Sesak Flashcards

1
Q

pasien datang dengan KU sesak, apa penyebabnya?

A
  1. ec Cardio
  2. ec Respiratory
  3. ec Other: metabolic acidosis, anemia, ARDS, poisoning, Anafilaksis
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2
Q

px penunjang yg dibutuhkan pada pasien sesak

A
  1. EKG
  2. CXR
  3. blood glucose
  4. AGD
  5. others: FBC, renal panels, troponin
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3
Q

apa saja penyebab sesak dengan kondisi life-threatening?

A
  1. obstruksi airway (upper)
  2. Tension pneumothorax
  3. Acute respiratory failure
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4
Q

prinsip manajemen pada pasien dengan KU sesak?

A
  1. eksklusi-kan dan tangani 3 life-threatening condition
  2. pasang monitor
  3. secure airway
  4. suplementasi O2 atau VTP non-invasive
  5. akses IV
  6. tangani penyebab dasar sesak
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5
Q

dd/ sesak ec cardiac

A
  • ALO/ gagal jantung
  • ACS
  • arritmia
  • Cardiac tamponade
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6
Q

dd/ sesak ec respirasi

A
  • pneumonia
  • PPOK
  • asma
  • efusi pleura
  • emboli paru
  • pneumothorax
  • chest trauma
  • upper airway obstruction (angioedem, aspirasi)
  • tenggelam
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7
Q

dd/ sesak ec metabolik

A
  1. asidosis metabolik:
    - KAD
    - uremia
    - poisoning
    - acidosis lactat
  2. anemia
  3. anafilaksis
  4. demam
  5. ARDS
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8
Q

pendekatan pada pasien dengan distress napas

A
  1. airway obstruction?
  2. breathing
    2a. pneumothorax?
    2b. Wheezing - SABA
    2c. Rhonki - nitrat dan furosemide
  3. ventilasi mekanik?
  4. diagnosis definitif = Tetep Civil
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9
Q

mnemonic Tetep Civil? Dd/ dyspnea (respiratory)

A

Trauma dada
Tractus respiratory
Parenkim hilang
Collapse pulmo
Vascular pulmo
Lainnya

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10
Q

apa perbedaan sesak kardiogenik dan respiratorik

A

kardiogenik:
- sesak saat aktivitas; orthopneu
- nyeri dada (menjalar)
- edem tungkai
- jvp meningkat

respiratorik:
- sesak tiba2/ bertahap
- nyeri dada pleuritik
- batuk

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11
Q

ARDS adalah

A

kumpulan gejala gangguan pernapasan akut akibat hipoksemia yang disebabkan kerusakan paru (inflamasi/infiltrat/etc)

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12
Q

indikasi ventilasi mekanik?

A
  • apneu
  • respiratory distress: hipoksemia, hiperkarbia,&raquo_space; WOB, takipnea, cyanosis
  • GCS <8
  • airway/respiratory comprimise: facial, neck and chest injury
  • persistent or refractory hypotension
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13
Q

manajemen ARDS (5P)

A

perfusion, positioning, protective lung ventilation, protocol weaning, and preventing complications.

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14
Q

manifestasi klinis gagal jantung akut

A
  • sesak yang memberat saat aktivitas
  • onset <2 minggu
  • Rh basah basal +
  • Ro: batwing appearance, kerley b line
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15
Q

manifestasi klinis gagal jantung kronik

A
  • sesak saat aktivitas
  • onset >2 minggu
  • DOE, PND, orthopneu
  • Rh +
  • edem tungkai
  • asites
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16
Q

treatment gagal jantung akut

A

POLMON
1. posisi semifowler
2. O2
3. Lasik/ furosemide iv
4. morfin atau ISDN

hati2: hipotensi

17
Q

treatment gagal jantung kronis

A
  1. furosemide
  2. ACEI/ARB
18
Q

Terapi eksaserbasi asma

A
  1. O2
  2. Saba = salbutamol (ventolin= albuterol) diulang 3x dalam 1 jam
  3. Saba + sama( ipratropium bromida) -> combivent
  4. Inhalasi corticosteroid = budesonide (pulmicort)
  5. Metilxantin (aminofilin)
  6. Epinefrin inhalasi
19
Q

derajat eksaserbasi asma

A

ringan
sedang
berat