IVORLD 'S #1 ACADEMIC OUTLINE

Basic Definitions of Tools, Tests, Equipment, Products & More!

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assessment techniques, tools & equipment

scissors with a blunted end. Used be calibrated to a variety of temperature scales. to safely remove first~aid bandages • Fahrenheit: A temperature scale still in use for most non~scientific purposes in the United States. In and dressings. this scale, the freezing point of water is 32' F and the boiling point is 212' F (at standard atmospheric

• Forceps: For removal of small foreign objects pressure), placing the boiling and free<ing points of water exactly 180 degrees apart. A degree on the with needle.point sharpness. Avai lable in a variety Fahrenheit scale is 1/ 1801h part ofthe interva l between the freezing point and the boil ing point. of styles for different uses; mosquito forceps, • Celsius: A temperature scale that is devised by d ivid ing the range of temperature between the freezing dressing forceps, curved or straighttine forceps, and boiling temperatures of pure water at standard atmospheric conditions (sea level pressure) into 100 and Kelly forceps are jus1 some examples. equal parts (used interchangeably with centigrade scale). In this scale, the freezing point of water is O°C

• Need le: Different types of needles exist. and the normal boiling point is 1 DO°C. Each type has a speciali<ed use. . To convert a temperature from Celsius to Fahrenhe it: [' Fl - U' CI x '/, )+ 32 . Hypode rmic needle: Ahollowneedle common- . To conve rt a temperature from Fahrenheit to Celsius: [' CI _ ([' F) - 32) x \I,

Iy used with a syringe to inject substances into the body. • Axillary temperature: Taken with a cl inica l thermometer placed under the armpit (axilla). Temperature

. Surgical needle: A needle with holes or eyes; under the arm is about 36.S· C (97.rF). supplied to the hospital separate from its suture • Oral temperature: Taken with a clinical thermometer p laced under the tongue. May only be taken from thread. a client who is capable of hold ing the thermometer in the mouth correctly and securely, wh ich generally Tuohy need le: A hollow needle suitable for excludes small chi ld ren, as well as people who are weak or vomiting and/or overcome by coughing. inserting epidural catheters. Another contraindication is if the client has drunk a hot or cold liquid beforehand, in which case one has

• Tourniqu .. t : A device. typically a tightly encircling to wait or use another method. Temperature in the mouth (oral) is about 36.8· C (98.2· F). bandage, used to ehetk bleed ing by temporarily • Recta l temperature: The most accurate and represents the body's core temperature. Taken with a cl inical stopping the flow of blood through a large artery thermometer placed in the rectum (via the anus). If not taken the correct way, a rectal temperature-taking

in a limb. Also used to distend a can be uncomfortable and, in some cases, painful for the cJient. It also may be considered embarrassing vein prior to venipuncture. in some countries or cultures. Rectal temperatureptaking is considered the method of choice for infants.

Temperature in the anus (rectum/recta l) is about 36.3 ' C (97.3 · F).

Charting: The act of documenting information about a client, focusing on the asse ssment and treatment of the disease process and the client's call for and response to nursing care. The goal of charting is communication.

• Charting by exception: A focus on deviation from the norm or significant findings.

• Compute r assiste d : Entering dient~specific data into a computer for storage and retrieva l.

• Electron ic me dical record (EMR) or ele ctronic health record (EHR): A medical record in digital format.

• Flow sheets: Recording or graphing of data to demonstrate patterns, trends or alteration in findings .

• Narrative charting: Charting by d iscipline using a narra tive to document activity based on chronology rather than systems.

• Problem-oriented medical records (POMR): The record is organized according to the individual's specific problems.

• SOAP Note: The acronym S-O-A -P stands for - ~ubjective (what the client feels or his/her symptoms); Qbjective (what the nurse observes or signs); Assess (what the nurse assesses the situation to be); El an (what the nurse is doingl.

• SOAPIER Note: Similarto SOAP. with the addition of - Implementation (nursing actions in response to the symptoms and signs or carrying out the plan); Evaluation (how the client responded); Revision (how the plan changes based on the client's response).

Thermometer: A device that measures temperature. • Basal therm ometer: Used to take th e basa I (base) body temperature, C ..

or the tempe rature upon waking. Basal body temperature is the lowest _ temperature attained by the body during rest (usually during sleep). Compared to daytime temperatures, basal body temperatures are much less affected by environmental factors such as exercise and food intake. This allows sma ll changes in body temperature to be detected. such as those caused by ovulation or changes in thyroid func1ion. Basal thermometers require accuracy of at least 0 .1°F (O.OSOC), so speCial glass basa l thermomete rs are sold separately from g lass fever thermometers.

• Clinical (medical) thermometer: Used for measuring human body temperature, with the tip of the thermometer being inserted either into the mouth (oral temperature), under the armpit (axiUary temperature), or into the rectum via the anus (rectal temperature). A medical thermometer may be g lass o r d igital.

• Digital thermometer: A clinical thermometer that uses a sensor based on thermistors, sol id~statee l ectronic devices whose electrical characteristics change with temperature. The reading is recorded within seconds, some having a red light or other device to indicate when maximum temperature is reached. Digital thermometers generally read to at least O.1·F (O.OS· C).

• Mercury thermometer: Consists of mercury in a glass tube. Calibrated marks on the tube allow the temperature to be read by the length of the mercury within the tube, which varies according to the heat g iven to it. Mercury thermometers typica lly have markings every O.2°F (0.1 °C). Mercury is a toxic and hazardous chemical. The Environmental Protection Agency (EPA). the American Academy of Pediatrics (AAf'). and other organizations warn against using mercury thermometers. If the thermometer breaks, the mercury may be breathed in or absorbed into the skin. In health-care settings, mercury thermometers have been replaced by digital thermometers o r g lass thermometers with alcohol or galinstan instead of mercury in them.

• Tympanic membrane thermometer: Measures the temperature of the tympanum. The molded thermometer is inserted into the external acoustic meatus of the ear in order to determine the body temperature by measuring the infra red rad iation emanating from the tympanic membrane.

Vital Signs (VS) - Breathing & Pulse/Heart Sounds Breathing (respiration): Anothe r VS a nurse must assess. Stethoscopes are used to assess respiration. Pulse : Peripheral pulse is a measure of heart rate. Peripheral pulses are usua lly assessed manually, whereas heart sounds (including rate and rhythm) are assesse d with a stethoscope. Stethoscope: An acoustic medical device for auscultation of (listening to) the intemal sounds of the body. It is most often used to lisien to heart sounds and breathing. It is also used to lisien to intestines/bowel and blood flow in arteries and veins . • Acoustic stethoscope: Operates on the transmission of sound from the chest piece, via air-fi lled hollow

tubes, to the listener's ears . The chest p iece usually consists of two sides that can be p laced against the client for sensing sound: a diaphragm (plastic disc) or bell (hollow cup). If the d iaphragm is placed on the client. body sounds vibrate the d iaphragm, creating acoustic p ressure waves that travel up the tubing to the listener's ears. If the bell is placed on the cl ient, the vibrations of the skin directly produce acoustic pressure waves traveling up to the listeners ears. The bell transmits low-frequency sounds, while the diaphragm transmits higher-frequency sounds.

