Oxygenation
Use during waking hours 5-10 times an hour
Reduce the risk of pneumonia
What is Incentive Spirometer
Shear
What is a tear between the subcutaneous and the muscles.
Drainage in order of wound healing
Sanguineous
Serosanguinous
Serous
The area around the wound
What is Peri-wound
What is the size of nasopharyngeal for adults?
What is 12-16
Used for patients with COPD; delivers EXACT % of oxygen
What is Venturi Mask
Wound edges come together (approximate); surgical incision
What is Primary Wound
How often should nurse perform skin assessment?
What is once a shift
q4h for high risk
Non-blanchable deep RED, MAROON, PURPLE discoloration
What is deep tissue wound
Auscultating the lungs= what do you hear?
When using 2 inhalers; a bronchodilator and a steroid; which would you use first
What is bronchodilator
Dehiscence
What is patrial or total separation of wound layers
When do we NOT use heat therapy?
What is areas of active bleeding, if pt has appendicitis or cardiovascular problems
What is the purpose of a wet-to-dry dressing?
Debridement
Max liters to give a COPD patient at high % of O2
What is 2L at 28%
1st response for a patient with dyspnea
What is HIGH FOWLERS
Inadequate tissue oxygenation at the cellular level
What is hypoxia
What should you do to a patient prior to tracheal suction to prevent hypoxia
What is hyperoxygenate
When would you use a calcium alginate dressing?
What is when there is significant exudate
Why can you not give a COPD patient a high percentage of oxygen
What is the brain will tell them to stop breathing
Used in critical care or emergency setting (CO2 poisoning)
3 valves on mask; does not mix CO2 and O2
10-15L/min. 60-90% O2
What is non-rebreather mask
Medical emergency; can lead to strangulation or organs
What is evisceration
6 Categories of things to look at during the wound assessment
What is s/s of skin breakdown, level of sensation, movement, continence status breakdown, use visual and tactile techniques, review labs- albumin and prealbumin
Passive drain (made of latex)- will drain on its own naturally; used to get rid of dead space or fluid
What is pinrose drain
Active drain; requires negative pressure, Max 100ml
What is a Jackson Pratt