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132 Cards in this Set
- Front
- Back
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(Blank) is an open wound from a sharp instrument, can be deep or shallow.
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Incision
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(Blank) is a closed wound caused by blunt force trauma. AKA a bruise
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Contusion
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A (blank) is a surface scrape.
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Abrasion
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(Blank) is a penetration of the skin and often underlying tissues by a sharp instrument.
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Puncture
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A (blank) thickness wound is confined to the skin, that is, the dermis and epidermis, heals by regeneration.
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A partial thickness wound
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a (blank) thickness wound is involving the dermis , epidermis, and sub Q tissue....possibly muscle and bone.
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A full thickness wound.
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(Blank) intention healing occurs where the tissues surfaces have been closed and there is minimal or no tissue loss.
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Primary Intention Healing
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(blank) intention healing is a wound that is extensive and involves considerable tissue loss and in which the edges cannot or should not be closed.
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Secondary Intention Healing
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(Blank) healing is when wounds are left open to drain or infection to resolve...and then be surgically closed.
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Tertiary Healing
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Name some factors that effect wound healing. Hint: D, N, L, and M
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Developmental Stages ( elderly take longer to heal)
Nutrition Lifestyle Medications |
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What can be some complications in wound healing?
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Hemmorhage, Infection, Dehiscence or evisceration.
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What are some risks of pressure sores? Hint: Friction or shearing is one
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Immobility, Inadequate nutrition, Incontinence, decreased mental status, demenished sensation, excessive body heat, advanced age(loss of body mass), Chronic illnes EX DM.
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What stage is this pressure sore in?
nonblanchable erythema |
Stage 1
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What stage is this pressure sore in?
PArtial thickness skin loss. Closed blister. |
Stage II
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What stager is this pressure sore in?
full thickness skin loss invlving damage or necrosis of sub Q tissue that may extend down to, but not thru, underlying fascia. |
Stage III
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What stage is this pressure sore in?
full thickness skin loss w/ tissue necrosis or damage to muscle or bone. Tunneling may also be present. |
Stage IV
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What is the bodies physiologic response to heat?
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vasodialation
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What is the bodies physiological response to cold?
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vasoconstriction
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WHAT ARE THE THREE TONICITIES OF INTRAVENOUS SOLUTIONS?
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ISOTONIC, HYPERTONIC, HYPOTONIC
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WHAT HAPPENS IN A ISOTONIC SOLUTION?
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NORMAL SALINE, NO FLUID SHIFT, STAYS WHERE IT IS BECAUSE IT HAS THE SAME CONCENTRATION OF SOLUTES AS BLOOD PLASMA
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WHEN GIVING AN ISOTONIC SOLUTIONS WHAT ADVERSE SIGNS SHOULD YOU LOOK FOR?
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SIGNS OF HYPOVOLEMIA, BOUNDING PULSE AND SOB & CLIENTS AT RISK FOR INCREASED INTERCRANIAL PRESSURE BECAUSE IT CAN INCREASE CEREBRAL EDEMA
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WHAT HAPPENS IN A HYPERTONIC SOLUTION?
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A LOT OF PULLING POWER DRAWING FLUID IN BECAUSE OF THE GREATER CONCENTRATION OF SOLUTES THAN PLASMA
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GIVE AN EXAMPLE OF WHAT IS IN A HYPERTONIC SOLUTION?
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SALINE MIXED WITH DEXTROSE
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WHO SHOULD NOT BE A RECEIVING A HYPERTONIC SOLUTION?
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CLIENTS WITH KIDNEY OR HEART DISEASE AND CLIENTS WHO ARE DEHYDRATED
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WHAT HAPPENS IN A HYPOTONIC SOLUTION?
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MOVE OUT INTO THE INTERSTITIAL SPACE LACK OF PARTICLE DUE TO LESSER CONCENTRATION OF SOLUTES
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FOR WHAT PURPOSE DO WE USE HYPOTONIC SOLUTIONS?
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USED TO PROVIDE FREE WATER AND TREAT CELLULAR DEHYDRATION. PROMOTE WASTE ELIMINATION BY THE KIDNEYS.
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WHAT ARE THE FOUR CATEGORIES OF IV SOLUTION ACCORDING TO THEIR PURPOSE?
