NURS3102 Clinical Practice (Questions 21- 37)

This document provides answers to questions 21-37 of NURS3102 Clinical Practice. It covers topics such as observations required for a patient with a sealed underwater drain, advantages of epidural analgesia over intravenous analgesia, steps for administering oral medication, indications for urinary catheter insertion, and common complications associated with epidural analgesia. The document also includes information on blood transfusion procedures and immediate adverse reactions to transfusion.

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Nursing
Name
Professor
Institution
Date

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NURS3102 Clinical Practice (Questions 21- 37)
21. What observations are required needed for a patient with a sealed underwater drain?
It is essential to observe the water seal hourly to ensure there is sufficient water. Also, check
that it is flowing as an indication of its proper working. Fluctuations should also be observed in
the chamber for the water seal on the drain’s left side. The following factors can cause lack of
fluctuations: kinked tubing, clamped tubing, dependent loop filled with fluid and drain
blockages (Matiti & Baillie, 2011).
22. What is meant by the “epidural space?”
Epidural space comprises the area between the vertebral wall and the dura matter. It contains
small vessels of blood and fat.
23. Identify two advantages to epidural analgesia over intravenous analgesia.
The two advantages to epidural analgesia over intravenous analgesia are:
a. Better analgesia
b. Reduced requirement for opioids (TK & Chandran, 2017).
24. Which two groups of medications are given via epidural infusion?
The two groups of medication are:
a. Post-operative analgesia
b. Epidural anesthesia (Wan, Breen & Zhang, 2010).
25. List six observations required when caring for the patient with an epidural infusion
The following are the six observations to make when caring for a patient with an epidural
infusion:
a. Respiratory rate
b. Heart rate

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c. Blood pressure and temperature
d. Pain score
e. Pulse oximetry
f. Vomiting score
26. List four potential complications associated with epidural analgesia
The following are the four potential complications associated with epidural anesthesia:
a. Loss of control of the bladder
b. Inadequate relief from pain
c. Itchy skin
d. Temporary damage to nerves (Price, 2019).
27. Outline the steps for administering a Schedule 8 oral medication as a third-year
nursing student
a. Wash hands
b. Organize the equipment
c. Check the medication’s legality
d. Complete the Drug Register and hygienically remove the appropriate dosage.
e. Perform general preparation at the bedside of the patient.
f. Identify the patient
g. Appropriately administer the prepared dose.
28. Outline the steps you will take to administer a Schedule 8 oral medication as a
registered nurse
a. Wash hands
b. Organize the equipment

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c. Check the medication’s legality and take note of the allergies with crucial consideration
to the patient’s score of pain and sedation, maximum daily dose and last dose time.
d. With two nurses at the DD cupboard, one must select the suitable drug, read its
expiration and calculate the ordered dose.
e. Complete the Drug Register and hygienically remove the appropriate dosage.
f. At the bedside of the patient, perform general preparation, inform the patient or the
caregiver the purpose of the medication, and the possible side effects.
g. Check the patient’s wrist band to identify them and ask them their details as well as their
allergies
h. Appropriately administer the prepared dose (Thompson, 2015).
29. List five indications for the insertion of a urinary catheter
The five indications for the insertion of a urinary catheter are:
a. Bladder decompression
b. Collection of samples of sterile urine
c. Medication installation into the bladder
d. Residual urine measure
e. Urinary obstruction
30. What is the most common and significant complication associated with an
indwelling catheter?
Catheter-related Urinary Tract Infection (UTI) is the most common and significant complication
associated with an indwelling catheter (Shi, 2013).
31. Why male catheterization is considered a higher risk than female catheterization:

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The incidence of bladder spasms in males is higher than in females, and this may lead to thick
sediments, a kink in the drainage tubing or the catheter, as well as blockages blood in the
catheter.
32. List 6 things that the nurse should check before sending for the blood pack for a
routine blood transfusion
a. The expiry date of the blood product.
b. The integrity of the blood product
c. The transfusion dose
d. Modifications
e. The relevant transfusion indication
f. Duration per unit or transfusion
33. Identify five (5) indications for transfusion of blood products
a. International normalized ratio
b. Surgical bleeding
c. Congenital dysfibrinogenemia
d. Hemorrhage following cardiac surgery
e. Hereditary angioedema (Nicol et al., 2012).
34. When would the following products be most commonly be used?
i. Packed cells – When hemoglobin reduces below 7 – 8 g/dl.
ii. Albumin – When blood cannot carry sufficient oxygen to body tissues
iii. Whole blood – When treating massive bleeding
iv. Cryoprecipitate – When replacing acquired or congenital hyperfibrinogenemia
v. Fresh Frozen Plasma (FFP) – When there is insufficient coagulation

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vi. Platelets – When there is inadequate or lack of blood clotting (Lloyd, Hancock &
Campbell, 2011).
35. What are the three patient identifiers?
a. Full name of the patient
b. Birthdate
c. Medical identification number (McSherry, MSherry & Watson, 2012).
36. Checking procedure for identification of the blood immediately before commencing a
blood transfusion
a. Scan the identification band of the patient
b. Scan the unit number
c. Scan the blood product’s registration number on the attached tag.
d. Scan the product code on the blood product.
e. Scan the blood type to ensure its compatibility with the blood type of the patient
(Benjamin & Curtis, 2010).
37. List three of the most common immediate adverse reactions to transfusion
a. Febrile reactions such as fever and chills
b. Hypothermia
c. Acute Hemolytic Reactions
References

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Benjamin, M., & Curtis, J. (2010). Ethics in Nursing: Cases, Principles, and Reasoning. New
York, NY: Oxford University Press, USA.
Lloyd, H., Hancock, H., & Campbell, S. (2011). Vital Notes for Nurses: Principles of Care.
Hoboken, NJ: John Wiley & Sons.
Matiti, M. R., & Baillie, L. (2011). Dignity in Healthcare: A Practical Approach for Nurses and
Midwives. London, United Kingdom: Radcliffe Publishing.
McSherry, W., MSherry, R., & Watson, R. (2012). Care in Nursing: Principles, Values and
Skills. New York, NY: Oxford University Press.
Nicol, M., Bavin, C., Cronin, P., Rawlings-Anderson, K., Cole, E., & Hunter, J.
(2012). Essential Nursing Skills E-Book. St. Louis, MO: Elsevier Health Sciences.
Price, B. (2019). Delivering Person-Centred Care in Nursing. Learning Matters.
Shi, L. (2013). Essentials of the U.S. Health Care System. Burlington, MA: Jones & Bartlett
Publishers.
Thompson, V. D. (2015). Health and Health Care Delivery in Canada. St. Louis, MO: Elsevier
Health Sciences.
TK, A., & Chandran, S. (2017). Introduction to Nursing Theories Introduction to Nursing
Theories. Application of Nursing Theories, 1-10. doi:10.5005/jp/books/13072_1
Wan, T. T., Breen, G., & Zhang, N. J. (2010). Improving the Quality of Care in Nursing
Homes: An Evidence-Based Approach. Baltimore, MD: JHU Press.