Reduction of oxygen in the body tissues
Inflammation of the lungs, usually caused by an infectious agent.
An artificial hole or opening (stoma) made into the trachea to allow air passage into and out of the lungs.
Why is deep breathing and coughing taught to a patient?
It is often taught as part of pre-op care to minimize atelectasis and pneumonia
What is the purpose of a chest tube?
1. Provide re-expansion of the lungs caused by air, blood, or fluid in the pleural space
2. Drainage permits re-expansion of a collapsed lung.
What are common complications of a chest tube?
1. Traumatic removal of chest tube
3. Pneumothorax or Hemothorax
5. Tension Pneumothorax
6. Tubing disconnection
What causes a tension pneumothorax when there is a chest tube in a patient?
a clamped tube or occluded tube allowing build up of preasure in the pleural space without an exit.
Who can instert and remove and a chest tube?
What are the BCD's of chest tubes?
D- Dressing and Drainage
What signs and symptoms of a chest tube need to be reported to the nurse?
1. Sudden onset of dyspnea, rapid shallow breathing, cyanosis
2. Complaint of chest preasure
3. subcutanueous emphusema
4. Increased temperature
5. Signs of infection at insertion site
6. Sucking noises
7. Drainage increases 100 mL/hr
8. Sudden change in color or type of drainage
9. Drainage stops
How often should a tracheostomy inner cannula be cleaned?
At least every 8 hours
What are the types of anesthesia?
3. conscious sedation
What is involed with gaining a surgical consent?
1. The patient is resposible for reading all information on a consent form
2. HM makes sure constant form is complete pior to pre-op medications, anesthesia and procedure/surgery
3. Witness may a a para professional not involved with performing or assisting with the procedure
4. Provider must explain the need for the procedure, provide a description and discuss any available alternative treatments
Who must check the surigcal checklist?
1. Unit Nurse
2. OR personnel
What must a patient remove prior to surgery?
1. Nail polish/makeup
2. Hair pieces/wigs
3. valuables including rings, jewelry, glasses dentures ext
4. Prosthetic devices
How is the surgical site marked?
With an X and initialed by the surgeon and the patient pre Joint Commission Standards
When do diagnotics test need to be available by?
Pior to surgery
What can you use to shave a patient?
Either a electic razor or blade.
Why do you do a surgical scrub/prep?
To prevent carrying contamination into the incision site.
After surgery how long and how many times do you righten the quadriceps?
10 seconds 4 times
When applying a pneumatic stocking devices sleeve pressure should not exceed what?
That patients distolic pressure between 35-45 mm/hg
How often should you monitor the neurovasular in a patient wearing a pneumatic stocking devices?
Every 2-4 hours
How often should patients perform leg exercises and change postion after surgery?
Every two hours
How soon can orders call for ambulation after surgery?
How soon should a patient void after surgery if there is no catheter?
Within 8 hours
A collapsed or airless state of all or part of the lung
What are signs and symptoms of Thrombophlebitis?
1. Pain or warmth in the calf of leg
2. Swollen leg
3. Warm are to touch on leg
4. Possible temperature elevation
How can WBC fight infections in the body?
1. Produce protective antibodies that overpower germs
2. surround and devour the germs
What is the normal life span of a WBC?
a few days to a few weeks
How many WBC can a drop of blood contain?
What happens when an infection is present?
WBC will significantly rise.
What are the three types of healing?
First intention healing
second intention healing- pressure ulcer
tertiary intention healing
What factors can affect healing?
1. type of wound
3. lifestyle- alcohol/smoking
5. age- metabolism slower in elderly
7. chronic illness
What can cause a pressure ulcer?
pressure, sheaing or friction on the site
Stage 1 of a pressure ulcer
an area of red, deep pink or mottled skin that does not blanch with fingertip pressure
Stage 2 of a pressure ulcer
partial thickness skin loss involving epidermis and/or dermis. May look like an abrasion, blister or shallow crater
Stage 3 of a pressure ulcer
full thickness skind loss that looks like a deep crater and may extend to the fascia
Stage 4 of a pressure ulcer
full thickness skin loss with extensive tissure necrosis or damage to muscle, bone or supporting structures.
What are signs of a systemic infection?
