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144 Cards in this Set
- Front
- Back
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PICC LINE INSERTION
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BASILIC, CEPHALIC, OR AXILLARY VEINS ON DOMINANT ARM
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TIP OF PICC LINE INSERTION
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SUPERIOR VENA CAVA
BRACHIOCEPHALIC VEIN |
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POTENTIAL COMPLICATIONS A/W PICC LINE
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MALPOSITION
PNEUMOTHORAX DYSRHYTHMIAS NERVE OR TENDON DAMAGE RESPIRATORY DISTRESS CATHETER EMBOLISM THROMBOPHLEBITIS |
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PICC LINE AND BP CUFF
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TAKE BP ON OPPOSITE ARM
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FREQUENCY OF PICC LINE DRESSING CHANGES
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2-3 X PER WEEK
WET NON-OCCLUSIVE |
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WHICH CATHETER INCREASES IN SIZE 2H AFTER IT IS INSERTED
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MIDLINE CATHETER (MLC)
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POTENTIAL COMPLICATIONS A/W MLC
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THROMBOSIS
PHLEBITIS AIR EMBOLISM INFECTION BLEEDING VASCULAR PERFORATION |
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FREQUENCY OF MLC DRESSING CHANGES
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2-3 X PER WEEK
WET NON-OCCLUSIVE |
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VENOUS PLACEMENT OF PERCUTANEOUS CENTRAL CATHETERS
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SUBCLAVIAN VEIN
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DESCRIBE EACH LUMEN OF A PERCUTANEOUS CENTRAL CATHETER
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PROXIMAL - INFUSE OR DRAW BLOOD, ADMINISTER MEDS
MIDDLE - TPN DISTAL - INFUSE OR DRAW BLOOD |
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TYPES OF PERCUTANEOUS CENTRAL CATHETERS
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HICKMAN/ BROVIAC
SUBQ PORT-A-CATHETER |
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LEUR-LOK CAP
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SECURE EACH LUMEN AND LABELED TO INDICATE LOCATION (PROXIMAL, MIDDLE, DISTAL)
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PATIENT POSITION WHEN PLACING PERCUTANEOUS CATHETER
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HEAD DOWN TO PREVENT AIR EMBOLISM
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FREQUENCY OF FLUSHING PERCUTANEOUS CATHETERS
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NS, NS + HEPARINIZED SALINE
AFTER INSERTION AFTER INFUSIONS AFTER SPECIMEN WITHDRAWAL WHEN DISCONNECTED |
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DESCRIBE FREQUENCY, PATIENT POSITION AND STERLITY CONSIDERATIONS DURING DRESSING CHANGES OF A PERCUTANEOUS CATHETER
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2-3 X PER WEEK, PRN
LOW-FOWLER'S NURSE AND PATIENT WEAR MASK |
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BLOOD TYPE -- ACT AS DONOR -- RECEIVE BLOOD FROM
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O -- O, A, B, AB -- O
A -- A, AB -- O, A B - B, AB - O, B AB -- AB -- O, A, B, AB |
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BLOOD AND FLUID COMPATIBILITY
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0.9% NaCl
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GENERAL RATE FOR RUNNING BLOOD
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1 UNIT Q 2H
ELDERLY, 1 UNIT Q 3-4H |
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VS REGIMEN DURING BLOOD TRANSFUSION
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BASELINE PRIOR TO STARTING TRANSFUSION
VS @ 15 MIN VS Q 1 HR UNTIL TRANSFUSION COMPLETE |
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NURSING INTERVENTIONS IF TRANSFUSION REACTION SUSPECTED
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STOP INFUSION
ADMINISTER NS SAVE TUBING, BAG FOR BLOOD BANK DRAW BLOOD FOR LAB - CULTURE, TYPING, HGB, PLASMA COLLECT URINE SAMPLE FOR LAB - HGB MONITOR FOR HEMATURIA |
