patient admitted with transmission-based precautions what is the minimum PPI needed to be worn in this room? ✔️Gloves and Gown
isotonic solution ✔️A solution in which the concentration of solutes is essentially equal to that of the cell which resides in the solution
hypertonic solution ✔️A solution in which the concentration of solutes is greater than that of the cell that resides in the solution
hypotonic solution ✔️A solution in which the concentration of solutes is less than that of the cell that resides in the solution
Heparin antidote ✔️protamine sulfate
INR ✔️International Normalized Ratio - a calculation based on the PT used to monitor patients using blood thinners. 2.0-3.0 is the range for
people taking warfarin:Coumadin
Causes of hematoma ✔️poor venipuncture technique, flow clamp left open, tourniquet left on to long, cannula to large, digging into vein
Signs of hematoma ✔️Ecchymosis, immediate swelling at the site & discomfort, leakage of blood at the insertion site- unable to advance cannula
Phlebitis ✔️inflammation of the inner lining of a vein
thrombophlebitis ✔️inflammation of a vein associated with a clot formation
bacterial phlebitis is caused by ✔️Poor hand hygiene, lack of aseptic technique, failure to check equipment, or recognize early signs of phlebitis
Often occurs during insertion
Phlebitis Scale ✔️0 = No symptoms
1 = Erythema at access site with or without pain
2 = Pain at access site with erythema and/or edema
3 = Pain at access site with erythema and/or edema, streak formation, palpable venous cord
4 = Pain at access site with erythema and/or edema, streak formation, palpable venous cord >1 inch in length, and purulent drainage
erythema ✔️redness of the skin
Infiltration ✔️admission of a non-vesicant med or solution into the surrounding tissue
Extravasation ✔️admission of a vesicant into surrounding tissue
CVAD ✔️central vascular access device or indwelling line
treatment of thrombophlebitis ✔️complete bed rest
avoid massage
heat and elevation promote venous return
anticoagulant therapy
treatment of phlebitis ✔️remove catheter, warm compress, elevate extremity, apply analgesic or anti-inflammatory PRN
active immunity ✔️immunity produced by exposure to an antigen, as a result of the immune response
pt has a saline lock in place but it is not being used, what should be done? ✔️call MD to verify it can be removed
which medication is most commonly used to clean an occlusion caused by a blood clot ✔️Activase- Alterplace
Systemic complications of IV therapy ✔️Circulatory overload
Speed shock
, Septicemia
Allergic reaction
Catheter embolism
Air embolism
BSI
what set would vancomyacin IVPB be given in ✔️secondary administration set
Circulatory overload is a concern for which patient ✔️Patients with elevated BUN and creatinine level
BUN ✔️10-20 mg/dL
Creatinine ✔️0.6-1.2 mg/dL
what are the LPN duties when assisting with blood transfusion ✔️monitor pt during transfusion
X-ray shows tip of PICC is in the jugular vein ✔️let RN know of x-ray reading
where should broken IV pumps be stored? ✔️Return pump to bio-med engineering dept
Is it okay to use a sharpie on a plastic IV bag? ✔️no, it will seep through
Who can insert PICC lines? ✔️Specially trained nurses
Skin is cool, taunt, edemic, what type of complication may have occurred? ✔️Infiltration
What steps should be take if BSI is suspected ✔️Notify MD
What statement about lorazepam would indicate the nurse needs further teaching? ✔️Used for nausea
Iv was hung by gravity but the tubing was not primed, what action is take by the nurse? ✔️place pt in trendelenburg and left side
signs and symptoms of pulmonary edema from receiving an infusion to quickly ✔️- cough
- dyspnea
- restless
- crackles
What should be included in charting for a grade 3 infiltration iv finding ✔️- assessment of site
- date and time
- notify MD
- treatment ordered
- carry out of treatment
What statement would indicate a nurse needs more teaching for central line dressing change ✔️bio-patches to prevent infections
central line site has purulent drainage, pt also has fever and elevated WBC, what can the LPN legally do? ✔️change dressing
hang ivpb to newly inserted peripheral iv
what statement would indicate a need for further teaching of transmission based precautions ✔️pt in airborne precautions can not come out of
their room for any reason
INR-5.5, Pt has been taking 2mg of warfarin daily. What order would be questions? ✔️Increase the coumadin to 4mg daily.
antidote for warfarin ✔️Vitamin K