S17 N110A Exam 2

Front 1

What is acute/transient pain?

Back 1

Severe pain with a rapid onset and of short duration.

-Protective and has an identifiable cause

-Has a rapid onset

-Varies in intensity

-Is of short duration

-Generally disappears with healing

Front 2

What is addiction?

Back 2

A compulsive physiologic need for a habit-forming drug.

Front 3

What is analgesia?

Back 3

A decreased or absent sensation of pain.

Front 4

What is anaphylaxis?

Back 4

An exaggerated hypersensitivity reaction to a previously encountered antigen. The reaction may be localized or generalized.

Front 5

What is cutaneous stimulation?

Back 5

Stimulation of the skin.

Front 6

What is drug tolerance?

Back 6

A decreased physiological response after repeated administration of a drug or chemically related substance.

Front 7

What is effleurage?

Back 7

A type of massage stroke that glides without manipulating deep muscles, smooths and extends muscles, increases nutrient absorption, and improves lymphatic and venous circulation.

Massage upward and outward from vertebral column and back again. Circles.

Front 8

What is epidural analgesia?

Back 8

Delivery of an analgesic into the epidural space in pain control.

Front 9

What is guided imagery?

Back 9

Technique in which patient focuses on an image, becoming less aware of pain.

Front 10

What is massage?

Back 10

A form of cutaneous stimulation that involves the application of tough and movement to muscles, tendons, and ligaments.

Front 11

What are nonopioids?

Back 11

Analgesics that do not contain opioids.

Front 12

What are opioids?

Back 12

Pertaining to natural and synthetic chemicals that have opium-like effects although they are not derived from opium.

Front 13

What is pain intensity?

Back 13

The degree or extent of pain perceived by an individual.

Front 14

What is a pain rating scale?

Back 14

Graphic or numeric representations that allow patients to quantify their pain experience.

Front 15

What is a PCA?

Back 15

Patient controlled analgesia which is a technique that allows patients to self-administer small, continuous doses of IV or SQ opioids if they feel the need.

Front 16

What is petrissage?

Back 16

A massage technique in which the skin is gently lifted and squeezed.

Pinching.

Front 17

What is physical dependence?

Back 17

A physiological state in which abrupt cessation of a drug results in a withdrawal syndrome.

Front 18

What is splinting?

Back 18

Supporting the abdominal area to reduce pain caused by coughing or sneezing after surgery.

Front 19

What are the three types of pain?

Back 19

Acute, chronic/persistent, and cancer pain.

Front 20

What are the JC pain standards?

Back 20

-Recognize the right of patients to appropriate assessment and management of pain

-Assess pain in all patients

-Record the assessment in a way that facilitates regular reassessment and follow-up

-Educate providers/patients and families

-Establish policies that support appropriate prescription or ordering of pain medicines

-Include patient needs for symptom control in discharge planning

-Collect data to monitor effectiveness and appropriateness of pain management

Front 21

How would you determine pain in a non-verbal patient?

Back 21

-Attempt a self-report of pain using simple yes/no responses or vocalizations or a numeric rating scale.

-Explain why a self-report cannot be used.

-Search for the potential cause of pain by using physical examination techniques (e.g., palpation).

-Assume that pain is present after ruling out other causes (infection or constipation).

-Identify pathologic conditions or procedures that may cause pain.

-Observe patient behaviors (e.g., confusion, pacing, facial expressions, vocalizations, body movements such as guarding) that indicate pain. These vary based on patient's developmental level.

-Ask family members, parents, and caregivers for a proxy report of patient's pain.

-Attempt an analgesic trial if pathologic conditions or procedures that may induce pain are present.

Front 22

What is chronic/persistent pain?

Back 22

Pain that persists beyond the period of healing, ceases to serve a protective function, degrades patient function, and serves no adaptive purpose.

-Eventually becomes a disease in its own right

-Often lacks identified pathology

-Rarely has autonomic signs

-Does not provide a protective function

-Disrupts ADLs and sleep

-Degrades health and function of the individual

Front 23

What is cancer pain?

Back 23

Pain related to cancer that may be acute, chronic, or intermittent. It is usually related to tumor recurrences or treatment.

Front 24

How often should you assess an individual on opioids for pain?

Back 24

Every 4 hours for the first 24 hours.

Front 25

When a PCA pump is used, who should press the button?

Back 25

The patient should be the only person who presses the button.

Front 26

What can NAPs do for pain?

Back 26

They cannot assess for pain, but can provide selected non-pharmacologic strategies such as back rubs, heat, cold, or elevation as instructed by the nurse.

Front 27

What are common PCA drugs?

