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Mental Health& Adult > Adult Health Test 2 > Flashcards

Adult Health Test 2 Flashcards

1
Q

Fluid and electrolyte balance
A.22-26 Bicarbonate
B.Drawn by respiratory therapists from artery. Used to treat and diagnose acid base disturbances
C.Homeostasis, necessary for life.

A

Homeostasis, necessary for life.

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2
Q

Ph range comparable with life.
A.6.8-7.8
B. >94%
C.22-26

A

6.8-7.8

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3
Q

Normal ph
A.6.8-7.8
B. 7.35-7.45
C. 35-45

A

7.35-7.45

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4
Q

Normal PaCO2 oxygen saturation of hemoglobin
A. 35-45 carbon dioxide
B. 22-26
C. 7.35-7.45

A

35-45 carbon dioxide

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5
Q

Normal HCO3
A. 6.8-7.8
B. >94%
C. 22-26 Bicarbonate

A

22-26 Bicarbonate

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6
Q

SPo2
A. >94%
B. <94%
C. >85%

A

> 94%

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7
Q

Abgs
A. Major extra cellular fluid buffer system- carbonic acid
B. Drawn by respiratory therapists from artery. Used to treat and diagnose acid base disturbances
C. Bicarbonate in ECF, can regenerate and absorb

A

Drawn by respiratory therapists from artery. Used to treat and diagnose acid base disturbances

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8
Q

Bicarbonate
A. Major extra cellular fluid buffer system- carbonic acid
B. Slow, hours or days. Take care of CO2 first since it’s faster.
C. Drawn by respiratory therapists from artery. Used to treat and diagnose acid base disturbances

A

Major extra cellular fluid buffer system- carbonic acid

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9
Q

Medulla controls?
A. Bicarbonate in ECF, can regenerate and absorb
B. Lungs
C. Kidneys

A

Lungs

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10
Q

Lungs regulate?
A. K+
B. PH
C. Co2

A

Co2

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11
Q

Kidneys regulate
A. PH
B. Bicarbonate in ECF, can regenerate and absorb
C. NA+

A

Bicarbonate in ECF, can regenerate and absorb

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12
Q

How fast is renal compensation?
A. Slow, hours or days. Take care of CO2 first since it’s faster.
B. Fast
C. Increases, increasing elimination of CO2 (reducing acid load)

A

Slow, hours or days. Take care of CO2 first since it’s faster.

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13
Q

In metabolic acidosis what does the respiratory rate do?
A. AG=NA+ + K+ -(CL- + HCO3-) or AG=Na+ - (Cl- + HCO3-)
Second used more often than the first.
B. Bicarbonate-carbonic acid
C. Increases, increasing elimination of CO2 (reducing acid load)

A

Increases, increasing elimination of CO2 (reducing acid load)

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14
Q

In metabolic alkalosis what does the respiratory rate do?
A. Decreases causing retention of CO2, increasing acid loss.
B. Increases, increasing elimination of CO2 (reducing acid load)
C. Value calculated from multiple medical lab tests. (8-12mEq/L w/o K+, 12-16 mEq/L with K+

A

Decreases causing retention of CO2, increasing acid loss.

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15
Q

What is the most common buffer system in the body?
A. pH
B. Bicarbonate
C. B/P

A

Bicarbonate

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16
Q

What is the serum anion gap?
A. AG=NA+ + K+ -(CL- + HCO3-) or AG=Na+ - (Cl- + HCO3-)
Second used more often than the first.
B. pH <7.35, HCo3 <22 mEq//L (due to kidney injury) or N/V
C. Value calculated from multiple medical lab tests. (8-12mEq/L w/o K+, 12-16 mEq/L with K+

A

Value calculated from multiple medical lab tests. (8-12mEq/L w/o K+, 12-16 mEq/L with K+

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17
Q

What is the anion gap calculation?
A. AG=NA+ + K+ -(CL- + HCO3-) or AG=Na+ - (Cl- + HCO3-)
Second used more often than the first.
B. Value calculated from multiple medical lab tests. (8-12mEq/L w/o K+, 12-16 mEq/L with K+
C. HA, confusion, drowsiness, (Inc resp. rate and depth) Dec. B/P, Dec. cardiac output, dysrhythmias, shock

A

AG=NA+ + K+ -(CL- + HCO3-) or AG=Na+ - (Cl- + HCO3-)

Second used more often than the first.

