DVT/ventilator management/organ transplant/kids

Question 1

what medicine helps prevent DVT?

Answer 1

coumadin

Question 2

what is the Hoffmans sign for DVT?

Answer 2

put patient into dorsiflexion and look for severe pain

Question 3

what would you expect to find in a healthy doppler ultrasonography?

Answer 3

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

Question 4

what is Wells criteria?

Answer 4

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

Question 5

what are some signs and symptoms of a pulmonary embolism?

Answer 5

rapid pulse, sweating, tachypnea, plummet in O2 sat

Question 6

a high V/Q can be the result of ________

Answer 6

pulmonary embolism

Question 7

a low V/Q can be the result of __________

Answer 7

emphysema or atelectasis

Question 8

what are some causes of respiratory failure?

Answer 8

drugs, metabolism, neoplasm, infection, trauma

Question 9

if a patient becomes confused or combative what can this be a sign of?

Answer 9

can be a sign of climbing pCO2

Question 10

how much O2 can a nasal cannula deliver?

Answer 10

6l/min

Question 11

what type of respiratory device can be used if more than 6l/min of oxygen is required?

Answer 11

pendant oxymizer, non-rebreather mask

Question 12

how is weaning done off the ventilator?

Answer 12

increase time off ventilator by 2-4 hours a day

Question 13

why would someone get a tracheostomy as opposed to a nasal cannula?

Answer 13

need for ventilator is greater than 2 weeks, inability to swallow, blockage of airway, frequent suction due to ineffective cough

Question 14

which type of trachs allow the patient to talk?

Answer 14

uncuffed and fenestrated

Question 15

how much FiO2 is added for each liter of O2 a patient is on?

Answer 15

3% up to 6l/min, after that it gets crazy

Question 16

what is a passy muir valve?

Answer 16

it allows patients with trach to talk

Question 17

what organ are the majority of people on the waitlist waiting for?

Answer 17

kidney

Question 18

what is the criteria for brain dead?

Answer 18

coma/unresponsive, absence of motor response to pain in all extremities, absence of brain stem reflexes, apnea

Question 19

what is one reason for organ rejection?

Answer 19

a mismatch of antigens

Question 20

what are some symptoms of organ rejection?

Answer 20

organs function decreases, general discomfort, fever, flu like symptoms

Question 21

what are some important keys to keep in mind during rehab of a patient with a heart transplant with respect to HR?

Answer 21

vagus nerve is gone so you need to extend warm up to get nor/epinephrine circulating to raise HR, higher resting HR

Question 22

what is the purpose of a ventricular assist device?

Answer 22

it circumvents the failing left ventricle and pumps blood out to body, used on patients waiting for heart transplant

Question 23

what are some cautions for a patient with a VAD?

Answer 23

always carry two batteries, know how to use hand pump, don’t kink wires

Question 24

why is osteoporosis a concern in transplant patients?

Answer 24

the immunosuppressive medicine decreases bone mass

Question 25

what occurs in patent ductus arteriosus?

Answer 25

there is a tube between the aorta and pulmonary artery that doesn’t close

Question 26

what is a very common defect in premature babies hearts?

Answer 26

PDA

Question 27

what is ASD?

Answer 27

atrial septal defect - hole in the heart between the atria

Question 28

what is VSD?

Answer 28

ventricular septal defect - hole in the heart between the ventricles

Question 29

what happens in SMA (spinal muscle atrophy)

Answer 29

body has to choose between posture or breathing, breathing always wins