Med Surg II
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| Pulmonary Function Tests | show 🗑
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| pH | show 🗑
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| CO2 | show 🗑
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| CO3 | show 🗑
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| O2 | show 🗑
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| show | Comprised oxygen to tissues
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| show | Life threatening
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| Incentive Spirometer | show 🗑
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| show | Greater responsiveness to environmental irritants; risk for a more rapid decline in lung function
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| show | 3-5% lower saturation
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| show | Feels like something is rubbing inside on deep inhalation or at end of inhalation/exhalation; not made worse by touching
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| show | Conscious sedation; CBC/platelet before, NPO 4-8h prior; benzocaine numb pharynx; lidocaine preferred
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| show | Can induce methemoglobinemia (altered iron state so less O carrying capacity)
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| show | 60-100%; most oxygen. Valves open expiration and close on inspiration
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| Oxygen Delivery | show 🗑
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| Droplet Precautions | show 🗑
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| show | lack of oxygen to tissues
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| Hypoxemia | show 🗑
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| Hypoxia Causes | show 🗑
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| show | Organs sensitive to hypoxia
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| Hypoxia symptoms | show 🗑
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| Pediatric Hypoxia Symptoms | show 🗑
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| show | Clubbing, polycythemia (increased Hgb), hypercarbia/capnia (increased CO2)
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| show | Characterized by recurrent episodes of upper airway obstruction and a reduction in ventilation
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| OSA Risk Factors | show 🗑
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| show | Hypercapnia, hypoxia, >5/hour, abrupt awakening, 3 S's (snoring, sleepiness, significant other)
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| show | personality changes, HTN, dysrhythmias, polycythemia, enuresis
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| show | Nasal decongestants (vasoconstriction), caudery, cotton tampon, petroleum jelly/gauze If bleeding unidentified
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| Epistaxis Education | show 🗑
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| Pneumonia | show 🗑
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| Sepsis | show 🗑
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| show | If pneumonia infection extends into pleural cavity; stiffens lung and decreased vital capacity
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| show | Early (dyspnea, cough, sputum) Late (TachyHR/R, decreased O sat, pleural pain, central cyanosis)
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| show | Reposition, encourage deep breathing, coughing, incentive spirometer, monitor for resp. acidosis, and chest physiotherapy
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| Chest Physiotherapy (CPT) | show 🗑
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| show | Increased Na/BUN/Creatinine (r/t dehydration), Crackles, wheezing (narrowed airways), rhonchi (secretions in large airways), fremitis increased, percussion dull, chest expansion diminished, o.hypo, dysrhythmias (r/t hypoxia)
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| show | Timely antibiotics w/n 4h ABGs w/n 24h-blood cultures prior to antibiotic; smoking risk factor, flu vaccine (oct-jan)
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| show | R/t hydrostatic pressure; pleural fluid has large protein amounts and results in fluid shift out of capillaries
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| show | Recurrent attacks of dyspnea, with wheezing due to spasmodic constriction of bronchi; inflammation and hyperresponsiveness leads to bronchoconstriction
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| Asthma Irritants | show 🗑
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| show | Males, family hx, onset before 12
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| show | Hypoxemia (tachyHR/R), cough, SOB, mucus, wheeze, CO2 retention decrease early increase late, prolong expiration, retractions, barrel chest (air trapping) O2 decrease
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| show | FVC, FEV1 (1st second), PEFR (peak expiratory flow rate)
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| Asthma Bronchodilators | show 🗑
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| Status Asthmaticus | show 🗑
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| show | years x #/day
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| show | Emphysema & Chronic bronchitis; c/b bronchospasm and dyspnea; not reversible
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| show | Loss of lung elasticity and hyperinflation of lung; increased R, air trapping and collapse of small airways; alveolar problem; air hunger CO2 retained and O2 drops
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| Chronic Bronchitis | show 🗑
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| show | cigarette smoking, alpha1-antitrypsin (AAT) deficiency, air pollution
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| AAT | show 🗑
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| COPD Drug Therapy | show 🗑
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| Pleural Effusion | show 🗑
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| Pneumonia | show 🗑
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| Bronchiesctasis | show 🗑
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| show | Cough with foul sputum, coughs with change in position, affects ability to hold job, fetid breath, clubbing, weight loss
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| Bronchiectais Tx | show 🗑
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| Lung Biopsy | show 🗑
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| show | operative side
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| show | either side
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| Segmental Resection | show 🗑
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| Pneumonectomy | show 🗑
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| Air | show 🗑
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| Liquid | show 🗑
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| show | 70-100 mL/h < or bright red drainage, tracheal deviation, dyspnea suddenly, o sat <90%, drainage stops
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| Suction Chamber | show 🗑
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| Post-OP CT | show 🗑
