ATI Med Surg Graded A+ 2024

ATI Med Surg Graded A+ 2024 When administering a transfusion of packed red blood cells, it is important to....️make sure the entire unit is transfused within 4 hours A patient who is anticipating total hip replacement is considering autologous transfusion. When teaching this patient about autologous transfusion, it is important to emphasize that...️It reduces the risk of mismatched blood A type of protein the immune system produces to neutralize a threat of some kind, such as an incompatible substance in the blood, is called an....️Antibody You are caring for a patient with severe trauma whose blood type is A. A blood transfusion is ordered stat. You know that the patient can safely receive blood from blood group O because...️type O blood contains no A antigens. -Type O blood contains no antigens at all, which is why people with type O blood are considered universal donors - because their blood can be transfused to people with any ABO-related type without putting them at risk for an ABO incompatibility. It is the specific antigens in the transfused blood that trigger hemolytic reactions. Since type O has no antigens, it is safe for this patient and for any other patient. A patient is about to receive a unit of packed RBCs. The unit of blood has arrived and you are about to initiate the transfusion. Which of the following procedures will help you protect the patient against the possibility of a blood-group incompatibility?️Comparing the ID numbers on the blood unit with those on the order form and the wristband Prior to administering a blood transfusion, it is essential to explain to the patient that....️he must immediately report any subjective symptoms like chills, nausea, or itching A patient about to receive a unit of packed RBCs states, "this is my third unit of blood today. I don't want to get some disease from all this blood." Which of the following would be your best response?️"Donated blood is carefully screened for infectious diseases." Which is an essential nursing action prior to starting a blood transfusion?️ensure informed consent has been obtained A platelet transfusion is indicated for a patient who️Has thrombocytopenia You started a transfusion of packed RBCs about *1 hour ago*. Your patient has suddenly developed shaking chills, muscle stiffness, and a temp of 101.4F. He appears flushed and reports a headache and nervousness. Your patient has most likely developed which type of transfusion reaction?️Febrile nonhemolytic A patient who sustained trauma from a motor-vehicle crash is transported to an emergency department. The provider determines the need for immediate central venous access for fluid and blood replacement and prophylactic abx therapy. The appropriate central venous access device for this patient is....️A nontunneled percutaneous central catheter -this type of central catheter is ideal for emergency situations where short term central venous access is required for multiple therapies A nurse is caring for a patient who has a central venous catheter. When flushing the catheter, the nurse uses a 10mL syringe to prevent which of the following complications associated with central vascular access devices?️Catheter rupture (larger syringes like 10mL generate less pressure when flushing) A nurse caring for a patient who has gastric cancer is initiating an infusion of parenteral nutrition via the patient's implanted port. Which of the following is an appropriate action for the nurse to take?️Cover the device and the needle with a sterile transparent dressing A nurse is caring for a patient who has a central venous catheter and suddenly develops dyspnea, tachycardia, and dizziness. The nurse suspects air embolism and clamps the catheter immediately. The nurse should reposition the patient in which of the following position?️On his left side in Trendelenburg position This position helps trap the air in the apex of the right atrium rather than allowing it to enter the right ventricle and, from there, move to the pulmonary system. An older adult patient who adheres to a regular cardiovascular rehabilitation schedule that includes water aerobics and swimming requires long term central venous access. Which of the following central venous access devices is the best choice for allowing him to continue his aquatic program?️An implanted port Because the entire device lies beneath the skin, the patient can be immersed in water when the device is not in use without any increased risk of infection. This is the best choice for patients who wish to continue aquatic activities A nurse is preparing to obtain a blood sample from a patient who has a triple lumen central catheter in place for multiple therapies. Which os the following is an appropriate action for the nurse to take?️Turn off the distal infusions for 1 to 5 minutes before obtaining the blood sample A nurse is caring for a patient who has a central venous access device in place. Which of the following routine measures should the nurse use specifically to prevent lumen occlusion?️Clamping the extension tubing while removing a syringe from the injection cap This is an example of a positive-pressure technique designed for use when a central venous access device does not have a specialized positive fluid-displacement needleless connector. This type of technique prevents the reflux of blood back into the catheter, which can clot and obstruct the catheter A nurse is preparing to flush a patient's PICC. Because the PICC has a valved tip, the nurse...️Uses non-heparinized saline solution for the flush (Valved tips do not require heparin flushes) A nurse is caring for a patient who has a chest tube in place attached to a closed chest water seal drainage system following thoracic surgery. Which of the following strategies should the nurse use to help promote comfort for this patient?️Have the patient splint the affected side (with a pillow) during coughing A patient injured in a motor-vehicle crash is transported to an ED. The provider determines the need for immediate thoracotomy and chest tube insertion and anticipates the need for maximal suction pressure. The appropriate type of closed chest drainage system for this patient is a️dry suction control system -Systems that use dry suction control allow for higher suction pressures by adjusting a dial on the front surface of the system to deliver suction pressure up to -40 cm of water. Some patients need high suction pressures due to a massive air leak from the lung surface, emphysema or viscous pleural effusion, or a reduction in pulmonary compliance A nurse is caring for a patient who is 6hr post op and has a chest tube in place attached to a closed chest water seal drainage system. The nurse should observe for which of the following indications of a problem in the drainage system?️Continuous bubbling in the water-seal chamber -indicates an air leak in the drainage system A nurse is preparing to transport to radiology a patient who has a chest tube and a closed chest wet suction drainage system. The provider allows disconnecting the drainage system from the suction source during transportation. Which of the following must the nurse do when detaching the suction source?️make sure the air vent is open A nurse is planning education for patient who has a chest tube in place attached to a closed chest drainage system following surgery for lung cancer. Which of the following should the nurse emphasize to the patient when he is ready to ambulate freely?️Keep the collection device upright at all times. While providing care for a patient who has a chest tube in place attached to a closed chest drainage system, the nurse accidentally disconnects the chest tube from the system. Which of the following should the nurse do to prevent a serious complication while preparing to reconnect the system?️Submerge the end of the chest tube in 1 inch of sterile water -This action creates a water seal and prevents air from entering the pleural space through the open end of the chest tube when the patient inhales A nurse is caring for a patient who has a chest tube in place attached to water seal drainage. Which of the following observations about the drainage should be reported if found 5 hr after insertion?️About 150 mL/hr over the past 2 hr -nurse should report drainage that exceeds 70ml/hr A nurse is assessing a patient who has a chest tube in place attached to a closed chest water seal drainage system. When the nurse palpated the area around the chest tube insertion site, she is checking for....️Subcutaneous emphysema -assessing for crepitus A nurse is teaching a patient newly diagnosed with type 1 diabetes how to check blood sugar levels. Which of the following is the appropriate instruction for transferring the patient's blood to the reagent portion of the test strip/monitor in most situations?️Hold the test strip next to the blood on the patient's fingertip A nurse instructing a patient about using an insulin pump should explain that the risk of diabetic