• Electronic stethoscope: Emits aud ib le sounds that are magnified through an amplifier to earphones, of which there may be more than one set, and may be broadcast through loudspeakers; regardless, the results are less precise than with an acoustic stethoscope.

• Fetal stethoscope or fetoscope : An acoustic stethoscope shaped like a listening trumpet It is placed against the abdomen of a pregnant woman to listen to the heart sounds of the fetus. The fetal stethoscope is also known as a Pinard's ste thoscope.

Vital Signs (VS) - Blood Pressure (BP) Blood pressure (BP) : Also VS a nurse must assess. BP is assessed manually with various types of manometers.

GU8SSmenr etc. (conrin()ed,

• ~sdi~~~:~l~odeJ~~~~h~~u~~~~~: !~~I~o~ei~ :nc~lib=~cee:~t~~~~ d::~~; :fthS~un~e~~~~~ ;~a~~u~uo~ BP. To maintain accuracy, ca),bration must be checked periodically, unlike the inherently accurate mercury manometer. In most cases, the cuff is inflated and released by an electrically operated pump and va lve, which may be fitted on the upper arm.

• Sphygmomanometer: An instrument for measuring arterial blood pressure (BP). It consists of an inflatable cuff p laced around the upper arm at roughly the same vertical height as the heart, attached to a mercury or aneroid manometer. · Aneroid manometer: Portable, handheld BP measurement unit consisting of a cuff that is easi ly applied

with one hand, a bui lt·in or attachable stethoscope, a valve that inAates and deflates the cuff automatically, and an easy·to-read data display screen.

· Electronic manometer: An instrument used to djgjtatly measure BP. · Mercury manometer: Considered to be the g old standard for arterial pressure measurement, measures the height of a column of mercury, giving an absolute result without need for calibration, and consequently not subject to the errors and drift of ca/ibratiDn that affect other methods. The use of mercury manometers is often re~uired in cl in ical trials and for the clin ical measurement of hypertension in h igh . risk cl ients .

Eyes, Ears & Reflexes A nurse must also check eyes j eari and re fl exes in order to properly assess a client's overall health. Eyes • Ophthalmoscope or funduscope: An instrument used to examine the eye. Its use is crucial in examining

the interior structures of the eye, especially the health of the retina and the vitreous humor. An ophtha lmoscope consists of a mirTor that reflects light into the eye and a centra! hole through which the eye is examined.

• Snellen chart: An eye chart used to measure visual acuity. The traditional Snellen chart is printed with 11 lines of block letters. The first line consists of one very large letter, which may be one of several letters; fo r example, E, H, N, or A. SubseC1uent rows have increasing numbers of letters that decrease in size. A client taking the test covers one eye, and then reads aloud the letters of each row, beginning at the top. The smallest row that can be read accurately indicates the dienes visual acuity in that eye.

Ears • Otoscope or auriscope: A devjce used to look into the ears. With an otoscope, it iSJ'0ssible to see

the outer ear and middle ear. Otoscopes consist of a handle and a head. The hea conta ins an electric lig ht source and a low. power magnifying lens . The front end of the otoscope has an attachment for disposable plastic ear specula. The examiner can then fook through a lens on the rear of the instrument and see in side the ear canal.

• Tuning fork: An acoustic resonator in the form of a two-pronged fork with the tines formed from a U-shaped bar of elastic metal. It resonates at a specific constant p itch when set vibrating by striking it against a surface or with an object, and em its a pure musical tone after wa iting a moment to allow some high overtones to die out. Tun ing forks (usually, C.S12) are used by medical practitioners to assess a client's hearing . Lower·ritched ones (usually, C. 128) are a lso used to check vibration sense as part 0 the examination of the peripheral nervous system.

Reflexes • Reflex hammer: An instrument used to test deep tendon reflexes (DTR). Testing for reflexes is an

important part of the neurological physical examination in order to detect abn ormalit ies in the central and/or peripheral nervous system.

lab tests

Syri nge: An jnstrument used to inject or w ithdraw fluids. A syringe is a simple piston pump consisting of a plunger that fits tightly in a tube. The plunger can be pulled and pushed a long inside a cylindrical tube {the ba rrell, allowing the syringe to take in and ex.pel a liquid or gas through an orifice at the open end of the tube. The open end of the syringe may be fitted with a hypodermic needle, a nozzle or tubing to help direct the flow into and out of the barrel. Syringes are often used to administer jniections, apply compounds such as lubricant, and measure liquids.

• Bulb syringe: A compressible rubber bulb with a pierced, pointed end that a llows suction and expulsion of flu ids. Useful in irrigating ears or small cavities, such as jn abscesses.

• Hypoderm ic syringe: Because of its calibrated barrel, plunger and tip, it can be used with a hypodermic needle for hypode rmk injections and for aspiration . Syringe sizes may vary from 0.25 mL to 450 mL, and can be made of glass or assorted plastics.

• Insu li n syringe: Marked in insul in "units." Syringes for insulin users are designed for standarel U· l00 insulin . The dilution of insulin is such that 1 mL of insulin fluid has 100 standard "un its" of insul in . Since insulin vials are typically 10 mL, each vial has 1,000 units. Insu lin syringes are made spec ifically for self.injections and have unique features: shorter needles, as insulin injections are subcutaneous (under the skin) rather than intramuscula r; finer gauge needles, for less ~ain; and markings in insulin units ill simplify drawing a measured dose of insulin .

• Irrigation syringe: A blunt-tipped syringe used to d irect an ir'rigation fluid at a wound . • Oral syringe: Hand les oral medication delivery. It is available in 10 mL, 5 mL, 3 mL and 1 m L sizes. The oral dispenser is designed to meet the demanding needs of safety. ease of use and accuracy of dose.

• TB syringe: A 1 mL syrin ge with a fixed needle. NOT to be used as an insulin syringe.

• Arterial blood gas (ABG): Used to determine the concentrations of gases, such as carbon dioxide and oxygen, and bicarbonate, as well as the pH of the blood. It involves puncturin g an artery with a th in needle and syringe. and then drawing a small volume of b lood. The most common puncture site is the radial artery at the wrist, but sometimes the femoral artery in the groin or other sites are used.

concentration over prolonged periods oftime. It is formed in a non-enzymatic pathway by hemog lobin'S norma l exposure to high plasma leve ls of g lucose .

