CDC Set 2, B4N051: Self Test Questions
What does the acronym AVPU mean?
A=alert, V=responsive to verbal stimulus, P=responsive to painful stimulus, and U=unresponsive.
What drug is used to treat hypertensive patients with neuropathy, and why?
ACE inhibitors can be used alone or combined with a diuretic. ACE inhibitors slow the progression of renal disease.
What form does a provider use to document orders on a patient admitted to the hospital?
AF Form 3066, Doctor's Orders.
Vol. 3 What form do you use to report a medication error?
AF Form 765, Medical Treatment Facility Incident Statement.
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? Vol 2
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.
What observations must you make upon the initial assessment of the postoperative patient? *4 things
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 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 no 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.
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.
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.
Vol 1. 027 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.
How long must an examinee blow into the PFT machine before a 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.
Why should you wear gloves when applying a dermatologic medication?
For infection control and to avoid having the medications affect you in some way.
When would a volumetric pump be used?
For intra-arterial infusions or deep central venous lines (cut-downs), for patients who have multiple IV lines and whose condition is such that they could roll onto or otherwise obstruct the line.
How do you administer ear drops in a patient younger than three years of age? In an adult?
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.
Why are CNS stimulants given?
For promoting CNS functioning.
Once a transfusion is initiated, how long should it run slowly?
For the first 15-30 minutes.
005. 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 (central venous pressure); and a fluffy- looking X-ray.
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.
What is the function of an antidepressant?
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.
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.
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? -How many mls does the patient receive?
-100 kg. -10 ml.
What information would you document on the I & O flowsheet when starting an IV on a patient? *5
-Time started -amount of fluid in the IV bag -type of fluid -rate per hour i.e (100 ml/hr) -medications.
Name three types of patient dispositions.
-Transfer -subsisting elsewhere -discharge
When monitoring the sterilization cycle, what are some problems to look for? *4
-Unsaturated (superheated) steam -wet (over-saturated) steam -incomplete air removal from the chamber -automatic timer failure and other mechanical failures.
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 area to most contaminated area.
What information should you obtain regarding deformity? *5
Time and mode of onset, sensory disturbances, location of the paralysis, trophic changes (simple changes in soft tissue) and disturbances in bowel and bladder control.
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.
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 is normally the purpose for performing an ear irrigation?
To remove cerumen or a foreign body.
Why is a chest x-ray taken prior to surgery?
To rule out any possible lung disease.
What should be the goal of rehabilitational needs for patients with mental disorders? Vol 2 (221)
To strengthen patient defenses so they can adjust to the demands of their environments.
Under what conditions are antiemetics used?
To treat or prevent nausea, vomiting, or motion sickness.
Volume 3. 401 What six things are medications used for?
To treat, cure, diagnose, or prevent disease, or to provide relief.
Which age group will most likely act very emotionally to pain? Vol (214)
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.
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.
What does the QRS complex result from?
ventricular depolarization
What are the two major components of nutrients?
vitamins and minerals
How often is the emergency room log generated?
every 24 hours
How often are restraints checked?
every one to two hours
Define the term reduction.
to set the bone
What is our normal body temperature?
98.6F
What is the target temperature of a tepid bath?
98.6°
What is the body's best natural barrier to infection?
Intact and unbroken skin.
How do you determine the patient's LOC?
Ask the patient his or her name, date, and location.
What does the EPA classify chemical disinfectant solutions as? *4
Sporicides, general disinfectants, hospital disinfectants, sanitizers.
What are antibodies?
Substances created in the body to attack specific foreign substances classified as antigens.
What category of therapeutic drug has the purpose of replacing body fluids or substances?
Substitutive.
Explain the difference between granulocytes and agranulocytes.
Granulocytes are leukocytes that have granular cytoplasm; agranulocytes are leukocytes that lack cytoplasmic granules.
What condition should be treated with blood volume expanders?
Hemorrhagic shock and other forms of shock characterized by an excessive plasma loss.
Why should you not attempt to catch up if the infusion is behind schedule?
Such an action could cause a circulatory overload.
Describe the function of a hemostat and rake retractors.
Hemostat—used for clamping or occluding. Rake retractors—used for exposing or retracting.
Who is responsible for ensuring documentation guidelines are in place and followed?
The Chief Nurse.
What three health risk factors cannot be changed?
Heredity, gender, and age.
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.
What is whole blood mixed with after it is collected from a donor?
The IV administration of whole blood or blood products.
What are the signs of vitamin C deficiency? *5
Muscle weakness cramping lethargy sore and bleeding gums in mouth degenerative changes in bone and connective tissue.
Vol 1. 022 Define visual acuity.
The eye's ability to distinguish an object's shape and details.
Where in the heart is the Purkinje fiber network most elaborate?
The left ventricle.
Who can diagnose a patient?
The licensed provider.
Which leukocytes are the most active phagocytes?
Neutrophils and monocytes.
Vol. 1 009 According to Maslow's "Hierarchy of Needs" theory, in what category would the ability to breath without problems be located?
Physiological.
What form or paperwork would you place on the front of a chart for a patient scheduled for surgery?
The locally devised surgical checklist.
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.
When conducting a patient interview, how is the "Objective" data determined?
"O"—Objective data is based on health care member's observations, physical examination and diagnostic tests.
What are the ABCs of observing and reporting the patient's condition? Vol 2 (222)
(1) Appearance of the patient. (2) Behavior of the patient. (3) Conversation of the patient.
Vol 3. List the four basic principles of medication administration.
(1) Be knowledgeable. (2) Use judgment. (3) Have skill in delivery. (4) Patient education.
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. (excess cortisol)
What are the five steps that make up the medication reconciliation process?
(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.
Vol 1. 031 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.
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.
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.
List the five stages of syphilis.
(1) Primary . (2) Secondary. (3) Latent. (4) Late. (5) Congenital.
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.
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.
List the three drug interactions with a brief description of each that the technician needs to be aware of.
(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.
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.
What are common reasons for ordering a bland diet? *4
(1) Ulcers. (2) Some intestinal disorders. (3) Gallbladder disorders. (4) Postoperative abdominal surgery.
Match the types of leukocytes in column A with the correct category in column B. The answers in column B can be used more than once. Column A a____ (1) Monocytes. b____ (2) Eosinophils. b____ (3) Neutrophils. b____ (4) Short life span of 12 hours. a____ (5) Lymphocytes. b____ (6) Basophils. a____ (7) Extended life span from weeks to years. Column B a. Agranulocytes. b. Granulocytes
(1) a. (2) b. (3) b. (4) b. (5) a. (6) b. (7) a.
Match the condition in column A to the necessary vaccine in column B. The answers in column B can be used only once. Column A _____For individual whose occupation makes them susceptible to simple lacerations and abrasions (i.e., crew chief, maintenance, and civil engineering). ____This disease causes approximately 250,000 deaths annually. ____Chicken pox. _____For persons going to areas such as Asia, Africa, Central and South America. ____A viral disease transmitted between humans by a mosquito. ____Can be spread by person-to-person contact until scab falls off. ______All Air Force recruits receive antibody screening and receive the vaccine only if results are negative. ____Vaccine administered annually to all active duty military. ____This disease causes approximately 14,000 deaths annually. ____ (10) This disease may affect your skin, digestive system, and lungs. ____ (11) 95 percent effective; no booster doses at this time. Column B a. Tetanus/diphtheria (Td). b. Typhoid. c. Anthrax. d. Hepatitis A. e. Yellow Fever. f. Measles, Mumps, Rubella (MMR). g. Influenza. h. Inactivated polio vaccine (IPV). i. Hepatitis B. j. Small pox. k. Varicella.
(1) a. (2) i. (3) k. (4) b. (5) e. (6) j. (7) f. (8) g. (9) d. (10) c. (11) h.
Match the name of the medications in column A to the analgesic classification in column B. The answers in column B may be used more than once. Column A B _____(1) ReVia. a____ (2) Bufferin. c____ (3) Stadol. a____ (4) Panadol. c____ (5) Codine. b____ (6) Narcan. a____ (7) Ultram. c____ (8) Demerol. a____ (9) Equagesic. c____ (10) Percocet. Column B a. Nonopioid analgesic. b. Opioid antagonist. c. Opioid analgesic.
(1) b 2) a. 3) c. 4) a. 5) c. 6) b. 7) a. 8) c. 9) a. 10) c.
Match the disorders in column A to the drug of choice in column B. The answers of column B may be used more than once. Column A ____ (1) Angina. ___ (2) Atrial fibrillation. ____ (3) Lung conditions. ____ (4) Life-threatening ventricular arrhythmias. ____ (5) Atrial flutter. ____ (6) Hypertension. ____ (7) Prophylactic after cardioversion. ____ (8) PVC (premature ventricular contraction) ____ (9) CHF. ____ (10) Tachycardia. Column B a. Atenolol. b. Calcium channel blocker. c. Procainamide. d. Cardiac glycoside. e. Lidocaine. f. Inderal. g. Tonocard. h. Quinidine.
