Commonly Asked Emergency Drugs Emergency Drug Adenosine Atropine sulfate Epinep"rine #asi$ #idocaine *agnesium sulfate *orp"ine

,ulfate -arcan -itroglycerine 'asopressin Agents Acetaminop"en Antic"olinesterase Antic"olinergics !en1odia1epines Coumadine Cyanide Digo$in Dopamine 4eparin 5ron #ead *agnesium ,ulfate -arcotics Initial Dose 6 mg 0.5 1 mg.q 3 5 min 1 mg.q 3 5 min 0.5 1 mg%kg 1 1.5 mg%kg 1 +g 1 3 mg 0.0+ +mg 0.. mg ,# .0 units Indications !radycardia Cardiac arrest &ulmonary edema 'entricular fi(rillation) 'entricular tac"ycardia 'entricular tac"ycardia r%t "ypomagnesemia C"est pain) pulmonary edema -arcotic respiratory depression C"est pain) pulmonary edema Cardiac arrest Antidotes Acetylcysteine /*ucomyst0 Atropine ,o. &"ysostigmine 2luma1enil 'itamin 3 ,odium nitrate Digo$in immune fa( /Digi(ind0 &"entolamine &rotamine sulfate Defero$amine Dimercaprol) edetate disodium and succimer Calcium gluconate -alo$one Drug Name Endings: What they can suggest you!!! Endings 6cain 6cillin 6dine 6done 6ide 6lam% 6pam 6micin% 6mycin 6mine% 61ide 6olol 6pril 6sone class #ocal anest"etics Anti(iotics Antiulcer agent 7piod analgesics 7ral "ypoglycemics Antian$iety Anti(iotics Diuretics !eta (lockers ACE in"i(itors ,teroids

Antidotes

Drugs Trade #$generics% Amino,*ylline /t"eop"ylline0 Am,*ogel /aluminum "ydro$ide0 Anta(use /disulfiram0 As,irin /A,A0

FREQUENTLY ASKED !lassi&ication Desired E&&ects !ronc"odilator 8o case (reat"ing

EDI!ATI"NS 'est Time to (e Ta)en A* % empty stomac"

. /

Antacid Antialco"olic agent Anti inflammatory Anti pyretic Analgesic Antic"olinergic and 'agolytic Anti(iotic

p"osp"ate le9el A9oidance of alco"ol temperature pain and inflammation "eart rate and decrease secretion s / 0 infection

!et:een meals and 4, After 1+ "rs. stoppage from alco"ol 2ull stomac"

"t*er -o -o C" ;i9 <e -o

0 1

Atro,ine S"/ 'acterium /cotrimo$a1ole0

30 &C &C

2 3

'enadryl /dip"en"ydramine "cl0

Anti"istamine Anti E&, ,teroids Antineoplastic Antidia(etic agent Antiglaucoma antidiuretics Cardiac glycoside Anti con9ulsant Diuretics

!elestone /(etamet"a1one0 4 !yto5an /cyclop"osp"amide0 +6 Dia(inase /c"lorpropaminde0 ++ Diamo5 /aceta1olamide0 +- Digo5in /lano$in0 +. Dilantin /p"enytoin0 +/ Diuril /c"lorot"ia1ide0

/ 0 allergy / 0 mo9ement syndrome respiratory distress in ne:(orn si1e of tumor

!est taken :it" food !est taken :it" food A*

C" ,yr o9e 7( A9 <e <a As nep A9

*o

-ormal glucose range A* urine output 9ertigo -ormal "eart rate / 0 sei1ure urine output A* :it" meals A* !est taken :it" food !est taken :it" food

5nc *o *o

&"o

+0 E,ine,*rine

!ronc"odilator

"eart rate

A*

+1 Flagyl /metronida1ole0

Anti"elmintic

/ 0 "elmint"

!est taken :it" food

+2 7aldol /"aloperidol0 +3 Kaye5alate

Antipsyc"otic &romote e$cretions

/>0 symptoms of psyc"osis serum 3

AC

As *o 8ap <e e$t 5nc Do dri As A9 -o 8et As &"o *a

+4 Lasi5 /furosemide0 -6 Lit*ane /#iC730 -+ Lo8eno5 /me9acor0

of 3 Diuretic Antimanic Antit"rom(otic

urine output "yperacti9ity / 0 t"rom(osis

A* &C

--.

