Med Surge - Test 1 P. 7-8

Front 1

Informed consent
-it implies that the patient has sufficient information to understand

5 things:

Back 1

-the nature of and reason for surgery
-who will be performing the surgery and whether others will be present during the procedure (students)
-all available options and the risks associated with each option
-the risks associated with the surgical procedure and its potential outcomes
-the risks associated with the use of anesthesia

Front 2

Informed consent
-What is the nurses responsibility related to this?

Back 2

-the nurse is responsible for providing detailed information about the surgical procedure

-the role is to clarify facts that have been presented by the physician and dispel myths that the patient or family may have about the surgical experience

Front 3

Informed consent

it is the nurse who is responsible for having the consent form signed before sedation is given and before surgery is performed

true or false

Back 3

false, it is the surgeons responsibility

Front 4

Informed consent

you verify that the consent form is signed and you serve as a witness s to the signature (not the fact that the pt is informed)

true or false

Back 4

true

Front 5

Informed consent

-It is the nurse’s responsibility to assure that indeed information was provided and that the patient was able to comprehend what was explained to them.
---what if the patient doesn't understand?

Back 5

-if you believe that the pt has not been adequately informed, contact the surgeon and request that he/she see the pt for clarification. documentation this action in the chart

Front 6

Preoperative education:
-what is the purpose of preop

Back 6

to get them ready for postop

Front 7

Preoperative education:
What type of pieces are introduced for education during this time....

Back 7

-Post operative expectations
-Cough and deep breathing exercises – helps prevent atelectasis (stagnation of air in the alveoli which can lead to pneumonia. One of the first signs is a low grade fever 99.2-99.6. decreased breath sounds at bases)
-Splinting of chest/abdomen with pillows to prevent the sutures from tearing.
-Antiembolism ose (ted hose)
-pneumatic compression devices
-Sequential compression devices (SCD’s) to prevent DVT
-Leg exercise –foot pumping
-PCA pump use –family members should not push button for pt
-Drains or tubes
-Pain expectations

Front 8

What type of adjunctive pain therapy would the nurse see used in the preop setting?

Back 8

-sedatives, hypnotics, anxiolytics, opioid analgesics and antichoinergic agents

Front 9

Post op

What are SCD’s?

Back 9

sequential compression device

Front 10

Post op
SCDs
- Why are they used

Back 10

? inflates with air to accelerate venous blood return, prevents clots from forming

Front 11

Incentive spirometer:
-what does it help the pt do?

-what is the purpose of this:

Back 11

it’s a way to encourage pts to take deep breaths.

its purpose is to promote complete lung expansion and to prevent pulmonary problems.

Front 12

Incentive spirometer:

How does the nurse instruct the pt to use it?

Back 12

seal lips tightly around the mouthpiece, inhale spontaneously, and hold breath for 3-5 seconds for effective lung expansion. by breathing in u expand the lung and alveoli..

Front 13

Nutrition:
Hospital diet types
(Clear liquid vs Full liquid)

can see through the liquid

Back 13

Clear liquid

Front 14

Nutrition:
Hospital diet types
(Clear liquid vs Full liquid)

there just for hydration..not nutrients.. at room or body temperature

Back 14

Clear liquid

Front 15

Nutrition:
Hospital diet types
(Clear liquid vs Full liquid)

examples: brewed tea,
grape and apple juice

Back 15

Clear liquid

Front 16

Nutrition:
Hospital diet types
(Clear liquid vs Full liquid)

-prevents dehydration and keep colon contents to a minimum

Back 16

Clear liquid

Front 17

Nutrition:
Hospital diet types
(Clear liquid vs Full liquid)

-ordered: prior to GI studies, post-op, N/V episodes

Back 17

Clear liquid

Front 18

Nutrition:
Hospital diet types
(Clear liquid vs Full liquid)

-used for a limited time (24-48 hrs)

Back 18

Clear liquid

Front 19

Nutrition:
Hospital diet types

-What are the 3 requirements for a clear liquid diet?

Back 19

-pt must be able to swallow

-need to have a functioning GI track

-you have to have bowel sounds in order to start feeding the patient..passing gas is a sign of a moving bowel: why? decreases stimulus to the GI track yet allows for hydration and some nutrient absorption to occur