(1) b, f. (2) d. (3) a. (4) g. (5) d. (6) b, f. (7) c, h. (8) e. (9) d. (10) d, h.
Match the definition in column A with its proper term in column B. ______________________________ Column A ____ (1) Course, gurgling sounds heard best on expiration. ____ (2) A whistling sound. ____ (3) Fine, crackling sounds. ____ (4) Noisy breathing caused by an obstructed airway. Column B a. Rales. b. Rhonchi. c. Wheezing. d. Snoring. Volume 2 (237)
(1) b. (2) c. (3) a. (4) d.
Match the conditions in column A to the short or long-term corticosterioid therapy in column B. The answers in column B may be used more than once. (1) b. (2) a. (3) b. (4) b. (5) a. (6) b. (7) a. (8) b. (9) a. (10) b. Column A _____(1) Delayed wound healing. _____(2) Organ transplant. _____(3) Muscle pain and weakness. _____(4) Fluid and electrolyte imbalance. _____(5) Acute respiratory disorders. _____(6) Gastric or esophageal irritation, ulceration, or hemorrhage. _____(7) Acute flare-ups of rheumatic or collagen disorders. _____(8) Stunting the growth in children. _____(9) Allergic reactions. _____(10) Petechia, easy bruising, and skin thinning or tearing. Column B a. Short-term therapy. b. Long-term side effects.
(1) b. (2) a. (3) b. (4) b. (5) a. (6) b. (7) a. (8) b. (9) a. (10) b.
Match column A with the correct healing stages in column B. The answers of column B may be used more than once. Column A b____ (1) Granulation tissue is formed. c____ (2) Epithelial cells migrate to form a scab. a____(3) Scar has a whitand glossyappearance. c____ (4) Capillaries are formed. a____ (5) Final stage of healing. b____ (6) Healing process takes from four days up to three weeks. c____ (7) Neutralizes and destroys harmful agents. a____ (8) Healing stage lasts up to two years. c____(9) Limits thespreadofinfection. b____ (10) Collagen is formed. Column B a. Maturation. b. Reconstruction. c. Inflammation
(1) b. (2) c. (3) a. (4) c. (5) a. (6) b. (7) c. (8) a. (9) c. (10) b.
Match each orthopedic appliance listed in column B with the statement in column A that best describes it. Items in column B may be used only once. Column A ___ (1) Used after the amputation of an extremity. ___ (2) These include the Stryker frame and the CircOlectric. ___ (3) Serve as legs for an indefinite period of time. ___ (4) Most often used to support and immobilize extremities during emergencies. Column B a. Splints. b. Artificial limbs. c. Orthopedic beds. d. Crutches.
(1) b. (2) c. (3) d. (4) a.
Match column A with the specific type of immunity it corresponds to in column B. Column A c____ (1)Directly exposed to whooping cough. a____ (2)Short-term immunity for an infant without stimulating the immune response. _b___ (3)Received injection of gamma globulins containing antibodies. c____ (4)Symptoms of the disease stimulate the individual immune response. d____ (5)Exposure to a killed or weakened vaccine. b___ (6)Immunityfor a short time without stimulating the individual's immune response. a___ (7)Received antibodies through placental barrier. d____(8)Stimulates the immune response without severe symptoms of the disease. Column B a. Naturally acquired passive immunity. b. Artificially acquired passive immunity. c. Naturally acquired active immunity. d. Artificially acquired active immunity.
(1) c. (2) a. (3) b. (4) c. (5) d. (6) b. (7) a. (8) d.
Match each type of traction listed in column B with the phrase in column A that best describes it. Items in column B may be used only once. Column A ____ (1) Skin traction used for fractures of the shaft of the humerus. ____ (2) Skin traction applied to the leg as temporary treatment for fractures of the upper portion of the shaft of the femur. ____ (3) Traction for cervical spine disorders. ____ (4) Skin traction for treating some fractures of the shaft and neck of the femur. Column B a. Buck's extension. b. Russell's traction. c. Lateral arm traction. d. Head halter traction.
(1) c. (2) a. (3) d. (4) b.
Oxygen needs of the body: 1. Match the subject in column A with its normal value in column B. Column A ___(1) Partial pressure of arterial oxygen. ___(2) Partial pressure of arterial CO2. ___(3) Percentage of hydrogen ions. ___(4) Arterial oxygen saturation. Column B a. 7.34-7.45. b. 35-45 mm/Hg. c. 80-100 mm/Hg. d. 95 to 98 percent. Volume 2 (236)
(1) c. (2) b. (3) a. (4) d.
Match the types of behavior listed in column B with the term or phrase that best relates to it in column A. Each item in column B may be used more than once. Column A ____ (1) Physically or verbally active. ____ (2) Be consistent; assign simple tasks that won't make them feel inadequate. ____ (3) Feels unloved, unneeded, or unwanted. ____ (4) Be factual, concise, and sincere with this patient. ____ (5) This patient usually feels guilty, sinful, and worthless. ____ (6) This patient has a fear of unknown causes. ____ (7) Try to channel patient energy into safe, nonstimulating outlets. _ ___ (8) This patient may be suicidal. ____ (9) The environment is seen as being hostile and threatening. ____ (10) False praise will cause loss of trust and increase this patient's condition. Column B a. Depression. b. Withdrawn. c. Aggressive. d. Suspicious. e. Anxious. Vol 2 (220)
(1) c. (2) e. (3) b. (4) d. (5) a. (6) e. (7) c. (8) a. (9) d. (10) b.
Special respiratory procedures __________________________ 1. Match terms for special nursing procedures listed in column B with appropriate statements about them from column A. Terms in column B may be used more than once. Column A ____ (1) The surgical puncture of the chest wall to remove fluid or air from the pleural space. ____ (2) A drainage system used to re-expand a collapsed or partially collapsed lung. ____ (3) This procedure maintains and cleanses the airway, improves vital capacity, and helps prevent such conditions as atelectasis and postoperative pneumonia. ____ (4) Helps to remove excess secretions by gravity. ____ (5) May be done to confirm the diagnosis of fluid in the pleural space, to obtain a culture of organisms present, or to relieve respiratory symptoms. ____ (6) Patient may become dizzy the first few times chest percussions are done in this position; however, in time, the length of time of this procedure may be extended to 15 or 20 minutes. ____ (7) The patient may be sitting on the side of the bed or lying in a lateral, recumbent position Column B a. Closed-chest drainage. b. Postural drainage. c. Breathing exercise. d. Thoracentesis.
(1) d. (2) a. (3) c. (4) b. (5) d. (6) b. (7) d.
Match each term listed in column B with its best definition in column A. Items in column B may be used only once. Column A ____ (1) A state identified by feelings of elation and well-being, flight of ideas, and physical overactivity. ____ (2) A fixed morbid fear of an object or a situation. ____ (3) A state of indecision that arises when an individual is confronted by alternatives of action or by contradictory ideas or ideals. ____ (4) Pertaining to or affected with a neurosis. ____ (5) A complex emotional state of tension or uneasiness, the cause of which is not recognized. ____ (6) Pertaining to or caused by psychosis. ____ (7) A false sensory perception occurring without external stimulus. Column B a. Anxiety. b. Conflict. c. Hallucination. d. Mania. e. Neurotic. f. Phobia. g. Psychotic.
(1) d. (2) f. (3) b. (4) e. (5) a. (6) g. (7) c.
Match the generic anti-infective/antibiotic name in column A with the trade name in column B. The answers in column B can only be used once. Column A d______(1) Doxycycline. g______(2) Ampicillin. f______(3) Ceftriaxone. i______(4) Gentamycin. e______(5) Cefazolin. a______(6) Amoxicillin-clavulanate. h______(7) Cefurozime. j______(8) Cephalexin. b______(9) Azithromycin. c______(10) Ciprofloxacin. Column B a. Augmentin. b. Zithromax. c. Cipro. d. Vibramycin. e. Ancef. f. Rocephin. g. Ominpen. h. Ceftin. i. Garamycin. j. Kflex.
(1) d. (2) g. (3) f. (4) i. (5) e. (6) a. (7) h. (8) j. (9) b. (10) c.
3. Match the accidental wound definition in column A with its medical term in column B. ____________________ Column A ____ (1) A cut produced by a sharp object. ____ (2) Loss of epidermis as the result of the skin being rubbed or scraped. ____ (3) Caused by a stab with a pointed object. ____ (4) Skin is torn completely loose or left hanging as a flap. ____ (5) A pool of blood that forms beneath the skin. ____ (6) Referred to as a bruise. Column B a. Contusion. b. Hematoma. c. Abrasion. d. Avulsion. e. Laceration. f. Puncture.