• Basic metabolic panel (BMP): A set of eight blood chemical tests, including: four electrolytes (sodium [Na' I, potassium [K' l. chloride (Cit bicarbonate [HeOl )), blood urea nitrogen (BUN)j creatinine, glucose and calcium.

• Bleeding time: A test done to assess platelet function .

• Blood culture: A test to check for bacteria or other microorganisms in a b lood sample. {Most cultures check for bacteria.) A minimum of 10 mL of blood is taken th rough venipuncture and injected in to two or more "blood bottles" with specific media for aerobic and anaerobic organisms.

• Cerebrospinal fluid (CSF) culture: A laboratory test to look for bacteria, fungi and viruses in the dear fluid that moves in the space sUrTounding the spinal cord.

• Coagulation screen: A combination of screening laboratory tests, designed to provide rapid non-specific information, which a llows an initial broad categorization of hematologic problems.

• Complete blood count (CBC): A test that gives information about the cells in a client's blood. The cells that circulate in the bloodstream are genera lly divided into three types : white blood cells (WBC - leukocytes), red blood cells (RBC - erythrocytes) and platelets (thrombocytes). Abnormally high or low counts may in dicate the Dresence of many forms of disease. Hence, blood counts a re among the most commonly perf.ormed b lood tests, as they can provide an overview of a cl ient's general health status.

• Erythrocyte sedimentation rate (ESR) or sedimentation rate: Rate at which RBCs precipitate in a period of 1 hour. It's a common b lood test that is a non· sl2ecifk measure o f inflammation.

• Fecal occult blood: A term for checking for hidden (occult) blood in the stool (feces).

• Glycosylated hemoglobin (hemoglobin A le! Hb,c' HbA1c' A le): A form of hemoglobin used p rimarily to identify the average p lasma glucose

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• Liver function tests (LFTs or LFs): G roups of laboratory b lood assays, wh ich include li ver enzymes, are designed to give information about the state of a client's liver. Most liver diseases cause only mifd symptoms initially, but it is vital that these diseases be detected early. Hepatic (liver) involvement in some d iseases can be of crucial importance.

• Platelet (thrombocyte) count: Small cytoplasmic bod ies derived from cells that circulate in the blood and are involved in hemostasis, leading to the formation of blood clots. If the number of platelets is too low, excessive bleeding can occur; however, if the number of platelets is too high, blood clots (thrombosis) can form. These can block blood vessels, and may cause a stroke and/ or a heart attack.

• Serology: The scientific study of blood serum. In practice, the term usually refers to the djagnostic identification of antibodies in the serum. Such antibodies are typica lly formed in response to an infection (aga in st a given mjcroorganism), against other foraign proteins (in response, for example, to a mismatched blood transfusion), or to one's own proteins (in instances of autoimmune disease). SerologiCilI tests may be performed for diagnostic purposes when an infection is suspected, in rheumatic illnesses, and jn many other situations, such as checking an individual's blood type. Serology blood tests help to diagnose clients with certain immune deficiencies associated with the lack of antibodies.

• Serum total protein or to'tal protein: A biochemical test for measuring the total amount of protein in blood plasma or serum.

• Thrombin clotting time (Ten or thrombin time (TT): A coagulation assay that rs usually performed in order to detect the therapeutic level of the anticoagulant heparin . It is a lso sensitive in detecting the presence of a fibrinoge n abnormality.

• Venipuncture or phlebotomy: The process of obtaining a sample of venous blood. Usua11y, a 5 m L to 25 mL sample of blood IS adequate, depend in g upon which blood tests have been requested. Blood is most commonly obtained from the median cubital vein, on the anterior forearm (the side wjthin the fold of the elbow). This vein lies dose to the surface of the skin and there is not a la rge nerve supply.

catneters & ports Catheter: A small, flexible, tubufar medical device for insertion into canals, vessels, passageways or body cavities, usually to permit injection or withdrawal of fluids, or to keep a passage open, or to obtain pressure readings. • Arterial catheter, arterial line or art-line: A thin catheter inserted into an

artery. It is most commonly used in intensive care medicine to monitor the blood pressure (BP) real·time (rather than by intermittent measurement), and

to obta in samples for arterial blood gas (ABG) measurements. It is NOT generally used to administer medication. An arterial line is usually inserted in the wrist (radial artery), but can also be inserted into the elbow (brachial artery), groin (femoral artery), foot (pedal artery) or neck (carotid artery).

• Balloon catheter: A "soft" catheter with an inflatable "balloon" at its tip, which is used during a catheterization procedure to enlarge a narrow opening or passage within the body. The deRated balloon catheter is positioned. jnflated to perform the necessary procedurel and then deflated again ;n order to be removed_

• Butterfly catheter: A metal needle with flexible plastic "wings" and a short length of tubing. The "wings" assist in placement in a vein and facil itate fixation with tape.

• Cardiac catheter: A long, fine catheter designed for passage, usually through a peripheral blood vessel, into the chambers of the heart under radiographic contro l_

• Central venous catheter or central line: A small. flexible plastic tube inserted into the large ve in above the heart, usually the subclavian vein, to gain access to the bloodstream. This allows d rugs and blood products to be given and blood samples withdrawn-painlessly. Some of the catheters have more than one lumen (channel), either a double or triple, and can be used to administer more than one drug simultaneously_ Such catneters can be left in place for many weeks to months_

• DeLee catheter: Used to suction meconium and amniotic debris from the nasopharynx and oropharynx of neonates.

• Dialysis catheter: Used for exchanging blood between the hemodialysis machine and th@ d ient. The dialysis catheter contains two lumens: venous and arterial ; however, both lumens are placed in the vein. The arterial lumen (typically mQ) withdraws blood from the cl ient and carries it to the dialysis machine, while the venous lumen (typically blue) returns blood to the client (from the dialysis machine). Flow rates of dialysis catheters range from 200 to SOOmUmin.

• Epidural catheter: A th in plastic catheter placed between two bones in the back by an anesthesiologist Where the catheter is placed in the back depends upon the type of surgery planned and the medicine to be received_

• Groshong cathe·ter: A tunneled intravenous (IV) catheter used for central venous access. Groshongs may be left in place for extended periods and are used when long-term IV therapy is needed, such as for chemotherapy The tip of the catlieter is in the superior vena cava, and the catheter is ru nneled under the skin to an incision on the chest wall. Where the dista l

end of the catheter exits the body, the Groshong line has a three-way valve that allows jnfusion, as well as blood aspiration, while reducing the risk of clotting ai r embolism and blood reflux_

• Over~the·needle catheter: A large-bore sharp needle housed with an indwelling stilette, inside a thin-walled plastic tube_ An incision is made over the filled vein, the needle-cannula inserted, the sti lette withdrawn, then the needle, leaving the plastic cannula in situ.

