NUR 4512 > Final Exam > Flashcards

Final Exam Flashcards

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1
Q

What are the steps to a central line dressing change?

A
  1. hand hygiene & PPE (if indicated)
  2. put patient into comfortable position
  3. apply mask for self & patient
  4. put on clean globes & assess site through old dressing
  5. perform hand hygiene again & put on sterile gloves
  6. apply new antimicrobial dressing
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2
Q

What do you document after changing a central line dressing?

A
  • time
  • date
  • location of site
  • assessment of site
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3
Q

How often are central line dressings changed?

A

once a week

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4
Q

What’s used to flush a central line?

A

normal saline (NS) & heparin

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5
Q

What lines can labs be drawn from?

A

Mid lines & central lines
- NO peripheral IVs or PICC lines

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6
Q

Use the _______ line first when drawing blood from a central line and the _______ line when administering meds w/ multiple lumen

A
  • distal
  • proximal
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7
Q

When removing a central line, the patient should be laying ________

A

flat

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8
Q

When are vital signs taken for a blood transfusion?

A
  • before administering blood
  • 15 minutes after
  • one hour after
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9
Q

Blood can run for _____ hours

A

4 hours

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10
Q

What are the steps for a blood transfusion?

A
  1. cover filter w/ NS
  2. clamp NS
  3. unclamp blood & roller clamp
  4. connect patient to blood
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11
Q

What interventions are given when you notice a patient having a reaction during a blood transfusion?

A
  • STOP transfusion
  • get new tubing
  • run NS
  • obtain labs (test blood)
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12
Q

S&S of blood transfusion reaction

A
  • fever/chills
  • flank pain
  • hypotension
  • tachycardia
  • feeling of impending doom
  • hives
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13
Q

What diuretic should you monitor electrolytes with?

A

Furosemide (Lasix)

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14
Q

What diuretic is potassium sparing?

A

Spironolactone (Aldactone)

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15
Q

MOA of antiplatelets

A
  • inhibit platelet aggregation
  • prevents cells sticking together & forming clots
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16
Q

Examples of calcium channel blocker (CCB) meds

A
  • Verapamil
  • Diltiazem
  • Amlodipine
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17
Q

Examples of anticoagulant & antiplatelet meds

A
  • ANTICOAG = Warfarin (Coumadin), Eliquis, Heparin
  • ANTIPLATE = Aspirin, Plavix, Brilinta
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18
Q

Examples of angiotensin II receptor blockers (ARBs) – sartans

A
  • Losartan (Cozaar)
  • Valsartan (Diovan)
  • Olmesartan (Benicar)
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19
Q

Examples of ACE inhibitor meds – prils

A
  • Quinapril
  • Lisinopril
  • Ramipril
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20
Q

What lab value is monitored for Warfarin?

A

INR – tells you how long it takes the body to clot

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21
Q

What is the reversal agent for Warfarin?

A

Vitamin K

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22
Q

What is the reversal agent for Heparin?

A

Protamine sulfate

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23
Q

What lab is monitored for Heparin?

A

PTT (partial thromboplastin time) – measures time it takes for a clot to form

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24
Q

What is the reversal agent for opioids?

A

Naloxone (Narcan)

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25
What is the reversal agent for benzodiazepines?
Flumazenil (Romazicon)
26
What meds are given for V-tach, V-fib, and asystole?
- Amiodarone - Epinephrine
27
What med can be given for bradycardia?
Atropine
28
Tx for increased ICP
- Mannitol - craniotomy
29
What is a normal GCS indicating no head injury?
15
30
What GCS score indicates MTN needs to be contacted?
< 8
31
What does GCS measure?
- Eye opening - Verbal response - Motor response
32
What does CPP stand for & what is the normal range?
- Cerebral perfusion pressure - 60 - 100
33
What is the formular for finding the CPP?
CPP = MAP - ICP
34
What does MAP stand for?
Mean arterial pressure
35
What's considered a normal MAP?
60-65 and higher
36
What does ICP stand for & what is the normal range?
- Intracranial pressure - 5 - 15
37
What is the formula for finding the MAP?
MAP = (DBP x 2) + SBP/3
38
What is the normal PR interval?
0.12 - 0.20 seconds
39
What does the PR interval measure?
Time from start of atrial depolarization to start of ventricular depolarization
40
What is a normal QRS interval?
< 0.12 seconds
41
What does the QRS complex represent?
ventricular depolarization
42
What does an elevation of ST indicate?
- Myocardial infarction (MI) - STEMI (ST elevated MI)
43
What is a normal QT interval?
< 0.43 0.35 - 0.45
44
An issue with the P wave indicates an issue with the _______
atria
45
An issue with the QRS complex or T wave indicates an issue with the ___________
ventricle
46
What is the difference between a PVC and a PAC?
Ventricular vs. Atrial
47
If there is a pacer mark before the P wave, this means the _______ is being paced
atria
48
If there is a pacer mark before the QRS, this means the __________ is being paced
ventricles - the complexes will also be inverted (upside down)
49
What would you do if a chest tube is pulled out?
Put on sterile water and a petroleum gauze dressing
50
What do you do if the atria falls for a chest tube?
Get a new one
51
T/F: the atrium connected to a chest tube going into the pleural space should be hung at the end of the bed.
False -->always down (gravity) and on a flat surface (floor)
52
What is the first intervention if the ventilator is giving you a high pressure alarm?
Suctioning
53
What could be causing a high pressure alarm on vented patients?
- blocked airway - coughing - biting the tube - tension pneumothorax
54
What should you check for if the ventilator has a low pressure alarm going off?
- check for chest rise - check for an air leak or disconnected tubing
55
What keeps the alveoli open on the ventilator?
PEEP
56
Open suctioning is _________ when closed suction is _________
- sterile - aseptic
57
What would you do before suctioning or changing a trach?
hyperventilate
58
Indications for NG tubes
- intake requirements - decompress the stomach - aspirate gastric contents
59
How should you position a patient during an NG tube insertion?
- sitting up (High Fowler's) - tuck the chin in
60
What would you instruct the patient to do while inserting an NG tube?
swallow
61
What does coughing during NG tube insertion indicate?
You are in the lungs -- immediately remove while patient holds breath
62
What does gagging indicate during an NG tube insertion?
This is a normal finding
NUR 4512
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