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WHEN IS BLOOD DONATION FOR AN AUTOLOGOUS TRANSFUSION COLLECTED
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4-6 WEEKS PRIOR TO SURGERY
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CONTRAINDICATIONS FOR AUTOLOGOUS BLOOD TRANSFUSION
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ACUTE INFECTION
CHRONIC DISEASE HGB < 11 HCT < 33% CEREBROVASCULAR DISEASE CARDIOVASCULAR DISEASE |
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TYPES OF TRANSFUSION REACTIONS
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ALLERGIC
FEBRILE HEMOLYTIC BACTERIA INFECTION CIRCULATORY OVERLOAD |
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CAUSE: ALLERGIC TRANSFUSION REACTION
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HYPERSENSITIVITY TO ANTIBODIES IN DONOR BLOOD
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CAUSE: FEBRILE TRANSFUSION REACTION
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ANTIBODIES TO DONOR PLATELETS OR LEUKOCYTES
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CAUSE: HEMOLYTIC TRANSFUSION REACTION
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INCOMPATIBILITY
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SXS'S: ALLERGIC TRANSFUSION REACTION
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MILD-UTICARIA, FLUSHING, ITCHING
ANAPHYLAXIS: HYPOTENSION, DECREASED O2-SAT, DYSPNEA, FLUSHING |
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SXS'S: FEBRILE TRANSFUSION REACTION
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FEVER, CHILLS, NAUSEA, HA, TACHYCARDIA, PALPITATIONS
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SXS'S: HEMOLYTIC TRANSFUSION REACTION
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LOW BACK PAIN, N/V, TACHYCARDIA, HYPOTENSION, DECREASED URINE OUTPUT, HEMATURIA
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SXS'S: BACTERIAL INFECTION TRANSFUSION REACTION
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FEVER, CHILLS, HYPOTENSION, TACHYCARDIA, SHOCK
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SXS'S: CIRCULATORY OVERLOAD
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INCREASED RR, DYSPNEA, CRACKLES, TACHYCARDIA
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PHARMACOLOGICAL TX FOR FEBRILE TRANSFUSION REACTION
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ASA
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PHARMACOLOGICAL TX FOR ALLERGIC TRANSFUSION REACTION
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BENADRYL
O2 CORTICOSTEROIDS |
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PHARMACOLOGICAL TX FOR BACTERIAL INFECTION TRANDFUSION REACTION
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ANTIBIOTICS
VASOPRESSORS STEROIDS |
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PHARMALOGICAL TX FOR HEMOLYTIC TRANSFUSION REACTION
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BENADRYL
O2 |
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BEST WAY TO STABILIZE VEIN FOR CATHETER INSERTION
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HOLD SKIN TAUGHT
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ANGLE USED FOR CATHETER INSERTION
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BEVEL UP @ 15-20 DEGREES
DECREASE ANGLE AND ADVANCE UNTIL FLASHBACK |
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SKIN TEMP A/W INFILITRATION
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COOLNESS AROUND IV SITE
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NURSING CARE W/X IV INFILTRATION
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WARM SOAKS
ELEVATE ARM |
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ASSESSMENT: PHLEBITIS AND THROMBOPHLEBITIS; SIMILARITIES AND DIFFERENCES
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SIMILARITIES: REDDENED AND WARM AROUND IV SITE OR ALONG PATH OF THE VEIN; TENDERNESS; SWELLING
THROMBOPHELBITIS: FEVER + LEUKOCYTOSIS |
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NURSING CARE A/W PHLEBITIS AND THROMBOPHLEBITIS
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WARM SOAKS
ELEVATE ARM |
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ASSESSMENT: IV HEMATOMA
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ECCHYMOSIS
IMMEDIATE SWELLING LEAKAGE OF BLOOD AT IV SITE |
