Chronic test 3
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| pH | 7.35-7.45
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| CO2 | 35-45
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| HCO3 | 22-28
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| PO2 | 80-100
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| SaO2 | 95-100
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| Compensated | pH normal, everything else outta whack
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| Emphysema S&Sx | DOE, progresses to continual dyspnea, scant or absent sputum, barrel chest, accessory muscle breathing, ^respir rate, prolonged expiratory phase, pink puffer/blue bloater
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| Chronic Bronchitis S&Sx | cough, sputum production, DOE
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| Chronic Bronchitis-prevention | smoking cessation, prompt tx of respire inf, vacc for flu & pneumonia
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| COPD-Improving Gas Exchange | continuous low-flow 02, 2-4L/nc, if too ^ respire will decrease
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| COPD-Why prone to weight loss | ^ work of breathing
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| Theophylline Levels | check for toxicity, 5-20mcg/mL is therapeutic, >20 is toxic, may see CNS/cardiac effects w/ toxicity
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| Potassium/K | 3.5-5mEq/dL
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| Albumin | 3.5-5.5g/dL
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| BUN | 10-20mg/dL
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| Creatinine | 0.7-1.4mg/dL
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| Bronchodialators-3 types | Beta-agonists, Anticholinergics, Theophyllines
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| Short-acting beta-adrenergics | Albuterol/Proventil & Ventolin, Levalbuterol/Zopenex
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| Long-acting beta-adrenergics | Salmeterol/Serevent
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| Anticholinergics | Ipratropium/Atrovent, Tiotropium/Spiriva
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| How Tiotropium/Spiriva administered? | pill into pop case, inhale
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| Corticosteroids effects | reduce inflammation, reduce airway swelling, reduce mucus
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| Corticosteroid SE | loss of bone-mineral density, thrush
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| To prevent Thrush | rinse out mouth after admin Corticsteroids
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| Corticosteroid | Methylprednisolone/Solumedrol
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| w/ Mucolytics & Expectorants(Guaifenesin/Humibid) | ^fluids
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| Leukotriene Inhibitors | Zafirlukast/Accolate, Montelukast/Singulair
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| Insentive Spirometry | place in mouth-breathe in-hold-exhale slowly, 10x/hr
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| Definitive Dx of TB based on | sputum cultures
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| TB Infection Control in hosp | neg pressure rm, airborne prec, N95 mask
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| TB Medications | Izoniazid(INH), Rifampin, Pyrazinamide, Ethambutol, Streptomycin
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| INH SE | peripheral neuropathy->give pyridoxine
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| TB-Physical Assessments | low grade fever, cough, night sweats, fatigue, weight loss
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| PPD or TST Interpretation | 0-4mm-neg, 10mm-significant exposure pos, 5mm-pos in HIV inf
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| Positive Reaction | followed up w/ CXR
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| TB Blood Test | QuantiFERON-TB Gold(QFT-G)-rapid test
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| TB-Why take Meds | strict adherence to med regimen is critical to suppressing disease
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| CD4#s-Normal | 300-2000/cubic mm blood
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| Concern w/ CD4# | <200
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| HIV-NNRTI’s | Sustiva, Atripla-block activity of reverse transcriptase so can’t make DNA
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| HIV-EIA | enzyme immunoassay detects presence of antibodies that indicate HIV inf
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| Tx for Thrush | Nystatin/Mycostatin, Clotrimazole/Mycelex troche or magic mouthwash
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| Antiretroviral SE of NRTI’s | nausea, diarrhea, lipidystrophy
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| Antiretroviral SE of NNRII’s | rash during 1st week of tx, liver function change
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| Antiretroviral SE of PI’s | nausea, diarrhea, lipidystrophy
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| Nutrition Concerns for HIV | diarrhea, malabsorption, protein energy malnutrition, futher impairment of immune sx, SE of antiretrovirals, food safety concerns, wasting syndrome-hypermetabolic state
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| Nutrition Therapy for HIV | high calorie, easily digestable protein, low-fat easily digestable fats, lactose free if lactose intolerant, nutritional supplement
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| Physical Assessments | poor wound healing, skin lesions, night sweats, SOB, cough, diarrhea, weight loss, N&V, visual changes
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| Opportunistic Infections | bacterial, fungal candida, fungal, viral, protozoal, malignancies
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| COPD-wheezing stops->good or bad | BAD-constricted airway
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