Comp I
What do Peg, feed bags and TPN tubing have in common? Correct Answer: Need to be changed every
24 hours
*What are nursing concerns with PEG tube?* Correct Answer: *Elevate HOB*
Aspiration
Do you store open tube feeding? Correct Answer: No
*How do you check PEG tube placement?* Correct Answer: *Checking residual from tube*
Ex: residual 50ml old tube feeing, do you continue? YES, Residual 250? NO
-Cutoff is 200+, stop feeding
How do you check placement for an NG tube? Correct Answer: Check gastric pH (0-4 low)
X-ray
Do not put air to listen for gurgle
*Be aware of expected vs unexpected* Correct Answer: *Ex: crackles in lungs, disease process CHF=
expected, does not require immediate action*
Unexpected results require immediate action
Know normal physiological growth and development of children Correct Answer: *Vital signs as they
grow*
Know basic growth and development
Why does TPN have an increased risk of infection? Correct Answer: Due to glucose content in TPN (very
high)
Need to change dressing regularly using sterile technique
If TPN is not available what can you do? Correct Answer: Give 10% dextrose or 20% dextrose
What happens if you stop your TPN at a high glucose level and you don't replace the glucose? Correct
Answer: Hypoglycemia will occur
Ex: D20 is hanging and pharmacy delivers TPN do you wait until D20 is done to hang TPN? NO, hang TPN
*How many nurses check TPN?* Correct Answer: *2*
How many nurses hang blood? Correct Answer: 2
, How long can you hang blood? Correct Answer: 4 hours
*Know blood type and who can receive* Correct Answer: low back pain is first symptom
*What are the nursing concerns for a patient receiving blood for the first time?* Correct Answer:
Monitor vitals q15 minutes
*RN needs to be in the room for the first 15 minutes, 30 or hour*
What is the smallest size needle for blood transfusion? Correct Answer: 20g, 18g ideal
If you patient is getting IV and IV solution is supposed to infuse in 4 hours and is running late, do you
increase the rate? Correct Answer: NO, it could cause fluid overload
*Besides checking the IV insertion site, what is the primary assessment for a patient receiving IV fluids?*
Correct Answer: *Respiratory checking for fluid overload*
What is the difference between hemoglobin and hematocrit? Correct Answer: Hg: is a protein that sits
on the RBS that holds the O2
Hct: is the percent of RBCs
What does a high HCT indicate? Correct Answer: Dehydration
More Hct=less fluid
What does a low Hct indicate? Correct Answer: Fluid overload
Bleeding
Anemia
*What risks exist for heparin?* Correct Answer: *bleeding*
*What is the reaction called when a person reacts to heparin?* Correct Answer: *Heparin induced
thromboyctopenia= low platelets (no clotting)
What lab value is checked with heparin? Correct Answer: aPTT (normal 30-40)
PT (normal
*If the patient is on coumadin or warfarin what lab value do you check?* Correct Answer: *INR (normal
2-3)
What is a normal albumin level? Albumin is a protein Correct Answer: 3.5-5 (same as K+)
What do Peg, feed bags and TPN tubing have in common? Correct Answer: Need to be changed every
24 hours
*What are nursing concerns with PEG tube?* Correct Answer: *Elevate HOB*
Aspiration
Do you store open tube feeding? Correct Answer: No
*How do you check PEG tube placement?* Correct Answer: *Checking residual from tube*
Ex: residual 50ml old tube feeing, do you continue? YES, Residual 250? NO
-Cutoff is 200+, stop feeding
How do you check placement for an NG tube? Correct Answer: Check gastric pH (0-4 low)
X-ray
Do not put air to listen for gurgle
*Be aware of expected vs unexpected* Correct Answer: *Ex: crackles in lungs, disease process CHF=
expected, does not require immediate action*
Unexpected results require immediate action
Know normal physiological growth and development of children Correct Answer: *Vital signs as they
grow*
Know basic growth and development
Why does TPN have an increased risk of infection? Correct Answer: Due to glucose content in TPN (very
high)
Need to change dressing regularly using sterile technique
If TPN is not available what can you do? Correct Answer: Give 10% dextrose or 20% dextrose
What happens if you stop your TPN at a high glucose level and you don't replace the glucose? Correct
Answer: Hypoglycemia will occur
Ex: D20 is hanging and pharmacy delivers TPN do you wait until D20 is done to hang TPN? NO, hang TPN
*How many nurses check TPN?* Correct Answer: *2*
How many nurses hang blood? Correct Answer: 2
, How long can you hang blood? Correct Answer: 4 hours
*Know blood type and who can receive* Correct Answer: low back pain is first symptom
*What are the nursing concerns for a patient receiving blood for the first time?* Correct Answer:
Monitor vitals q15 minutes
*RN needs to be in the room for the first 15 minutes, 30 or hour*
What is the smallest size needle for blood transfusion? Correct Answer: 20g, 18g ideal
If you patient is getting IV and IV solution is supposed to infuse in 4 hours and is running late, do you
increase the rate? Correct Answer: NO, it could cause fluid overload
*Besides checking the IV insertion site, what is the primary assessment for a patient receiving IV fluids?*
Correct Answer: *Respiratory checking for fluid overload*
What is the difference between hemoglobin and hematocrit? Correct Answer: Hg: is a protein that sits
on the RBS that holds the O2
Hct: is the percent of RBCs
What does a high HCT indicate? Correct Answer: Dehydration
More Hct=less fluid
What does a low Hct indicate? Correct Answer: Fluid overload
Bleeding
Anemia
*What risks exist for heparin?* Correct Answer: *bleeding*
*What is the reaction called when a person reacts to heparin?* Correct Answer: *Heparin induced
thromboyctopenia= low platelets (no clotting)
What lab value is checked with heparin? Correct Answer: aPTT (normal 30-40)
PT (normal
*If the patient is on coumadin or warfarin what lab value do you check?* Correct Answer: *INR (normal
2-3)
What is a normal albumin level? Albumin is a protein Correct Answer: 3.5-5 (same as K+)
