comp exam 3 galen 280 – well answered
UAP delegation tasks? Name examples... - ** VERIFIED ANSWERS **✔✔- vital signs rouitine
STABLE PT
- IN & OUT of food and f/c
- ADL'S shower, grooming, shaving etc.
- toileting and walking (not post op who has never walked)
- feeding without aspiration precautions
- positioning
Can a UAP measure the drainage of a Hemovac or Jackson-Pratt? - ** VERIFIED ANSWERS
**✔✔yes measure the amount of fluid cant assess the drainage system.
Can a UAP collect specimens? - ** VERIFIED ANSWERS **✔✔yes!!! stool and urine
Can a UAP empty a colostomy bag ? - ** VERIFIED ANSWERS **✔✔yes ! not the wafer.
end of life care - ** VERIFIED ANSWERS **✔✔the support and care given during the time
surrounding death = HOSPICE
hospice care - ** VERIFIED ANSWERS **✔✔comfort measures in the last phases of life
hospice care and family - ** VERIFIED ANSWERS **✔✔- private room
- encourage the client and family to express feelings
- provide support and advocancy
- provide privacy
- LET THEM TOUCH THE CLIENT AS MUCH AS THEY WANT !
,PRIORITY QUESTIONS use what formula? - ** VERIFIED ANSWERS **✔✔SPEC
SPEC stands for ? - ** VERIFIED ANSWERS **✔✔S= stable vs non stable
P= potential vs real
E= expected vs unexpected
C= chronic vs acute
priority patients are? - ** VERIFIED ANSWERS **✔✔- neuro changes ex: GCS LOW 8
- very low values labs ex: DM with 50 BS
- client returning form invasive procedures and a comlication happens ex: eviceration
- ABC's airway problems and there acid base inbalanced
- client with chest pain and syncope not ecpected
- pt w/ 2-3 rd degree burns
- client with new onset of infectious disease = TB
- any unexpected events= MI, STROKE, HHS, DKA, ADDISONS CRISIS, THYROID STORM,
MYXEDEMA COMA, HTN CRISIS, PREECLAMPSIA, STROKE...
Maslow's Hierarchy of Needs - ** VERIFIED ANSWERS **✔✔physiological, safety, love/belonging,
esteem, self-actualization
physiological needs? 1ST NEED - ** VERIFIED ANSWERS **✔✔AIRWAY
RESPIRATORY EFFORT
HR, RHYTHM, CONTRACTIONS STRENGTH
NUTRITION
ELIMINATION
SAFETY AND SECURITY = 2N NEED - ** VERIFIED ANSWERS **✔✔- PROTECT FROM INJURY
- PROMOTE FEELING OF SECURITY
- TRUST IN NURSE CLIENT RELATIONSHIP
, TRIAGE RED TAG EXAMPLES? CLASS 1 - ** VERIFIED ANSWERS **✔✔EMERGENT THREAT
TO LIFE EX:
CARDIAC TEMPONADE
STROKE
SHOCK
AIRWAY OBSTRUCITON
YELLOW TAG CLASS 2 - ** VERIFIED ANSWERS **✔✔Urgent within 30 min to 2 hours- can wait
a little
- OPEN FRACTURES W DISTAL PULSES
- LARGE WOUNDS
GREEN TAG CLASS 3 - ** VERIFIED ANSWERS **✔✔the walking wounded
- CLOSED FRACTURES
- SPRAINS
- ABRASIONS
- CONTUSION
BLACK TAG CLASS 4 - ** VERIFIED ANSWERS **✔✔EXPECTED TO DIE!
- MASSIVE HEAD TRAUMA
- FULL THICK BURNS TO WHOLE BODY
- HIGH CERVICAL SPINE INJURY REQUIRING MECHANICAL VENTILATION
ABGS NORMAL VALUES - ** VERIFIED ANSWERS **✔✔PH = 7.35- 7.45
CO2= 35- 45
HCO3= 21- 28
respiratory acidosis - ** VERIFIED ANSWERS **✔✔low pH, high CO2
UAP delegation tasks? Name examples... - ** VERIFIED ANSWERS **✔✔- vital signs rouitine
STABLE PT
- IN & OUT of food and f/c
- ADL'S shower, grooming, shaving etc.