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18
Q

Lab values of Metabolic Acidosis
A. AG=NA+ + K+ -(CL- + HCO3-) or AG=Na+ - (Cl- + HCO3-)
B. pH <7.35, HCo3 <22 mEq//L (due to kidney injury) or N/V
C. HA, confusion, drowsiness, (Inc resp. rate and depth) Dec. B/P, Dec. cardiac output, dysrhythmias, shock.

A

pH <7.35, HCo3 <22 mEq//L (due to kidney injury) or N/V

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19
Q

Symptoms of Metabolic Acidosis
A. Watch for hyperkalemia (monitor potassium) and look for hypocalcemia, Cardiac monitor, if due to chronic renal failure may need treatment with hemodialysis, or peritoneal dialysis.
B. HA, confusion, drowsiness, (Inc resp. rate and depth) Dec. B/P, Dec. cardiac output, dysrhythmias, shock.
C. >7.45 PH, >26 Bicarb (Vomiting, and gastric suction, or long-term diuretic use)

A

HA, confusion, drowsiness, (Inc resp. rate and depth) Dec. B/P, Dec. cardiac output, dysrhythmias, shock.

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20
Q

Treating Metabolic Acidosis
A. Watch for hyperkalemia (monitor potassium) and look for hypocalcemia, Cardiac monitor, if due to chronic renal failure may need treatment with hemodialysis, or peritoneal dialysis.
B. Hypokalemia (prominent U waves), symptoms of dec. calcium, resp. depression, Tachycardia, and symptoms of hypokalemia. Test urine chloride levels, leads up to paralytic ileus, or decreased motility.
C. Administer Bicarb.

A

Administer Bicarb.

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21
Q

Nursing Treatment, Metabolic acidosis
A. Watch for hyperkalemia (monitor potassium) and look for hypocalcemia, Cardiac monitor, if due to chronic renal failure may need treatment with hemodialysis, or peritoneal dialysis.
B. Administer Bicarb.
C. Before treating Met. Acid. , to avoid tetany

A

Watch for hyperkalemia (monitor potassium) and look for hypocalcemia, Cardiac monitor, if due to chronic renal failure may need treatment with hemodialysis, or peritoneal dialysis.

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22
Q

Correct Electrolytes in Metabolic Acidosis
A. Before treating Met. Acid. , to avoid tetany
B. Hypokalemia (prominent U waves), symptoms of dec. calcium, resp. depression, Tachycardia, and symptoms of hypokalemia. Test urine chloride levels, leads up to paralytic ileus, or decreased motility.
c. Watch for hyperkalemia (monitor potassium) and look for hypocalcemia, Cardiac monitor, if due to chronic renal failure may need treatment with hemodialysis, or peritoneal dialysis.

A

Before treating Met. Acid. , to avoid tetany

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23
Q

Lab values for Metabolic Alkalosis
A. PH<7.35, Pao2 > 42 mmHg Due to inadequate excretion of co2, (hypercapnia)
B. >7.45 PH, >26 Bicarb (Vomiting, and gastric suction, or long-term diuretic use)
C. Inc. pulse, inc. respiratory rate, and inc. B/P, Feeling of fullness in the head

A

> 7.45 PH, >26 Bicarb (Vomiting, and gastric suction, or long-term diuretic use)

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24
Q

What to look for in Metabolic Alkalosis
A. Give chloride allowing excretion of bicarb, or sodium chloride, Monitor I&O, Possibly KCL
B. PH<7.35, Pao2 > 42 mmHg Due to inadequate excretion of co2, (hypercapnia)
C. Hypokalemia (prominent U waves), symptoms of dec. calcium, resp. depression, Tachycardia, and symptoms of hypokalemia. Test urine chloride levels, leads up to paralytic ileus, or decreased motility.

A

Hypokalemia (prominent U waves), symptoms of dec. calcium, resp. depression, Tachycardia, and symptoms of hypokalemia. Test urine chloride levels, leads up to paralytic ileus, or decreased motility.

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25
Q

Treatment for metabolic alkalosis
A. Give chloride allowing excretion of bicarb, or sodium chloride, Monitor I&O, Possibly KCL
B. Inc. pulse, inc. respiratory rate, and inc. B/P, Feeling of fullness in the head
C. Respiratory failure, sedation, sleep apnea, PE, Asthma

A

Give chloride allowing excretion of bicarb, or sodium chloride, Monitor I&O, Possibly KCL.

