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Terms Definitions
pH 7.35-7.45
PD catheter Tenckhoff
CO2 (acid) alkalosis
CCRT length 24 hrs
Heparin antidote Protamine Sulfate
PaO2 50% ARDS
Classic finding prerenal AKI. Oliguria
3 Phases of ALI ExudativeFibroproliferativeResolution
Needle aspiration, thoracentesis, small catheter c flutter valve & chest tube insertion with use of low suction are all treatments for what? Pneumothorax
Type so fburns thermalchemicalelectrical radiation
Long term dialysis access AV fistula
Drugs to improve cardiac output Pressors
Strongest independent variable to increase a stay in the hospital. Reversible and acute mental state. May be hospital acquired. Delirium
48-72 hrs post burn Resuscitative stage
Why do we debride burns? Bacteria
A burn with redness,pain,edema,nausea and vomiting, diarrhea, fatigue, a headache, fever, blood problems, and gi later... radiation
Perianal ecchymosis, pain on palpation, rocking of iliac crests, loweer limb persis or hypoesthesia, hematuria Pelvic fracture
Labs on donor pt Q 2-4 hr
Penetrating injuries cause this type of pneumothorax. Open
this may be present post-extubation due to inflammation caused by tube irritation to the trachea Stridor
Medication used in intercostal nerve block Lidocaine
Lung compliance is increased with _____. COPD
Which blood pressure medicine causes angiodema? ARB
If hypotension persists with crystalloid infusion... ..give blood
Used for anticoag in dialysis (2) heparintrisodium citrate
What can insertion site infection in PD turn into? Peritonitis
Other Tx for DIC Recombinant human protein CAntithrombin III
Care of pelvic fracture Control hemorrhage, stabilize, immediate surgey
Tx for hemothorax 1 or more chest tubes
Initial specific Dx test for PE V/Q scan
Steps for intubation 1. Sedation2. Intubation3. Ambubag4. Auscultation5. Secure tube6. Xray confirmation
What psych issue can burn patients have? PTSD
Patient inhales a radiolabeled gas and air mixture. Ventilation
Direct contact with acidic or basic compound, bleach, anhydrous ammonia or industrial chemicals causes this kind of burn. Chemical
What CXR finding does ALI have? white out
Paradoxical movement of thoracic wall when patient breathes Flail chest
Where should you contain glass, bullets, nails, paint chips, fiber, and soil? PAPER ENVELOPE
What is azotemia? Elevation of BUN and Creatnine
What is rhabdomylosis? Rhabdomylosis is myoglobin being forced out of the muscle cells in relation to strenuous exercise, crush injuries, and any trauma of skeletal muscle.
What is bad about synthetic fabrics? highly flammable
What assists the regional distibution of renal blood flow? intrarenal prostaglandins
What is a transplant between two different genetically diff people... allografts
This is 1% of acute hospital admits, complicates 7% of episodes, inc. mortality rate of critical patients. AKI
Signs indicating some type of internal hemorrhaging Cullen'sGray-Turner's Kehr's
With these injuries we worry about life-threatening hemorrhage, hemodynamic instability, coagulopathies, acidosis and hyperthermia. Liver injuries
Collected in a sterile manner if suctioned via ET or trach. Sputum Collection
Within 72 hours of insult chemicals are released that cause injury to what? Pulmonary Capillaries
This allows you to visualize bony structures; organs such as lung & heart, fluid & foreign objects. Chest Xray
A clot (blood or other matter) that occurs in body and travels through venous circulation to the pulmonary circulation and partially or completely occludes a pulmonary artery. PE
Elastic property of lung & airflow resistance . Lung compliance
Necessary Tx for full thickness burns Debridement & grafting
What is the pressure exerted by proteins,primarily albumin? oncotic pressure
This stage of ED trauma is immediate treatment with threat to life/limb/and vision? emergent
What should you collect hair evidence in? paper envelope
Heat related comatose, low bp, tachy, hot and flushed, and core temp is greater than 105 heat stroke
What is the significance of tongue lacerations? seizure activity
When internal filtering structures are affected by ischemia. Acute Tubular Necrosis (ATN)
2 most common causes acute pancreatitis Alcoholism (men)Gall stones (women)
Care of donor site Cover with tegaderm, acticoat or xeroform & remove edges as they come up
This B2 agonist is delivered SQ or IV and is also used to stop preterm labor terbutaline
In Hemothorax PaO2 is_____, PaCO2 is _______ and pH is _______. decreased, increased, low
Tx suppressed blink reflex Artificial tears/lacrilube. Tape eyes close with clear tape
Important nursing intervention c fractured ribs Bronchial hygiene (coughing, deep breathing, sighing)
Full thickness burns there is a problem if it is _________. Circumferential (compartment syndrome)
Chichi? Providing care at the end of life that is unnecessary.
