4093 3 Flashcards
determine the HR using the ECG paper
Count the number of R to R intervals within the 30 large squares
Multiple by 10
Why is the T wave so important?
It represents ventricular repolarization. It’s the time when the heart is reseting, so if this gets messed up you can have real problems
Is most prominent in the presence of hypokalemia
U wave
Represents the time required to completely depolar-
ize and repolarize the ventricles
QT interval
Cardiac tamponade results from
fluid accumulation in the pericardial sac
3 signs of Cardiac Tamponade
Hypotension
Parodoxical Pulse
JVD
first thing you do if there’s Cardiac Tamponade
escalate
Parodoxical Pulse
BP varies too much between breathing in and out
Cardiac Tamponade: Administer IV fluids to combat
hypotension
Sepsis: Administer _____, such as dopamine, to combat vasodilation in the late phase
vasopressors such as dopamine
Sepsis: positioning
elevate the feet
Sepsis: give heparin if
they get DIC
Sepsis: during the late phase administer
clotting factors and blood products (clotting factors are depleted in the early stage).
Disaster: Triage: Goal:
Maximize the number of survivors by sorting the injured according to treatable and untreatable victims
What is the order in the triage color system
Red, Yellow, Green, Black
overweight BMI
25 to 29.9
obese BMI
30 +
morbidly obese BMI
40 +
___ ___ is a better predictor of CAD than BMI
waist circumference
Waist Circumference that indicates obesity
+35 (women) +40 (men)
Waist to hip ratio that indicates obesity
.80 (women) .95 (men)
2 not so obvious complications of obesity
slower healing
prone to infection
One of the most common causes of being overweight is eating too much __ and __
fat and cholesterol
The 2 kinds of healthy fat are
mono and poly
3 examples of drugs that can cause weight gain
NSAIDs
Female hormones
HTN drugs
A special consider during a head to toe assessment of an obese person
check under skin folds for breakdown
obese MEN can get
ED
obese WOMEN can get
problems with their cycle and with pregnancy
3 things that could be used as criteria for weight loss surgery
Non surgical efforts aren’t working
BMI over 40
IBW over 100%
2 kinds of very-low-cal-diets
protein-sparing modified fast
liquid formula diet
Before we start you on a very-low-cal-diet you need a
cardiac evaluation
“Balanced diet”
1200 calories
To lose 1 pound a week, you should subtract
500 cal per day
You could be a candidate for drug therapy if you’re BMI is
30 (or 27 plus a comorbidity)
___ is the drug of choice for obesity
Orlistat
Orlistat is contraindicated for pts with h___, ___ ___, hyper____, and ___ meds
HTN
Heart Disease
Hyperthyroid
Psyc Meds
____ is not a solution for people with morbid obesity
lipo
Candidates for weight loss surgery have BMI of
40, or 35 plus other risk factors
The only long term solution for Morbid obesity is
surgery
The 3 broad classes of bariatric surgery are
Restrictive
Malabsorption
Both
Restrictive surgery allows for
normal digestion without the risk for nutritional deficiency
One way that malabsorption surgery is better than restrictive is
it’s better at keeping weight off LONG term
An example of a surgery that combines restriction and malabsorption
Gastric Bypass
After bariatric surgery the diet is liquid or puree for
6 weeks
A bariatric patient could be having a LIFE threatening leak if the develop i____ ___, r____, t____, o____
increasing pain
restlessness
tachycardia
oliguria
After bariatric surgery, remove the catheter within
24 hours
After bariatric surgery its common to have
constipation or other altered bowel habits
