CDC B4N051 Volume 1, 2, & 3, CDC B4N051 URE + STQ
What is consensual reflex?
Both eyes' neurological functions are working together and can be seen when both pupils react and become smaller when light stimulates either eye (one eye at a time).
Name four possible insertion sites for a CVP line.
Brachial, femoral, subclavian, or jugular veins.
What are five reasons for the use of an NG tube?
Diagnose a disorder, feed a patient, relieve distension, drain the stomach, or wash out the stomach.
What is the minimum number of times ROM exercises should be performed?
Each exercise should be performed a minimum of three to five times, either actively or passively; usually twice per day, or more if tolerated.
What information must be on a patient's inpatient record?
Each form must include, at a minimum, the patient's name, hospital admission register number, Social Security number, and name of the treating facility.
What type of restraint is used to prevent the child from reaching his or her face or head or to prevent the child from scratching?
Elbow restraint.
Psychotherapy usually does not include
Electroconvulsive therapy (ECT)
What type of treatment is used when milder forms of treatment have failed?
Electroconvulsive therapy.
What are the substances that release irons in the water called?
Electrolytes.
What is telemetry?
Electronic monitoring of the heart rhythm over airwaves.
It is the underutilization of the thyroid. Symptoms are caused by a slowed metabolism, and include fatigue, dry skin, weight gain, sensitivity to cold, irregular menses, and mental deterioration, if untreated.
Explain hypothyroidism and the signs and symptoms.
The onset is the amount of time between the time a drug is administered and the first sign of its effects. The peak is the highest concentration attained from a dose. The duration is the time period from the onset of the drug action to the time when response is no longer seen.
Explain peak, onset, and duration of medication concentration.
Works by decreasing hepatic glucose output and enhancing insulin sensitivity in muscle.
Explain the action of Glucophage.
They alter the synthesis of blood coagulation factors in the liver by interfering with vitamin K.
Explain the action of coumarin derivatives.
What are two causes of temperature elevations in children, and what is the difference between the two?
Fever and hyperthermia. Fever is a symptoms of illness and hyperthermia is caused by external conditions.
What is the body's attempt to fight an infection by self-inducing a hyperthermic response?
Fever.
Where should fluids be stored in a treatment room? Why?
Fluids should always be stored on the bottom shelf(s). If they leak they will not contaminate other supplies below them.
How are corneal abrasions detected?
Fluorescein stain
What action should you take if there are foreign material in a wound you are cleaning?
Flush out all the foreign material possible, but do not attempt to dig out any embedded particles.
When cleaning a two inch laceration on a healthy active duty male's right forearm, you notice some foreign material in the wound, what would be the next step?
Flush the wound
How long must an examinee blow into the PFT machine before tracing can be considered acceptable?
For at least five seconds, or until an obvious plateau in the volume-time curve has occurred.
What is the purpose of a glucose meter?
For diabetics to quickly obtain blood glucose levels.
When would a volumetric pump be used?
For intra-arterial infusions or deep central venous lines (cut-down), for patients who have multiple IV lines and whose condition is such that they could roll onto or otherwise obstruct the line.
What type of laxative is Sorbitol?
Hyperosmotic
What is hyphema?
Hyphema is bleeding into the anterior chamber of the eye.
What controls the functions to regulate the body temperature?
Hypothalamus.
What fluid imbalance is characterized by dry mucous membranes, weak and rapid pulse, orthostatic hypotension, and low central venous pressure?
Hypovolemia
What term is used to define a fluid volume deficit?
Hypovolemia.
What term means the patient has a low oxygen content in the arterial blood?
Hypoxemia.
What items in an IV tray or cart require expiration date checks?
IV fluids, IV needles, blood tubes, antiseptic wipes and bandages.
Sitting.
Ideally, in what position should you place a patient to administer an oral medication?
Try to find out why the patient is refusing the medication, report the situation promptly to the nurse or provider, and document the situation.
If a patient refuses to take a medication, what should you do?
Under what conditions can a roommate be placed with an isolation patient?
If both patients have the same disorder and are the same gender. A patient with an infectious disease may sometimes be placed with a patient without an infectious disease if they are both cooperative, understand the infectious process, and have been taught how to use the isolation techniques.
What factors determine whether you should immobilize an IV?
If it is in a precarious position, near a joint, or if the patient is fairly active.
How do you correct an error in a patient's record?
Make corrections by simply lining through the incorrect information, write the correct information next to the lined through information, and then initial and write the date you made the correction.
What measure are included in the treatment for fluid overload?
Intubating the patient; positive-pressure ventilation; administration of a diuretic; and administration of furosemide and opioids, such as morphine.
What is the body deprived of without vitamin C?
Iron.
With type I diabetes, the pancreas
Is unable to produce enough insulin to control blood sugar
What are the two physiological causes of a stroke?
Ischemia or hemorrhage in the brain.
What precaution is taken for a postoperative patient who received a radioisotope implant?
Isolation is necessary
Which medication acts as an absorbent and protectant to achieve a drying effect to the gastrointestinal tract?
Kaopectate
Why should your feet be parallel when you're standing?
Maintain balance and prevent back, hip, and leg strain
Quinidine is used primarily as prophylactic therapy to
Maintain normal rhythm after cardioversion
State the purposes of ROM exercises.
Maintain or increase muscle strength and endurance, as well as to maintain cardiorespiratory status in a patient who is immobilized.
Antipsychotic medications are categorized as
Major tranquilizers
What is your last step before leaving a patient you have moved?
Make sure the patient is comfortable and his or her body is aligned properly.
When caring for a patient with electrical burns at a facility, you first priority is
Management of the patient's airway
Which psychiatric term defines a mood disorder identified by feelings of elation and well-being, flight of ideas, and physical overactivity?
Mania
What is done by the first EMT to reach the patient?
Manual in-line stabilization for the head and neck is performed. If necessary, this stabilization is done during assessment of the airway, breathing and circulation.
How do patients who are on bed rest differ from other immobilized patients?
Many do not want to be on bed rest and will resist limitation.
What is the basic treatment for severe dehydration?
Massive infusion of IV fluids and close monitoring of electrolytes.
Why should patients without a confirmed Vitamin B12 deficiency avoid taking large doses of it?
May mask symptoms of folic acid deficiency or cause complications in patients with cardiac or gout conditions.
When cutting through thick muscular skin of the back, a provider would most likely use
Mayo scissors
For the unresponsive medical patient, what should you look for to give you knowledge of the patient's medical history?
Medic alert devices or Vial of life and information from family or bystanders.
What are the four methods used to monitor and control the sterilization process of a hydrogen peroxide plasma sterilizer?
Message screen, status indicator lights, paper printout, and beeps.
What type of acid-base imbalance occurs in the metabolism of food or fluids and is usually associated with insulin deficiency?
Metabolic acidosis.
Excessive gastric suctioning that removes too much hydrochloric acid can result in what type of acid-base imbalance?
Metabolic alkalosis.
During what stage of life do people often look back at the goals they have accomplished so far?
Middle adult.
Which healthcare providers found in AF medical facilities are authorized to both treat and admit patients?
Military and civilian physicians, dentists, and CNM.
Minerals are usually extracted from what source?
Minerals are usually extracted from the soil by plants, and we in turn obtain them form the plant foot sources or from the animal source that have eaten the plants.
A partial-thickness burn that involves less than 15 percent of the body surface is classified as what type of burn?
Minor burn.
When administering potassium intravenously, you should
Mix the potassium thoroughly before administration
How do you apply moist heat?
Moisten a towel and place between heat application and patient
What actions should you take when moving a patient on a venture mask?
Monitor in transport and reassess patient on arrival
What body functions must be monitored carefully for the first 48 hours after a spinal cord injury?
Monitor respiratory, cardiac, and GI functioning during this crucial period.
What is the priority when providing care to a patient that has abused a substance?
Monitor vital signs and sustain life
Which statement is a disadvantage of inhalation medication?
Monitoring the precise amount of drug administration is difficult
What are two reasons you should provide privacy when moving a patient?
Most patient do not want other patients staring at them as they are dragged around the bed, and some patients are accidentally exposed during the procedure.
What are the four main categories of drugs often abused?
Narcotics, sedatives, central nervous system stimulants, and hallucinogens.
What type of mask is used to administer inspired oxygen concentrations of 60-90 percent?
Nonrebreathing mask.
What type of person needs security, self-esteem, recognition, love, and affection?
No particular type; everybody has these needs.
What should you do with an isolation patient's food tray?
No special precautions are needed; hospital dishwasher are capable of decontaminating dishes.
What does the term crepitus mean?
Noise heard when bones are moved.
When conducting a patient interview, how is the "Objective" data determined?
"O"- Objective data is based on health care member's observation, physical examination and diagnostic test.
Where do you place yourself when walking with a blind patient?
Walk slightly ahead of the patient.
Which statement is true regarding how ambient temperature can affect drug action?
Warmer temperatures increase circulation and cause rapid drug action
What three veins are preferred for IV sites in the hand and arm?
the metacarpal, cephalic, and basilica veins
Describe droplet transmission.
Occurs when infectious agents are transmitted through the air short distances (less than three feet) by a person coughing, sneezing, or talking.
What nursing intervention can help to prevent dehydration when a child has anorexia
Offer small amounts of flavored fluids at frequent intervals.
Which is a sign of uremia?
Oliguria
How are paraplegic patients transferred during aeromedical evacuation?
On a Stryker frame.
For administration of an enema, the patient in preferably positioned
On his or her left side
How should items be loaded in a steam sterilizer?
On their sides.
Increased GI peristalsis, contraction of the urinary bladder, increased secretions and skeletal muscle strength, lower intraocular pressure, constrict pupils, and slow heart rate.
Once cholinergic medications have been introduced into the body, what are the actions of this type of drug?
As a minimum, how often should controlled temperature drug storage areas be monitored?
Once per day
Why do you need two people to take an apical-radial pulse?
One listens over the apex of the heart with a stethoscope, while the other counts the pulse rate of the radial artery.
When measuring urine output of an infant, one gram of diaper weight is equal to
One milliliter
In what stage do helminthes normally enter the human host?
One of the larval stages.
How should the technicians position themselves to slide a patient onto a stretcher?
One technician goes to the far side and holds the patient so the patient doesn't fall out of bed. The other two technicians place the stretcher alongside the bed and then position themselves on the far side of the stretcher. Once they are positioned, the third technician on the far side raises the siderail and joins them.
What type of orthopedic patient requires special skin care?
One who is in a cast or traction.
When are patients who are not eligible under DEERS program treated/admitted to AF medical facilities?
Only under emergency circumstances.
Which classifications of fracture are considered more serious because greater blood loss or contamination is possible?
Open
Why is it important to determine if the fracture is open or closed?
Open PSDs are usually more serious because they involve a greater blood loss and possibility of contamination.
What are the four signs that indicate an infant may be experiencing pain?
Open mouth, eyes tightly closed, flaring nostrils, and loud crying.
How are wounds classified?
Open or closed.
Pin care is required with what type of reduction to the bone?
Open reduction, external fixation
Opioid antagonists are used in the treatment of
Opioid overdose
What administration method delivers medication directly into a patient's digestive system?
Oral
Briefly describe the steps you should follow to implement a nursing activity.
Organize and find out what you have to do. Wash your hands and collect your equipment. Greet the patient, check his or her ID, explain what you are going to do, and do the procedure. Observe the patient. Clean up (wash hands) and report your actions and observation to the nurse.
What are the physical sensations that can cause a loss of appetite?
Pain, discomfort, and unpleasant sights, sounds, or odors.
What are the common causes of immobility?
Pain, neurological damage, structural defects, weakness, psychological problems, and rehabilitation measures.
List three symptoms of a fracture.
Pain, swelling, and discoloration.
What are the signs and symptoms of a fracture (PSD)?
Pain, swelling, deformity, tenderness, guarding, edema and ecchymosis, crepitus, exposed fragments, and false motion.
Which acronym is used by EMTs in the field to describe a possible fracture?
Painful, swollen, deformity (PSD)
What items should you bring to the bedside of a newly admitted patient?
Pajamas or gown, slippers, towel, washcloth, bath basin, emesis basin, water pitcher, cup, and if needed, a urine specimen cup and an IV pole.
Nonopioid analgesic.
Panadol.
What is paralysis?
Paralysis is the loss of sensation and/or the ability to move a part of the body.
What type of pathogen uses parts of the host's tissues as nutrients?
Parasitic, or infectious agents that act parasitic.
What are four methods to treat warts?
Paring down verrucae, cryotherapy, curettage, and topical chemotherapy.
Patients treated for what specific disease are advised not to take B6 supplements?
Parkinson's
What is a stupor?
Partial or almost complete unconsciousness.
Damage to the epidermis with possible damage to the dermis and its appendages is classified as what type of burn?
Partial thickness
Which statement allows a patient to depart from the medical facility for a short period of time, usually between 24 and 48 hours?
Pass
Which type of patient exercise is provided for patients who are either unable or not allowed to exercise?
Passive
What are three methods of disinfection?
Pasteurization, exposure to chemical germicides, and ultraviolet irradiation.
What type of disinfection is done by lacing small items in boiling water for a specified period of time?
Pasteurization.
What most accurately describes an organism that causes infection and disease?
Pathogen
A fracture that results from disease, such as metastatic cancer of the bone, is called
Pathologic
What is a fracture that results from disease called?
Pathologic fracture.
What is your responsibility in the pseudofolliculitis barbae clinic?
Patient education; convince them that their previous shaving program is a failure, and that you can help them.
List several examples of specific clinics or treatments that may use care extender protocols.
Patient follow up appointments in wound care, suture removal, wart treatment, throat culture and pseudofolliculitis barbae (PFB) clinics.
What two methods are used in inpatient units to help monitor the location of patients?
Patient status boards and sign-out procedures.
Which element is not required on a medication order?
Patient's age
What considerations determine the steps in the routine admission process?
Patient's condition and the facility policy
What factors determine the type of ambulation aid that will be used for each patient?
Patient's physical condition, support needed, type of disability, and the doctor's orders.
What two types of patient should be moved with the two-person technique?
Patients too heavy for one person to handle safely and patients who are incapable of assisting with the move.
How do platform crutches differ from Canadian crutches?
Patients using Canadian crutches support themselves on their hands; platform crutches are designed to support the patient's weight on the forearms and require very little hand strength.
What types of patients should receive passive exercises?
Patients who are unable or not allowed to do active exercises.
For what type of patient is an oxygen tent used?
Patients who are very sick, restless, or uncooperative.
What type of patients should receive parenteral hyperalimentation?
Patients who have a gastrointestinal disorder.
What types of patients cannot be moved by the shoulder-lift technique?
Patients who have back, shoulder, or chest injuries.
What type of patient may have daily abdominal girth measurements?
Patients with cirrhosis of the liver or when internal bleeding is suspected.
What preparation normally differs in a pediatric patient from an adult?
Pediatric patients will normally remain in their own pajamas until anesthesia is given. Adult patients change into a clean hospital gown or pajama top.
One of the most common and serious complications a female may develop from gonorrhea is
Pelvic inflammatory disease
Rheumatic fever and endocarditis.
Penicillins are used prophylactically for what diseases?
How do environmental factors influence personality development?
People develop personality characteristics by imitating or rebelling against people or objects in their environment.
What are some disadvantages of the peracetic acid sterilizer?
Peracetic acid must penetrate or directly contact all surfaces of items being sterilized, in order for Peracetic acid to effectively sterilize, all items must be thoroughly clean and free of grease and oil, cannot be used for long-term storage, this process is designed for "just-in-time" sterilization, you cannot sterilize items that cannot be submersed in liquid, you must avoid contact with the skin because Peracetic acid is corrosive and may cause skin irritation.
What does the "pH" refer to?
Percentage of hydrogen ions (atoms) present in a solution.
Opioid analgesic.
Percocet.
How do you detect corneal abrasions?
Perform a fluorescein eye stain.
Clinical signs of B12 deficiency are first noted by
Pernicious anemia
What are five physical needs of a geriatric patient?
Personal hygiene, rest and sleep, elimination, nutrition, and exercise.
What is the strongest force that affects a person's appetite?
Personal preference.
All that a person is, feels, and does is generally termed
Personality
The cramping, burning, or crushing pain complained about by amputees in their missing limb is referred to as a
Phantom limb pain
Define phantom limb pain.
Phantom limb pain is mostly experienced by the patient who was experiencing pain prior to surgery. This pain can be described as a feeling of coldness, cramping, shooting, burning, or crushing pain.
Define phantom limb sensations.
Phantom limb sensations are described as a feeling of aching, tingling, or itching in the missing limb.
In what phase of the PFB program is medical assistance no longer needed?
Phase III.
What can cause a child to feel a sense of "loss of control"?
Physical restrictions, altered routines, or dependency.
What are the three basic methods of sterilization?
Physical sterilization, chemical sterilization, and ionizing radiation.
Which on of these is a common reference source for drugs?
Physician's Desk Reference
According to Maslow's "Hierarchy of Needs" theory, in what category would the ability to breath without problems be located?
Physiological.
What is one of the easiest and most effective treatments for a patient experiencing nausea?
Place a cool, wet washcloth or hand towel on the patient's forehead and offer reassurance.
What steps should you take if you identify a small object while straining urine?
Place it in a sterile urine cup and notify the nurse
Describe how to reduce the risk of spreading infectious agents by the "airborne" route.
Place patient in a private room that has monitored negative air pressure, keep the door closed, and personnel should wear protective respiratory equipment (such as a mask).
Once a patient is pronounced as deceased, how should the body be placed?
Place the body in a natural, straight, recumbent position with the head and shoulders slightly elevated.
What are the steps used to determine the length of tube needed to reach the stomach?
Place the end of the tube at the tip of the nose, extend it to the patient's earlobe, and then down to the xiphoid process.
How can you prevent slipping in the bath tub?
Place towel or nonslip pad on the bottom of the tub to prevent slipping.
Which nursing activity is the main aspect of resolving nursing diagnoses?
Planning
What lipids are found in blood plasma?
Plasma lipids include triglycerides, phospholipids, and cholesterol.
Complex carbohydrates are called
Polysaccharides
What has a significant impact on the patient's perceived quality of care and treatment?
Professionalism and caring attitude of the staff
The semi-recumbent position should be avoided over long periods of time in patients with orthopedic disorders because it
Promotes flexion deformities of the hip
What is an accurate definition of leukocytes?