agnesium S"/

Anticon9ulsant C"olinesterase in"i(itor 7$ytocic for post partum atony Antidepressant

/ 0 con9ulsion muscle strengt" 2irmly contracted uterus 5mpro9ed sleeping pattern / 0 c"est pain / 0 fat in t"e stool &C &C

astinon /pyridostigmine0 -/ at*ergine /met"ylergono9ine maleate0 -0 onoamine o5idase in*i(itor -1 Nitroglycerin -2 9ancrease /pancreatin0

*o 5nc 3 *o De ,of -o 3e As An *o An *o <e

Antiangina &ancreatic en1yme

!est taken (efore any strenuous acti9ity !et:een meal and snacks Empty stomac" !est taken :it" meals A* % &C A* A* !est taken :it" food &C AC

-3 9*energan /promet"a1ine "yroc"loride0 -4 Reser,ine /serpasil0 .6 Ritalin /met"ylp"enidate0 .+ Ro(a5in /met"ocar(amol0 .- Synt*roid /le9ot"yro$ine sodium0 .. Tagamet /cimetidine0 ./ T*ora:ine /c"lorproma1ine "cl0 .0 ;alium /dia1epam0 .1 <ylocaine /lidocaine0

Anti"istamine Anti"ypertensi9e ,timulant ,keletal muscle rela$ant 8"yroid "ormone supplement Antiacidity Antipsyc"otic Antian$iety Antiarryt"mic

/ 0 allergy !& "yperacti9ity / 0 muscle spasm -ormal 8. le9el / 0 "eart(urn / 0 positi9e signs of psyc"osis / 0 an$iety -ormal "eart rate

-o As *o 8ak 3e &re don 7( An

-o *o *o de9 -o An *o

.2 =ylo,rim /allopurinol0

Antigout

uric acid

!est taken :it" food

A9 &"o *o -o *o con ,% 5nc 9it.

!ommon Tu(es

Ta(le or A,,aratus *iller A((ott tu(e

9ur,ose #onger t"an #e9in tu(e? "as mercury of air in (ags so tu(e can (e used to decompress t"e lo:er intestinal tract

E5am,les o& Use 1. ,mall (o:el o(structions +. 5ntussusception 3. 'ol9ulus

Cantor 8u(e

8o drain (ile from t"e common (ile duct until edema "as su(scri(ed

C"olecystectomy :"en a common duct e$ploration /CDE0 or c"oledoc"ostomy :as also done

8 tu(e

A type of closed :ound drainage connected to suction used to drain) a large amount of serosanguineous drainage from under an incision A met"od of closed :ound suction drainage indicate :"en tissue displacement and tissue trauma may

1. *astectomy +. 8otal "ip procedure 3. 8otal knee procedure

4emo9ac

1. +. 3. ..

-eurosurgery -eck surgery *astectomy 8otal knee and "ip replacement 5. A(dominal surgery

Key ,oints 1. Care similar to t"at #e9in -; tu(e irrigated. +. connected to suction) not sterile tec"nique 3. orders :ill (e :ritten on "o: to ad9ance t"e tu(e gently pus"ing tu(e a fe: inc"es eac" "our) patient position may affect ad9ancement of tu(e .. A rays determine t"e desired location of tu(e 1. !ile drainage is influenced (y position of t"e drainage (ag. +. Clamp tu(es as ordered to see if (ile :ill flo: into duodenum) normally. 1. *ay compress unit) and "a9e porta(le 9acuum or connect to :all suction. +. ,mall drainage tu(e may get clogged p"ysician may irrigate t"ese at times Empty reser9oir :"en full) to pre9ent loss of :ound drainage and (ack contamination

Cackson &ratt 8"ree :ay 2oley

occur :it" rigid drain tu(es /e.g 4emo9ac0 ,ee 4emo9ac 8o pro9ide a9enues for constant irrigation and constant drainage of urinary (ladder

6. Brological procedure ,ee 4emo9ac 1. 8ransuret"ral resection /8B<0 +. !ladder infection

,uprapu(ic cat"eter

Breteral cat"eter

8o drain (ladder 9ia an opening t"roug" t"e a(dominal :all a(o9e t"e pu(ic (one 8o drain urine feom t"e pel9is of one kidney) or for splinting ureter

