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Med Surg II > test two > Flashcards

test two Flashcards

1
Q

Which vent. is this?
most commonly used, preset volume or a preset pressure for each breath , Patient can trigger a breath or the breath can be time triggered

A

assist control (a/c)

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2
Q

Which vent. is this?

set volume or pressure, pt initiates breaths, if not vent will breath at low set rate, some assisted, some not

A

SIMV

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3
Q

Which vent is this?
Requires stable respiratory effort from patient, does not control the rate or tidal volume, not triggered unless patient breathes above the VE (mandatory rate)
Ventilator senses (-) pressure on inspiration supports the patient-initiated breath
-assists spontaneous breathing

A

Pressure Support (usually used with SIMV for spontaneous breaths)

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4
Q

Which vent is this?
Clinician sets rate and pressure, tidal volume is allowed to vary, Usually reserved for patients with noncompliant lungs, difficult to ventilate and oxygenate, used when pt can’t breath at all (respiratory failure)

A

Pressure Controlled Ventilation (PCV)

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5
Q

What does V/Q stand for?

A

ventilation/perfusion

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6
Q

What is a normal V/Q ratio?

A

0.8 (4:5)

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7
Q

What is pulmonary shunting? What is the V/Q ratio? Causes?

s/s?

A

blood but no air, blood returns to L heart deoxygenated
<0.8
-caused by hypoventilation, obstruction
-s/s cough, crackles, distended neck veins, hypotension

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8
Q

What is dead space? What is the V/Q ratio? Causes?

A

air but no blood
> 0.8
-occurs from decreased CO, PE, or pneumothorax

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9
Q

Pt with PE at first… (ABG values, PaO2, PaCo2, pH) then…

A

at first high PaO2, low Co2, high pH (resp. alk, hyperventilation)
then.. low O2, high Co2, low pH (resp. and metabolic acidosis)

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10
Q

What is the gold standard for PE diagnosis?

A

CTPA, CT angiogram, spiral CT scan (pt receives dye)

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11
Q

How should you position a dead space pt?

A

pt should lay down to increase perfusion

-if pneumonia, lie good side down

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12
Q

How should you position in pt with shunting?

A

sit up! (CPOD pt)

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13
Q

_____ is an overreaction to a problem (bad pneumonia), decreased perfusion and ventilation, happens fast, lungs fill with fluid

A

ARDS!

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14
Q

What do you do when pt has low perfusion and low ventilation?

A

intubate! it’s acute respiratory failure, can be from shunting

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15
Q

ARDS can lead to…

A

pulmonary edema

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16
Q

In pulmonary edema you want to treat…

A

the cause! find the source, treat s/s but find the cause, reduce inflammation

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17
Q

Pulmonary edema can lead to..

A

pulmonary effusion

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18
Q

Notify MD if chest tubes drain more than ….

A

200 mL/hr!

19
Q

What is the normal value for CK/CKMB? peaks?

A

occurs within hours and peaks at 18 hrs after MI
-CK: 30-170
CKMB: 0-5% of total CK

20
Q

What is the normal value for troponin I? peaks?

A

<0.03

-increases in 4-6 hours

21
Q

What is the normal value for myoglobin? peaks?

A

<90

30mins – 2hrs

22
Q

What is the normal value for total lipids?

A

400-1000

23
Q

What is the normal value for cholesterol?

A

122-200

24
Q

What is the normal for HDLs?

A

> 50

25
Q

What is the normal range for LDLs?

A

60-180

26
Q
  1. The nurse is working with parents of a seriously ill client. Surgery has been purposed for the client, but chances of cusses are unclear. In helping parent resolve the ethical problem…
A

Collecting all available information

27
Q

A document that lists the medical treatment a person chooses to refuse if unable to make the decision is the

A

advanced directives

28
Q

Which action should not be used to monitor the effects of an acute stressor on a hospitalized pt.

A

Assess for bradycardia

29
Q

The nurse assess a postoperative patient who is receiving PCA. Which information is most important to report to the health care provider

A

The patient’s respiratory rate is 10 breaths/minute (ABC)

30
Q

Which illness is the client’s history would alert the nurse to the possibility of an abnormality of the heart valves?

A

Rheumatic fever

31
Q

RA nurse is monitoring a pt undergoing exercise electrocardiography (stress test) which assessment finding necessitates the test be stopped

A

The ECG indicates ST segment depression

32
Q

What will the nurse administer to pt with SVT?

A

Diltiazem (cardizem)

33
Q

A pt’s ECG tracing shows a run of sustained ventricular tachycardia. What is the first action that the nurse will take?

A

Assess the pt’s airway, circulation, and LOC

34
Q

A nurse is caring for a pt with second-degree AV block type II. Which is the nurse’s priority intervention

A

Prophylactic pacing

35
Q

How will the nurse intervene for the pt with ventricular fibrillation?

A

Carry out defibrillation (V. fib you D.fib)

36
Q

Which client is most at risk for developing left sided HF?

A

Middle aged women with aortic stenosis

37
Q

A pt has been admitted to the ICU with worsening pulmonary manifestations of heart failure. Which primary collaborative intervention should the nurse perform?

A

administer loop diuretics

38
Q

A pt is preparing to be discharged home following mitral valve replacement. Which statement indicates that the pt requires further education?

A

I will have my teeth cleaned…

39
Q

Which condition would the pt not experience with left sided HF?

A

Pulmonary hypertension (you can’t feel it, it’s a medical diagnosis)

40
Q

For which manifestations of myocardial infarction should the nurse monitor in the older adult.

A

Disorientation or confusion

41
Q

The nurse monitors for which clinical manifestation of poor organ perfusion in the pt with left vent. Failure secondary to MI?

A

Urine output of less than 30 mL/hr

42
Q

The nurse correlates which rationale with the administration of aspirin to the pt experiencing angina-like chest pain?

A

Inhibition of platelet aggregation and clot formation

43
Q

A pt brought to the emergency room has been diagnosed with MI and is ordered thrombolytic therapy with retaplase. The nurse correlates which rationale with the administration of this medication?

A

Restoring perfusion to the injured area, reducing the size of the infarct

44
Q

A pt with a history of heart failure is being discharged. Which instruction will assist the pt in the prevention of complications associated with heart failure

A

Weigh yourself daily wearing the same amount of clothing

Med Surg II (5 decks)

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