• Peripheral venous catheter (PVC), peripheral venous line or peripheral venous access catheter: A small, flexible catheter placed into a peripheral vein in order to administer medjcation or fluids. Once placed, the line can also be used to draw blood. The catheter is introduced into the vein by a needle (similar to blood drawing), which is subsequently removed while the small tube of the cannula remains in place. The catheter is then fixed by taping it to the dient's skin_

feeding tools & equipment Feeding tube: A flexible, narrow plastiC or rubber rube inserted into some portion of the digestive tract to provide nutritjon to dients who cannot obtain nutrition by swallowing. The state of being fed by a feeding tube is called enteral feeding or tube feeding. Placement may be temporary for the treatment of acute conditions or lifelong in the case of chronic disabilities. A variety of feeding tubes are used in medica l practice. They ane usually made of polyurethane or silicone. The diameter of a feed ing tube is measured in Fnench units (each French unit eguals 0.33 millimeters). They are classified by site of insertion and intended use. • Gastrostomy tube: A gastric feeding tube, or "G~tube," is a tube inserted

th rough a small incision in the abdomen directly into the stomach and is used for long-term enteral nutrition. The most common type is the percutaneous endoscopic gastrostomy (PEG) tube.

• Jejunostomy tube: A .. J~tube" is surgically jmplanted in the upper section of the small intestine caJled the jejunum which is just below the stomach_ The primary

reason for use of the J-tube is to bypass the stomach and to be fed directly into the intestinal tract. The rube will be located lower and mone toward the center of the abdomen, as compared to the location of a G-rube. • Nasogastric tube: A nasogastric feeding tube. or "NG-tube," is passed

tl-Irough the nares, past the pharynx down tl-Ie esophagus and into tl-Ie stomach. NG9tUbeS are used for those individuals who are unable to ingest nutrients by mouth. The length of tube required can range from 36" to 45". After placement is cheCked, it is then secured to the nose with tape. Placement must be checked before each feeding.

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• Peripherally inserted central catheter (PICC or PIC) line: A form of IV access that can be used for a prolonged period of time (e.g., for chemotherapy regimens, extended antibiotic therapy or total parenteral nutritjon). It is an alternative to su bdavian lines, interna l jugular lines or femoral lines, which have higher rates of infection. A Pice is inserted in a peripheral vein, such as the cephalic vein, basi/ic vein or brachial vein, and then advanced through increasing ly larger veins towa rd the heart until the tip rests in the distal supen·or vena cava or cavoatrial junction.

• Port or portacath: A small medical appliance that is installed beneath the skin_ A catheter connects the port to a vein. Under the skin, the port has a sepru m throug h which drugs can be injected and blood samples can be drawn many times, usually with less discomfort for the client than a more typical "needle stick ."

• Suction catheters: Flexible, long tubes used to remove respiratory secretions from the airway_ O ne end of the suction catheter is connected to a collection container (suction canister) and a device that generates suction. The open end is advanced through the airway (endotracheal or tracheostomy tube) to remove secreti ons. The purpose of suctioning is to keep the airway clear of secretions and to prevent plugging.

• Swan-Ganz catheter: A soft, flow-directed catheter with a balloon at the tip for measuring pulmonary arterial pressures .

• Umbilical catheter·: A catheter placed in the vessels of a neonate's umbilical cord. An umbilical artery catheter (UAC) allows b lood to be taken from an infant at d iffe rent times, without repeated needle sticks. It can also be used to contin uously monitor a baby's blood pressure. A UAC is most often used if a neonate needs mechanical ventilation or very strong medicines to treat blood pressure problems. An umbilical venous catheter (UVC) allows fluids and medications to be given without having to frequently replace an IV line_ Th is type of catheter may be used if a neonate is very premature, has bowel problems that prevent feeding, or needs very strong medicines to treat blood pressure probl ems_

• Urinary catheter: Arly tube system placed in or on the body to drain and collect urine from the bladder. · Foley catheter: Flexible (usua ll y latex) tube that is passed through the

urethra during urinary catheterization and into the bladder to drain urine. It is retained by means of a balloon at the tip, which is inflated with sterile wate r. The balloons typica lly come in two d ifferent sizes: 5 cc and 30 cc. They are commonly made of si licone or natural rubber. The relative size o f a Foley catheter is described using French units (F). The most common sizes range from 10 F to 28 F. Foley catheters come in severa l sub-types:

1. Couda catheter: French for "elbowed," it has a 45(1 bend at the tip to allow easier passage th rough an enlarged prostate.

2. Council tip cath .. ter: Has a small hole at the tip, which allows it to be passed over a wire.

3. Condom catheter: An external urinary col/ection device that frts over the penis like a condom; used in the management of urinary incontinence in males.

4. Straight catheter: A short, nearly straight cathete r that can be passed into the bladder of the female. Once the bladder is emptied, the catheter is removed.

5. Three~way catheter: Used primarily after bladder, prostate cancer or prostate surgery. It has a third anm, or bell, that allows an irrigant to pass to the tip of the catheter through a small separate channel into the bladder. This serves to wash away blood and small clots through the primary arm th at drains into a collection device. This prevents larger clots, which might plug the catheter, from forming. The second, or inflation. arm has a small plastiC valve that allows for the introduction or removal of sterile water through a very small channel to inflate or deflate the retain ing balloon_

~ "1:;1 ~ 'i:L!I'.""'"'' I L-____________ -,

Respiratory Tubes Airway: A tube or tube~l ike device that is inserted through the nose, mouth or directly into the trachea to provide an opening for ventilation. • Endotracheal tube (ETT): Common ly made from polyvinyl chloride, with a

radiopag ue line from top to bottom, and with standard size connectors (for anesthesia machines, venti lators or bag-mask devices, a high pressure/low volume infiatable balloon, and a hole at the beveled, distal end Iknown as Mu rphy's eyell. The tube is inserted into a client's trachea in order to ensure that the airvvay is not dosed off and that air is able to reach the lungs. The En is regarded as the most reliable method for protecting a client's airway. Ens come in a number of sizes, ranging 2 to 10_5 mm in internal diameter. Different sizes are chosen based on the clienfs body size, with the smaller sizes being used for ped iatric and neonatal clients. The choice of En size is alwa ys a compromise between choosing the largest size to maximize flow and minimize airway resistance and the smalles1 size to minimize airway trauma . The re are many types of Ens: oral un ·cuffed, oral cuffed, Rae tube, nasal tube, Nasal-Rae tube, reinforced tube, double-lumen tube, tracheostomy tube, laser tube, septiflex, Rexometallic, portex plain and red rubber cuffed_

• Nasopharyngeal tube or trumpet: Inserted through one nostril to create an air passage between the nose and the nasopharynx. The nasopharyngeal tube is preferable to the oropharyngeal airway in conscious clients because it is better tolerated and less likely to induce a gag reflex.