,uprapu(ic prostatectomy 1. Cystoscopy for diagnostic :orkups +. Breteral surgery 3. &yelotomy

,ee 4emo9ac Datc" for (locking (y clots causes (ladder spasms 5rrigant solution often "as anti(iotic added to normal salin or sterile :ater ,terile :ater rat"er t"an normal saline may (e used for lysis of clots *ay "a9e orders to irrigate prn or continuously -e9er clamp t"e tu(e pel9is of kidney only "olds . E m# Bse only 5 m# sterile normal saline if ordered to irrigate

!ommon Diagnostics 9rocedures Nonin8asi8e Diagnostic 9rocedures !*aracteristics: 1. it pro9ides an indirect assessment of organ si1e) s"ape) and % or function +. it is safe 3. it is easily reproduci(le .. it requires less comple$ equipment for recording 5. it does not require t"e :ritten consent of patient or guardian ;eneral -ursing 8asks@ 1. Decrease patients an$ieties and offer support (y a. E$plain purpose and procedure of test (. Ackno:ledge questions regarding safety of t"e procedure c. <emain :it" t"e patient :"ile t"e procedure is going on +. Bse procedure in t"e collection of specimens t"at a9oids contamination A> ?ra,*ic studies o& 7eart and (rain 1. Electrocardiogram /EC;0 grap"ic record of electrical acti9ity generated (y t"e "eart during depolari1ation and repolara1ation. diagnose a(normal cardiac r"yt"ms and coronary "eart disease

+. Ec"ocardiograp"y /ultrasound cadiograp"y0 grap"ic record of motions produced (y cardiac structure as "ig" frequency sound 9i(rations are ec"oed t"oug" c"est :all into t"e "eart. used to demonstrate 9al9ular or ot"er structural deformities) detect pericardial effudion) diagnose tumors and cardiomegaly) e9aluate prost"etic 9al9e function. 3. Electroencep"alogram /EC;0 grap"ic record of t"e electrical potentials generated (y t"e p"ysiological acti9ity of t"e (rain used to detect surface lesions or tumors of t"e (rain and presence of epilepsy. .. Ec"oencep"alogram (eam of ultrasound is passed t"oug" t"e "ead) and returning ec"oes are grap"ically recorded. used to detect su(dural "ematomas) intracere(ral "emorr"age) or tumors. '> Roentgenological studies $<@ray% 1. C"est used to determine si1e) contour of t"e "eart? si1e) location) and nature of pulmonary lesions@ pleural t"ickening and effusions@ pulmonary 9asculature@ disorder of t"oracic ones and soft tissues. used lead s"ield to protect pregnant :oman +. 3idney) Breter) and !ladder /3B!0 used to determine si1e) s"ape) and position of kidney) ureter and (ladder -o special consideration 3. !reast /*ammograp"y0 e$amination of t"e (reast :it" or :it"out t"e inFection of t"e radiopaque su(stance into t"e duct of mammary gland. used to determined t"e presence of tumor or cyst /(est done a :eek after menstruation0 no deodorant) perfume) po:der) or ointment in underarm area on t"e day of A ray /contains Calcium o$alate0 *ay (e uncomforta(le due to t"e pressure on t"e (reast. /uses t:o $ ray plates0 !> Roentgenological studies $FLU"R"S!"9Y% requires t"e ingestion or inFection of a contrast medium to 9isuali1e t"e target organ. Additional Nursing Tas)@ a. Administration of enemies or cat"artics (efore t"e procedure and la$ati9e after. (. 3eeping t"e patient -&7 6 1+ "ours (efore e$amination c. Ascertain patient=s allergy and allergic reactions d. 7(ser9ing for allergic reactions to contrast medium e. &ro9iding fluid and food after procedure to pre9ent de"ydration f. 7(ser9e stool for color and consistency until (arium passes 1. U,,er ?I $'arium sAalloA% ingestion of (arium sulfate or meglumine diatri1oate /;astrografin G:"ite and c"alky su(stanceH) follo:ed (y fluoroscopic and $ ray e$amination0