Front 20

Nutrition:
Hospital diet types
(Clear liquid vs Full liquid)

plain water,

Back 20

examples of clear liquid

Front 21

Nutrition:
Hospital diet types
(Clear liquid vs Full liquid)

fruit juices without pulp

Back 21

examples of clear liquid

Front 22

Nutrition:
Hospital diet types
(Clear liquid vs Full liquid)

strained lemonade or fruit punch

Back 22

examples of clear liquid

Front 23

Nutrition:
Hospital diet types
(Clear liquid vs Full liquid)


broth

Back 23

examples of clear liquid

Front 24

Nutrition:
Hospital diet types
(Clear liquid vs Full liquid)

clear sodas or sports drinks

Back 24

examples of clear liquid

Front 25

Nutrition:
Hospital diet types
(Clear liquid vs Full liquid)

plain gelatin

Back 25

examples of clear liquid

Front 26

Nutrition:
Hospital diet types
(Clear liquid vs Full liquid)

honey

Back 26

clear liquid

Front 27

Nutrition:
Hospital diet types
(Clear liquid vs Full liquid)

ice pops without bits of fruit

Back 27

clear liquid

Front 28

Nutrition:
Hospital diet types
(Clear liquid vs Full liquid)

tea or coffee without cream

Back 28

clear liquid

Front 29

Nutrition:
Hospital diet types
(Clear liquid vs Full liquid)

-can’t see through liquid. consists of food that are liquid at room or body temperature.

Back 29

Full liquid

Front 30

Nutrition:
Hospital diet types
(Clear liquid vs Full liquid)


-used to provide oral nourishment for patients who have difficult chewing or swallowing solid foods

Back 30

Full liquid

Front 31

Nutrition:
Hospital diet types
(Clear liquid vs Full liquid)


-ex: cream of mushroom, custards, creams

Back 31

Full liquid

Front 32

Nutrition:
Hospital diet types
(Clear liquid vs Full liquid)

-usually ordered after a cl liq diet, transitional to solid food be given

Back 32

Full liquid

Front 33

Nutrition:
Hospital diet types
(Clear liquid vs Full liquid)

-pts who have diff swallow food, mandible injuries or dental

Back 33

Full liquid

Front 34

Nutrition:
Hospital diet types
(Clear liquid vs Full liquid)

-nutritional supplements included – ex ensure, (precautions still need to addressed in pts with swallowing deficits)

Back 34

Full liquid

Front 35

Mechanical Soft

-uses:

Back 35

-it can help to ease difficulty in chewing and/or swallowing due to dental problems or extreme weakness and it is sometimes recommended to relieve mild intestinal or stomach discomfort

Front 36

what kind of diet:

-this diet is a close cousin of the soft diet. it gets its name from the fact that household tools like machines, like a blender, meat grinder, or knife are used to make foods easier to chew and swallow

Back 36

mechanical soft

Front 37

-mechanical or mechanical soft (which one can chew?)

Back 37

mechanical soft can

Front 38

-ex: pancakes

Back 38

-Soft diets

Front 39

Diets:

-pt can eat anything, they have no restrictions

Back 39

regular diet

Front 40

Low sodium:

-patients can eat what?

Back 40

-patient is restricted to less than 2000 mg/day

Front 41

Assessment of an IV site

-check patency of vascular access devices (VAD)- flow rate will be slowed or stopped)

what does "patency of the IV needle or catheter" mean

Back 41

- that the tip of the needle or catheter is without clots and that the catheter or needle tip is positioned away from the vein wall.

Front 42

Assessment of an IV site

Patency-
what is one way to asses patency?

Back 42

one way to assess patency is by lowering the IV bag below the level of the IV insertion site and observing for a blood return.

Front 43

Assessment of an IV site

-observe patient during palpation of vessel for signs of discomfort (tenderness is an early sign of ________)

Back 43

phlebitis

Front 44

Assessment of an IV site

-inspect insertion site, note color, inspect for swelling, infiltration, and phlebitis, palpate temperature of skin above dressing

Back 44

:)

Front 45

Assessment of an IV site

redness, inflammation, tenderness, and warmth indicate

Back 45

vein inflammation or phlebitis.

Front 46

Assessment of an IV site

swelling above insertion site and cool temperature indicates what?

Back 46

infiltration of fluid into tissue

Front 47

Assessment of an IV site

-infiltration: what should you do?

Back 47

stop infusion and discontinue. elevate affected extremity ( which promotes venous drainage), restart new IV if continued therapy is necessary .

Front 48

-why does infiltration occur?

Back 48

occurs because IV fluids enter the surrounding space around the site. there is swelling (from increase tissue fluid) and pallor and coolness (caused by decreased circulation)

Front 49

-phlebitis: what should you do?

Back 49

stop infusion and discontinue IV, restart new IV if therapy is necessary, place warm moist compress over area of phlebitis
-inflammation of the vein


-tenderness, pain, burning can indicate phlebitis

Front 50

IM Injection sites for adult and infant

adults:
infant:

Back 50

IM Injection sites for adult and infant
adults: deltoid, Vastus lateralis, ventrogluteal
infant: Vastus lateralis

Front 51

Insulin mixing and administration of

11 steps

Back 51

1. roll the bottle of cloudy insulin
2.wipe off tops of both insulin vials with alcohol swab
3.verify insulin dose against MAR
4.take insulin syringe and aspirate volume of air equivalent to dose to be withdrawn from intermediate/long acting first
5.insert needle and inject air into vial
6.remove syringe
7.inject air equal to the dose of rapid or short acting insulin into the vial and withdraw the correct dose into the syringe
8.verify short acting insulin dose with MAR and then show another nurse to verify
9.place the syringe back into the vial of intermediate or long acting insulin
10.invert the vial, and carefully withdraw the desired amount of insulin to syringe
11.withdraw needle, check fluid level

Front 52

Insulin

what is clear solution that can be given subcutaneously or intravenously

Back 52

(unmodified) insulin like:
-regular (Humulin R)

Front 53

Insulin

what kind can only be given subcutaneously

Back 53

-Modified insulin preparations, such as NPH or Lente, can .

