Other
Completed Exam 3 Blueprint (HIGHLY RECOMMEND!!)
- Course
- NURS 4626
- Institution
- University Of Texas - Tyler
This blueprint breaks down every subject covered for Exam 3. Gives details that will help answer questions asked for the exam.
[Show more]
Seller
Follow
Content preview
NURS 4626 Test Blueprint – Exam 3 Fall 2022Alternate question types-8; Dosage Calculations-2 https://quizlet.com/_c7a6xd?x=1jqt&i=imkpf
Week Six:
19
●
CVAD
2 - central venous access device ○
Permit frequent continuous, rapid, or intermittent administration of fluids and medications ○
Allow for drugs that are vesicants to be given ○
Used for Blood/blood products and parenteral nutrition ○
No fluids until x-ray confirms placement**** ○
Centrally inserted Catheter: ■
Inserted in the chest or neck area (Subclavian or Jugular)funneled through to the heart at the
end of the vena cava ■
tip of catheter ends in SUPERIOR vena cava ■
Dacron cuf f anchors and prevents infection ■
up to 3 lumens (types Hickman, Broviac, Groshong) ○
Peripherally Inserted Central catheter: ■
Cephalic or Basilic veins in the arm ■
1 week - 6 months ■
Can't use arm for BP or blood draw ■
T
his has lower infection rate and cost ○
Nursing management: ■
Inspect site, assess for pain ■
change dressing and clean according to hospital policy (chlorhexidine cleaning agent) ■
Change injection caps (patient to turn head opposite side, valsalva if no clamp) ■
flushing is important (saline, 10mL or more,
push-pause
technique
) ●
Complications: Catheter occlusion (tip against wall, clamped/kinked, thrombosis,
buildup), Embolism (catheter breaking, dislodged thrombus, entry of air) , Infection
(contamination, immunosuppressed), Pneumothorax (perforation of visceral pleura),
Catheter migration (bad suturing, trauma, spontaneous) ●
Differ entiate the differ ent types of acute blood transfusion r eactions.
1 ○
Hemolytic: ■
Infusion of
incompatible blood, RBCs
, or at least
10mL of RBCs, antibodies attach to the added blood antigens causing destruction ■
S/S (occur within 15 mins):
Fever
with or without
chills,
back/abdominal/chest/flank pain
, infusion site pain
, tachycardia,
dyspnea, tachypne
a,
hypotension, hemoglobinuria, acute jaundice, dark urine, bleeding, AKI, shock, cardiac arrest, DIC, death ■
Management: Treat any complication that occurs, draw blood samples slowly , insert foley and monitor output and send of f urine specimen, maintain BP with IV colloid solutions, and give diuretics to help with urine output, do not give more blood till tests have been done ○
Febrile: ■
sensitization to
donor WBCs (most common), platelets,
or plasma pr oteins ■
S/S:
Sudden chills,
rigors, and
fever (rise in temperatur e
>1degr ee celsius
), HA, vomiting ■
Management: Give antipyretics
(acetaminophen
), Do
not restart transfusion unless HCP orders ○
Aller gic: ■
Sensitivity to donor plasma protein ■
Mild reaction: ●
S/S: Facial flushing, hives (urticaria), rash Pruritus ●
Management: Give antihistamine, corticosteroid, epinephrine ■
Severe: ●
S/S: Anxiety , abdominal pain, urticaria, dyspnea, wheezing, progressing to cyanosis, bronchospasms, hypotension, shock, cardiac arrest ●
Management: CPR, give o2, epinephrine, maybe antihistamines and B-blockers ●
Describe the nursing management of the patient r eceiving transfusions of blood and blood
components who develop acute blood transfusion r eactions.
2
○
IN ORDER:
■
Stop transfusion
■
maintain patient line with saline
■
notify HCP and Blood bank
■
Reidentify tags and bags
■
Monitor VS and urine
■
Implement providers orders
■
Save tubing/bags to send back to blood bank
■
Collect blood blood/urine specimens
■
document incident
●
Discuss the principles, interpr ofessional car e, and nursing management of the patient r eceiving hemodynamic monitoring, specifically arterial and CVP (central venous pr essur e) lines.
3 ○
Arterial Line: ■
Identify the Phlebostatic Axis- 4th intercostal space, and in line with the heart → CRIMSON CHIN ■
Before insertion do the Allen test (ulnar and radial artery blood flow test, <6 seconds is good) ■
Keep pressure bag inflated to 300 mmHg, Flush bags of normal saline are changed q96 hr or
PRN ■
All lines must have rigid non-compliant tubing ■
Immobilize site ■
keep visible ( no bandage on art line)
■
normal Cardiac Output (CO) is 2.2-4 L/Min
■
MAP calc =𝑆𝐵𝑃 + (2𝑥𝐷𝐵𝑃)3 ■
Pulse pressure = SBP-DBP (normal =30-50) ○
Central Venous Pressure (CVP): ■
PICC or Central Line used ■
Measures the Preload, and best measurement of fluid status in distributive shocks (septic,
neurogenic, anaphylactic)
■
no fluids pushed until CXR r eceived ■
2-8 mmHg ■
Hypovolemic goal: 8-12 mmHg ■
Cardiogenic goal: <8 mmHg ●
Differ entiate the clinical manifestations, interpr ofessional car e including drug therapy , and nursing
management of patients with: Table completed
○
Cardiogenic Shock
2
■
MI, HF , CAV, etc; want to restore blood flow → stent, revascularization, drug to reduce work
of heart
■
heart not strong enough to perfuse body- or gan malperfusion → or gan failure
■
keep CVP <8
■
tachycardia, hypotension, edema, crackles in lungs
■
infuse fluids with caution → fluid overload
■
treatment: increase bp (fluids NS) (vasopressors if unresponsive), O2
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller orlandomontoyajr. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $20.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
78252 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now