fundamentals

What are the steps to collect a midstream urine specimen. in order. -closed lid -release first urine -hold urine -clean first collect midstream specimen

1. Clean first (front to back) 2. Release first urine 3. Hold urine 4. Collect midstream urine/specimen (AVOID touching the inside of container) 5. Closed the lid

Medication routes has the fastest rate of absorption (slowest to fastest) 1. Topical 2. Enteral 3. Intramuscular 4. Intravenous

1. Topical (subcutaneous)- (slowest) - placed on/absorbed through skin · 2. Enteral- by mouth · 3. Intramuscular - placed into muscle tissue · 4. Intravenous (fastest) - vein directly into the bloodstream

loop of bowel protruding from the surgical incision (3 steps)

1. get sterile gauze and cover it if it protrudes 2. gauze should be moist 3. notify provider when done

v Medication routes has the fastest rate of absorption (fastest to slowest) 1. Topical 2. Enteral 3. Intramuscular 4. Intravenous

1. intravenous 2.intramuscular 3.Enteral 4.topical

if there's sign of separation, what actions should be taken? (3 steps)

1. leave remaining sutures in place 2. document description 3. report health provider

5 processes

1. obtain physician's order 2. gather supplies 3. remove every other suture or staples 4. remove every other staple/suture and replace w/ steri strip 5. remaining staple/suture in same order

A nurse is assisting with teaching a client about a new medication. (Select all that apply) ·- The nurse should provide a quiet environment for the client to promote learning. ·- Simple language- The nurse should use simple, easy to comprehend language to ensure client understanding and promote learning. · -The nurse should provide educational material written at a 5th- to 6th-grade reading level to promote learning. the nurse should begin with the most important information because the client is likely to remember the information taught at the beginning of the education session.

1.The nurse should provide a quiet environment for the client to promote learning. 2.Simple language- The nurse should use simple, easy to comprehend language to ensure client understanding and promote learning. 3. The nurse should provide educational material written at a 5th- to 6th-grade reading level to promote learning.

The nurse is removing staple from a surgical wound and separation occurs, what do you do? (3 steps)

1.cease removal 2.cover w/ a dry dressing 3.record separation

What are the benefits of occlusive dressing, and why do you use it?

1.keeps incision moist and increase epithelialization 2. avoid wet to dry dressings

taking_______________medications and _____________might interact with certain antibiotics

1.over the counter 2.herbal supplements

The WBC count is elevated. A WBC count greater than __________ is a typical manifestation of leukemia.

10,000/mm³

WBC count in a child who has sickle cell anemia can be as high as 12,000 to ____________due to chronic ____________

20,000/mm³ inflammation

Hematocrit range for females

37-47%

white blood cell range (WBC)

4,500-11,000

Hematocrit range male

42-52%

Key to reducing the risk for medication errors

6 rights of medication

a client who is pregnant and whose routine diagnostic testing reveals a negative rubella titer (SELECT ALL THAT APPLY) A need a booster, but can't get it until after she delivers B even if they've had rubella in the past it doesn't matter, they need a booster C If they get it while pregnant, it can harm the baby or fetus ·D Advised client to not get pregnant within 3 months of administration

A, C

is used to measure the client's blood clotting time.

APTT

Thin needles are placed into certain muscles to record responses to stimuli during an electromyography. This procedure gives the provider data about muscle weakness and helps distinguish muscle disorders from nerve disorders.

Electromyography

A nurse is collecting research to revise the protocol for specimen collection on their unit. From which of the following sources should the nurse retrieve the information?

Evidence-based practice

What substance is found in the clot that holds the wound together

Fibrin

Dye is injected through an IV during a fluorescein angiography test to visualize the vessels in the eye.

Fluorescein angiography test inject

biggest muscle absorber

Gluteus maximus

first phase termination of bleeding

Hemostasis

fibroblasts begin to exit the wounds and the wounds continue to gain strength

Maturation

A dual-energy absorptiometry scan is the mostly commonly used screening and diagnostic tool for measuring bone mineral density.

Osteoporosis

thick yellow green or brown (pus)

Purulent

has the appearance of thick, yellow, green, tan, or brown drainage.

Purulent drainage

bright red blood

Sanguineous

is bright red and indicates active bleeding

Sanguineous drainage

mixture of serous which Is clear watery plasma

Serosanguineous

drainage is pale, red, and watery, and is a mixture of serous and sanguineous drainage.

