PPE/ Infection
What is the order of Donning PPE
Hand Hygiene
Gown
Mask / N95
Goggles / Face Shield
Gloves
high pitched harsh crowing sign that means there is an upper airway obstruction
stridor
emergency
intubation tools nearby
What does PQRST mean?
P: provoking, palliating
Q: quality
R: region / radiation
S: severity
T: timing / duration
Normal BUN, Creatinine, UO
what's the most reliable indicator of
fluid status?
renal function?
hydration?
BUN: 8-22 (hydration)
Creatinine: 0.8-1.2 (renal function)
UO: 30 ml/hr or 0.5ml/kg/hr
(fluid status)
Nursing Proccess
ADPIE:
Assessment, Diagnosis, Planning, Implementation, Evaluation
What is the order of Doffing PPE
Gloves
Goggles / Face Shield
Gown
Mask or N95
Hand Hygiene
Landmarks for auscultating heart sounds (region on body and name)
Apical - 2nd right
Pulmonic - 2nd left sternal border
Erb's Point - 3rd left sternal border
Tricuspid - 4th right sternal border
Mitral - 5th left intercostal midclavicular line
3 categories of Glasgow Coma Scale
eye opening
verbal response
motor response
8 = intubate
Potassium levels - risks?
3.5-5.0
cardiac dysrhythmias
BP cuff too tight? BP cuff too loose?
tight = false elevated BP
loose = false low BP
must cover 40% of upper arm circumference and encircle 80% of the arm
What precautions? Influenza, Pertussis, Meningitis, Mumps
What PPE required?
Droplet
Surgical Mask + Gown + Gloves
what pattern do you use to auscultate lung sounds?
zig zag to compare right and left
Most accurate core temperature measurement?
Rectal Temp
used in infants < 3 months unless contraindicated
Normal pH?
Normal PaCO2?
Normal HCO3?
7.35-7.45
35-45
22-26
You're assessing what cranial nerve when you do the Weber, Rinne, Romberg tests?
CN8: Vestibulocochlear
What type of precautions require a closed door and why?
Airborne
Negative Pressure room
(TB, Measles, Varicella)
N95 required
what lung sound would be most often heard when there is:
fluid in alveoli?
narrowed or partially blocked airway in bronchial tubes?
Crackles = fluid (HF, pneumonia)
Wheezes = asthma, COPD
Normal HR, RR, BP for a neonate (0-28 days old)
HR: 100-160 (180 if crying)
RR: 30-60
BP: 90/60 to lowest 60/20
Values + Symptoms of Hypocalcemia?
Values + Symptoms of Hyponatremia
8.5-10.5 (chvostek, trousseau)
135-145 (seizure, neuro changes)
Explain unstageable injuries?
Tissue damage obscured by
slough: soft, moist, and yellow, white
eschar: thick, dry, hard, and black or dark brown
Scabies and SRV require what precautions?
Contact
Cdiff / MRSA
soap and water for cdiff
What is happening during the LUB / DUB of a heartbreat?
Lub - AV valves shut (systole starts)
tricuspid, mitral
Dub - Semilunar Valves shut (diastole)
aortic, pulmonic
6 P's of PAD, or Compartment Syndrome?
Pain
Pallor
Pulselessness
Paresthesia
Paralysis
Poikilothermia
Target range for aPTT on heparin?
Target range for INR on warfarin?
Antidotes for each?
60-80 (dan says 60-90)
Protamine Sulfate
2-3 for afib, dvt; 2.5-3.5 for mechanical heart valves
Vitamin K
Reasons someone would be in these positions?
High Fowler's, Supine, Trendelenburg, Sims, Left Lateral Recumbent>
HF: dyspnea, respiratory distress, eating
Supine: SCI, post catheterization, low BP
Trendelenburg: air embolism, cord prolapse
Sims: enema administration
Left Lateral: pregnancy relieves cord compression on inferior vena cava