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26
Q

Lab values for Respiratory Acidosis
A. Inc. pulse, inc. respiratory rate, and inc. B/P, Feeling of fullness in the head
B. PH<7.35, Pao2 > 42 mmHg Due to inadequate excretion of co2, (hypercapnia)
C. >7.45 PH, >26 Bicarb (Vomiting, and gastric suction, or long-term diuretic use)

A

PH<7.35, Pao2 > 42 mmHg Due to inadequate excretion of co2, (hypercapnia)

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27
Q

Symptoms of Respiratory Acidosis
A. Respiratory failure, sedation, sleep apnea, PE, Asthma
B. Inc. pulse, inc. respiratory rate, and inc. B/P, Feeling of fullness in the head
C. Airway patency, Vitals, Nero. stat., cardiopulmonary stat. , Pulse ox, ABGs, serum electrolytes

A

Inc. pulse, inc. respiratory rate, and inc. B/P, Feeling of fullness in the head

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28
Q

Causes of Respiratory acidosis
A. Respiratory failure, sedation, sleep apnea, PE, Asthma
B. Inc. pulse, inc. respiratory rate, and inc. B/P, Feeling of fullness in the head
C. Airway patency, Vitals, Nero. stat., cardiopulmonary stat. , Pulse ox, ABGs, serum electrolytes

A

Respiratory failure, sedation, sleep apnea, PE, Asthma

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29
Q

Treatment for Respiratory Acidosis
A. Airway patency, Vitals, Nero. stat., cardiopulmonary stat. , Pulse ox, ABGs, serum electrolytes
B. PH>7.45, PaCO2 <35 mm Hg (due to hyperventilation)
C. Can increase intracranial pressure, Give prescribed drugs, Bronchodilators, IV fluids as ordered, supplimental o2, Elevate HOB, Take slow deep breaths, s Relaxation and stress management, ensure airway, suction as necessary, Assist with ET tube,

A

Can increase intracranial pressure, Give prescribed drugs, Bronchodilators, IV fluids as ordered, supplimental o2, Elevate HOB, Take slow deep breaths, s Relaxation and stress management, ensure airway, suction as necessary, Assist with ET tube,

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30
Q

Monitor for Respiratory acidosis
A . Lower PH
B. Airway patency, Vitals, Nero. stat., cardiopulmonary stat. , Pulse ox, ABGs, serum electrolytes
C. Light headed, inability to concentrate, numbness and tingling, maybe LOC

A

Airway patency, Vitals, Nero. stat., cardiopulmonary stat. , Pulse ox, ABGs, serum electrolytes

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31
Q

Lab values for Respiratory Alkalosis
A. PH>7.45, PaCO2 <35 mm Hg (due to hyperventilation)
B. Slow down ventilation, Brown Bag
C. 20:1 Bicarb, to hco2

A

PH>7.45, PaCO2 <35 mm Hg (due to hyperventilation)

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32
Q

Symptoms of Respiratory Alkalosis
A. Higher PH
B. 20:1 Bicarb, to hco2
C. Light headed, inability to concentrate, numbness and tingling, maybe LOC

A

Light headed, inability to concentrate, numbness and tingling, maybe LOC

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33
Q

Treatment for Respiratory Alkalosis
A. Slow down ventilation, Brown Bag
B. Higher PH
C. 20:1 Bicarb, to hco2

A

Slow down ventilation, Brown Bag

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34
Q

Lower the H+=
A. Lower PH
B. Higher PH
C. conserve hydrogen ions, and excrete bicarb ions

A

Higher PH

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35
Q

Higher the H+=
A. Lower PH
B. Higher PH
C. Slow down ventilation, Brown Bag

A

Lower PH

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36
Q

ABGs are
A. CO2 on ECF
B. 20:1 Bicarb, to hco2
C. conserve hydrogen ions, and excrete bicarb ions

A

20:1 Bicarb, to hco2

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37
Q

Effects on Kidneys on MAcid, RAcid
A. Kidneys excrete hydrogen ions, and conserve bicarb ions
B. Resp rate inc. causing co2 to be eliminated
C. conserve hydrogen ions, and excrete bicarb ions

A

Kidneys excrete hydrogen ions, and conserve bicarb ions

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38
Q

Effects on Kidneys on Malk, Ralk
A. CO2 on ECF
B. Resp Dec. causing co2 to be retained
C. conserve hydrogen ions, and excrete bicarb ions

A

conserve hydrogen ions, and excrete bicarb ions

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39
Q

medulla controls lungs and lungs control?
A. CO2 on ECF
B. Resp Dec. causing co2 to be retained
C. two or more, Normal PH in the presence of changes in the PaCO2 and HCO3. Acidosis and Alkalosis can’t occur together.