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NURSING CARE FOR IV HEMATOMA
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APPLY PRESSURE WITH STERILE DRESSING
APPLY COOL COMPRESS/ ICE BAG FOR 24H FOLLOW UP WITH WARM SOAK |
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ASSESMENT: IV CLOT
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DECREASED FLOW RATE
BACKFLOW OF BLOOD INTO TUBING |
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ISO/HYPO/HYPER-TONIC SOLUTIONS
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EQUAL CONCENTRATION AS BODY FLUIDS
LESS CONCENTRATED THAN BODY FLUIDS MORE CONCENTRATED THAN BODY FLUIDS |
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PRIMARY PURPOSE OF IV ACCESS
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MAINTAIN OR RESTORE FLUID AND ELECTROLYTE BALANCE
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EXAMPLES: ISOTONIC SOLUTION
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0.9% NACL
LACTATED RINGERS |
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EXAMPLES: HYPOTONIC SOLUTION
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0.33% NACL
0.45% NACL D5W |
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EXAMPLES: HYPERTONIC SOLUTION
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D50.45%NS
3%, 5% NS (EMERGENCY) |
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ACTION/USE: ISOTONIC FLUIDS
AND THEREFORE, WHAT ARE SOME NURSING CONSIDERATIONS? |
VASCULAR EXPANSION, ELECTROLYTE REPLACEMENT
FVE, EDEMA, HEMO-DILUTION |
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ACTION/USE: HYPOTONIC FLUIDS
AND THEREFORE, WHAT ARE SOME NURSING CONSIDERATIONS? |
HYDRATES CELLS
EDEMA, HYPOTENSION, HYPONATREMIA |
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ACTION/USE: HYPERTONIC FLUIDS
AND THEREFORE, WHAT ARE SOME NURSING CONSIDERATIONS? |
VASCULAR EXPANSION
FVE, HYPERNATREMIA, IRRITATES VEINS |
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INDICATIONS FOR THIS GROUP OF MEDS: NEED LOTSA EFFORT AND DETERMINATION IF DUMB BLONDE IS PASSING NCLEX: DO DRUGS, MUCH PRACTICE, SLEEPLESS NIGHTS
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SHOCK
CARDIAC ARREST ANAPHYLAXIS |
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MEDS USED TO TREAT SHOCK, CARDIAC ARREST, AND ANAPHYLAXIS
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NE (LOVEPHED)
EPI (ADRENALINE) DOPAMINE (INOTROPIN) DIPHENHYDRAMINE HCL (BENADRYL) ISOPROTERENOL (ISUPREL) PHENYLEPHRINE (NEO-SYNEPHRINE) DOBUTAMINE HCL (DOBUTREX) MILRINONE (PRIMACOR) SODIUM NITROPRUSSIDE (NITROPRESS) |
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NE & FLUID COMPATIBILITY
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DEXTROSE SOLUTION
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DOPAMINE, MOA: LOW DOSE VERSUS HIGH DOSE
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DILATES CORONARY & RENAL ARTERIES
VASOCONSTRICTION |
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EPINEPHRINE: ROUTE OF ADMINISTRATION
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INADVERTENT IV ADMINISTRATION CAN BE HARMFUL
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ISUPREL ALSO TREATS
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ASTHMA AND BRONCHOSPASM
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DOBUTAMINE HCL & IV FLUIDS
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HIGHLY INCOMPATIBLE
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BLOCKS EFFECT OF HISTAMINE ON BRONCHIOLES, GI TRACT AND BLOOD VESSELS
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BENADRYL
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BENZODIAZEPINES "ENDING" RECOGNITION
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'AM'S
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EXAMPLES: BENZODIAZEPINES
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LIBRIUM
VALIUM XANAX KLONOPIN ATIVAN SERAX VERSED |
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BENZODIAZEPINES & CNS
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CNS DEPRESSANT
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BENZODIAZEPINES THAT ARE NOT SAFE FOR USE WITH ELDERLY
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LIBRIUM
VALIUM |
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WHEN IS VERSED PRIMARILY USED?