• Oropharyngeal airway or oral airway: Used to maintain a patent/open airway. It is a curved piece of p lastic inserted over the tongue that creates an air passage between the mouth and the posterior pharyngeal wall. It prevents the tongue from (either partially or completely) covering the epiglottis. which cou ld prevent the cl ient fro m b reathing . When a person becom es unconscious, the muscles in the j aw relax and m ay allow the tongue to obstruct the airway; in fact, the tongue is the most common cause of a blocked airway.

• Tracheal tube : A flexible tube inserted nasally {nasotracheaJj, orally {orotracheaO o r through a tracheotomy into the trachea to provide an a irway.

Oxygen Administration • Ambu bag or bag -valve-mask (BVM): A hand-held device used to

provide ventilation to a client who is not breathing (respiratory arrest) or who is breath ing inadequately. An oxygen reservoir bag is attached to a central cylindrica l bag, attached to a valved mask that adm inisters almost 100% concentration oxygen at 8· 15 bpm . The central bag is squeezed manua lly to deliver a "breath" to the cl ient, or assist him/her in b reathing by doing some o f the work for the lungs.

• Nasal cannula (NC): A device consisting of a plastic tube that fits behind the ears, and a set of two prongs that a re placed in the nostrils. The nasal cannula is connected to an oxygen source . Oxygen Rows from these prongs into the nasal ajrway. It is the most commonly employed device for low·flow oxygen del ivery. A nasal cannula provides supplemental oxygen at flows ra ng ing from 0 to 8 Urn in. enabling a maximum of 40% oxygen (0] ) to be delivered. The oxygen concentratio n (F I O~ can be estimated by adding 4% per liter of 0 2 del ivered.

• Nebulizer: A device used to administer medication in the form of a mist inhaled into the lungs. The most common nebu lizer is the jet nebulizer, which is a lso called an atomizer. Jet nebu lizers are connected by tubing to a compressed air source that causes air or oxygen to blast at high velOcity through a I;quid medicine to turn it into an aerosol, which is then inhaled by the client_

• Non -rebreather mask (NRB): Similar to the partia l rebreather mask, except that it has a series of one-way valves. One valve is placed between the bag and the mask to prevent exhaled air from returning to the bag_ There should be a minimum flow of 10 Umin. The delivered FI0 2 of th is system can be g reater than 70%, depending on the oxygen flow and breathing pattern .

• Oxygen mask: Covers the nose and mouth (oral nasal mask) or the entire face (full-face mask). It may be made of plastic, silicone o r rubber, and is hooked up to an oxygen source. This is a low-flow delivery system. I

• Partial rebreather mask : An oxygen mask w ith a reservoir bag . Oxygen flow should a lways be supplied to maintain the reservoir bag at least one· th ird to one-half full o n inspiration. At a flow of 6· 10 Llm in. the system can provide 40-70% oxygen . It is considered a high -flow system .

• Pocket mask: A small dev ice that can be ca rried on one 's person and com bines a Jaw-resistance one· way valve with a djsposable hydrophobic filter to help prevent the passage of liquids and secretions. It is used fo r the same clients for whom the ambu bag / BVM is indicated; but, instead o f de live ring breaths by squeezing a reservoir, the care provider must exha le into the mask. Exhaled air from the provider can p rovide up to 16% oxygen to the client.

• Venturi mask or air-entrainment mask: Delivers a known oxygen concentration to cl ients on controlled oxygen therapy. Ven turi masks are considered high.flow oxygen therapy devices. Ventu ri masks are able to provide total inspiratory flow at a specified FI0 2 to cl ients. The venturi mask kits usua lly inc lude multiple jets in o rder to set the desired F102 ,

The jets a re usua lly co/or.coded, with the color of the device reflecting the delivered oxygen concentration: blue - 24%; white - 28%; orange - 31 %; yellow - 35%; red • 40%; g reen - 60%. Howeve r, the color· cod ing varies among diHerent brands, and the user must check the instructions to determine the correct color for the desired FI02•

Respiratory Equipment • Flowmeter: An instrument fo r monitoring, measuring or recording the

rate of flow, pressure or discharg e of a fluid, as of a gaseous fuel. • laryngoscope: A laryngoscope is a rig id instrument used to examine

the larynx and to facilitate intubation of the trachea. It is composed of two separate parts: the handle (a lso contains the battery) and the blade (inc ludes an incandescent bulb at the tip), wh ich is used to move the tong ue and soft tissues aside to reveal a view of the larynx. When the blade is locked in a 90-degree position, the light illum inates.

Pressure regu lator: Used to control the high pressure of oxygen delivered from a cylinder to a low pressure controllable by the

flowmeter, Regulators are used to allow high~pressure fluid supply lines or tanks to he reduced to safe and/ or usable pressures for various applications.

4

Skin Care • Cleanser: A skin care product that is used to remove dead skin cells, oil,

dirt and other types of pollutants from the skin surface. Using a cleanser to remove dirt is considered to be a better a lternative to bar soap. because bar soap has a high p H (in the area of 9 to 10), whereas the pH of skin cleansers is closer to the skin's natural pH of 5 .5.

• lotion : A Jow· to medium.viscosity, topical preparation intended for applicat ion to unbroken skin. Most lotions are o;t·jn~water emuls;ons using a substance such as cetearyl alcohol to keep the emu lsion together, but water- in -oi l lotions are also formulated. Lotions are usually applied to external skin with bare hands. a clean cloth. cotton wool or gauze; on the other hand, creams and gels have a higher viscosity, and creams and gels a re usually a p plied with one's fingers or palms.

• Moisture barrier cre am : Provides protection against urine and fecal matter while moisturizing and soothing reddened, irritated skin.

• Ointment: A viscous, semisolid preparation used top;callyon a variety of body surfaces, including the skin and the mucus membrane s of the eye, vagina, anus and nose. An ointment may or may not be medicated.

• Protective skin barriers: A liquid barrier film that dries guickly to form a breathable, transparent protective film on the skin. Forms a film or "second skin" that protects the skin from exposure to wetness, urine acid or fecal enzymes. Some skin barriers contain calamine. a loe vera and vitamins A, 0 and E to p romote healing of fragile or irritated skin , while others contain antimicrobial properties to protect against infection and reduce odor. Designed to protect intact or damaged skin from urine, feces, other body fluids/secretions, tape trauma and friction.

• Skin paste : Thick, rich paste appl ied to protect and condition sensitive, excoriated, inflamed skin resulting from contact with caustic diarrhea or enzymatic drainage. Commonly used for severe incontinence.

• Soap: An anjonic suriactant used in conjunction with water for washing and cleaning . Soap, consisting of sodium (soda ash) or potassium (potash) salts of fatty acids is obtained by reacting fat with lye in a p rocess known as saponification . The fats a re hydrolyzed by the base, yield ing alkali salts of fatty acids (c rude soap) and glycerol. Many cleaning agents today are technica lly not soaps but detergents. which are less expensive and easier to manufacture.

