Test 2 Flashcards
Pleuritic pain can
Be pointed at!
Cardiac pain can
Not be pointed at!
S/S of Pulmonary Embolism
- SOB
- Acute Pleuritic chest pain
- Hemoptysis(coughing up blood)
- Cyanosis
- tachypnea
- Hypoxia
- Sudden death
Cystic Fibrosis
Genetic disease: causes thick mucus in respiratory and digestive tract
Mucus can cause life threatening respiratory infections
Pt.s usually know their disease well and should be utilized in Rx
Viral respiratory Infections
URI
Respiratory Flu
RAS must have constant supply of:
Oxygen
Glucose
Water
Glucose needs what to get in bloodstream?
Insulin
Oxygen and what is important and needs a constant supply of for the body?
Insulin
Pancreas does?
Produces insulin
Type one diabetes
Insulin dependent
Has a broken or damaged pancreas
Type two diabetes
Non-Insulin dependent
Most likely obese pt.’s
Poor dieting can create type two diabetes which can prob form type one diabetes
Hypoglycemia
Most common diabetes emergency
Low blood sugar
What causes hypoglycemia?
Takes too much insulin
Reduces sugar intake by not eating
Over exerts or over exercises
Vomits
S/S of hypoglycemia(any of them)
Pale, moist(clammy) skin Diaphoresis Dizziness, headache Rapid bounding pulse Slightly elevated BP Fainting, seizure, or coma Aggressive, lethargic or unusual behavior Hunger
Can stress raise the need for insulin
Yes
Low insulin equals
Hyperglycemia
Normal ranges for blood sugar
80-120
60-80 symptomatic diabetic
120 possible Hyperglycemia
Healing time for diabetics….
Take longer than usual
Do u give glucose to an unconscious pt. ?
No
Oral Glucose: generic, trade, actions, indications, contra, adverse effects, dose
Generic: glucose Trade: glucose, Insta-glucose Actions: increases blood sugar levels Indications: ALOC w/ diabetic history Contra: unconscious unable to swallow Adverse effects: none if given properly Dose: 1 tube
While at a diabetic call where the pt. just needed oral glucose what do you do before you leave?
Make sure she eats something
What are the 3 “P’s”?
Polyuria: frequent urination
Polydipsia: frequent drinking of liquid
Polyphagia: excessive eating(rare)
Ventilation Problems
- Upper/lower airway obstruction
- Chest wall Impairment
- Neurogenic Dysfunction
Examples of upper/lower airway obstruction
- Foreign body
- Edema
- Asthma
- Epiglottis
What usually causes chest wall impairment?
Trauma
Causes to Neurogenic Dysfunction?
- Depressant drugs
2. CVA
Diffusion problems
- Inadequate O2 in ambient air
- Alveolar pathology
- Interstitial space pathology
Reasons for Inadequate O2 in ambient air?
- Fire environment
2. Carbon Monoxide poisoning
What is some examples of alveolar pathology?
- Lung disease
2. Inhalation Injury
What are some examples of Interstitial space pathology?
- Pulmonary Edema (fluid in lungs)
2. Near Drowning
Ventilation means
Getting oxygen to lungs
Diffusion means
Getting oxygen to the blood
Perfusion means
Getting oxygen to tissue
Perfusion problems
- Inadequate blood vine or Hgb levels
- Impaired circulatory blood flow
- Capillary blood pathology
What can cause inadequate blood volume or Hgb levels?
- Shock
2. Anemia
What can cause impaired circulatory blood flow?
Pulmonary Embolism
What can cause capillary blood pathology?
Trauma (damaged capillaries)
S/S of SOB
- ALOC
- Tachycardia
- Bradycardia(especially in children)
- Changes in RR
- Changes in Respiratory Rhythm
- Changes in skin signs
- NBIOB
- Inability to speak in complete sentences
- Accessory muscle use
- Retractions
- Coughing
- Flared nostrils, and pursed lips
- What poison were they found in?
What are the general treatment guidelines?
- Focused history& physical exam
- Poison of comfort
- Give O2
- Airway management
- Transport ASAP
Assessments for respiratory problems
- ABC’s
- OPQRST
- Check for:
- JVD
- Accessory muscle use
- Lung sounds
- Abdominal discomfort/distention
- Pedal edema
The 4 Lung sounds
- Wheezes
- Crackles
- Rhonchi
- Stridor
Wheezes are….
High pitched sounds when air moves through narrowed passages
Crackles(rakles) are…..
Fine crackling or bubbling caused by fluid in alveoli
Rhonchi(lung butter) are….
Caused by secretions in the lower airway
Stridor is a ….
High pitched sound in upper airway often from partial obstruction
What is CPAP?
A special mask that blows pressurized O2 into lungs
What does CPAP do?
- Prevents alveoli from collapsing at end of exhalation
2. Pushes fluid back into capillaries
When do you use CPAP?
- When there is fluid in the lungs(drowning, pulmonary edema)
- Obstructive diseases(asthma, and COPD)
When do you not use CPAP?
- ALOC (need to protect own airway)
- Lack of respiratory drive (CPAP increases pressure but not respiratory rate)
- Inability to sit up
- Hypotension (systolic must be >90)
- Inability to maintain tight seal w/mask
- Vomiting
- Penetrating chest trauma
- Shock
- GI bleeding
What can pulmonary edema result from?
- Usually CHF
- Near drowning
- Smoke inhalation
- Toxic chemical inhalation
- Traumatic chest injuries
- Altitude illness