CRN flashcards

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

ASA physical status I

A normal, healthy patient without systemic disease. The ASA class is assigned before sedation or anesthesia to communicate procedural risk.

Mallampati class III

With the mouth open, only the soft and hard palate are visible. Classes III and IV suggest a potentially difficult airway. Pre-sedation airway assessment is required.

Sedation vital sign interval

During moderate sedation, heart rate, blood pressure, respiratory rate, and oxygen saturation are documented at least every 5 to 15 minutes with continuous observation of ventilation.

Pre-sedation clear liquid fast

Clear liquids are permitted up to 2 hours before sedation, while breast milk requires 4 hours and formula, nonhuman milk, or a light meal requires 6 hours.

Glasgow Coma Scale scoring

Eye, verbal, and motor responses are scored separately and summed. Totals range from 3, indicating deep coma, to 15, indicating full consciousness.

Metformin with iodinated contrast

For patients with eGFR 30 to 59, hold metformin at the time of iodinated contrast and for 48 hours afterward, restarting only when renal function is confirmed stable.

CI-AKI diagnostic threshold

Contrast-induced acute kidney injury is a serum creatinine rise of at least 0.3 mg/dL, or 50 percent above baseline, within 48 to 72 hours of contrast administration.

Extravasation first actions

Stop the injection, remove the cannula, elevate the affected limb, apply a cold compress, document the volume and site, and notify the radiologist promptly.

Vasovagal reaction signs

Bradycardia, hypotension, pallor, and diaphoresis. Place the patient supine or in Trendelenburg, give IV fluids, and use atropine if bradycardia persists.

Epinephrine for contrast reaction

The adult dose is 0.3 to 0.5 mg intramuscularly of 1:1000 concentration for hypotension or bronchospasm; the pediatric dose is 0.01 mg per kg.

Gadolinium and NSF

Nephrogenic systemic fibrosis risk is greatest with linear group I agents when eGFR is below 30; macrocyclic agents are preferred when renal function is impaired.

Flumazenil reversal

A benzodiazepine antagonist given 0.2 mg IV and titrated to effect up to 1 mg. It can precipitate seizures in patients who chronically use benzodiazepines.

Barium contraindication

Barium sulfate is avoided when bowel perforation or obstruction is suspected because leakage causes peritonitis. Water-soluble iodinated contrast is used instead.

ALARA

An acronym stating that radiation exposure should be kept as low as reasonably achievable, balancing diagnostic image quality against the dose delivered to patient and staff.

Inverse square law

Radiation intensity is inversely proportional to the square of the distance from the source, so doubling the distance from the source reduces exposure to one quarter.

Occupational dose limits

Radiation workers are limited to 50 mSv per year effective dose, 150 mSv to the lens, and 500 mSv to the extremities or skin.

Declared pregnancy fetal limit

After a worker declares pregnancy in writing, the conceptus dose limit is 0.5 mSv in any month and 5 mSv over the entire gestation.

MRI zone IV

The magnet room itself. Only patients and personnel who have been screened and cleared may enter, because ferromagnetic projectile risk is highest there.

Lead apron attenuation

A 0.5 mm lead-equivalent apron attenuates roughly 90 to 95 percent of scattered radiation at typical fluoroscopic energies and is inspected annually for cracks.

Dosimeter placement

Personnel badges are worn at the collar outside the lead apron and exchanged monthly or quarterly to record both deep and shallow radiation dose.

Teach-back method

The patient restates instructions in their own words. It verifies comprehension and exposes misunderstandings more reliably than asking whether they understand.

Health literacy reading level

Printed patient education should be written at a fifth- to sixth-grade reading level, because average adult health literacy is well below general reading ability.

Informed consent elements

Disclosure of the diagnosis, proposed procedure, risks, benefits, alternatives, and the right to refuse, all documented before the procedure begins.

Qualified medical interpreter

Required for patients with limited English proficiency. Family members, especially children, should not interpret consent discussions or complex discharge instructions.

Claustrophobia in MRI

Prone positioning, mirror glasses, reassurance, a companion in the room, and shorter scan sequences reduce anxiety; anxiolytics may be ordered before the scan.

Toddler preparation approach

Toddlers fear separation and bodily intrusion, so preparation uses brief, simple explanations, parent presence, and comfort objects rather than detailed teaching.

Sentinel event

An unexpected occurrence involving death, permanent harm, or severe temporary harm that requires immediate investigation and a formal root cause analysis.

PDSA cycle

Plan, Do, Study, Act. A rapid-cycle improvement method in which a small change is tested, measured, and refined before being adopted more widely.

Nurse Practice Act

State legislation that defines nursing scope of practice, licensure, and discipline. Institutional policy may be stricter but can never expand the legal scope.

Incident report

A confidential internal record of an unexpected event, written factually and objectively. It is not filed in the medical record and is not mentioned in charting.

Malpractice four elements

Duty owed to the patient, breach of the standard of care, causation linking that breach to the injury, and measurable damages. All four must be proven.

HIPAA breach notification

Covered entities must notify affected individuals within 60 days of discovering a breach of unsecured protected health information, with regulatory reporting as required.