aurora study.docx

Study Guide for Exam 2 In order to prepare for **Exam 2**, it is recommended that you read all the assigned chapters in their entirety. This will help ensure that you are well-prepared and confident in the material. Complete all Essential Skills tests for Weeks 3 & 4. Review ATI videos engagement (...

Study Guide for Exam 2 In order to prepare for **Exam 2**, it is recommended that you read all the assigned chapters in their entirety. This will help ensure that you are well-prepared and confident in the material. Complete all Essential Skills tests for Weeks 3 & 4. Review ATI videos engagement (clinical assignment) associated with vital signs, pain, & medication administration. Review the PowerPoints for Week 3 & 4. Please do not wait until the last day to study. Some questions have select all that apply, drop down, multiple choice, etc. Several topics listed below have multiple questions. It is expected you read the book. This study guide is not all inclusive. This study guide is provided for you so you can prepare at least a week & half in advance. The exam is 61 questions worth 100 points. 1. Acute vs chronic pain 2. Cancer pain vs neuropathic pain 3. Phantom limb pain- what type is it 4. Education on pain medication- opioid vs non opioid 5. Opioid toxicity 6. Orthostatic hypotension 7. Radiation, Convection, Evaporation, Conduction 8. Vitals signs (normal ranges)- review clinical skills mini test for all vitals 9. Review clinical skills mini test for week 5 10. Med calculation mg to g 11. Tsp, oz, liter, quart 12. Review alterative therapy chart- ch 32 pg 719 Table 32.2 13. Nociceptive pain 14. PQRSTU  15. Safe medication administration 16. Nebulizer (Clinical Skills Essential) A small machine that turns liquid meds into a mist that can be inhale. Administering Nebulized Medications #### **ALERT** - **Immediately a [discontinue] the medication and notify the practitioner if severe [bronchospasm] occurs during treatment.** - **Use caution when administering medications with systemic effects to patients with cardiac disease because of the possibility of hypertension, arrhythmias, or coronary insufficiency. ** - **If the patient or family express concerns about the accuracy of a medication, do not give the medication. Explore the patient's concern, notify the practitioner, and verify the order. ** 1. Verify the healthcare provider's order. 2. Ensure privacy and perform hand hygiene. 3. Introduce yourself to the patient and family, if present. 4. Identify the patient using two identifiers.  5. Ask the patient if he or she has any drug or other allergies. 6. Explain the procedure to the patient and ensure that he or she agrees to treatment.  7. Compare the label of the medication with the information in the medication administration record (MAR) twice. Do a third check at the patient's bedside. Check the expiration date of the medication. Apply the Six Rights of Medication Administration. Refer to the Video Skill \"Ensuring the Six Rights of Medication Administration.\"  8. Complete the appropriate patient assessment for the medication being administered. 9. Perform hand hygiene and don gloves. Don appropriate personal protective equipment (PPE) based on the patient's need for isolation precautions or the risk of exposure to bodily fluids. 10. Assemble the nebulizer per the manufacturer's instructions. If the patient will be using the nebulizer at home, explain and demonstrate the nebulizer's assembly and use. 11. Add the prescribed medication to the nebulizer cup. If a diluent is needed, also add it to the nebulizer cup. 12. Attach and secure the top of the nebulizer cup. 13. Ensure the mouthpiece or facemask is connected. 14. Help the patient to an upright position, if possible. 15. Turn on the airflow and ensure that a mist has formed. 16. Have the patient hold the mouthpiece between his or her lips using gentle pressure. a. If the patient is an infant, a child, a fatigued adult, or unable to follow instructions, use a face mask. b. Use special adapters for a patient with a tracheostomy.  17. Have the patient slowly take a deep breath, inhaling a volume slightly greater than normal. Encourage a brief, end-inspiratory pause and then have the patient exhale passively. Have the patient repeat this breathing pattern until the drug is completely nebulized. If the patient is dyspneic, encourage him or her to breathe slowly with a normal tidal volume and to take an occasional deep breath when able. 18. Tap the nebulizer cup occasionally during treatment and toward the end of treatment. This releases droplets that are clinging to the side of the cup, allowing the solution to be re-nebulized. 19. Monitor the patient's pulse as indicated during the procedure, especially if a beta-adrenergic bronchodilator is used. 20. When the medication is completely nebulized, turn off the machine. 21. If steroids are nebulized, instruct the patient to rinse his or her mouth and gargle with warm water after the nebulizer treatment.  22. Reassess the patient after treatment and compare findings with preassessment information. 23. Disassemble all parts of the nebulizer, shake the nebulizer cup to remove the remaining medication solution, rinse each part in sterile water, shake off excess water, and allow parts to air-dry completely. Store the completely dry nebulizer cup and tubing assembly in a clean bag until its next use. 24. When you have completed all necessary care, discard all used supplies. Remove and dispose of gloves and perform hand hygiene.  25. Provide patient teaching using the Teach Back method. 26. Help the patient into a comfortable position, and place toiletries and personal items within reach. 27. Place the call light within easy reach, and make sure the patient knows how to use it to summon assistance. 28. To ensure the patient's safety, raise the appropriate number of side rails and lower the bed to the lowest position. 29. Document your care, patient teaching, and patient's tolerance to the therapy. a small machine that turns liquid medicine into a mist that can be easily inhaled a small machine that turns liquid medicine into a mist that can be easily inhaled 17. sub cutaneous injections (ppt) (From slides) Subcutaneous Injections - Medications placed into loose connective tissue under dermis - Medication absorption is slower than IM injections due to less blood supply. - Exercise and hot or cold compresses influence rate of absorption - Administration of low-molecular-weight heparin requires special considerations. - The site most frequently recommended for heparin injections is the abdomen. - Select site that is free of skin lesions, bony prominences, and large underlying muscles or nerves. +-----------------------------------+-----------------------------------+ | SQ | IM | +===================================+===================================+ | - insulin for diabetes | - antibiotics- penicillin G | | | benzathine penicillin, | | - heparin, or blood thinners | streptomycin | | | | | - the measles (MMR) and | - biologicals- immunoglobins, | | chickenpox (varicella) | vaccines, and toxoids | | vaccines | | | | - hormonal agents- | | - palliative care pain | testosterone, | | medications such as fentanyl | medroxyprogesterone | | and morphine | | | | | | - other home administered drugs | | | such as Dupixent and | | | fertility medications. | | +-----------------------------------+-----------------------------------+ Figure 31.20 Comparison of angles of insertion for intramuscular (90 degrees), subcutaneous (45 to 90 degrees), and intradermal (15 degrees) injections. +-----------------------------------------------------------------------+ | 18. insulin types to their correct descriptions regarding onset, | | peak, duration, and role in blood sugar management. (from power | | point) ex: Rapid, short, long acting | | | | | | | | 19.  Sublingual Administration vs Buccal Administration | | | | **Sublingual administration** involves placing a drug under your | | tongue to dissolve and absorb into your blood through the tissue | | there. | | | | **Buccal administration** involves placing a drug between your gums | | and cheek, where it also dissolves and is absorbed into your blood. | +-----------------------------------------------------------------------+