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ABSN Cohort 19 > MedSurg Exam2 > Flashcards

MedSurg Exam2 Flashcards

1
Q

Xerosis

A

dry skin (common in older pts)

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2
Q

Urticaria

A

hives

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3
Q

Contamination

A

presence of organisms w/out infx

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4
Q

Infection

A

organisms grow/spread, Ø control by body’s immune sys.

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5
Q

Hirsutism

A

excessive growth of body hair or in ab. areas

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6
Q

Acute paronychia

A

inflammation of skin around nail

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7
Q

Lichenification

A

thick skin (caused by scratching r/t dry skin)

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8
Q

Diagnosing Skin (5)

A

C&S - reveals fungal, bacterial, viral
Wood’s light - colors show infx, lighter pts
Tzank Smear - reveals viral
Potassium Hydroxide (KOH) - reveals fungal (threads)
Biopsy

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9
Q

4 Biopsies and 2 reqs?

A 
Punch = 2 - 6 mm plug
Shave = raised area only w/ razor
Excisional = deep specimen, reqs. sutures
Incisional = cross-section through center lesion. reqs. sutures

Biopsies req. consent and local anesthesia

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10
Q

Assessment of Darker pts

A 
Pallor = ashe gray on mucous membranes
Cyanosis = lips, mouth, tongue for blue
Inflammation = palpation
Jaundice = hard palate
Bleeding = compare affected to unaffected. Also petechiae!
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11
Q

3 Phases of wound healing

A

Inflammatory
Proliferative
Maturation

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12
Q

Inflammatory Phase (3)

A

3 - 5 days when injury starts
WBC/macrophages migrate -> wound
S/S = edema, pain, erthyema, warmth

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13
Q

Proliferative/Fibroblastic (2)

A

2 - 4 weeks past 4th day

Epithelialization (tissue repair) takes place

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14
Q

Maturation Phase (3)

A

3 weeks after injury -> 1 year?
Collagen
Scar tissue becomes thinner/paler

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15
Q

Process of Wound Healing (3)

A

Depends for each wound.
1st - edges brought together
2nd - granulation/contraction
3rd - delayed closure, ↑% infx and scarring

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16
Q

Skin Risk Factors labs (3)

A

Albumin < 3.5 mg/dL
Prealbumin < 19.5 mg/dL
Lymphtocye < 1800/mm3

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17
Q

Skin Assessment Factors (7)

PCSE-CSL

A 
Presense of foreign bodies
Condition of surrounding tissue
Spreading
Extent of Tissue involvement
Color
Size
Location
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18
Q

Skin S/S Infx Present (5)

A 
Fever
Exudate
WBC > 10k
↑ CRP
↑ ESR
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19
Q

Cellulitis

A

Deep skin infx 2ndary to infx in open wound

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20
Q

MRSA

A

Mild folliculitis -> Extensive Furuncles

↑% incidence in communal environments

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21
Q

Herpes 1 and 2

A

1 - recurring sores last for 3 - 10 days
contagious first 3 - 5 days, tingling/burning lip!
2 - genital, lol.

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22
Q

Autoinoculation

A

transfer from 1 viral type to another part of body

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23
Q

Herpetic Whitlow

A

Occurs on fingertips of medical personnel

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24
Q

Herpes Zoster (shingles) (3)