- toileting and walking (not post op who has never walked)
- feeding without aspiration precautions
- positioning
Can a UAP measure the drainage of a Hemovac or Jackson-Pratt? - ** VERIFIED ANSWERS
**✔✔yes measure the amount of fluid cant assess the drainage system.
Can a UAP collect specimens? - ** VERIFIED ANSWERS **✔✔yes!!! stool and urine
Can a UAP empty a colostomy bag ? - ** VERIFIED ANSWERS **✔✔yes ! not the wafer.
end of life care - ** VERIFIED ANSWERS **✔✔the support and care given during the time
surrounding death = HOSPICE
hospice care - ** VERIFIED ANSWERS **✔✔comfort measures in the last phases of life
hospice care and family - ** VERIFIED ANSWERS **✔✔- private room
- encourage the client and family to express feelings
- provide support and advocancy
- provide privacy
- LET THEM TOUCH THE CLIENT AS MUCH AS THEY WANT !
,PRIORITY QUESTIONS use what formula? - ** VERIFIED ANSWERS **✔✔SPEC
SPEC stands for ? - ** VERIFIED ANSWERS **✔✔S= stable vs non stable
P= potential vs real
E= expected vs unexpected
C= chronic vs acute
priority patients are? - ** VERIFIED ANSWERS **✔✔- neuro changes ex: GCS LOW 8
- very low values labs ex: DM with 50 BS
- client returning form invasive procedures and a comlication happens ex: eviceration
- ABC's airway problems and there acid base inbalanced
- client with chest pain and syncope not ecpected
- pt w/ 2-3 rd degree burns
- client with new onset of infectious disease = TB
- any unexpected events= MI, STROKE, HHS, DKA, ADDISONS CRISIS, THYROID STORM,
MYXEDEMA COMA, HTN CRISIS, PREECLAMPSIA, STROKE...
Maslow's Hierarchy of Needs - ** VERIFIED ANSWERS **✔✔physiological, safety, love/belonging,
esteem, self-actualization
physiological needs? 1ST NEED - ** VERIFIED ANSWERS **✔✔AIRWAY
RESPIRATORY EFFORT
HR, RHYTHM, CONTRACTIONS STRENGTH
NUTRITION
ELIMINATION
SAFETY AND SECURITY = 2N NEED - ** VERIFIED ANSWERS **✔✔- PROTECT FROM INJURY
- PROMOTE FEELING OF SECURITY
- TRUST IN NURSE CLIENT RELATIONSHIP
, TRIAGE RED TAG EXAMPLES? CLASS 1 - ** VERIFIED ANSWERS **✔✔EMERGENT THREAT
TO LIFE EX:
CARDIAC TEMPONADE
STROKE
SHOCK
AIRWAY OBSTRUCITON
YELLOW TAG CLASS 2 - ** VERIFIED ANSWERS **✔✔Urgent within 30 min to 2 hours- can wait
a little
- OPEN FRACTURES W DISTAL PULSES
- LARGE WOUNDS
GREEN TAG CLASS 3 - ** VERIFIED ANSWERS **✔✔the walking wounded
- CLOSED FRACTURES
- SPRAINS
- ABRASIONS
- CONTUSION
BLACK TAG CLASS 4 - ** VERIFIED ANSWERS **✔✔EXPECTED TO DIE!
- MASSIVE HEAD TRAUMA
- FULL THICK BURNS TO WHOLE BODY
- HIGH CERVICAL SPINE INJURY REQUIRING MECHANICAL VENTILATION
ABGS NORMAL VALUES - ** VERIFIED ANSWERS **✔✔PH = 7.35- 7.45
CO2= 35- 45
HCO3= 21- 28
respiratory acidosis - ** VERIFIED ANSWERS **✔✔low pH, high CO2