[N-clex] 엔클렉스 정리-기본

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기본

 

● insulin RI, NPH 조제 방법

RI : short

NPH : Intermediate , not shake, roll, rotate

 

순서

1, wash hand

2, roll NPH

3, wipe off top

4, withdraw 48unit air

5, air in NPH 36unit

6, air in RI 12unit

7, invert & withdraw 12unit RI

8, withdraw 36unit NPH

 

● Wound Cx

- old dressing off

- wound clean(죽은세포, 삼출물

- sterile glove

- rotate gently

- push tip(crush & push ampule) + label

- irrigation wound

- new dressing

● Inspirometer

- sitting

- exhale completely

- monthpiece tightly

- inhale slowly → hold 2~3 sec

- exhale slowly

- breath normally short period

- 10회/min

 

● Allen test

- explain

- pressure on ulnar, radial

- open & close

- release pressure from UA

- Assess color return in 6sec(7,8sec도 ㄱㅊ)

 

● sputum culture 순서

1) early morning before drink or eat

2) rinse mouth with 물 (입안 헹구기, 검체 오염방지)

3) DB & cough(깊은)

4) collect specimen : 5~10cc

5) lab immediately

 

● pulse oximeter 순서

1) 기기를 obtain한다

2) 부착부위를 선정한다

3) 부착부위의 capillary refill 테스트

4) 기기를 부착한다

5) 알람을 확인한다

6) correlate 환자 pulse 확인

- 방해요소 : smoking 방금, 황달, motion(움직임), nail polish

● IV 제거

- clamp

- dressing film 제거- dry 거즈

- catheter제거

- 압박(2~3min)

- catheter 확인

- dressing

 

● IV 시작

- site선택

- 터니켓 적용(4~6inch이상), vein확장(마사지, 주먹잼잼, 톡톡, 따뜻한 moist 타월)

- 소독

- 15~30도 찌르기(dominent hand), 노인 15도 미만 SQ↓, 자주확인필요

/ non-dominent hand : vein stabilize

- blood regurgitation 확인 후 더 밀어넣음

- 살짝 누른 상태 터니켓 제거

- IV tube attach

 

● Metabolic syndrome

1, FBS(공복시혈당) 100↑

2, abd obesity or abd girth(허리둘레) F 35↑ M40↑ or BMI 30↑

3, Triglyceride 150↑, HDL F50↓, M40↓

4, HTN 130/85↑

 

● Cane, crutch 보행

Up with Good 1st

Down with Bad 1st(cane, crutch)

- cane, crutch with affected leg

ex) Lt.Fx or 마비, cane(정상, Rt적용)

Up : Rt -> Lt with cane(Rt)

Down : Lt with cane(Rt) -> Lt

● MAP(mean arterial pressure)

정의 : average pressure in systemic circulation throughout cardiac cycle

(몸 전체에 받는 평균 혈관압력)

MAP = (SBP + DBP x 2) / 3

 

● UGI radiography

- x-ray 검사(barium 조영제 이용)

pre)

- MN NPO

during)

- position change

post)

- laxative, fluid↑ : barium 배출↑

 

● latex allergy

- High : Avocado, banana, chestnut, kiwi(tropical fruits)

 

● 우선순위

A irway

B reath

C irculation

S afety

P ain

E ducation

E motion

 

● cranial nerve

 

● GCS scale

8점↓ coma

● Bioterrorism

- intentional attack

- virus, bacterin, other germs

- Anthrax(탄저), botulism, plague(페스트), viral hemorrhogic infection(ebola), small pox, tularemia(야토병)

- easy transmission, high mortality, public panic

 

● organ donation

- final decision 가족(평소에 가족들한테 기증의사 알려야함)

- 감염, cancer X

- 뇌사 범주의 경우 가능

 

● 대체의학 CAM(complimentary & Alternative medicine)

1, Yoga

- breathing↑, posture, streching (BP↓, HR↑, respiratory function, anxiety↓)

- manage : MS(Multiple sclerosis), RA (chronic)

2, biofeedback

- learn to control bodyfunction(brain wave, breathing, V/S, muscle relaxtion)

- Tx migrain HA, chronic pain(BP↓)

3, meditation

- self directed pratice to relax body & mind (anxiety↓, pain↓, BP↓)

4, Imaginary

- pain↓, N/V↓, anxiety↓, comfort↑

5, Accupuncture/Accupressure

- meridain(혈) : endorpine↑ → pain↓

6, chiropractic

- mechanical manipalation of spinal column

7, TENS(저주파자극)

- Tx acute, chronic pain

- tingling, vibrating sensation

- X pacemaker, 상처부위, 얼굴 및 호흡기

 

● Drainage

- 1~3일 뒤 제거, 24hr 30cc ↓ 경우

● postural BP

- 한 포지션 3분

- SBP 20↑ DBP 10↑ : 기립성저혈압(orthostatic hypotension)

 

● Protection PPD

Donning	Removing (outer>inner / front>back)
before enter gown maks, N95 goggle gloves	gown waist tie front - untie gloves goggles gown in room ------------------------------- mask, N95 - lower stirp first

PPE 벗기

glove - gown - (hand hygiene) and leave the room - close the door - mask - hand hygiene

 

● Sprain 등

R rest

I ce ~24hr, 24hr~ warm

C ompression

E levation