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NUTRIENT SOLUTIONS, ELECTROLYTE SOLUTIONS, ALKALINIZING SOLUTION,AND ACIDIFYING SOLUTIONS
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WHEN ARE NUTRIENT SOLUTIONS COMMONLY USED?
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PREVENTING DEHYDRATION AND KETOSIS BUT DO NOT PROVIDE SUFFICIENT CALORIES TO PROMOTE WOUND HEALING, WEIGHT GAIN, OR NORMAL GROWTH IN CHILDREN
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WHEN ARE ELECTROLYTE SOLUTIONS COMMONLY USED?
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RESTORE VASCULAR VOLUME, PARTICULARLY AFTER TRAUMA OR SURGERY
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WHEN ARE ALKALINIZING SOLUTION COMMONLY USED?
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TO TREAT METABOLIC ACIDOSIS
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WHEN ARE ACIDIFYING SOLUTIONS COMMONLY USED?
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ADMINISTERED TO COUNTERACT METABOLIC ACIDOSIS
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WHERE ARE VENIPUNCTURE SITES IN ADULTS? INFANTS?
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ADULTS-VEINS IN HAND AND ARM
INFANTS-VEINS IN SCALP AND DORSAL FOOT VEINS |
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WHAT ARE THE NAMES OF THE COMMONLY USE VEINS?
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METACARPAL, BASILIC AND CEPHALIC VEINS
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FOR WHAT MEDICAL REASON WOULD A CENTRAL VENOUS CATHETER BE USED?
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LONG TERM IV THERAPY, PARENTERAL NUTRITION, IV MEDICATIONS THAT ARE DAMAGING TO VESSELS (CHEMO)
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WHERE IN THE BODY IS A CENTRAL VENOUS CATHETER INSERTED AND WHO DOES THIS?
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SUBCLAVIAN OR JUGULAR VEIN, WITH THE DISTAL TIP OF THE CATHETER RESTING IN THE SUPERIOR VENA CAVA ABOVE THE RIGHT ATRIUM. THE PHYSICIAN
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WHEN WOULD YOU NEED TO PUT IN A CENTRAL VENOUS CATHETER?
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HEART MULTI TRAUMA
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WHAT GAUGES ARE USED IN A CENTRAL VENOUS CATHETER?
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18 AND 16 GAUGE
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WHAT IS A PICC?
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PERIPHERAL CENTRAL VENOUS CATHETER
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WHERE IS A PICC INSERTED AND WHO CAN INSERT A PICC?
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AN RN CERTIFIED IN THIS SKILL CAN DO THIS PROCEDURE AND IT IS INSERTED IN THE BASILIC OR CEPHALIC VEIN IN THE ARM
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FOR WHAT REASON WOULD YOU USE A PICC?
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LONG TERM IV USE WHEN THE CLIENT WILL BE MANAGING IV THERAPY AT HOME
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FOR WHAT REASONS DO WE USE IMPLANTED PORTS?
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CLIENTS WITH CHRONIC ILLNESS WHO REQUIRE LONG TERM IV THERAPY SUCH AS CHEMO, PARENTERAL NUTRITION AND FREQUENT BLOOD SAMPLES
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WHAT ARE THE TWO TYPES OF SOLUTION CONTAINERS?
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PLASTIC AND GLASS
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WHAT IS THE RESPONSIBLITY OF THE NURSE WHEN ADMINISTERING IV MEDS?
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KNOW YOUR DRUGS AND THE RATE TO GIVE
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HOW MANY DRIPS ARE IN A MACRO DRIP?
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15-20 DROPS PER MIN.
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HOW MANY DIPS ARE IN A MICRO DRIP?
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60 DROPS PER MIN.
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WHAT IS PRIMARY TUBING?
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MAIN TUBING THAT GOES FROM IV BAG TO PT
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WHAT IS SECONDARY TUBING?
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ATTACHES IN, IV PIGGY BACK (IVPB), EXP. ANTIBIOTIC
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WHAT IS BLOOD TUBING?
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BIG DRIP CHAMBER, 2 TUBES = BLOOD & SALINE
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WHEN CHOOSING A CATHETER WHAT IS SOMETHING TO REMEMBER?