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| show | 2cm, one-way valve, moves with breathing (up-inhalation), bubbles indicate leak
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| Tension Pneumothorax | show 🗑
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| show | reconnect quickly and reinforce with tape (tip in sterile water)
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| CT pulls out of chest | show 🗑
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| show | Disconnect suction and send drainage system with pt below chest level - don't clamp
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| show | Lung has expanded or kinks/clots
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| show | lung has expanded or clots
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| show | clamp near insertion site and move down tube until leak found
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| show | Changing to new system, looking for leaks, orders
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| show | Open (atm air enters into pleural cavity) closed (air enters pleural space from w/n lung), tension (pulseless electrical activity)
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| Pneumothorax S | show 🗑
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| Isotonic Dehydration | show 🗑
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| show | hypoNa dehydration; shift from EC to IC; burns, prolonged dehydration, renal dx; D5W, 1/2NS, 0.33 NS
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| Hypertonic dehydration | show 🗑
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| show | liquid that can hold another substance
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| show | Substance dissolved in a solution
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| show |
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| Na | show 🗑
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| show | 3.5-5
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| show | 8.6-10
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| show | Pedialyte, rehydralyte, ceral-based, infalyte, home made
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| show | water, soft drinks, fruit juice, broth, sports drinks
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| show | <5 years 2 episodes/year; caused by rotavirus, salmonella, diarrhea, gluten sensitivity, lactose, antibiotics, iron; rotavirus most common
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| Rotavirus | show 🗑
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| show | Correct f&e imbalances - avoid antidiarrheals
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| HyperNa | show 🗑
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| HypoNa | show 🗑
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| HyperK | show 🗑
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| HypoK | show 🗑
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| show | Long floppy epiglottis, larynx&glottis higer (risk for aspiration) fewer muscles
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| show | Common due to immature resp tract; mucous membranes can't produce enough mucous to warm/humidify inhaled air
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| Funnel chest | show 🗑
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| Wide nipple space | show 🗑
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| show | 30-60
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| 1-3 year resp rate | show 🗑
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| 6-10 year resp rate | show 🗑
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| show | cessation of resp for longer than 20s
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| show | 30-50% O, loss greater at bottom
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| Oxygen Hood | show 🗑
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| Cystic Fibrosis | show 🗑
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| Cystic Fibrosis Digestion Issues | show 🗑
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| Earliest Sign CF | show 🗑
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| CF Diagnosis | show 🗑
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| CF Tx | show 🗑
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| Lactulose | show 🗑
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| Asthma S | show 🗑
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| Peak Flow Meter | show 🗑
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| Acute Asthma Attack | show 🗑
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| Rescue Medications | show 🗑
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| Asthma Controller Medications | show 🗑
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| show | Peaks 5-10 mins after exercise, more easy on cold dry day, give Albuterol 10-15 min before exercise to prevent
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| show | Worse at night, viral, winter months; mucosa swelling, secretions, and muscle spasms
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| Croup Tx | show 🗑
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| show | Medical emergency r/t H.influenzae, ages 2-8; abrupt onset
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| Acute Epiglottitis S | show 🗑
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| show | Bark cough, stridor, crackles/wheezes, increased R
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| show | R/t staph or group A strep; common in children immunized against H. influenza, drooling rare; child on back, not improved with nebulized epi, antibiotics
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| Respiratory Syncytial Virus | show 🗑
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| show | Fever, cough, wheezing, abnormal breathing
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| show | Common cold, runny nose, sore through, headache, mild fever
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| RSV tx | show 🗑
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| show | Invasion through Eustachian tube, sudden and short duration; ear pain
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| show | Middle ear inflammation with fluid behind TM and no signs of infection
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| show | Inflammation of middle ear longer than 3mo; found via exam on asymptomatic child
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| Pediatric Eustachian Tubes | show 🗑
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| Nonverbal expressions OM | show 🗑
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| OM Tx | show 🗑
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| OM Prevention | show 🗑
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| show | Children more prone r/t more lymphoid tissue, frequent URI, infected children; sore throat, dysphagia, fever
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| show | Viral - warm saline gargle, non-ASA analgesics; bacterial - same with antibiotic
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| Post-op tonsillectomy | show 🗑
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| Tonsillectomy Recovery | show 🗑
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| Simple Pneumothorax | show 🗑
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| Tension Pneumothorax | show 🗑
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