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75 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Hematocrit |
M: 40-54%, W: 36-46% |
% of total volume that is RBC'S |
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Mean corpuscular hemoglobin concentration |
31-37% |
% of each RBC bound by hemoglobin |
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Neutrophils |
50-70% |
WBC |
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Lymphocytes |
25-45% |
WBC |
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Monocytes |
4-6% |
WBC |
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Eosinophils |
1-3% |
WBC |
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Basophils |
0.4-1.0% |
WBC |
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WBC |
4500-11k/mm^3 |
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Platelet count |
150k-350k/mm^3 |
Sticky when they need to clot, otherwise just slide along vessels |
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RBC count |
M: 4.6--6 million/mm^3 |
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Hemoglobin |
M: 13.5-18g/dL W: 12-15g/dL |
Iron containing protein in RBC that transports 02 thru the body |
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Mean corpuscular volume |
M: 80-98 micrometers^3 W: 78-102 micrometers^3 |
Average size of each RBC |
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Mean corpuscular hemoglobin |
25-35 picograms |
How much hemoglobin is present in each RBC |
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6 Rights of med administration |
Right client Right medication Right dose Right route Right time Right documentation |
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First pass effect |
Oral meds only. Drug is partially metabolized in liver before reaching bloodstream. Gut=>hepatic vein=>liver=>blood Higher initial dose required. |
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Steps of Communication |
Sender =>Message => Receiver I ^ I ^ v I v I Decode <=Response <= Encode |
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Types of communication |
Verbal Non verbal Electronic |
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Personal space |
1. Intimate: touch-1.5 ft 2. Personal: 1.5-4 ft 3. Social: 4-12 ft 4. Public: 12-15 ft
Intimate: Touching-1.5 ft. Appropriate for cuddling baby, touching sightless client, onserving incision, rest. Toddler for injection Inform client you need to enter this space, explain why-procedure. Also use to communicate warmth, caring.
Personal: 1.5-4 ft. Handshake, shoulder touch. Appropriate for med admin, sitting with client, starting IV. Conveys involvement to pt. Can create tension if distance encroaches their personal space.
Social: 4-12 ft. Communication is more formal, heard by others, will get a more general response. Don't stand at door and ask pts how they are doing. Client feels protected and out of reach for personal sharing of thoughts/feelings.
Public: 12-15 ft. Loud communication, individuality is lost, perception is of the whole group. ER cardiac arrest situation. |
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Therapeutic communication |
Promotes understanding Cans help establish constructive relationship between nurse and client |
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Attentive listening |
Active listening, whole body involved |
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Therapeutic Comm. Techniques |
Using silence Provide general leads Be specific and tentative Use open-ended questions Use touch Restate/rephrase Seek clarification Perceptual checking/seek consensual validation Offering self Giving info Acknowledging Clarify time/sequence Present reality Focusing Reflecting Summarize/Planning |
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Therapeutic Comm. BARRIERS |
Stereotyping Agreeing/disagreeing Being defensive Challenging Probing ("Why didn't you. ..") Testing Rejecting Change subject Unwarranted reassurance Passing judgment Give advice Complete their sentence |
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Blooms 3 Domains |
Cognitive-thinking/analyzing Affective-emotional Psychomotor-hands on |
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Factors affecting learning |
Age/Developmental stage Motivation Readiness Active involvement Relevance Feedback Non-judgmental support Simple to Complex Repetition Timing Environment Emotions Physiological events Cultural aspects Psychomotor ability |
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Barriers to Learning |
Acute illness Pain Prognosis Biorhythms Emotion (anxiety, grief, depression) Age: Older- hearing, vision, motor impairment Age: Children-short attention span, vocabulary differences Culture/religion Physical/mental disability |
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Health Literacy |
Capacity to obtain, process, and understand the basic health information and services needed to make appropriate health decisions. |
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4 verbal teaching techniques |
Plain language Use 'teach-back' or 'show-back' Teach only 3 important points at a time Use drawings or models |
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Teaching strategies |
Explanation/description One to one discussion Answering questions Demonstration Discovery Group discussion Practice Print/AV materials Role-playing Modeling Computer learning resources |
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Teaching guidelines: |
Respectful relationship Use clients previous learning Optimal time for session Clear & concise Use layperson vocabulary Sensitive to too fast/too slow Best environment Teaching aids Involve all the senses Help them discover content for themselves Repetition reinforces learning Employ organizers |
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6 steps of Med Admin |
ID client Inform client Administer drug Perform adjunctive therapy PRN Record administration Evaluated clients response to drug |
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G&D considerations - older Adult |
Chronicity of illness Growth & Development Kidney failure Slower/obstructed excretion Toxicity Visual acuity |
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Oral meds |