A

Follows a dermatome (Cervial Nerve Ending)
Dormant active
Ø midline

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25
Fungal Infx (2)
Dermatophyte - tinea, direct contact | Candida Albicans - vagina/mouth. In mouth, swish/swallow mystatin
26
Parasitic Infx (3)
Pediculosis - lice. S/S pruritis. c/w sprays, creams, changing bedding. Scabies - S/S curved/linear ridges. Common w/ poor hygiene/living. Tx scabicides/laundry Bedbugs - blood suckers. Tx topical antihistamines
27
Skin Lesion Configurations (9) ACCCC - U DSL!
``` annular - ringlike, raised borders circinate - circular circumscribed - well defined sharp borders clustered coalesced - merge w/ one another diffuse - widespread linear serpiginous - wavy borders universal - all body fx'ed. ```
28
Primary Lesions (7) MP N/T VPTW
``` Macule - color▲, Ø palpable Papule - circumscribed < 1 cm Nodule/Tumor - circumscribed, firm 2 cm Vesicle - serous fluid filled, < 1 cm Pustule - pus-filled Tumor - solid mass > 2 cm Wheal - irregular border ```
29
Secondary Lesions (5) C-FUSE
Erosion - Lost epidermis, moist, Ø bleeding Crust - dried blood Scale - skin flakes Fissue - linear crack Ulcer - Lost epidermis AND dermis w/ bleeding
30
Skin Color ▲'s (4) JPEC
Pallor - anemia/Ø blood flow Cyanosis - hypoxia, thrombocytopenia, bruising Jaundice - liver/RBC d/fx Ertthema - inflammation/vasodilation
31
Abnormal Skin ABC's
``` A - asymmetry B - Border irregularity C - color D - diameter E - Evolving ```
32
Benign Tumors (4) SKNC
Cysts - dent upon palpation Seborrheic Keratoses - scaly patches Keloids - scar overgrowth Nevi - moles
33
Actinic Keratosis are...?
Pre-malignant
34
Basal vs. Squamous cell carcinomas
Basal - mostly by UV and outter skin. Squamous - cancer in epidermis/can be metastatic. On ear, lip, and external genitalia.
35
Melanomas !!!'s (2)
> 6mm have doc check | Highly metastatic
36
Advanced Surgical Skin Managment
``` Crosurgery Electrodesiccation Excision Moh's for Basal Cell Carcinomas Wide Excisions ```
37
Dystrophic Nails reason
Clubbing b/c impaired gas exchange
38
Alopecia reasons (3)
Endocrine dz, ↓nutrition, male pattern baldness
39
Psoriasis
Autoimmune dz, 7x growth rate.
40
Psoriasis Big r/fs (4)
Infections - strep throat, candida, upper resp. infx Seasons - warm weather Hormones - puberty/menopause Medications - Lithium, BBlockers, Anti-malarials, Indocin
41
3 Types Psoriasis
Vulgaris - silvery white scaly Exfoliative - red severe inflammatory Palmoplantar - browned hyperkaratotic
42
Psoriasis Big 4 Medications
Topical Corticosteroids Topical Epidermopoiesis Suppresive Meds Tar Preparations Cytotoxic Meds
43
Topical Corticosteroid EFP | example, fx, precaution
Triamocinolone Acetonid (Kenalog) ↓ inflammatory response Ø face skin, asses for thinning/hypopigmentation
44
Topical Epidermopoiesis Suppresive Meds EFP
Calcipotriene (Dovenex) Mild - Moderate Psoriasis, ↓ epidermal development TERATOGENIC and r/in hypercalcemia
45
Tar Preperations EFP
Anthralin (Drithocreme, Lasan) ModeratePsoriasis, ↓ cell division/itching STOP Creams, STARTs Cancer, stains and smells!
46
Cytotoxic Meds EFP