A

CO2 on ECF

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40
Q

In metabolic acidosis
A. Resp Dec. causing co2 to be retained
B. conserve hydrogen ions, and excrete bicarb ions
C. Resp rate inc. causing co2 to be eliminated

A

Resp rate inc. causing co2 to be eliminated

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41
Q

In met. Alk.
A. Resp Dec. causing co2 to be retained
B. Collapse of aveoli
C. Resp rate inc. causing co2 to be eliminated

A

Resp Dec. causing co2 to be retained

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42
Q

Mixed Acid base disorders
A. Tachycardia, tachypnea, pleural pain, and central cynosis when large portions of lungs are affected.
B. two or more, Normal PH in the presence of changes in the PaCO2 and HCO3. Acidosis and Alkalosis can’t occur together.
C. Insideous increasing dyspnea, cough, and sputum production.

A

two or more, Normal PH in the presence of changes in the PaCO2 and HCO3. Acidosis and Alkalosis can’t occur together.

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43
Q

Atelectasis
A. Tachycardia, tachypnea, pleural pain, and central cynosis when large portions of lungs are affected.
B. Insideous increasing dyspnea, cough, and sputum production.
C. Collapse of aveoli

A

Collapse of aveoli

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44
Q

Symptoms of Atelectasis
A. Insideous increasing dyspnea, cough, and sputum production.
B. same as acute, due to pulmonary infection
C. Tachycardia, tachypnea, pleural pain, and central cynosis when large portions of lungs are affected.

A

Insideous increasing dyspnea, cough, and sputum production.

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45
Q

Symptoms of acute Atelectasis
A. same as acute, due to pulmonary infection
B. Tachycardia, tachypnea, pleural pain, and central cynosis when large portions of lungs are affected.
C. Increased work for breathing and hypoxemia, dec breath sounds and crackles over affected area, chest x-ray, pulse ox less than 90%

A

Tachycardia, tachypnea, pleural pain, and central cynosis when large portions of lungs are affected.

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46
Q

Symptoms of Chronic Atelectasis
A. Tachycardia, tachypnea, pleural pain, and central cynosis when large portions of lungs are affected.
B. same as acute, due to pulmonary infection
C. Frequent turning, early mobilization, incentive spirometer, voluntary deep breathing, pressurized meter- dosed inhaler.

A

same as acute, due to pulmonary infection

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47
Q

Assessing and diagnosing Atelectasis
A. PEEP, CPAB, ICOUGH, CPT (hooked to vent) Intubation, Thoracentesis
B. Frequent turning, early mobilization, incentive spirometer, voluntary deep breathing, pressurized meter- dosed inhaler.
C. Increased work for breathing and hypoxemia, dec breath sounds and crackles over affected area, chest x-ray, pulse ox less than 90%

A

Increased work for breathing and hypoxemia, dec breath sounds and crackles over affected area, chest x-ray, pulse ox less than 90%

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48
Q

Nursing interventions for Atelectasis
A. Demyelination disease of the CNS ( destruction of the fatty protein material that surround certain nerve fibers in the brain and spinal cord)
B. Sudden acute life-threatening deterioration of gas exchangeto lungs. no adequate o2 or ventilation to blood (pao2<55 /, PACO2 >55, and PH <7.35
C. Frequent turning, early mobilization, incentive spirometer, voluntary deep breathing, pressurized meter- dosed inhaler.

A

Frequent turning, early mobilization, incentive spirometer, voluntary deep breathing, pressurized meter- dosed inhaler.

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49
Q

Management for atelectasis
A. PEEP, CPAB, ICOUGH, CPT (hooked to vent) Intubation, Thoracentesis
B. Trauma-Boating accidents, car accidents, pneumonia, ARDS, HF, COPD, PE, cystic fibrosis (anesthetic, analgesic, and sedative agents) or pain
C. Deteriorization in the gas exchange function of the lung that has been insideously or persisted for long periods of time after ARF (No acute SX)

A

PEEP, CPAB, ICOUGH, CPT (hooked to vent) Intubation, Thoracentesis

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50
Q

Acute Respiratory Failure
A. COPD, MS, Muscular dystrophy, Myasthenia Gravis, Gukllian barre syndrome
B. Trauma-Boating accidents, car accidents, pneumonia, ARDS, HF, COPD, PE, cystic fibrosis (anesthetic, analgesic, and sedative agents) or pain
C. Sudden acute life-threatening deterioration of gas exchangeto lungs. no adequate o2 or ventilation to blood (pao2<55 /, PACO2 >55, and PH <7.35

A

Sudden acute life-threatening deterioration of gas exchangeto lungs. no adequate o2 or ventilation to blood (pao2<55 /, PACO2 >55, and PH <7.35