Most common Cost effective/cheapest Preferred unless N/V NPO means 'nothing by mouth' |
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What kind of pills can we crush? |
NON-ENTERIC coated |
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Pouring meds? |
Eye level Dose at base of meniscus |
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What type of drug is more viable in body? Albumin-bound or free floating? |
Free floating is free to be therapeutic; albumin bound (transport fx) is locked on to drug |
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Eye drop admin |
Pt lying down Give Kleenex Drops onto conjunctiva DO NOT TOUCH dropper to skin/eye |
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What type of lubricant for med admin into any body cavity? |
Water soluble! |
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Sim's position |
By definition on their LEFT side |
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Rectal med admin |
Insert SMOOTH, ROUNDED end |
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What kind of environment do Alz. Patients need? |
SOFT ENVIRONMENT |
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My patient looks angry, what do I do? |
VERIFY & VALIDATE |
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What do we use to build patient relationships, communicate best with our patients, have great relationships with doctors, other nurses and THE WORLD?!?!?!?! |
THERAPEUTIC COMMUNICATION!! |
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Blood glucose testing |
Finger prick- side of finger Or can use earlobe Lancet perpendicular to site Don't smear blood Report abnormal results to doc Outer aspect of heel for infants Do return demonstration Stress keeping records |
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Guaiac test |
Fecal occult (hidden) |
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What does fecal occult test for? |
Blood in stool Blood in stool Blood in stool |
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What color is a positive guaiac test? |
Blue=blood present |
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What color is a negative guaiac test? |
No change or any color other than blue |
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What is worse: false positive or false negative? |
False NEGATIVE. |
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What foods can cause fec. occult to be false positive? |
Red meat (beef, lamb, liver, processed meats) Raw vegetables or fruits (radishes, turnips, horseradish and melons) Medications that irritate gastric mucosa and cause bleeding (aspirin, NSAIDS, steroids, iron preparations, and anticoagulants.) |
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What foods can cause fec. occult to be false negative? |
More than 250mg/day of Vitamin C (dietary and supplemental) up to 3 days before test, even if bleeding is present. |
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How many mL's minimum are needed for a urinalysis? |
10 ml |
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What labels do we put on urine samples? |
Correct specimen label Correct lab requisition Both attached securely to specimen container |
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Purpose of clean-catch/midstream urine specimen? |
Identify microorganisms causing UTI |
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What do you need to do before you begin head-to-toe assessmemt? |
Gather your equipment |
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Principles of head-to-toe assessment |
Head to toe Methodical Sequential Bilateral Consider G&D (chunks, warmth,etc) |
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UA specific gravity |
1.010-1.025 |
Amt of metabolic waste and electrolytes in urine. As urine becomes more concentrated, specific gravity increases. |
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UA pH |
6, slightly acidic |
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Piaget |
Sensorimotor Preconceptual Intuitive thought Concrete operations Formal operations |
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Normal temp range |
96.8F ----- 99.5F |
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Generic name |
Name used thru life of drug |
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Brand/trade name |
Name given to drug by that particular manufacturer |
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Chemical name |
Name chemist knows drug by |
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Schedule I |
No medical use, high addiction |
LSD, heroine, ectasy |
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Schedule II |
Some med use, high addiction |
Opioids, CNS stimulants, depressants |
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Schedule III |
Some dependency |
Anabolic steroids, codeine |
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Schedule IV |
Lesser dependency |
Benzos, sedatives, prescription appetite suppressant |
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Schedule V |
Least dependency |
Antidiarrheal w/ small amt of controlled substance (Lomotil) |
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Idiosyncratic effect |
Unexpected, rare, gets added to nursing drug guide |
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Additive effect |
1+1=2 |
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Synergistic effect |
1+1=50 |
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Iatrogenic |
Caused by drugs Cure worse than disease |
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Vesicular breath sounds |
Soft -intensity, low pitched "gentle sigh" sound. Created by air movement through bronchioles/alveoli |
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Broncho - vesicular sounds |
Moderate intensity and moderate pitched "blowing" sounds Created by air moving through larger airways (bronchi) |
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Bronchial (tubular) sounds |
High pitched, loud, "harsh" sounds Created by air moving through trachea |
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5 types of assessment? |
Inspection (always #1) Auscultation Palpation Olfaction Percussion |
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