Methotraxate (Trexal) Severe Psoriasis, ↓ epidermal turnover TERATOGENIC, also r/in sore throat, fever, bleeding, fatigue
47
Photochemotherapy and Ultraviolet Light (PUVA)
Methoxsalen (Uvadex) ↓ cell proliferation Report any extreme redness, swelling, long term aging fx.
48
Seborrheic Dermatitis | What? R/in 2? Tx 2? Report if 2?
Inflammation of areas w/ sebaceous glands. R/in papulopustules (oily) and flakes (dry) Topical Corticosteroids/Antiseborrheic Shampoos. Exacerbations/remissions
49
Pruritis 4 Tx
Cool environment Hygiene Antihistamines Topical Steroids
50
Braden Scale 7 Factors SPAMMNF
``` Sensory Perception Moisture Activity Mobility Nutrition Friction/Sheer ```
51
Pressure Ulcer 5 Stages
``` 1 - Intact, unblanchable redness 2- Non-intact w/ partial skin abrasian/blister 3 - full skin loss, subq visible 4 - full skin loss, bone/muscle visible 5 - eschar/slough ```
52
``` UlCcer Assessment (like skin) PCSE - CSL ```
Presence foreign body Condition surrounding tissue ...
53
NonSurgical Ulcer Tx's (4)
Dressing Whirlpool Drug Nutrition
54
Future is Now Ulcer Tx (5)
``` Electrical Vaccum Assisted Hyperbaric O2 (HBO) Topical Growth Skin Substitutes ```
55
Surgical Ulcer (2)
Debridement | Skin Grafting
56
S/S Organ Rejection
Tachycardia, fever, pain AST/ALT values ↓ (liver) Pigmentation/Diaphoresis
57
Hyper-Acute Transplant Rejeciton
Remove STAT | HLA Ø recognize object
58
Acute Transplant Rejection
1 - 3 months post-transplant | Tx immunosuppresants
59
Chronic Rejection
Scarring impedes organ fx
60
S/S Appendicitis
Pain epigastric/umbilical area that migrates to Mc.Burney's Point (R). Rebound tenderness. Appendectomy req.
61
Paracentesis, Colonoscopy, and Thoracentesis Procedure.
Paracentesis - trocar catheter removes fluid (r/t liver cirrhosis) Colonoscopy - camera up butt! Thoracentesis - aspiration of fluid in pleural space
62
Key findings of Abdomen Organ Trauma (3) CMM
Cullens - bruising around umbulicus (GI bleed) McBurney's - tenderness LQ (appendicitis) Murphy's - R side pain, increases w/ inspiration (Choli/gallblader)
63
Acute vs. Chronic Cholesystitis
Acute - Flatulence Blumberg's rebound tenderness Steatorrhea fatty stools R/in calculous (kidney stones) Chronic - Pancreatitis Jaundice & Icterus - yellow eyes Pruritis - b/c bile salts in skin R/in ↓motility, absorption
64
GERD CM | Cause, 2K M
Relaxed lower esosphincter and backward flow of stomach content (reflux esophagitis) Dyspepsia (heartburn) Waterbrash (hypersalivation)
65
GERD NonSurgical Management (4)
Diet Therapy Education Lifestyle changes (sleep head up, don't strain, smoke) Drug Therapy
66
GERD Drug Therapies (4) and EFPs
Antacids - Tums, Maalox, Mylanta. neutralize Ph > 3. Fx is Short! H2 Antagonists - Pepcid, Zantac, Tagamet. ↓ acid secretion. PPI - Prevacid, Prilosec. long acting ↓ acid secretion. ↓Ca and Protein absorption Prokinetics - Reglan. ↑ gastric emptying. Tardive dykensia
67
Gastritis Cause and Tx
``` Inflammation gastric mucosa (Acute/Chronic) b/c H. Pylori in Serum, Breath, and Stool Triple Therapy (H2, PPI, Antibiotics) ```
68
Cholecystitis | How to Dx and different lab S/S comparative (6)