(1) e. (2) c. (3) f. (4) d. (5) b. (6) a.
Match the classification of drugs in column B with the signs and symptoms associated with each in column A. Column A ____ (1) Slurred speech, flushed face, poor coordination, confusion, and altered LOC. ____ (2) Tachycardia, rapid breathing, dilated pupils, diaphoresis, excitement, euphoria, and anorexia. ____ (3) Sluggish, lack of coordination, slurred speech, pulse and breathing slow, sleepiness. ____ (4) Rapid pulse, dilated pupils, flushed face, aggressiveness, tremors, patient sees and hears things. ____ (5) Reduced pulse and respiratory rate, pupil constriction, coma, diaphoresis, euphoria, sleepiness, and anxiety. Column B a. Depressant. b. Stimulant. c. Hallucinogen. d. Narcotic. e. Alcohol. Vol 2 (224)
(1) e. (2) b. (3) a. (4) c. (5) d.
What are the seven regions of major lymph node locations and their respective functions?
(1)Cervical, associated with the lymphatic vesseldrains 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 lymphatic vessels of the pelvic viscera. (5) Abdominal cavity, primarily 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 the four classifications of cephalosporins and what they treat.
(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.
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 treatment of choice for simple constipation, and what form is it available in?
*Cellulose derivatives and bran, *powders, flakes, granules, tablets, or liquids.
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 are the signs of lithium toxicity?
*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 some typical procedures performed in SDSCs (same day surgical center)?
*Myringotomy (surgical incision in the ear drum to relieve pressure or drainage), *odontectomy (tooth removal) *and cystoscopy (allows doctor to examine lining of your bladder).
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.
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? -How many tablets will the patient receive in one 12 hr shift?
-0.5 tab -1.5 tabs
What should you use to lubricate a PtL or ETC? What should not be used? *The pharyngeotrachael lumen airway (PtL) and esophageal tracheal combitube (ETC) are multi-lumen airways that are inserted blindly (without visualization of the vocal cords). They have been designed to deliver ventilation to the lungs when placed into the trachea or the esophagus.
-A water-soluble product or the patient's saliva. -Do NOT use silicone or petroleum-based products as they can cause lung damage.
Explain the guidelines for giving thrombolytic agents.
-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.
What complications are associated with the IV therapy itself? *5
-Alterations of the infusion rate -infiltration -phlebitis -infection -embolism.
Explain the difference between an antitussive and an expectorant.
-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.
How should transdermal hormone contraception patches be applied? What should you ensure the patient understands?
-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 often should controlled temperature drug storage areas be monitored, and why is this done?
-At least once daily. -Medications may become unstable or deteriorate if not stored properly.
What should the patient education include when taking absorbents and protectants? *5
-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. *background info: -With antidiarrheal agents, there are three actions of classifications: absorbent and protectant, slowing intestinal motility, and acid-producing bacterium. -Kaolin and pectin preparations, like Kaopectate, act as an absorbent and protectant to achieve a drying effect to the GI tract.
What are some of the side effects of iron supplements? *5
-Black stools -constipation or diarrhea -nausea and vomiting.
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.
What information should be included on the label? (of a sterile package)*5
-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.
List the signs and symptoms of hypoglycemia, and when do these signs usually occur?
-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.
What are the contraindications for taking Lomotil and Imodium? *5
-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 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 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.
Vol 1. 023 What are the two most useful purposes of a PFT?
-Evaluating losses in respiratory function -following the course of certain respiratory diseases.
What should you inform the patient about before performing tympanometry? *4 things
-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 results. -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.
Barbiturates are commonly associated with what situations, and why?
-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.
Vol 3. 404 What are the two main federal laws that apply to the administration of drugs?
-Food, Drug, and Cosmetic Act -Comprehensive Drug Abuse Prevention and Control Act.
List the contraindications or extreme cautions of quinolones.*6
-For elderly patients, especially with GI diseases or arteriosclerosis. - Children or adolescents are at higher risk for cartilage damage. -Patients who are pregnant, lactating -pts w/severe renal impairment -pts w/seizure disorders, -cardiac disease must be monitored for adverse effects.
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. -water helps to regulate body temperature.
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.
Before administering the PFT, what information must you find out from the patient that may have an effect on the test? *4 things
-If the patient has smoked or administered a bronchodilator within the past hour -eaten a meal within the past two hours -or is acutely ill -has experienced an upper or lower respiratory tract infection during the past three weeks.
What is the difference between anterior/anterior and anterior/posterior electrode placement?
-In anterior to anterior placement (A V 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.
Once cholinergic medications have been introduced into the body, what are the actions of this type of drug? *6 effects *Cholinergic drug, any of various drugs that inhibit, enhance, or mimic the action of the neurotransmitter acetylcholine, the primary transmitter of nerve impulses within the parasympathetic nervous system
-Increased GI peristalsis, -contraction of the urinary bladder, -increased secretions and skeletal muscle strength, -lower intraocular pressure, -constrict pupils -slow heart rate.
Prior to use, what is an LMA (laryngeal mask airway) inspected for? *3
-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.
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.
What should you check on the cardiac electrode *3? Why?
-It needs to be checked frequently to secure placement on the patient. -The expiration date must be checked -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.
008. Universal Protocol concepts 1. What are NPSG (national patient safety goals) used for? (purpose) *2
-It reliably identifies the individual -matches the service or treatment to that individual.
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.
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 print out -beeps.
List the side effects of nonbarbiturates.
-Nausea, vomiting, diarrhea -rash -dizziness -ataxia -leukopenia with prolonged use -daytime sedation -confusion and headache -amnesia -hallucinations. -It is contraindicated for patients with known severe liver and renal impairment and porphyria.
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) -report your actions and observations to the nurse.
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.
Vol 3. 417 What factors will the choice of antacid be dependant upon?
-Palatability (pleasant taste) -adverse effects -acid-neutralizing capacity -the sodium content -patient's renal and cardiovascular function.
What are four methods to treat warts?
-Paring down verrucae -cryotherapy -curettage -topical chemotherapy.
What are three methods of disinfection?
-Pasteurization -exposure to chemical germicides -ultraviolet irradiation.
What are the seven essential parts of a drug order? *6
-Patient's name -date order was written -drug name, -drug dosage -method of administering the drug (route) -signature of the provider.
The use of local anesthetics for antiarrhythmic therapy is contraindicated for what type of patients? *4
-Patients who are hypersensitive to local anesthetics (amide-type) -which have respiratory depression or known heart block -children -women who are pregnant and lactating.
List the contraindications of sulfonylureas. *3
-Patients with known liver and kidney impairment -debilitated or malnourished patients -patients with severe infection. *Sulfonylureas are a group of medicines used in the management of Type 2 diabetes. Sulfonylureas lower blood glucose levels by stimulating insulin release from the Beta cells of the pancreas.
What preparation normally differs in a pediatric patient from an adult? (before a procedure)
-Pediatric patients will normally remain in their own pajamas until anesthesia is given. -Adult patients change into a clean hospital gown or pajama top.
What are some disadvantages of the peracetic acid sterilizer? *5
-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.
Vol 3. 412 What are the disadvantages of the oral method of administering medication? *3
-Possible unpleasant taste -potential for gastric irritation -slower rate of absorption.
What type of instrument should you use to label a sterile package? *3
-Preprinted indicator tape -an indelible-ink (permanent marker) -felt-tipped marker to write the information on the "external chemical indicator" tape.
What are the key components that the UP (universal protocol) during surgery is built on? *3
-Preprocedure verification -site marking -preprocedure time out.
How should tape and bandages be removed? *4
-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.
What does SOAPP stand for?
-Subjective information -objective information -assessment -plan -prevention (counseling or education).
Explain the function of the sympathetic nervous system. Which category of drugs is used to prevent its action in the body?
-Sympathetic nervous system is used to mobilize the body for quick response and action. -Adrenergic Blockers.
What instructions should be given to patients being treated with erythromycin?
-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.
How is an LMA-laryngeal mask airway- 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.
What information should be documented after the IV is initiated? *8
-The date and time, -location of site, -type and size of needle, -type of solution -rate of infusion, -any special equipment (EID) or tubing that was used.
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.
Explain peak, onset, and duration of medication concentration.
-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.
What are the primary factors affecting visual acuity? (10)
-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 -individual variations.
What are the disadvantages of formaldehydes? *3
-The solution is irritating to the skin, eyes, and mucous membranes; gloves and face protection must be worn when using it. - Instruments must be thoroughly rinsed in sterile water after disinfection, and items that may absorb the solution should not be disinfected in formaldehyde. -The fumes are highly toxic and prolonged inhalation must be avoided. In fact, the fumes are so toxic that formaldehyde is not suitable for housekeeping use.
What factors should you consider when selecting an IV injection site?*6
-The type of solution -rate of infusion -age and condition of the patient, -condition of the veins, -duration of the therapy, -type of equipment used.
