4/27 Flashcards
Cholecystitis
Pancreatic enzymes
Bile in from gallbladder
Blocked what happen as a result
Tumor - not leave
Blockage - autodigestion: pancreatitis; bile blockage
RUQ pain and clay color stool
Bile duct
Sx: speed everything up; exophalus
Thyroid in gen - safe - remembering that corresponds to OB with neurogenic fever issues - priority diff if infective fever
Recognize what hypo and hyperthyroid patient looks like
Grave’s sys
Sickle in first place: lack of O2
O2 is first line
Hydration is imp but not first line
Pain control also imp
SCD
Anything affect the liver
Func of the liver
If something affecting the liver - perform funcs appropriately - NO
Know disease processes of liver and what do to liver and what can cause
Liver
Priority: daily weight; fluid volume
Fluid restrictions
High carb diet
Monitoring for complications
Antihypertensive medications
Lab values: BUN, Cr, electrolytes, monitoring protein in urine - see protein loss - watch for edema
Glomerulonephritis
Within first few hours after surgery
Sx: organ and body incompatible
Did do lot testing but sometimes have odd antibodies not test for or unaware of
Fix it - remove organ - no amount of drugs will help
Result: scar tissue - block blood vessel - block O2 - kill tissue - more often in stem cell
Hyperacute
Couple months to yr
Pt developing antibodies against organ and attacking organ over longer period of time
Issue with meds - not taking it or not enough
Catch before too much damage done
Sign of it failing: same initial prob pt had
Body attack organ
Result: scar tissue - block blood vessel - block O2 - kill tissue - more often in stem cell
Acute
Organ itself develop antibodies against body
Over longer period time
Organ versus body
Result: scar tissue - block blood vessel - block O2 - kill tissue - more often in stem cell
Chronic
Angioedema sx of anaphylaxis - swelling of face - can have it without full fledge angioedema - plan for worst and hope for best
Anaphylaxis - overarching - inflammation top thing - dilating blood vessels - no BP - facial edema
Recognize angioedema so not go full anaphylaxis
After stab epipen - go to the hospital
Angioedema vs anaphylaxis
Stroke like sx - first things want done: deviated gaze, complete flaccid one side and speech deficit: want do NIH, CT with no contrast, blood glucose - make sure not mimic
More hx - fell and hit head on curb 6 hrs ago and noticed deficit worsening - CT without contrast and see white spidering all throughout the brain - blood into all creases - bleeding causing ICP
Do not TPA since bleed
venous/arterial - can be quick or develop over sev hours to days - increased risk with blood thinner
Relieve ICP - ICU transfer
Do anticipate artiovasopasms - namotapine
Subarachnoid hemorrhage
Autonomic dysreflexia - how pt presents and what do first
First thing - healed SCI with profuse sweating, blasing headach, BP 190/120 - look for offending cause - foley, palpate bladder, look at skin - not having major pressure, can clear their bowels - need to eliminate issue - will take care of sx but not BP - need give some type of BP med
A lot not complete SCI
Have keep aligned all time - spinal traction is imp - leave hanging at all time - if not, hold to keep aligned if incomplete SCI
Primary injury - compresses SCI when hit head on bottom SCI - worst is swelling and inflammation - want stop further injury - corticosteroids - O2 up high so not run out to SC - want get swelling down - once swelling down a lot times func can return
SCI
before event; response and recovery after event
Mitigation and preparedness
Responding to issue as it happens
Feeding immediately after
Response
Temporary housing
Food pantry
Getting back to normal
Recovery
Anaphylaxis - hives is sx
Type I
Blood transfusion
Safety - IMP
Type II
SLE
RA
Autoimmune
Type III
TB
Poison ivy
Contact dermatitis
Make sure crash cart good working order just in case and lot epi available - and allergy exposure
Type IV
Not seen frequently
Autoimmune
Start IV impossible
Skin and CT tissues hard and denses
Scar tissue where not move freely - affects CT - and those around organs not able move freely
Wrap arm with arm moist towel and allows it to go through; can also us US
Systemic sclerosis
CM - decreased O2 - paradoxical chest movement - prepare intubation
Flail chest
Treatment - decompress chest with chest tube
SOB and SpO2 74% and circumoral cyanosis - see neck deviated trachea
If have tracheal deviation - priorities: O2 and have doc come see pt immediately
Tension pneumothorax
Flail chest and pneumothorax
Chest trauma
Bruised lungs
Not lot treatment - turn, cough, deep breathe
Pulmonary contusion
Go assess
Then go lay eyes
Sig other is acting weird