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51
Q

Causes of ARF
. A, Trauma-Boating accidents, car accidents, pneumonia, ARDS, HF, COPD, PE, cystic fibrosis (anesthetic, analgesic, and sedative agents) or pain
B. COPD, MS, Muscular dystrophy, Myasthenia Gravis, Gukllian barre syndrome
C. Deteriorization in the gas exchange function of the lung that has been insideously or persisted for long periods of time after ARF (No acute SX)

A

Trauma-Boating accidents, car accidents, pneumonia, ARDS, HF, COPD, PE, cystic fibrosis (anesthetic, analgesic, and sedative agents) or pain

52
Q

Chronic Respiratory failure
A. Bilateral infiltration, sever dyspnea, Racing heart, Retractions, hypoxia, tachycardia, Crackles (ABG dyspnea
B. Deteriorization in the gas exchange function of the lung that has been insideously or persisted for long periods of time after ARF (No acute SX)
C. Life threatening and resembles severe pulmonary edema, Inflammatroy process causing damage to aveoli, leading to sudden and progressive pulmonary edema

A

Deteriorization in the gas exchange function of the lung that has been insideously or persisted for long periods of time after ARF (No acute SX)

53
Q

Causes of Chronic Respiratory failure
A. Retractions, hypoxia, tachycardia, Crackles (ABG dyspnea
B. Massive trauma, Severe respiratory disorder, Prolonged mechanical ventilation, Hemorrhage shock, Fat embolism (due to broken bone), Septic condition
C. COPD, MS, Muscular dystrophy, Myasthenia Gravis, Gukllian barre syndrome

A

COPD, MS, Muscular dystrophy, Myasthenia Gravis, Gukllian barre syndrome

54
Q

Acute Respiratory distress syndrome
A. Life threatening and resembles severe pulmonary edema, Inflammatroy process causing damage to aveoli, leading to sudden and progressive pulmonary edema S
B. PEEP,

C. Rapid onset of severe dyspnea, within 72 hours of incident.Rapid onset of severe dyspnea, within 72 hours of incident.

A

Life threatening and resembles severe pulmonary edema, Inflammatroy process causing damage to aveoli, leading to sudden and progressive pulmonary edema S

55
Q

Characterizations of ARDS
A. Massive trauma, Severe respiratory disorder, Prolonged mechanical ventilation, Hemorrhage shock, Fat embolism (due to broken bone), Septic condition
B. Bilateral infiltration, sever dyspnea, Racing heart, Retractions, hypoxia, tachycardia, Crackles (ABG dyspnea
C, REstless, HA, dyspnea, Air hunger, tachycardia, inc. B/P

A

Bilateral infiltration, sever dyspnea, Racing heart, Retractions, hypoxia, tachycardia, Crackles (ABG dyspnea

56
Q

Treating ARDS
A. REstless, HA, dyspnea, Air hunger, tachycardia, inc. B/P
B. Rapid onset of severe dyspnea, within 72 hours of incident.
C. PEEP,

A

PEEP,

57
Q

Acute phase of ARDS
A. Rapid onset of severe dyspnea, within 72 hours of incident.
B. Prepare to intubate, Monitor co2, Secretions, ABG’s, Turning, mouth care, ROM, Prone positioning, enteral feedings,
C. REstless, HA, dyspnea, Air hunger, tachycardia, inc. B/P

A

Rapid onset of severe dyspnea, within 72 hours of incident.

58
Q

Cause of ARDS
A, Common (Pneumonia, Aspiration of gastric contents) Uncommon (Pulmonary contusion, Near drowning, Inhalation injury, fat embolism, reperfusion injury)
B. Massive trauma, Severe respiratory disorder, Prolonged mechanical ventilation, Hemorrhage shock, Fat embolism (due to broken bone), Septic condition
C. REstless, HA, dyspnea, Air hunger, tachycardia, inc. B/P

A

Massive trauma, Severe respiratory disorder, Prolonged mechanical ventilation, Hemorrhage shock, Fat embolism (due to broken bone), Septic condition

59
Q

Symptoms of ARDS
A. Common (Pneumonia, Aspiration of gastric contents) Uncommon (Pulmonary contusion, Near drowning, Inhalation injury, fat embolism, reperfusion injury)
B. Prepare to intubate, Monitor co2, Secretions, ABG’s, Turning, mouth care, ROM, Prone positioning, enteral feedings,
C. REstless, HA, dyspnea, Air hunger, tachycardia, inc. B/P

