Karteikarten
Adult Health 2 Final
Karten in diesem Stapel (27)
- 1Signs/sx of MISub-sternal pain/pressure radiating to L arm
Pain/discomfort in jaw, back, abd., or shoulder
Happens without cause
Relieved only by opiods
>30 minutes
WOMEN: ATYPICAL ANGINA - 2What hemodynamic changes occur with septic shock?Hypodynamic changes in early sepsis and shock.
SEVERE: hyperdynamic: ^HR, ^stroke volume, normal CVP. Progression to DIC->Clots, ischemia, and hypoxia - 3Superficial BurnPink-red
Mild Edema
Painful
No blisters, eschars, or grafting
3-6days
{Sun burn, flash burn} - 4Superficial partial-thickness burnpink-red
mild-moderate edema
Painful
Blisters
No Eschar
2 weeks to heal
No grafts
{ Scald, flames, brief contact with hot objects} - 5Deep-partial thickness burnRed- white
Moderate edema
Painful
Blisters rare
soft and dry eschar
2-6wk healing
Grafts for prolonged healing
{scalds, flames, prolonged contact with hot objects, tar, grease, chemicals} - 6Full-ThicknessBlack, brown, yellow, white, red
Severe edema
Blisters but not always
hard and inelastic eschar
weeks-months for healing
Grafting necessary
{Scalds, flames, prolonged contact with hot objects, tar, grease, chemicals, and electricity} - 7Deep-full thickness burnsBlack
No edema, Absent pain
No blisters
Hard and inelastic eschar
Weeks-months with grafts to heal
Flames, electricity, grease, tar, chemicals - 8fluid resuscitation for burnsStart and maintain large bore IV in area of intact skin
Talk with Drs to determine fluid type and total volume for first 24hrs
Give one half of total 24hr volume in first 8hrs(from time of burn) and the rest over 16hrs
qhr check: IV site, infusion rate, and infused volume, VS, breath sounds, voice, o2sat, and end-tidal carbon dioxide levels, urine output, protienuria, watch for FVE - 9Parkland FormulaCrystalloid (LR) 4ml/kg/% TBSA burn
- 10Early Shockbaseline MAP is <5-10mmHG
^sympathetic stimulation: mild vasoconstriction, ^HR
slight increase in diastolic - 11SEPSIS WITH SIRSTemp >100.4 or <96.8
HR>90/min
RR > 20/min or Paco2 <32mmHG
WBC: >12k/mm3 or <4k/mm3 or >10%segs or >10%bands
Septic if 2+SIRS criteria with any infection or one or more of these: - 12Med TX during Hyperdynamic phase of shockVasoconstrictors to to improve blood flow, ^venous return to hearn, and improving contractility
Inotropic agents to stimulate adrenergic receptor sites on heart muscles improving heart muscle contraction[Caution-increase in heart o2 consumption]
Sodium nitroprusside to improve blood flow to hear by dilating coronary arteries[ watch for systemic hypotension] - 13HemoglobinW: 12-16g/dl
M: 14-18 g/dL - 14HematocritW: 37-47%
M: 42-52% - 15Urea Nitrogen10-20mm/dl
- 16Glucose70-105mg/dL
- 17Sodium136-145mEq/L
- 18Potassium3.5-5
- 19Chloride98-106
- 20PaO280-100mm/Hg
- 21PaCo235-45mmHg
- 22pH7.35-7.45
- 23Carboxyhemoglobin0-10%
- 24Total Protein6.4-8.3g/dL
- 25Albumin3.5-5g/dL
- 26cholelithiasis key featuresEpisodic/vague upper abd. pain/discomfort that can radiate to the R shoulder
Pain triggered by high-fat/high-volume meal
Anorexia
N&V
Dyspepsia
Eructation
Flatulance
Feeling of abd. fullness
Rebound tenderness (Blumbergs sign)
Fever
Jaundince, clay-colored stools, dark urine, statorrhea (Most common with chronic cholecystit) - 27ThoracentesisTell pt to expect stinging and explain imporatance of not moving
Wear goggles and masks to prevent splashing
Cleanse skin with antiseptic before local anesthesia
Monitor for shock, pain, nausea, pallor, diaphoresis, cyanosis, tachypnea, dyspnea.
After procedure apply pressure et monitor for pneumothorax et mediastinal shift