S/S p eating fatty foods Lab changes ↑ WBC, AST, ALT, serum albumin, amylase and lipase (if pancreas involved)
69
Cirrhosis C3, labs S3 , assess S3
Extensive scarring of liver b/c inflammation Laennec - alcohol Postnecrotic - Viral Hep C or drugs Biliary - biliary obstrx ↑ Labs ALT, AST, LDH Ascites ↑ portal pressure Hepatic encephalopathy
70
Transjugular Intraheptatic Portosystemic Shunt Fx
Controsl long term ascites to ↓ variceal bleeding
71
NonSurgical Tx for Excessive Volume Cirrhosis (3)
Drug Therapy - BBlocker (propranolol) ↓ bleeding Gastric intubation - detect bleeding Esophagogastric ballon tamponade - controls bleeding by putting pressure on wound. Protects airway!
72
NO Liver Transplant is you have...? (5)
``` ♥ Dz Alcohol abuse/dependence Metastatic Cancer Respiratory Issues Refusal to follow up with Drug Therapy ```
73
Labs associated w/ Liver d/fx
``` ↑ ALT, AST, LDH, alkaline phosphates, serum bilirubin, urobilinogen ↓ serum protein, albumin, Hgb, Hct, WBCs Thrombocytopenia ↑ Creat. level = death close ↑ ammonia ```
74
Peptic Ulcers C2, S0, T5
H.Pylori infx r/in lesion in stomach/duodenum Pain relief H. Pylori eradications Ulcer Healing Recurrence prevention Education to avoid bedtime snacks, alcohol, and smoking
75
Ulcer Complications (4)
Hemorrhage (vomiting blood) Perforation <- life threatening!!! Pyloric Obstructx r/in vomitting Intractable dz - pt Ø manages and recurrence
76
GI Bleed High vs. Low
Melena | Frank Hematochezia
77
Labs for GI Bleeds (8)
``` CBC BUN Electrolytes PT/PTT ABGs Liver Enzymes (AST, ALT, ammonia) Blood Glucose H & H ```
78
Dx for GI Bleeds
Type and Cross | Endoscopy
79
Hiatal Hernia C1, Types2, Education?
Protrusion of stomach through hiatus in diaphragm Sliding = most common Rolling = intestinal torsion, reqs. surgical intervention Regular GI stuff... head elevated, no eating late, smoking, alcohol, etc.
80
Ulcerative Colitis C1, S4, T4 with EFØP
Inflammation of rectum/sigmoid colon 15 - 20 watery stools w/ blood/pus LLQ pain Pseudopolyps B12 Ø absorption (pernicious anemia) ``` Drug Therapy Salicylate compounds (5ASAs) Sulfasalzine ↓ inflammation Corticosteroids Prednisone ↓ exacerbations Immunosuppresants Humira ↓ immune response Antidiarrheal drug Lomotil, Imodium S/S tx ```
81
ONLY TRUE CURE FOR UC (& 3 types)
Colectomy Total permanent Total continent Total w/ stripping/ileoanal pouch
82
Crohn's Dz C1, S5, TØ
Inflammation/ulceration GI tract ``` Fistulas 5 watery stools w/ pus/musucs RLQ paint Steatorrhea - fatty stool Req. B12 injection ```
83
Labs betwwen UC and Crohns | 5↓ 6↑
↓ HH, Albumin, K, Mg, Ca ↑ ESR, WBC, Cprotein, Platelets, ↑pANCA (UC only) ↑ Antiglycan antibodies (Crohns only)
84
Diverticulitis C, S3, T
↑ pressure in intestinal lumen (usually asymptomatic) Pain LLQ, ab. distension, low fever Ø seeds n stuff
85
Pancreatis Fx on 2 labs
serum amylase and lipase ↑
86
Esophageal Varices C, S2, TØ (relation to exercise)
Distended esophageal veins r/in ↑ pressure straining exercise ↑% Bleeding (hemetemesis or melena) !!! LIFE THREATENING EMERGENCY
87
Bariatric/Cholecystectomy Precautions (4 ea)