Protect against disease at the cellular level
Give three reasons for the use of a dressing over the wound.
Protection from trauma and bacteria, apply pressure to wound, patient comfort, and promote healing.
Amino acids are the small molecular building blocks of
Proteins
Name the three phases of separation anxiety.
Protest, despair, and detachment.
What cautions should the EMT take when loading or unloading a patient into an ambulance on a stretcher?
Provide safety for the patient and rescue personnel. Ensure you have at least two personnel to load a patient. EMTs must use proper lifting techniques to minimize the risk of dropping a patient or incurring a back injury to themselves and other rescue personnel.
What action do you take if the patient is not alert and his or her breathing is slower than eight breaths per minute?
Provide ventilations with a BVM and high-flow oxygen (100 percent oxygen).
What ideal situation helps a child cope with separation anxiety?
Rooming-in for parents.
What are two main causes of nausea and vomiting in the surgical patient?
Rough handling of the patient during transportation and frequent position changes in the recovery room.
Define routine and terminal cleaning.
Routine cleaning is general cleaning that's done every day and usually is performed the same as in other areas of the hospital; terminal cleaning is directed primarily toward objects the patient has actually had contact with.
The side of the body that is affected by a stroke is determined by the
Side of the brain that was traumatized
What are the signs and symptoms associated with a sodium excess?
Signs and symptoms similar to dehydration including: thirst, dry sticky mucus membranes, oliguria (scanty urine output), hyperthermia, dry tongue, and lethargy. If untreated, may lead to coma.
To use the internal girdle of support, you must
Simultaneously contract abdominal and buttocks muscles
What two procedures are preliminary steps for both transferring a patient to a chair and ambulating a patient?
Sitting up and dangling.
Which drug classification causes euphoria, excitement, dilated pupils, diaphoresis, tachycardia, and rapid breathing?
Stimulant
Describe third-degree child sexual abuse.
Third-degree sexual abuse consists of nudity, disrobing, genital exposure, observation of the child in a state of undress, intimate kissing of a child, fondling, and pornography.
Stool samples are obtained for what reasons?
To check for occult blood, parasites, fat, and other abnormalities.
What is the purpose of taking an apical-radial pulse?
To compare the pulse rate at the apex of the heart with that at the radial artery.
Describe the primary purpose of having housekeeping duties?
To control the spread of infection.
Why is the patient taught to perform the "Valsalva maneuver" prior to insertion of a CVP line?
To decrease the chance of an air embolism.
What position should a patient be placed in for insertion of a central venous pressure line into the neck veins?
Trendelenburg
The very low- density lipoproteins transport
Triglycerides that are synthesized in the liver from carbohydrates to adipose cells
What should you do if the nursing activity is unsuccessful?
Try to find out what went wrong and develop a better plan.
What type of pulmonary disorder is frequently discovered through sputum collection?
Tuberculosis.
If your conscious medical patient is complaining of pain, what would you need to ask when gathering the history?
Use the OPQRST acronym: O - Onset. What was the patient doing when the pain started? P - Provoke. What is the cause of the pain? What affects it or makes it feel better or worse? Q - Quality. What does the pain feel like? Describe it as sharp, dull, burning, stabbing or crushing. R - Radiation. Does the pain spread from one part of the body to another? Cardiac pain, for example, is commonly characterized by radiating to other areas such as the jaw or shoulder. S - Severity. Is the pain moderate, mild, or severe? Again, this is strictly a matter of individual interpretation. T - Time. Is the pain constant or intermittent? Has the pain occurred before? When did it start, how does the intensity change, and how long does the pain last?
Which wrapping method is used for most packages?
Use the diagonal method or straight method to double wrap the package to create multiple layers.
Describe how you can use leverage to help move a patient to the side of the bed.
Use your body weight to help pull the patient towards you.
Why is it easier to lift a patient with a smooth, steady motion than with a series of jerky motions?
Using jerky motions, you lose your momentum and need more energy to start moving again.
A health care provider notifies Public Health of a suspected communicable disease by
Using the telephone or locally derived form
Usually, what are the qualifications of an infection control officer?
Usually a registered nurse with training and background in epidemiology, microbiology, statistics, and research methods.
When preparing a patient for insertion of a central venous pressure line, what maneuver is taught to the patient to decrease the chance of an air embolism?
Valsalva
What type of information can a CVP provide to a physician?
Venous blood volume, assessment of right-sided heart failure, and determination of heart infarctions.
If the patient is not alert and his or her breathing is slower than eight breaths per minute, provide
Ventilations with a BVM and high flow oxygen
What does the QRS complex result from?
Ventricular depolarization.
What type of mask is used when the patient needs low concentrations of oxygen, 24-50 percent?
Venturi mask.
List the six basic tasks you must accomplish before performing a procedure?
Verify the provider order, gather all of your equipment, identify the patient, explain the procedure to the patient, use proper body substance isolation (BSI) precautions with personal protective equipment (PPE), and always provide privacy.
What is the normal range for the PCWP?
8-10 mm/Hg.
What is another term use for surgical asepsis?
Sterile technique.
What is the method of choice for chemical disinfection?
Sterilization.
What is used to determine the extent of burned surface area?
"Rule of Nines."
What are the ABCs of observing and reporting the patient's condition?
(1) Appearance of the patient. (2) Behavior of the patient. (3) Conversation of the patient.
What are the four methods used for assuring proper NG tube placement?
(1) Aspiration of stomach contents, (2) auscultating for air sounds with injection of 5-15 mL of air into the stomach, (3) assuring the patient can speak, and (4) an x-ray to ensure placement.
List three ways immediate postoperative pain is managed with medication.
(1) By injecting a long-duration, local anesthetic agent into the tissue surrounding the incision just before wound closure. (2) Using a continuous epidural catheter placed for postoperative administration of local anesthetics or narcotics. (3) Injecting narcotics intramuscularly or intravenously. (4) Giving patient nonnarcotic analgesics, such as aspirin, ibuprofen, or acetaminophen.
What are the seven regions of major lymph node locations and their respective functions?
(1) Cervical, associated with the lymphatic vessel drains the skin of the scalp, face and the tissue of the nasal cavity and pharynx. (2) Axillary, drains lymph into the upper limbs, wall of the thorax, the mammary glands, and the upper wall of the abdomen. (3) Inguinal, receive lymph from the lower limbs, the external genitalia, and the lower abdominal wall. (4) Pelvic cavity, receive lymph from the abdominal viscera. (6) Thoracic cavity, receive lymph from the thoracic viscera and from the internal wall of the thorax. (7) Supratrochlear (peripheral), in children are often enlarged as a result of infections from cuts and scrapes of the hands.
List at least four actions nursing personnel can take when a patient exhibits signs of emergence delirium?
(1) Check the airway and administer oxygen to treat hypoxia. (2) Ensure patient and staff safety by using restraining devices and siderails. (3) Check blood oxygen levels with a pulse oximeter or with arterial blood gas samples to confirm or rule out hypoxia. (4) Change the patient's position. (5) Children may be calmed by being held by their parents. (6) Drugs, such as physostigmine, may be given to reverse the effects of scopolamine. (7) Catheter may be inserted to drain the bladder. (8) Tranquilizers, such as diazepam, may be injected to calm patient fears. (9) Narcotic agents, such as morphine, may settle the patient down.
What are the normal steps for applying elastic stockings?
(1) Collect supplies, (2) Check doctor's orders, (3) Measure leg length and circumference, (4) Clean and dry the legs, (5) Turn the stocking inside out down to the heel, (6) Stretch the stocking over the heel and rest of the foot, (7) Pull the stocking over the ankle (calf and thigh [if using thigh highs]), and ensure the stocking fits smoothly and without wrinkles.
What are the four disease processes mentioned in the text that can cause a fluid volume excess?
(1) Congestive heart failure. (2) Renal failure. (3) Cirrhosis. (4) Cushing's syndrome.
What are the six parts to the initial assessment?
(1) General impression. (2) Mental status assessment. (3) Airway assessment. (4) Breathing assessment. (5) Circulation assessment. (6) Determination of priority.
Cite five factors or causes that can contribute to emergence delirium.
(1) Hypoxemia. (2) Administration of drugs, especially barbiturates and scopolamine. (3) Fear of cancer. (4) Fear of disfigurement. (5) Preoperative claustrophobia. (6) Poorly managed postoperative pain. (7) Cramping of muscles and joints caused by extended immobilization. (8) A full bladder.
List the five steps you take if a patient vomits after surgery.
(1) Immediately turn the patient's head to one side. (2) Lower the head of the bed. (3) Suction vomitus out of the mouth if the patient cannot clear it. (4) Administer oxygen. (5) Auscultate (listen to) the patient's breath sounds on both sides of the chest.
Specify five side effects of a patient vomiting.
(1) Increases recovery time. (2) Increases the risk of airway obstruction. (3) Increases risk of aspiration. (4) Causes abdominal muscle cramps. (5) May lead to wound disruption. (6) Extended nausea or vomiting may lead to dehydration and electrolyte imbalance.
Name five patient situations that would require immediate transport after the initial assessment.
(1) Poor general impression, unresponsiveness, responsive, but not following commands. (2) Difficulty breathing. (3) Shock. (4) Complicated childbirth. (5) Chest pain with a systolic blood pressure less than 100. (6) Uncontrolled bleeding. (7) Severe pain anywhere.
What are the three types of wound closure treatments, and give a brief description of each?
(1) Primary, little tissue loss or damage, wound edges are approximated and leaving only a slight chance for infection. (2) Secondary, a wound that has tissue loss such as a pressure ulcer or severe laceration edges of the wound are not approximated and the wound is left completely open to close from the inside to the out with granulation tissue and then scar tissue. (3) Tertiary-intention healing, delayed closure because there is a delay in the suturing of a wound; wounds are sutured after the granulation tissue has begun to form.
List the five stages of syphilis.
(1) Primary. (2) Secondary. (3) Latent. (4) Late. (5) Congenital.
What are three reasons for the use of cleansing enemas?
(1) Relieve constipation, (2) preparation for surgery, and (3) preparation for diagnostic procedures.
What are three reasons a catheterization is performed?
(1) Relieve or prevent bladder distention, (2) collect a sterile urine specimen, or (3) empty the bladder before certain surgical procedures.
What are the four steps you use when you plan nursing care?
(1) Set priorities. (2) Establish goals. (3) State objectives or outcomes. (4) Select nursing activities.
Cite three areas that typically cause postoperative pain.
(1) Skin and subcutaneous pain from the incision. (2) Deeper tissue pain from manipulation, retraction, electrocautery, etc. (3) Airway/respiratory tract pain from drying agents, endotracheal tubes, NG tubes, oral or nasal airways. (4) Localized pain from pressure or immobilization resulting from the surgical position. (5) IV site pain from the needle or catheter insertion, infiltration, or internal pressure.
What are the five aspects of a scene sizeup?
(1) The need for body substance isolation (standard precautions). (2) Scene safety. (3) The need for additional resources. (4) The mechanism of injury. (5) Determining the number of patients.
What are the three main causes of airway obstruction after surgery?
(1) The tongue. (2) Mucous secretions. (3) By posture.
Besides being uncomfortable, pain causes other problems. List three.
(1) respiratory problems. (2) Cardiovascular problems. (3) Nausea and vomiting. (4) Patient agitation or delirium.
What are the three steps used to disentangle patients from a wrecked car, crashed plane, or collapsed building?
(a) Gain access by disposing of the roof. (b) Create exitways by displacing doors and roof posts. (c) Disentangle occupants by displacing the front end of the vehicle.
What is the max dosage of folic acid individuals are advised to take?
0.4 mg.
LtCol McNamara ordered a single dose Phenergan 12.5 mg to be administered intramuscularly to A1C Jones for nausea and vomiting. The Phenergan is supplied in 50mg/2mL pre-filled syringes. How many mLs would you administer?
0.50
When using an oxygen tent, how frequently should oxygen concentrations and temperature be checked?
1- 2 hours
After obtaining a blood sample, instruct the patient to maintain pressure over the venipuncture site for
2- 3 minutes
How far into the urethra is the catheter inserted for the female patient?
2-3 inches or until urine begins to flow.
In cubic centimeters (cc), what is the slowest possible flow rate per hour you may set for an intravenous (IV) solution?
10- 50 cc
How many minutes will it take to properly administer a tube feeding?
10-20 minutes.
When there is an apparent vehicle fire, how many feet should the ambulance be parked from the affected vehicle?
100
When administering a vaginal douche, how high above the patient's vagina do you hang the bag?
12- 18 inches
What ages are included in the adolescent stage?
12-20 years.
What is the temperature range of the sterilization cycle in a peracetic acid sterilizer?
122- 131 degrees F
During the catheterization of a female patient, how many inches is the catheter inserted for placement in the urinary bladder?
2- 3
What size suction catheters are normally used on adult patients?
14, 16, and 18 Fr.
How many pounds are equal to 65 kg?
143
When not near aircraft, what is the maximum speed limit while driving near an aircraft?
15 mph.
When performing oropharyngeal suctioning, what is the maximum length of time you apply suction?
15 seconds.
At what age is visual acuity at its best?
15- 20
How many ways can a provider initiate a drug order?
2
When performing a pulmonary function test on a patient, according to Air Force standards, abnormal functions are present if the predicted forced expiratory volumes at one second (FEV1) or forced vital capacity (FVC) percentage is less than
80
How many pounds are in one kilogram?
2.2 lbs.
As a minimum, how many minutes should you irrigate a patient's eye with chemical burns?
20 minutes
How long is a tepid bath given?
20-30 minutes.
What is the normal sequence of joules given during defibrillation?
200, 300, and 360 joules.
A toddler is expected to weigh four times the birth weight at
24 months
How much time is required for complete crying of a cast?
24-48 hours.
During pulmonary function testing, the minimum number of practice attempts and acceptable tracings an examinee must perform are
2; 3
When do patient begin to worry about surgery?
After visiting hours are over and the patient is alone.
During catheterization of a male patient, at what angle is the penis held, and how many inches is the catheter inserted?
90 degrees, 6-10 inches
What is the normal arterial oxygen saturation range?
95- 98 percent
Notify the nurse or physician immediately if the patient's oxygen saturation falls below
97 percent
What is the target temperature of a tepid bath?
98.6 F
What is our normal body temperature?
98.6 F.
There is a high rate of success if a dentist carries out a tooth replacement procedure within how many minutes of the accident?
30
Without provider approval, what is the maximum number of minutes antiembolism stockings may be removed?
30
What is the guideline for the maximum minutes of time from pick up to the transfusion start of blood products?
30 minutes
When should Dramamine be taken when orally administered?
30 minutes before expected motion
How much vacuum must suction units provide when the tube is clamped?
300 mm Hg when the tube is clamped.
How much vacuum must suction units provide when the tube is clamped?
300 mmHg
What percentage of the body's weight are minerals responsible for?
4
What is the weight limit for the patient's baggage during aeromedical evacuation?
66 lbs.
What is the normal plasma pH?
7.34 to 7.45.
What is the normal arterial mean pressure?
70-90 mm/Hg.
The eye can generally see wavelengths between
400- 750 nanometers (nm)
How is whole blood normally supplied?
450 cc units
In minutes, what is the recommended interval for reassessment of an unstable patient?
5
What is the maximum speed limit while driving near an aircraft.
5 mph.
What is the normal CVP range?
5-12 cm H2O.
How far out from the accident scene does the danger zone extend when there are no apparent hazards?
50 feet in all directions.
During late childhood, how many words are children capable of understanding?
50,000.
Har far into urethra is the catheter inserted for the male patient?
6-10 inches or until the urine begins to flow for straight catheters and to the catheter bifurcation for indwelling catheters.
Dr. Young has ordered Mrs. Green to receive 5 mg/kg of Ancef twice a day. Mrs. Green weighs 65 kg. The medication Ancef is supplied in vials 50 mg/mL. how many mLs of the Ancef will be given for each dose?
6.5
For patient using a nonrebreathing mask, the inspired oxygen concentration is
60- 90 percent
How many pounds of baggage are allowed for a patient being aeromedically evacuated to another facility?
66
Dopamine, serotonin, and norepinephrine.
Antidepressents work in conjunction with which neurotransmitters?
What two emotions can interfere with the patient's response to surgery?
Fear and anxiety.
Drug administration is controlled primarily by
Federal law
What is whole blood mixed with after it is collected from a donor?
An anticoagulant.
What important factor of blood pressure assessment is essential to obtaining accurate results?
An appropriately sized cuff.
What routine labs are frequently completed the day before surgery?
A CBC and urinalysis.
What prevents the mixing of primary and secondary infusions when a piggyback setup is used?
A back-check valve on the primary tubing.
What is a catalyst?
A catalyst is a particular molecule that can change the rate of a reaction without itself being consumed.
What procedure should be performed if a PAP test is positive?
A cervical biopsy.
What is an electrolyte?
A chemical substance (ion), capable of carrying an electrical charge when it is in water.
What is the best position for the person who is controlling a move?
At the head of the patient so he or she can see the patient and what the other technicians are doing.
What causes backaches?
A combination of poor posture, lack of support, and stretched muscles.
A common side effect of sedatives and hypnotic medications is
A depressed state of rapid eye movement (REM) phase of sleep
Who is normally responsible for inserting endotracheal tubes?
A doctor or anesthetist.
What is one cause of cardiogenic syncope?
A fall in cardiac output.
What is emergence delirium?
A form of extreme irrational behavior exhibited by a patient emerging from a general anesthetic, characterized by screaming, shouting, and violent thrashing as if in a rage.
A neurologic check is performed at regular intervals on patients who may have what condition(s)?
A head injury or neurological problem such as a seizure or complain of a neurological symptoms such as weakness, numbness or tingling in a particular area of the body.
Rehabilitation for a patient with a spinal cord injury is normally
A lifelong process
What can you use as a substitute if you don't have a commercial transfer belt?
A litter (stretcher) strap or even the patient's own belt.
How far out from the accident scene does the danger zone extend when there is a vehicle fire?
A minimum of 100 feet.
When a child discloses that he or she was sexually abused, what type of attitude should you, as a medic, display?
A nonjudgmental attitude.
Where do the technicians grasp the drawsheet if there are only two people trying to move the patient?
At the hip and neck level.