A

REstless, HA, dyspnea, Air hunger, tachycardia, inc. B/P

60
Q

Treatment for ARDS
A. Common (Sepsis, Severe trauma with shock, Multiple transfusion) Uncommon (Post cardiac surgery, Pancreatitis, drug overdose, After massive rransfusion)
B. Prepare to intubate, Monitor co2, Secretions, ABG’s, Turning, mouth care, ROM, Prone positioning, enteral feedings,
C. Common (Pneumonia, Aspiration of gastric contents) Uncommon (Pulmonary contusion, Near drowning, Inhalation injury, fat embolism, reperfusion injury)

A

Prepare to intubate, Monitor co2, Secretions, ABG’s, Turning, mouth care, ROM, Prone positioning, enteral feedings,

61
Q

Direct Causes of ARDS

A

Common (Pneumonia, Aspiration of gastric contents) Uncommon (Pulmonary contusion, Near drowning, Inhalation injury, fat embolism, reperfusion injury)

62
Q

In-diret cause of ARDS

A

Common (Sepsis, Severe trauma with shock, Multiple transfusion) Uncommon (Post cardiac surgery, Pancreatitis, drug overdose, After massive rransfusion)

63
Q

Autoimmune Neurologic disorders

A

Multiple sclerosis, Myasthenia gravis, Duillian- barre syndrome

64
Q

What is Multiple Sclerosis?

A

Demyelination disease of the CNS ( destruction of the fatty protein material that surround certain nerve fibers in the brain and spinal cord)

65
Q

Peak of Multiple sclerosis

A

25-35 (women) Genetic predisposition, smoking, lack of vit-D, Epsein Barr virus (no cure)

66
Q

Symptoms of Multiple Sclerosis

A

Ringing of the ears, blurred vision, dec. hearing, nystagmus, dysphagia, weakness may turn into paralysis, Urinary retention, spastic bladder, constipation, ataxia, vertigo, numbness, bradycardia

67
Q

Life expectancy for MS

A

5-7 years.-, frequent remission

68
Q

Symptom treatment for MS

A

Interferon b-1a, and interferon b-1b, glatiramer acetate, IV methylprednisolone

69
Q

Nurse treatment for MS

A

Emotional support, promote mobility, rest, self care, and promoting sexual function

70
Q

Assessment for MS

A

Neurologic deficits, secondary complications, Impact of disease on physical, social, and emotional function and on lifestyle, Patient and family coping

71
Q

Nrusing diagnosis for MS

A

Impaired physical mobility, risk for injury, impaired bowel and bladder function, impaired communication, disturbed thought process, ineffective coping, impaired home maitenance, Potential sexual dysfunction

72
Q

Nursing process of MS Planning

A

Promote mobility, avoidance of injury, bowel and bladder continence, speech and swallowing mech., improve cognitive function, develop coping strengths, improve home maint.,adapt to sexual dysfunction

73
Q

Is the following statement true or false? Myasthenia gravis is an autoimmune attack on the peripheral nerve myelin

A

False, Myoneural junction,

74
Q

What is myasthenia gravis?

A

Autoimmune disorder affecting myoneural junction directed at acetylcholine

75
Q

Symptoms of Myasthenia gravis

A

Diplopia, and ptosis, weakness of facia muscles caused ny lower neuron lesion, Swallowing and voice impairment (dysphonia), larynheal dysfunction, and dysphagia, weakness in all extremeties and intercostal muscles. (no cure)

76
Q

Medical management of Myasthenia gravis

A

Directed at improving function and reducing and removing circulating antibodies, Meds: Anticholinesterase, and immunosuppresive therapy, IV immunoglobulin, plasmapheresis, thymectome

77
Q

What is acetylcholines involvement in MG?

A

Decreased binding to the receptor site required for muscular contraction in the thymus gland

78
Q

Pharmacologic treatment of symptoms

A

corticosteroids suppress immune response

79
Q

Nursing process (diagnosis) for MG

A

Fespiratory failure R/T severe weakness of intercostal muscles

80
Q

Myasthenic Crisis

A

Disease exacerbation, or precipitating event (respiratory infection), Severe generalized muscle weakness with respiratory and bulbar weakness, Respiratory compromise or failure

81
Q

Cholinergic crisis

A

Over medication with cholinesterase inhibitors, severe muscle weakness with respiratory and bulbar weakness, May develop respiratory compromise and failure

82
Q

What is dysphonia?

A

voice impairment or altered voice production

83
Q

MEdical manegement of MG

A

Adequate ventilation, intubation and mechanical ventilation may be needed, ABG’s, serum electrolytes, I&O, daily weight, NG feeding may be needed, Avoid sedatives and tranquilizers

84
Q

What is Guillain-barre syndrome?