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PREOPERATIVE SEDATION
CONSCIOUS SEDATION FOR ENDOSCOPIC PROCEDURES AND DIAGNOSTIC TESTS |
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CLASS: BUSPAR, VISTARILL
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NON-BENZO ANTI-ANXIETY AGENTS
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IMPORTANT CONSIDERATION WHEN TAKING ANTACIDS AND OTHER MEDICATIONS
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ABSORPTION OF OTHER DRUGS MAY BE DECREASED AND HAVE DECREASED EFFECTIVENESS
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ASSESSMENT: EXTRAVASATION
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PAIN
BURNING EDEMA COOLNESS BLANCHING/ WHITENESS |
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PNEUMONIC: MEDS THAT CAN CAUSE EXTRAVASATION IF INFILTRATED
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PHYSICIANS PRESCRIBE DRUGS AND GOOD NURSES CHECK VENOUS EXTRAVASATION
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EXAMPLES: MEDS THAT CAN CAUSE EXTRAVASATION IF INFILTRATED
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POTASSIUM
PENICILLIN DILANTIN ANTI-NEOPLASTICS GENTOMYCIN NITROPRESS CALCIUM VANCOMYCIN EPI |
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WARM OR COOL COMPRESS WHEN TREATING EXTRAVASATION?
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COOL COMPRESS
*WARM IF VANCO |
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CLASS: DIGOXIN (LANOXIN)
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POSITIVE INOTROPE
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DIGITALIZE OR "LOADING DOSE"
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0.75 MG - 1 MG / 3 DOSES Q 8H
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MOA: DIGOXIN
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INCREASES FORCE OF MYOCARDIAL CONTRACTION
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THERAPEUTIC LEVEL: DIGOXIN
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0.5-2.0
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ELECTROLYTES R/T DIGOXIN
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LOW K+ AT RISK FOR DIG-TOXICITY
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ASSESSMENT: DIG-TOXICITY
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N/V
CONFUSION BLURRED VISION BRADYCARDIA PVC'S |
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TX: DIG-TOXICITY
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STOP THE DIG
TX SYMPTOMATICALLY: KCL, ANTI-ARRHYTHMICS, ATROPINE, DIGIBIND |
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PARAMETERS: DIGOXIN
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HOLD IF APICAL HR < 60 BPM
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MOA: NA-CHANNEL BLOCKERS
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BLOCKS THE MOVEMENT OF NA INTO CARDIAC CELLS AND SLOWS CONDUCTION
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EXAMPLES: NA-CHANNEL BLOCKERS
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QUINIDINE
LIDOCAINE (XYLOCAINE) FLECANIDE (TAMBOR) |
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MOA: BETA-ADRENERGIC BLOCKERS
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BLOCKS THE SNS, SLOWS CONDUCTION
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RECOGNITION: BETA-ADRENERGIC BLOCKERS
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'LOL'S
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MOA: K-CHANNEL BLOCKERS
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SLOWS REPOLARIZATION AND PROLONGS REFRACTORY PERIOD
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EXAMPLES: K-CHANNEL BLOCKERS
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AMIODARONE (CARDARONE)
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MOA: CA-CHANNEL BLOCKERS
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SLOWS DEPOLARIZATION
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RECOGNITION: CA-CHANNEL BLOCKERS
PROTOTYPE: CA-CHANNEL BLOCKERS |
'DIPINE'S
VERAPAMIL (CALAN) |
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MOA: NITRATES
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RELAX SMOOTH MUSCLES AND CAUSES VASODILATION
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EXAMPLES: NITRATES
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NITROGLYCERINE (NITROSTAT)
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PARAMETERS: NITRATES
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HOLD IF SYSTOLIC BP < 90 MMHG
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MOA: ACE INHIBITORS
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BLOCKS ENZYME THAT CONVERTS ANGIOTENSION I TO ANGIOTENSION II THEREBY, PREVENTING VASOCONSTRICTION
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DESCRIBE RENIN-ANGIOTENSION SYSTEM