To prevent contamination and accidental spills, liquid medications being administered to inpatients are usually poured at what location?
At the patient's bedside
What is an interservice transfer, and when does one usually occur?
A transference from one service to another with no physical movement involved; it occurs when the physician determines that the patient requires some sort of specialized care.
Antacids containing aluminum or calcium have the common side effect of
Constipation
What should you use to lubricate a PtL or ETC? What should not be used?
A water-soluble product or the patient's saliva. Do NOT use silicone or petroleum-based products as they can cause lung damage.
Adrenergic Blockers.
A patient you are caring for has CHF and is taking oral digitalis. What category of medications is contraindicated for use with the patient?
What prevents blood from backing up into the tubing of an arterial line?
A pressure bag.
What is schizophrenia?
A psychotic disorder characterized by disorientation and disorganized patterns of thinking.
Relative to the nursing process, what is a client goal?
A realistic and measurable statement of the expected change in patient behavior
Briefly define a goal in terms of patient care.
A realistic and measurable statement of the expected change in patient behavior or condition.
What is the cause of cyanosis?
A reduced amount of hemoglobin in the blood.
A rapid trauma assessment is performed on a patient with
A significant mechanism of injury, and focuses on the area of the body where the greatest threats to the patient are
What basic equipment is needed to initiate an IV?
A solution container, an administration set, and a needle.
What is a good example of first intention healing?
A surgical closure.
Define open reduction.
A surgical procedure to set, align, and stabilize a fracture.
What electrolyte deficit or excess can cause dysrhythmias, leading to cardiac or respiratory arrest?
Hyperkalemia
Why is a clean-shaven face important to continued worldwide duty?
Air Force personnel must be able to wear protective equipment for prolonged intervals. The individual who cannot be assured of a tight gas mask fit, or whose skin will become irritated that he cannot function at full efficiency.
What causes embolisms?
Air bubbles or foreign particles (clots) in the vein.
Where are medications usually added to the IV container?
In the pharmacy or nursing unit.
What are the three types of transmission-based precautions?
Airborne, droplet, and contact precautions.
What does the acronym AVPU mean?
A=alert, V=responsive to verbal stimulus, P=responsive to painful stimulus, and U=unresponsive.
What effect does cold temperature have on the blood vessels?
Causes vessels to constrict.
On what form do you identify where the patient will eat?
AF Form 1094, Diet Order.
What form does a provider use to document orders on a patient admitted to the hospital?
AF Form 3066, Doctor's orders.
What form should be filled out when reporting a medication error?
AF form 765
Describe the AF policy on substance abuse.
AF policy states that all personnel are expected to refrain from substance abuse and maintain AF standards of behavior, performance, and discipline consistent with the Uniform Code of Military Justice, public law, and AF publications. Such conduct will not be tolerated and can lead to criminal prosecution and discharge under other than honorable conditions.
What Air Force instruction provides a list of forms to be assembled after the discharge of a patient?
AFI 41-210.
What directive discusses how reportable disease lists must be updated?
AFI 48-105.
Briefly describe the AIDS disease and the virus known to cause it.
AIDS is a group of symptoms that usually result from an infection caused by the retrovirus HIV.
When helping a patient to ambulate, how should you stand and where should you place your hands?
Beside and a little behind the patient with one hand on the patient's waist and one hand under the patient's near arm
What position should a technician take when preparing to turn a patient to the dangling position?
Beside the patient with one arm behind the patient's shoulders and the other arm beneath the patient's thighs.
What are three methods to treat a subungual hematoma?
Cautery, needle, and paper clip.
When providing skin care for the elderly, it is important to avoid using
Alcohol
Insulin may potentiate a hypoglycemic effect when taken concomitantly with
Alcohol or salicylates
What should not be used as a backrub on an elderly patient?
Alcohol.
When performing an initial assessment on a patient and the patient responds by spontaneously opening his or her eyes or answers clearly, how would you assess the patient's mental status?
Alert
The method of parenteral medication administration that involves injecting a drug into a muscle is
Intramuscular (IM)
Patients who are allergic to penicillin are also most likely to be allergic to
Cephalosporins
What is another term used for medical asepsis?
Clean technique.
If a solution has a high "pH," is it referred to as "acidic" or "alkaline"?
Alkaline.
What skin preparation should you complete prior to applying a plaster cast?
Clean, dry, and protect the skin with stockinet or sheet wadding.
What is the first level of care provided for injuries of the joint?
Adequate transportation and splinting to prevent further damage to soft tissues by bone fragments.
What is involved in preparing the skin for surgery?
Cleaning, disinfecting, and hair removal.
What general tasks are included in the sterilization procedure?
Cleaning, disinfecting, wrapping, and sterilizing.
When and why are adhesive skin closures used?
Adhesive skin closures are used to approximate wound edges in areas with minimal tension on the wound (e.g., small wounds), to support wounds in which deeper structures are sutured, following suture removal to support wound edges, in tissues with poor circulation, to secure skin grafts, and in areas where cosmetic appearance is important.
The basic purpose of infusion therapy is to
Administer fluids into the circulatory system
Vaginal suppositories are
Administered to combat infection
Which pain management method must be closely monitored because it can result in a depressed respiratory system?
Administration of narcotics
Where should you insert the needle in relation to the vein you are trying to penetrate?
About 1/2 inch below the planned entry sit into the vein.
How should you place your feet when preparing to turn a patient to his or her side?
About 12-15 inches apart with one slightly behind the other.
Loss of epidermis as the result of the skin being rubbed or scraped.
Abrasion
The process by which a drug in transported from the site of entry to the circulatory system is known as
Absorption
How are patient problems and diagnoses prioritized?
According to the most life-threatening problems.
Electrolytes that release hydrogen ions in water are called
Acids
Where do you place the patient's arms using the two-person technique?
Across the chest.
What are the different types of active exercises?
Active ROM exercises, isometric exercises, bed exercises, dangling, and ambulation.
If after five days of the penicillin treatment the patient develops diarrhea, what advice would be appropriate?
Add yogurt or buttermilk to her diet and monitor the number of episodes
When can the minor surgery procedure begin?
After the consent form is signed
What specific action would you take if the above patient was scheduled for hand or arm surgery?
All jewelry on both arms or hands must be removed, including a wedding ring, even if it has to be cut off.
What are environmental factors?
All of the outside influences and conditions that affect a person's life and development.
Hypersensitivity reaction is also known as what type of reaction?
Allergic reaction.
What should you do to help patients who become angry and hostile?
Allow them to channel their hostility through verbal expression
What is the purpose of bed rest?
Allows injured tissues to heal.
What complications are associated with the IV therapy itself?
Alterations of the infusion rate, infiltration, phlebitis, infection, and embolism.
Who is responsible for completing the information in the ambulance log?
Ambulance driver
What are the building blocks of proteins?
Amino acids.
What observations must you make upon the initial assessment of the postoperative patient?
Amount and type of IV solution infusing, patient skin temperature and color, observe the dressing for bleeding, and check any drainage bags and tubes.
What are two types of enemas?
Cleansing and retention.
How can height and weight influence a person's personality?
An individual's feelings about himself or herself affects his or her perception of themselves and the world around them.
What is a regional infection?
An infection that has spread to the lymph nodes.
What are the basic components of an administration set?
An insertions spike, drip chamber, plastic tubing, clamp, vent port, medication port, secondary port, and needle adaptor.
What type of wound is created during surgery?
An intentional wound.
What type of dressing should be used on neck injuries and why?
An occlusive dressing is used to prevent the possibility of an air embolus being sucked in through a vein.
What type of exercise involves taking in less oxygen than the body needs?
Anaerobic.
Which medication's primary action in pain relief?
Analgesics, sedatives, and hypnotics
When performing a crash cart check, what should you do after ensuring the defibrillator or cardiac monitor operate?
Annotate date and time on a rhythm strip
The diet that in inadequate in all nutrients and should not be given for more than three days is the
Clear liquid
What type of medication would be prescribed for a patient with allergies to grass and tree pollen?
Antihistamines
What type of medication is given to reduce a fever?
Antipyretics.
Which substance is used to inhibit the growth and development of microorganisms on LIVING TISSUE
Antiseptic
Define an artifact.
Any artificial product or features that appear on an ECG tracing.
What is the normal rate for a KVO IV?
Between 10 and 50 cc/hour, with the amount infused at less than 500 cc.
What parts of the body are inspected during a rapid trauma assessment?
Areas of the body where the greatest threats to the patient are.
Which device is commonly used for patient transfers in wartime and disasters situations?
Army field litter
During what phase of an ambulance call do you accomplish an initial scene sizeup?
Arrival.
Where should the stretcher be positioned if the patient is to be transferred by lifting?
At a 90° angle to the foot of the bed.
When giving a cleansing enema, how many minutes should the solution be retained?
At least five minutes.
As a minimum, how often should biological testing be conducted on a peracetic acid sterilizer?
At least weekly.
When performing venipuncture, how is the needle inserted?
Bevel up, at a 45 degree angle into the vein.
What is a hazardous material?
Any substance or material in a form that poses an unreasonable risk to health, safety, and property when transported in commerce.
What are the first symptoms that should be attended to for a potential PTSD patient?
Any that may require emergency intervention, such as significant suicidal or homicidal ideation, hopelessness, self-injurious behavior, and/or acute psychotic symptoms.
Of the four item PTSD questionnaire, how many positive responses would indicate the need for a structured PTSD interview?
Any three.
Define arrhythmia.
Any variation from the normal electrical rate and/or sequence of cardiac activity.
What aspects of the inpatient unit routines should you explain to the patient?
Anything that affects the patient, including times for meals, vital signs, AM and PM care, and lights out.
How much can the prodromal period vary for different diseases?
Anywhere from a few hours to a few days.
Where is the best anatomical location to hear heart sounds?
Apex of the heart.
Which pulse point should be checked before the administration of digitalis
Apical
How can you tell a burn is a partial-thickness type?
Appearance of vesicles or blisters.
How should you handle a laceration that extends all the way through the cheek?
Apply pressure on both sides of the cheek.
When giving a cleansing enema, how high should the solution container be held above the rectum?
Approximately 12 inches above the rectum, but no more than 18 inches.
What term is used to describe the pulling together of tissue before suturing?
Approximating.
What term is used to describe the pulling together of tissue prior to suturing?
Approximation.
What term is used to describe any variance in the normal electrical rate or sequence of cardiac activities discovered on electrocardiogram tracings?
Arrythmia
What does a pulse oximeter measure?
Arterial hemoglobin oxygen saturation.
What can cause diminished pulses?
Arteriosclerosis, shock, or hypovolemia.
Any artificial products or features which appear on an electrocardiogram tracing are called
Artifacts
Why is a tracheostomy usually performed?
As an emergency measure when there is obstruction of the upper air passages.
How exact should your reports about the patient be?
As exact as possible.
When should the CISD occur?
As soon as possible following the incident.
When does the rehabilitation process begin with a mentally ill patient?
As soon as the patient is admitted
Which medical term means the absence of infection?
Asepsis
How do you determine the patient's LOC?
Ask the patient his or her name, date, and location.
What actions should you take if your patient is wearing jewelry and he or she is to go to surgery?
Ask the patient to remove his or her jewelry and leave with a family member or have the valuables placed in a safe or vault if there is not family member to leave them with.
What do you do to ensure a conscious patient is well-ventilated prior to suctioning out the trachea?
Ask the patient to take four or five deep breaths while breathing humidified oxygen.
What should you do if there are visitors present when you go to start an IV?
Ask them to step out of the room until the IV is in place.
The person in charge of a bed to stretcher transfer should be positioned
At the head of the bed on the stretcher side
Schedule III.
Aspirin with codeine falls under what schedule of drugs?
After you have applied a topical anesthetic to a wound that requires treatment, what should you do next?
Assess sensory awareness
What action should you take when you patient complains of pain?
Assess the pain and report your findings to the nurse or physician.
How should you help to prepare a patient for mealtime?
Assist the patient with oral hygiene, assist the patient to the bathroom or bedpan, provide equipment to wash his or her hands, straighten the linen, and raise the head of the bed to a sitting position.
Where should you place the call bell?
Attach it to the bed within the patient's reach.
How is the pulse taken on children less than two year of age?
Auscultated over the apex of the heart for one full minute.
When cleaning equipment, what things should you do to prevent self-contamination?
Avoid splashing, wear gloves, eye protection, and adhere to locally required protection.
Skin is torn completely loose or left hanging as a flap.
Avulsion
What type of crutch is most commonly used for short-term patients?
Axillary crutches.
Which method of temperature assessment is the easiest for children?
Axillary method.
What actions, if any, should you take if your patient complains that his or her short leg cast feels tight?
Bivalve the cast
What are some of the side effects of iron supplements?
Black stools, constipation or diarrhea, and nausea and vomiting.
The most serious complication of thrombolytic therapy is
Bleeding
Extrapyramidal side effects (EPS) common to typical phenothiazines antipsychotic medications is a result of
Blocking dopamine receptors
What is vitamin K necessary for?
Blood clotting.
What is alkalosis?
Blood pH in the range of 7.5 to 7.8 is called alkalosis, making one feel agitated and dizzy.
What is most likely to be a part of a work site wellness program?
Blood pressure screenings
What is "Battle's sign?"
Bluish discoloration on the area behind the ears (mastoid process).
A patient's weight is a factor in drug action due to
Body fat absorption
What basic rule should a crutch patient follow when going up stairs?
Body first, then crutches.
Why should "No Smoking" signs be posted outside rooms where oxygen is in use?
Because oxygen supports combustion and makes things more flammable.
What action must be taken once the premed is given?
Bed siderails must be pulled up and remain up.
When providing respiratory care, when do you listen to lung sounds?
Before and after respiratory treatments.
When using a mask in an isolation unit, put the mask on
Before entering, and take it off before leaving
For patient's who suffer from pain, the best way to ensure a successful exercise activity program is to
Begin the program early in the patient's hospital stay
When observing and reporting on mentally ill patients, the most important factor to consider is
Behavior
How should you position yourself if you are moving a near-helpless patient by yourself?
Behind the patient with your arms under the patient's arms and grasping the patient's forearms.
In a piggyback setup, what prevents the mixing of primary and secondary infusions?
Back-check valve
What possible consequences of using poor body mechanics are discussed in the text?
Backaches, muscle strains, and other permanent problems.
Which infectious agents are primitive one-celled, plant- like organisms that reproduce rapidly?
Bacteria
What is the average rate of reproduction for bacterial cells?
Bacterial cells divide every 30-120 minutes.
What should you do with disposable equipment when it becomes contaminated?
Bag, label, and dispose of it according to local policy.
Fatalities due to accidental ODs, especially when combined with other CNS depressants or alcohol. They are particularly dangerous because they are metabolized and excreted slowly and remain in the system longer.
Barbiturates are commonly associated with what situations, and why?
What are three important things you should keep in mind when conversing with a patient in regard to personal concerns?
Be a good listener and demonstrate a genuine concern, do not offer advice or solutions on matters that only the provider should address, refer the patient's concern to the nurse or provider in a timely manner.
What can you, the medical technician, do to comfort a patient concerned about his or her surgery?
Be friendly, caring, professional and be a good listener for the patient.
What two precautions should you take before moving a patient to a wheelchair?
Be sure the wheels are locked and the footrests are out of the way.
Why are both the one-person and two-person techniques unsatisfactory for moving a near-helpless patient from a bed to a chair?
Because it puts too much strain and pressure on the back of the person lifting the patient's upper body; the first technician's back.
What is the final effect of disuse osteoporosis on bones?
Bones become brittle and susceptible to damage.
What equipment is needed to apply a Plaster of Paris cast?
Bucket of tepid water, large bandage scissors, stockinet or sheet wadding, felt padding, and rolls of plaster bandage of the desired width.
Nonopioid analgesic.
Bufferin.
Describe the cycle of spouse abuse.
Build-up of tension stage, abuse stage, and the honeymoon stage or "loving phase."
For what purpose is ionizing radiation primarily used?
Bulk sterilization of commercial products.
What are the three ways used to assess a burn victim?
By agent and source, by degree, and by severity.
Before performing nasopharyngeal suctioning, how can you approximate the length of catheter that needs to be inserted to reach the pharynx?
By holding the catheter alongside the patient's face and measuring the distance between the tip of the nose and the external ear opening.
When performing intratracheal suctioning, how can you determine when the catheter is properly positioned in front of the larynx?
By listening for an increased loudness of breath sounds and by feeling more air coming from the open suction port at the base of the catheter.
How is closed reduction performed?
By manipulation and manual traction.
How does a physician notify the PH office of a reportable disease?
By phone or locally derived form.
How can the patient help with the one-person technique?
By pulling with the arms and pushing with the feet.
How do you detect an infection on a body are that is inside a cast?
By the odor.
What condition is indicated if a patient complains of pain that increases with activity?
Joint strain.
How would you help stimulate the appetite of an elderly patient?
Cater to the patient's customs
What type of medication has a cleansing action that produces watery evacuation of internal content?
Cathartics
Which over the counter central nervous system stimulant is frequently taken in prolonged high doses producing habituation and psychological dependence?
Caffeine
What triggers the body's need for more calcium intake, and what elements are needed to aid in its absorption to fulfill the need?
Calcium absorption is based on the body's need for the mineral. Calcium needs the help of vitamin D and proteins to promote the calcium absorption.
Which electrolyte in excessive amounts can cause fractures?
Calcium.
List the components of the chain of infection.
Causative agent, reservoir, portal of exit, mode of transfer, portal of entry, and susceptible host.
What is the most common reason for receiving a colostomy?
Cancer of the rectum.
Turning a patient on a Stryker frame quickly after a spinal cord injury can cause
Cardiac arrest
What are your responsibilities as an emergency medical technician at the scene of a hazmat incident
Caring for the injured and monitor and rehabilitating the hazmat team members
What should you do if the clothes you are wearing at work become contaminated?
Change into clean clothes, bag the dirty clothes and launder them in hot soapy water
What is the appearance of full-thickness burns?
Charred, coagulated, or white and lifeless surface appearance.
Which precaution should be taken just prior to performing a procedure hat uses the patient's nasogastric (NG) tube?
Check for tube placement
What should you always do before opening a sterilizer door?
Check the chamber pressure.
What should you do with a patient's labs and x-rays the morning of surgery?
Check to see if there are any labs or x-rays that need to accompany the patient to surgery.
