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213 > Unit 2 Study Guide > Flashcards

Unit 2 Study Guide Flashcards

1
Q

ARDS risk factors

A

Direct lung injury, indirect lung injury.

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2
Q

ARDS direct lung injury example

A

Aspiration,chest trauma, pneumonia,pulmonary contusions, inhalation injury,PE

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3
Q

ARDS indirect lung injury

A

Sepsis, shock, pancreatitis,burn, multiple blood transfusions, cardio bypass, drug/ alcohol overdoses.

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4
Q

Can ARDS be reversed

A

Some lung damage may heal over long time but not all and not always

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5
Q

ARDS clinical manifestation

A

Dyspnea,tachycardia, crackles in lungs, from non cardiac pulmonary edema, REFRACTORY HYPXEMIA, deteriorating ABG level, bilateral pulmonary infiltrate.

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6
Q

What is refractory hypoxemia

A

Hypoxemia that does not improve with 100% o2 . Major indication of ARDS

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7
Q

What is pulmonary infiltrate

A

Fluid\mucus/blood in lungs. Looks “cloudy white” on XR. Bilateral PI indicates ARDS

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8
Q

ARDS complications

A

Barotrauma, renal failure, multi system dysfunction system, ventalator associated pneumonia

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9
Q

Two types of ARF

A

Hypoxemia, captneia.

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10
Q

Risk factors for hypoxemia in ARF

A

Pulmonary edema. Pneumonia, PE

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11
Q

Risk factors for capnea ARF

A

Asthma, narcan, myasthenia gravis

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12
Q

Early ARF symptoms

A

Dyspnea, restlessness, anxiety,fatigue, increased BP, tachycardia, tachypenea,

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13
Q

Intermediate ARF symptoms

A

Confusion, lethargy, pink skin

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14
Q

Late ARF symptoms

A

Cyanosis, coma,

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15
Q

ARF complications

A

Cardiac failure. Organ failure, death

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16
Q

ARF hypoxemia pathophysiology

A

Two possible scenarios. Either air is able to reach lungs but blood is unable to reach aveoli to exchange gas; or blood is able to reach lungs but air can’t reach aveoli

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17
Q

Describe low V/Q

A

Aveoli is perfused with blood but air is unable to reach aveoli to exchange gas

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18
Q

Describe high V/Q

A

Air may reach aveoli but blood is unable to reach aveoli to exchange gas.

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19
Q

Hypercapnic respiratory failure pathophysiology

A

Lungs cannot adequately expand (hypovenalate). CO2 is not able to be released. Hypercarbia eventually leads to hypoxemia

20
Q

ARF DIAGNOSTIC TESTING

A

ABG
Hypoxemia cause >7.45 PH, PACO2 low
Hypercapnea cause respiratory acidosis <7.35 ph PACO2 high
CXR
CT scan

21
Q

ARF NURSING INTERVENTIONS

A

Administer oxygen with humidity
Position patient with good lung downs
Chest physiotherapy and suctioning
Prepare ventilation support

22
Q

3 ARDS phases

A

Exudative, proliferatove, fibrotic

23
Q

Exudative phase

A

Occurs 24-48 hrs after injury, inflammatory mediator activated, disruption of alveolar capillary membrane, fluid moves from capillaries into interstitial space

24
Q

ARDS proliferation phase

A

Fluid fills aveoli, edema results in severe V/Q mismatch, pulmonary hypertension develops, hypoxemia, right side heart failure, lungs become stiff.

25
Q

Fibrotic phase

A

Pulmonary HTn worsens, defuse fibrosis and scaring, severe tissue hypoxia and lactic acid

26
Q

What is barotrauma

A

Sudden change in air or water pressure in body.

27
Q

Barotrauma pulmonary symptoms and causes

A

Symptoms, chest pain, sob, bloody nose, bloody mouth.
Mechanical ventilation increases alveolar pressure and can cause shifts in pressure.

28
Q

ARDS treatment

A

Mechanical ventilation is primary treatment for refractory hypoxemia.
ECMO:pump that circulates blood through artificial lung.

29
Q

Neuromuscular blocks used in ARDS

A

Vecuronium, succinylcholine

30
Q

ARDS medication

A

Antibiotics, corticosteroids, neuromuscular blocking agents, hydration,enteral and parental nutrition.

31
Q

Hepatitis patient symptoms

A

abdominal pain, irritability, pruritus (itching of the skin), malaise, fever, nausea, vomiting, jaundice (yellowish skin color)

32
Q

hepatitis lab values

A

elevated liver enzymes (aspartate aminotransferase- [A S T] and alanine transaminase [A L T]), elevated bilirubin (total and direct), elevated serum ammonia, and decreased albumin

33
Q

hepatitis client education

A

Handwashing, Eat low fat high carb diet, personal hygeine products no share, activity conservation, toxins to avoid, individual bathroom, test results, interferon injections, small frequent meals.

34
Q

toxcins to avoid hepatitis

A

alchohol, sedatives, asprin, acetaminophen

35
Q

hepatitis treatment.

A

Oral anti-viral medication, pegylated sub q injections, vaccines for A and B.

36
Q

hepatitis diagnosis

A

Alanine aminotransferase (ALT)
Aspartate aminotransferase (AST)
Alkaline phosphatase (ALP)
Gamma-glutamyltransferase (GGT)
Lactic dehydrogenase (LDH)
PT/INR, PTT
Serum bilirubin
Serum albumin
Liver biopsy

37
Q

cirrhosis clinical manifestations

A

Shortness of breath
Jaundice
Increased abdominal girth
Abdominal pain and bloating
Enlarged spleen
Elevated liver enzymes
Increased risk of bleeding
Thrombocytopenia
Prolonged P T
Hemorrhoids
Elevated serum ammonia levels
Changes in level of consciousness
Changes in motor function
Hyponatremia

38
Q

Lab diagnosis for cirrhosis

A

Liver enzymes
AST, ALT,ALP
Albumin
PTT, PT/INR
Platelets
Bilirubin
Alpha-fetaprotein (AFP)
Ammonia

39
Q

diagnostic test for cirrhosis

A

CT, EGD, Liver biopsy, ERCP

40
Q

acute pancreatitis nursing interventions

A

Maintain NPO status
NGT to low sxn
Administer ordered meds
Analgesics
Antiemetics
Histamine blockers
Sedatives/Anti-anxieties
Promote bedrest
Semi-fowler’s
Fetal
Encourage coughing & deep breathing

40
Q

cirrhosis client education

A

No alcohol intake
Educate about medications metabolized in liver
Seek routine care
Consume adequate calories to minimize weight loss
Minimize risk of bleeding

40
Q

cirrhosis nursing interventions

A

Administer medications as ordered
Electrolyte replacement
Restrict protein intake
Elevate HOB and legs
Administer blood products
Promote rest periods

41
Q

acute pancreatitis treatment

A

NPO status
IV fluid
NS or LR
ICU level care, if other organs involved
Treat cause of pancreatitis

42
Q

acute pancreatitis clinical manifestations

A

L U Q epigastric pain
Deep and sharp
More intense when eating fatty food
Abdominal fullness
Gas, bloating
Hiccups, indigestion
Fever
Tachycardia
Hypotension

43
Q

normal urin finding in acute pancreatitis.

A

Higher lipase and amylase in urin

44
Q

labs for pancreatitius

A

Amylase (elevated)
Lipase (elevated)
Alkaline phosphate (elevated)
Bilirubin (elevated)
Glucose (elevated d/t lack of insulin)

45
Q

scans for pancreatitis

A

Abd CT
US
ERCP

213 (6 decks)

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