Fundamentals 3

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  1. "Pushing" force.
    hyrostatic pressure
  2. An antibody that causes a clumping of specific antigens.
  3. Emptying the bladder without the sensation of the need to void.
    Reflex incontinence
  4. Amt of urine remaining in the bladder immediately after voiding.
    postvoid residual
  5. Catheter used for long-term continuous drainage.
    suprapubic catheter
  6. A cutaneous urinary diversion (used for pts with obstructions or tumors in urinary tract).
    Ileal conduit
  7. A condition caused by direct manipulation of bowel during abdominal surgery - a temporary stoppage of peristalsis normally lasting 24-48 hrs.
    paralytic ileus
  8. The part of the ostomy that is attached to the skin.
  9. Allows liquid fecal content from the ileum of the small intestine to be eliminated through a stoma.
  10. Kidneys normally filter ____ L plasma, and excrete _____ L urine.
    • 170
    • 1.5
  11. Cardiovascular system pumps and carries _____ and _____ in the body.
    • nutrients 
    • water
  12. _______ help body conserve Na+, save CL- and H2O, and excrete K+
    Adrenal glands
  13. Thyroid gland increases ______ and ______.
    • BF
    • renal circulation
  14. A deficit in carbonic acid in ECF.
    Respiratory alkalosis
  15. Excess in carbonic acid in ECF.
    Respiratory Acidosis
  16. Excess of bicarb in ECF.
    Metabolic Alkalosis.
  17. Deficit of bicarb in ECF.
    Metabolic Acidosis.
  18. Decreased pH, increased PCO2.
    Respiratory Acidosis.
  19. Increased pH, decreased PCO2.
    Respiratory Alkalosis
  20. Increased pH, increased HCO3.
    Metabolic Alkalosis
  21. Decreased pH, decreased HCO3.
    Metabolic Acidosis
  22. "pulling force" of fluid by use of a protein.
    Colloid osmotic pressure
  23. Hypomagnesemia may lead to?
    • heart block
    • change in mental status
    • hyperactive DTRs
    • respiratory paralysis
  24. Best indication of pt's fluid status.
    daily wt
  25. When is an over-the-needle catheter (type of peripheral vascular catheter IV) NOT used?
    • vesicant (blister agent) chemotherapy
    • irritant drugs
    • TPN
  26. How often should a peripheral venous IV site be rotated?
    • 72-96 hrs for adult
    • can remain in place for child
  27. Midline peripheral catheters are not used to infuse what?
    • vesicants
    • hyperosmolar solns
    • irritating solns
  28. How long should a particular insertion site be kept in place for a midline peripheral catheter?
    2-6 weeks
  29. Type of IV used in home for IV therapy, acute care settings, and long-term IV therapy.
    PICC (peripherally inserted central catheters)
  30. Indications for PICCs.
    • antibiotics for 2-6 wks
    • TPN
    • chemotherapy
    • continuous narcotic infusions
    • vesicants
    • blood components
    • long-term rehydration
  31. Type of IV with less risk of complications (such as infection and peumothorax).
  32. All ______ require radiographic confirmatio of position.
  33. Type of IV mainly used in critical care and emergencies.
    nontunneled percutaneous central venous catheter
  34. Type of CVAD with a high risk for complications (account for most catheter-related bloodstream infections).
    nontunneled percutaneous central venous catheter
  35. ________ is a potential complication when the catheter is placed in the subclavian vein.
    • pneumothorax
    • (like with a nontunneled percutaneous central venous catheter)
  36. Two types of CVADs intended for long-term use.
    • tunneled percutaneous central venous catheter
    • implanted port
  37. Universal recipients.
    AB blood type
  38. Universal donors.
    Blood type O
  39. The desire to void usually occurs when the bladders fills to about ______ mL in an adult.
  40. Type of incontinence that appears suddenly alnd lasts for 6 months or less.
  41. Type of incontinence that occurs ehwn there is an involuntary loss of urine related to increase in intra-abdominal pressure (commonly occurs during coughing, sneezing, laughing, etc).
