using a skin puncture blood sample?
|
Sed Rate
Coag Studies Blood Cultures |
|
|
How deep do you puncture the plantar surface of an infant to draw blood?
|
< 2.4mm
|
|
|
What are the indications for a lumbar puncture?
|
Meningits (bacterial #1)
cell count, glucose, protein, culture relieve intraventricular pressure administration of meds demylinated dz |
|
|
What are the contraindications for a lumbar puncture?
|
increased intracranial pressure
local infection nevi, hair tufts, sinuses, bony abnormality severely ill or mentally unstable |
|
|
What are the potential complications of a lumbar puncture?
|
postural puncture headache
herniation into the foramen magnum nerve damage transient CN dysfunction hematoma intraspinal epidermoid tumor infection needle breakage - consult neurosurgeon |
|
|
Where is the lumbar puncture preformed?
|
L4-L5 or L3-L4
never above L3 |
|
|
If a pt undergoes a lumbar puncture in the outpatient setting, how long must they monitored?
|
1-2 hrs
|
|
|
What materials are needed for a lumbar puncture?
|
3 sterile swabs
1% lidocaine 25 gauge needle 4 sterile vials sterile gauze/dressing pressure manometer w/3 way stopcock 22-25 gauge needle w/stylet spare needle sterile gloves & drapes |
|
|
What position should the pt be placed in when performing a lumbar puncture?
|
lateral recumbent w/knees flexed toward chest & chin touching knees with back at edge of table
|
|
|
If the pt who is to undergo a lumbar puncture is not able to be placed in the preferred position, what is the alternative position?
|
sitting upright w/legs hanging over the side & trunk forward flexed over a pillow or table, arms forward and head flexed toward chest
|
|
|
How often does a traumatic lumbar puncture occur?
|
40%
|
|
|
What can cause a "dry tap" when performing a lumbar puncture?
|
dehydration
blockage of fluid circulation congenital abnormalities |
|
|
What are the recommendations for initial or mild PDPH
|
bed rest
otc analgesics caffeine 300mg q8hrs theophylline 300mg q8hrs |
|
|
What are the recommendations for moderate to severe PDPH > 24hrs
|
Return to clinic for eval
Methylxanthines Epidural blood patch |
|
|
What are the indications for an in-out catheter?
|
obtain sterile sample
decompress distended bladder neurogenic bladder (Robinson) delivery of topical antineoplastic meds or IC (DMSO) |
|
|
What are the contraindications for a catheter?
|
urinary structural trauma
UTI inflammation secondary to procedure bladder neck stricture enlarged prostate |
|
|
Which type of catheter is rubber and has a soft rounded tip with 1 or 2 drainage holes on the tip?
|
Robinson
|
|
|
Which type of catheter has a flared tip and an inflatable balloon?
|
Foley (indwelling)
|
|
|
Which type of catheter has a bend in the distal tip to facilitate insertion of pts with false passages (BPH or other obstructions)?
|
Coude'
|
|
|
What size catheter should be used for pediatric pts?
|
5-12 Fr
|
|
|
What size catheter should be used for adult female pts?
|
14-18 Fr
|
|
|
What size catheter should be used for adult male pts?
|
16-18 Fr
|
|
|
Which vaginal speculum is metal, resusable, has a narrow blade, and is more comfortable for most women?
|
Pederson
|
|
|
Which speculum is best for viewing the cervix if the patient is obese, has a lot of redundant skin in the introitus, or a severely retroverted uterus?
|
Graves
|
|
|
A Bethesda result of: low-grade squamous intraepithelial lesion, would indicate what?
|
cellular change associated with HPV
mild dysplasia/ CIN 1 |
|
|
A Bethesda result of: high-grade squamous intraepithelial lesion (HSIL), would indicate what?
|
moderate dysplasia / CIN 2
severe dysplasia / CIN 3 carcinoma in situ / CIN 3 |
|
|
A Bethesda result of: atypical squamous cells, would indicate what?
|
unspecified (ASC-US) - includes unspecified & favor benign/inflammation
cannot exclude HSIL (ASC-H) |
|
|
A Bethesda result of: atypical glandular cells of uncertain significance (AGC-US), would indicate what?
|
AGC is broken down into endocervical, endometrial, NOS, or endocervical adenocarcinoma in situ
atypical glandular cells, favor neoplastic (AGC-H) |
|
|
What is the contraindication for a prostate exam?
|
bacterial prostatitis
|
|
|
Which type of hernia transverses the inguinal canal from the internal ring to the external ring, sometimes resulting in abdominal contents in the scrotum?
|
indirect hernia
|
|
|
Which type of hernia transverses the abdominal wall directly through the external ring?
|
direct hernia
|
|
|
What are the indications for joint aspiration?
|
painful effusion
monoarticular inflammation suspicion of rheumatic disorder |
|
|
What are the indications for a bursal aspiration?
|
-painful swelling persists after conservative treatment
-olecranon bursitis perpetually aggravated by normal activities |
|
|
When sampling synovial fluid, which tests require the fluid to be sent to the lab in the sterile syringe?
|
routine culture
gram stain TB culture fungal culture |
|
|
When aspirating a joint, the needle may be introduced into the joint space either ________ or _______.
|
anteromedially
anterolaterally |
|
|
What are the follow-up instructions for the pt following joint aspiration?
|
-avoid use x 1 day
-call office if sudden swelling, heat in joint, fever, chills, or severe increase in pain -refer to ortho if strong suspicion of infection at time of tapping |
|
|
To aspirate the olecranon bursa, enter the join at a ____degree angle
|
90 degree
|
|
|
What are the follow up instructions for pts after a bursal aspiration?
|
-avoid use x 2 days
-avoid resting elbows on tables, arm rests etc -contact office if warm elbow, fever, chills, or increased severe pain |
