Medication Math and Ethical Considerations

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Questions and Answers

Which action is most critical in minimizing the risk of Catheter-Associated Urinary Tract Infections (CAUTIs)?

Using a catheter without any securement

Selecting the largest possible catheter size

Inserting the catheter without aseptic technique

Performing routine perineal care and catheter care (correct)

What is the first step in the process of delegating tasks effectively?

Right directions and communication

Right supervision and evaluation

Right task (correct)

Right person

Which of the following best describes a primary strategy for managing arterial lines?

Keep the line open and free of clots with regular flushing (correct)

Maintain the line at the patient's hip level at all times

Use the line for blood sampling only once every 24 hours

Disconnect the line for routine blood pressure checks

Which of these considerations is essential when performing inline closed system suctioning?

Perform suctioning for no more than 5 seconds at a time Signup and view all the answers

In the context of delegation, which activity should never be delegated to unlicensed personnel?

Educate patients on medication Signup and view all the answers

What is the primary purpose of a suprapubic catheter?

To allow urine drainage when other routes are contraindicated Signup and view all the answers

What is the primary focus of hospice care?

Comforting the patient in their final stages Signup and view all the answers

Which technique is essential for changing the dressing of a suprapubic catheter?

Applying aseptic technique Signup and view all the answers

During which time frame does rigor mortis begin to set in after death?

Within 2-6 hours after death Signup and view all the answers

In post-operative care for a suprapubic catheter, what should be done first after applying gloves?

Inspect and palpate the bladder Signup and view all the answers

Why is it important to keep the drainage bag below the level of the bladder?

To prevent urine from flowing back into the bladder Signup and view all the answers

What is one of the key differences between palliative care and hospice care?

Palliative care can be initiated at any illness stage Signup and view all the answers

What should be assessed about the urine drainage bag during post-operative care?

The volume, clarity, color, and odor of the urine Signup and view all the answers

What is livor mortis?

The pooling of blood resulting in a purplish discoloration Signup and view all the answers

What is the appropriate action if the catheter is not sutured in place during care?

Rotate the SPC according to protocol Signup and view all the answers

What does algor mortis refer to in the post-mortem process?

The cooling of the body to ambient temperature Signup and view all the answers

What is the best method for cleaning the catheter site?

Using a circular motion starting at the insertion site and moving away Signup and view all the answers

What personal protective equipment is indicated during the post-operative care of a suprapubic catheter?

Gloves and gown if there is risk of exposure Signup and view all the answers

What is the primary reason for delaying wound care in burn patients?

Airway patency and adequate circulation must be ensured Signup and view all the answers

What is the Parkland formula used for in burn treatment?

Determining fluid replacement required after burn injury Signup and view all the answers

Which of the following is NOT a common drug used for pain management in burn patients?

Ibuprofen Signup and view all the answers

In the context of managing cardiovascular symptoms, what does MONA stand for?

Morphine, O2, Nitrate, Aspirin Signup and view all the answers

What is a key indicator of a STEMI on an EKG?

ST elevation Signup and view all the answers

What is the caloric requirement for a burn patient as part of nutritional therapy?

5000 kcal/day Signup and view all the answers

Which of the following is an important emotional need to address in burn patients?

Promote self-esteem and provide support groups Signup and view all the answers

What type of therapy is indicated for a patient experiencing a non-ST elevation myocardial infarction (NSTEMI)?

Coronary Angiography and Anticoagulants Signup and view all the answers

What should be done to maintain proper positioning for burn patients?

Keep arms elevated and extended Signup and view all the answers

Which of the following is a symptom of SII in burn patients?

Respiratory distress Signup and view all the answers

What is the primary purpose of a chest tube?

To drain air, fluid, or blood from the pleural space Signup and view all the answers

What does continuous bubbling in the water-seal chamber indicate?

An air leak is present Signup and view all the answers

What intervention should be taken if a chest tube becomes dislodged?

Cover the site with a sterile dressing Signup and view all the answers

Which of the following is NOT part of chest tube nursing care?

Clamping the tube whenever necessary Signup and view all the answers

What physiological change occurs in burn patients due to increased capillary permeability?