  42. Type of incontinence that is the involuntary loss of urine that occurs soon after feeling an urgent need to void.
  43. Type of incontinence that indicates that there is urine loss with features of two or more types of incontinence.
  44. Type of incontinence that is the involuntary loss of urine associated with overdistention and overflow of the bladder.
  45. Type of incontinence in which urine loss is caused by the inability to reach the toilet because of environmental barriers, physical limitations, loss of memory, or disorientation.
  46. Scanty or greatly diminished amt of urine in a given time; 24-hr urine is less than 400 mL
  47. 24-hr UOP is less than 50 mL
    • Anuria, aka:
    • complete kidney shutdown or
    • kidney failure
  48. Proteinuria is indicative of ______.
    kidney disease
  49. Urine appears cloudy (pus in urine).
  50. Normal production rate of urine in adult kidneys.
  51. Repeated inability to control urination.
  52. Dehydration = _____ urine specific gravity.
  53. Increased UOP (fluid overload) = _____ specific gravity.
  54. Color of urine with use of diuretics.
    pale yellow
  55. Color of urine with use of anticoagulants.
  56. Color of urine with use of antidepressants.
    green or blue-green
  57. Color of urine with use of Levodopa.
    brown or black
  58. Normal pH of urine.
  59. Direct visual exam of bladder, uretral orifices, and urethra.
  60. Abuse of _____ such as ____ and _____ cause increased concerns with voiding.
    • analgesics;
    • aspirin & ibuprofen (NSAIDs)
  61. Inability to void even though the kidneys are producint urine that enters thge bladder.
  62. _____ or ______ is is ECF and composes 5% of total body fluid.
    • Intravascular fluid; 
    • PLASMA
  63. Normal HCO3 values.
  64. What is needed to ensure proper placement for any central venous access device?
    chest radiograph
  65. Where are nontunneled percutaneous CVADs placed?
    subclavian or internal jugular
  66. Primary controller of body's carbonic acid supply.
  67. Breathing slowly would be advised in which situation?
    • a pt with respiratory alkalosis
    • -it will reverse carbonic acid deficit & increase CO2
  68. Primary organ of bowel elimination.
    lg intestine
  69. Increase in frequency and a change in consistency of stools; passage of more than THREE loose stools per day. (infant)
  70. Meds that produce pink to red to black stool.
    • aspirin 
    • anticoagulants
  71. Meds that produce black stool.
  72. Meds that produce white discoloration or speckiling in stool.
  73. Meds that produce green-gray stool.
  74. To prevent constipation, encourage ____ g of fiber per day.
  75. Max amt of fluid used for cleansing enema.
  76. Usual amount of solution administered with a retention enema for an adult.
  77. ____ and _____ mixture helps expel flatus.
    milk & molasses
  78. Stoma size with an ileostomy usually stabilizes within  ____ to _____ weeks.
  79. ______ lubricate stool.
  80. _______ soften the stool.
  81. ______ promote peristalsis by irritating the intestinal mucosa or stimulating nerve endings in the intestinal wall.
  82. _______ laxatives act by causing stool to absorb water and swell.
  83. What is a barium enema?
    a radiographic exam of lg intestine
  84. Most common cause of chronic constipation.
    habitual laxative use
  85. Moderate sedation/analgesia is also called? What is it used for?
    • conscious or procedural sedation
    • used for short-term & minimally invasive procedures.
  86. The pt maintains cardiorespiratory fxn and can respond to verbal commands while the IV admin of sedatives & analgesics raise pain threshold & produce altered mood with some degree of amnesia.
    moderate sedation/analgesia AKA conscious or procedural sedation
  87. Surgery that is performed within 24-48 hrs.
    Urgent (kidney stone, ulcer erosion)
  88. Anesthesia that blocks the pain stimulus at the cortex; a drug-induced depression of CNS.
    General Anesthesia
  89. Anesthesia that produces a state of analgesia, amnesia, unconsciousness with loss of reflexes & muscle tone.
    General Anesthesia
  90. Anesthesia that blocks the pain at the origin, afferent neuron or spinal cord.
    Regional Anesthesia
  91. Anesthesia that produces loss of painful sensation in only ONE region of body & does NOT result in unconsciousness.
    Regional Anesthesia
  92. Anesthesia where the pt retains CV fxns & can respond to verbal commands with IV sedation; analgesia & amnesia.
    Conscious Sedation
  93. 3-4 of these conditions must be met for informed consent.
