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20 Cards in this Set
- Front
- Back
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Angiography and dye |
Preprocedure: Allergies iodine fish Consent Renal fx Void Education Peripheral pulses Post procedure bed rest 4-6 hrs Loc Renal fx Hydrate Pressure to site Renal fx Embolus |
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MRI Truths |
Picks up on pathology earlier than CT Claustrophobia Remove jewerly |
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Glasgow coma scale |
Measures LOC Used anytime client has altered loc3 assessments are: eye opening. Motor response. Verbal responseGood is 15Less than 8 intubate 3 assessments are: eye opening. Motor response. Verbal response Good is 15 Less than 8 intubate |
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Head injury precautions |
Maintain neck in neutral position Quiet environment Elevate at HOB 35 Pad side rails |
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Effectiveness of mannitol. How does nurse measure? |
Assess loc every hoir |
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Precaution prior to admin for mannitol |
Check Bag and tubing for crystallization. |
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Reflex scale |
2+ normal 3+ slight hyperactive 4+ brisk hyperactive |
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cspine injury and increase in BP low pulse (autonomic dysreflexia) |
Elevate HOB |
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Autonomic dysreflexia |
Full bladder Constipation Painful stimuli Treat Sit up to lower BP and stop stimuli as stated above! |
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Major depression |
Feelings of Guilt Sitting in Darkroom Angry outbursts Hypersomnia Anhedonia |
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Signs Client contemplating suicide |
Isolation Will Harmful objects Giving away belongings Sudden happiness |
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Promoting a safe environment |
Contract to postpone Develop coping mechanism Rechannel anger with excercise Observation 10-15 min Intervals or one on one |
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Restraints |
Document Hydrate, feed, eliminate Safety |
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SSRI |
Interacts with St John's wort and increases risk of serotonin syndrome SS= excessive nerve cell activity |
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Complications of etoh disorder |
Thiamine and niacin defficiencies Korsakoff syndrome Werneikes syndrome Gastritis Liver and pancreas problems Mg and K problems Seizures Delerium tremens |
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Tension pneumothorax |
Tracheal deviation Elevated cvp They need a thoracotomy (chest tube with closed drainage system) |
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Chest tube info |
Put water until 2cm mark Never empty drainage collection chamber just get a new one We want bubbling in suction control chamber Specimen from cdu comes from.chest tube bc plastic tube reseals |
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Focused assessment on client with cdu |
Oxygen RR and depth Accessory muscles Loc Pulse ox Elevated WBC Restlessness Patency of cdu Connector secure no leaking free of kinks, drainage, output, water level, incision site appearance, Vaseline dressing, etc |
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Chest tube pulls out or case falls out |
Place palm of hand. Gauze with Vaseline, at 3 corners If disconnect place in liquid and get new stuff |
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Fractured ribs and flail chest |
Ribs: symmetrical, tenderness, shallow resp, crepitus Flail: paradoxical chest, cyanosis. Dyspnea, tachycardia, respiratory emergency!!!! Stabilize!! Both:pain, impaired respirations. |