Fluid leakage into the interstitial space causing edema Signup and view all the answers

What is a priority intervention for airway maintenance in burn patients?

Early endotracheal intubation Signup and view all the answers

What is the purpose of an escharotomy in burn victims?

To release the constrictive effects of burned skin Signup and view all the answers

What indicates increased drainage from a chest tube that necessitates immediate reporting?

Draining bright red blood Signup and view all the answers

How can a nurse assess for patency in chest tube drainage?

By checking for kinks, loops, or occlusions in the tubing Signup and view all the answers

What should a patient be taught to do during chest tube removal?

Perform a Valsalva maneuver Signup and view all the answers

What is the primary purpose of giving insulin in the management of DKA?

To reduce blood glucose levels Signup and view all the answers

Which medication is used primarily for sedation and anxiety control in severe alcohol withdrawal symptoms?

Lorazepam Signup and view all the answers

What does an elevated serum lactate level indicate?

Potential tissue hypoperfusion and metabolic disturbances Signup and view all the answers

Which normal range indicates a healthy PaCO2 value?

35-45 mmHg Signup and view all the answers

What does the Richmond Agitation-Sedation Scale (RASS) measure?

Alertness and agitation levels in sedated patients Signup and view all the answers

In the treatment of DKA, what is the maximum rate at which blood glucose should be reduced per hour?

100 units/hr Signup and view all the answers

Which laboratory components are included in a Complete Blood Count (CBC)?

WBC, RBC, platelets Signup and view all the answers

Which medication is primarily administered for cardiac arrest and anaphylaxis?

Epinephrine Signup and view all the answers

Study Notes

Medication Math

Exam includes 10 questions on various medication math calculations
Calculations may involve infusion rates, IV push volumes, weight-based calculations, drug concentration identification, and oral medication dosage calculations.

Experience 1: Restraints

Demonstrate proper restraint application and removal, emphasizing ethical considerations, as outlined in the ANA position statement.
Restraints are a last resort when less restrictive alternatives have failed, and used for shortest duration possible.
Key considerations include sedation over restraints when appropriate.
Methods to reduce restraint use include alternative measures, such as 1:1 observation and restraint rounds.

Violence Prevention

Recognizing, assessing, reporting, and preventing potential incidents of violence.
Incorporate de-escalation techniques and education.
Utilizing appropriate resources and tools for violence prevention.

Ethical Considerations

Obtain informed consent from the patient and family before applying restraints.
Provide 1:1 supervision to the patients when restrained
Education of the patient and family must take place prior to using restraints.
Address any complaints and provide continuous assessments.

Initial Assessment

Understand the reason for restraint use.
Evaluate the patient's current condition, including risk of self-harm or harm to others and related history.
Identify alternative measures attempted.

De-escalation Techniques

Calm, non-threatening communication to build rapport.
Offer choices or involve patient in decision-making.
Focus on reorientation to reduce feelings of powerlessness.
Note any triggers that exacerbate their agitation.

Care Plan for Physical Restraint Application

Select the least restrictive restraint appropriate for the situation (e.g., soft wrist restraints).
Ensure a quick-release mechanism for safety, avoiding side rails.
Maintain 2-finger space between restraint and skin to prevent circulation issues.

Skin Integrity Assessment

Prevent pressure ulcers, bruises, or sores
Regularly assess skin integrity, including inspection of pressure points.
Apply padding at pressure points and reposition patients regularly.
Document any issues or changes

Frequent Monitoring

Monitor patient every 15-30 minutes (or more frequently).
Assess vital signs, mental status, circulation, comfort level, and signs of distress.
Remove restraints for at least every 2 hours, to note any other considerations.

Safety Hazard Evaluation

Ensure restraints don't restrict access to or cause harm from equipment.
Prevent strangulation and ensure patient safety with proper setup.
Carefully consider the environment surrounding the patient to limit the risks of injury
Consider and document any changes to the care plan following restraint removal.