used to determine patency and cali(er of t"e esop"agus and to detect esop"ageal 9arices) mo(ility of gastric :all) presence of ulcer) filling defects due to tumor) patency of pyloric 9al9e and presence of structural a(normalities +. LoAer ?I $'arium Enema% rectal instillation of (arium sulfate follo:ed (y glouroscopic and $ ray e$amination used to determine contour and mo(ility of colon and presence of any space occupying tumors. &erform (efore upper ;5 9atients ,re,arations: no food after e9ening meal t"e e9ening (efore t"e test stool softener la$ati9es and enema suppositories to cleanse t"e (o:el (efore t"e test -&7 after midnig"t (efore t"e test A&ter care: increased fluid intake) food and rest la$ati9es for at least t:o days or until stools are normal in color and consistency 3. !*olecystogram ingestion of organic iodine contrast medium /8elepaque0 follo:ed in 1+ "our (y $ ray 9isuali1ation gall(ladder disease is indicated :it" poor or no 9isuali1ation of t"e (ladder accurate only if ;5 and li9er function is intact perform (efore (arium s:allo: and (arium enema 9atients ,re,arations: administer large amount of :ater :it" contrast capsule lo: fat meal (efore e9ening (efore $ ray oral la$ati9e of stool softener after meal no food allo:ed after contrast capsule A&ter care: increased fluid intake) food and rest o(ser9e for any unto:ard reactions .. Intra8enous 9yelogra,*y $I;9% inFection of a radiopaque contrast medium in t"e 9ein of t"e client to 9isuali1e ureter) (ladder and kidney 9atients ,re,arations: #a$ati9e in t"e e9ening (efore t"e e$amination -&7 for 1+ "ours Cleaning enema morning of t"e procedure A&ter care: increased fluid intake) food and rest? o(ser9e for any unto:ard reactions

D> !om,uted Tomogra,*y $!T% an $ ray (eam s:eeps around t"e (ody) allo:ing measuring of 9arious tissue densities. &ro9ides clear radiograp"ic deficition of structures t"at are not 9isi(le (y ot"er tec"niques. initial scan may (e follo:ed (y Icontrast en"ancementJ using an inFection of contrast agent iodine 9ia 9ein) follo:ed (y a repeat scan. 9atients ,re,arations: instructions for eating (efore test 9ary clear liquids up to + "ours (efore t"e procedure are permitted E> agnetic resonance imaging $ RI% nonin9asi9e tec"nique t"at produces cross sectional images (y e$posure to magnetic energy sources. 5t uses no contrast medium? takes 30 0 minutes to complete. &atient may still for periods of 5 +0 minutes at a time.

9atients ,re,arations: patient can take food and medications e$cept for lo: a(dominal and pel9ic studies /food and fluid :it""eld0 . 6 "r to decrease peristalsis0 Restrictions a. t"ose :"o "a9e metal implants (. t"ose :it" permanent pacemakers c. t"ose :"o are pregnant F> Ultrasound $sonogram% B uses sound :a9es to diagnose disorders of t"e t"yroid) kidney) li9er) uterus) gall(ladder) fetus and intracranial structures of t"e neonate. 9atients ,re,arations: ad9ise client not to c"e: gum or smoke (efore t"e procedure no $ ray for gall(ladder studies? -&7 for E "ours for lo:er a(domen and uterus ? 3+ ounces of :ater &7 30 minutes (efore t"e procedure ?> 9ulmonary &unction studies 'entilatory studies use of incenti9e spirometer to determine "o: :ell t"e lung is 9entilating. 1. ;ital ca,acity $;!% B largest amount o& air t*at can (e e5,elled a&ter ma5imal ins,iration Normal = 4000 5000 mL. Decrease = indicate lung disease Increase or decrease = indicate chronic obstructive lung disease +. Forced e5,iratory 8olume $FE;% B ,ercentage o& 8ital ca,acity t*at can (e &orci(ly e5,ired in +C -C or . seconds> Normal = 80 83% in sec !0 !4% in " sec

!5 !#% in 3 sec decrease = indicate e$%irator& air'a& obstruction 7> S,utum Studies 1. ;ross sputum e9aluations collection of sputum samples to ascertain quantity) consistency) color and odor +. ,putum smear sputum is smeared t"inly on a slide so t"at it can (e studied microscopically. used to determine cytological c"anges or presence of pat"ogenic microorganism 3. ,putum culture sputum samples are implanted or inoculated into special media. used to diagnosed pulmonary infection I> E5amination o& t*e gastric contents 1. ;astric analysis aspiration of t"e contents of t"e fasting stomac" analysis of free and total acid (astric acidit& increase (astric acidit& decrease ) ) duodenal ulcer %ernicious anemia an cancer o* the stomach