Vitamin C can't be naturally found in which food? citrus, cheese, broccoli or tomatoes?
Cheese
Who approves a medical facility transfer?
Chief of service.
Which statement is not considered one of the patient's legal and ethical rights?
Choose the method of administration
What is the proper method of annotating shift change totals on the DD Form 792?
Circle the last accumulated total
What do you look for when you are inspecting extremities that have been casted?
Circulatory impairment and pressure on body tissues, especially over bony parts.
As a general rule, apply a cervical collar if there is any blow above the
Clavicles
A specialist who can guide a provider in prescribing drugs is best defined as
Clinical pharmacist
What are the two categories normally found on a surgical checklist?
Clinical records and patient-care procedures.
The physiological function that the heart sounds SI ("lub") is associated with is
Closure of the mitral and tricuspid valve
During auscultation of heart sounds, what does the S1 sound represent?
Closure of the mitral and tricuspid valves.
What is a code 3 response?
Code 3 refers to an emergency response using lights and sirens or HOT.
Opioid analgesic.
Codine.
List three signs of shock.
Cold, clammy, and pale skin.
What type of relationship develops when host is exposed repeatedly to a pathogen but is never successful in eliminating it?
Commensalism.
What is the first step in the actual transfusion process?
Compatibility testing.
Why should compression not be applied to an eye laceration?
Compression can interfere with the blood supply at the back of the eye and result in loss of vision from damage to the retina. Furthermore, the pressure may squeeze the vitreous humor out of the eye and cause irreparable damage.
Which psychiatric term defines an irresistible urge to perform apparently meaningless actions?
Compulsion
What do many medical treatment facilities use to avoid errors when copying a drug order?
Computer- generated product
Where is the concentration of potassium found?
Concentrated inside cells.
What two factors determine where the patient goes after finishing with the A&D office?
Condition of the patient and policy of the facility.
What are the symptoms associated with a sodium deficit?
Confusion, weakness, restlessness, hyperthermia (elevated body temperature), tachycardia, muscle twitching, and abdominal cramping. In severe cases, convulsions and coma can be the complications.
Orthopaedic deformities, such as a clubfoot or wryneck, are categorized as
Congenital
List three factors that can result in an orthopedic problem.
Congenital problems, infectious disease, and trauma.
On what types of patients can you conduct a neurological exam?
Conscious and unconscious.
Your behavior or actions in the presence of a patient who is anxious should be
Consistent
As a minimum, how often should the crash ambulance be checked?
Daily.
Hepatitis A is contracted through the transmission of
Contaminated food or water
What information should be included on the label?
Contents of the package; preparer's initials; designation for the receiving unit; a sterilization control number that usually consists of the sterilizer number, load number, and Julian date of sterilization. Depending on the local policy on shelf life, the label may also include an expiration date.
What should you do if defibrillation is unsuccessful?
Continue CPR until the physician decides the next course of action.
What law requires a periodic inventory of all controlled substances?
Controlled substance act
Referred to as a bruise.
Contusion
Which endocrine therapy drugs are used to prevent organ transplant rejections?
Corticosteroids
What type of blanket must be used in areas where oxygen is in use?
Cotton.
Which item may not be placed in a hydrogen peroxide plasma sterilizer?
Count Sheets
How do you prepare a stretcher for a patient?
Cover it with a clean, dry sheet, tuck it in around the edges to eliminate wrinkles, have another sheet and blanket available to cover the patient after he or she is on the litter, also have a pillow available if allowed, and have in place attachments to support any equipment (e.g., IV tubing, catheters, or oxygen tubing) that is attached to the patient.
How should you support a body part when you are doing passive exercises?
Cradle or cup the body part and support it above and below the involved joint.
Which term is used to describe the sound that bones make as they rub together?
Crepitus
A full-thickness burn that involves more than 10 percent of the body surface area is classified as what type of burn?
Critical burn.
What are two ways that you can impede the circulation to your lower legs when you are sitting?
Crossing your legs or sitting so the back of the chair is pressing against your popliteal area.
Penicillin administered to treat an infection is an example of what category of drugs?
Curative
What are two advantages of preadmissions?
Cuts down on patient waiting time and frustration.
What are the indications of a circulatory overload?
Cyanosis, dyspnea, coughing, blood-tinged sputum, edema, distended neck veins, weight gain, decreased urinary output, weak rapid pulse, and rapid shallow respirations.
List three sources of protein.
Dairy products, meat, fish, poultry, eggs, cereals, some vegetables, and nuts.
What are three reasons for the use of restraints?
Ensure safety, facilitate exams, and to carry out procedures.
If you are treating a severely injured patient with a life threatening problem, it may be appropriate to skip the
Detailed physical exam
While undergoing heparin treatment, Mr. Johnson's diet should be monitored closely for foods rich in vitamin
K
What type of information do you gather at the scene sizeup?
Determine threats to yourself, patients, and bystanders. It is also time when you determine the need for additional help.
What acronym is used to help you remember what to look for when conducting a physical exam, and what do the letters mean?
DCAP-BTLS: D - Deformities, body shapes that no longer appear normal; C - Contusions, bruises; A - Abrasions, scrapes; P - Punctures/penetrations, holes in the body; B - Burns, reddened, blistered, or charred skin; T - Tenderness, areas of pain identified by the patient during palpation; L - Lacerations, cuts, open wounds; S - Swelling, enlarged edematous areas.
What form is used to record I&O?
DD form 792.
When examining the scalp or cranium while performing the detailed physical exam, what do you look for?
DCAP-BTLS, bleeding, tender areas, and crepitation.
Explain debridement.
Debridement is the actual removal of foreign particles and mutilated or dead tissue from the wound and surrounding area. It is necessary to prevent contamination and promote wound healing. Debridement is usually accomplished by the physician or under the direct supervision of the physician. The procedure itself is sterile. The wound is draped, and sterile gloves and sterile techniques are used. Following debridement, the wound is irrigated again to remove any small particles and inspected by the physician in preparation for closure.
What is the primary function of washer-sterilizers?
Decontaminate/terminally sterilize used patient care items.
Angiotensin- converting enzyme (ACE) inhibitors lower blood pressure by
Decreasing vasoconstriction
Endogenous analgesics produced within the brain as a reaction to severe pain or intense exercise (aka runner's high), and these endorphins block the transmission of pain.
Define endorphins.
Initial high dose used to elevate the level of the drug in the blood quickly.
Define loading dose.
To prevent damaging the urethra, what must you remember to do what when removing an indwelling catheter?
Deflate the balloon.
What are the three distinguishable waves of an ECG called?
Deflection waves.
When caring for a child with nausea and vomiting, a primary concern would be
Dehydration
Opioid analgesic.
Demerol.
The first stage of dying is
Denial
List five emotional stages of death and dying.
Denial, anger, bargaining, depression, acceptance.
A gelatinous container that holds a drug in powder, liquid, or oil form.
Describe a capsule.
When planning activities for patients with psychological problems, your primary goal should be to
Develop a good rapport
Define exertional dyspnea.
Difficulty breathing on exertion, which is relieved by rest.
On what areas of the body would you refrain from using an anesthetic with Epinephrine?
Digits (fingers and toes), the nose, ear or penis and most flaps of skin.
What are the three simple papillary tests?
Direct, consensual, accommodative.
When applying ECG limb leads on the fleshy portion of an extremity, where should the electrodes not lie?
Directly on a bone.
What is the difference between disinfectants and antiseptics?
Disinfectants are designed to destroy pathogenic organisms and usually are used on inanimate objects. Antiseptics are designed to inhibit the growth of microorganisms on living tissue, but do not necessarily kill them.
What procedure is designed to destroy pathogens but usually does not affect spores?
Disinfecting.
What PPE does the EMT wear for protection against contacting a bloodborne pathogen?
Disposable gloves and protective eyewear or a mask.
What is the last office to be cleared by a patient when discharged?
Disposition clerk.
What are indications of internal bleeding?
Distention and firmness of the abdomen.
Central- acting alpha- adrenergic inhibitors are usually combined with
Diuretics
What symptoms may occur with blood pH alkalosis?
Dizzy and agitated
Mr. Johnson has undergone a hip replacement and is receiving heparin treatment. Mr. Johnson's daughter has received education from the nurse at the hospital regarding the heparin treatment. What patient education instructions would Mr. Johnson's daughter receive in regards to the site of the heparin injection?
Do not aspirate
What should you do with a particle that is lodged on the cornea?
Do not attempt to remove it. Notify the doctor and let him or her handle the problem.
What patient- education would be appropriate for a patient who has been prescribed Tessalon perles to help stop coughing?
Do not chew the capsule
What precaution should you take when applying tape to a dressing?
Do not wrap the tape completely around the arm.
What information will help you decide the type of exercises patients need?
Doctor's orders and patient's diagnosis and capabilities.
List at least four responsibilities of the medical technician when in pre- and post-procedures.
Don a gown if it is required; position the patient and prepare the patient's body area affected by the procedure by cleaning and irrigating as required; set up sterile fields. Make sure you also get the patient's vital signs. Assist the provider during the procedure and in dressing the wound after surgery, if required, and dispose of all sharps into the designated biohazard container. Repeat the patient's vital signs, and then assist the patient in sitting up and getting down from exam/procedure table. Be available to assist the patient in getting dressed as necessary, and then escort the patient to the waiting room if required. Ensure the patient has wound care instructions, and make any follow-up appointment as necessary. Once this is completed, clean and restock the procedure room so it will be ready for the next procedure.
Wha should you do before you begin actual contact procedures with the patient?
Don gloves.
What safety precautions should you take if you are using a metal oxygen tank?
Ensure that the fill date does not exceed five years and that the tank is secured to keep it from falling over.
To administer ear drops in a patient under three years of age, you gently pull the earlobe
Down to straighten the canal
Which devices can be used to slide a patient from the bed to a stretcher?
Drawsheet and roller board
Why is foot care important to diabetic patients?
Due to the increased risk of circulatory and healing problems, diabetic patients can have an injury or wound to a lower extremity or foot without realizing it, putting them at high risk for infection.
Why do you never restrain a patient who is drug or alcohol intoxicated in a supine position?
Due to the possibility of aspiration.
Potentiation; undesirable.
During her medical history screening at the Family Practice Clinic, Mrs. Jones admitted to taking OTC Tagamet for her heartburn at home and that her doctor had previously prescribed Tofranil for her current depression. For what type of drug interaction do you need to be alerted, and is it desirable or undesirable?
What is the primary goal during the acute stage of a stroke?
During the acute stage of the stroke, the primary goal is to sustain life.
What word is used to indicate that a mentally ill patient left the nursing unit without permission?
Elopement.
What is an endoscopic examination?
Endoscopic examination is the inspection of a body cavity or hollow organ by means of a lighted instrument.
What does it mean to phagocyte?
Engulf.
What special precaution must be taken after using the cautery method to treat a subungual hematoma and why?
Ensure the batteries are removed prior to throwing it away (normally in a sharps container). Otherwise a fire can easily start in the trash or in a sharps container if other objects press on the activator.
Prior to feeding the patient via an NG tube, what is your first priority?
Ensuring proper placement of the NG tube.
Nonopioid analgesic.
Equagesic.
Why should equipment and supplies be checked daily?
Equipment should be checked for proper function and supplies for adequate quantity, cleanliness and expiration date to ensure you are able to provide the best care possible at a moment's notice.
What are ametropias?
Errors in the eye's ability to focus on the retina when the eye is at rest.
Colostomy irrigations are performed to
Establish fecal control
What are two reasons for colostomy irrigations?
Establishing fecal control and keeping the patient clean.
What are the two most useful purposes of a PFT?
Evaluating losses in respiratory function and following the course of certain respiratory diseases.
How often are vital signs taken on a stable patient and an unstable patient?
Every 15 minutes for the stable patient; every five minutes for the unstable patient.
How often is the emergency room log generated?
Every 24 hours.
How often are oxygen humidifiers changed?
Every 48 hours.
To reduce the possibility of infection and vessel damage on patients scheduled for long- term therapy, how often should you change a patients intravenous (IV) site?
Every 48- 72 hours
How often should tracheostomy care be performed?
Every eight hours, or as often as the physician orders it.
How often should you check on a patient receiving a heat treatment?
Every five minutes.
How often are restraints checked?
Every one to two hours.
At a minimum, how frequently should immobilized patients be turned?
Every two hours.
As a minimum, how frequently should area-specific general operating instructions (OI) be reviewed?
Every two years
Antitussives work by raising the cough threshold in the cough center located in the medulla of the brain, thereby controlling coughing. Expectorants help thin and stimulate the flow of bronchial secretions and expel the loosened mucous.
Explain the difference between an antitussive and an expectorant.
NSAIDs that selectively inhibit cyclooxygenase-2 prostaglandin synthesis; they do not inhibit platelet aggregation.
Explain the function of a COX-2 inhibitor.
Sympathetic nervous system is used to mobilize the body for quick response and action. Adrenergic Blockers.
Explain the function of the sympathetic nervous system. Which category of drugs is used to prevent its action in the body?
Administration of a thrombolytic agent is administered in the emergency room or intensive care unit in the first few hours (less than six) after the onset of acute MI or CVA. Close monitoring of hemodynamics and vital signs is standard for the first 48 hrs with thrombolytic therapy.
Explain the guidelines for giving thrombolytic agents.
What should you inform the patient about before performing tympanometry?
Explain the procedure and what the patient can expect to see and hear. Also realize some of the sounds may be loud or startling, so they should do their best to remain relaxed. Advise the patient to sit quietly, avoid speaking or swallowing during the test as it can change the pressure of the middle ear and invalidate the result. Since this can be a challenge with young children, ask the parent to assist you in keeping the child quiet and still while the test is being run.
What information should you cover when orienting the patient and family to your unit?
Explain the unit's policies on visitation, use of day rooms, unit sign-in and out procedures, fire safety and evacuation procedures, patient passes, physical layout of the unit, and so forth.
What five factors determine the length of time required for a fracture to heal?
Extent of the injury, location of the fracture, the age of the patient, the size of the bone, and the circulation to the area.
Into what body cavity are otic medications administered?
External auditory canal
Why is the mortality rate high for facial burns?
Facial burns are usually accompanied by injuries to the respiratory tract.
Why should you schedule activities for a patient at a time when the patient is feeling energetic?
Fatigue lowers pain tolerance.
What is the most common lipid?
Fats.
What are the reasons patients are moved to the edge of the bed?
For repositioning, to perform various procedures, and in preparation for getting out of bed.
Once a transfusion is initiated, how long should it run slowly?
For the first 15-30 minutes.
Observing the patient's reaction to pain through vital signs, positions, and emotional responses by the patient.
How can a healthcare worker assess a patient's level of pain?
Which is a safe, stable gait that can be used by patients who can bear some weight on both legs?
Four- point
What does the term "asepsis" mean?
Freedom from infection (absence of all microorganisms), but only as applied to inanimate objectives.
Where do normal flora originate?
From exposure to various sources within our environment. They are usually found in a specific body area; they are considered normal flora for that area alone.
What signs can a patient with extreme fluid overload exhibit?
Frothy, pink sputum; obvious respiratory distress; elevated CVP; and a fluffy- looking X-ray.
What are the standard identifiers associated with the National Patient Safety Guidelines?
Full name and date of birth
A burn is classified as moderate if it involves
Full- thickness burns that involve 2- 10 percent of the body's surface
Which infectious agents includes two structural categories known as yeasts and molds?
Fungi
During placement of the NG tube, what patient reactions will indicate the need for you to stop and remove the tube?
Gasping for air, coughing, or turning cyanotic.
What term is used to denote tube feedings?
Gavage.
For what purpose is low-level disinfection useful?
General cleaning.
What virus is responsible for most warts?
Human papillomavirus or (HPV).
What nursing intervention can help to relieve most of the patient's concerns prior to surgery?
Good preoperative teaching.
What should infectious patients wear when they are being transported through the hospital?
Gown, mask, and gloves.
If you are driving your ambulance and you notice that it is hydroplaning, what should you do?
Gradually slow down without jamming on the brakes.
Explain the difference between granulocytes and agranulocytes.
Granulocytes are leukocytes that have granular cytoplasm; agranulocytes are leukocytes that lack cytoplasmic granules.
Calcium channel blockers should not be taken with
Grapefruit juice
What food or drink is known for its high potential to change intestinal tract enzymes and interfere with the effectiveness of certain antibiotics, antifungals, antihistamines and sedative- hypnotic drugs?
Grapefruit juice
At what blood alcohol level is a person considered to be intoxicated?
Greater than 100 mg/dl.
What four steps should preface any movement procedure?
Hand washing, greeting the patient, checking the ID, and explaining the procedure.
What are two ways to test upper extremity strength?
Have the patient squeeze your fingers (index and middle fingers) with both hands (ensure you have your fingers crossed or it may hurt!), push his or her feet against your hands and have them hold his or her arms straight in front and push down on your hands and then resist as you push down on his or her outstretched forearms.
What is the procedure for measuring crutch length in a standing patient?
Have the patient stand up straight and measure from a point six to eight inches out from the side of the patient's heel. Adjust the crutch so the top piece is two to three fingerbreadth below the patient's axillary fold.
What does the provider often do to help a patient relax and sleep prior the night before surgery?
He or she will normally order medications to help the patient relax and sleep.
Opioids are contraindicated with
Head injury treatment
What symptoms indicate possible mild TBI?
Headache, irritability, fatigue, dizziness, confusion, and ringing in ears.
How do you place stretcher patients onto an elevator?
Headfirst.
What type of community health program is designed to assess health status and provide services that assist in maintaining a healthy lifestyle?
Health and wellness programs.
Care must be taken to ensure patients do not strain while holding their breath when performing isometric exercises as that may cause
Heart attack
What elements can cause burns to body tissues?
Heat, chemicals, electricity, and radiation.
When using the appropriate namogram to determine predicted values, what two factors must be known?
Height and age.
What can you do to reduce patient problems with ambulation?
Help the bedridden patient remain as active as possible and move the patient out of bed in gradual stages.
What types of patients are transported on stretchers?
Helpless and near-helpless patients, preoperative and postoperative patients, and others who must remain in a lying position.
What are the functions of water in a body?