Front 54

Insulin
-When mixing insulin, always fill the syringe with the regular insulin first to prevent contamination of the regular insulin bottle with the modified insulin.....
why??????

Back 54

The reason for preparing the regular insulin first is that the immediate effect of short-acting regular insulin can be altered if it is contaminated with longer-acting modified insulin preparations
-administer within 5 minutes of combing insulin

Front 55

Nutrition:
Hospital diet types

Clear Liquid
-what is the purpose of this diet?

Back 55

used to prevent dehydration and keep colon contents to a minimum

Front 56

Nutrition:
Hospital diet types

Clear Liquid
-what is the "bad thing" about this diet?

Back 56

has inadequate energy and nutrients.

it should not be used for more than 24 hrs

Front 57

Nutrition:
Hospital diet types

Clear Liquid
-when should this not be used?

Back 57

when pt has inadequate GI function

Front 58

Nutrition:
Hospital diet types

Clear Liquid
-examples of why a dr would prescribe this diet

Back 58

before or after surgery

minimize stimulation of GI tract

Front 59

Nutrition:
Hospital diet types

examples: apple, cranberry, grape juice

Back 59

clear liquid

Front 60

Nutrition:
Hospital diet types

what is ordered after clear liquid

Back 60

full liquid

Front 61

Nutrition:
Hospital diet types

Full liquid
-when is this used?

Back 61

for pts who have problems chewing or swallowing solid foods

or for pts who have mandible or dental injuries

Front 62

Nutrition:
Hospital diet types

example is lactose (milk based products)

Back 62

full liquid

Front 63

Nutrition:
Hospital diet types

which diet has nutritional supplements added to supply adequate amounts of energy and nutrients to make it nutritionally complete

Back 63

full liquid

Front 64

Nutrition:
Hospital diet types

examples are ice cream

Back 64

full liquid

Front 65

Nutrition:
Hospital diet types


example is milk shakes

Back 65

full liquid

Front 66

Nutrition:
Hospital diet types

what is used with transition from liquid diets to regular or general diets?

Back 66

soft diets

Front 67

Nutrition:
Hospital diet types

soft diets
-what kind of foods are used

Back 67

whole foods that are low in fiber and lightly seasoned are used

Front 68

Nutrition:
Hospital diet types

soft diets
-used for what kind of pts?

Back 68

pts with GI problems

Front 69

Nutrition:
Hospital diet types

example is white toast

Back 69

soft diet

Front 70

Nutrition:
Hospital diet types

Soft diet
-what is the texture of the food like?

Back 70

soft and easy to swallow and chew

Front 71

Nutrition:
Hospital diet types

Soft diet can also be usd for pts who have problems chewing and swallowing their food

true or false

Back 71

true

Front 72

Nutrition:
Hospital diet types

example: melted, ricotta, cottage cheese

Back 72

soft diet

Front 73

Nutrition:
Hospital diet types

example: frozen yogurt, custard, pudding

Back 73

soft diet

Front 74

Nutrition:
Hospital diet types


example: applesauce, banana

Back 74

soft diet

Front 75

Nutrition:
Hospital diet types

example:cooked veggies

Back 75

soft diet

Front 76

Nutrition:
Hospital diet types

example is ground beef or chicken moistened with gravy

Back 76

soft diet

Front 77

Nutrition:
Hospital diet types

example: cooked pasta

Back 77

soft diet

Front 78

Nutrition:
Hospital diet types

example: mashed potatoes without the skin

Back 78

soft diet

Front 79

Nutrition:
Hospital diet types

consists of foods that are belnded, chopped, or ground with added liquid to make them easier to eat

Back 79

mechanical soft

Front 80

Nutrition:
Hospital diet types

all meats, fruits, and vegetables are purreed. soups are blended. breads and cookies aer pureed as well.

Back 80

pureed

Front 81

Nutrition:
Hospital diet types

for person who are unable to swallow their foods without chewing

Back 81

pureed

Front 82

Nutrition:
Hospital diet types


no fresh fruits or vegetables. no gas forming foods

Back 82

soft

Front 83

Nutrition:
Hospital diet types


designed for persons unable to tolerate a general diet

Back 83

soft

Front 84

Nutrition:
Hospital diet types

foods that are liquid at body temperature and leave a minimal amount of residue in the gastrointestinal tract

Back 84

clear liquid