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KIDNEYS AND BARORECEPTORS DETECT LOW BP AND SIGNAL TO SNS
SNS RELEASES RENIN - RELEASES ANGIOTENSION I - RELEASES ALDOSTERONE ANGIOTENSION I IS CONVERTED TO ANGIOTENSION II - POWERFUL VASOCONSTRICTOR ALDOSTERONE SIGNALS NA AND H2O RETENTION |
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RECOGNITION: ACE INHIBITORS
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'PRIL'S
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MOA: ARB'S
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ANGIOTENSION II IS RELEASED BUT RECEPTORS ARE BLOCKED
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RECOGNITION: ARB'S
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'SARTAN'S
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ADE: BETA-BLOCKERS
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BRONCHOSPASM
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BENZODIAZEPINES R/T SEIZURE USE
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EMERGENCY TO BREAK CONVULSIONS, NOT USED FOR DAILY TX
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PHARMACOLOGICAL TX FOR ALCOHOL W/D
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BENZODIAZEPINES
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ANTEDOTE: BENZODIAZEPINES
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FLUMAZENIL (ROMAZICON)
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MOA: DIURETICS
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INHIBITS RESORPTION OF NA AND H2O
BLOCKS EFFECTS OF ALDOSTERONE |
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TYPES: DIURETICS
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THIAZIDES
LOOP K+ SPARING OSMOTIC |
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PROTOTYPE: THIAZIDE DIURETICS
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CHLOROTHIAZIDE (DIURIL)
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PROTOTYPE: LOOP
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FUROSEMIDE (LASIX)
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PROTOTYPE: K+ SPARING
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SPIRONOLACTONE (ALDACTONE)
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PROTOTYPE: OSMOTIC
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MANNITOL (OSMITROL)
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ADMINISTRATION: ANTACIDS
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WITH MEALS, BEST ONCE DIGESTION HAS STARTER, BEFORE GASTRIC EMPTYING
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ANTACID: ALUMINUM HYDROXIDE AKA...
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AMPHOGEL
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ANTACID: MAGNESIUM AKA...
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MILK OF MAGNESIA
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ANTACID: ALUMINUM + MAGNESIUM AKA...
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MAALOX
MYLANTA GELUSEL DI-GEL |
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ANYACID: SODIUM BICARBONATE AKA...
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ALKA-SELTZER
BROMO-SELTZER |
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ANTACID: CALCIUM CARBONATE
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TUMS
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CLASS: SUCRALAFATE (CARAFATE)
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ULCER ADHERENT
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ADMINISTRATION REGIMEN: SUCRALAFATE (CARAFATE)
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EMPTY STOMACH
1-2H AC AND HS |
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CLASS: CIMETIDINE (TAGAMET)
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H2 RECEPTOR BLOCKER
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ACTION: H2
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INCREASES GASTRIC ACID SECRETION
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ACTION: CIMETIDINE (TAGAMET)
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INHIBITS GASTRIC ACID SECRETION
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RECOGNITION: H2 RECEPTOR BLOCKING AGENTS
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'DINE'S
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CLASS: OMEPRAZOLE (PRILOSEC)
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PROTON PUMP INHIBITORS
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MOA: PROTON PUMP INHIBITORS
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INHIBITS "PUMPING" ACTION OF GASTRIC ACID SECRETION
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DIET: BRAT
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BULK FORMING DIET FOR DIARRHEA
BANANAS, RICE, APPLES, TEA |
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CLASS: COLACE
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STOOL SOFTENER