What is the basic difference between a routine admission and a direct or newborn admission? Vol 2
The order in which the various procedures are carried out.
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 non-dominant hand, use the index finger of your dominant hand 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.
What situations are stimulant laxatives used for?
-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.
3. Why should "No Smoking" signs be posted outside rooms where oxygen is in use? 4. What type of blanket must be used in areas where oxygen is in use? 5. What safety precautions should you take if you are using a metal oxygen tank? 6. What factors determine the method of oxygen administration the physician will select? *4 things 7. For what type of patient is an oxygen tent used? 8. How is the concentration of oxygen monitored within the oxygen tent? 9. What type of mask is used to administer inspired oxygen concentrations of 60-90 percent? 10. What type of mask is used when the patient needs low concentrations of oxygen, 24-50 percent? 11. When is a CPAP mask used? 12. What will happen if the humidifier is too full when you are using a nasal cannula? 13. How often are oxygen humidifiers changed? 14. Who is normally responsible for inserting endotracheal tubes? Volume 2 (237)
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Face and throat injuries ___________________________________ 1. What types of head and facial injuries could result in airway problems? 2. How does the conjunctiva react to injury or irritation? 3. Why does a small particle continue to irritate the eye even after it is removed? 4. What should you do with a particle that is lodged on the cornea? 5. Why should you cover both eyes when a patient has an injury to only one eye? 6. What is the treatment for chemical burns to the eyes? 7. Why should compression not be applied to an eye laceration? 8. What is hyphema? 9. Under what circumstances would you remove contact lenses in the field? 10. How do you detect corneal abrasions? 11. How should you handle a laceration that extends all the way through the cheek? 12. How should you handle a patient who is bleeding from the mouth and has a possible spinal cord injury? 13. Why should you not attempt to remove objects that have been forced into a nose? 14. What are the indications of facial fractures? 15. What type of dressing should be used on neck injuries and why? Volume 2 (241)
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Hospital diets recommended for the patient's needs ______________________________ 1. Who specifies what diet the patient is to receive? 2. Match the diet description in column A with its name in column B. Column A: __(1) Used for patients with hypertension or congestive heart failure. __(2) Eliminates chemicals, mechanical, and thermal irritants. __(3) Used as a transition between a full liquid diet and a regular diet. __(4) Inadequate in all nutrients and not given for more than three days. __(5) Easily digested foods that melt and foods free from cellulose and spices. __(6) Used for patient who suffer from excessive weight loss. __(7) Contains fewer calories than the patient normally metabolizes. __(8) No restrictions on types of nutrients that patient can eat. __(9) Used for patients with kidney or liver disease. Column B: a. Full liquid. b. High-calorie, high protein regular. c. Clear liquid. d. Regular. e. Soft. f. Bland. g. Calorie-restricted. h. Protein-restricted. i. Sodium-restricted. Vol 2 (232)
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Procedures related to the body's circulatory needs ____________________________________ 1. What is the purpose of taking an apical-radial pulse? 2. Why do you need two people to take an apical-radial pulse? 3. What is the purpose of defibrillation? 4. What should you do if defibrillation is unsuccessful? 5. What is telemetry? 6. What is the normal arterial mean pressure? 7. What prevents blood from backing up into the tubing of an arterial line? 8. What type of information can a CVP (central venous pressure) provide to a physician? 9. Name four possible insertion sites for a CVP line (aka central line). 10. Why is the patient taught to perform the "Valsalva maneuver" prior to insertion of a CVP line? 11. What is the normal CVP range? 12. What is the normal range for the PCWP (Pulmonary Capillary Wedge Pressure)? 13. What are PCWPs greater than 20 mm/Hg associated with? Vol 2 (240)
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Techniques and equipment used to ambulate patients ______________________________________ 1. Why can't patients who have been bedridden for a long period of time just get up and walk? 2. What can you do to reduce patient problems with ambulation? 3. What can you use as a substitute if you don't have a commercial transfer belt? 4. What is the preferred technician's position for ambulating a patient? *(URE) 5. What objects should the patient avoid using for support? 6. What factors determine the type of ambulation aid that will be used for each patient? 7. What type of crutch is most commonly used for short-term patients? 8. What is the procedure for measuring crutch length on a standing patient? 9. Describe the four-point gait used by patients using crutches. 10. What basic rule should a crutch patient follow when going up stairs? 11. How do platform crutches differ from Canadian crutches? Volume 2 (230)
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What is the max dosage of folic acid individuals are advised to take?
0.4 mg
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.
Principles of effective body mechanics ______________________________ 1. What possible consequences of using poor body mechanics are discussed in the text? 2. Define posture. 3. How does contracting your abdominal and buttocks muscles help protect your back? 4. What is the proper position for your head? 5. What are two ways that you can impede the circulation to your lower legs when you are sitting? 6. What three factors should you consider when you are planning a task? 7. What will happen if you don't accept and work with your physical limitations? 8. What is the relationship between your stability and your center of gravity? 9. Why is it easier to lift a patient with a smooth, steady motion than with a series of jerky motions? 10. Describe how you can use leverage to help move a patient to the side of the bed. 11. Where are your largest muscles located? 12. Why should you use pulling or pushing movements rather than lifting movements? Volume 2 (227)
1. Backaches, muscle strains, and other permanent problems. 2. The proper relationship of body parts to one another. 3. 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. 4. Your head should be erect and in line with your back—not leaning in any particular direction. 5. Crossing your legs or sitting so the back of the chair is pressing against your popliteal area. 6. How you will do the task, what equipment you will need, and how much help you will need. 7. You would injure either yourself or your patient, or both. 8. Your stability increases as your center of gravity moves closer to your base of support.
When performing intratracheal suctioning, how can you determine when the catheter is properly positioned in front of the larynx?
1. By listening for an increased loudness of breath sounds and 2.by feeling more air coming from the open suction port at the base of the catheter.
Wound care _____________________ 1. How are wounds classified? 2. What type of wound is created during surgery? Vol 2 (243)
1. Open or closed. 2. An intentional wound.
What are two uses for AF Form 3066?
1.Transmit written orders for the patient's care and treatment to the nursing personnel 2.establish and maintain a drug profile on the patient.
What ages are included in the adolescent stage?
12-20
What size suction catheters are normally used on adult patients?
14, 16, and 18 Fr.
When not near aircraft, what is the maximum speed limit on the flight line?
15 mph.
When performing oropharyngeal suctioning, what is the maximum length of time you apply suction?
15 seconds.
Oxygen needs of the body: 2. What term means the patient has a low oxygen content in the arterial blood? 3. Hyperventilation can cause what type of acid-base imbalance? 4. Hypoventilation can cause what type of acid-base imbalance? Volume 2 (236)
2. Hypoxemia. 3. Respiratory alkalosis. 4. Respiratory acidosis.
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.
How much time is required for complete drying of a cast?
24-48 hours.
What is the normal plasma pH?
7.34-7.45
How much vacuum must suction units provide when the tube is clamped?
300 mm Hg when the tube is clamped.
What is the maximum speed limit while driving near an aircraft?
5 mph.
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
What is the weight limit for the patient's baggage during aeromedical evacuation?
66 lbs.
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 causes backaches?
A combination of poor posture, lack of support, and stretched muscles.
In order to avoid errors, what do many facilities use to copy a medication order?
A computer-generated product that lists all the medication orders that apply to a particular patient.
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.
Describe a capsule.
A gelatinous container that holds a drug in powder, liquid, or oil form.
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 complains of a neurological symptoms such as weakness, numbness or tingling in a particular area of the body.
What type of medication is used to induce sleep or dull the senses?
A hypnotic.
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.
What is schizophrenia?
A psychotic disorder characterized by disorientation and disorganized patterns of thinking.
Briefly define a goal in terms of patient care.
A realistic and measurable statement of the expected change in patient behavior or condition.
Volume 3. 401 What is a formulary?
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 basic equipment is needed to initiate an IV? *3 things
A solution container, an administration set, and a needle.
Define open reduction
A surgical procedure to set, align, and stabilize a fracture.
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.
When the plunger of a syringe is pulled back, what occurs within the barrel?
A vacuum is created and fluid is pulled into the barrel.
Where should you insert the needle in relation to the vein you are trying to penetrate?
About 1⁄2 inch below the planned entry site into the vein.
What is the process called in which a medication is transported from the site of entry to the circulatory system?
Absorption.
How are patient problems and diagnoses prioritized?
According to the most life-threatening problems.
Who is responsible for completing the information in the ambulance log?
Ambulance driver.
What is the first level of care provided for injuries of the joint? vol 2 (211)
Adequate transportation and splinting to prevent further damage to soft tissues by bone fragments.
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.
A patient you are caring for has CHF and is taking oral digitalis. What category of medications is contraindicated for use with the patient?
