DVT/ventilator management/organ transplant/kids Flashcards
what medicine helps prevent DVT?
coumadin
what is the Hoffmans sign for DVT?
put patient into dorsiflexion and look for severe pain
what would you expect to find in a healthy doppler ultrasonography?
you will be able to squish the vein all the way down and see no room between the walls, unhealthy will have a gap that is a DVT
what is Wells criteria?
it is a list of risk factors for DVT that have a score attached to them. These scores are added and then assigned to a risk catergory
what are some signs and symptoms of a pulmonary embolism?
rapid pulse, sweating, tachypnea, plummet in O2 sat
a high V/Q can be the result of ________
pulmonary embolism
a low V/Q can be the result of __________
emphysema or atelectasis
what are some causes of respiratory failure?
drugs, metabolism, neoplasm, infection, trauma
if a patient becomes confused or combative what can this be a sign of?
can be a sign of climbing pCO2
how much O2 can a nasal cannula deliver?
6l/min
what type of respiratory device can be used if more than 6l/min of oxygen is required?
pendant oxymizer, non-rebreather mask
how is weaning done off the ventilator?
increase time off ventilator by 2-4 hours a day
why would someone get a tracheostomy as opposed to a nasal cannula?
need for ventilator is greater than 2 weeks, inability to swallow, blockage of airway, frequent suction due to ineffective cough
which type of trachs allow the patient to talk?
uncuffed and fenestrated
how much FiO2 is added for each liter of O2 a patient is on?
3% up to 6l/min, after that it gets crazy
what is a passy muir valve?
it allows patients with trach to talk
what organ are the majority of people on the waitlist waiting for?
kidney
what is the criteria for brain dead?
coma/unresponsive, absence of motor response to pain in all extremities, absence of brain stem reflexes, apnea
what is one reason for organ rejection?
a mismatch of antigens
what are some symptoms of organ rejection?
organs function decreases, general discomfort, fever, flu like symptoms
what are some important keys to keep in mind during rehab of a patient with a heart transplant with respect to HR?
vagus nerve is gone so you need to extend warm up to get nor/epinephrine circulating to raise HR, higher resting HR
what is the purpose of a ventricular assist device?
it circumvents the failing left ventricle and pumps blood out to body, used on patients waiting for heart transplant
what are some cautions for a patient with a VAD?
always carry two batteries, know how to use hand pump, don’t kink wires
why is osteoporosis a concern in transplant patients?
the immunosuppressive medicine decreases bone mass
what occurs in patent ductus arteriosus?
there is a tube between the aorta and pulmonary artery that doesn’t close
what is a very common defect in premature babies hearts?
PDA
what is ASD?
atrial septal defect - hole in the heart between the atria
what is VSD?
ventricular septal defect - hole in the heart between the ventricles
what happens in SMA (spinal muscle atrophy)
body has to choose between posture or breathing, breathing always wins
