RRT Patient Evaluation Flashcards
If the ABG looks good but the patient looks and feels bad, think these three things in order.
CO poisoning
then Anemia
then Pulmonary Embolus
When examining ABG’s, look at ___ first because that’s the most important thing.
If there’s an abnormal PCO2 but a normal pH and the patient is a COPD’er, should you make vent changes?
PCO2
No don’t make vent changes.
A normal respiratory quotent (amount of CO2 produced) is ___.
A diet for COPD’ers should include foods high in ___. Alternatively you could also give them foods high in ___. Avoid foods high in ___.
0.8
Best: Fats
Second best: Proteins
Avoid: Carbohydrates (Produces most CO2 to digest.)
If you have an emergency, don’t seek to prove it. Instead, ___ and ___.
Suspect and treat.
In pulmonary embolus patients, give ___. Also give analgesics to relieve ___. To maintain circulation, give ___ or ___. ALso give thrombolytic agents such as ___ or ___.
Low dose heparin Chest Pain Digitalis or Digoxin Urokinase or streptokinase (NPS)
To treat pulmonary embolus, give ___% FiO2. Get an ___ and ___ test, as well as a spiral CT.
100%
ABG and coagulation test (NPS)
What four drugs can you give for TB?
INH, Rifampin, Ethambutol, and Streptomycin. (NPS)
HIV patients may have ___. You will have to order a ___ to test for this because it can’t grow outside the body.
Pneumocystis Carinii / Jerovecii.
Bronchoscopy
Burn victims, smoke inhalation victims, and CO poisoning victims: Intubate these patients. Also consider ___ for severe cases. Set FiO2 at ___. Upstairs these patients should have a ___ room. Patient may require ___ to clear mucus plugs and evaluate airway.
Hyperbaric chamber
100%
Isolation
Bronchoscopy
Cold water drowning victims should be reheated with ___. Also a heated lavage of gastric intrathoracic pericardial and peritoneal spaces may be considered. To not reheat hypothermia patients faster than ___.
Heated IV solutions
No faster than a few degrees per hour
What patients should get an ELISA test?
Suspected HIV patients
Any reading with a “v”, such as CvO2, is associated with ___. (Not venous or flow)
Cardiac output
Swan-Ganz is inserted through a ___ with the baloon (Inflated or deflated). Then it’s advanced through the ___ and into the ___. When the Swan-Ganz reaches ___, it’s in the correct position.
Central vein Deflated Inferior Vena Cava R Atrium 50 cm
The best location for a Swan-Ganz catheter is in the ___ with the balloon deflated. The Swan-Ganz will now detect ___. When the balloon is inflated, it will detect ___.
Pulmonary Artery
PAP
Wedge Pressure
Mixed blood samples are best drawn from the ___. When getting a mixed blood sample, the balloon should be (inflated or deflated).
Pulmonary Artery.
Deflated
When ___ cm of catheter is inserted, you should read pressures from the ___. If not, the catheter is probably curled up in the ___. If this happens, (inflate or deflate) the balloon and withdraw it.
50
Pulmonary Artery
Heart (R atrium or R ventricle)
Deflate
The waveform seen from a Swan-Ganz looks tall with a little notch on top. This indicates the catheter is in the ___.
If it’s tall with no notch, the catheter is in the ___.
If it’s short with no notch and pressures are low, you’re in the ___.
If they’re around 10-15 with no notch, you should ___.
Pulmonary Artery
Right ventricle
Right atrium
Pull it back a little bit.
If there is movement of the PA catheter, the first thing you want to do is check the ___.
PAP waveform