``` Bariatric Notify if displacement Monitor for leak Ambulate asap 6 small meals ``` ``` Cholcystectomy Report ↑ drainage Monitor drainage Empty q8h Clamp q1-2h tp assess food tolerance ```
88
Labs r/t Enteral 3 and Parenteral 2 nutrition
Enteral - ↓Na, ↑K, and fluid overload | Parenteral - ↑Blood glucose, all electrolytes (Na/K imba common), ↑Ca
89
``` 7 Labs r/t Nutrition HH Albumin Squad C TL ```
Hgb - anemia, hemorrhage, hemodilution/concentration Hct - ↑ditto Serum albumin (3.5 - 4.0 mg/dL) - reflects previous weeks. Prealbumin (15 - 36 mg/dL) - most sensitive b/c 2 day HL (MOST ACCURATE) Transferrin - iron-transport protein. ↑ sensitivity to protein status. HL 8 - 10 days Cholesterol (160 - 220 mg/dL)) - ↓w/ malabsorption or malnutrition Total Lymphocyte Count - TLC < 1500/mm3 = malnourishment which = ↓immune fx
90
Nursing Interventions r/t restoral oral HP (3)
Hygiene q2h soft toothbrush Ø toothetes/foam brushes b/c Ø bacteria control Ø commerical mouthwash b/c alcohol and acidity
91
Stomatitis C1, Types2, Tx2
Inflammation oral cavity Primary - most common. includes cakers, herpes, and ulcers Secondary - b/c opportunistic fungi, bacteria Rinse mouth q2-3hours w/ baking soda/saline solution SLS toothpaste
92
Hep ABCDE
A - fecal self limiting. GI S/S. B - blood sex and needles. Whitlows! Nausea, fatigue. C - Continuation of B. Carrier! Asymptomatic for decades. D - Must have B. Needle sharers. E - waterborne, self limiting.
93
Labs fx'ed by ALL Hepatitis
AST/ALT
94
R/f for ↑% Cancer 4 Antigens of importance?!
↑Alpha-fetoprotein HepB and C Esophageal tumors Cancer of Liver (most common in the WOOOORLD!) Oncofetal antigens.
95
Diarrhea Organism Cause and Diagnostics 2
C. Diff | Stool culture and C.Diff test (enzyme-linked immunosorbent assay 'ELISA' results w/in 2-6 hrs
96
Jaundice main lab and r/t which organs 3.
↑Bilirubin b/c liver Ø excreting | Liver d/fx, cancer gall bladder, panceratiis
97
Peritonitis and Perforation | Cause/Symptoms
``` Peritonitis - acute inflammation of peritoneum ab. pain and fetal position. ↓ GI Perforation - ulcers sudden sharp pain that spreads ↑ GI SURGICAL EMERGENCY!!! ```
98
4 Hernias S/S for 1st two. 2 Dx and 1 Tx?
``` Sliding - eso up ♥burn,dysphagia, belching Rolling - stomach up Fullness, worse when recumbent Inguinal (Femora) and Umbilical ``` Barium swallow, Endoscopy. Nissen Fundoplication to prevent respiratory complication
99
Cirrhosis Early2, Late2r, Other3 Assessment
↑ wieght, pain Jaundice & liver issues Neuro changes, fetor hepaticus (fruity/musty breath), asterixis (tremors in wrists, hands, fingers)
100
Cirrhosis Lab changes ↑↓ | 7↑ 3↓ 1 Prolonged
↑ AST, ALT, ALP, LDH, bilirubin, ammonia, creatinine ↓ albumin, platelet, HH Prolonged PT/INR
101
Types Pancreatitis 3
Chronic - progressive destruction w/ remissions/exacerbations Acute - life threatening by premature activation of enzymes (autodigestion) Necrotizing Hemorrhagic - bleeding! r/in high fever
102
Pancreatitis Assessment 5 and how to Dx CT LABs
``` Cullens - perumbilical bluish grey Turners - Ecchymoses on flanks LUQ pain Ø bowel sounds Ascites ``` CatScan with Contrast