Helps with the transportation of chemicals within the body. Blood plasma is made up of 90-95 percent water, enabling vital substances to be transported throughout the body. Substances carried by the blood are sugars, salts, vitamins, and, of course, oxygen. Blood also transports the waste products of carbon dioxide, and urea out to the lungs and kidneys, respectively. Water is a major component of body fluids where most biochemical reactions occur and it helps to regulate body temperature.
What special test is used to detect occult blood in the urine?
Hematest.
A pool of blood that forms beneath the skin.
Hematoma
What condition should be treated with blood volume expanders?
Hemorrhagic shock and other forms of shock characterized by an excessive plasma loss.
Describe the function of a hemostat and rake retractors.
Hemostat - used for clamping or occluding. Rake - used for exposing or retracting.
Which ailment is not treated by vitamin K? Ulcerative colitis, heparin overdose, malabsorption syndromes or prolonged use of salicytes
Heparin overdose
What three health risk factors cannot be changed?
Heredity, gender, and age.
Which position is the bed placed in preparation to receive a postoperative surgical patient?
High
What position is the patient placed in for NG insertion?
High Fowler's position.
When are pneumatic stockings normally used?
High-risk patients who are undergoing general anesthesia.
How do you start the first suture?
Hold the instrument in your dominant hand, perpendicular to and above the point you want to pass the needle through. Pass the suture material through the epidermal and dermal layers of the skin.
What does muscle tone do?
Holds the body erect when you are standing, sitting, walking, or balancing.
Define the term lavage.
Introduction of a solution into the stomach through a tube and then siphoning the solution back out.
What is not a commonly used disinfecting agent?
Hydrochloric acid
Exert a therapeutic effect on an individual's mental process, emotions, or behavior.
How do psychotropic medications work?
Secrete hormones called corticosteroids that act on the immune system to suppress the body's response to either infection or trauma.
How do the adrenal glands function?
For patients less than three years of age, gently pull the earlobe down to straighten the canal. For adults, pull the auricle up and back to straighten the canal.
How do you administer ear drops in a patient younger than three years of age? In an adult?
They combat arrhythmias by inhibiting adrenergic (sympathetic) nerve receptors.
How do β-adrenergic blockers work?
Immediately or may take months.
How long does it take for the effects of drug toxicity to be noticed?
Before, during, and after the therapy.
How often do you assess a patient's vital signs when administering an inhalation?
At least once daily. Medications may become unstable or deteriorate if not stored properly.
How often should controlled temperature drug storage areas be monitored, and why is this done?
Apply one patch once weekly for three weeks, then let the patient have one week free of patches, and then repeat the cycle. The application site should be rotated each time a new patch is applied. Ensure the patient understands that the old patch must be removed when a new one is applied!
How should transdermal hormone contraception patches be applied? What should you ensure the patient understands?
What three factors should you consider when you are planning a task?
How you will do the task, what equipment you will need, and how much help you will need.
Name the parts of a needle
Hub, shaft, and bevel
When is keeping a child's I&O records appropriate?
If the child has a fever, hyperventilation, renal or cardiac disease, or diaphoresis; is receiving IV or diuretic therapy; is placed on restricted fluids; or has cystic fibrosis. It is also important when a child has electrolyte losses associated with vomiting, diarrhea, GI drainage, or extensive open wounds, such as burns, that can deplete or alter fluid reserves.
Under what circumstances would you remove contact lenses in the field?
If the patient has a chemical or foreign object in the eye and is unable to remove the contacts by himself or herself.
How should you handle a patient who is bleeding from the mouth and has a possible spinal cord injury?
If the patient has a potential spinal injury, avoid airway maneuvers that may cause further damage (i.e., neck lift). Stabilize the spine and turn the patient to the side to allow drainage.
Before administering the PFT, what information must you find out from he patient that may have an effect on the test?
If the patient has smoked or administered a bronchodilator within the past hour, eaten a meal with the past two hours, or is acutely ill or has experienced on upper or lower respiratory tract infection during the past three weeks.
While working in the emergency room, a patient comes in and states that he or she has splashed a chemical in his or her eye, what should you determine first?
If the patient is wearing contact lenses and which type
What is the treatment for chemical burns to the eyes?
Immediate and thorough flushing with sterile saline or water for 20 minutes.
What is the primary cause of decubitus ulcers?
Impaired circulation to the skin and subcutaneous tissue in areas of the body where the bony prominences lie close to the skin surface.
Which signs or symptoms of nervous system impairment would you look for in an intoxicated patient?
Impaired vision, uncoordinated movement, behavioral changes
How is plasma supplied?
In 225 cc units as pooled, fresh frozen, or single-donor plasma.
How should you greet a patient when he or she first arrives on you unit?
In a friendly manner.
What is the difference between anterior/anterior and anterior/posterior placement?
In anterior to anterior placement (AV Node failure), The negative electrode is placed under the right clavicle and the positive electrode is placed at the V6 position. In anterior and posterior placement (SA Node failure), the negative electrode is placed at the chest at the V3-V1 position and the positive electrode is placed on the patient's back to the left of the spine.
Why should you cover both eyes when a patient has an injury to only one eye?
In most people, the eyes move together as individuals focus on different things. Even though it is patched and injured, the injured eye follows the motions of the uninjured eye as the patient looks at different things.
A computer-generated product that lists all the medication orders that apply to a particular patient.
In order to avoid errors, what do many facilities use to copy a medication order?
How do you move a patient to the edge of the bed if you are working alone?
In stages.
When educating the patient with psuedofolliculitis barbae (PFB) on proper shaving methods, you should instruct the patient to shave in
In the direction of the hair growth
Lower conjunctival sac.
In what part of the eye do you administer ophthalmic medications?
Schedule I.
In which schedule are drugs not acceptable for medical use and have a high potential for abuse?
What are two causes of weakness?
Inactivity or degenerative processed like cancer.
What causes orthostatic hypotension?
Inadequate vasoconstriction.
What is the potential side effect when antacids are taken concurrently with coumarin derivatives?
Increase bleeding time
What are the actions of sulfonylurea medications?
Increase the insulin production of the pancreas and better peripheral insulin activity
A major contributor of young children developing type II diabetes is
Increased obesity
How do patients benefit from pull-up and push-up exercises?
Increased upper body strength.
Which stage of infection is the period of time between the invasion of the infectious agent into the body and the onset of symptoms of the particular disease?
Incubation
What are the stages of an infectious disease?
Incubation, prodromal, illness, and convalescence.
Describe indirect contact.
Indirect contact is touching contaminated objects such as forks, spoons, coffee cups, and medical equipment.
What kind of individuals are more susceptible to stresses than others?
Individuals with no sense of security, lack self-esteem, or receive very little recognition, love, or affection.
During what stage of life does the development of stable sleep patterns occur?
Infant.
During which stage of healing are immature fiber cells and capillaries formed?
Inflammation
Define hepatitis.
Inflammation of the liver that can be caused by bacteria, viruses, protozoa, helminthes, chemicals, or drugs.
What is meningitis, and what is the most serious type?
Inflammation of the meninges covering of the brain and/or spinal cord; bacterial meningitis.
Which vaccine should not be administered to individuals allergic to eggs or egg products?
Influenza
Explain the progression of the electrical impulse through the heart.
Initiating in the ST node, the electrical impulse passes through the AV node down the Bundle of His to the left and right bundle branches, and then through the Purkinje fibers which terminate in the ventricular walls.
What types of head and facial injuries could result in airway problems?
Injuries to the face and throat can lead to airway obstruction from bleeding, loose dentures or teeth, deformity, or swelling. The patient may also have a direct injury to the trachea or a brain injury that interferes with breathing.
What equipment or areas commonly have a daily checklist?
Inpatient/outpatient and treatment rooms, crash carts and IV trays.
What are two possible treatments for postural/orthostatic hypotension?
Intravenous therapy, or blood transfusion therapy.
How do you "prime" the administration set?
Insert the spike onto the appropriate opening and allow a small amount of solution to flow through the tubing to eliminate air bubbles.
What type of needle is most commonly used when the possibility of extravasation is possible?
Inside-the-needle catheters.
Prior to use, what is an LMA inspected for?
Inspect the cuff for tears and other abnormalities, inspect the tube for blockage or loose particles, deflate the cuff to verify it will hold a vacuum, and inflate the cuff to check for leaks.
What is the body's best natural barrier to infection?
Intact and unbroken skin.
What is the purpose of a patient pass?
It allows a patient to depart from the medical facility for a short period of time, usually 24 and 48 hours.
Briefly describe how ultrasonic cleaning works.
It cleans by passing ultrasonic waves through a fluid. This produces submicroscopic bubbles, which collapse and pull dirt from objects by suction.
Briefly describe the construction of a hydraulic hoist.
It consists of a canvas sling supported by a metal frame on wheels. The lift has several pivot points that can be adjusted by a hydraulic cylinder.
When performing a skin puncture, why is the first of blood wiped away?
It contains epithelial cells that may interfere with test results
What is the purpose of a preop urinalysis?
It gives the surgeon information about the blood and function of the kidneys.
How does the frequent use of restraints reflect the quality of nursing care?
It is a general indication that the quality of care is poor.
What is a sprain?
It is a joint injury in which the joint is partially, temporarily dislocated, and some of the supporting ligaments are either stretched or torn.
What is the purpose of using a pulse oximetry/oxygen saturation device?
It is a noninvasive method used to rapidly determine the pulse and oxygen profusion of a patient.
What is the purpose of convalescent leave?
It is nonchargeable leave for the minimal time required to meet medical needs for reoperation.
What does the term extrication mean?
It is the process by which entrapped patients are rescued from vehicles, buildings, tunnels, or other places.
Why is exercise important to the patient with arthritis?
It keeps the muscles toned and prevents contractures and deformities.
How does inflammation affect movement of body parts?
It limits joint motion and causes fibrous tissue to form, producing fibrous or bony ankylosis.
Briefly describe the effects hypothermia can have on a patient.
It may intensify the depressant effects of anesthetic agents, slowing respiration and causing the patient to shiver uncontrollably making him or her use oxygen more rapidly. The net result is a significant lowering of the amount of oxygen in the blood.
What do you do if there is a discrepancy between the patient's ID band and his or her surgical paperwork?
It must be brought to the attention of the unit nurse and corrected immediately.
What should you check on the cardiac electrode? Why?
It needs to be checked frequently to secure placement on the patient. The expiration date must be checked, and the gel on the electrode must be moist. An outdated electrode is more likely to be dried out, and a dry electrode will not accurately transmit tracing.
What is a disadvantage of the scoop stretcher?
It pinches the patient as the sides are brought together.
What are NPSH used for?
It reliably identifies the individual and matches the service or treatment to that individual.
How should equipment and supplies be stored in the ambulance?
Items should be stored according to their relative importance and frequency of use.
For sterilization processes, what type of patient use items are classified as semicritical?
Items that come into contact with intact mucous membranes, but do not penetrate body surfaces.
If you suspect a patient has a spinal cord injury, what technique would you use to open his or her airway?
Jaw-thrust.
Which type of lipoprotein has characteristics of having relatively high concentration of cholesterol?
LDL.
What are the technician's duties when tissue sample is taken and must be processed by pathology?
Label specimen, log it into AHLTA and or log into a hardcopy book, and transport the specimen to pathology.
A cut produced by a sharp object.
Laceration
What are three reasons an elderly patient might have difficulty with regular bowel eliminations?
Lack of proper exercise, reduced muscle tone in the GI tract, and less roughage and fluids in the diet.
Simple diarrhea caused by antibiotics, infection, irritable colon, colostomy, or amebiasis.
Lactinex is used for the treatment of what conditions?
What is the most common cause of airway obstruction in the conscious patient?
Large, poorly chewed food particles.
When do you serve patients who require the most assistance?
Last.
Cathartics are categorized as
Laxatives
What position is the patient placed when administering an enema?
Left lateral recumbent or on his or her back.
What are PCWPs greater than 20 mm/Hg associated with?
Left ventricular failure, pulmonary congestion, and hypervolemia.
What neurological checks need to be done frequently on a stroke patient?
Level of consciousness, pupil reactions, hand-grip strength, and foot strength. Vital signs need to be monitored as well.
What cells do lymph nodes contain in large number to fight invading microorganisms?
Lymphocytes and macrophages
The drug of choice when treating premature ventricular contractions associated with a myocardial infarction is
Lidocaine
What kind of light rays does a constricted pupil allow to enter the eye?
Light rays going relatively straight to the eye.
What objects should the patient avoid using for support?
Light, unstable objects and objects that are on wheels (overbed tables) or ordinary chairs.
What diet is usually ordered for patients who have difficulty chewing or swallowing or need to alter the amount of residue in the digestive tract?
Liquid
Arthritis, bursitis, gout, muscle strains, and sprains that cause swelling, limiting an individual's mobility.
List five disorders for which anti-inflammatories are commonly prescribed.
Patients with known liver and kidney impairment, debilitated or malnourished patients, and patients with severe infection.
List the contraindications of sulfonylureas.
For elderly patients, especially with GI diseases or arteriosclerosis. Children or adolescents are at higher risk for cartilage damage. Patients who are pregnant, lactating, have severe renal impairment, seizure disorders, or cardiac disease must be monitored for adverse effects.
List the contraindications or extreme cautions of quinolones.
The medication, dosage, time, route, location if an injection, adverse signs or reactions, and the patient's response.
List the elements of proper medication documentation.
(1) Be knowledgeable. (2) Use judgment. (3) Have skill in delivery. (4) Patient education.
List the four basic principles of medication administration.
(1) First generation is usually effective against gram-positive organisms, such as those that cause some pneumonias or urinary tract infections. (2) Second generations are usually effective against many gram-positive and gram-negative bacteria like many strains causing bacterial influenza. (3) Third-generations drugs are used in the treatment of mostly gram-negative bacteria and sometimes used for sexually transmitted diseases, such as gonorrhea. (4) The fourth generation of cephalosporins is new. The parenteral cephalosporin, Maxipime, works well with both gram-positive and gram-negative bacteria.
List the four classifications of cephalosporins and what they treat.
Nausea, vomiting, diarrhea, rash, dizziness, ataxia, leukopenia with prolonged use, daytime sedation, confusion and headache, amnesia, and hallucinations. It is contraindicated for patients with known severe liver and renal impairment and porphyria.
List the side effects of nonbarbiturates.
Sedation, confusion, euphoria, restlessness, hypotension, and bradycardia. The respiratory rate may be depressed, urinary retention may occur, along with blurred vision, and seizures with large doses.
List the side effects of opioids.
Develops suddenly and is usually seen during the peak of the insulin action. These symptoms may include increased perspiration, irritability, confusion, or bizarre behavior. Individuals may experience tremors, weakness, headache, or tingling of the fingers. In severe cases the individual may lose consciousness and have convulsions, if untreated. These signs usually occur as a result of an OD of insulin, a delay or insufficient food intake, excessive or unusual exercise, or when there has been a change in the type of insulin being used. An example may be when the patient changes from pork to human insulin.
List the signs and symptoms of hypoglycemia, and when do these signs usually occur?
(1) Synergism—Action of two drugs working together, for a more effective result. (2) Potentiation—Two drugs, one prolongs or multiplies the effect of another. (3) Antagonism—Opposing action of two drugs, one decreases or cancels the action of another.
List the three drug interactions with a brief description of each that the technician needs to be aware of.
What organ is primarily responsible for controlling lipid metabolism?
Liver
What factors determine the cleaning method to be used for equipment?
Local policy, type of object to be cleaned, and amount and type of organic material on the object.
What are the signs and symptoms of a superficial burn?
Localized areas of redness due to dilation and hyperemia of the blood vessels in the skin. Pain, tenderness, and temperature elevation of the affected area are also present.
What is the goal of care provided during the immediate postoperative period?
Look for adverse reactions or complications from surgery. What is the goal of care provided during the immediate postoperative period?
What three possibilities should you suspect if the blood pressure of a postoperative patient begins to drop?
Loss of blood, drug effect, or shock.
What effect does immobility have on the respiratory system?
Loss of respiratory muscle tone, inadequate exchange of oxygen and carbon dioxide, disruption of the acid-base balance, hypostatic pneumonia, and atelectasis.
What is the third level of needs on Maslow's Hierarchy?
Love and belonging.
Which need is satisfied when people are able to establish and maintain meaningful relationships?
Love and belonging.
Why are oral medications that are taken before meals generally faster acting?
Lower digestive system content
Adrenergic blockers are used in low doses for patients with
Lung conditions that cause bronchospasm
What actions should you take when preparing to assist a patient from a vehicle into a wheelchair?
Move the wheelchair to the patient side of the car, open the door, and introduce yourself. It is best to ask if you can help the patient move into the wheelchair. Lock the wheels of the wheelchair to keep it from sliding away. Ask the patient if it is okay if you place your hands under his or her arms or around the waist once he or she stands to keep him or her from swaying, falling over, or collapsing down.
What is adduction?
Movement toward the center of the body.
10 ml.
Mr. Adams has an order to receive 5 mg/kg of medicine each day. Mr. Adams weighs 220 lbs. The medicine is supplied in 50 mg/ml. How many mls does the patient receive?
100 kg.
Mr. Adams has an order to receive 5 mg/kg of medicine each day. Mr. Adams weighs 220 lbs. The medicine is supplied in 50 mg/ml. How much does Mr. Adams weigh in kgs?
What must you do to the predicted FEV1 and FVC values for non-Caucasian examinees and why?
Multiply them by 0.85; to adjust for the lower (15 percent difference) predicted normals.
Which is a characteristic of late adulthood?
Muscle atrophy
What are the signs of vitamin C deficiency?
Muscle weakness, cramping, lethargy, sore and bleeding gums in mouth, degenerative changes in bone and connective tissue.
What are some typical procedures performed in SDSCs?
Myringotomy, odontectomy and cystoscopy.
When transmitting information about a patient over the radio, what information should not be broadcast?
Name
Physical and psychological.
Name the two types of drug dependence.
What type of information is considered inappropriate for transmission over the radio?
Names of those you are transporting and anything of a personal nature about them.
Opioid antagonist.
Narcan.
What are the general categories of suture material?
Natural or synthetic and absorbable or nonabsorbable.
List all equipment needed to perform venipuncture.
Needle (20 gauge or larger), syringe (size depends on amount of blood needed), antiseptic, 2x2 gauze sponges, vacutainer and vacutainer needle ( if using vacutainer system), test tubes with proper color for tests ordered by the physician, tourniquet, and nonsterile gloves.