Adrenergic Blockers.
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.
16. What are the three types of transmission-based precautions?
Airborne, droplet, and contact precautions.
When do patients begin to worry about surgery?
After visiting hours are over and the patient is alone.
What factors may cause reduced muscle mass at a potential injection site?
Age, inactivity, malnutrition, or disease processes.
What factors influence the action that drugs have on the body?
Age, weight and sex, genetic factors, psychological factors, illness and disease, time of administration, and external environment.
What reference source is a collection of drug monographs kept current by periodic supplements prepared by pharmacists?
American Hospital Formulary Service.
What are environmental factors?
All of the outside influences and conditions that affect a person's life and development.
What is the purpose of bed rest?
Allows injured tissues to heal.
What important factor of blood pressure assessment is essential to obtaining accurate results?
An appropriately sized cuff.
What type of preparation is described as one or more drugs dissolved in water?
An aqueous solution.
How can height and weight influence a person's personality? Vol 2 (218)
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? (8)
An insertion spike, drip chamber, plastic tubing, clamp, vent port, medication port, secondary port, and needle adapter.
What is the term used for severe drug allergic reaction?
Anaphylactic reaction.
How exact should your reports about the patient be?
As exact as possible.
When should the CISD occur? *critical incident stress debriefing
As soon as possible following the incident.
What type of medication is given to reduce a fever?
Antipyretics.
Define an artifact.
Any artificial product or features that appear on an ECG tracing.
Cite five factors or causes that can contribute to emergence delirium.
Any five of the following: (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.
Specify five side effects of a patient vomiting.
Any five of the following: (l) 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.
List at least four actions nursing personnel can take when a patient exhibits signs of emergence delirium?
Any four of the following: (l) 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 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.
List three ways immediate postoperative pain is managed with medication.
Any three of the following: (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 patients nonnarcotic analgesics, such as aspirin, ibuprofen, or acetaminophen.
Besides being uncomfortable, pain causes other problems. List three.
Any three of the following: (1) Respiratory problems. (2) Cardiovascular problems. (3) Nausea and vomiting. (4) Patient agitation or delirium.
Cite three areas that typically cause postoperative pain.
Any three of the following: (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, and mask pressure. (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.
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? vol 2
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.
What term is used to describe the pulling together of tissue before suturing?
Approximating.
What parts of the body are inspected during a rapid trauma assessment?
Areas of the body where the greatest threats to the patient are.
During what phase of an ambulance call do you accomplish an initial scene sizeup?
Arrival.
What does a pulse oximeter measure?
Arterial hemoglobin oxygen saturation
List five disorders for which anti-inflammatories are commonly prescribed.
Arthritis, bursitis, gout, muscle strains, and sprains that cause swelling, limiting an individual's mobility.
What actions should you take when your patient complains of pain?
Assess the pain and report your findings to the nurse or physician.
As a minimum, how often should biological testing be conducted on a peracetic acid sterilizer?
At least weekly.
When do double-locked drugs need to be accounted for?
At the end of each shift.
Where should you place the call bell? vol 2
Attach it to the bed within the patient's reach.
How is the pulse taken on children less than two years 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.
What does the lay public need to be aware of when considering nonopioid analgesics?
Aware of the dangers of self-medication, overdosage, side effects, and interactions by inappropriate use of these readily available drugs.
Which method of temperature assessment is the easiest for children?
Axillary method.
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 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.
Volume 3. 410 What is the most common method of calculating drug dosages?
Basic calculation formula.
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 concerns 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.
Why is insulin administered parenterally?
Because it is destroyed through the GI tract. parenternal: administered or occurring elsewhere in the body than the mouth and alimentary canal. common parenteral routes are intramuscular (IM), subcutaneous (SC) and intravenous (IV).
What action must be taken once the premed is given?
Bed siderails must be pulled up and remain up.
Volume 2 (237). Providing oxygen to the body: 1. When providing respiratory care, when do you listen to lung sounds?
Before and after respiratory treatments.
How often do you assess a patient's vital signs when administering an inhalation?
Before, during, and after the therapy.
What is the normal rate for a KVO (keep vein open) IV?
Between 10 and 50 cc/hour, with the amount infused at less than 500 cc.
When performing venipuncture, how is the needle inserted? (2 parts)
Bevel up, at a 45 degree angle into the vein.
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 "Battle's sign?"
Bluish discoloration on the area behind the ears (mastoid process).
What is the final effect of disuse osteoporosis on bones?
Bones become brittle and susceptible to damage.
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).
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.
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.
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.
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 do you detect an infection on a body area that is inside a cast?
By the odor.
What should you always do before opening a sterilizer door?
Check the chamber pressure.
Which electrolyte in excessive amounts can cause fractures?
Calcium.
What disorders are both Remeron and Serzone used to treat?
Calming antidepressants that are useful in treating agitated depression, mixed anxiety and depression, or fibromyalgia.
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.
003. List the components of the chain of infection. (6) (list the order)
Causative agent, reservoir, portal of exit, mode of transfer, portal of entry, susceptible host.
Who approves a medical facility transfer?
Chief of service.
Vol 1. 030 What type of information do you gather at the scene size up?
Determine threats to yourself, patients, and bystanders. It is also the time when you determine the need for additional help.
What is another term used for medical asepsis?
Clean technique.
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 involved in preparing the skin for surgery?
Cleaning, disinfecting, and hair removal.
007. What general tasks are included in the sterilization procedure? *4 (objects)
Cleaning, disinfecting, wrapping, and sterilizing.
What are the two categories normally found on a surgical checklist?
Clinical records and patient-care procedures.
What is a code 3 response in ambulance?
Code 3 refers to an emergency response using lights and sirens or HOT.
List three signs of shock.
Cold, clammy, and pale skin.
What type of relationship develops when a host is exposed repeatedly to a pathogen but is never successful in eliminating it?
Commensalism.
What are some of the common side effects of antineoplastic medications? *5 *Antineoplastic drugs are medications used to treat cancer. Antineoplastic drugs are also called anticancer, chemotherapy, chemo, cytotoxic, or hazardous drugs.
Common side effects include nausea, vomiting, anorexia, thrombocytopenia (bruising), and alopecia (hair loss).
What is the first step in the actual transfusion process? Vol 2 (207)
Compatibility testing.
Where is the concentration of potassium found in regards to the cell?
Concentrated inside cells.
What two factors determine where the patient goes after finishing with the A&D (admissions and disposition) office? Vol 2
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.
List three factors that can result in an orthopedic problem. vol 2 (209)
Congenital problems, infectious disease, and trauma.
On what types of patients can you conduct a neurological exam?
Conscious and unconscious.
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? Vol 2 (215)
Elbow restraint.
Vol 3. 402. Safety considerations for medication administration 1. What two essential patient history considerations must be obtained and documented before administering a medication?
Current medications and allergies.
What are two advantages of preadmissions? Vol 2
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.
What type of treatment is used when milder forms of treatment have failed? (for mentally ill pts) Vol 2 (222)
Electroconvulsive therapy.
What are the substances that release ions in the water called?
Electrolytes.
When examining the scalp or cranium while performing the detailed physical exam, what do you look for?
DCAP-BTLS, bleeding, tender areas, and crepitation.
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
Vol 1. 028 As a minimum, how often should the crash ambulance be checked?
Daily
List three sources of protein.
Dairy products, meat, fish, poultry, eggs, cereals, some vegetables, and nuts.
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.
What are the three distinguishable waves of an ECG called?
Deflection waves.
Vol 3. 419 What is the first step in anti-infective drug therapy?
Determine the causative organism and the specific medication to which it is sensitive.
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 pupillary 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.
Vol 3. 415 How do psychotropic medications work?
Exert a therapeutic effect on an individual's mental process, emotions, or behavior.
What information should you cover when orienting the patient and family to your unit? vol 2
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 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? *3
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? hint: think physical assessment
Distention and firmness of the abdomen.
What precaution should you take when applying tape to a dressing?
Do not wrap the tape completely around the arm.
What should be done if a medication is to be administered on a date other than when it was ordered?
Document the fact.
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 required 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.
What should you do before you begin actual contact procedures with the patient?
Don gloves.
Antidepressents work in conjunction with which neurotransmitters? *3
Dopamine, serotonin, and norepinephrine.
When an overdose of a drug occurs, what normally results?
Drug toxicity.
Why do oral medications taken before meals usually act faster in the body?
Due to a low digestive system content.
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? Vol 2 (224)
Due to the possibility of aspiration.
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 information must be on a patient's inpatient record? Vol 2. 202
Each form must include, at a minimum: -the patient's name -hospital admission register number -Social Security number -name of the treating facility.
What word is used to indicate that a mentally ill patient left the nursing unit without permission?
Elopement.
Define endorphins.
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. *Endogenous substances and processes are those that originate from within an organism, tissue, or cell.