103
Pancreatis Labs
↑ amylase/lipase ↑ glucose ↑ liver enzymes ↓ calcium
104
Pancreatitis Pt education (4) PAIN
PERT Antiemetics Insulin therapy NPO early
105
Pancreatic Enzyme Replacement Therapy (PERT)
Administering enzymes w/ meals/glass of H2O. | Wipe lips after consuming.
106
Lungs place in pH defense. | Response to Respiratory Acidosis/Respiratory Alkalosis
2nd behind chemical buffers RAcid - ↑ RR/depth to ↓ CO2 and pH RAlk - ↓RR/depth to ↑ CO2 and pH
107
Smoking Calculations
(#years smoked) x (pks/day) = PACK years
108
Early/Late findings in declining Respiratory status
Early - tachy, restlessness, pallor | Late - brady, confusion/stupor, cyanosis
109
O2 Delivery Systems 7 (rates and key notes)
Nasal Cannula : 1 - 6 L. Fitting/Nasal patency Simple Facemask : 5 - 8 L. Moisture r/in breakdown Partial RBreather : 6 - 11 L. Deflation = ↓O2 Non RBreather : 80 - 95%. Suffocation if kinks.For unstable pts. Venti Mask : 4 - 10 L. For chronic lung dz. Tent/Collar : > 10L. For high humidity b/c thick secretions T- Piece : > 10L. For tracheostomy and other procedures.
110
COPD | 2 R/F, 3 Labs, 3 ABG fx
Primarily smoking, Alpha 1 antitrypsin (AAT) deficiency (genetic) ↑Hct, sputum for infx, electrolytes Hypoxemia for PaCO2 < 80mm Hypercarbia for PaCO2 > 45mm during attack Respiratory Acidosis
111
COPD Dx 3 and 2 Medications
Chest X-Ray for hyperinflation (late) PulseOx AAT Bronchodialtors and Anti-inflammatory
112
Cystic Fibrosis C1, SØ, Dx2
Genetic dz b/c error in chloride transport in lungs. | Dx with sweat chloride analysis and genetic testing
113
Cystic Fibrosis Interventions 4
Postural drainage Ø mechanical ventilation Heliox (50/50 oxy.helium Avoid direct contact b/c Burkholderia Cepacia (IGGY)
114
Emphysema and Chronic Bronchitis
Emphysema - loss in elasticity and hyperinflation. R/in dysnpea and ↑RR. Stretches alveoli and bullae. Chronic Bronchitis - inflammation r/t tobacco smoke. ONLY airways, not alveoli. Thick mucus and congestion
115
Sinusitis CST2 and Pharnygitis CSDx2
Frontal/Maxillary swelling b/c bacteroides. S/S similar to colds. Tx antibiotics, also Functional Endoscopic Sinus Surgery (FESS) Sore throat b/c Strep. Dysphagia. Rapid Antigen Test (RAT), results in 15 minutes. C&S
116
Upper Airway Infx Retropharyngeal Abscess Tonsilar Infx
Cause by Staph/MRSA Kids < 2 yrs old Usually unilateral
117
3 Types of Pneumonia
Bacterial Viral - most common Atypical - look @ labs CRP and CBC
118
Bronchoiolitis
Viral induced lower respiratory for kids
119
Aspiration pneumonitis
Older folks and (Myconeum) babies
120
Pneumonia Labs 5 and Dx 2
``` Sputum C&S CBC ABG Blood Culture Electrolytes ``` Chest X-Ray PulseIOx
121
Pneumonia Tx 3
Antibiotics Bronchodialators Anti-inflammatories
122
``` Myobacterium Tuberculosis (TB) Vector? Level communicable? 3 S/S Best Dx? Other Dx? ``` Similar infx?
Airborne High Persistent cough, night sweats, heoptysis (spitting up blood) Nucleic Acid Amplicification Test (NAAT) 2 hrs QuantiFeron GOLD (blood test) Acid-Fast Bacilli Smear/Culture Miliary TB blood Dz
123
TB Interventions PIE!!!