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THE LOWER THE #, THE BIGGER THE OPENING
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WHEN WOULD YOU USE A 14-16 G CATHETER?
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MULTIPLE TRAUMA, HEART SURGERY
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WHEN WOULD YOU USE A 18 G CATHETER?
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MAJOR TRAUMA, BLOOD PRODUCTS
"GREEN" |
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IF YOUR PATIENT WAS INVOLVED IN A MINOR TRAUMA OR SURGERY, WHAT SIZ CATHETER WOULD YOU USE?
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20 G
"PINK" |
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IF YOU HAVE A PEDIATRIC PT, A PT W/SMALL VEINS OR A PT THAT NEEDS ANTIBIOTIC THERAPY, WHAT SIZE CATHETER WOULD YOU USE?
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22 G
"BLUE" |
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WHEN USING GLASS OR PLASTIC SOLUTION CONTAINERS, YOU NEED TO LABEL THEM WITH....
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DATE, TIME & INITIALS OF NURSE
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WHAT DO ALL IV SITES NEED TO HAVE WHEN YOU ARE FINSHED WITH THE PRODECURE?
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A LABEL WITH DATE & INITIALS OF NURSE
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WHAT ARE ONC?
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OVER THE NEEDLE CATHETERS OR ANGIOCATHS. PLASTIC CAP OVER THE NEEDLE AND WHEN INSERTED, THE NEEDLE IS REMOVED AND THE PASTIC CAP STAYS IN. ALLOWS THE PT MORE MOBILITY AND RARELY INFILTRATES
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WHAT IS A BUTTERFLY?
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FLAPS OR WINGS OF THE BUTTERFLY ARE HELD TIGHTLY TOGETHER TO HOLD THE NEEDLE SECURELY DURING INSERTION AND AFTER INSERTION THE WINGS ARE FLATTENED AND SECURED WITH TAPE TO THE SKIN
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WHAT ARE THE DIFFERENT TYPES OF INFUSION PUMPS?
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AUTOMATED, SELECT RATE, AND ACCURATE
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WHAT ARE THE NURSING RESPONSIBILITES WHEN MONITORING IV THERAPY?
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OBSERVE SITE AND DOCUMENT: CLEAN, DRY AND INTACT, NO REDNESS, LEAKING, SWELLING, LABELED WITH DATE OF INSERTION
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WHEN SHOULD YOU CHANGE A LABEL SOLUTIONS?
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Q 24 HOURS
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WHEN SHOULD YOU CHANGE AND LABEL TUBING?
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Q 72 HOURS
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WHEN DISCONTINUING AN IV, WHAT NEEDS TO BE DONE?
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OBSERVE INTEGRITY OF CATHETER, INTACT?? AND DRESS WITH DSD
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WHAT IS A LEGAL CONCERN IN TERMS OF NURSING RESPONSIBILTIES WHEN ADMINISTERING AN IV?
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MEDICATION VARIANCE
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TWO WAYS TO MAINTAIN A DRIP?
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WITH OR WITHOUT A PUMP
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Rwlieves the symptoms of a disease but does not effect the disease itself is an example of what kind of therapeutic drug relief?
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Paliative
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Vitamins, minerals, and supplements are examples of what type of therapeutic drug action?
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Restorative
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Pruitis is an example of what reaction to drug therapy?
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An adverse, mild allergic reaction causing itching without a rash.
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This effect occurs when two different drugs increase the action of one or the other drug.
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A synergisic effect
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A drug that inhibits cell function by occupying receptor cites is called:
EX: Narcan |
An Antagonist
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(blank) is the process by which drugs PASS into the bloodstream
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Absorption
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If a drug is swallowed , this drug will be absorbed into the bloodstream and carried to the liver, where it will be destroyed. This is called:
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The first pass effect
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(Blank) is when the transportation of drugs from the site of absorption to its site of action
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Distributuion
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(Blank) is when metabolites and drugs are excreted from the body.
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Excretion
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Most drugs are excreted through:
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The urine
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Some factors that effect medication action are:
hint(D, G, cultural..., D,) |
Developmental Factors
Gender Cultural, Ethnic, Genetic Factors Diet Environment Illness/Disease Time of administration |
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Oral medications should be taken within what time frame to be the most fast acting?