A

Autoimmune disorder with acute attack of peripheral nerve myelin (rapid segmental demyelination of perepherial nerves, and cranial nerves (prepare to intubate)

85
Q

Symptoms of GBS

A

dyskanesia (cant execute involuntary movement) Hyporeflexia, and paresthesias (follows viral infection)

86
Q

Other sx of GBS

A

weakness, paralysis, paresthesias, pain, and absent reflexes, starting at feet working up, bulbar weakness, cranial nerve sx, tachycardia, bradycardia, hypertension or hypotension

87
Q

GBS

A

More frequent in males between 16-25 and over 55. peaks at week 2, but no linger than 4 weeks

88
Q

Medical management of GBS

A

Intensive care management, contiuous monitoring, and respiratory support. Complete recovery, Mobility, IV fluids, Parenteral nutrition, bowel sounds, gag reflex, Watch for DVT

89
Q

Nursing care of GBS DX

A

ineffective br3eathing pattern, impaired gas exchange, impaired physical mobility, imbalance nutrition, impaired verbal communication, fear, anxiety

90
Q

Interventions GBS

A

Physical mobility and prevention of /DVT, limbs in functional position, Passive ROM, Twice daily, frequent repositioning every 2 hours, elastic compression hose, or compression boots, swallowing and gag reflex, Plan for communication, Dec. fear and anxiety, Info and support, refer to support group, relaxation measures, positive attitude and atmosphere, and diversional activities.

91
Q

What is Muscular dystorphy?

A

Incurable characterized by progressive weakening and wasting of skeletal and voluntary muscles, genetic (duchenne muscular dystrophy

92
Q

Symptoms of MD

A

Muscle wasting and weakness, abnormal elevation in serum levels of muscle enzymes, monitor CPK Mostly males, Dont live to adulthood

93
Q

Nursing care for MD

A

supportive care, educate about self care, and continuing care, max level of function. Deformed thorax to secondare or severe scoliosis, Chest infection, atelectasis, pulmonary hypoplasia and ventalitory failure leading causes of death

94
Q

Simple non-invasive therapy

A

o2,nebulizer therapy, chest physiotherapy [CPT], breathing retraining

95
Q

Highly invasive treatments

A

intubation, mechanical ventilation, surgery

96
Q

Oxygen Therapy

A

administering oxygen at a concentration greater than what is in the atmosphere

97
Q

Reasons for oxygen therapy

A

hypoxemia, decrease in the arterial oxygen tension in the blood. Hypoxia- decrease in oxygen perfusion to the tissues and cells.

98
Q

symptoms that cause need for oxygen therapy

A

fatigue, drowsiness, apathy, inattentiveness, and delayed reaction time may occur

99
Q

Oxyen

A

Is a medication and should be prescribed by a doctor unless it’s an emergency situation (2ml/dl)

100
Q

subtle indicators of inadequate oxygenation when oxygen is given by any method

A

confusion, restlessness progressing to lethargy, diaphoresis, pallor, tachycardia, tachypnea, and hypertension.

101
Q

Oxygen Toxicity

A

may occur when too high concentration of oxygen (greater than 50%) is given for an extended period (generally longer than 24 hours

102
Q

Signs and symptoms of oxygen toxicity

A

substernal discomfort, paresthesias, dyspnea, restlessness, fatigue, malaise, progressive respiratory difficulty, refractory hypoxemia, alveolar atelectasis, and alveolar infiltrates evident

103
Q

Absorption Atelectasis

A

adverse effect of the administration of high concentrations of oxygen (greater than 50%) to patients who are sedated and breathing small tidal volumes of air (volume of air inspired and expired with each breath

104
Q

Devises of oxygen administration

A

Cannula

1—2
3–5
6	24–28
32–40
44	
Lightweight, comfortable, inexpensive, continuous use with meals and activity

Easily dislodged, from nares, skin breakdown over ears or nares, nasal mucosal drying, variable FiO2

105
Q

Devises of oxygen administration, low

A

Nasal catheter, Flow rate of 1-6, o2 percentage 24-44, Inexpensive, does not require a tracheostomy. Can cause.
Nasal mucosa irritation; catheter should be changed frequently to alternate nostril

106
Q

Devices of oxygen administration, low

A

simple mask, 5-8l/m, o2% 40-60, Simple to use, inexpensive

Complications, Poor fitting, variable FiO2, must remove to eat

107
Q

Partial rebreathing mask, low, have a reservoir bag that must remain inflated during both inspiration and expiration, the first third of the exhalation fills the reservoir bag.

