blood
IV meds & CL's
Enteral Tubes
Airway management
Misc
100
When is HLA matching required/used?
transplant matching
100
Identify 3 advantages of Central Lines
Allows for rapid infusion of large volumes Can administer irritating, vesicant and hypertonic medications safely Preserves peripheral veins Can be used to draw blood Eliminates IV pokes Used for longer term IV access, administration of medications, TPN, recurrent IV requirements
100
identify three possible functions of an ng tube
Nutrition medications gastric decompression gastric lavage
100
When is a Yankauer Suction used?
drooling/impaired swallowing suction - oral suction
100
Identify 3 advantages of subcutaneous infusion
Can be used if poor venous access Can be used if unable to tolerate oral meds Allows pt to be ambulatory Onset of action about 20 min Continuous admin = better pain control Costs and risks far smaller than IV More efficient medication action/use ex: insulin
200
What might you be seeing if you see this progression of symptoms during blood transfusion? Severe kidney, back and chest pain, fever, tachycardia, infusion vein pain, headache, nausea, dyspnea, bronchospasm, hypotension, vascular collapse, DIC, death
Acute Hemolytic Transfusion Reaction
200
Identify 4 types of central lines
Non tunneled percutaneous central venous catheters Tunneled central venous catheters Peripherally inserted central catheters (PICC) Implanted Subcutaneous ports
200
What is the greatest risk factor associated with NG tubes?
Aspiration
200
When is the use of an oropharyngeal airway appropriate?
Unconscious - post op or "passed out" Used to keep upper airway open when it may become obstructed by secretions or tongue Stimulates gag reflex, so only for those with altered LOC
200
two things to do if you are seeing swelling or fluid buildup at the insertion site of a subcutaneous infusion
Rubbing site will aid absorption Assess rate of flow
300
What should you do if you identify a transfusion reaction is taking place?
SPIN
300
what is the function of a Dacron cuff? (2 functions)
secures in place and prevents infection – scar tissue grows around dacron cuff
300
What is the difference between the Hanson and the NEX system of measurement?
NEX method – Nose, ear, xyphoid process Hanson Method – Measure 50 cm then do NEX and choose midpoint
300
What equipment should always be available for a tracheostomy patient?
Another trach tube of the same size or one size smaller than the inserted one Tracheostomy Dilator suction
300
3 advantages of epidural anesthesia
Excellent analgesia Retains LOC Earlier recovery from analgesia Decreased incidence of pulmonary complications and venous thrombosis Smaller doses required than by other routes because it is direct to spinal roots
400
What is another name for the test called "type and screen"?
group and hold
400
What should you do if you suspect air embolism for your patient? (3 things)
clamp catheter turn on left side with head down so air can enter rt atrium and disperse through pulmonary artery O2 call medical emergency code
400
What is the purpose of checking for residuals?
ensure food is being digested
400
Identify three signs that your trach patient requires suctioning
Dyspnea Bubbling Rattling adventitious breath sounds Palor Restlessness Tachycardia Decrease SpO2 look of panic
400
3 things that need to be monitored with a patient receiving epidural analgesia
Respiratory rate Sedation score Vital signs Pain score Vomiting Motor block Dermatomes Insertion site
500
What is the FIRST tube/or syringe of blood withdrawn from a central line when blood work is required?
the discard
500
what does each letter of ASASH stand for and why do you do each step?
Aspirate: to assess patency/placement Salinate - to wash out the aspirated blood/heparin/clear the line Administer - administer the medication Salinate - clear the line Heparinize - to prevent clotting
500
What is the advantage of a salem sump tube for decompression?
double lumen – one is suction/drainage lumen, the other is an air vent to prevent sucking gastric mucosa into tube
500
What are the three components of a chest tube drainage system?
Air seal or air leak chamber Drainage Collection Chamber Suction Control Chamber
500
maximum infusion volume with a subcutaneous line at one time
2mL
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