Wound Care Drain : A device for removing fluid from a cavity or wound . A dra in is typically a tube or wick . • Constant suction drain : In th is type of drain, constant suction removes

fluid _ . Bulb drain or Jackson~Pratt drain (JP drain): A dra inage device used

to pull excess fluid from the body by constant suction. The device consists of a flexib le p lastic bulb (shaped something like a hand grenade) that connects to an internal plastic drainage tube. Removing the plug and squeezing the bulb removes air, which creates a lower air pressure within the drainage tubing.

. Spring evacuator drain (Hemovac): A three-spring evacuator dra in con taine r connected to a n interna l plast ic drainage tube. Removes drainage by exerting constant suction. Provides reliable suction for surgical cases with la rger amounts of d rainage.

• Gravity drain : A conduit that allows the gravity flow of flu id . Penrose drain : Consists of a soft rubber tube that is placed in a wound area in order to prevent the buildup of fluid . T-tube: Used fo llowing open gallbladder procedure to drain bile . Tube allows b ile to d rain out of the cl ient's body into a small pouch, known as a bile bag . Before removing the T-tube, an X·ray is taken to make sure that the duct has healed and no stones remain.

Dressing : Any materia l used for covering and protecting a wound . • Absorptive dressing: A bulky dressing designed to absorb drainage

from a wound. • Ace wrap: Rubber.rein forced cotton fo r wrapping sprains and strains.

Available in a variety of sizes, a ll of which can be laundered and reused. • Adhe sive bandage: Bandage consisting of pIa in absorbent gauze held

in p lace by a plastic or fabric tape coated with adhesive . • Antiseptic dressing : Gauze impregnated with antiseptic material. • Compression bandage: A bandage designed to provide pressure to a

particular area (i.e ., a pressure dressing) or a bandage that stops the flow of blood from an artery by applying pressure.

• Drain sponge: A non ·woven, highly absorptive dressing which has been pre -cut to fit around most drains tubes and catheters.

• Elastoplast: An elastic adhesive bandage for covering cuts wounds or incisio ns.

• Foam dress ing : A highly absorbent dressing, which a llows less-frequent changing of dressings and less maceration of surrounding tissues. Used fo r heavily exudating wounds (especially after debridement or desloug hing when drainage peaks) and for deep cavity wounds or weeping ulcers.

• Gauze: A th in, loosely woven surgjcal dressing, usua lly made of bleached cotton cloth.

• Hydrocolloid {DuoDERM®} dressing : An opaque dressing used to protect wounds from contamination and to provide a moist wound ­healing environment. Hydroco ll oids were initially utilized in health care as reliable, skin -friendly adhesjves. usefu l for securing colostomy appliances to the client's abdomen. It is biodegradable, non -breathable and adheres to the skin, so no separate taping is needed.

• Kerlix gauze bandage roll : Prewashed , fluff-dried 100% woven gauze with unique cr i nkle~weave pattern for loft and bulk. Provides fast-wi eking act ion, superior aeration and excellent absorbency. Self-adhe rent and conforming gauze roll bandage perfect for holding dressings in place.

• Laparotomy pad or abdominal (ABO) pad: Steri le all-purpose bandaging and wound cJeanjng item that is fle xible, absorbent and breathable. Made from several layers of gauze folded into a rectangu lar shape and used as a sponge fo r packing off the viscera in abdominal operations. Used for controll ing bleeding and preventing contamination of large wounds.

• Montgomery strap: Facilitates quick. dressing changes and el im inates the need to remove and re-apply tape during a d ressing change. Consists of a 7" x 11" breathable strap with reinforced eyelets that are tied together with Mill ties. They are most commonly used when a wound requires a large, bulky dressing that requires frequent changes.

• Non·stick pad: Sterile gauze pad with porous membrane allows flu ids to be absorbed, yet will not adhere to wound surface . Ideal for abrasions and burns.

• Non·adherent dressing/Te lfa: A non·adherent dressing consists of an absorbent, non·adherent Telfa pad with a non -woven adhesive backing . Ideal for non-draining and lightly draining wounds, abrasjons, lacerations, surgjcal incisions, skin tears, and IV sites. Island pad construction seals out dirt and contaminants . Will not adhere to the wound. Water-resistant. Comes in a variety of sizes.

• Occlusive dressing : One that seals a wound from contact with air or bacteria; OR, a plastjc {;1m p laced over medication that has been applied to the skin, enhancing absorption by trapping mo isture, ra ising skin temperature and concentrating the me dication .

• Petrolatum gauze : Gauze saturated with petrolatum . • Pre ssure dressing : Exerts pressure on covered area to pre vent colle ction

of flu ids in underlying t issues. The constant pressure may also control bleeding .

• Sponge: A gauze pad used to absorb blood and other fluids, as in surgery or the dressing of a wound.

• Tsgaderm TM: A transparent dressing that can be used to cover and protect wounds and catheter sites. A th in, clear sterile dressing that keeps out water dirt and germs yet lets skin b reathe. Allows visualization and monitoring of the wound, without changing the dressing . It conforms to the skin so that it adheres in places such as the fingers and toes.

• Wet dressing : Soaking, with e ither a normal saline or medicated solution, of a bulky dressing to aid in cleaning. drainage and debridement of a wound. May be applied interm ittently or continuously.

Tape : A narrow, long strip of fabric or other flexible material, usua lly rolled up, that adheres to skin and other materials. • Cloth tape : Hypoallergenic surgical tape. Offers excellent adhesion, yet

is gentle to the skin . Reduces the risk of skin irritation . • Micropore/ paper tape: A latex ~free, hypoallergen;c paper tape that is

gentle to the skin, yet adheres well and leaves minimal adhesive residue upon remova l.

• Silk tape: Multipurpose, easy to tear, si lk· like tape with excellent adhesion. Permeable, hypoallergen jc, high strength , high adhesion, and js easy to use. It is an excellent choice for securing regular and bulky dressings tubing and immobilization of tubes. catheters and other equ ipment.

• Surgical tape or med ical tape : A fo rm of pressure-sensitive adhesive tape used in a bandage to hold a dressing onto a wound. It has hypoalJergenic adhesive and is breathable to allow a ir to reach the skin. Surgical tape is white because it contains z inc oxide, which is added to help prevent infections.

circulatory care

Skin closure : Any means used to close open skin of a wound . Includes sutures, staples and adhesives . • Butterfly stitch e s : Thin adhesive strips that can be used to close small

wounds. They are applied across the laceration in a manner which p u lls the skin on either side of the wound together. They are not true sutures but can often be used in add ition to, or in p lace of sutures for sma II wounds. Butterfly stitches can be advantageous in that they do not need a medical professional to be placed or removed, and are thus a common item in first aid kits.