D> Do,,ler ultrasound B measures (lood &loA in t*e maEor 8eins and arteries> T*e transducer o& t*e test instrument is ,laced on t*e s)inC sending ultra@*ig*@&reFuency sound> sound 9aries :it" respiration and 9alsal9a maneu9er no discomfort to t"e patient. K> ?lucose Testing B to detect disorder o& glucose meta(olismC suc* as dia(etes> 1. 2asting (lood sugar /2!,0 (lood sample is dra:n after a 1+ fast /usually midnig"t0. Dater is allo:ed. Normal blood glucose + ,0 "0 mg-dL Diabetic %atient = ", mg-dL +. + "r postprandial /&&!,0 (lood is taken after meal 9atients ,re,arations: offer a "ig" car(o"ydrate diet for + . days (efore testing patient fast o9ernig"t eats a "ig" car(o"ydrate (reakfast (lood sample is dra:n + "r inter9al no cigarette smoking and caffeine for t"ese may increase glucose le9el

!ommon Diagnostics 9rocedures In8asi8e Diagnostics 9rocedures !*aracteristics: 1. it directly records t"e si1e) s"ape and function of an organ? +. it requires t"e :ritten consent of t"e patient or guardian? 3. it may result in mor(idity and occasionally deat". ?eneral Nursing Tas): +> 'e&ore ,rocedure: a. "a9e patient sing permit to procedure (. ascertain and repot any patient "istory of allergy or allergic reaction c. e$plain procedure (riefly and accurately d. e$plain t"at contrast medium mig"t cause flus"ing or :arm feeling e. keep patient -&7 6 1+ "our (efore procedure if anest"esia is to (e used f. allo: patient to 9er(ali1e concerns g. administer preprocedure sedati9es) as ordered ". if procedure done at (ed side@ remain :it" patient and offer reassurance assist :it" optimal positioning of patient o(ser9e for indication of complications s"ock) pain and dyspnea -> A&ter ,rocedure: a. o(ser9e and record 9ital signs (. c"eck inFection or (iopsy sites for (leeding) infection) tenderness) or t"rom(osis report unto:ard reaction to t"e p"ysician apply :arm compress to ease discomfort) as ordered c. if tropical anest"esia is used during procedure) do not gi9e food or fluid until gag refle$ returns d. encourage rela$ation (y allo:ing patient to discuss e$perience and 9er(ali1e feelings. A> 9rocedures to e8aluate t*e cardio8ascular system 1. Angiogra,*y intra9enous inFection of radiopaque solution or contrast for t"e purpose of studying its circulation t"roug" t"e patient=s "eart) lungs and great 9essels. Bsed to c"eck t"e competency of t"e "eart 9al9es) diagnose congenital septal defects) study "eart function and structure (efore cardiac surgery) detect occlusions of coronary arteries. +. !ardiac cat*eteri:ation insertion of a radiopaque cat"eter into a 9ein to study t"e "eart great 9essels. Bsed to confirm diagnosis of "eart disease and determine e$tent of disease) measure pressures in t"e "eart c"am(er and great 9essels) o(tain estimate of cardiac output) and o(tain (lood samples to measure o$ygen content. a. <ig"t "eart cat"eteri1ation cat"eter is inserted t"roug" a cut do:n in t"e antecu(ital 9ein into t"e superior 9ena ca9a) t"roug" t"e rig"t atrium and 9entricle and into t"e pulmonary acti9ity.

