Questions and Answers
A subacute setting is a special unit for those who need more care than most long-term facilities can give.
True
Hospitals can provide subacute care, but skilled nursing facilities cannot.
False
People who have had surgery, have chronic illnesses, or require dialysis or complex wound care may need subacute care.
True
A mechanical ventilator is a machine that assists with or replaces breathing when a person cannot breathe on their own.
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What type of surgery must be performed for health reasons but is not an emergency?
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______ surgery is unexpected and unscheduled and must be performed immediately to save a life or limb.
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Which type of surgery is chosen by the patient and is planned in advance?
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Which type of anesthesia is injected directly into the surgical site or area and is used for minor surgical procedures?
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An epidural is an example of this type of anesthesia.
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Before a person has surgery, the doctor will most likely not tell what to expect because it may frighten the person too much.
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People who are going to have surgery often experience anxiety, fear, worry, and sadness.
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A nursing assistant (NA) can help a person who is worried about surgery by avoiding the person until the surgery is over.
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If a person has an NPO medical order before surgery, this means that she cannot have food or anything to drink except for water.
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A NA's duties may include making sure that the person's identification bracelet is accurate and on the wrist or ankle prior to transport.
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What are three goals of postoperative care?
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What concerns and possible complications should a NA watch for after a person has surgery?
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What type of equipment might a NA be asked to gather while a resident is in recovery after surgery?
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List a few postoperative care tasks that NAs may be required to do.
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Pulse oximetry is commonly used for people who are?
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A pulse oximeter measures?
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The pulse oximeter's sensor is usually clipped on a person's?
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The sensor ______ to measure blood oxygen level.
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A normal blood oxygen level is usually between?
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Which of the following should be reported to the nurse regarding pulse oximetry?
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Telemetry is used to measure the heart ______ and ____ on a continuous basis.
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Wires are attached to the ____ with sticky pads or patches.
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The nursing assistant should report to the nurse if the pads become ____ or soiled.
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If the _____ sounds, the NA should notify the nurse.
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The NA should check _____ signs as ordered.
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The skin around the pads should be checked for sores, redness or _____ .
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List three situations in which an artificial airway might be necessary.
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What is a tracheostomy?
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What are four guidelines for NAs working with residents who have artificial airways?
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A tracheostomy is always permanent.
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It may be difficult for the resident to talk after first having a tracheostomy inserted.
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Cancer, infection, and severe neck or mouth injuries are some reasons why a tracheostomy may be necessary.
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Gurgling sounds are normal due to the placement in the neck and do not need to be reported to the nurse.
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NAs do not perform tracheostomy care or suctioning.
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Shortness of breath or trouble breathing should be reported right away.
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Residents with tracheostomies are prone to respiratory infections.
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To help prevent infections when working with residents with tracheostomies, the NA should wash his hands often.
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Being on a ventilator has been compared to breathing through this.
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Nursing assistants should answer these promptly.
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An agent or drug that helps calm and soothe a person is called a?
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Regular, careful skin care can prevent these types of wounds.
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Something that a person will no longer be able to do while on the mechanical ventilator because air will no longer reach the larynx is to?
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Mechanical ventilation inflates and deflates these.
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Suctioning is needed when a person cannot remove mucus and secretions from the lungs on his own.
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Suctioning is usually a non-sterile procedure.
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The nursing assistant is normally responsible for suctioning.
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A portable pump may be used to suction the resident.
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One sign of respiratory distress is a gurgling sound of secretions.
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If a person is flaring his nostrils, he may be in respiratory distress.
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Vital signs, especially respiratory rate, should be monitored closely.
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Chest tubes are inserted during a ______ procedure.
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Chest tubes drain air, blood, or fluid from?
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Chest tubes may be required for?
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The drainage system must be?
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The drainage system must be kept ______ the level of the resident's chest.
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Study Notes
Subacute Care
- A subacute setting provides more specialized care than typical long-term facilities.
- Hospitals can provide subacute care; skilled nursing facilities can also offer it.
Patient Needs
- Individuals post-surgery, those with chronic illnesses, or requiring dialysis or wound care may need subacute care.
Surgery Types
- Urgent Surgery: Necessary for health reasons but not an emergency.
- Emergency Surgery: Unscheduled, requires immediate action to save life or limb.
- Elective Surgery: Planned in advance by the patient.
Anesthesia
- Local Anesthesia: Injected into the surgical site for minor procedures.
- Regional Anesthesia: Includes epidurals and affects a larger area.
Preoperative Communication
- Surgeons typically inform patients about what to expect to alleviate anxiety and fear.
Patient Emotions
- Anxiety, fear, worry, and sadness are common feelings before surgery.
NA Responsibilities Pre/Post Surgery
- NAs ensure identification bracelets are accurate prior to transport.
- Postoperative goals include preventing infections, promoting healing, and restoring health.
- Common concerns post-surgery: breathing issues, mental status, pain, wound healing, urinary retention or infection.
Equipment in Recovery
- Potential equipment for recovery includes bed protectors, towels, vital signs tools, and emesis basins.
Monitoring Vital Signs
- Pulse oximetry used for monitoring blood oxygen levels during recovery.
- A normal blood oxygen level is between 95% - 100%.
Telemetry Monitoring
- Monitors heart rhythm and rate continuously with pads attached to the chest.
Artificial Airway Necessity
- May be needed due to obstruction caused by illness, injury, or aspirated secretions.
- A tracheostomy is a surgical opening in the neck to facilitate breathing.
Guidelines for NA Care with Artificial Airways
- NAs observe residents closely, monitor vital signs, perform oral care, and provide emotional support.
Ventilation Considerations
- Being on a ventilator can affect speaking ability as air cannot reach the larynx.
- Regular skin care prevents pressure injuries for patients on ventilators.
Suctioning and Respiratory Care
- Suctioning is performed when patients cannot clear respiratory secretions; it's a sterile procedure.
- Signs of respiratory distress include gurgling sounds, flaring nostrils, and need for close monitoring of vital signs.
Chest Tubes
- Inserted during sterile procedures to drain air, blood, or fluid from the pleural cavity.
- The drainage system must be airtight and positioned below the resident's chest level to function correctly.
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Description
This quiz covers key concepts in subacute care, including patient needs and types of surgery. It also delves into anesthesia and the importance of preoperative communication to manage patient emotions. Ideal for nursing assistants and healthcare students.