Back 27

Morphine sulfate, hydromorphone (Dilaudid), and fentanyl.

Front 28

What does opioid naïve mean?

Back 28

A person who has never taken any opioids for any reason or who have not taken opioids in the pas 5 weeks are more susceptible to effects of opioids.

Front 29

Which patients may be at risk of over sedation when using a PCA pump?

Back 29

Those with sleep apnea or obese patients with short, thick, necks.

Front 30

What is the most common type of PCA error?

Back 30

Incorrect programming. Other errors include failing to clamp or unclamp tubing, improperly loading syringe or cartridge, failing to monitor for side effects/overdose, and not responding to alarms.

Front 31

What is an opioid reversing agent?

Back 31

Naloxone (Narcan)

Front 32

How should a massage end?

Back 32

With long, stroking effleurage movements.

Front 33

In which direction should a massage go?

Back 33

From buttocks to shoulders.

Front 34

What is a CRBSI?

Back 34

Catheter-related bloodstream infection.

Front 35

What is a CVAD?

Back 35

Cardio vascular access device.

Front 36

What is a CLABSI?

Back 36

Central line-associated bloodstream infection.

Front 37

What is an EID?

Back 37

Electronic infusion device; Used to infuse intravenous (IV) fluid at a prescribed rate. There are two types: an infusion pump, which is designed to deliver a measured amount of fluid over a period of time; and an IV controller, which delivers fluid with the aid of gravity.

Front 38

What is an electrolyte?

Back 38

An element or compound that, when melted or dissolved in water or another solvent, dissociates into ions and is able to carry an electric current.

Front 39

What is an embolus?

Back 39

A foreign object, a quantity of air or gas, a bit of tissue or tumor, or a piece of thrombus that circulates in the bloodstream until it becomes lodged in a vessel.

Front 40

What is the exit site?

Back 40

The point at which a catheter leaves a body site.

Front 41

What is FVD?

Back 41

Fluid volume deficit; An alteration characterized by the loss of fluids and electrolytes in an isotonic fashion.

Front 42

What is FVE?

Back 42

Fluid volume excess;

An alteration characterized by the abnormal retention of fluids and electrolytes in an isotonic fashion.

Front 43

What is a heparin lock?

Back 43

An IV needle connected to a small "well" that allows for the intermittent injection of medication without the need for repeated venipuncture.

Front 44

What is infiltration?

Back 44

Presence of IV fluids within the subcutaneous space surrounding the venipuncture site.

Front 45

What is an infusion pump?

Back 45

A device designed to deliver a measured amount of fluid over a period of time.

Front 46

What is an isotonic solution?

Back 46

A solution with a total electrolyte content of approximately 310 mEq/L

Front 47

What is a ONC?

Back 47

Over-the-needle catheter; A type of angiocatheter. The needle used for peripheral intravenous access is encased in a catheter made of Teflon, plastic, or another flexible material. After the needle pierces the skin, the catheter is threaded into a vein, and the needle is withdrawn. The catheter remains in the vein for the instillation of fluid.

Front 48

What is percutaneous?

Back 48

Performed through the skin, such as a biopsy or the aspiration of fluid from a space below the skin using a needle, catheter, and syringe.

Front 49

What is a PICC?

Back 49

A peripherally inserted catheter that extends to the superior vena cava or right atrium.

Front 50

What is phlebitis?

Back 50

Inflammation of the vein.

Front 51

What is a smart pump?

Back 51

Infusion devices, referred to as a smart pumps by the Institute for Safe Medication Practices (ISMP), are commercially available infusion systems that perform a “test of reasonableness” to check that programming is within pre-established institutional limits before infusion can begin.

Front 52

What is a subcutaneous tunnel?

Back 52

A tunnel under the skin between the exit site of a catheter and the entrance into a body cavity (such as the epidural space) or vein.

Front 53

What is thrombosis?

Back 53

An abnormal vascular condition in which thrombus develops within a blood vessel of the body.

Front 54

What is venipuncture?

Back 54

Technique in which a vein is punctured transcutaneously by a sharp rigid stylet (such as a butterfly needle), a cannula (such as an angiocatheter that contains a flexible plastic catheter), or a needle attached to a syringe.

Front 55

What is the goal of IV therapy?

Back 55

To maintain or prevent fluid and electrolyte imbalances, administer continuous or intermittent solutions or medications, replenish blood volume, and assist in pain management.

Front 56

What are hypotonic solutions used for?

Back 56

Used to hydrate cells.

Front 57

What are hypertonic solutions used for?

Back 57

Used to increase intercellular fluid, or pull fluids from cells.

Front 58

When is a central line used?