Serosanguineous drainage

preparing to administer a metered dose inhaler (MDI) medication (what action would you take to prepare the pt)

The nurse should ask the client to inhale the medication slowly for 3 to 5 seconds to promote absorption of the medication.

pernicious anemia

Vitamin B12 deficiency

_______count is consistent with leukemia and sickle cell anemia.

WBC

is used to diagnose infection

WBC

Schilling test

a diagnostic test for vitamin B12 deficiency

A nurse is preparing to collect a specimen from a client for a guaiac test. The client asks what the test will detect in his stool. Which of the following responses should the nurse make? a-Blood - A guaiac (fecal occult blood) test measures occult blood in the stool and screens for colon cancer. b-Lipids - A fecal fat test measures lipids (fats) in feces. It confirms steatorrhea, which is an indication of several disorders, including cystic fibrosis, celiac disease, sprue, and Crohn's disease. c-Bacteria- A guaiac test does not measure bacteria in the stool, as it is common knowledge that bacteria are present in feces. To identify specific bacteria, fungi, or parasites, the nurse would collect a separate stool specimen for laboratory technicians to culture. D-Bile- Bile is present in feces and does not require a laboratory test to confirm it.

a. blood. a guaiac test measures occult blood in the stool and screens for colon cancer.

method based on cognitive domain of learning, participates, addresses any concerns

active teaching

What is used for macular degeneration?

an Ampler grid test is used to check for impaired central vision and diagnose macular degeneration.

surgical procedure to restore the function of the joint

arthroplasty

the Papanicolaou (PAP) detects?

cervical cancer

Before administering powdered medication to a client. what actions should the nurse take first (actions prepping)

check for allergies

The nurse should check the client's response to the medication to monitor the client for a therapeutic response and/or adverse effects. However, there is another action the nurse should take first. -Document -Mix the medication -Check the client for allergies

check the PT for allergies

A nurse administers the wrong medication to a client. Which of the following actions should the nurse take first? -Check the client's vital signs. ·-Notify the charge nurse. ·-Fill out an incident report. ·-Document the client's condition in the electronic medical record.

check the client's vital signs

The nurse should document information about the client's condition in the electronic medical record. However, there is another action the nurse should take first. -Check the client's vital signs. ·-Notify the charge nurse. ·-Fill out an incident report. ·-Document the client's condition in the electronic medical record.

check the client's vital signs

what should the nurse instruct pts to do for newly prescribed antibiotics?

check with provider before taking over the counter meds

clean-contaminated wound

clean bacteria

A ________ is an uninfected surgical wound with less than a 5% chance of becoming infected postoperatively.

clean wound

urinary catheterization to obtain a urine specimen for a client

close door and provide privacy

the nurse should instill the Ophthalmic medication on the pt's _________sac

conjunctival

dirty wound

dirty bacteria

If you have assistant personnel and you ask them to take the specimen to the lab and they refuse, what should you do if they refuse?

educate them

An EMG is performed to determine if there is damage to the nerves leading to muscles. During an EMG, very small needles are inserted into a muscle. The needles are attached by a wire to an EMG machine that records the electrical activity in the muscle. Damage to a nerve will alter this electrical activity.

electromyography (EMG) test

endometrial biopsy (EMB) detects?

endometrial cancer

transvaginal ultrasound detects?

endometrial cancer

when the wound must granulate

healing

epithelialization

healing process

An upper GI endoscopy is performed to evaluate the esophagus, stomach, and upper intestine for clients who report heartburn, nausea, vomiting, and difficulty swallowing.

heartburn test

A child who has __________can have bruising related to an alteration in clotting from a factor VIII deficiency

hemophilia

Bleeding is consistent with leukemia and ____________ .

hemophilia

Children who have ____ can experience excessive bleeding from even slight trauma due to a deficiency of the clotting factor VIII.

hemophilia

With _______ hemorrhages can occur within the joints, which causes stiffness and aching in the affected joints.

hemophilia

It is related to ___________of the bone marrow by immature WBCs.

infiltration

peripheral IV catheter site is cool and taut, and there is IV fluid leaking. -Phlebitis -localized pain, heat, & swelling are manifestations of phlebitis -infiltration -infection

infiltration

During the _________ phase, blood and fluid leak out of the blood vessels into the vascular space.

inflammatory

__________ phase is a wound in when blood and fluid flow into the vascular space and produce edema, erythema, heat, and pain

inflammatory

If a patient has a rapid pulse, decreased blood pressure, decreased urinary output, and the dressing is dry, then the diagnosis is most likely an _____________.

internal hemorrhage

performed to diagnose glaucoma

intraocular pressure

What actions should the nurse take when obtaining a wound drainage specimen for culture

irrigate before specimen collection with normal saline 0.9

When irrigating a leg wound, which direction should the flow go?

irrigation flow from least to most contaminated

Pt with cholelithiasis filters bile out of the body by the ______

kidneys

passive teaching method, cognitive domain of learning

lecture

Due to a low platelet production, children who have ______________can have increased bleeding

leukemia

The child has an elevated temperature. A child who has __________can present with a fever and persistent mild infection.