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 are three reasons for the use of restraints?
Ensure safety, facilitate exams, and to carry out procedures.
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 light on the retina when the eye is at rest.
What type of oral contraceptive is the most widely used, and what methods is it formulated in?
Estrogen-progestin hormone contraceptives are the most widely used and it is formulated in monophasic, biphasic, and triphasic methods.
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.
Why should you schedule activities for a patient at a time when the patient is feeling energetic?
Fatigue lowers pain tolerance.
What two emotions can interfere with the patient's response to surgery?
Fear and anxiety.
What are two causes of temperature elevations in children, and what is the difference between the two?
Fever and hyperthermia. Fever is a symptom of illness and hyperthermia is caused by external conditions.
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.
For what purpose is low-level disinfection useful?
General cleaning.
Volume 3. 401 What drug name is assigned by the US Adopted Name Council?
Generic name.
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? *3 things
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.
Why should drinking grapefruit juice be avoided with many medications?
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.
At what blood alcohol level is a person usually considered to be intoxicated?
Greater than 100 mg/dL.
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 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.
What symptoms indicate possible mild TBI?
Headache, irritability, fatigue, dizziness, confusion, and ringing in ears.
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.
When using the appropriate nomogram to determine predicted values, what two factors must be known?
Height and age. nomogram: a diagram representing the relations between three or more variable quantities by means of a number of scales, so arranged that the value of one variable can be found by a simple geometric construction. *used for spirometry purposes
What special test is used to detect occult blood in the urine?
Hematest.
When are pneumatic stockings normally used?
High risk patients who are undergoing general anesthesia.
What does muscle tone do?
Holds the body erect when you are standing, sitting, walking, or balancing.
What virus is responsible for most warts?
Human papillomavirus or (HPV).
What controls the functions to regulate the body temperature?
Hypothalamus
Vol1. 015 What term is used to define a fluid volume deficit?
Hypovolemia.
What type of parenteral injection technique is administered to the skin's dermis layer?
ID
What are the two types of IV drug administration methods?
IV drip and IV push.
What items in an IV tray or cart require expiration date checks? (5)
IV fluids, IV needles, blood tubes, antiseptic wipes and bandages.
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. *precarious-not securely held or in position; dangerously likely to fall or collapse.
Vol 1. 037 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.
What are two causes of weakness?
Inactivity or degenerative processes like cancer.
What causes orthostatic hypotension?
Inadequate vasoconstriction (blood vessels remain dialated and will not constrict causing hypotension)
What is the antidepressant action of the MAOIs?
Increase the concentration of serotonin, norepinephrine, and dopamine in the neuronal synapse by inhibiting the monoamine oxidase enzyme.
What is the treatment for chemical burns to the eyes?
Immediate and thorough flushing with sterile saline or water for 20 minutes.
Vol 3. When should you document the medication you have given?
Immediately after administration.
How long does it take for the effects of drug toxicity to be noticed?
Immediately or may take months
What is the primary cause of decubitus ulcers? (think what happens to the body)
Impaired circulation to the skin and subcutaneous tissue in areas of the body where the bony prominences lie close to the skin surface.
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 your unit? vol 2
In a friendly manner.
Where must all syringes and needles be stored?
In a locked cabinet or storage area.
Where (what location in hospital) are medications usually added to the IV container?
In the pharmacy or nursing unit.
What are the stages of an infectious disease? (4)
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.
Vol 1. 010 Human growth and development: During what stage of life does the development of stable sleep patterns occur?
Infant.
Why are infants highly affected by drugs?
Infants have immature liver and kidney functions that result in a slower excretion of a drug.
What is meningitis, and what is the most serious type?
Inflammation of the meninges covering of the brain and/or spinal cord; bacterial meningitis.
Vol 3. Define loading dose.
Initial high dose used to elevate the level of the drug in the blood quickly.
Explain the progression of the electrical impulse through the heart. (6 steps)
Initiating in the SA 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. *SA node>AV Node>Bundle of His>LT&RT bundle branches>purkinje fibers>ventricular walls
What equipment or areas commonly have a daily checklist? *4
Inpatient/outpatient and treatment rooms, crash carts and IV trays.
How do you "prime" the administration set?
Insert the spike into 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.
Where are SC injections given?
Into the loose connective and fatty tissue.
Vol 1. 025 What are two possible treatments for postural/orthostatic hypotension?
Intravenous therapy, or blood transfusion therapy.
What measures are included in the treatment for fluid overload? *4 things
Intubating the patient; positive-pressure ventilation (CPAP) administration of a diuretic; and administration of furosemide and opioids, such as morphine.
What are the two physiological causes of a stroke?
Ischemia or hemorrhage in the brain.
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.
When performing a skin puncture, why is the first drop 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.
Vol 1. 036 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 convalescent leave?
It is nonchargeable leave for the minimal time required to meet medical needs for recuperation.
Vol 1. 034 What does the term extrication mean?
It is the process by which entrapped patients are rescued from vehicles, buildings, tunnels, or other places.
Explain hypothyroidism and the signs and symptoms.
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.
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? (orthopedics)
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 is a disadvantage of the scoop stretcher?
It pinches the patient as the sides are brought together.
Vol 1. 029 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 purposes, 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.
What condition is indicated if a patient complains of pain that increases with activity?
Joint strain.
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.
Which type of lipoprotein has characteristics of having relatively high concentrations of cholesterol?
LDL
What are the technician's duties when a 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.
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.
What is the most common cause of airway obstruction in the conscious patient?
Large, poorly chewed food particles.
What neurological checks need to be done frequently on a stroke patient? *5 Vol (213)
Level of consciousness, pupil reactions, hand-grip strength, and foot strength. Vital signs need to be monitored as well.
What kind of light rays does a constricted pupil allow to enter the eye?
Light rays going relatively straight to the eye.
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.
Who ensures the local formulary is updated as needed?
Local facility pharmacy.
What factors determine the cleaning method to be used for equipment? *3
Local policy, type of object to be cleaned, and amount and type of organic material on the object.
What is the goal of care provided during the immediate postoperative period? vol 2. 206
Look for adverse reactions or complications from surgery.
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.
In what part of the eye do you administer ophthalmic medications?
Lower conjunctival sac.
Vol 3. What medication references are available to the technician, if needed? *3
Medication package insert, PDR, MTF approved medication list.
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.
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.
How do patients who are on bed rest differ from other immobilized patients? Vol 2 (225)
Many do not want to be on bed rest and will resist limitations.
What is the basic treatment for severe dehydration?
Massive infusion of IV fluids and close monitoring of electrolytes.
Vol 3. What is the largest amount of the drug that will produce a therapeutic effect without symptoms of toxicity?
Maximum dose.
What signs and symptoms must the technician warn patients they may experience after taking an adrenergic medication? *Adrenergic drugs are medications that stimulate certain nerves in your body. They do this either by mimicking the action of the chemical messengers epinephrine and norepinephrine or by stimulating their release
May include palpitations, nervousness or tremors, tachycardia, cardiac arrhythmias, anginal pain.
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.
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.
Which healthcare providers found in AF medical facilities are authorized to both treat and admit patients? Volume 2 (201)
Military and civilian physicians, dentists, and CNM (certified nurse midwife)
Minerals are usually extracted from what source?
Minerals are usually extracted from the soil by plants, and we in turn obtain them from the plant food sources or from the animal source that have eaten the plants.
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 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.
Explain the function of a COX-2 inhibitor.
NSAIDs that selectively inhibit cyclooxygenase-2 prostaglandin synthesis; they do not inhibit platelet aggregation. *Cyclooxygenase-2 (COX-2) inhibitors are a type of nonsteroidal anti-inflammatory drug (NSAID) that specifically blocks COX-2 enzymes. Nonsteroidal anti-inflammatory agents (usually abbreviated to NSAIDs) are a group of medicines that relieve pain and fever and reduce inflammation
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.
What are the four main categories of drugs often abused?
Narcotics, sedatives, central nervous system stimulants, and hallucinogens.
What are the general categories of suture material? *4
Natural or synthetic and absorbable or nonabsorbable.
Vol 1. 020 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.
What type of person needs security, self-esteem, recognition, love, and affection? Vol 2 (221)
No particular type; everybody has these needs.
What should you do with an isolation patient's food tray?
No special precautions are needed; hospital dishwashers are capable of decontaminating dishes.
What does the term crepitus mean? vol 2 (210)
Noise heard when bones are moved.
How high should the IV container (bag) be positioned?
Normally between 24 and 36 inches above the patient.
Normally, what admission procedures are done by the admissions nurse and technician? vol 2
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? Vol 2
Observations of the patient's condition, any final treatments, and discharge instructions.
Volume 3. 414. How can a healthcare worker assess a patient's level of pain?
Observing the patient's reaction to pain through vital signs, positions, and emotional responses by the patient.