Combined Drug Therapy Pyrazinamide Isonazids Ethambutol
124
Pulmonary Empyema
Collection of pus in pleural space
125
Asthma Is it like COPD? Reason for S/S? Age? Cause?
Reversible airflow obstruction (contrary to COPD) Airway hyperresponsiveness None, Unknown
126
Asthma Classifications 4
Mild intermittent - < 2x a week Mild persistent - > 2x a week but Ødaily Moderate persistent - daily w/ exacerbations 2x a week Severe persistent - continuous w/ exacerbations FML
127
Bronchospams ...and Meds that trigger?
Narrowing of bronchial tubes b/c smooth muscle constriction in response to pollutants/viruses. Airway hyperresponsiveness. Triggered by Aspriin and NSAIDS b/c leukotrine
128
Asthma 1 Lab 3 Fx and other lab
PaCO2 Hypoxemia - ↓ PaCO2 < 80mm Hypocarbia - ↓ PaCO2 < 35mm early in attack Hypercarbia - ↑ PaCO2 > 45mm later in attack (Administer 1L O2) Eosinophils and IgE for allergic
129
Asthma Dx 2
Pulmonary Function Test (Ø smoking 4 - 6 hrs before test) | Chest XRay
130
Asthma Tx 3
Bronchodialators Short/Long acting B2 Agonist Cholinergic Agonists
131
Peak Flow Meter X used per day, X number times each use Green, Yellow, Red Zones?
2x a day/3 times per use Green = good control, 80% personal best Yellow = Caution. Have rescue med. Red = Med. Alert. Instruct to take med/seek med. attention
132
3 Pulmonary Fx Tests
Forced Vital Capacity (FVC) - full in/exhalation Forced Expiratory Volume in the 1st second (FEV1) - volume air blown out forcefully 1st second exhalation Peak Expiratory Flow Rate (PEFR) - fastest airflow rate during exhalation 15 - 20% < expected value is seen in asthmatics This % increases 12% when given bronchodialators
133
Status Asthmaticus
Life threatening acute episode of asthma
134
Inhaler Education 3
Inhale drug as long as possible Spacer helps Full inhalers sink to bottom
135
Trach Education 2
Too large r/in hypoxia | Fenestrated vs. Non Fenestrated - fenestrated allows pt to speak
136
Trach Interventions 5
Confirm breath sounds q2hrs Assess site qShift Keep pressure 14 - 20 mm Equipment left @ bedside for first 72 hours
137
Suctioning Complications 5 and follow-ups if(true)
Hypoxia, trauma, infx, vaginal stimulation, cardiac dysrhythmia (b/c hypoxia) ANY? STOP IMMEDIATELY and 100% O2
138
Chest Tube Nursing Focus and 3 Chamber of Secrets
Ensure Integrity of System 1 - collects fluid. tube must Ø touch liquid 2 - water seal prevents air from entering pt pleural space. 2 cm H2O. Add sterile H2O as needed. 3 - Suction control.
139
Chest Tube Assessment 3
Drainage, Leaks, Crepitus (SubQ emphysema)
140
Ranges: BUN Creatinine Blood Glucose Urine Specific Gravity
10 - 20 0.5 - 1.5 70 - 120 1.00 - 1.03
141
Ranges: ``` Na K Ca Mg P Cl ```
``` 135 - 145 3.5 - 5 9 - 10.5 1.3 - 2.1 3.0 - 4.5 98 - 106 ```
142
Ranges: T3 T4 HDL LDL
70 - 205 4 - 12 > 50 < 190
143
Ranges: WBC RBC HH Platelets
4k - 10k 4.6 - 5.5 13.4 - 15.5 / 39 - 49 140 -400
144
Ranges: ``` AST ALt ALP Amylase Bilirubin Albumin Ammonia ```
``` 5 - 40 8 - 20 30 - 120 56 - 90 0.1 - 1.0 3.5 - 5.0 15 - 110 ```

ABSN Cohort 19 (28 decks)

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