Which leukocytes are the most active phagocytes?
Neutrophils and monocytes.
A sign of vitamin A deficiency is
Night Blindness
How high should the IV container be positioned?
Normally between 24 and 36 inches above the patient.
Normally, what admissions procedures are done by the admissions nurse and technician?
Nursing medical history, patient evaluation, vital signs, and height and weight.
How do objectives relate to goals?
Objectives are the day-to-day activities that the patient must do to reach a goal.
What information is included in the nurse's discharge note?
Observations of the patient's condition, any final treatments, and discharge instructions.
What would be the responsibility of the medical technician during a routine patient admission to a nursing unit?
Obtain patient's vital signs, height, and weight
What kind of information and assistance does the CDC provide military hospitals?
Outlines how infection control programs should be developed and operated, assists in solving infection problems, analyzes infection survey data, and investigates the outbreak of serious infections and diseases. The CDC also researches and publishes guidelines on a variety of infection control topics.
Nonopioid analgesics are available
Over the counter
What is the most common/serious complication of gonorrheal infections in women?
PID
Because you cannot diagnose a fracture, how do you refer to the possibility of one in the field?
PSD.
What are the indications of facial fractures?
Pain and swelling, bite irregularity, loose or absent teeth, inability to talk or swallow, increased salivation, bleeding in the mouth, and loose bone fragments.
What is a primary concern when administering potassium intravenously, and how can it be prevented?
Pain at the injection site or phlebitis may occur; potassium should always be run at a slow rate, mixing potassium in an IV solution where it must be mixed thoroughly by inverting and agitating the bag before the solution is hung for administration.
What are the eight signs and symptoms of fluid volume deficit?
Poor skin turgor, concentrated urine which will result in a high specific gravity, dry mucous membranes, weak and rapid pulse, orthostatic hypotension, a low venous pressure (below four cm of H2O), confusion, and restlessness.
Calcium can be found in all of the following sources except Kale, Pork, Salmon or Turnip Greens
Pork
If the patient has a priapism, what should you suspect?
Possible spinal cord injury.
What is another term for orthostatic hypotension?
Postural hypotension
What is the most common side effect of antihypertensives?
Postural hypotension
What electrolyte deficit and excess can cause dysrhythmias leading to cardiac or respiratory arrest?
Potassium.
When Angiotensin- converting enzyme (ACE) inhibitors are taken in conjunction with diuretics or vasodilators, what effect is produced?
Potentiate hypotension
A good source of protein is
Poultry
A finely ground drug that can be used internally or used externally describes a type of medication preparation called a
Powder
What is a way to help relieve most of the patient's concerns prior to surgery?
Preoperative teaching
What are the three steps to proper shaving technique taught to the PFB patient?
Preparation of the face, the shave, and the finish.
What type of instrument should you use to label a sterile package?
Preprinted indicator tape, or use an indelible-ink, felt-tipped marker to write the information on the "external chemical indicator" tape.
What are the key components that the UP is built on?
Preprocedure verification, site marking, and preprocedure time out.
During which child development stage is separation anxiety the most stressful?
Preschool
Which type of sterilization uses gravity displacement sterilizers, prevacuum sterilizers, and washer-sterilizers?
Pressurized steam sterilization.
When administering eye medications, ensure the patient's treated eye is lower than the other in order to
Prevent the solution from running into the patient's unaffected eye
What is the purpose of isolation precautions?
Prevent the spread of microorganisms among staff, patients, and visitors.
Anti-inflammatory actions are associated with
Preventing the formation of prostaglandins
What are the immediate postoperative goals for the amputee?
Prevention of hemorrhage, infection, and contractures.
What is the best treatment for musculoskeletal problems related to immobility?
Prevention.
What additional advantage do you obtain by bracing your feet against the patient's feet when helping the patient to a standing position?
Prevents the patient's feet from sliding out from under him or her.
Nathan has broken out with chicken pox for the first time. His body's response is called a
Primary immune response
What are the foundations of safe and effective healthcare?
Proactive risk identification, assessment, and control
When you ask a medical patient what may have triggered his or her pain, you are questioning about
Provocation
What is pseudofolliculitis barbae?
Pseudofolliculitis barbae (shaving bumps) is an inflammatory condition of facial skin that develops around ingrown hair fragments resulting when curved hair is closely cut.
What enables the amoebae to propel itself and ingest food particles?
Pseudopods or false feet.
How should tape and bandages be removed?
Pull tape parallel to skin, toward dressing, and hold down uninjured skin. If over hairy areas, remove in the direction of hair growth. Obtain patient permission to clip hair from area. Remove any adhesive from skin.
In the objective information section of the paperwork, it is important to identify the patient's
Pulse rate
Caused by a stab with a pointed object.
Puncture
What is not a side effect of tricyclics?
Pupil constriction
What does PERRLA stand for?
Pupils Equal, Round, Reactive to Light, and Accommodation.
According to Florence Nightingale's theory, what are the controllable environmental factors medics should be concerned about?
Pure or fresh air; pure water, efficient drainage; cleanliness; light (especially direct sunlight).
What controllable factor did Florence Nightingale link with health and environment?
Pure water
When should you put on and take off a mask?
Put it on before you enter the room and take it off before you leave.
How do you prepare the bed for moving a patient?
Raise it to a working level, lock the wheels, lower the head of the bed, and place the pillow against the headboard.
When turning a patient, what is the most important precaution to take whether you are pushing or pulling the patient?
Raise the far siderail
What is the main treatment for excessively high body temperatures?
Rapid cooling of the body, both internally and externally.
At what temperature should the tube feeding solution be when you use it?
Room temperature.
Nonopioid analgesic.
ReVia. a. Nonopioid analgesic. b. Opioid antagonist. c. Opioid analgesic.
Define self-actualization.
Reaching one's full potential.
What should be done prior to operating a glucose meter?
Read the operating instructions
What is the responsibility of a dispatcher?
Receiving and processing calls. Other responsibilities include: providing medical instructions to patients, dispatching and coordinating emergency personnel, and possibly coordinating with other on-base/off-base agencies.
A proctoscopy is an inspection of the
Rectum
What are the signs of post traumatic stress disorder?
Recurrent and intrusive recollections of the injury, dreams of the event; feeling of being wounded again, psychological distress when the memory of the accident/incident is triggered.
Which of the following best states the purpose of the standard precautions recommended by the Centers for Disease Control (CDC)?
Reduce the risk of transmission of micro-organisms from both recognized and unrecognized sources of infection in hospitals
What is the best reason for prepping the skin prior to surgery?
Reduces the chance of infection
What are benefits the patient receives from frequent oral hygiene?
Reduces the growth media for bacteria and it refreshes the patient and stimulates the appetite.
Closed- chest drainage is a drainage system used to
Reexpand a collapsed lung
What reflex action would be caused if you leave a heat treatment in place for a prolonged period of time?
Reflex vasoconstriction
What are three reasons nonmedical individuals contaminate themselves when attempting to deal with isolation?
Refusal to believe that they can be contaminated, so they ignore the precautions; lack of understanding what they are supposed to do and they become contaminated without knowing it; individuals who are illiterate or don't read English and become infected due to their inability to understand the caution signs posted on isolation room doors.
Which individual is not authorized to see and treat patients?
Registered Nurses
The normal adaptive mechanism used by children when they lose their sense of control is
Regression
What psychological condition is exhibited when a patient spends a great ideal of time worrying about meals and bowel movements?
Regression and child-like behavior.
Nursing actions that facilitate self- actualization is pertinent during which aspect of the nursing care?
Rehabilitation
What is the proper sequence for cleaning a wound?
Remove old dressing, don sterile gloves, wipe from the wound out
What is the best way for a medical technician to ensure sterility of an intravenous (IV) solution?
Remove protective devices yourself
What steps are accomplished during an ongoing assessment and how often is it performed?
Repeat initial assessment continually checking for life-threatening problems, reassess and record baseline vital signs, repeat focused assessment regarding patient complaint or injuries, and check the interventions. The ongoing assessment is performed every 15 minutes for a stable, oriented patient and every 5 minutes for an unstable patient.
What action, if any, should you take if you notice a child shows signs of abuse, such as burns and bruises?
Report the suspected abuse
What are nursing activities designed to do?
Resolve nursing diagnoses.
Which of the vital signs is taken first for pediatric patients? Why?
Respirations, because taking the pulse or temperature may disturb and irritate the infant or child causing them to cry.
Deficiency in respirations such as slow or irregular shallow respirations can lead to excessive accumulation of carbon dioxide in the blood which results in a condition called
Respiratory acidosis
What condition occurs if CO2 builds up and mixes with water in the blood stream?
Respiratory acidosis
An increase in carbonic acid in the body fluids associated with difficulty breathing can result in what type of acid-base balance?
Respiratory acidosis.
Hypoventilation can cause what type of acid-base imbalance?
Respiratory acidosis.
Which acid- base imbalance is caused by hyperventilating?
Respiratory alkalosis
Hyperventilation can cause what type of acid-base imbalance?
Respiratory alkalosis.
What type of acid-base imbalance is associated with a patient hyperventilating?
Respiratory alkalosis.
What are the normal exit portals for infectious agents?
Respiratory tract, gastrointestinal tract, skin and mucus membranes.
List four common complications of uncontrolled diabetes?
Retinal changes leading to blindness, kidney disease, nerve damage, and circulatory disorders.
While arriving at a scene there is loud shouting and gunfire, what would you do?
Retreat to a safe area and call for help from the Security Forces.
What type of organism causes Rocky Mountain spotted fever?
Rickettsiae.
In what anatomical location is the pacemaker lead inserted when using a temporary external pulse generator system?
Right atrium
Regarding vision, what is the difference between rods and cones?
Rods do not provide images as sharp as cones.
What should the solution temperature be during gastric gavage?
Room temperature
What does SAMPLE assist you in remembering when you are checking the patient?
S - Signs or symptoms; A - Allergies; M - Medications; P - Pertinent past history; L - Last oral intake; E - Events leading to the illness or injury.
What kind of format is used to document an interview with a patient?
SOAPP.
Shelter is a consideration that falls into which need category?
Safety and security.
If you find calculi when straining urine, what should you do?
Save it and send it to the laboratory for analysis.
What can happen if staples or sutures are left in place too long?
Scarring and infection.
The action of assessing the scene of an accident to provide valuable information to the emergency medical technician is called
Scene sizeup
Narcotics, such as codeine, cocaine, and amphetamines, which have a high potential for abuse, but have accepted medical uses are classified as
Schedule II
Pregnant women who overdose on B6 may cause newborns to be born with
Seizures
What need relates to how others feel about you?
Self-esteem.
What affects an individual's feeling about themselves?
Self-perception
Ideally, in what position is a patient placed before performing oropharyngeal suctioning?
Semisitting
List four stressors that influence the way children cope with hospitalization.
Separation, loss of control, fear of bodily injury, and pain.
What is probably the greatest stimulant to the appetite of an elderly patient?
Serving an attractive meal with considerations for the individual likes and dislikes and catering to the patient's personal customs.
How should you react to a patient who becomes verbally or physically abusive?
Set limits and enforce these limits. Let the patient see that you have the support of others.
What are some of the general patient skills 4N0s perform?
Set-up minor surgery, set-up/maintain sterile field, perform height and weight, record temperature, assess pain scale, perform and label venipuncture, assess APGAR score, obtain body measurements, perform immunizations, collect and label emesis, urine, stool samples, assess respiratory rate, and perform intake and output measurements.
What is the purpose of shivering?
Shivering is an attempt by the body to produce heat.
Why don't you want a child with a temperature elevation to shiver?
Shivering is rapid muscle contractions that produce more heat.
For many patients who suffer from severe injuries or medical conditions, their first psychological reaction is
Shock and disorientation
What are some of the feelings patients may share in response to illness or injury?
Shock and disorientation, fear and anxiety, depression, guilt, post traumatic stress disorder.
What complications could occur to the patient following a thoracentesis?
Shock, bleeding, and dyspnea
Aminoglycosides are used for
Short term treatment
Where are your largest muscles located?
Shoulders, upper arms, thighs, and hips.
What preoperative action do most patients perform the evening before surgery?
Shower or bathe using an antiseptic soap, such as povidone-iodine (Betadine), to reduce the number of microorganisms on the skin.
Which factors determine the technique you will use to move the patient up in bed?
Size and capabilities of the patient
What physical characteristics of bacteria are used to determine their classification?
Size, shape, and attachments.
Intoxication dramatically affects the central nervous system. What signs make this evident?
Slurred speech, lack of coordination, impaired sensory capability (especially vision), and behavioral changes.
Which childhood disease was nearly eradicated worldwide by 1972 and in early 2000s the vaccine was reintroduced as a mobility vaccine for military personnel?
Small pox
What is the primary side effect of central- acting alpha- adrenergic inhibitors?
Sodium and water retention
How do sodium and chloride maintain homeostasis of the body?
Sodium chloride helps to maintain the electrolyte balance and regulate the ph level through the concentration of extracellular fluids in the body's cells.
List three useful functions of fungi.
Some are edible; others are involved in fermentation of breads and alcoholic beverages; and still others are used to produce antibiotics.
Schedule II.
Special inventory procedures are required for what schedule of drugs?
Which urine test is done to determine the hydration level of a patient?
Specific gravity
What test is used to determine the hydration level of the patient?
Specific gravity.
What are the three basic bacterial shapes?
Spherical, rod-shaped, and spiral-shaped.
What does the EPA classify chemical disinfectant solutions as?
Sporicides, general disinfectants, hospital disinfectants, sanitizers.
What occurs in the third and final phase of spousal abuse?
Spouse states it will never happen again
Opioid analgesic.
Stadol.
Which form is used to document a patient's blood transfusion?
Standard form 518
What are the two recommended tiers of isolation precautions developed by the CDC?
Standard precautions and transmission-based precautions.
What is the preferred technician's position for ambulating a patient?
Standing beside and a little behind the patient, with one hand on the patient's waist and the other hand supporting the patient's near arm.
Which exercise is not commonly used for postoperative patients?
Standing hamstring stretches
What actions should you take if you discover a patient has taken a poison and the patient is unconscious?
Start resuscitative measures, notify the physician, and try to locate the type of drug or poison and the amount the patient took.
What type of technique is used when inserting a catheter?
Sterile aseptic.
Why should you avoid adding extra supplies or equipment to a sterile pack?
Sterile packs are designed for one-time use. Adding materials is a waste of time and space.
What should you do if the patient begins to experience pain or fatigue during exercise?
Stop the exercise and notify the doctor or nurse.
if a patient you are monitoring is receiving a blood transfusion and you notice distended neck veins and dyspnea. What should you do first?
Stop the transfusion
What are two types of catheters?
Straight and Foley (double-lumen).
Why should you instruct patients not to hold their breath as they do isometric exercises?
Straining causes irregular heartbeats that may cause a heart attack.
What is the primary rehabilitation need of a mentally ill patient?
Strengthening the patient's defenses
What type of patient is not usually able to communicate effectively?
Stroke victim.
What does SOAPP stand for?
Subjective information, objective information, assessment, plan, prevention (counseling or education).
A patient who is authorized to live outside the hospital while still receiving treatment is considered
Subsisting out
What are antibodies?
Substances created in the body to attack specific foreign substances classified as antigens.
Why should you not attempt to catch up if the infusion is behind schedule?
Such an action could cause a circulatory overload.
Why should you avoid using pins, clips, or staples to secure sterile packages?
Such objects make holes in the wrapper that allow microorganisms to enter and they may cause the package to be too tightly wrapped.
Why should you not attempt to remove objects that have been forced into a nose?
Such objects should be removed by the doctor in the ER. If you attempt to remove them, you may end up pushing them further back into the nose.
Among the endocrine medications, what drug action category do adrenal corticosteroids fall within?
Supportive
What are the four types of cancer treatment?
Surgery, chemotherapy, radiation therapy, and immunotherapy.
What condition must be present for a virus to multiply?
Susceptible tissue
What direction do you wipe when cleaning a wound?
Swipe from the wound edge, then outward.
What cardiac related condition may be caused by a fall in cardiac output resulting in cerebral ischemia?
Syncope
Which lymphocyte is responsible for producing the biochemical cytokine, and what is the cytokine used for?
T lymphocytes (T-cells) produce cytokine, which is a protein necessary for proper cell reproduction and division and is directly liked to the immune responses.
What are three important postoperative exercises?
TC&DB, incentive spirometer, and leg and foot exercises.
Toxic side effects of digitalis does not include Vertigo, diplopia, tachycardia, bradycardia
Tachycardia
What effect does immobility have on the flow of blood through the body?
The flow is slower because there is no muscle activity helping to push the blood through the body.
What bedside activities normally take place the day or night before surgery?
Teaching the patient activities that will be required once he or she returns from surgery. Examples are turning, coughing, deep breathing, diaphragmatic breathing, incentive spirometry, and leg and foot exercises.
Which statement is true regarding the role of a medical service technician in medication administration?
Technicians are permitted to administer medications under the supervision of a nurse or physician
What types of cardiac pacemaker will you be most likely to assist with?
Temporary system with external pulse generator and transcutaneous cardiac pacing.
A washer sterilizer cycle should only be used for what type of sterilization?
Terminal.
Which vaccine do all recruits receive a booster for upon entering the Air Force?
Tetanus
Who is responsible for the preparation of the patient's records for an aeromedical evacuation?
The AE clerk.
What is a transfusion?
The IV administration of whole blood or blood products.
What organization is responsible for establishing the hospital accreditation evaluation criteria?
The Joint Commission
How is an LMA selected, and why is selecting the proper size so important?
The LMA is selected based on the weight of the patient. The proper size ensures no leakage of air when inserted.
Who ensures civilian agencies are notified of reportable diseases?
The PH office.
What condition may complicate phlebitis?
The formation of a clot along the vein.
What area of the retina is responsible for the best vision?
The fovea centralis.
What type of behavior can you expect of a person who abuses his or her spouse?
The abuser displays distrust, isolates from others, will not ask for help in a crisis, and does not offer anyone else help. Personality characteristics include a poor self-image, immaturity, use of drugs or alcohol to help handle difficulties, and a lack of confidence in handling stressful situations.
Explain how to prepare a patient for a sigmoidoscopy.
The bowel must be empty, so the patient is given a cathartic, enema, or both the night before the procedure.