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Two hours before meals
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Name some routes of administration:
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Oral, Buccal, Sublingual, parenteral, topical.
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Name the five rights of Rx admin:
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Right Dose, Right Rx, Right person, Right time, Right route
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What are the four types of Rx orders?
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PRN, Stat, Standing, or single
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What are the essential parts of a drug order?
Hint: There are 7 |
Full name of Pt, Date and time order was written, name of Rx, route of Rx, dose of Rx, frequency of Rx, and a signiture of MD, etc.
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Convert 110 lbs to kg.
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2.2 lbs in a kg. Approx 55kg
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How are dosages for children calculated?
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Body Surface Area
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What are the steps of Rx admin?
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1) Identify client (check 5 rights 3 times)
2) Inform the client 3)Administer the Rx 4) provide adjunctive interventions (ex: help w/ fluids) 5) Record Rx administered 6)Evaluate client's response |
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If a NG tube is attached to suction, how long is the NG tube clamped after Rx admin?
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20-30 min.
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What are the three part of a syringe?
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The plunger, shaft or barrel, tip or needle...
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What is important to do before administering Rx in an IM injection?
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Asparate first
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When withdrawing med froma vial, what should you do first to prevent a vaccuum?
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Insert air into the vial.
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The technique of adding a diluent to a powdered drug to prepare it for administration is called:
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Reconstitution
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When giving an IM inj. what is the acceptable needle length and guage for an obese adult?
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1-1 1/2 in. #20-#22 gauge
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What are some acceptable sites for intradermal injections?
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inner lower arm, upper chest, back (beneath the scapula)
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What are some acceptable areas for subQ inj.?
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upper arm, inner thigh, abdomen, upper ventrogluteal areas, and dorsoglutel areas.
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If heparin is being administered...what type of syringe and what site would be used for healthy adult?
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a tuberculin syringe (tenths), abdomen
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How long should a pt remain in the sims position after receiving a suppository?
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at least 5 minutes
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The primary care provider prescribed 5mL of Rx to be given deep IM for 40yof who is 5'7" and 135 lbs. WHich os the following is the most appropriate method of admin?
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A) A tuberculin syringe, 25#-27# gauge, 1/4-5/8 needle
B) Two 3 mL syringes, #20-#23 gauge, 1 1/2 needle(correct) C) Two 2 mL syringe, #20-#23 gauge, 1 in needle. |
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The client has been found to have a gene that affects how the liver metabolizes one of the medications that have been prescribed. Which of the following statements is accurate?
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1)If the client has slowed liver metabolism, the nurse might expect the medication to reach a toxic effect.
2)If the client’s liver rapidly metabolizes the medication, the client will require lower doses of the medication to avoid an undesired effect. (Correct) 3) If the client has slowed liver metabolism, the nurse must closely monitor for an anaphylactic response to the medication. 4) If the client’s liver rapidly metabolizes the medication, the client will require higher doses of the medication in order to maintain the proper levels of drug in the client’s body. |
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Order: “Cytarabine 50 mg intrathecal every 2 weeks for a total of 5 dosages.” The nurse explains to the client that the medication will be given into the:
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Rectum.
Spinal canal.(correct) Ear. Subcutaneous tissue. |
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The nurse is preparing to administer a parenteral medication to a client. How does the nurse describe this route of administration to the family member at the bedside?
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1)“The dropper is positioned above the eye to release the medication into the conjunctival sac.”
2) “This medication will be placed in the rectum.” 3)“This medication will be injected into the tissue just below the skin.” (correct) |
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A medication dose is written as 25 mg/ kilogram (kg). The client weighs 113 pounds. The nurse will administer a dose of ??????
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Since the patient weighs 113 pounds, kg will be calculated as (113/ 2.2) X 25 mg = dose.
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An elderly client with renal insufficiency is to receive a cardiac medication. The nurse is most likely to administer which of the following?
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a) An increased dosage
b)A decreased dosage (correct) c)The standard dosage d) Divided dosages |
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Define Hyperglycemia
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A fasting blood glucose level of 126 mg/dl or higher or a nonfasting blood glucose level of 200 mg/dl or higher.
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Define Hypoglycemia
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A blood glucose level of less than 50 mg/dl.