(. #eft "eart cat"eteri1ation cat"eter may(e passed retrograde to t"e left 9entricle t"roug" t"e (rac"ial and femoral artery) it can (e passed t"roug" t"e left atrium after rig"t "eart cat"eri1ation (y means of a special needle t"at punctures t"e septa? or it may (e passed directly into t"e left 9entricle (y means of a posterior puncture. S,eci&ic nursing considerations: 1. &reprocedure patient teac"ing@ a. 2atigue is a common complaint due to lying still for 3 "r (. 2eeling of fluttery sensation :"ile t"e cat"eter is passed (ack into t"e left 9entricle c. 2lus"ed) :arm feeling may occur :"en contrast medium is inFected. +. &ostprocedure o(ser9ations@ a. monitor EC; pattern for arr"yt"mias (. c"eck e$tremities for color and temperature) perip"eral pulses for quality. 3. Angiograp"y /Arteriograp"y0 inFection of a contrast medium in to t"e arteries to study t"e 9ascular tree. Bsed to determine o(structions or narro:ing of perip"eral arteries. !. &rocedure to e9aluate t"e respiratory system 1. #ung scan inFection of radioacti9e isotope into t"e (ody) follo:ed (y lung scintiscan) :"ic" produces a grap"ic record of gamma rays emitted (y t"e isotopes in t"e tissues. used to determine lung perfusion :"en pulmonary em(oli and infarctions are suspected. +. &ulmonary angiog"rap"y $ ray 9isuali1ation of t"e pulmonary 9asculature after t"e inFection of a radiopaque contrast medium. used to e9aluate pulmonary disorders suc" as pulmonary em(olism) lung tumor and aneurysms) and c"anges in t"e pulmonary 9asculature due to suc" conditions as emp"ysema. 3. !ronc"oscopy introduction of a fi(eroptic scope into t"e trac"ea and (ronc"i used to inspect trac"eo(ronc"ial tree for pat"ological c"anges) remo9e foreign (odies or mucous plugs causing air:ay o(struction) and apply c"emot"erapeutic agents. a. &re(ronc"oscopy inter9entions@ oral "ygiene postural drainage as indicated (. &ost(ronc"oscopy inter9entions@ 5nstruct patient not to s:allo: oral secretions ,a9e e$pectorated sputum for la(oratory analysis -&7 till gag refle$ returns 7(ser9e for su(cutaneous emp"ysema and dyspnea

Apply ice collar to reduce t"roat discomfort

.. 8"oracentesis needle puncture t"roug" t"e c"est :all and into t"e pleura used to remo9e fluid and occasionally air from t"e pleural space nursing considerations a. position @ "ig" fo:ler=s position or sitting upon edge of t"e (ed) :it" feet supported on t"e c"air. (. 5f t"e patient is una(le to sit up turn unto unaffected side

a. &osition@ "ig" fo:ler=s position or sitting upon edge of t"e (ed) :it" feet supported on t"e c"air. (. 5f t"e patient= is una(le to sit up turn unto unaffected side !> 9rocedures to e8aluate t*e renal system 1. Renal angiogram small cat"eter is inserted into t"e femoral artery and passed into t"e aorta or renal artery) radiopaque fluid is in stilled) and serial films are taken. Bsed to diagnose renal "ypertension and p"eoc"romocytoma and differentiate renal cyst from tumors. 9ostangiogram nursing actions: 1. C"eck pedal pulse for signs of decreased circulation. +. !ystosco,y 'isuali1ation of (ladder) uret"ra) and prostatic uret"ra (y insertion of a tu(ular) lig"ted) telescopic lens /cystoscope0 t"roug" t"e urinary meatus. Bsed to directly inspect t"e (ladder? collect urine from t"e renal pel9is? o(tain (iopsy specimens from (ladder and uret"ra? remo9e calculi? and treat lesions in t"e (ladder) uret"ra) and prostate. Nursing actions &olloAing ,rocedure: 7(ser9e for urinary retention Darm sit1 (at"s to relie9e discomfort 3. Renal (io,sy needle aspiration of tissue from t"e kidney for t"e purpose of microscopic e$amination. 9rocedures to e8aluate t*e digesti8e system: +> Eso,*agosco,y and gastrosco,y 9isuali1ation of t"e esop"agus) t"e stomac") and sometimes t"e duodenum (y means of a lig"ted tu(e inserted t"roug" t"e mout". -> 9roctosco,y 9isuali1ation of rectum and colon (y means of a lig"ted tu(e inserted t"roug" t"e anus.