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CLASS: VISTARIL, DRAMAMINE, ODANSETRON (ZOFRAN), KYTRIL
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ANTIEMETICS
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ELECTROLYTE IMBALANCE A/W ANTI-DIARRHEALS
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HYPOMAGNESIA
HYPOKALEMIA |
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STORAGE: NITRATES (NITROGLYCERINE)
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AMBER BOTTLE
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TYPES: AUTONOMIC DRUGS
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ADRENERGIC
ADRENERGIC BLOCKERS CHOLINERGIC CHOLINERGIC BLOCKERS |
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ADRENERGICS: SYNONOMOUS TERMS & EFFECTS ON ANS
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SYMPATHOMIMETICS
ALPHA-ADRENERGIC AGONISTS BETA-ADRENERGIC AGONISTS STIMULATE SNS |
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ANTIADRENERGICS: SYNONOMOUS TERMS & EFFECTS ON ANS
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SYMPATHOLYTICS
ALPHA-ADRENERGIC BLOCKERS BETA-ADRENERGIC BLOCKERS INHIBITS SNS |
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CHOLINERGICS: SYNONOMOUS TERMS & EFFECTS ON ANS
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PARASYMPATHOMIMETICS
CHOLINOMIMETIC STIMULATES PNS |
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ANTICHOLINERGICS: SYNONOMOUS TERMS & EFFECTS ON ANS
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PARASYMPATHLYTICS
CHOLINERGIC BLOCKERS INHIBITS PNS |
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EXAMPLES: ADRENERGICS
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EPI (ADRENALINE)
NE (LOVEPHED) DOPAMINE (INOTROPIN) ISOPROTENEROL (ISUPREL) |
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ADRENERGICS/ ANTI-ADRENERGICS: ALPHA, BETA-1, BETA-2
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ALPHA - ARMS AND LEGS
BETA (1 HEART) BETA (2 LUNGS) |
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CLASS: MINIPRESS & ITS EFFECTS
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ALPHA-ANTIADRENERGIC; VASODILATES ARMS AND LEGS
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EXAMPLES: BETA-ANTIADRENERGICS & ITS EFFECTS
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BETA-BLOCKERS = 'LOL'S
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CLASS: NEOSTIGMINE (PROSTIGMINE), TENSILON, MESTINON, ARICEPT
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CHOLINERGICS
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DEFINE MYASTHENIA GRAVIS
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CLIENT HAS DECREASED ACETYLCHOLINE RECEPTORS AND THEREFORE LESS STIMULUS FOR MUSCULAR CONTRACTION; THIS RESULTS IN MUSCULAR WEAKNESS
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CHOLINERGIC CRISIS
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CHOLINERGIC RESPONSE TO Nth DEGREE
MIMICS ACETYLCHOLINE |
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MYASTHENIA GRAVIS VERSUS CHOLINERGIC CRISIS
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PRESENTS THE SAME
ADMINISTER TENSILON RESOLVES? THEN MYASTHENIA GRAVIS WORSENS? THEN CHOLINERGIC CRISIS |
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ANTEDOTE: CHOLINERGIC CRISIS
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ANTICHOLINERGIC
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MOA: TENSILON
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INHIBITS DESTRUCTION OF ACETYLCHOLINE
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CLASS: ATROPINE, ROBINUL, BELLADONNA, BANTHINE, SCOPALAMINE, ARTANE, ATROVENT
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ANTI-CHOLINERGICS
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RECOGNITION: CHOLINERGICS VERSUS ANTI-CHOLINERGICS
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"WET" VERSUS "DRY"
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CHOLINERGICS: HR, BRONCHUS, PUPILS, GI, BS, SWEAT, UA, CNS
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DECREASED HR, VASODILATION
BRONCHOCONSTRICTION, INCREASED SECRETIONS, INCREASED SALIVATION CONSTRICTION, DECREASE IOP INCREASED MOTILITY, INCREASED SECRETIONS NO AFFECT INCREASED INCREASED NO AFFECT |
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ADRENERGICS: HR, BRONCHUS, PUPILS, GI, BS, SWEAT, UA, CNS
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INCREASED HR, PERIPHERAL VASOCONSTRICTION
BRONCHODILATOR DILATE DECREASED ACTIVITY INCREASED BS, INCREASED FA'S INCREASED NO AFFECT TENSION, ANXIETY |
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RECOGNITION: ADRENERGICS VERSUS ANTI-ADRENERGICS
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"WIRED" VERSUS "RELAXED, RESTORATIVE"
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