• Skin (dermal) adhesive : A sterile, liquid glue that holds wound edges together, e lim inating the need for sutures. Glued closure produces less scarring and is less prone to infection than sutured or stapled dosure. There is a lso no residual closure to remove, so fo llow.up visits for removal are not required.

• Skin (surgical) staples: Specia lized staples used in surgery in place of sutures to close skin wounds, connect or remove parts of the bowels or lungs . Stapling is much faster than suturing by hand, and also more accurate and consistent. In bowel and lung surgery, staples a re primarily used because staple lines are less likely to leak blood. air or bowel contents.

• Steri strips: Strips of adhesive-backed paper tape that a re placed across an incision or minor cut, keeping the edges of a wound together as it heals. May be used in place of sutures, because they cause less scarring; also, may be appl ied when sutu res a re removed to sup port the incision line .

• Suture : Refers to a stitch used to hold tissues of the human body together:. l iterally means "join ." Sutures are d ivided into two kinds: absorbable (break down harmlessly in the body over time without intervention) and non ·absorbable (must be manually removed or left in indefinitely). . Absorbable sutures: Made of materials that are broken down in tissue

after a given period of time, wh ich, depending on the mate rial, can take anywhere fro m 10 days to 8 weeks . They are used on the internal tissues of the body. They were originally made of the intestines of sheep, the so· ca lled "catgut." Today, gut sutu res are made of specially prepared beef and sheep intestine, and may be untreated (plain gut), tanned with chromium salts to increase their persistence in the body (chrom ic gut), or heat·t reated to g ive more rapid absorption (fast gut). However, the majority of absorbable sutures a re now made of synthetic polymer fibers, which may be braided or monofilament. These offer numerous advantages over gut sutu res; notably, ease of hand ling, low cost, low t issue reaction, cons istent performance and guaranteed non · toxicity. Occasjonally, absorbable sutures can cause inflammation and be rejected by the body rather than absorbed.

. Non·absorbable sutures: Made of materia ls that are not metabolized by the body, and, therefore, are used either on skin wound closure (where the sutures can be removed after a few weeks) andlor in some inner t issues in which absorbable sutures are not adequate. This is the case, for examp le , in the heart and in blood vessels, the rhythm ic movements of which requ ire a suture that stays in longer than th ree weeks, in order to give the wound enough t ime to close. Other organs, like the bladder, contain fluids that make absorbable sutures disappear in only a few days, too early for the wound to heal. Inflammation caused by the foreign protein in some absorbable sutures can amplify scarring. There are severa l mate rials used for non·absorbable sutures . The most common is a natural fiber, silk, which undergoes a special manufacturing process to make it adequate for its use in su rgery. Other non -absorbable sutures are made of artific ial fibe rs, like polypropylene, polyester or nylon; these mayor may not have coatings to enhance their performance characteristics. Fina lly, stajnless steel wires are commonly used in orthopedic surgery and for sternal closure in cardiac surgery.

Techniques & Equipment • Cardioversion: Refers to the conversion of one

cardiac rhythm (electrical pattern) to another, a lmost always from an abnorma l to a normal one . This conversion can be accomplished by pharmacologic means (i.e ., using medications) or by electrical cardioversion using defibrillator.

heart muscle, terminates the arrhythmia. and allows normal sinus rhythm to be re-established by the body's natural pacemaker, in the sino· atrial node of the t,eart. Defibrillators can be external, transvenous or implanted, depending on the type of device used.

his/ her prior knowledge and experience, and will del iver the shock through paddles or pads on the client 's chest. '------....... - 1

. Synchronized electrical cardioversion : The process by which an abnormally fast heart rate or cardiac arrhythmia is term inated by the del ivery of a therapeutic dose of electric current to the heart at a specific moment in the cardiac cycle.

. Pharmacologic cardioversion : Involves the same process, but uses medication, instead of an electrical shock, to convert the cardiac arrhythm ia .

• Defibrillator: A device used to deliver a therapeutic dose of electrical energy to the heart. This depolarizes a critica l mass of the

. Automated externa l defibrillator (AEO): A portable electronic device that automatically d iagnoses the potentially life. th reatening cardiac arrhythmias of ventricular fibrillation and ventricular tachycardia , and is ab le totreat them through defibrillat ion, the application of electrical therapy, which stops the arrhythmia , allowing the heart to re-establish an effective rhythm . Manual external defibrillator: Used in conjunction with (or, more often, have in-built) electrocardiogram (ECG/EKG) reade rs, which the clinician uses to d iagnose a card iac condition that can be treated by d iffe rent shocks. The clinician will then decide what cha rge {in joules> to use, based on

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. Manual internal defibrillator: Virtually identical to the externa l version, except that the charge is delivered through internal paddles in d irect contact with the heart. These are almost exclusively found in surgical areas, where the chest ;s likely to be open, or can be opened quickly by a surgeon.

. Implantable cardioverter-defibrillator (ICO) or automatic internal cardiac defibrillator (AleD): Constantly monitors the cl ient's heart rhythm, and automatically administers shocks for various life-threatening arrhythmias, according to the device's programming. Implanted, similar to pacemakers, and also can perform the pacemaking function.

circulatory care lconfiI1I.Jed}

• Electrocardiogram (ECG or EKG): A recording of the electrical activity of the heart over time, usually in a non~ i nvasive record ing via skin e lectrodes.

• Pacemaker: A device that uses electrical impulses, del ivered by electrodes in contact with the heart mu scles to regulate the heartbeat. The primary purpose of a pacemaker is to maintain an adequate heart rate, eithe r because the heart's natural pacemaker is not fast enough, or there is a block in the heart's electrical conduction system.

. Transvenous pacing: Used as an altemative to transcutaneous pacing. A pacemaker wire is placed into a vein, under steri le conditions, and then passed into either the right atrium or right ventricle. The pacing wire is then connected to an external pacemaker {outside the body). Transvenous pacing is often used as a bridge to permanent pacemaker placement. It can be kept in p lace until a permanent pacemaker is implanted, or until there is no longer a need for a pacemaker, and then it is removed.

devices. A data log can be useful in d iagnosis of the cl ient's condition and an alerting function can notify nurses if the client is suffering from an acute or dangerous condit ion.

Products • Compression stockings: Used to support the

venOLlS an d lymphatic systems of the leg. They offer graduated compression where maximum compression is achieved at the ankle and decreases as you move up the leg. This compression, when combined with the musde pump effect of the ca lf, aids in circulating blood and lymph fluid through the leg5.

· Transcutaneous pacing (TCP) or external pacing: Used for the initial stabilization of hemodynamical ly significant bradycard ia of all types. It is an emergency procedure that acts as a bridge until transvenous pacing or other therapjes can be applied.

