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Unformatted text preview: 9:21 4 Done Exam 1 Paper (45 of 3... Q Respiratory Acidosis Myasthenia metabolic Acidosis typo xemic Ropfail ABG values Coz- Respiratory Why : Anything decreasing tours, copp why? Diabetes E excess ketones, ARD's PH 7.35-7.45 Heons metabolic rate or depth of respirations narcotic no strudelbrain. renal failure can't regulate HOOS/ H, Renal PCO: 35-45 Boz 90-100 (hypoventilation)- coz retention aa Poisoning, diarrhea, losing basic stool fe DKA HCO3 22-26 mron : rate or depth of nypwent,lander obie metabolism PCOL 80-100 760 Okay CARDS) respiration Intervention: treat underlyingcause , Breathing: slow RR or reg rate c ( give Or), give Na bicarbonate Criteria for Abnormal ABG Metabolic Acidosis metabolic Alkalosis Shallow / ineffective respirations compensation: Respiratory - deep PH 27.35 PH 7 7.45 Compensation: metabolic- kidney or rapid ( kussmaul's) respirations coz normal Coz normal AHCO s production or & HCO; removal SZS of acidosis - Drowsiness HA, HCog 728 In urine or TH+ removal in urine SIS of Acidosis: Drowsiness HA, V LOC LLOC or even coma, Akt 1 BP due Respiratory Acidosis Resp. Alkalosis oreven coma, MKT V BP due to to peripheral rasodilation PH 2 7.35 PH >7.45 Peripheral rasodilation . A TX - ARDS- Proning, rotational cor 745 Con 2 35 ion . AveDlarhypoventilation Bed , Paraly+ Soapislor Hcog normal HCDs normal Beserratory Alkalasis (ARDS),I mpakametabolic Alkalosi's "Syn Acidosis caused by ACOZ, AH, LHCO3 Why ? Hyperventilation, may be due to why ? over ingestion of base /antacids, Alkaloses caused by beaz $13, AHCos low oz states Vomiting/NG Suction losing stomach Intervention : slow breathing, rebreather/ acid, diuretics increasing Htexcretion Priority management of Resp Acidosis Interventions : Theat underlying cause, Improde areolar vent. treat the cause Paper bag of fix oxygenation problem Breathing- Deep and lor rapid- causing Diamox ( Acetazolamide)- HCO; waster Resp Acid caused by Pacos Pacbe the problem, Altered Loc compensation: Respiratory - slow/shallow) TX: Bronchial Hygiene((6, tum. DB) Compensation: metabolic kidney WHOs resp bronchodilator, pain management, reduction or 1 HCOs removal in Genine 5/S of Alakalosis: Hypocalecemis, &kt, fintuation (mu) ort it removal in urine SIS of Alkalosi's: Hypocalcemiactingling. NIV In Resp/mela Acidosis - V-LOC, Hypotenia fingers/ toes, letany, chrostek's muscle Illnesses ca Acid): Hypercapnic Respy hyperkalemia myasthenia graves. cool Crathping , tit, NN. se, hypeventilation how pressure Alarm my; - leak 40 : Hyporemic respfail, pneumonia ventilate Pf manually trauma, surgery, coughing ARCS, lactic Acid Production, DIA, Renal fail High Pressure R . obsintron - secrections, Reasons For er placement complaints/ assessment pneumothorax Chest pain, SOB,-Loz, unequal . intrathoracic pressuret . Pneumothorax . Empyema(pus) breath Sounds, diminished breath . Tracheal deviation to the opposite side . Hemothorax . Chylothrox (lymph) . Pleuraleffusion . prevention of cardiac sounds on the side of Doneumothoras cushings Triad - widened pulse Tamponade post Heart SK . Sub-a emphysema Chest Drainage unit (cou) Pressure , brady cardue, RRERation Positron it for optimal drainage = 30-8450for . Tidaling in the water seal chamber is normal signs of AICP/cioc highflowers 60-90 for Shui'd Blood thoracotmy-surgicalincision to chest . Absence of Tidalingof Kinkin tube, healing of pneumothorax continue bubbling in the water seal chamber & air leak . Shetren will have continue bubbling motor funds * 16 waterseal is not maintain, airwillenter the pleural space on inhalation, placing the patient at risk pneumothorax only time a chest drainage should be clamp: Changing the COU( replacing a fullor broken), troubleshooting an air leak, and prescribed by the physician . Chest tube disconnects from water seal a Place in Sterile Had Chest tube complications : Site infection, pneumonia, nasonagel, reexpansion pulmonaryedema, shoulder disuse atrophy . Chest tube is partially pulled out : assess P4 2 call the HCP J Chest lube pulled and? assess At, call HCP, coversite I dressing /tape ssides my Resp Failure manifestations ( Resp failure is present when retained Coz causes resp acidosis , there is hypoxenng lise of accessory muscles TX: Supplemental Ozshumidifred Or can help secretions reduce drying of mucow . wheezing . Rapid Rep Rate (THRi BP) membranes -516 hypoxeric must give oz lowest amt. for least amt of time - . cyanosis (late sign), A WOB breathing tX, THOB, turn, cough.? DB * VAP- suction, uralhygiene, wear important points to remember RespFail C MV suction AICP . Ertube will prevent the epiglottis from closing- the pt can't swallow their salvialoral secretions Ercuff, while inflated, does not prevent the removal of the Et-tube . At can't speak when inflated & resp nop ntemp. V Pike . Although the ET-tobecuff is inflated, oral gastric secretions can leak in to lungs around ET tube Goals of my adequate oz Positive Pressure PEEPE IN All (asissi /control) mode - Set Rale Vr are delivered - WOB is . delivery of can cause venous Return done by ventilator / - Removal of COz CO HRTend ofexpiration . reduce dyspnea promote . LBP colume controlled . ky weight is used to determine a Prescribed Vr ventilator delivers set VY rest/ reconditioning of . cause RAAS activation fatigued Resp muscles - PEER. 3-5cm Normal Pressure gas is delivered ata until pressure is reached * if the problem is with the " . helps keep alveoli open . As lungs stiffen , VT may & inadequate ventilation (D's) = = change Tor Resort. * -> if ptis breathing close to what the vent is + try towean Py from vent TIA - Presents sis of stroke- complication- BarotraysIMV mode - Allows pt to breath spontaneously of theirown rate/depth - vent delivers each breath in synchrony 2 Pt's - can be use for weaning Types of stroke: thrombotic, embolic, hemorrhagic PEEP PSV. (pressure suppers ventilation)-helps wearingc " Horst HA of mylife "- intracranial bleeding mannitol) LPS) ICP- normal 5-15 mmly Assessment Stroke (ABCs ) 20 orless ptsspontaneous thrown CPP(cerebral perfusion pressure ) (A) patentarrway Antihypertensive aFibrinolytic (tPA) . CPP= 70-100 mmig MAP to or let( B) altered breathing pattern! HOB: 8245 MAPS 130, Systolic 23- 4hrs CPP = MAP - ICP infarchug oxygenation 7220- dropping no past lik of trauma, CPP 2 70 mining NICPy .87(c) Circulation. BP, Pulse up too quickly could Heart Attack, HTM ishemia result in rachemia major rest: intracebar 2 0 = bad STscars - stroke (D) LOC-neuro assessment or infect hemorrhage 250 = 1 brain perfusion Gas<8 intubate systolic BP > 90 CT Scan should be done w/T PI should be NPS until Cov Pulser, 25 minutes gag reflexesare assess -BP Normal...
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