Comp #1 Review
1) What do PEG feed bags and TPN tubing have in common?
a) Both need to be changed every 24 hours
2) Why is TPN infusion associated with bacteria?
a) High in glucose, bacteria loves that
i) TPN must be used in a Central Line - Change sterile dressing Q 48-72 hrs, use sterile
technique
3) What do you hang if TPN isn’t available?
a) Dextrose 10/20%
4) What is PPN vs. TPN?
a) Partial Parental Nutrition (has less glucose, electrolytes, minerals) small concentration. The
patient may be eating some with PPN (can be admin through a peripheral line). vs. Total
Parental Nutrition
5) IV solution infused in 4 hours do you increase the rate?
a) No, risk of fluid overload. Listen to lungs (primary priority).
6) Hemglobin and Hematocrit
a) HBG= low @risk for anemia, protein that carries oxygen
i) F- 12-16 M- 14-18
b) Hematocrit= concentration of blood, high=dehydration
i) F- 37-47 M- 42-52
7) Heparin- check aPTT
a) (30-40) should be 1.5 to 2.5x the normal value
8) Warfarin- check PT/INR
a) (2-3x)
9) Lab values: CBC 5-10, Basic lab values…
10) Graves vs. Hyperthyroidism
a) Graves: autoimmune disorder, leads to hyperthyroidism. Produces an enzyme TSI,
overstimulating TSH production.
b) Hyperthyroidism: over stimulation of the Thyroid (TSH, T3, T4)
11) Thyroid Storm, Pheocromocytoma, and Malignant Hyperthermia alike?
a) High fever… >104.0*
b) Thyroid storm, cardiac issues? Dysrythmias. Tachy! Leads to heart failure.
c) Pheocryocytoma: tumor on adrenal glands. Don’t palpate
d) Malignant Hyperthermia: caused by anesthesia, reaction that causes a very high fever and Tachy
arrhythmias.
e) PTU expected outcome, lower pulse and weight gain
f) Hypothyroidism: High fiber, low calorie
12) Mixing insulin
a) Clear (regular) then Cloudy (NPH)
13) Discarded insulin needles
a) Coffee Can, Glass jar…
14) DNR vs. POA
1) What do PEG feed bags and TPN tubing have in common?
a) Both need to be changed every 24 hours
2) Why is TPN infusion associated with bacteria?
a) High in glucose, bacteria loves that
i) TPN must be used in a Central Line - Change sterile dressing Q 48-72 hrs, use sterile
technique
3) What do you hang if TPN isn’t available?
a) Dextrose 10/20%
4) What is PPN vs. TPN?
a) Partial Parental Nutrition (has less glucose, electrolytes, minerals) small concentration. The
patient may be eating some with PPN (can be admin through a peripheral line). vs. Total
Parental Nutrition
5) IV solution infused in 4 hours do you increase the rate?
a) No, risk of fluid overload. Listen to lungs (primary priority).
6) Hemglobin and Hematocrit
a) HBG= low @risk for anemia, protein that carries oxygen
i) F- 12-16 M- 14-18
b) Hematocrit= concentration of blood, high=dehydration
i) F- 37-47 M- 42-52
7) Heparin- check aPTT
a) (30-40) should be 1.5 to 2.5x the normal value
8) Warfarin- check PT/INR
a) (2-3x)
9) Lab values: CBC 5-10, Basic lab values…
10) Graves vs. Hyperthyroidism
a) Graves: autoimmune disorder, leads to hyperthyroidism. Produces an enzyme TSI,
overstimulating TSH production.
b) Hyperthyroidism: over stimulation of the Thyroid (TSH, T3, T4)
11) Thyroid Storm, Pheocromocytoma, and Malignant Hyperthermia alike?
a) High fever… >104.0*
b) Thyroid storm, cardiac issues? Dysrythmias. Tachy! Leads to heart failure.
c) Pheocryocytoma: tumor on adrenal glands. Don’t palpate
d) Malignant Hyperthermia: caused by anesthesia, reaction that causes a very high fever and Tachy
arrhythmias.
e) PTU expected outcome, lower pulse and weight gain
f) Hypothyroidism: High fiber, low calorie
12) Mixing insulin
a) Clear (regular) then Cloudy (NPH)
13) Discarded insulin needles
a) Coffee Can, Glass jar…
14) DNR vs. POA