Alarm Fatigue

Adjust alarm settings to address patient sensory overload.
Implement alarm systems that appropriately prioritize patient safety.
Use alarms systems safely; do not turn off unnecessarily.
Regular assessment of alarm response from patients.

Alcohol Withdrawal

Recognizing symptoms of alcohol withdrawal and providing appropriate medical interventions.
Addressing long-term effects and promoting supportive long-term care and health habits.

End of Life Care

Demonstrate knowledge of advanced directives and legal issues related to end-of-life care.
Understand palliative and hospice care concepts and their differences.
Emphasize recognizing cultural values of the patient/family during end-of-life care.

Airway Suctioning

Understanding indications and complications of airway suctioning.
Recognizing signs of respiratory distress and ineffective cough, as well as decreased oxygen levels.
Avoiding potential complications like hypoxia, trauma or infections, with appropriate monitoring during suctioning.
Ensuring careful suction technique to maintain patient safety.

Arterial Line Management

Identifying potential complications and ensuring safe practice.
Checking connections and using proper technique.
Maintaining prescribed pressures and monitoring the arterial line.

Prioritizing Care of Multiple Patients

Applying the Maslow hierarchy of needs.
Understanding the urgency and severity of patient needs.
Properly delegating care based on the scope of practice.

Delegation Decisions

Knowing scope of practice for each level of care provider.
Matching tasks to competency levels.
Providing clear instructions and ongoing monitoring.

Communication Skills for Delegation

Providing clear and concise instructions.
Using active listening to understand patient needs, and any concerns.
Ensuring role responsibilities are clear, and encouraging questions as needed.
Feedback is required to ensure the process of delegation is functional and effective

Telehealth Considerations

Recognizing the role of technology in healthcare, and telehealth in particular.
Demonstrating awareness of issues in access, and the patient's access to appropriate support systems.
Adapting care appropriately in different settings.

DKA Complications

Utilizing appropriate protocols and measures to address Diabetic Ketoacidosis.
Monitoring vital signs, electrolytes, fluid balance, and blood glucose levels frequently.
Identifying factors and complications leading to DKA requiring appropriate treatment.

Patient Care in the Context of Telehealth

Awareness of factors that increase the risk of mortality in rural areas, including access to healthcare and care.
Recognition of the importance of technology-supported care for effective delivery and health outcomes.

Nursing Considerations During End-of-Life and Post-mortem Care

Applying appropriate end-of-life and post-mortem care measures
Addressing the physiological changes associated with death and the emotional needs of the family.
Incorporating cultural considerations into the care plan, to respect the patient's preferences and values.

Cardiac Arrest

Identifying and responding to cardiac arrest (including signs, causes, and appropriate interventions).
Knowing factors to consider during cardiac arrest, and providing and managing early resuscitation steps.
Performing CPR and defibrillation as required depending on the assessment and rhythm detected.
Knowing the significance of appropriate patient assessment, and identification of reversible factors leading to cardiac arrest.
Management of patients in cardiac arrest requiring additional consideration.

Suprapubic Catheters

Understand indications for placement, post-operative care, and how to properly handle the catheter.
Following the appropriate sterile technique measures for any interactions with this catheter.
Understanding the importance of monitoring for potential complications, and notifying the appropriate healthcare provider as required.

Chest Tubes

Proper insertion and maintenance of chest tubes.
Assessing for any issues, such as hemorrhage or fluid build-up.
Understand the importance of timely communication with appropriate personnel.
Proper care, management and monitoring following chest tube insertion.

Burn Patient/Patient with Damage

Demonstrating understanding and application of the principles of burn care and patient management.
Knowing the importance of airway management, fluid replacement, and pain management measures.
Identifying and recognizing potential issues that could arise in these patients.

Cardiac Symptoms

Recognizing the signs and symptoms of cardiac events.
Addressing potential concerns and implementing appropriate care measures and referrals if necessary.
Application of reperfusion therapy to improve patient outcomes.

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Description

This quiz covers essential medication math calculations, including infusion rates and drug dosage calculations. Additionally, it emphasizes ethical considerations in restraint application and violence prevention techniques. Prepare to explore both the mathematical and ethical dimensions of nursing practice.