Back 58

When fluid to be administered via IV has a pH less than 5.0 or greater than 9.0 and osmolarity greater than 600 mOsm/L

Front 59

Which type of PVAD would you use for a patient needing continuous infusion for 1 to 4 weeks?

Back 59

A midline peripheral catheter

Front 60

What catheter size would you use for a trauma, surgery, or blood transfusion?

Back 60

14, 16, or 18.

Front 61

What size catheter would you use for children or elderly patients?

Back 61

22

Front 62

What size catheter would you use for someone with fragile veins?

Back 62

24

Front 63

How often should gauze dressing that cover a catheter site be changed?

Back 63

Every 48 hours.

Front 64

How long to IV tubing sets remain sterile for?

Back 64

96 hours.

Front 65

What are signs of FVD?

Back 65

-Decreased urine output

-Dry mucous membranes

-Decreased cap refill

-Disparity in central and peripheral pulse

-Tachycardia

-Hypotension

-Shock

Front 66

What are signs of FVE?

Back 66

-Crackles in lungs

-Shortness of breath

-Edema

Front 67

What are indicators of IV infiltration?

Back 67

-Slow infusion

-Insertion site is cool to touch

-Insertion site is pale

-Insertion site is painful when touched

Front 68

When should IV fluids be changed?

Back 68

Before 24 hours.

Front 69

When should primary and secondary continuous infusion sites be changed?

Back 69

-Every 96 hours for fluids other than lipid, blood, or blood products.

Front 70

When should primary intermittent infusion sites be changed?

Back 70

-Every 24 hours because of increased risk of infection with repeatedly disconnecting and reconnection the administration set.

Front 71

What is a systematic IV complication?

Back 71

Complications that occur within the vascular system and are usually remote to the infusion site.

-Septicemia

-Circulatory overload

-Embolism

Front 72

What is a local IV complication?

Back 72

Complications resulting from trauma to the inner layer of the vein as a direct result of many factors such as poor insertion technique, inappropriate size of short peripheral device, pH of solution not within recommended ranges, and poor assessment and incorrect technique for short peripheral dressing changes.

Front 73

What is the most common site of colonization and infection for IV catheters?

Back 73

The skin insertion site.

Front 74

What can be done to prevent colonization and infection with IV catheters?

Back 74

Securely apply catheter dressing and change dressings when wet, soiled, or loosened.

Front 75

When removing an IV and the patient is not taking anticoagulants, how long should you apply pressure for?

Back 75

A minimum of 30 seconds.

Front 76

When removing an IV and the patient is taking anticoagulants, how long should you apply pressure for?

Back 76

5 to 10 minutes.

Front 77

How long can a PICC line be in place?

Back 77

As long as it functions properly with no evidence of IV related complications.

Front 78

Which types of CVADs are considered permanent?

Back 78

Hickman, Broviac, and Groshong external tunneled devices.

Front 79

What is bacteremia?

Back 79

The presence of bacteria in the blood.

Front 80

What are amino acids?

Back 80

An organic compound composed of one or more basic amino groups and one or more carboxyl groups. Amino acids are the building blocks that construct proteins and the end products of protein digestion.

Front 81

What is parenteral nutrition?

Back 81

The administration of nutrition into the vascular system. It is intended to meet the nutritional needs of patients until their GI function has improved enough to allow adequate intake using the oral or tube feeding route.

Front 82

What are risks of PN?

Back 82

-Risk of sludge in gallbladder

-Liver disease

-Severe GI disease

Front 83

How is a PN solution produced?

Back 83

Using sterile technique in a laminar airflow hood in a pharmacy to reduce the risk of microbial and pyrogen contamination.

Front 84

What is in a PN solution?

Back 84

Amino acids, glucose, and lipid as energy sources, with the addition of electrolytes, minerals, trace elements, vitamins, and water.

Front 85

What is the Valsalva maneuver used for?

Back 85

To prevent air from entering a line.

Front 86

When using PN therapy, how often should blood sugars be checked?

Back 86

Every 6 hours for the first 48 hours, then checked daily.

Front 87

What is the ideal method for PN?

Back 87

Central venous catheter which allows for a higher concentration of nutrients.

Front 88

How should medications be passed on someone with a central line used for PN?

Back 88

Use an alternative IV line and do not obtain blood samples or CVP readings through the PN port.

Front 89

Should PN infusion be interrupted?

Back 89

No, never.

Front 90

When should CPN tubing be changed?

Back 90

Every 24 hours or immediately if it become contaminated or soiled.

Front 91

How often should you check on a PN patient?

Back 91

-Check flow rate every hour

-Monitor I/O every 8 hours

-Check BS every 6 hours