Nursing Test #4 - Subacute Care
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Questions and Answers

What is subacute care, and where is it usually provided?

Care for people who need more care than long term facilities can provide. It happens in hospitals and long term care facilities.

What conditions might require subacute care?

Chronic illness, cardiac surgery, recent stroke.

A pulse oximeter measures a person's blood oxygen level and pulse rate.

True

A normal blood oxygen level is approximately 84%.

<p>False</p> Signup and view all the answers

Diseases such as chronic obstructive pulmonary disease can lower a person's blood oxygen level.

<p>True</p> Signup and view all the answers

If the alarm on the pulse oximeter sounds, the nursing assistant should turn it off.

<p>False</p> Signup and view all the answers

The nursing assistant should report cyanotic skin or mucous membranes.

<p>True</p> Signup and view all the answers

Telemetry is the application of a ________________ monitoring device.

<p>cardiac</p> Signup and view all the answers

The telemetry unit transmits information about the heart's _________________ and __________________.

<p>rhythm, rate</p> Signup and view all the answers

A portable telemetry unit attaches to a resident's _______________.

<p>chest</p> Signup and view all the answers

The nursing assistant should monitor _______________________ carefully as ordered.

<p>vital signs</p> Signup and view all the answers

The nursing assistant should report if pads become _________________

<p>loose</p> Signup and view all the answers

An artificial airway may be needed in order to facilitate?

<p>ventilation</p> Signup and view all the answers

A surgically created opening in the neck into the trachea is called?

<p>tracheostomy</p> Signup and view all the answers

When assisting a resident with an artificial airway, the nursing assistant should?

<p>Use other methods of communication, such as writing notes or communication boards, if the resident cannot speak.</p> Signup and view all the answers

A nursing assistant should provide this for the site around the tracheostomy.

<p>skin care</p> Signup and view all the answers

One position that a resident may need to be in when he has a tracheostomy is?

<p>fowlers</p> Signup and view all the answers

A cuffless tracheostomy tube is often used if the resident has a low risk for this.

<p>aspiration</p> Signup and view all the answers

One reason why a tracheostomy may be necessary is?

<p>cancer</p> Signup and view all the answers

A person with a tracheostomy may not be able to do this.

<p>speak</p> Signup and view all the answers

Another name for the opening for the tracheostomy is?

<p>stoma</p> Signup and view all the answers

A ventilator performs the process of breathing for a person who cannot breathe on his own.

<p>True</p> Signup and view all the answers

A resident using a mechanical ventilator is usually able to speak, although his voice will be weaker.

<p>False</p> Signup and view all the answers

A resident using a mechanical ventilator will prefer to be left alone as much as possible.

<p>False</p> Signup and view all the answers

A resident using a mechanical ventilator is often sedated.

<p>True</p> Signup and view all the answers

A resident using a mechanical ventilator needs to be positioned flat on his back at all times.

<p>False</p> Signup and view all the answers

The nursing assistant should reposition a resident using a mechanical ventilator at least every two hours.

<p>True</p> Signup and view all the answers

Residents using mechanical ventilators will require one-on-one care during a power failure.

<p>True</p> Signup and view all the answers

Most residents using mechanical ventilators will show nervousness or anxiety, so it is not necessary for the nursing assistant to notify the nurse if this occurs.

<p>False</p> Signup and view all the answers

When is suctioning needed?

<p>When a person has increased secretions they cannot expel themselves.</p> Signup and view all the answers

What are signs of respiratory distress?

<p>Gurgling, elevated respiratory rate, shortness of breath, cyanosis.</p> Signup and view all the answers

What are some guidelines of suctioning?

<p>Observe skin color, be supportive during periods of difficult breathing, answer call lights promptly, give oral and nasal care after suctioning, monitor vital signs, follow standard precautions.</p> Signup and view all the answers

Chest tubes are inserted during what type of procedure?

<p>Sterile</p> Signup and view all the answers

Chest tubes drain air, blood, or fluid from what?

<p>The pleural cavity</p> Signup and view all the answers

Chest tubes may be required for?

<p>Surgery or injuries.</p> Signup and view all the answers

A drainage system must be?

<p>Airtight</p> Signup and view all the answers

The drainage system must be kept _____________ the level of the resident's chest.

<p>below</p> Signup and view all the answers

What is a central venous line?

<p>Placed in one of the larger veins in the body when total parenteral nutrition is expected to be continued for a period of time.</p> Signup and view all the answers

What is gastric suctioning?