A

8-11, o2% 50-75, Moderate O2 concentration

Warm, poorly fitting, must remove to eat

108
Q

Non-rebreathing mask, low, A one-way valve located between the reservoir bag and the base of the mask allows gas from the reservoir bag to enter the mask on inhalation but prevents gas in the mask from flowing back into the reservoir bag during exhalation

A

10-15, o2% 80-95, High O2 concentration

Poorly fitting, must remove to eat

109
Q

Transtracheal catheter high flow, insert a catheter through a small incision directly into the trachea. It is indicated for patients with chronic oxygen therapy needs

A

1/4-4, 60-100, More comfortable, concealed by clothing, less oxygen liters per minute needed than nasal cannula

Requires frequent and regular cleaning, requires surgical intervention, with associated risk for surgical complications

110
Q

Mask, Venturi, high flow, most reliable and accurate method for delivering precise concentrations of oxygen through noninvasive means.

A

(4-6, 24,26,28), (6-8, 30,35,40)Provides low levels of supplemental O2

Must remove to eat

Precise FiO2, additional

111
Q

Mask, aerosol, high flow

A

8*10, 30-100, Good humidity, accurate FiO2

Uncomfortable for some

112
Q

Tracheostomy collar, high flow

A

8-10, 30-100,

Good humidity, comfortable, fairly accurate FiO2

113
Q

T-piece, high flow, onnects to the endotracheal or tracheostomy tube and is useful in weaning patients from mechanical ventilation

A

8-10, 30-100, Same as tracheostomy collar

Heavy with tubing

114
Q

Face tent, high flow

A

8-10,30-100, Good humidity, fairly accurate FiO2

Bulky and cumbersome

115
Q

Oxygen-Conserving Devices, Pulse dose (or demand)

A

10-40ml/breath, Deliver O2 only on inspiration, conserve 50–75% of O2 used

Must carefully evaluate function individually

116
Q

low-flow (variable performance)

A

the patient breathes some room air along with the oxygen

117
Q

high-flow (fixed performance)

A

provide the total inspired air. A specific percentage of oxygen is delivered independent of the patient’s breathing. High-flow systems are indicated for patients who require a constant and precise amount of oxygen.

118
Q

Hyperbaric oxygen therapy

A

treat conditions such as decompression sickness, air embolism, carbon monoxide poisoning, cyanide poisoning, smoke inhalation, gangrene, tissue necrosis, wound healing, skin grafts, refractory anaerobic infections, and refractory osteomyelitis , 100% o2

119
Q

Patient teaching for oxygen therapy

A

patient is instructed to see their primary provider every 6 months or more often, if indicated. Arterial blood gas measurements and laboratory tests are repeated annually or more often if the patient’s condition changes.

120
Q

Incentive spirometry

A

method of deep breathing that provides visual feedback to encourage the patient to inhale slowly and deeply to maximize lung inflation and prevent or reduce atelectasis. The purpose of an incentive spirometer is to ensure that the volume of air inhaled is increased gradually as the patient takes deeper and deeper breaths.

121
Q

volume type, incentive spir

A

the tidal volume is set using the manufacturer’s instructions. The patient takes a deep breath through the mouthpiece, pauses at peak lung inflation, and then relaxes and exhales. Taking several normal breaths before attempting another with the incentive spirometer helps avoid fatigue. The volume is periodically increased as tolerated.

122
Q

flow type, incentive spir

A

olume is not preset. The spirometer contains a number of movable balls that are pushed up by the force of the breath and held suspended in the air while the patient inhales. The amount of air inhaled and the flow of the air are estimated by how long and how high the balls are suspended.

Indications

123
Q

Incentive spiro use

A

Incentive spirometry is used after surgery, especially thoracic and abdominal surgery, to promote the expansion of the alveoli and to prevent or treat atelectasis.

124
Q

Nursing managemet for Incentive spiro

A

placing the patient in the proper position, educating the patient on the technique for using the incentive spirometer, setting realistic goals for the patient, and recording the results of the therapy (see Chart 21-3). Ideally, the patient assumes a sitting or semi-Fowler’s position to enhance diaphragmatic excursion; however, this procedure may be performed with the patient in any position.

125
Q

Chest physiotherapy (CPT

A

postural drainage, chest percussion and vibration, and breathing retraining. In addition, educating the patient about effective coughing technique is an important part of CPT. The goals of CPT are to remove bronchial secretions, improve ventilation, and increase the efficiency of the respiratory muscles

126
Q

Endotracheal intubation

A

The oral route is preferred since oral intubation is associated with less trauma and lesser rates of infection; furthermore, the oral route can typically accommodate a larger diameter

Mental Health& Adult (1 decks)

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