CNA Medical-Surgical LPN (MSPNC(C)) flashcards

33 cards. Read the term and the definition here. The deck at the top of this page is optional.

Five Rights of Delegation

Right task, right circumstance, right person, right direction and communication, and right supervision and evaluation. The LPN uses these to decide whether a task may be safely assigned to unlicensed assistive personnel.

SBAR Handoff

A structured communication format: Situation, Background, Assessment, and Recommendation. It organizes a concise report during shift change or when notifying a provider of a change in patient condition.

Informed Consent Elements

The patient must be competent, act voluntarily, receive full disclosure of risks, benefits, and alternatives, and understand the information. The provider obtains consent; the nurse witnesses the signature.

Incident Report Rule

Complete an incident report for unusual events, documenting objective facts only. Do not place the report in the medical record; chart the patient's condition and the care provided instead.

Airborne Precautions

Used for tuberculosis, measles, and varicella. Requires an N95 respirator, a negative-pressure room with the door closed, and hand hygiene. Standard precautions continue alongside these measures.

C. difficile Hand Hygiene

Wash hands with soap and water because alcohol-based gel does not kill C. difficile spores. Use gown and gloves for contact precautions and clean surfaces with a bleach-based product.

RACE Fire Response

Rescue anyone in danger, Alarm the fire alarm, Contain the fire by closing doors, and Extinguish or Evacuate. This sequence prioritizes saving lives before protecting property.

Restraint Monitoring

An order is required and time-limited, typically renewed every 4 hours for adults. Assess circulation, skin integrity, and needs at least every 15 minutes and document findings.

Sterile Field Contamination

Items below waist level or out of direct view are contaminated, as is any item touched by an unsterile object. Never turn away from or reach over a sterile field.

Blood Pressure Categories

Normal is below 120/80 mm Hg; elevated is 120-129 over below 80; stage 1 is 130-139 or 80-89; stage 2 is 140/90 mm Hg or higher.

Adult Immunization Schedule

Influenza vaccine annually, Td or Tdap booster every 10 years, shingles vaccine at age 50 and older, and pneumococcal vaccine based on age and risk factors.

Teach-Back Evaluation

The patient restates information or demonstrates a skill in their own words. This confirms understanding and reveals gaps, rather than assuming learning occurred after instruction.

Normal Adult Vital Signs

Temperature 36.5-37.5 degrees Celsius, pulse 60-100 per minute, respirations 12-20 per minute, and oxygen saturation 95 percent or higher on room air.

Maslow Hierarchy Order

Needs are met from the bottom up: physiologic, safety, love and belonging, esteem, then self-actualization. Lower-level needs generally take priority when several are unmet.

Delirium Versus Dementia

Delirium has acute onset, fluctuating course, inattention, and is often reversible from illness or drugs. Dementia is gradual, progressive memory loss with consciousness intact.

Therapeutic Communication Techniques

Use open-ended questions, reflection, restating, clarification, and silence. Avoid false reassurance, giving personal advice, and asking why questions that imply judgment.

Alcohol Withdrawal Timeline

Tremor and anxiety appear 6-12 hours after the last drink, seizures at 12-48 hours, and delirium tremens at 48-96 hours. Vital signs and withdrawal scales guide treatment.

Pressure Injury Staging

Stage 1 is non-blanchable erythema; stage 2 is partial-thickness skin loss; stage 3 is full-thickness with fat visible; stage 4 extends to fascia, muscle, or bone.

Pain Assessment Scales

Numeric 0-10 scale for adults, Wong-Baker FACES for children, and PAINAD or FLACC for nonverbal or cognitively impaired patients who cannot self-report.

Dysphagia Feeding Precautions

Position upright at 90 degrees, offer small bites, use thickened liquids as ordered, encourage chin tuck, and check the mouth for pocketed food after the meal.

Urinary Catheter Care

Keep the drainage bag below bladder level and off the floor, empty it when half full, provide daily perineal hygiene, and remove the catheter as soon as it is no longer indicated.

IV Flow Rate Formula

Milliliters per hour equals total volume divided by time in hours. Drops per minute equals volume times drop factor divided by time in minutes.

Insulin Onset Times

Rapid-acting insulin starts in about 15 minutes, regular in 30 minutes, NPH in 1-2 hours, and glargine has no peak. Only regular insulin may be given intravenously.

Antidote Pairs

Protamine sulfate reverses heparin, vitamin K reverses warfarin, naloxone reverses opioids, and flumazenil reverses benzodiazepines. Knowing these guides emergency response.

Transfusion Reaction Response

Stop the transfusion immediately, keep the IV line open with normal saline, assess vital signs, notify the provider and blood bank, and return the bag and tubing per policy.

Digoxin Administration Check

Check the apical pulse for a full minute before giving digoxin and hold the dose if the adult rate is below 60 per minute. Report the finding to the provider.

Hypoglycemia Treatment

For a conscious patient, give 15 grams of fast-acting carbohydrate, recheck glucose in 15 minutes, and repeat if still low. Follow with a protein and carbohydrate snack.

Increased Intracranial Pressure Signs

Early changes include decreased level of consciousness, headache, vomiting, and pupil changes. Late findings are hypertension with bradycardia and irregular respirations, called Cushing response.

Extravasation Management

Stop the infusion, do not immediately remove the catheter, aspirate per protocol, and apply the antidote or prescribed cold or warm compress. Notify the provider and document.

Postoperative Priority Sequence

Assess airway, breathing, and circulation first, then pain, wound status, and thromboembolism prevention. Early ambulation and compression devices reduce deep vein thrombosis risk.

COPD Oxygen Target

Use low-flow oxygen, typically 1-2 liters per minute, targeting saturation of about 88-92 percent. Monitor for somnolence, which may indicate carbon dioxide retention.

Diabetic Ketoacidosis Findings

Glucose above 250 mg/dL, pH below 7.30, bicarbonate below 18, ketones, and Kussmaul respirations. Treatment includes IV fluids, insulin, and potassium replacement.

Stroke Recognition

Sudden facial droop, arm weakness, or speech difficulty suggests stroke. Note the exact time symptoms began because thrombolytic therapy has a limited treatment window.