.> 9eritoneosco,y direct 9isuali1ation of t"e li9er and peritoneum (y means of a peritoneoscope inserted t"roug" an a(dominal sta( :ound. /> Li8er (ios,sy needle aspiration of tissue for t"e purpose of microscopic e$amination? used to determine tissue c"anges) facilitate diagnosis) and pro9ide information regarding a disease course. Nursing action: 1. &lace patient on rig"t side and position pillo: for pressure) to pre9ent (leeding. 0> 9aracentesis needle aspiration of fluid from t"e peritoneal ca9ity used to relie9e e$cess fluid accumulation or for diagnostic studies. a. ,pecific nursing actions (efore paracentesis@ a. 4a9e patient 9oid to pre9ent possi(le inFury to (ladder during procedure (. &osition sitting up on side of (ed) :it" feet supported (y c"air. c. C"eck 9ital signs and perip"eral circulation frequently t"roug"out procedure d. 7(ser9e for signs of "ypo9olemic s"ock may occur due to fluid s"ift from 9ascular compartment follo:ing remo9al of protein ric" ascitic fluid. (. ,pecific nursing actions follo:ing paracentesis@ a. Apply pressure to inFection site and co9er :it" sterile dressing. (. *easure and record amount and color of ascitic fluid? send specimens to la( for diagnostic studies. D> 9rocedures to e8aluate t*e re,roducti8e system in Aomen 1. !uldosco,y surgical procedure in :"ic" a culdoscope is inserted into t"e posterior 9aginal cul de sac Bsed to 9isuali1e uterus) fallopian tu(e) and peritoneal contents. +. 'reast (io,sy needle aspiration or incisional remo9al of (reast tissue for microscopic e$amination. used to differentiate among (enign tumors) cysts) and malignant tumor in t"e (reast. 3. Uterotu(al insu&&lation $Ru(inGs Test% inFection of car(on dio$ide into t"e cer9ical canal. Bsed to determin fallopian tu(e patency E> 9rocedure to e8aluate t*e neuroendocrine system 1. !ere(ral angiogra,*y &luorosco,ic 8isuali:ation o& t*e (rain 8asculature a&ter inEection o& a contrast medium into t*e carotid or 8erte(ral arteries used to locali1e lesions /tumors) a(scesses) and occlusions0 t"at are large enoug" to distort cere(ro9ascular (lood flo:.

+. *yelogram t"roug" a lum(ar puncture needle) a contrast medium is inFected into t"e su(arac"noid space of t"e spinal column to 9isuali1e t"e spinal cord. Bsed to detect "erniated or ruptured inter9erte(ral disks) tumors and cysts t"at compress or distort spinal cord. Nursing consideration@ Ele9ate "ead of (ed K :it" :ater solu(le contrast 2lat position :it" oil contrast '%s e9ery . "r for +. "r. 3. Lum(ar ,uncture puncture of t"e lum(ar su(arac"noid space of t"e spinal cord:it" a needle to :it"dra: samples of cere(rospinal fluid. Bsed to e9aluate C,2 for infections and determine presence of "emorr"age. -ote@ not done if increased 5C& is suspected &osition@ !efore @ fetal position % knee c"est position After @ flat or supine

Test Antigen skin !enedict=s test !entonite 2lacculation 8est !eutler=s test !lanc"ing test !ronsulpt"alein test Caloric test CD. determination Cere(ral perfusion test Coom(=s test C&3 !! C&3 *! C&3 ** Dark field illumination test and kalm test Dick test Dull=s eye test E#5,A test ;ram staining and Culture of

Indication 8est to rule out cancer of t"e lungs 2or glucose monitoring 8est for filariasis 8est for galactosemia Determines t"e impairment in circulation #i9er angiograp"y 8est done (y placing :ater in t"e ear canal causes nystagmus. A test for inner ear C"ecking t"e immune status to A5D, patient 8est used to c"eck t"e cere(ral function Determines t"e production of t"e anti(odies. <"o;A* is gi9en /1st L+ "ours0 8est for (rain muscles 8est for cardiac muscles@ for *5 8est for muscle inFury Determination for t"e presence of syp"ilis Detect scarlet fe9er Determines t"e presence of (lindness. Done in 1st ten days />0 normal / 0 a(normal Determines presence of 45' Determination for t"e presence of gonorr"ea

cer9ical and uret"ral smear ;ross "earing test ;ut"rie test 4eat and Acetic acid test 5mmunoc"romatograp"ic test Cones Criteria #epronin test #i9er en1yme test #i9er profile test #um(ar puncture *alaria smear *antou$ test *eniere=s test *et"ylene (lue test *oloney test 7$ytocin c"allege test &andy=s test &"enosulpt"alein test Mueckkenstedt=s test <ectal s:a( <inne 8est <om(erg=s test ,c"ick test ,c"iller=s test ,c"illing test ,c":a(ac" test ,"ake test ,kin test ,lit skin smear ,pecific gra9ity test ,perm count test ,putum e$am ,ulko:itc" test ,:eat c"loride test 8ensilon /Endop"onium0 test 8onometer