What pulse do you palpate if you are having difficulty locating the radial?
The carotid.
What unique quality does the cell wall of the protozoa possess, and what does it allow the cell to do?
The cell wall is flexible and allows the cell to form a variety of shapes.
What may happen if the skin is scratched or nicked near the surgical site prior to surgery?
The chance for bacterial growth near the operative site increases the danger of infection being carried into the incision.
Who is responsible for ensuring documentation guidelines are in place and followed?
The chief Nurse.
What additional precautions should be taken with cleaning equipment if the patient's condition requires a private room?
The cleaning equipment should be disinfected with an approved solution before going on to another room. If cleaning cloths and mop heads are grossly contaminated, bag and label them appropriately before sending them to be laundered.
What method is used to explain the location of foods to a blind patient?
The clock method.
How does the conjunctiva react to injury or irritation?
The conjunctiva frequently becomes bright red.
Define "biopsies".
The removal and examination, usually microscopic, of tissue or fluid from the living body to establish a precise diagnosis.
What information should be documented after the IV is initiated?
The date and time, location of site, type and size of needle, type of solution, rate of infusion, and any special equipment (EID) or tubing that was used.
Define appetite.
The desire for food or an agreeable attitude toward eating food.
1.5 tabs.
The doctor ordered Mrs. Smith to receive a medication of 1 g of Flexeril q4h. The medication from pharmacy is supplied in 2000 mg/tab. How many tablets will the patient receive in one 12 hr shift?
.5 tab.
The doctor ordered Mrs. Smith to receive a medication of 1 g of Flexeril q4h. The medication from pharmacy is supplied in 2000 mg/tab. How many tablets will the patient receive?
Why should the patient's legs not be allowed to hang unsupported from the edge of the bed?
The edge of the bed will put pressure on the backs of the patient's legs and interfere with circulation.
Define visual acuity.
The eye's ability to distinguish an object's shape and details.
Why do patients undergoing a colonoscopy normally require a sedative?
The fiberoptic scope is inserted into the large intestine and most patients would not be able to tolerate the discomfort without sedation.
Define granulation.
The filling in of new pink tissue in a wound.
List three goals of successful rehabilitation for substance abusers.
The first goal for successful rehabilitation is for the patient to accept the need for change; secondly, assist the patient to stop the abuse; and third to attain sobriety.
What is a dislocation?
The injury to the supporting ligaments and capsule is so severe that the joint surfaces are completely displaced from one another. The bone ends lock in the displaced position, making any attempt at motion of the joint very difficult as well as very painful.
Where in the heart is the Purkinje fiber network most elaborate?
The left ventricle.
Who can diagnose a patient?
The licensed provider.
What form or paperwork would you place on the front of a chart for a patient scheduled for surgery?
The locally devised surgical checklist.
What role does the lymphatic system play in the body's disease defense system?
The lymphatic system contains special nodes and glands that produce large leukocytes called lymphocytes, which engulf and destroy invading pathogens. Also, the lymphatic system transports pathogens to regional lymph nodes where they are trapped and destroyed, before they can enter the bloodstream.
In performing the trauma patient's history and physical, after the initial assessment, what must you first reconsider?
The mechanism of injury.
Why is substance abuse behavior not compatible with military duty?
The military's need for continuous readiness and reliable adaptability for contingency missions is gravely threatened if personnel are unavailable or only marginally effective due to psychoactive substance abuse.
Which two-person technique adds an element of speed to the move?
The modified shoulder drag technique.
How do mucous membranes defend against infection?
The moist surfaces of the membranes in the nose, throat, respiratory and genitourinary trap microorganisms. This is enhanced in some areas, as in the nose and trachea, by hair or cilia growing out of the membranes that help filter and trap foreign matter. Also, the mucous membranes are highly vascular, enabling white blood cells to be rapidly supplied to the area of pathogen invasion. They may also harbor normal flora that combat pathogens.
Explain the environmental control program.
The monitoring and/or eliminating of various environmental hazards. Specifically, contaminants that can have an adverse effect on air, food, or water are concerns that are addressed in an environmental control program.
Where should you start an IV if it will be in place for a long time?
The most distal vein possible to preserve other sites for future use.
How does the nurse indicate that the physician's orders have been carried out?
The nurse writes "noted" to indicate that the orders have been carried out and the time and the date and signs the column next to the physician's signature.
What is the basic difference between a routine patient and a direct or newborn admission?
The order in which the various procedures are carried out.
Why does a small particle continue to irritate the eye even after it is removed?
The particle often leaves a small scratch on the surface of the conjunctiva that continues to irritate the eye and makes it feel like the particle is still in place.
How do carriers differ from individuals who actually develop an infectious disease?
The pathogen inhabits the carriers but does not produce any symptoms of infection.
Why is a private room the most effective type of isolation unit?
The patient is physically separated from other people and personnel are more likely to remember to wash their hands before going on to other patients.
What do you need to watch for when you allow the patient to stand for a few moments before being transferred to a bedside chair?
The patient may be a little unsteady when first standing up.
When exposing the patient's pupils to light, what could it indicate if the pupils remain dilated?
The patient may be severely frightened, unconscious, in pain, hypoxic, or have suffered brain injury, a stroke, or has taken drugs such as atropine.
What are two reasons an immobilized patient's metabolic rate might increase instead of decrease?
The patient may have a fever or be in pain.
Define guarding?
The patient may protect his or her abdomen by tightening the abdominal muscles or by actually pushing your hands away.
Briefly describe the effects severe dehydration can have on the body.
The patient's blood pressure falls; the heart rate increases; seizures can occur; the patient eventually lapses into a coma and dies.
To whom must the medical provider recommend the patient be permitted to grow facial hair up to 1/4-inch long?
The patient's commander.
Why should you use pulling or pushing movements rather than lifting movements?
The resistance of friction is less than the resistance of gravity.
What is considered a safe zone after a hazardous materials incident?
The safe zone is at the same level as, and upwind from, the hazardous materials accident site.
What initiates electrical impulses in the heart?
The sinoatrial (SA) node.
What factors determine the type of intravenous solution used?
The patient's condition, fluid and electrolyte balance, and purpose for the IV.
What factors determine the method of oxygen administration the physician will select?
The patient's condition, the immediate situation, the available equipment, and whether the patient can tolerate the specific type of equipment necessary for its administration.
What are the two standard identifiers associated with the NPSH?
The patient's full name and date of birth.
Who is the approval authority for patient passes?
The patient's physician.
Who specifies what diet the patient is to receive?
The patient's physician.
Who should you consult with when you set priorities and establish goals?
The patient.
Who is responsible for notifying the inpatient unit that a routine patient is being admitted?
The physician, or physician's designated representative.
What is the most common position for a patient having a pelvic exam?
The position most commonly used is the lithotomy position.
Define posture.
The proper relationship of body parts to one another.
By measuring the various waves, complexes, interval, and electrical voltage, what can a trained person determine from an ECG?
The rate, rhythm, and axis of the heart, along with any evidence of myocardial hypertrophy or infarction.
What are the primary factors affecting visual acuity?
The region of the retina stimulated, illumination, spectral quality of light, contrast, pupil size, time of exposure, patient's age, condition of the ocular media, presence of ametropias, and individual variation.
What is tonicity?
The relative concentration of dissolved substances in a solution as compared to the solution concentration within the red blood cells (RBC).
How is suture size determined?
The smaller the number, the larger the suture's diameter.
What are the disadvantages of formaldehydes?
The solution is irritating to the skin, eyes, and mucous membrane; gloves and face protection must be worn when using it. Instruments must be thoroughly rinsed in sterile disinfection, and items that may absorb the solution should not be disinfected in formaldehyde. The flumes are highly toxic and prolonged inhalation must be avoided. In fact, the flumes are so toxic that formaldehyde is not suitable for housekeeping use.
What information should be included on the medication label placed on the side of the bottle/bag?
The start time, stop time, and hourly intervals.
What is the difference between the gravity displacement sterilizer and the prevacuum steam sterilizer?
The sterilization cycle.
What effect does the application of heat have on the superficial blood vessels?
The superficial blood vessels in the area become dilated or enlarged.
Describe the four-point gait used by patients using crutches.
The supports move one at a time. If you start with the right crutch, it is followed by the left foot which is followed by the left crutch, and finally by the right foot.
What is an amputation and why is it usually done?
The surgical removal of all or part of an extremity. The need for amputation is usually due to trauma or disease to the limb.
What criteria should you use when selecting a transfer technique to move the patient from sitting on the edge of the bed to the standing position?
The technique that you are most comfortable with, allows you to control the patient's movements, and still permits you to use good body mechanics.
Antianxiety medications are prescribed for
The treatment of insomnia
What factors should you consider when selecting an IV injection site?
The type of solution, rate of infusion, age and condition of the patient, condition of the veins, duration of the therapy, and type of equipment used.
What is the most common type of knife used during minor surgeries?
The type with detachable blades.
What are the effects of a stage III ulcer?
The ulcer has penetrated down to the muscle causing distortion of muscle and loss of body fluids.
Patients who are hypersensitive to local anesthetics (amide-type), which have respiratory depression or known heart block, children, and for women who are pregnant and lactating.
The use of local anesthetics for antiarrhythmic therapy is contraindicated for what type of patients?
Explain autoimmunity.
The virus "borrows" proteins from the body's cells during replication and incorporates them into the virus cell and gives the body cell some of the viral proteins. When the immune system identifies the virus to destroy it, it also recognizes the virus proteins in the body's cell and miss identifies the body cell as a viral cell that should be destroyed.
What is the smallest known microorganism?
The virus.
Define anatomical dead space.
The volume of the conducting respiratory passageways (area in and around the nose, pharynx, larynx, trachea, and bronchial tree) which fills with inspired air, but never contributes to gas exchange in the alveoli.
What characteristics should wrapping material for sterile packs have?
The wrapper must be constructed so that it allows the sterilizing agent to enter and leave, but does not allow microorganisms or dust particles to enter. It must be durable enough to withstand conditions in the sterilizer and in storage, and it must provide physical protection for delicate items. The wrapper must also be flexible enough to adapt to the shape of the object and allow the package to be opened without contaminating the contents. Finally, the wrapper must be cost-effective.
Why can't patients who have been bedridden for a long period of time just get up and walk?
Their muscles have atrophied and weakened, and they are usually unsteady.
Which medication can interact with quinolones to potentiate cardiac arrest?
Theophyline
Why do safety precautions and principles of body mechanics apply more to transfer techniques than they do to simple patient movements?
There is more lifting and moving involved as well as a greater chance for injury to the patient and technician.
Why are bed-to-stretcher transfers hard on technicians?
There is more lifting and reaching involved.
Why do medical staff members violate isolation principles?
They are in a hurry and try to take shortcuts; they don't understand how to follow the precautions; they think the precautions don't apply to them.
What are three reasons immobilized patients might be frightened?
They are in a strange environment, they don't know what is going to happen, and they can't do anything to protect or help themselves.
How is the solution that is used for terminal cleaning selected?
They are selected by the local infection control committee according to EPA standards.
What are two ways that a causative agent may cause disease?
They destroy surrounding tissue or produce toxins (poisons).
Why is it sometimes difficult to initiate an IV on elderly patients?
They have fragile veins that collapse when punctured with a needle.
In most cases, why do parents abuse their children?
They have no other way to cope with the situation at hand. These parents often lack the skills and abilities necessary to provide emotionally for themselves.
What type of special nursing challenge do patients in pain present?
They must be convinced that the activity is going to help and motivated to do the activity.
How do masks protect the wearer?
They prevent inhalation of large droplets and small droplet nuclei. They might also prevent personnel from touching their mucous membranes and contaminating themselves.
How do ROM exercises help prevent joint fixation?
They prevent shortening of the muscles, tendons, ligaments, and joint capsules that lead to joint fixation.
What are disadvantages of steam sterilizers?
They produce great amounts of heat and cannot be used for delicate items made of plastics and rubber.
Explain the function of local poison control centers.
They provide the health care personnel with up-to-date information and treatment guidelines for all types of drug abuse situations.
How do tears defend against infection?
They wash away dirt, debris, and microorganisms that could cause infection.
How would you make a neurological assessment of a patient's mental orientation?
This is generally completed by asking the patient to state his or her full name; the month, day or year; name the current President or a relevant question the patient should be able to answer. Keep the patient's age in mind when doing this. A 3 year old probably won't be able to tell you who the president is, but can probably point to or name an appropriate toy or parent.
Restorative.
This term is applied when drugs are used to return the body to health but not cure the disease.
What technique do you use to reposition a patient in the bed?
Three-person technique.
Signs of sodium chloride deficiency can be seen
Through an excessive amount of fluid loss
The primary central gland of the lymphatic system is the
Thymus gland
Which organ is considered the primary central gland of the lymphatic system?
Thymus.
How tight should you make the tourniquet?
Tight enough to obstruct the venous flow, but not the arterial flow.
While gathering a history of illness, when you ask a medical patient if the pain is constant or intermittent, what are you trying to determine?
Time
What information should you obtain regarding deformity?
Time and mode of onset, sensory disturbances, location of the paralysis, trophic changes, and disturbances in bowel and bladder control.
What information would you document in the I & O flowsheet when starting an IV on a patient?
Time started, amount of fluid in the IV bag, type of fluid, rate per hour, medications.
What is the purpose of a Balkan frame?
To attach various pulleys for traction devices and a trapeze bar to assist patients in helping themselves as much as possible.
Why should some of the technicians kneel on the bed when moving a patient with a drawsheet?
To avoid excessive reaching.
What is the purpose of a physical examination?
To determine the patient's state of health and detect any physical or mental deficiencies that may impact job performance. It is also a good opportunity to educate patients on ways to improve health behaviors and live healthier lifestyles to maintain a physically fit force, capable of performing at the highest possible level.
What is the purpose of a tourniquet when performing venipuncture?
To distend the veins and allow you to visualize and palpate the vein.
What is the OF 522 used for?
To document the patient's consent for a specific procedure.
Why do you aspirate a small amount of saline into a suction catheter before and between uses?
To ensure that the suction device is working properly and to lubricate the inside and outside of the catheter.
What is the purpose of a detailed physical exam and on what type of patient is it performed?
To gather additional information to help in further interventions you may need to do and provide more information for the emergency room staff. In most cases, you only need to perform a detailed exam on a trauma patient with a significant mechanism of injury and less often on the trauma patient with no significant mechanism of injury. The detailed physical exam is seldom done on a medical patient.
Why do you suction a tracheostomy prior to changing the dressing?
To help maintain a clean and dry area longer.
Why should ventilation masks be transparent?
To help monitor respirations and to easily notice vomiting.
Why are patients who have been placed in skeletal traction to immobilize the spine placed on a special bed such as a Stryker frame?
To help prevent pressure sores, cardiorespiratory complications, muscle atrophy, and urinary complications.
What is the nursing team's goal for the patient with an amputation?
To help the patient attain the highest possible level of independence.
Why are irrigations performed?
To improve or ensure patency of the NG tube.
What are the three major goals during the preoperative period?
To prepare the patient mentally, spiritually, and physically for his or her operation.
What is the primary purpose for treatment and medications given to a preoperative patient?
To prepare the patient's body for surgery.
Why do you pinch the catheter tube prior to removing it?
To prevent air from entering the bladder.
Why is it important to decompress the bladder slowly?
To prevent bladder damage, shock, chills, and fever.
Why are contaminated articles bagged before they are taken out of the isolation unit?
To prevent contamination of the general environment and other people.
Why are hyperalimentation solutions administered through central veins?
To prevent damage and irritation to the small vessels.
Why is strict aseptic technique required for intratracheal suctioning?
To prevent introduction of potential pathogens deep into the patient's respiratory tract.
Why were standard precautions developed?
To prevent nosocomial infection.
Why is it important to avoid applying suction to a suction catheter during insertion?
To prevent the removal of oxygen from the patient's respiratory tract and to prevent the catheter from causing trauma to delicate tissues.
What are the basic purposes of patient restraints?
To protect the patient or others from harm, to give certain necessary treatments, or to restrain the patient for traveling when the patient's condition and the conditions of travel make restraints necessary.
What are retention enemas used for?
Treat diseases of the rectum and lower colon, soften fecal material or soothe an irritated colon or rectum, and administer medication.
For what reasons are gloves worn?
To provide a protective barrier and prevent gross contamination of the hands when touching blood, body fluids, secretions, excretions, mucous membranes, and non intact skin; to reduce the likelihood that microorganisms present on the hands will be transmitted to patients during invasive or other patient care procedures that involve touching a patient's mucous membranes and non intact skin; and to reduce the likelihood that hands contaminated with microorganisms from a patient or fomites can transmit these organisms to another patient.
What are two purposes of mechanical aids?
To provide a smooth transfer and to reduce the possibility of injury to patient and technician.
What is normally the purpose for performing an ear irrigation?
To remove cerumen or a foreign body.
What is the purpose of bladder irrigations?
To remove or wash out blood, pus, bacteria, or waste products following urinary surgery.
Why is a chest x-ray taken prior to surgery?
To rule out any possible lung disease.
Define the term reduction.
To set the bone.
Before turning a patient to the side-lying position, why should you bend the patient's legs?
To shift the patient's weight and to prevent him or her from rolling back to the original position.
What should be the goal of rehabilitational needs for patients with mental disorders?
To strengthen patient defenses so they can adjust to the demands of their environments.
What is the purpose of defibrillation?
To terminate ventricular fibrillation or ventricular tachycardia.
Which age group will most likely act very emotionally to pain?
Toddlers and preschoolers.
What treatments can be used for decubitus ulcers?
Topical agents, surgery, heat lamps, and various other remedies.
What are the three types of anesthetic agents?
Topical, local infiltration, and digital blocks.
What equipment is essential to have at the postoperative bedside after surgical amputation of a limb?
Tourniquet
Out of several names given each medication, which of these drug names is given by the manufacturer?
Trade name
Name three types of patient dispositions.
Transfer, subsisting elsewhere, and discharge.
What are two uses for AF Form 3066?
Transmit written orders for the patient's care and treatment to the nursing personnel and establish and maintain a drug profile on the patient.
List five causes of paralysis.
Trauma, spinal cord tumors, disease, infections, and congenital defects.
To aid in preventing decubitus ulcers, patient positioning should be changed every
Two hours
How long is pressure maintained over a venipuncture site?
