Adv Procedures
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| What is an artificial airway? | inserted to maintain patent air passage in pt whose air way has become or may become obstructed
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| Reasons for artificial airways (4) | relieve mechanical airway obstruction, provide mechanical ventilation, permit easy access for secretion removal, protect airway from aspiration d/t impaired cough/gag reflex
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| Types of airways (3) | endotrachel, tracheostomy, permanent tracheostomy
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| Types of synthetic trachs (4) | obturator, cuff trach, double cuffed trach (high pressure), single cuff (low pressure)
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| Purposes of cuff (3) | anchor tube in place, creates seal that prevents aspiration of secretions, prevents leakage of air
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| Fenestrated def | whole on both sides so air can come past tube and be able to talk
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| Disadvantages of trachs (3) | lost cough reflux, reduction of ability to speak normally, lose all fx or features that normal upper respiratory passage can do - normal person has warming and humidifying upon inhalation and track doesnt have that
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| complications of trachs (9) | obstruction below trach (end) & tube itself, expulsion of tube (use hemastat), itis & infection, pneumothorax, hemorrhage,ischemia & necrosis which leads to fistula formation, aspiration of secretions, cardiac arrest d/t anoxia from prolonged suctioning
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| Purposes for suctioning (4) | clear airway of secretion & prevent obstruction, relieve respiratory distress, reduce or prevent hypoxia, prevent pneumonia from secretion accumulation - new pt needs suctioning every 10-15 min
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| Cleaning trachs purposes (3) | prevent infection at site, maintain patent airway, prevent skin breakdown around stoma
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| Signs death is near (10) | gradual loss of motion and sensation, begins in extremities, activity of GI tract decreased, reflexes gradually disappear, circulatory collapse, respiration's change, restlessness, pupil changes, sphincter muscles relax, mental alertness change
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| signs of circulatory collapse (4) | skin cool/clammy but increase body temp, skin color changes - pale & gray, pulse becomes irregular, fast, weak, BP decreases
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| For removal of life support the following has to happen (4) | unreceptive & unresponsive to external stimuli as evidence by coma, no muscle movement esp breathing, no brainstem reflexes, no EEG activity for 24 hrs
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| Rigor mortis | muscles become contracted and joints immobilized b/c of lack of ATP (needed for muscle contraction) - once starts it can last up to 36hrs
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| Algor mortis | post mortum cooling, temp will decrease 1 degree C per hr until reaches room temp
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| Liver mortis | RBC breakdown esp in areas where blood is pooling (collecting), discoloration of skin (bruising/mottled appearance), important for position - supine
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| Tissue softening | b/c of bacteria in body - works away at tissue until it becomes liquidified - heat increases the process
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| Post mortum care purposes (2) | maintain best possible appearance of body by preventing skin damage & discoloration, retain dignity of deceased by safely handling belongings & body
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| Pt rights for dying (6) | right to die with dignity & peace, right to not die alone (NODA), right to be free of pain, right to have questions answered honestly, right to express feeling/emotions about dying in own way, right to be cared for
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breinard
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