. Permanent pacing : Involves transvenOU5

· Temporary padng: Used to stimulate cardiac contraction until the underlying pathology is corrected or a permanent pacing device is inserted.

· Epicardial (temporary) pacing: Used dur ing open heart surgery should the surgical procedure create atrioventricular block. The electrodes are placed in contact with the outer wa ll of the ventricle (epicardium) to maintain sat isfactory card iac output unti l a temporary transvenous e lectrode has been inserted .

placement of one or more pacing electrodes with in a chamber, or chambers, of the heart. The procedure is performed by incision of a su itable vein Into which the electrode lead is inserted and passed along the vejn, through the valve of the heart, unti' positjoned in the chamber. The procedure is facilitated by fluoroscopy, wh ich enables the cardiologist to view the passage of the electrode lead. After satisfactory placement of the electrode is confirmed, the opposite end of the electrode lead is connected to the pacemaker generator.

. TED (thrombo·embolic.deterrent) anti-e mbolism stockings: These stockings are designed to prevent blood dots in the recumbent(bed.ridden) client. TED stockings have graduated compressjon to speed blood flow.

• Sequential compression devices (SCDs) o r Iymphodema pumps: Designed to limit the development of deep vein thrombosis (Dvn and peripheral edema in immobile cl ients. They consist of an ajr pump connected to a d isposable sleeve by a series of air tubes. The sleeve is p laced around the client's leg. Air is then forced Into different parts of the sleeve, in sequence, creating pressure around the calves and improving venous return.

• Telemetry: A technology that allows the remote measurement and reporting of information. Telemetry is used for clients who a re a·t risk of abnormal heart activny. The client is outfitted with measuring, recording and transmitting

hospital terminology

Equipment, Tools & Terms • Balkin overbed frame: An overhead bar used to support a trapeze, o r a series

of pulleys and weights used for traction equipment. • Bed scales: Used to weigh clients who cannot get out of bed easily. The client

is placed on a pad that is elevated by a hydraulic system. When the client is completely suspended above the bed, provided that the scale is properly calibrated. the bed scale provides an accurate weight

• Bedpan: An object used for the toileting of a bedridden cl ient, usually made of a metal. g lass or plastiC receptacle. A bedpan can be used for both urinary and fecal discharge.

• Commode: A movable toilet that does not use running water. It looks like a chair with a toilet seat and has a bucket o r container underneath. This container ca n be removed for clean in g after the commode is used. A commode can be used beside the bed if the client cannot get to the bathroom.

• Crash cart o r code cart: A set of trays on a wheeled cart that contains all the basic equipment necessary to follow advanced card iac life support (ACLS) protocols and potentiallv save someone's life. A crash cart typically contains a defibrillator and intravenous (IV) medications (such as epinephrine and atropine), pl us a variety o f medical supplies such as latex gloves and alcohol swabs.

• Emesis basin: A shallow basin with a kidney-shaped footprint and sloping walts. Contrary to its name, emesis basins are NOT usually used fo,- vomiting as the depth, size and sloping walls all contribute to spilling or splashing the vomit rather than catching it. Emesis basins are suited for more controlled situations.

• Footboard: A solid support placed on the bed where the soles of the feet touch. Footboards are used to prevent permanent plantar flexion (footdrop) and to exercise leg muscles.

• Gait belt: A device used to transfer p'eople from one position to another. The ga it belt is customarily made out of cotton webbing and a durable metal buckle on one end, and is worn around the client's waist. Its purpose is to put less strain on the back of the caregiver and to provide support for the client. The proper way to apply it is to keep two fingers between the belt and the cl ient's body. Tighten it until it has just enough room for your finge rs. If the belt is too loose, you could ejther have it slip upward and injure the client's chest (espeCially the femaJe client) or increase your risk of dropping the client once the weight is put on the belt.

• Hospital bed: A singJe bed with a frame in three sections so that the head or mi ddfe or foot can be raised as required.

u.s. $5.95 AUTHOR: Deborah A. Raines , Ph.D, RN, AN EF

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· Bariatric bed: A heavy·duty bed frame with a capacity ranging from 600-1 ,000 pounds. Sleep surface is extra~wjde, ranging from approximately 42·4S"W

· Birthing bed: Used in labor and birthing settings. The foot portion is retractable for removal dun·ng the birth event.

· ICU bed: Used in critical care settings. Includes CPR emergency release handle. Some beds in corporate a digital weight sca le system and/or IV poles.

• Hoyer lift: An assistive device that allows clients to be transferred between a bed and a cha ir o r other similar resting places, using hydraulic power. Hoyer lifts are used for clients whose mobility is limited and who are too heavy for nursing staff to lift.

• Kardex: A convenient and readily accessible format conta ining current client information.

• NPO (Latin: nil per os): Nothing by mouth. • Pulse oximeter: A device that ind irectly measures the

oxygen saturation of a client's blood, as opposed to measu ring oxygen saturation d irectly through a blood sample. It measures the amount o f light absorbed by oxyhemoglobin in the <D Ii:!. red b lood ce ll , in rela tion to the amount of deoxyhemoglobin, and prod uces a photoplethysmograph (pPG), making these changes easier to visualize. The sensor is attached to the body over the arteriolar area such as the earlobe, fingertip or big toe. Most monitors a lso d isplay the heart rate.

• Restraint: Any involuntary method of restricting an individual's freedom of movement, physical activity or normal access to the body. Restraints are used as a last resort, and ONLY with a physician's o rder. as we ll as with constant surveillance and monito,-ing of client safety. · Chemical restraint: Uses of a sedating psychotropic drug to manage o r

control behavior. · Mechanical restraint : Containment of a person in a cha ir or bed to provide

safety. · Physical restraint: Any manual method or physical/mechanical device that

restricts freedom of movement and/or normal access to one's body. Holding a client in a manner that restricts his/her movement.

• Speculum: An inst:rument th at is used to dilate the ope ning of a body cavity for med ical exam ination . It comes in a variety of shapes specific to the examination o f the mouth, ear, eye or vagina .

Customer Hotline # 1.800.230.9522

ISBN - 13 : 978- 14 2320955 - 3 ISBN · 10: 142320955 - 9

9 11~ IIIJ~ nlillUIJIJIJll lllll1111 II1II1I NOT Ie E TO STUD E N TS This gu lela 1& Intendoo for informatlonsl pLIrposes only. Dua 10 lIS conden!led format this Qlul'de cannot cover every aspect of the aublect. TillS guide IS NOT Inrended for tile dlSg. nosis. lreatmsnt or CLIrB 01 any medJCBI condillDll ar HlnaBIil. ana ghould NOT be used as B gl.Ibs1l!ule

for profass/anaJ medlcs( cars. BarCharts. Inc .. I[B wri ters . eeillorSi and staff a ra not reSiponBlble or liable lor the U8a or mlBuSie of the Intor matlon contained In th lB guide.

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