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.
How are paraplegic patients transferred during aeromedical evacuation?
On a Stryker frame.
How should items be loaded in a steam sterilizer?
On their sides.
In what stage do helminthes normally enter the human host?
One of the larval stages.
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 the DEERS program treated/admitted to AF medical facilities? Vol 2
Only under emergency circumstances.
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.
What are the three classifications of analgesics?
Opioid, nonopioid, and adjuvant.
Vol 3. 407 What is a PDR?
Physician's Desk Reference is a reference source containing the latest drug product information prepared by manufacturers.
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.
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 common causes of immobility? Vol 2 (225)
Pain, neurological damage, structural defects, weakness, psychological problems, and rehabilitation measures.
What are the signs and symptoms of a fracture (PSD)?
Pain, swelling, deformity, tenderness, guarding, edema and ecchymosis, crepitus, exposed fragments, and false motion.
What items should you bring to the bedside of a newly admitted patient? vol 2
Pajamas or gown, slippers, towel, washcloth, bath basin, emesis basin, water pitcher, cup, and if needed, a urine specimen cup and an IV pole.
What is paralysis? Vol 2 (213)
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.
Vol 3. 409 What are the five general routes of medication administration?
Parenteral, oral, sublingual, buccal, and topical.
What is a stupor? Vol 2 (219)
Partial or almost complete unconsciousness.
What type of disinfection is done by placing small items in boiling water for a specified period of time?
Pasteurization.
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 registers.
Who is the approval authority for patient passes?
Patient's physician
What type of patients should receive parenteral hyperalimentation? aka Total parenteral nutrition (TPN)
Patients who have a gastrointestinal disorder.
What type of patient may have daily abdominal girth measurements?
Patients with cirrhosis of the liver or when internal bleeding is suspected.
How do environmental factors influence personality development?
People develop personality characteristics by imitating or rebelling against people or objects in their environment.
What does the symbol "pH" refer to?
Percentage of hydrogen ions (atoms) present in a solution.
What are five physical needs of a geriatric patient? Vol2 (216)
Personal hygiene, rest and sleep, elimination, nutrition, and exercise.
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.
Volume 3. 401 Who is involved in selecting, obtaining, and storing different medications, as well as accounting for the safe dispensation of medications?
Pharmacists.
In what phase of the PFB program is medical assistance no longer needed?
Phase III.
Name the two types of drug dependence.
Physical and psychological.
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.
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.
How can you prevent slipping in the bath tub?
Place a towel or nonslip pad on the bottom of the tub to prevent slipping.
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 lipids are found in blood plasma? *3
Plasma lipids include: triglycerides, phospholipids, and cholesterol.
What are the eight signs and symptoms of fluid volume deficit?
Poor skin turgor, concentrated urine which will result in a high specific gravity, oliguria, dry mucous membranes, weak and rapid pulse, orthostatic hypotension, a low central venous pressure (below four cm of H20), confusion, and restlessness.
Name the three phases of separation anxiety.
Protest, despair, and detachment.
If the patient has a priapism, what should you suspect?
Possible spinal cord injury.
What electrolyte deficit and excess can cause dysrhythmias leading to cardiac or respiratory arrest?
Potassium.
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?
Potentiation; undesirable.
What are the three steps to proper shaving technique taught to the PFB patient?
Preparation of the face, the shave, and the finish.
Which type of sterilization uses gravity displacement sterilizers, prevacuum sterilizers, and washer-sterilizers?
Pressurized steam sterilization.
What is the purpose of isolation precautions?
Prevent the spread of microorganisms among staff, patients, and visitors.
What are the immediate postoperative goals for the amputee?
Prevention of hemorrhage, infection, and contractures.
What is an antiemetic used for?
Prevention or relief of nausea.
What is the best treatment for musculoskeletal problems related to immobility?
Prevention.
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 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.
When patients do not believe a certain medication will help them, what factors are influencing them?
Psychological factors.
Vol 1. 011 According to Florence Nightingale's theory, what are the controllable environmental factors medics should be concerned about?*5
Pure or fresh air; pure water; efficient drainage; cleanliness; light (especially direct sunlight).
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.
What is the main treatment for excessively high body temperatures?
Rapid cooling of the body, both internally and externally.
Define self-actualization.
Reaching one's full potential.
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.
What is the primary use of antidiarrheal agents?
Reduce the number of loose stools an individual is having.
What are the benefits the patient receives from frequent oral hygiene?
Reduces the growth media for bacteria and it refreshes the patient and stimulates the appetite.
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.
What psychological condition is exhibited when a patient spends a great deal of time worrying about meals and bowel movements?
Regression and child-like behavior.
Vol. 3 405 What is the purpose of a palliative drug action?
Relieve symptoms of a disease without affecting the disease itself.
When administering medication, what dangerous practice should you avoid?
Relying on your memory for drug information.
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 are nursing activities designed to do? vol 2. 203
Resolve nursing diagnoses.
Which of the vital signs is taken first for pediatric patients? Why? Vol (215)
Respirations, because taking the pulse or temperature may disturb and irritate the infant or child causing them to cry.
An increase in carbonic acid in the body fluids associated with difficulty breathing can result in what type of acid-base balance?
Respiratory acidosis.
What type of acid-base imbalance is associated with a patient hyperventilating?
Respiratory alkalosis.
What are the normal exit portals for infectious agents? (3)
Respiratory tract, gastrointestinal tract, skin and mucus membranes.
This term is applied when drugs are used to return the body to health but not cure the disease.
Restorative.
List four common complications of uncontrolled diabetes.
Retinal changes leading to blindness, kidney disease, nerve damage, and circulatory disorders.
Penicillins are used prophylactically for what diseases? prophylactic: to prevent disease
Rheumatic fever and endocarditis.
What type of organism causes Rocky Mountain spotted fever?
Rickettsiae.
Vol 3. What are the "Six Rights" of medication administration?
Right patient, right medication, right dose, right route, right time, and right documentation.
Regarding vision, what is the difference between rods and cones?
Rods do not provide images as sharp as cones.
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.
What are the three basic bacterial shapes?
Spherical, rod-shaped, and spiral-shaped.
Vol 3. 411 What are the four types of parenteral injection methods?
SC, ID, IM, and IV.
Vol 1. 021 What kind of format is used to document an interview with a patient?
SOAP
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.
In which schedule are drugs not acceptable for medical use and have a high potential for abuse?
Schedule I.
Special inventory procedures are required for what schedule of drugs?
Schedule II.
Aspirin with codeine falls under what schedule of drugs?
Schedule III.
Vol 3. 418 How do the adrenal glands function?
Secrete hormones called corticosteroids that act on the immune system to suppress the body's response to either infection or trauma.
List the side effects of opioids.
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.
What need relates to how others feel about you?
Self-esteem.
List four stressors that influence the way children cope with hospitalization. Vol (214)
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 consideration 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.
001. General patient care skills 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, stoolsamples, assess respiratory rate,and perform intake and output measurements.
Why don't you want a child with a temperature elevation to shiver?
Shivering is rapid muscle contractions that produce more heat.
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 preoperative action do most patients perform the evening before surgery? vol 2. 205
Shower or bathe using an antiseptic soap, such as povidone-iodine (Betadine), to reduce the number of microorganisms on the skin.
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.
Lactinex is used for the treatment of what conditions?
Simple diarrhea caused by: -antibiotics -infection -irritable colon -colostomy -amebiasis (Amebiasis is a disease caused by the parasite Entamoeba histolytica.).
Ideally, in what position should you place a patient to administer an oral medication?
Sitting.
What physical characteristics of bacteria are used to determine their classification?
Size, shape, and attachments.
Vol 3. 413 What three general areas of the body are topical medications administered to?
Skin surface, body cavities, or body orifices.
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.
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.
What test is used to determine the hydration level of the patient?
Specific gravity. *A urine specific gravity test compares the density of urine to the density of water. This quick test can help determine how well your kidneys are diluting your urine
What are the two recommended tiers of isolation precautions developed by the CDC?
Standard precautions and transmission-based precautions.
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.
Volume 3. 403 What are the four types of medication orders?
Stat, single, standing, and PRN. definitions: https://pharma.knoji.com/the-drug-order/
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 is another term use for surgical asepsis?
Sterile technique.
What is the method of choice for chemical disinfection?
Sterilization.
Which form of cathartic is the primary choice for pregnant women and children? *cathartic: accelerates defecation
Stool softener, Docusate.
What type of patient is not usually able to communicate effectively?
Stroke victim
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.
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 (turning coughing & deep breathing), incentive spirometer, and leg and foot exercises.
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.
Who is responsible for the preparation of the patient's records for an aeromedical evacuation?
The AE clerk.
Who ensures civilian agencies are notified of reportable diseases?
The PH office.
What type of behavior can you expect of a person who abuses his or her spouse? Vol 2 (223)
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.