leukemia

The child reported generalized pain of the extremities. Children who have ______might report bone pain related to infiltration of the bones with nonfunctional immature WBCs.

leukemia

a child who has ___________often has bruising and petechia related to low production of platelets.

leukemia

bruising is consistent with_________ and _____________

leukemia and hemophilia

temperature is consistent with_________ and __________________anemia

leukemia and sickle cell

removing every other staple or suture will prevent_______________.

line separation

leading cause for blindness

macular degeneration

The primary purpose of a wet-to-dry dressing is to debride a wound mechanically. type of dressing and process

mechanical debridement

irrigating from lest to most contaminated prevents what?

microorganisms from entering the wound

food is transported through the gastrointestinal (GI) tract (1-4 in order) mouth-esophagus-stomach small intestine-large intestine- rectum stomach-

mouth, stomach, small intestine, rectum

The CA 125 diagnostic test detects?

ovarian cancer

24-hr urine. if a urinary output is missed?

process will start over

collect a 24-hr urine specimen.

pt urinates then discarded and all others after are collected

contaminated wound

pus, discharge, bacteria

collagen formation occurs

reconstruction

performed to diagnose the need for corrective lenses

refraction test

preventing puncture injuries

replace sharps containers when full to reduce risk

A nurse is preparing to obtain a sputum specimen for a client.

rinse Pt's mouth w/water to reduce risk of specimen contamination

elevated WBC count pt going into surgery is at risk for?

risk for pneumonia and infection

active teaching method based on the affective domain of learning

role play

active teaching method based on the cognitive domain of learning. study, the client actively participates in learning and can address any concerns.

role play and active teaching method

clear watery plasma

serous

drainage has the appearance of clear, watery plasma

serous drainage

During a ____________crisis, a child could experience painful bones and joints of the hands and feet due to decreased blood flow.

sickle cell

a child experiencing a ________________crisis due to inflammation can also have a fever

sickle cell

is used to check visual acuity and to diagnose need for corrective lenses

snellen chart

When obtaining a urine specimen for culture and sensitivity via a straight catheterization

sterile procedure

another test for cystic fibrosis but not as definitive?

stool fat analysis

How do you diagnose cystic fibrosis for first test at top

sweet chloride test

active teaching method where pt repeats the information in their own words. during which a nurse can assess

teach-back

teaching method most used

teach-back

A nurse is assisting with teaching a client about a new medication. Which of the following strategies should the nurse plan to use? -teach back -lecture -role play -active teaching

teach-back method during the session

is used to diagnose sickle cell anemia

the sickledex

A nurse's sibling had a diagnostic test sibling asks the nurse to look up the result in the computer

there's no legal or professional basis for a nurse-client relationship between them. it's a breach of confidentiality for the nurse to access information.

what must be avoided during midstream collection?

touching inside of the container

What specimens can assistive personnel (AP) handle, you delegate? (Select all that apply) § Sputum specimen § Stool specimen for blood § Arterial blood gas specimen § Urinalysis specimen § Wound culture specimen

§ Sputum specimen § Stool specimen for blood § Urinalysis specimen

occult blood test in order: · The nurse should apply two drops of developing solution to each stool specimen. · The nurse should use a wooden applicator to transfer the stool to avoid contamination of the specimen. · The nurse should collect two stool specimens from different areas of the stool to obtain an accurate test. · The nurse should wait 30 to 60 seconds after applying the developing solution before reading the test to obtain an accurate reading.

· 3. The nurse should apply two drops of developing solution to each stool specimen. · 2. The nurse should use a wooden applicator to transfer the stool to avoid contamination of the specimen. · 1. The nurse should collect two stool specimens from different areas of the stool to obtain an accurate test. 4. The nurse should wait 30 to 60 seconds after applying the developing solution before reading the test to obtain an accurate reading

when you prepare to administer an Opthalmic medication

· Nurse should not instill the medication directly on the client's cornea -can cause pain, irritation, and increased systemic effects.

6 rights of medication administration

· Right patient · Right dose · Right route · Right medication · Right time · Right documentation

Client refuses to take the medication (2 steps)

· provide education to the pt · then notify the provider

Discussion is an active teaching method using the expression of feelings and application of the material. It is based on the affective or the cognitive domain of learning.

-Role play is an active teaching method based on the affective domain of learning. In role playing, the client acts in a role to practice a desired behavior.

A nurse is caring for a client who has cholelithiasis with bile duct obstruction

-dark/amber colored urine -biliary obstruction -backwards flow of bile

normal creatine range for female

0.59-1.04

normal creatine range for men

0.74-1.35