Med Surg II
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show | Most accurate test for asthma; evaluates lung mechanisms, gas exchange, acid-base, lung volumes, ABGs
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show | 7.35-7.45
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CO2 | show 🗑
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show | 22-27
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show | 80-100mm Hg
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show | Comprised oxygen to tissues
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<70% | show 🗑
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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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Pulmonary Pain | show 🗑
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show | Conscious sedation; CBC/platelet before, NPO 4-8h prior; benzocaine numb pharynx; lidocaine preferred
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Benzocaine | show 🗑
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show | 60-100%; most oxygen. Valves open expiration and close on inspiration
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show | Nasal V Simple Non-Rebreather
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Droplet Precautions | show 🗑
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show | lack of oxygen to tissues
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show | decreased arterial oxygen (O2 <50)
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show | Decreased cardiac output, arterial supply, anemia, carbon monoxide poisoning
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Kidney, Brain, Heart | show 🗑
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Hypoxia symptoms | show 🗑
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Pediatric Hypoxia Symptoms | show 🗑
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Chronic Hypoxia | show 🗑
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Obstructive Sleep Apnea | show 🗑
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OSA Risk Factors | show 🗑
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OSA S | show 🗑
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OSA Complications | show 🗑
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Epistaxis Tx | show 🗑
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Epistaxis Education | show 🗑
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Pneumonia | show 🗑
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show | if organisms of pneumonia move into blood stream
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Empyema | show 🗑
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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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show | In morning (1h AC 2-3 PC) Stop if in pain, bronchodilators q15min before, percuss 1-2 minute and vibrate
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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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Asthma | show 🗑
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Asthma Irritants | show 🗑
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Asthma Risk Factors | show 🗑
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Asthma S | show 🗑
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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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show | Life threatening; intensifies and doesn't respond to common therapy, may develop pneumothorax/cardiac arrest/resp arrest
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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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Emphysema | show 🗑
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show | Airway problem; exposure to irritants (especially smoking); produces thick mucus
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COPD Risk Factors | show 🗑
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show | Helps regulate proteases; recessive; proteins degrade proteases to destroy/eliminate particulates and organisms inhaled during breathing; when present in large amounts damage small airways by breaking down elastin
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show | Beta agents, cholinergic antagonists, methylxanthines, steroids, NSAIDS, mucolytics
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Pleural Effusion | show 🗑
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Pneumonia | show 🗑
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show | Abnormal dilation a/w necrotic infection and occurs usually as complication of recurrent resp infections, cystic fibrosis, etc
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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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show | Drain cavities (can't heal them), elevated food, 3-4L/day, avoid URI, high calorie/protein, antibiotics
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Lung Biopsy | show 🗑
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show | operative side
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Lobectomy | show 🗑
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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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show | NSAIDS, Opiods, PVCs, Afib/flutter (regular pattern)
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show | 2cm, one-way valve, moves with breathing (up-inhalation), bubbles indicate leak
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show | if tubing enters fluid drainage stops and can lead to this
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CT disconnects from drainage system | show 🗑
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show | Cover with Vaseline or dry gauze - watch for pneumothorax
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show | Disconnect suction and send drainage system with pt below chest level - don't clamp
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No tidaling in water seal chamber | show 🗑
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Drainage stopped collecting | show 🗑
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show | clamp near insertion site and move down tube until leak found
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Clamp CT | show 🗑
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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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show | Sudden sharp pain, SOB, decreased breath sounds one side, decreased chest movement, subcutaneous emphysema, cyanosis, trachea deviated to unaffected side
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show | isonatremic; ringers and NS
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Hypotonic dehydration | show 🗑
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Hypertonic dehydration | show 🗑
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show | liquid that can hold another substance
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Solute | show 🗑
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Hourly UO | show 🗑
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show | 135-145
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show | 3.5-5
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Ca | show 🗑
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show | Pedialyte, rehydralyte, ceral-based, infalyte, home made
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Inappropriate Rehydration | show 🗑
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Gastroenteritis | show 🗑
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show | Causes watery diarrhea (18-36h after eating), prevent dehydration, spread by contaminated hnds
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show | Correct f&e imbalances - avoid antidiarrheals
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show | Children with dev. delay don't perceive thirst, [high sugar], inadequate breast milk, DI; decreased LOC
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HypoNa | show 🗑
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show | Kidney probs, K in IV, blood transfusion, false + heel stick; muscle weakness
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HypoK | show 🗑
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Pediatric Respiratory | show 🗑
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Pediatric URI | show 🗑
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show | rickets or marfans
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show | Turner's syndrome
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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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apnea | show 🗑
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show | 30-50% O, loss greater at bottom
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show | 40% O, used with smaller infants, must be able to breath on own
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show | Mutation on chromosome 7; reduced ability to regular Cl channels to transport NaCl; increased viscosity of mucous and abnormal mucociliary action
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show | Excrete undigested food; bulky stool (foul,frothy fatty - steatorhea), pancreatitis, diabetes, vitamin def A D E K, anemia, rectal prolapse
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show | Meconium ileus
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CF Diagnosis | show 🗑
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show | CPT, flutter device, chest wall oscillation, + expiratory P, ibuprofen qd, higher dose antibiotics, high cal high protein diet
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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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show | Assess, O, Quick relief meds, IV, radiograph prep, abg blood sample
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Rescue Medications | show 🗑
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show | Beta agonist, methylxanthines, mast cell inhibitors, corticosteroids, leukotriene modifers, NSAIDS
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Exercise induced Asthma | show 🗑
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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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show | Drooling, dysphonia, dysphagia, difficulty breathing; restless and frog like croak on inspiration
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Croup S | show 🗑
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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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show | Most common cause of bronchiolitis; r/t parainfluenza; classic sign of wheezing and secretions; transmission hands and droplets
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RSV under 2 S | show 🗑
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RSV older children | show 🗑
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RSV tx | show 🗑
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AOM | show 🗑
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OME (Effusion) | show 🗑
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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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show | 1st - Amoxil 2nd - Augmentin
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OM Prevention | show 🗑
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Tonsillitis | show 🗑
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Tonsillitis Tx | show 🗑
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show | Don't blow nose or cough, no straws, cool non-carb non-acid beverages, soft food 3 weeks, lots of fluid, limited activity
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Tonsillectomy Recovery | show 🗑
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show | Trachea midline, decreased expansion and breath sounds, normal or hyperresonant percussion
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Tension Pneumothorax | show 🗑
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