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A collection of questions and answers related to advanced nursing skills, covering topics such as insulin administration, chest tube management, tracheostomy care, and parenteral injections. It serves as a valuable resource for nursing students preparing for exams or seeking to enhance their knowledge of essential nursing procedures.
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*What is the order for mixing rapid acting/long acting insulin from two vials? - ANSWER- Cloudy-clear-clear-cloudy *Where should the nurse administer a subcutaneous insulin injection? - ANSWER- Abdomen *What site best absorbs insulin? - ANSWER- Abdomen (followed by arm, thighs, and buttocks. *Chest tube insertion for hemothorax is between the ___ and ___ ICS - ANSWER- 4 - 6 *Chest tube insertion for pneumothorax goes into the ____or ___ICS - ANSWER- 2nd or 3rd *Empynema - ANSWER- pus from an infection (pneumonia) *It is important for the nurse to obtain informed consent from the patient before ______________. - ANSWER- administering pain medication (Opioids) *If needing to take longer to set up a new chest tube system the nurse should______________. - ANSWER- Place the end of the chest tube in sterile water. *In the instance that the chest tube becomes disconnected the nurse knows to: - ANSWER- Quickly cover insertion site with occlusive vaseline gauze during the PEAK of INSPIRATION. *The nurse know to ______________ if she notices changes in drainage greater than ________mL/hr. - ANSWER- Notify MD of changes >100 mL/hr *The nurse knows to encourage the patient to ______________, and ______________ as the chest tube is being pulled out. - ANSWER- Take a deep breath and hold, and tape on three sides (when the chest tube___________________) *True/False The nurse should always be sure to take the velcro ties off before she puts the new one on. - ANSWER- FALSE she only does this if there is an assistant present to hold tracheostomy tube in place until new ties are firmly tied down. *True/False: If the nurse notices a change in the patient with a chest tube's condition she should notify the MD. - ANSWER- True
*Correct incision site is made between ____________________ and the tube is inserted directly into the trachea- just below the larynx. - ANSWER- second and third tracheal rings *You must take no longer than _______ when cleaning a trach - ANSWER- 15 sec *No fluctuations in water-seal chamber indicates: - ANSWER- Lung re-expansion; kink or clot in tubing indicates: *True/False The nurse knows not to recap any needle - ANSWER- True Box 31- 23 *True/False The nurse should maintain a sharps injury log that includes: type and brand of device involved in the incident; location of the incident; description of the incident; and privacy of the employees who have had sharps injuries to prevent needlestick injury
Before injecting, the nurse knows which three things? - ANSWER- The volume of the injection; the characteristics and viscosity of the medication; the location of the anatomical structures underlying the injection site. Administer insulin when blood sugar is: High or Low? - ANSWER- High Why does the nurse start with the vial when preparing a combination of medication from an ampule and a vial? - ANSWER- Because it is not necessary to add air to withdrawal medication from an ampule. Why is insulin administered by injection? - ANSWER- Because insulin administered via oral is broken down by the GI tract What is the indication for using U-500 insulin vs U-100 insulin? - ANSWER- Patient is very resistant to insulin. To provide safe and effective care, the nurse needs to know the _______, ________, and _________ of for each of the patient's ordered insulins. - ANSWER- Onset, peak, and duration True/False A nurse should never mix insulin garden (Lantus) or insulin detemir (Levemir) with other types of insulin. - ANSWER- True Inject rapid-acting insulins mixed with NPH insulin within ___________ before a meal. - ANSWER- 15 min The best subcutaneous injection sites are: - ANSWER- The outer posterior aspect of the upper arms, the abdomen from below the costal margins to the iliac crests, and the anterior aspects of the thighs. The site most frequently recommended for heparin injections is the: - ANSWER- abdomen Alternative subcutaneous sites for medications include - ANSWER- The scapular areas of the upper back and the upper ventral or dorsal gluteal areas. The subcutaneous injection site needs to be free of _________, __________, and __________. - ANSWER- Skin lesions, bony prominences, and large underlying muscles or nerves. U-500 insulin is given in __________ syringes. - ANSWER- 1mL tuberculin Intrasite rotation - ANSWER- rotating injections within the same body part Insulin injections are to be given at least _______ from the previous site - ANSWER- 1 inch
Insulin injection sites should not be reused for at least _________ - ANSWER- 1 month The angle of insertion of an IM injection is - ANSWER- 90 degrees Muscle is (more or less) sensitive to irritating and viscous medications. - ANSWER- Less Normal cardiac output is ___________in the normal healthy adult at rest. - ANSWER- 4 - 6mL/min Intradermal injections are used for ________ - ANSWER- skin testing Intradermal injections are inserted at an angle of __________ degrees. - ANSWER- 5 - 15 degrees The bevel of the needle is _________ when giving an intradermal injection. - ANSWER- bevel is up The nurse knows that if she has administered an intradermal injection, and no bleb has formed, that ________. - ANSWER- The medication is likely in subcutaneous tissue