1. temp greater then 101
2. WBC greater the 10,000
3. Feelin of malaise
clear to straw color, watery fluid. Fluid found in a blister
thin, clear to staw color, watery drainage that is blood tinged
thick green, yellow or brown drainage
What are sign of an infection in a burn?
1. Change of color to burned area and surrounding skin
2. purplish discoloration
3. change in thickness of burn
4. purulent drainage
What are sign of dehydration?
2. lightheadness or dizziness
4. dry skin
5. decreased urine output
How do you estimated the size a burn?
the rule of nines
What are the four types of wound debridement?
using scissor forceps or a scalpel blade.
using topical substances that break down dead tissue
using bodys enzymes to break down tissue
physical removal of debris by irrigation, hydrothereapy or wet to dry dressing application.
A doctor must give orders for the application of what in a dressing?
What is the purpose of wound debridement in a burn?
To remove dead tissue as new tissue grows
flushing of an area with a liquid
When irrgating how far do you hold the tip from the wound?
What does a dry dressing do?
Prevent microogransims from entering or escaping a wound and to absorb drainage.
What are the types of dry dressing?
1. dry sterile gauze
2. telfa- non-adherent dressing
3. surgipads or abdominal pads
What are wet to dry dressing used for?
How often should a wet to dry dressing be changed?
every 6 hours
What are wet to wet dressings used for?
clean open wounds. Gauze dressings saturated with solution and placed on the wound.
Who can apply restraints?
Licensed personnel under a doctor's orders
When restraints are applied what must the doctors orders include?
1. type of restraint
2. length of time device will be used
How often must restraints by checked?
Every 15 minutes
When are restraints released and why?
Every 2 hours for 5 minutes to inspect tissue and provide joint range of motion and postion change
When do you replace an oxygen tank?
When it is below 1500 psi
When do you replace a sharps container?
two thirds to three fourths full
How do you transfer a patient on a cardiac monitor?
1. ensure monitor is fully charged with new batteries
2. connect transfer tray at foot of strectcher
3. turn on monitor and place on lead 2
How do you transfer a patient on oxygen?
1. check of regulator fit and function
2. place tank in carrier on stretcher. If one is not available tank with be strapped next to patient
3. disconnect patient from fixed oxygen and connect ot portable
4. ensure wall unit flow meter is turned off prior to transfer
What are some examples of drainage systems?
1. drain tubes
2. indwelling catheters
3. NG tubes
How do you transfer a patient with an IV
1. Check iv pump to for battery statues
2. check all line connections prior to moving patient
3. upon arrival ensure lines are reconnect to electonic pump of gaining unit
How do you transfer a patient with immobilixation devices
1. When leaving ensure another provider is at the foot of the bed maintaining control of weights
2. upon completion of transfer ensure alignment and weights are correct
When moving a patient of a ventilator the person at the patient's head is responsible for?
ensuring the airway is not compromised.
How many people are required for moving a patient on and off an elevator?
a minimum of two
How do you move a patient onto an elevator?
How do you remove a patient from an elevator?
inflammation of the gingiva around a partially erupted tooth.
Inflammation of the gingiva that involves the creast of the alveolar bone and the periodontal ligament above the alveolar crest.
A gerneral term used to denote inflammation of the oral mucosa
What is the common cause of dental caries?
infection of the pulpal tissue that spreads out of the apex of the root
Post-Extraction Alveolar Osteitis
normally results when a blood clots fails to form or washes out of the socket at a recently extracted tooth. Dry Socket
What are signs and symptoms of Post Extraction Alvolar Osteitis?
1. Severe constant pain that can run from the ear to the lower jaw
2. absence of a blood clot
3. food visible in the socket
4. alveolar bone visible in the socket
5. fould odor in the mouth
6 pain not responding to medication
Type 1 Enamel Fracture
chip or fractur of the tooth enamel without dentin involvement
Type 2 Enamel/Dentin Fracture
Extensive fracture involving the enamel and dentin layers with no pulp exposure
Type 3 Enamel/Dentin Fracture with Pulp Exposure
Extensive toothe fracture with pulp exposed.
Type 4 Root Fracture
Fracture of the root which may inclde fracture of the crown. verified by a dental x-ray