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69 Cards in this Set
- Front
- Back
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what veins do you typically look for? |
cephalic, basilic, and accessory cephalic |
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Why do you avoid palmar side of wrist? |
radial nerve |
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what kind of people have veins that roll? |
people with lower subcutaneous fat levels |
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What might happen with butterfly needle? |
the flashback may be slower |
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what do you call it when you have chemicals or medications infiltrating the body tissue? |
extravasation |
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most common sites for venipuncture |
antecubital arm, back of hand
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Less common sites |
lower arm, wrist, top of feet |
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tourniquet applied where? |
3-4 inches above site |
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bevel of tip up or down? |
up |
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collapsing veins |
pull back on syringe plunger slowly to avoid suction |
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angle of needle |
the needle should form a 15-30 degree angle with the surface of the arm |
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why do air bubbles are form in a syringe? |
due to the dead space in the needle hub |
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when will you have more bubbles, size |
the smaller the needle or gauge |
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withdrawing fluid from vial slowly |
decreases amount bubbles you will encounter |
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one way to get bubbles out |
inject medication back into the vial then extract a second time for desired amount (this replaces air in the dead space) |
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its good to remove air bubbles when |
when the needle is still in the vial so there are no accidental sticks |
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take out needle from vial when |
when it is turn upright so you don't leak mediciaton |
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subjective information |
what the patient tells you |
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objective information |
what you see, hear, smell, feel, or read on patient's chart |
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Pain assessment format APQRSTU |
A- associated symptoms P- precipitation/prodromal/provocative/pallative Q- quality vs. quanitity R- region or radiation S- severity scale T- timing U- understanding patients perception of pain |
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P- precipitation |
what brings on the pain?
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P- prodromal |
what was the patient doing when they noticed the pain |
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Provocative |
what makes the pain worse
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Pallitive |
what makes the pain better |
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qualitiy or quantitiy |
how does it feel? stabbing, aching, burning? how intense? |
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severity scale |
1-10 |
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pulses are felt with how many fingers |
3
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lower edge of cuff should be how many inches above the antecubital fossa? |
one inch |
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palpatory method |
inflate raptly up to 70 and then slowly in 10 increments, note the pressure at which the pulse disappears, this provides preliminary approximation of the systolic bp to ensure an adequate level of inflation when the ausculatory method is used |
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inflate cuff approximately ___ above the palpated systolic pressure |
30 mm Hg |
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how long until brain death can occur without 02 |
2-6 minutes |
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room is what % oxygen |
21%
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exhaled air is what % oxygen |
16%
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humans use what percent of oxygen from the atmosphere to sustain life |
5% |
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oxygen is measured as |
oxygen tension or partial tension and expressed as P02 |
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carbon dioxide is expressed as |
PC02, CD enters RBCS and is carried in combination with Hgb, which helps remove it from the body |
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FI02 |
flow intake, or fraction of inspired oxygen |
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arterial blood gas |
drawn directly from artery, measures sa02 |
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pulse ox |
measures sp02 continuous monitoring of hemoglobin oxygen saturation |
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Normal ABG's PH |
7.35 - 7.45 |
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PaCo2 |
35-45 |
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Pa02 |
80-100 |
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HC03 (bicarbonate) |
18-25 |
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Hgb (hemoglobin) |
12-16 |
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Sa02 (oxygen saturation) |
95-100% |
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Acidosis |
ph below normal in arterial blood |
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alkalosis |
PH above normal in the arterial blood |
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hypercapnea |
carbon dioxide above normal in arterial blood |
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hypocapnea |
carbon dioxide below normal in arterial blood |
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hypoxemia |
oxygen below normal in arterial blood |
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hypoxia |
decreased oxygen at tissue and cellular level |
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primary reasons for oxygen therapy |
hypoxemia
hypoxia
air hunger/respiratory distress
sickle cell anemia
cardiac and lung distrubances
COPD - chronic bronchitis and chronic emphysema
possible allergic reactions to contrast agent |
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early symptoms of hypoxia and respiratory distress |
sleepiness/yawning restlessness and anxiety confusion or change in behavior dyspnea use of accessory muscles intercostal or neck m. visual disturbances and headache tachypnea tachycardia |
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late symptoms of hypoxia and respiratory distress |
shock: hypotension, decreased bp, tachycardia, cold, clammy bradycardia metabolic acidosis due to lactic acid metabolism diaphoresis (sweating) pallor: pale skin that is diff than baseline cyanosis |
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examples when oxygen should be used with caution |
copd- chronic emphysema and chronic bronchitis tracheobronchitis or parynchymal lung injury |
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nasal cannula delivers |
1-6 liters per minute |
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simple oxygen mask |
require flow rates higher than 5 liters/minute to prevent accumulation of carbon dioxide, delivers up to 35-60% oxygen |
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Venturi mask |
air enhancement mask, delivers 24-50% oxygen good for COPD because precise delivery |
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non-rebreather mask and partial rebreather masks |
prevent exhaled air from coming back in high flow of 6 L or more |
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aerosol mask |
used when high concentrations of oxygen and humidication are required |
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when to use humidificaiton |
if more than 2 L per minute, long term, dry or irritated airways |
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ventilators |
deliver 100% oxygen, used for artificial airways (endotracheal tubes) |
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no smoking within |
10-20 feet of an oxygen tank |
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green vs. blue can |
green oxygen blue nitrous oxide |
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portable tanks are called |
E-cylinders |
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a full tank = |
2000 pounds of pressure per square inch |
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when to change tank before transport |
if less than 500 pounds per square inch of pressure |
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wall oxygen pounds |
60-80 pounds of pressure per square inch |
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never let oil touch |
coupling |