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.
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. *a way to view the lower 20 inches of a person's sigmoid colon and rectum *Sigmoidoscopy is the minimally invasive medical examination of the large intestine from the rectum through the nearest part of the colon, the sigmoid colon
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.
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.
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.
List three goals of successful rehabilitation for substance abusers. Vol 2 (224)
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 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 condition may complicate phlebitis?
The formation of a clot along the vein. *phlebitis:inflammation of a vein
What area of the retina is responsible for the best vision?
The fovea centralis.
Who is responsible for documenting the administration of a medication?
The individual who administers the medication.
What are the initial treatments used for mild hypertension?
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 is a transfusion?
The intravenous administration of whole blood or blood products.
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.
Vol 1. 032 In performing the trauma patient's history and physical, after the initial assessment, what must you first reconsider?
The mechanism of injury.
Why is there a minimal loss of potency when administering an SL medication?
The medication bypasses the liver.
Vol 3. List the elements of proper medication documentation.
The medication, dosage, time, route, location if an injection, adverse signs or reactions, and the patient's response.
What three veins are preferred for IV sites in the hand and arm?
The metacarpal, cephalic, and basilic veins.
Why is substance abuse behavior not compatible with military duty? Vol 2 (224)
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
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.
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.
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? Vol 2 (226)
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.
Vol 1. 017 What factors determine the type of intravenous solution used? *3
The patient's condition, fluid and electrolyte balance, and purpose for the IV.
What are the two standard identifiers associated with the NPSG?
The patient's full name and date of birth.
Who is responsible for notifying the inpatient unit that a routine patient is being admitted? Vol 2
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
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 is tonicity?
The relative concentration of dissolved substances in a solution as compared to the solution concentration within the red blood cells (RBC). *solutes:RBCs
Define "biopsies."
The removal and examination, usually microscopic, of tissue or fluid from the living body to establish a precise diagnosis.
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.
Vol 1. 024 What initiates electrical impulses in the heart?
The sinoatrial (SA) node.
How is suture size determined?
The smaller the number; the larger the suture's diameter.
Vol 3. 408 What determines which category a drug is placed in?
The specific action of a drug.
What information should be included on the medication label placed on the side of the bottle/bag? *3 things
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 is an amputation and why is it usually done? Vol 2 (212)
The surgical removal of all or part of an extremity. The need for amputation is usually due to trauma or disease to the limb.
Vol 3. 416 What are some of the factors considered when antiarrhythmic agents are chosen? *4
The type of arrhythmia, the frequency, cardiac and renal condition, and the current signs and symptoms the patient is showing.
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? (what does it look like)
The ulcer has penetrated down to the muscle causing distortion of muscle tissue and loss of body fluids.
How tight should you make the tourniquet?
Tight enough to obstruct the venous flow but not the arterial flow.
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.
Explain the action of coumarin derivatives.
They alter the synthesis of blood coagulation factors in the liver by interfering with vitamin K.
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? Vol 2 (226)
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 do β-adrenergic blockers work?
They combat arrhythmias by inhibiting adrenergic (sympathetic) nerve receptors.
002. What are two ways that a causative agent may cause disease?
They destroy surrounding tissue or produce toxins (poisons).
Why are the quadriceps femoris sites preferred for pediatric patients?
They do not contain nerves or blood vessels.
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? Vol 2 (223)
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? Vol 2 (225)
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.
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.
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.
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.
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. *balkan frame: a frame employed in the treatment of fractured bones of the leg or arm that provides overhead weights and pulleys for suspension, traction, and continuous extension of the splinted fractured limb.
Why does the site of administration need to be documented when an injection is given?
To avoid duplicate injections at the same site.
Stool samples are obtained for what reasons?
To check for occult blood, parasites, fat, and other abnormalities.
Describe the primary purpose of having housekeeping duties?
To control the spread of infection.
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.
Volume 3. 401 Why were drug standards developed?
To ensure uniform product quality.
Vol 1. 035 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 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.
Vol 3. 406. What is the purpose of most drug therapy?
To maintain a constant level of a drug in the body to permit the therapeutic action to be achieved.
What are the three major goals during the preoperative period? vol 2 (204)
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.
List five causes of paralysis.
Trauma, spinal cord tumors, disease, infections, and congenital defects.
What should you do if the nursing activity is unsuccessful?
Try to find out what went wrong and develop a better plan.
Vol 3. If a patient refuses to take a medication, what should you do?
Try to find out why the patient is refusing the medication, report the situation promptly to the nurse or provider, and document the situation.
Vol 1. 019 What type of pulmonary disorder is frequently discovered through sputum collection?
Tuberculosis.
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.
What reference is a combination of two official publications?
US Pharmacopoeia—National Formulary.
What is probably the greatest cause of fear and anxiety in an elderly patient? Vol 2 (216)
Uncertainty of the future or the prognosis of a disorder.
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.
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.
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.
Vol 3. What is the first step in preparing a medication?
Verify the medication order.
What is the first step to take when preparing a medication for administration?
Verify the order.
Vol 1. 026 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 most common type of meningitis?
Viral meningitis.
When are variable pressure volumetric pumps used?
When patients require critical volume or critical medication.
When is it important to use masks, goggles, or face shields?
When splattering or splashing of blood or body fluids is possible.
Which of the four respiratory capacities represents the total amount of exchangeable air?
Vital capacity (VC).
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.
Which vitamins cannot be stored by the body and must be ingested daily?
Vitamins B and C.
Where do you place yourself when walking with a blind patient? Vol 2 (217)
Walk slightly ahead of the patient.
How should you treat the skin after a cast is removed?
Wash it gently with soap and water.
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 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?
What types of litters should be carried in an ambulance?*3
Wheeled litter, folding litter, and collapsible device.
When does a steam sterilizer begin timing the actual sterilization cycle?
When all the air is removed and the heat reaches a preset point.
Vol 3. 421 When is histamine released?
When bodily injury from a pathogen, chemical, or physical trauma occurs.
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. *Infiltration occurs when the infusion cannula moves out of a vein, and the medicaton or fluid seeps into the surrounding tissue. When the infusion is nonvesicant, or non-irritating to the surrounding tissue, the damage will likely be minimal. The infiltration may cause the patient some mild discomfort and may require stopping the infusion and re-siting the IV elsewhere. Extravasation, however, occurs when a vesicant (agent that is irritating to human tissue) is inadvertently administered into the surrounding tissue instead of into the intended 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.
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? Vol 2
When the unit is first notified that a new patient is coming or a scheduled patient arrives.
If droplet precautions are in effect, when should you wear a mask?
When working within three feet of the patient.
What is consensual pupillary 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.
Vol 1. 033 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.
Which cells are the first line of defense to fight diseases?
White blood cells.
What are the three basic types of intravenous needles?
Wing-tipped needle, over-the-needle catheters, and inside-the-needle catheters.
What type of needle is commonly used to initiate an IV in the scalp of a pediatric patient?
Wing-tipped needle.
Explain the action of Glucophage.
Works by decreasing hepatic glucose output and enhancing insulin sensitivity in muscle. i.e metformin
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. vol 2
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.
At what stage of life does physical deterioration start?
Young adult, after age 30.
Hypersensitivity reaction is also known as what type of reaction?
allergic reaction
What should not be used for a backrub on an elderly patient?
alcohol
If a solution has a high "pH," is it referred to as "acidic" or "alkaline"?
alkaline
What are the building blocks of proteins?
amino acids
What type of exercise involves taking in less oxygen than the body needs?
anaerobic
What is vitamin K necessary for?
blood clotting
List five emotional stages of death and dying.
denial, anger, bargaining, depression, acceptance
What are three methods to treat a subungual hematoma?
drain the blood from nail using: Cautery, needle, and paperclip. *Cauterization is a medical practice or technique of burning a part of a body to remove or close off a part of it. It destroys some tissue in an attempt to mitigate bleeding and damage,
What is the most common lipid?
fats
What is the body's attempt to fight an infection by self-inducing a hyperthermic response?
fever
004. Description of common communicable diseases: Define: Inflammation of the liver that can be caused by bacteria, viruses, protozoa, helminths, chemicals, or drugs.
hepatitis.
What are the basic components of the needle?
hub, shaft, bevel
What is the body deprived of without vitamin C?
iron
During what stage of life do people often look back at the goals they have accomplished so far?
middle adult
List three symptoms of a fracture.
pain, swelling, discoloration
Patients treated for what specific disease are advised not to take B6 supplements?
parkinson's
What are the four types of cancer treatment?
surgery, chemotherapy, radiation therapy, immunotherapy
Who should you consult with when you set priorities and establish goals?
the patient
Which organ is considered the primary central gland of the lymphatic system?
thymus
When unloading a hydrogen peroxide plasma sterilizer, you must first check to make sure the chemical strips have changed to what color?
yellow