Two to three minutes.
How many types of processing trays are there for the parectic acid sterilizer?
Two types.
What are the minimum number of straps used to secure a patient to a litter or stretcher?
Two.
What is the difference between Type I and Type II diabetes?
Type I is insulin dependent, has a sudden onset, and is the most common form of diabetes in children and young adults. Type II is not insulin dependent and normally develops after 40 years of age.
In what ways does culture affect the way a person eats?
Types of food, eating utensils, and methods of preparation.
If you are performing an electrocardiogram on someone who is rated, a copy of that electrocardiogram must be sent to the
US Air Force Central Electrocardiographic Library
What are common reasons for ordering a bland diet?
Ulcers, Some intestinal disorders, Postoperative abdominal surgery.
Nonopioid analgesic.
Ultram.
What is probably the greatest cause of fear and anxiety in an elderly patient?
Uncertainty of the future or the prognosis of a disorder.
Patients under what age and over what age have the most severe reactions to burns?
Under 5 and over 55.
To treat or prevent nausea, vomiting, or motion sickness.
Under what conditions are antiemetics used?
When monitoring the sterilization cycle, what are some problems to look for?
Unsaturated (superheated) steam, wet (over-saturated) steam, incomplete air removal from the chamber, automatic timer failure and other mechanical failures.
How long is an oral airway left in a patient's mouth following surgery?
Until the patient reacts and regains sufficient reflex responses to spit or pull the airway out. If he or she is choking on it, then, you remove it to prevent vomiting.
What are palpitations?
Unusual or irregular heartbeats felt by the patient.
When a patient is receiving penicillin for the treatment of sever strep throat, what further patient- education is appropriate if the patient is also taking oral contraceptives for birth control?
Use a back up method of birth control while taking penicillin
How should a wound be cleaned?
Use a sterile swab or gauze for each cleansing stroke, or spray the wound surface. Clean from least contaminated are to most contaminated area.
When the patient has hyperthermia, what can be done to help lower the body's core temperature?
Use of commercial cooling blankets, cool applications, and tepid baths.
What is the most common type of meningitis?
Viral meningitis.
Which of the four respiratory capacities represents the total amount of exchangeable air?
Vital capacity (VC).
If an inpatient chart with doctor's orders for vital signs every four hours was blank for the day, you would assume the
Vital signs were not completed
List several items needed in the patient's room prior to his or her return from the recovery room.
Vital-sign equipment, emesis basin, waterproof bed protector, I&O sheet, vital-sign record, oxygen regulator, and suction regulator.
What vitamins are necessary for RBC production?
Vitamin B12 and folic acid are the B-complex vitamins necessary the production of RBCs.
What antidote is administered for serious bleeding complications while under coumarin (Coumadin) treatment?
Vitamin K
Which vitamins cannot be stored by the body and must be ingested daily?
Vitamins B and C.
What are the two major components of nutrients?
Vitamins and minerals.
Explain how to remove a soft contact lens.
Wash hands, place a drop of wetting solution or sterile saline in the eyes to moisten the contact surface, open the eye with your middle finger and thumb of nondominant hand, use the index finger of your dominant had and place it gently on the lower edge of the lens and slide it down towards the lower lid, gently pinch the lens between your index finger and thumb and lift it out. If you can't remove the lens, try a contact lens suction cup to remove the contact lens. Place the lenses in separate containers with sterile water, label which eye the lens was removed from.
How should you treat the skin after a cast is removed?
Wash it gently with soap and water.
What will happen if the humidifier is too full when you are using a nasal cannula?
Water may overflow into the gauges.
What special precaution must be taken when using ultraviolet irradiation?
Wear protective garments such as gowns, gloves, and protective glasses when using this process to prevent injury.
What type of shoes should a patient wear when being transferred to a chair?
Well-fitting, hard-soled shoes.
How would you apply a dressing with the intention od debriding the wound?
Wet to dry
Common side effects include nausea, vomiting, anorexia, thrombocytopenia (bruising), and alopecia (hair loss).
What are some of the common side effects of antineoplastic medications?
The type of arrhythmia, the frequency, cardiac and renal condition, and the current signs and symptoms the patient is showing.
What are some of the factors considered when antiarrhythmic agents are chosen?
Right patient, right medication, right dose, right route, right time, and right documentation.
What are the "Six Rights" of medication administration?
Hub, shaft, and bevel.
What are the basic components of the needle?
Diarrhea induced by infection or poisoning, patients with colitis associated with broad-spectrum antibiotics, ulcerative colitis, and cirrhosis. It is contraindicated to medicate young children and pregnant patients with these drugs.
What are the contraindications for taking Lomotil and Imodium?
Possible unpleasant taste, potential for gastric irritation, and a slower rate of absorption.
What are the disadvantages of the oral method of administering medication?
Parenteral, oral, sublingual, buccal, and topical.
What are the five general routes of medication administration?
(1) Develop a list of current medications. (2) Develop a list of medications to be prescribed. (3) Compare the medications on the two lists. (4) Make clinical decisions based on the comparison. (5) Communicate the new list to appropriate caregivers and to the patient.
What are the five steps that make up the medication reconciliation process?
Stat, single, standing, and PRN.
What are the four types of medication orders?
SC, ID, IM, and IV.
What are the four types of parenteral injection methods?
The initial treatment includes lifestyle changes that range from diet modification (low sodium), weight reduction, mild exercise program, smoking cessation, and stress reduction planning.
What are the initial treatments used for mild hypertension?
Patient's name, date order was written, drug name, drug dosage, method of administering the drug, and signature of the provider.
What are the seven essential parts of a drug order?
Drowsiness, confusion, blurred vision, and photophobia. With toxicity some of the side-effects signs worsen, such as tremors, muscle weakness, seizures may develop, or the cardiovascular system may collapse, resulting in coma or death.
What are the signs of lithium toxicity?
Opioid, nonopioid, and adjuvant.
What are the three classifications of analgesics?
Food, Drug, and Cosmetic Act and the Comprehensive Drug Abuse Prevention and Control Act.
What are the two main federal laws that apply to the administration of drugs?
IV drip and IV push.
What are the two types of IV drug administration methods?
Substitutive.
What category of therapeutic drug has the purpose of replacing body fluids or substances?
The specific action of a drug.
What determines which category a drug is placed in?
Calming antidepressants that are useful in treating agitated depression, mixed anxiety and depression, or fibromyalgia.
What disorders are both Remeron and Serzone used to treat?
Aware of the dangers of self-medication, overdosage, side effects, and interactions by inappropriate use of these readily available drugs.
What does the lay public need to be aware of when considering nonopioid analgesics?
ACE inhibitors can be used alone or combined with a diuretic. ACE inhibitors slow the progression of renal disease.
What drug is used to treat hypertensive patients with neuropathy, and why?
Generic name.
What drug name is assigned by the US Adopted Name Council?
Age, weight and sex, genetic factors, psychological factors, illness and disease, time of administration, and external environment.
What factors influence the action that drugs have on the body?
Age, inactivity, malnutrition, or disease processes.
What factors may cause reduced muscle mass at a potential injection site?
Palatability, adverse effects, acid-neutralizing capacity, the sodium content, and the patient's renal and cardiovascular function.
What factors will the choice of antacid be dependant upon?
AF Form 765, Medical Treatment Facility Incident Statement.
What form do you use to report a medication error?
That GI side effects are expected and adding buttermilk or yogurt to their diet may help regulate the intestinal flora and reduce the incidence of diarrhea. Erythromycins should be taken with a full glass of water one hour before or two hours after meals.
What instructions should be given to patients being treated with erythromycin?
Physician's Desk Reference is a reference source containing the latest drug product information prepared by manufacturers.
What is a PDR?
When rapid, thorough emptying of the bowel is required. When a patient is scheduled for a sigmoidoscopy, GI x-rays when barium is used or proctoscopies, the use of stimulant laxatives is commonly given as preprocedure medication dosaging.
What situations are stimulant laxatives used for?
A reference book or pamphlet that lists medications available at a specific healthcare facility. In addition, a formulary lists recommended dosages and special considerations.
What is a formulary?
Prevention or relief of nausea.
What is an antiemetic used for?
Increase the concentration of serotonin, norepinephrine, and dopamine in the neuronal synapse by inhibiting the monoamine oxidase enzyme.
What is the antidepressant action of the MAOIs?
Determine the causative organism and the specific medication to which it is sensitive.
What is the first step in anti-infective drug therapy?
Verify the medication order.
What is the first step in preparing a medication?
Verify the order.
What is the first step to take when preparing a medication for administration?
Usually the treatment of choice for major depression and for depressive episodes of bipolar disorder. Enables neurotransmitters to travel across the synapse (the contact point of two neurons) to transmit the messages between the nerve cells.
What is the function of an antidepressant?
Maximum dose.
What is the largest amount of the drug that will produce a therapeutic effect without symptoms of toxicity?
Basic calculation formula.
What is the most common method of calculating drug dosages?
Reduce the number of loose stools an individual is having.
What is the primary use of antidiarrheal agents?
Absorption.
What is the process called in which a medication is transported from the site of entry to the circulatory system?
Relieve symptoms of a disease without affecting the disease itself.
What is the purpose of a palliative drug action?
To maintain a constant level of a drug in the body to permit the therapeutic action to be achieved.
What is the purpose of most drug therapy?
Anaphylactic reaction.
What is the term used for severe drug allergic reaction?
Cellulose derivatives and bran, powders, flakes, granules, tablets, or liquids.
What is the treatment of choice for simple constipation, and what form is it available in?
If an individual walks in to a medical treatment facility and asks for assistance bringing in a family member you should ask
What is wrong with the patient to determine the appropriate transfer device
Medication package insert, PDR, MTF approved medication list.
What medication references are available to the technician, if needed?
To treat, cure, diagnose, or prevent disease, or to provide relief.
What six things are medications used for?
US Pharmacopoeia—National Formulary.
What reference is a combination of two official publications?
American Hospital Formulary Service.
What reference source is a collection of drug monographs kept current by periodic supplements prepared by pharmacists?
Document the fact.
What should be done if a medication is to be administered on a date other than when it was ordered?
Avoidance of self-medicating for longer than 48 hrs or if a fever develops. A diet should consist of bland foods, such as apples without peels or sugar added, rice, or bananas. Roughage should be taken out of the diet when trying to control diarrhea. Individuals should also be advised to increase their fluid intake to prevent dehydration. Drinking soda and apple juice should be avoided, but water should be encouraged or power drinks with high-electrolyte content in moderation.
What should the patient education include when taking absorbents and protectants?
May include palpitations, nervousness or tremors, tachycardia, cardiac arrhythmias, or anginal pain.
What signs and symptoms must the technician warn patients they may experience after taking an adrenergic medication?
Skin surface, body cavities, or body orifices.
What three general areas of the body are topical medications administered to?
Current medications and allergies.
What two essential patient history considerations must be obtained and documented before administering a medication?
What questions should you consider before selecting a nursing activity?
What type of activity was used to treat this sort of problem in the past? How successful was it? Do you have the necessary skills to do the activity? Is the activity patient-centered? Does it take into consideration all aspects of the patient? Most of all, will the patient agree to it? Is the activity realistic? How do the other healthcare providers feel about your plan?
A hypnotic.
What type of medication is used to induce sleep or dull the senses?
Estrogen-progestin hormone contraceptives are the most widely used and it is formulated in monophasic, biphasic, and triphasic methods.
What type of oral contraceptive is the most widely used, and what methods is it formulated in?
ID.
What type of parenteral injection technique is administered to the skin's dermis layer?
An aqueous solution.
What type of preparation is described as one or more drugs dissolved in water?
What types of litters should be carried in an ambulance?
Wheeled litter, folding litter, and collapsible device.
Relying on your memory for drug information.
When administering medication, what dangerous practice should you avoid?
When does a steam sterilizer begin timing the actual sterilization cycle?
When all the air is removed and the heat reaches a preset point.
Drug toxicity.
When an overdose of a drug occurs, what normally results?
At the end of each shift.
When do double-locked drugs need to be accounted for?
When should you back up with a patient in a wheelchair?
When going through a doorway or entering an elevator.
When bodily injury from a pathogen, chemical, or physical trauma occurs.
When is histamine released?
In the Air Force, you can use lights and sirens on an ambulance call only
When local protocol authorizes it
When is a CPAP mask used?
When other attempts to increase the patient's PaO2 have failed and prior to intubation.
What is the shelf life for sterilized equipment using the event- related method?
When package integrity in compromised
Psychological factors.
When patients do not believe a certain medication will help them, what factors are influencing them?
When are variable pressure volumetric pumps used?
When patients require critical volume or critical medication.
Immediately after administration.
When should you document the medication you have given?
When is it important to use masks, goggles, or face shields?
When splattering or splashing of blood or body fluids is possible.
What causes infiltrations?
When the needle becomes dislodged or penetrates the vein wall and the IV solution flows into the tissues instead of through the vein.
When should restraints be removed?
When the physician feels that removal is advisable.
When is a patient considered deceased, and prior to this, how does this affect any treatment?
When the physician makes a physical determination of the fact. Any treatment or nursing procedure should continue until the physician makes the determination the patient is dead.
A vacuum is created and fluid is pulled into the barrel.
When the plunger of a syringe is pulled back, what occurs within the barrel?
When should you report a pulse oximetry reading immediately?
When the reading is below 97 or the patient appears to be in any respiratory or circulatory distress.
When should you begin to assemble the inpatient record?
When the unit is first notified that a new patient is coming or a scheduled patient arrives.
Why should patients who have weak hearts consult a physician before using a hot sauna or Jacuzzi?
When we increase blood flow in one part of the body, it will be decreased somewhere else. It usually affects internal organs, such as the heart. As the circulation decreases through the heart, the blood pressure drops but the pulse increases in an effort to maintain equilibrium. These effects are usually minute unless you are applying heat to a large part of the body. In that case, there is always a possibility that the patient receiving the treatment could go into shock.
If droplet precautions are in effect, when should you wear a mask?
When working within three feet of the patient.
Why is it best to pull rather than push a patient into a different position?
When you push, you lose some control and risk the possibility of accidentally pushing the patient out of bed.
How does contracting your abdominal and buttocks muscles help protect your back?
When you simultaneously contract your abdominal muscles and your buttocks muscles, you create a muscular barrier around the intervertebral discs of your lower back. This barrier, or "girdle," helps protect your lower back when you strain to lift or move objects.
At what point do you become involved in moving patients?
Whenever the patient cannot move himself or herself.
Into the loose connective and fatty tissue.
Where are SC injections given?
In a locked cabinet or storage area.
Where must all syringes and needles be stored?
What is consensual papillary reflex testing?
Where you shine the light into one eye but actually observe the opposite eye for a reaction, which would be constricting of the pupil.
After the initial assessment, you determine that your patient is a medical patient; what would be your next determination?
Whether the medical patient is responsive or unresponsive.
Stool softener, Docusate.
Which form of cathartic is the primary choice for pregnant women and children?
Which cells are the first line of defense to fight diseases?
White blood cells.
Local facility pharmacy.
Who ensures the local formulary is updated as needed?
Pharmacists.
Who is involved in selecting, obtaining, and storing different medications, as well as accounting for the safe dispensation of medications?
The individual who administers the medication.
Who is responsible for documenting the administration of a medication?
For promoting CNS functioning.
Why are CNS stimulants given?
Infants have immature liver and kidney functions that result in a slower excretion of a drug.
Why are infants highly affected by drugs?
They do not contain nerves or blood vessels.
Why are the quadriceps femoris sites preferred for pediatric patients?
Due to a low digestive system content.
Why do oral medications taken before meals usually act faster in the body?
To avoid duplicate injections at the same site.
Why does the site of administration need to be documented when an injection is given?
Because it is destroyed through the GI tract.
Why is insulin administered parenterally?
The medication bypasses the liver.
Why is there a minimal loss of potency when administering an SL medication?
Grapefruit juice can lower activity levels of specific enzymes in the intestinal tract that normally break down medications and end up allowing larger amounts of the medication to reach the bloodstream and result in increasing the drug activity.
Why should drinking grapefruit juice be avoided with many medications?
For infection control and to avoid having the medications affect you in some way.
Why should you wear gloves when applying a dermatologic medication?
To ensure uniform product quality.
Why were drug standards developed?
What are the three basic types of intravenous needles?
Wing-tipped needle, over-the-needle catheters, and inside-the catheters.
What type of needle is commonly used to initiate an IV in the scalp of a pediatric patient?
Wing-tipped needle.
Under what circumstances would you remove contact lenses in the field?
With a chemical burn of the eye.
What is the preferred method for moving a patient from a bed to a stretcher?
With a drawsheet.
How is the concentration of oxygen monitored within the oxygen tent?
With an oxygen analyzer.
How do you prevent entrance of the NG tube into the trachea?
With the NG tube at the level of the nasopharynx, have the patient flex his or her head to his or her chest and begin to swallow as you pass the tube.
A patient who feels unloved, unneeded, inferior, and hurt displays a behavior of
Withdrawal
What term is used to refer to a wound when the initial suture closure breaks open?
Wound dehiscence.
What is the treatment for a thermal burn to the back?
Wrap burn with a dry sterile dressing.
The life span of lymphocytes is
Years
Which viral disease do mosquitos transmit?
Yellow fever
What vaccines are given to individuals deploying to Africa?
Yellow fever and typhoid
When unloading a hydrogen peroxide plasma sterilizer, you must first check to make sure the chemical strips have changed to what color?
Yellow.
Which reason is not appropriate for restraining a child?
You have other task to do, and no time to sit with the child
When using the KED, when is the head secured?
You must secure the torso first and the head last.
Briefly describe your responsibilities for the inpatient record when there is no 4A assigned.
You should know what paperwork is required and how to properly label the chart and papers.
Describe how you would care for an abused child who does not trust anyone.
You will have to show consistency in your care. Showing acceptance and tenderness toward the child is very important.
What will happen if you don't accept and work with your physical limitations?
You would injure either yourself or your patient, or both.
At what stage of life does physical deterioration start?
Young adult, after age 30.
What is the proper position for your head? (when lifting)
Your head should be erect and in line with your back - not leaning in any particular direction.
What is the relationship between your stability and your center of gravity?
Your stability increases as your center of gravity moves closer to your base of support.
Which route is injectable iron administered?
Z- track