    • 1.Adequate disclosure
    • 2. Sufficient comprehension
    • 3. Voluntary consent
    • 4. Competence (assumed)
  94. Who is responsible for securing the informed consent?
    Physician.  NOT nurse.
  95. Pts with a large habitual intake of _______ require larger doses of anesthetic againts & postoperative analgesics, increasing risk for drug-related complications. (p.827)
  96. Pts who have ____ or _____ incisions are especially prone to shallow breathing b/c of incisional pain with deeper respirations.
    • thoracic
    • high abdominal
  97. If a pt shows a Hgb of ______ and hct of _____, blood or blood component therapy may be given preoperatively to maintain volume and increase O2 of tissues during surgery.
    • less than 10 g/L
    • less than 33%
  98. ______ meds may react with radiologic iodinized contrast dyes & cause ARF.
    oral antidiabetic
  99. Abrubt w/d of ______ may cause cardiovascular collapse.
    adrenal steroids
  100. Antibiotics in _____ group can cause respiratory paralysis when combined with certain muscle relaxants.
  101. The most common PACU emergency.
    Respiratory obstruction
  102. How to assess for respiratory obstructin in PACU.
    • ineffective resp fxn
    • observe for wheezing or crowing sounds with resp effort
  103. Interventions used in PACU to maintain patent airway and tissue oxygenation.
    • positioning
    • humidified O2
    • deep breathing
    • suctioning
  104. An incomplete expansion or collapse of alveoli with retained mucus, involving a portion of lung and resulting in poor gas exchange.
  105. Inflammation of alveoli as a result of an infectious process or presence of foreign material.
  106. Why is food and fluid restricted before surgery?
    to ensure that the stomach contains a minimal amt of gastric secretions which reduces risk of aspiration.
  107. What position should pt be placed in upon return from PACU.
    • semi- or high Fowler's or 
    • side-lying
  108. Three components of universal protocol.
    • preoperative verification
    • marking operative site
    • final verification just prior to start of procedure
  109. Bowel sounds with intestinal obstruction.
    hyperactive, high-pitched tinkling sounds
  110. Extreme drowsiness but will respond to stimuli.
  111. Can be aroused by extreme or repeated stimuli.
  112. With the visually impaired, assist them with ambulation by walking where?
    slightly ahead of the person
  113. When pt returns from PACU, what position should you place them in?
    semi- or high Fowler's or side-lying.
  114. When assessing bladder volume using an ultrasound bladder scanner,  place the gel midline on pt's abdomen, about ______ above the _______.
    • 1" to 1 1/2" 
    • symphysis pubis
  115. Ensure that the bedpan is in proper posn and pt's buttocks are resting on the ______ of the regular bedpan or the ______ of the fracture bedpan.
    • rounded shelf;
    • shallow rim
  116. Advance catheter (female) until there is a RETURN OF URINE.  Then what?
    Once urine drains, advance catheter another 2" to 3".

    DO NOT FORCE CATHETER THRU URETHRA TO BLADDER. (rotate gently if resistance is met)
  117. When performing intermittent closed catheter irrigation, cleanse the access port with ______.
    antimicrobial swab
  118. When administering a continous closed bladder irrigation, cleanse the irrigation port on the catheter with _______ and use ______.
    • an alcohol swab
    • aseptic technique
  119. A pt has a fecal impaction. With an oil-retention enema, what should you instruct the pt to do?
    retain the enema for at least 30 min
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Fundamentals 3
2014-04-07 20:32:02
Fundamentals 3
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