Med Admin
What is the liver?
Three things that increase risk of falls
What are:
Orthostatic hypotension
Age
History of falls
Incontinence
Medications
Confusion
Assistive devices
IV
Hypertonic IV Solutions and what they are used for
What are D50.9NS, 3% or 5% Normal Saline?
Used to pull fluid out of the cell and into the vasculature. Use with caution, causes cellular dehydration, but increases BP as fluid in vasculature is increased. Hypertonic saline used to correct severe hyponatremia
A problem that a chest tube would be beneficial for
What is a pleural effusion, a hemothorax, or a pneumothorax?
3 Pharmacological and 3 Nonpharmacological methods for pain control
What are: narcotics, non-opioid analgesics (i.e. acetominophen, NSAIDs), and adjuvant analgesics (i.e. anticonvulsants, antianxiety, antidepressants)
What are: distraction, relaxation, imagery, cutaneous stimulation, acupuncture, ice, heat?
Discuss uses of some of these, contraindications, key concerns
The 6 rights of medication administration
What are:
1. Right medication
2. Right dose
3. Right patient
4. Right route
5. Right time
6. Right documentation
Three ways to reduce the risk of falls
What are
A bed/chair alarm
Hourly Rounding
4 P's - Pain, Potty, Possessions, Positioning
Room near nurses' station
Sitter
Nonskid footwear
Risk factors: heat stroke, fever, burns
Expected findings: Thirst, hyperthermia, irritability, confusion, reduced DTRs
What is hypernatremia?
Clients who would benefit from chest physiotherapy
Who are clients with thick secretions such as with chronic bronchitis or cystic fibrosis?
Five Rights of Delegation
Right task
Right circumstances
Right person
Right direction
Right supervision/evaluation
Discuss: Give an example of a right and wrong of 3 of the above.
The effect experienced when a medication accumulates in the blood due to impaired metabolism or excretion
What is a toxic effect?
Fire response sequence - acronym and what it stands for
What is RACE?
Rescue
Alarm
Contain
Extinguish
Discuss: What are some fire safety considerations in home care?
Risk factors: vomiting, metabolic alkalosis, diarrhea
Expected findings: irregular heart rhythm, muscle cramping, hypoactive bowel sounds,
What is hypokalemia?
How to prevent hypercarbia (elevated levels of Co2) in a patient with COPD
What is minimize supplemental O2?
Discuss: What is the typical goal range for pulse ox in a patient with COPD? Why? What are some signs and symptoms of hypercarbia?
3 Factors to consider when delegating tasks
What are:
Predictability of outcome
Potential for harm
Complexity of care
Need for problem solving (assessment vs data collection)
Level of interaction (conversation vs teaching)
Stability of client
The lowest drug concentration in the blood
What is the trough?
When should this be drawn?
Appropriate use of restraints
What are:
Violent/aggressive clients
or
To protect lines/tubes as a last resort
Discuss: What are examples of restraints, and what are some nursing responsibilities related to using them
pH: 7.32
PaCO2: 65 mmHg
[HCO3-]: 32 mEq/L
What is respiratory acidosis, partially compensated?
Isolation precautions for a client with pneumonia
What is droplet isolation? Requires a surgical mask
2 uses of an NG tube and 2 safety considerations
What are decompression (suction) and feeding
NGs can also be used for lavage (washing out) of the stomach during bleeding, or poison, or with a balloon to apply pressure when hemorrhaging
Safety considerations: placement, discomfort, patency, excoriation, maintaining in the right place
Discuss: NG vs NJ
The four components of pharmacokinetics
Bonus round: Name something that impacts each of these 4 components
What are:
Absorption
Distribution
Metabolism
Excretion
2 Key safety concerns in the school age child
Drowning
Motor vehicle injury
Firearms
Play injury
Burns
Poison
Discuss: Ways to minimize these risks. How do these vary risks at other stages in the lifespan?
pH:7.38
PaCO2:53 mmHg
[HCO3-]:30 mEq/L
O2 Delivery device that delivers 6-12 L/min of O2
What is a simple face mask?
Kubler Ross stages of grief
What are: denial, anger, bargaining, depression, and acceptance?
Discuss: What are some signs of normal vs complicated grieving processes?