What is the normal BUN for males and females? 10-20
What does albumin and protein value look like with nephrotic syndome? Hypoalbuminemia and proteinuria
What is endoscopic ligation and injection used for and how? GI Bleeds...sclerosing agent..burns down bleeding...sealant agent...fibrinogen glue..and clip off bleed...want to make a scar to stop bleed
What percentage of TBSA of a burn causes systemic response? > 25%
How long does a kidney have for surgery with renal vascular surgery? 24 hours
When is cultured epitheleal autografting used? To close massive burn wounds
Heat related depletion of na due to excess sweating which causes dehydration. Headache, dizzy, nausea, weakness, mild hypotension, and cool, clammy skin.. heat exhaustion
What step of triage process relates to the incident command system. This coordinates efforts among all that respond. Response plan
Insert needle through abdomen and draw back fluid. If clear, no hemorrhage in abd cavity. (negative) Diagnostic peritoneal lavage (DPL)
This type of ventilation has a preset tidal volume/pressure and a preset minimum breaths/minute but the patient can change the RR and pattern of breathing. AC (Assist Control)
With this type of ventilation the patient has to be able to initiate the breath. You use this right before you are ready to extubate. Pressure support ventilation (PS)
What surgery may be used for a PE pt with massive PE or decompensating? Embolectomy
Drug class on which pts must be ventilated Neuromuscular blocking agents
Do you want to keep a burn wound dry or moist? Moist
What can smoke poisoning result in and what can it cause? Edema,sloughing, tracheobronchitis, and inflammation..ARDS
What test is performed on an abdominal injury that involves infusing saline into a catheter and allowing it to drain via gravity and then evaluated? Diagnostic peritoneal lavage
What are the three things assessed during START? RPM
respirations > 30
pulse- radial...have bp 80 sysy
mental stat: command following
This full thickness burn has damage throughout the dermis and has eschar which is painless. The surrounding skin hurts. 3rd degree full thickness
What does vassopressin do? increases blood pressure and is given for V FIB
What do h2 agonists do? The decrease volume and concentration of gastric secretions.
Should you give pain medication to a client with a head injury and decreased blood pressure? very careful
What fluid changes can happen with AKI? 3rd spacing, hypotension; monitor preload (CVP)
Patients will feel more in control and family will feel more useful if you let them do what? Be involved with care.
Systemic process that is considered to be the pulmonary manifestation of MODS. Acute Lung Injury (ALI) (ARDS)
Hallmark signs of Acute Respiratory Failure Hypoxemia (PaO2 Hypercapnia (PaCO2 >50 - can be present but does not have to be)
If epinephrine is in a medication you are giving for a wound injury, what parts of the body should you avoid? digits, penis, ear, nose
How do you treat chemicals on the skin? Dust off then rinse
What are the two causes of renal artery disease? atherscleosis and fibromuscular dysplasia
How do you treat an ARF patient with pericarditis? Steroids and NSAIDs
How does a client with nephrotic syndrome present? Waxy looking, anorexia, malaise, irritable, menses abnormal or absent, proteinuria severe, cell casts and fat bodies
If PaO2 is less than ___ mm Hg it is a life threatening event. 40
What are manifestations of acute glomerulonephritis? Rapid onset; hematuria with RBC casts and proteinuria. Fever, chills, weakness, pallor, anorexia, nausea, vomiting, edema,facial swelling. Ascites, pleural effusion,and heart failure.
What is the renal insufficiency stage of ESRD? Involves mild azotemia with impaired urine concentration, nocturia,mild anemia
What occurs in impaired gas exchange that is related to obstruction,infection,or injury? pulmonary edema occurs and inflicts acute damage to the alveolar capillary membrane
Are renal tumors always cancerous? Most of the time, but benign ones cannot be distinguished from malignant ones on x-rays.
What can o2 do to an ekg reading? It can mask EKG changes.
If you don't think a graft will take what should you do? Use a temporary skin substitute
How does an acute tubulointerstitial disease present? Has a rapid onset of an allergic reaction. Fever, rash, eosinophilia, oliguria, hematuria
Why is the failing kidney in metabolic acidosis? Bicarbonate is leaking out and hydrogen ions are being retained.
Where is chest tube inserted with hemothorax? Between 5th & 6th ICS at midaxillary line
Why do serum urea nitrogen and creatnine levels decrease with kidney failure? The kidney cannot filter as it once could and the GFR is reduced and clearance as well. This results in an excess that enters the blood instead of being excreted.
What should you do to assess new skin grafts? Watch for bleeding. Remove accumulated serum beneath sheet grafts and prevent unwanted movent and shearing of autograph sites.
What is important about the incubation period? It is critical and each disease has its own length.
What do antacids do to acid and ph? Decreases amount of acid and increases ph
What should you do if you suspect the ET tube is in wrong position? Assess LS, manually bag & notify provider
What is the goal of nursing in a disaster situation? the greatest good for the greatest number of people
How should you put a patients bed to prevent PE? Elevate knees c no gatch to prevent pooling of blood.
What should you do in the event of an amputation? Clean it with normal saline.
Wrap it in sterile saline soaked gauze, and place in plastic bag. Ice.
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