8est used (y :"ispering :ords or spoken 9oice test 8est for &3B 2or protein or al(umin detection A rapid assessment met"od done for filariasis. 8"e antigen test t"at can (e done at daytime 7ne :ay of diagnosing <"eumatic "eart fe9er A screening test for leprosy 2or ,;78 and ,;&8 Determines 4epa ( surface antigen Determines for t"e presence of meningitis and encep"alitis. &osition t"e patient in side lying position 8est to confirm malaria? specimen is taken at t"e "eig"t or peak of fe9er Determination for 8! e$posure 8est for 9esti(ular function 2or ketone detection 4ypersensiti9ity test for Dip"t"eria Determines if t"e fetus can tolerate uterine contraction? />0 C, is necessary Determines t"e presence of protein in t"e C,2 3idney angiogram 8est t"at in9ol9e t"e compression of Fugular 9eins Done in patient :it" c"olera) pin:orm detection ,"ifted (et:een mastoid (one and t:o inc"es from t"e ear canal opening Assess gait and station suc" as ata$ia ,uscepti(ility test for dip"t"eria />0 no immunity / 0 :it" immunity ,taining t"e cer9i$ :it" an iodine solution. 4ealt"y tissues :ill turn (ro:n) :"ile cancerous tissue resist t"e stain Bsed to patient :it" se9ere c"illing sensation? for confirmation of pernicious anemia Differentiate (et:een conducti9e and sensorineural deafness) mastoid of patient and e$aminer Determines t"e amount of surfactant in t"e lungs. &urpose it to produce antigen reaction A confirmatory test for leprosy 2or dia(etes mellitus and insipidus as :ell as for de"ydration 2or male infertility /lo: sperm count o9erse$0 2or defection and sensiti9ity of causati9e microorganism) for pneumonia and 8! Brine test detection for calcium deficiency and calcium in t"e urine Bsed to diagnosed cystic fi(rosis 2or rapid detection of myast"enia gra9is 8est used to measure ocular tension and "elping in detecting

8orniquet test 8NA-3 test De(er test Dedal=s 8est Destern (lot test

early glaucoma -K1+ +0 mm4g Done to determine presence of petec"iae in Dengue 4emorr"agic fe9er Determination for t"e presence of "erpes simple$ E9aluation of (one conduction. 8uning fork is placed on patient=s fore"ead or teet" 2or typ"oid fe9er determination A confirmatory for A5D,

Arterial 'lood ?ases

Ty,e Res,iratory Acidosis p4OL.35? &aC7+P.5 Res,iratory Al)alosis p4PL..5? &aC7+O35 eta(olic Acidosis p4OL.35? 4C73)++ eta(olic Al)alosis &4PL..5? 4C73P+6 Remem(er Facts !auses . C7&D . <espiratory . 79erdose . Atelectasis . &ulmonary edema . Aspiration . 4yper9entilation . An$iety . &ain . 'entilators . D3A . Diarr"ea . A,A poisoning . <enal failure . 'omiting . -;8 . Diuretics and Antacids ani&estations . Deakness . 8ac"ycardia . Decreased #7C . 4eadac"e . #ig"t"eadedness . <inging of t"e ears . 8ingling . 4eadac"e . -%' . 3ussmaul respiration . Dysr"yt"mias . 8ingling . Di11iness . !radypnea anagement . Assess ', . *onitor . A!; . C&8 . 8CD! . ,lo: (reat"ing . &aper (ag . Administer sodium (icar(onate . *onitor 5%7 . Bse sei1ure precautions . *onitor ', . 5%7 . A!;

@ <espiratory 7pposite? *eta(olic Equal @ p4 K L.35 L..5 &C7+ K 3. .5 4C73K++ +6