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What are the characteristics of type 1 diabetes?
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Lack of insulin produciton, 10% of cases, production of defective insulin, require exogenous insulin.
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What are the characteristics of type 2 diabetes?
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90% of cases, caused by both insulin resistance and insulin deficiency, but not an absolute lack of insulin.
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What are some treatments of hypoglycemia?
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If severe: Buccal tablets, TPN preparations, intravenous glucose, dietary modifcations.
**KNOW THE 15/15 rule: 15 grams of CHO repeat in 15 minutes and give 15 grams CHO again |
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What is the onset/peak/duration of normal (rapid acting) insulin?
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1/2 hr - 1 hr/2-4 hrs/5-7 hrs
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What is the onset/peak/duration of NPH (intermediate acting) insulin?
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3-4 hrs/6-12 hrs/18-24 hrs
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What are the signs of hypoglycemia?
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BS<60, sweating, shakiness, palpitations, nervousness, confusionm and visual disturbance. It is an adrengergic response.
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What is diabetes mellitus?
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A multisystem disease resulting from the bodys inability to produce or utilize insulin. It is a major health problem as it is a silent killer.
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What are the 5 rights of med administration?
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Right Client, dose, time, route, drug.
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What two drugs are never aspirated?
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heparin and insulin
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Name the IM sites.
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Ventrogluteal, vastus lateralis, dorsogluteal, deltoid.
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Who should be involved when the nurse is teaching a new skill to a client?
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The client and the significant other/family.
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What are the five rights of medication?
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Right Drug
Right Dose Right Time Right Route RIGHT PATIENT |
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The Nurse should check for compliance with all of the Five Rights at least ______ times before giving the medication.
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Three
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Medications must be given no more than ______ hour before or after the actual time specified in the physician's order.
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1/2 Hour before or after
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The nurse is reviewing the orders for a newly admitted patient. One order reads: Tylenol, 2 tablets PO, every 4 hours as needed for pain or fever. What is wrong with this order.
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The order is missing the "Right Dose" and needs to be clarified.
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Pharmacokinetics is
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the study of what the body does to the drug molecules.
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What are the processes of Pharmacokinetics?
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Absorption
Distribution Metabolism Excertion |
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Absorption is
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The movement of a medication from its site of administration to the bloodstream
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Distribution is
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the transportation of a medication to its site of action by bodily fluids.
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Excretion is
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the elimination of a medication from the body primarily through the kidneys
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Give an example of a C-II(controlled substance) drug the dispensing restrictions that make it so?
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Codeine, morphine, oxycodone, amphetamine.
written rx only, no refills |
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Give an example of a C-IV(controlled substance) drug the dispensing restrictions that make it so?
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Phenobarbital, the benzodiazepines (diazepam, temazepam, lorazepam)
written or oral rx that expires in 6 mo., no more than five refills in 6 mo. period |
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What is an investigational new drug (IND)?
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a drug not approved for marketing by the FDA, but available for use in experiments to determine its safety and efficacy; also, the actual name of the category of application that the drug maufacturer submits to the FDA to obtain permission for human (clinical) studies following successful completition of animal (preclinical) studies.
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What is phase I of investigational drug studies?
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small numbers of healthy subjects rather than those who have the disease or ailment that the new drug is intended to treat. The studies determine the optimal dosage range and the pharmacokinetics of the drug and to ascertain if further tests are needed
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Who is involved in Phase II of the investigational drug studies?
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small numbers of people who actually have the disease or ailment that the drug is designed to diagnose or treat
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What does phase III of the investigational drug studies involve?
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Placebo, blinded investigational drug study, double blinded investigated drug study
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What happens in Phase IV of the investigational drug studies?
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Studies are postmarketing studies voluntarily conducted by pharmaceutical companies to obtain further proof of the therapeutic effects of the new drug
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What disease might elicit an expedited drug approval?
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AIDS
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What is drug polymorphism?
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effect of a patient's age, gender, size, body composition, and other characteristics on the pharmacokinetics of specific drugs
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what drugs do african americans respond to differently to than other races?
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Antihypertensive drugs
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what drugs do asians and hispanics respond differently to than other races?
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Antipsychotic and antianxiety drugs
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