<p>Used for removal of materials inside the body via suctioning.</p> Signup and view all the answers

What is a gastrostomy?

<p>Surgically created opening in the abdomen and the stomach through which a PEG tube is placed.</p> Signup and view all the answers

What is a nasogastric tube?

<p>A tube inserted into the nose, down the back of the throat through the esophagus, and into the stomach.</p> Signup and view all the answers

What is a percutaneous endoscopic gastrostomy (PEG) tube?

<p>A tube placed through the abdominal wall into the stomach.</p> Signup and view all the answers

What is total parenteral nutrition (TPN)?

<p>Nutrients are received intravenously, bypassing the digestive tract.</p> Signup and view all the answers

What is kidney dialysis and why is it used?

<p>It cleans the body of waste that the kidneys are unable to filter due to chronic renal failure.</p> Signup and view all the answers

What sort of things should a nursing assistant report to the nurse about dialysis?

<p>Itchy skin, change in intake and output, swelling of extremity, pain, drainage, respiratory distress, change in vital signs.</p> Signup and view all the answers

Study Notes

Subacute Care Overview

  • Subacute care provides more intensive treatment than long-term care facilities.
  • Typical settings include hospitals and long-term care facilities.

Conditions Requiring Subacute Care

  • Chronic illnesses
  • Cardiac surgery recovery
  • Recent stroke recovery

Pulse Oximetry

  • A pulse oximeter measures blood oxygen levels and pulse rate.
  • Normal blood oxygen levels are not approximately 84%; they are generally around 95-100%.
  • Chronic obstructive pulmonary disease can lead to decreased blood oxygen levels.
  • Nursing assistants must respond to alarm sounds from pulse oximeters rather than turning them off.
  • Cyanotic skin or mucous membranes should always be reported to a nurse.

Telemetry Monitoring

  • Telemetry involves cardiac monitoring through specialized devices.
  • The telemetry unit transmits heart rhythm and rate information.
  • A portable telemetry unit is attached to the resident's chest.

Vital Signs and Monitoring

  • Nursing assistants should carefully monitor vital signs as ordered.
  • Loose pads on telemetry devices must be reported.

Tracheostomy Care

  • Tracheostomy: a surgical opening in the neck leading to the trachea, facilitating ventilation.
  • Assist residents with artificial airways using alternative communication methods if they cannot speak.
  • Skin care around the tracheostomy site is essential.
  • Residents may need to be positioned in Fowler's position for comfort and breathing ease.

Tracheostomy Details

  • Cuffless tracheostomy tubes reduce aspiration risk.
  • Tracheostomies may be necessary due to conditions like cancer.
  • Individuals with tracheostomies may lose the ability to speak.
  • The stoma refers to the opening created by the tracheostomy.

Mechanical Ventilation

  • A ventilator aids those unable to breathe independently.
  • Residents using mechanical ventilators cannot typically speak.
  • Mechanical ventilator patients may prefer companionship and may often be sedated.
  • Regular repositioning every two hours is necessary for comfort.
  • One-on-one care is crucial during power outages for ventilator-dependent residents.
  • Anxiety or nervousness in ventilator users must be reported to nurses.

Suctioning and Respiratory Care

  • Suctioning is needed for individuals unable to expel secretions.
  • Signs of respiratory distress include gurgling, elevated respiratory rates, shortness of breath, and cyanosis.
  • Guidelines for suctioning involve observing skin color and providing support during difficult breathing.

Chest Tubes and Drainage

  • Chest tubes are inserted in sterile procedures to drain air, blood, or fluid from the pleural cavity.
  • A drainage system must be airtight and maintained below chest level.

Nutritional and Renal Support

  • A central venous line is used for long-term total parenteral nutrition.
  • Gastric suctioning is a method for removing materials from the body.
  • Gastrostomy involves creating an opening in the abdomen for a PEG tube.
  • Nasogastric tubes are inserted through the nose to the stomach.
  • Total parenteral nutrition (TPN) delivers nutrients intravenously, bypassing the digestive system.
  • Kidney dialysis cleanses waste due to chronic renal failure.

Reporting During Dialysis

  • Nursing assistants should report symptoms such as itchy skin, changes in intake/output, swelling, pain, respiratory distress, or vital sign changes to nursing staff.

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Description

Test your knowledge on subacute care through this flashcard quiz. Learn about the definitions, conditions that require subacute care, and key concepts within this important nursing topic. It's essential for nurses to understand this area to provide better patient care.

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