Acute Care Flashcards by PHILYP EPHRAIM PARANGALAN

discuss patient safety

top priority

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basic guidelines in patient safety

reduce HAI

familiarity c alarm systems

confirmation of correct pt

proper biomech

ensure equipment is good working condition

keep pt room clean and clutter free

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discuss fall

coming to rest inadvertently on floor

can be conscious or result to LOC

assoc c neuro, ortho, cognitive and OH

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discuss latex allergy

some can be allergic hence best practice to use latex free equipment

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when are restraints indicated

pt is risk to others or self-harm

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downsides of restraints

can inc agitation

nerve damage

altering skin integrity

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discuss the ICU

for pts who require constant monitoring and medication

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what are the diff types of ICU

PICU

CICU

SICU

MICU

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what are the downsides of ICU

can cause physical restrictions, sleep deprivation

added stress to pt

can cause ICU delirium or syndrome

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what is the last sense to go away

hearing

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effect of prolonged bed rest in cardiac system

inc HR at rest and submax ex

dec SV, VF, CO, VO2 max

myocardial thinning

stroke

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effect of prolonged bed rest in hematologic system

dec total blood, RBC and plasma volume

inc hematocrit

virchow’s triad - venous stasis, hypercoagulability and BV damage

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effect of prolonged bed rest in respiratory system

dec lung volumes and capacities

dec mucocilliary clearance

inc risk for pneumonia, atelectasis and embolism

dec arterial O2

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effect of prolonged bed rest in GI system

dec appetite, fluid intake, bowel motility

GERD - dec gastric bicarb secretion

diff swallowing

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effect of prolonged bed rest in genitourinary system

inc mineral excretion, kidney stones, retention and UTI

diff voiding

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effect of prolonged bed rest in endocrine system

altered temp and sweating, circadian rhythm. hormones

inc cortisol

glucose intolerance

dec metabolism

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effect of prolonged bed rest in MSK system

inc weakness, atrophy, endurance, contracture, weak MTJ

osteoporosis

degen of cartilage, synovium, ankolysis

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effect of prolonged bed rest in neurologic system

sensory and social deprivation

dec dopamine, noradrenaline, serotonin

depression, restlessness, insomnia

dec balance, coordination and acuity

reduced pain threshold

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effect of prolonged bed rest in integumentary system

risk of pressure injury information

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effect of prolonged bed rest in immune system

inc risk of reactivation of latent virus - shingles and herpes zoster

reduced immune response

HAI

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effect of prolonged bed rest in psychological system

impaired self-worth/esteem

delirium, depressiona nd PTSD

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effect of prolonged bed rest in body composition

inc sodium, potassium, calcium, phosphorus, nitrogen loss

inc body fat and dec lean mass

fluid shift to legs, abdomen, thorax and head

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edema in pelvic region

anasarca

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most common HAI

pneumonia

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what are antibodies

protein manufactured in response to antigens and defends against infection

what are antigens

vaccines capable of producing antibodies

what are communicable diseases

can be person to person direct or indirect airborne, droplets or contacts

what are HAI

dapat no infection or incubating during admission

what are non HAI called

community acquired

what are immunocompromised pts

incapable of normal response to pathogens AIDS

what is immunodeficiency

dec or compromised ability to respond to antigens AIDS

what is immunosupression

prevent or diminution of immune system via drugs or radiation

what are nosocomial infections

old term of HAI

what opportunistic infections

develops in immunosupressed or compromised pts wala sa mga intact immune system

what are subclinical infections

disease nasa incubation period

what are the long term effects of corticosteroid use

immunosuppressive inc susceptibility to infections delayed wound healing

standard precautions against infections

wash hands new gloves sanitize equipment

standard precautions against airborne infections

respirator or mask - can stay in air for 1 hr and travel 10 ft AIIR active TB

standard precautions against droplet infections

mask or face shield - large kasi usually 3 ft lang protect eyes and mucus membranes spatial separation and curtains covid

standard precautions against contact infections

gown and gloves - person to person disposable or dedicated equipment patient precautions MRSA usually

what is reverse isolation

wearing PPE to protect patient from us

discuss antibiotic resistant infections

MDR - one agent in 3 XDR - one agent in 2 PDR - immune to all

what is oxygen therapy

for hypoxemia SaO2 < 90% and arterial blood O2 <60 mmHg

what is FiO2

fraction of inspired oxygen percent of O2 in inspired air

medications that effect mobilization of pt

meds of brain, BP and blood sugar

what to assess in mobilization prescription

multisystem review pt level of cooperation pt concerns impact of med procedures and med

when to consider not to mob in MAP

MAP: <65 or >110 HR: <40 or

when to consider not to mob in BP

drop in systolic of >20 or rise of >200 >100 diastolic

when to consider not to mob in HR

HR: <40 or >130 bpm

when to consider not to mob in hemodynamic

new pressors or mroe inc or uncontrolled HTN active bleeding

when to consider not to mob in cardiac status

MI, arrythmia. ischemia intraaortic baloon meds

when to consider not to mob in pulmonary embolus

may mob if may anticoagulant or heparin check MD

when to consider not to mob in hemoglobin level

<5-7g/dL

when to consider not to mob in SpO2

<88% or cyanosis

when to consider not to mob in RR

<5 or >40

when to consider not to mob in FiO2

>60%

when to consider not to mob in ventilator support

patient-ventricular asynch

when to consider not to mob in respiratory status

unsecure airway uncontrolled airway irration and asthma pressure constrol ventialtion

when to consider not to mob in neuro status

patient status ICP of >20mmHg uncleared or unstable SCI, head injury

what to monitor during mob

S: dizzy, vertigo, SOB, borgz O: cognition, balance, cyanosis, CV status

steps in mobilization and progression

prepare - obstacles, medication, baseline VS, plan safety first - proper biomech, GBRE, monitoring when to defer - signs of fatigue, pain, diaphoresis, intolerance montior and progress - use OMTs. monitor before duting and after