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202 Resp Student PPP W 2011 days 1 and 2

202 Resp Student PPP W 2011 days 1 and 2 - Advanced...

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1 Advanced  Respiratory NURS 202 Winter, 2011 W - 2011
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2 Acute Respiratory Failure Classified by ABG abnormalities PaO2 < SaO2 < PaCO2 > with pH < Caused by failure of: Ventilation Oxygenation Both W - 2011
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3 Acute Respiratory Failure Pulmonary system is unable to maintain Common causes pulmonary embolism (PE) flail chest pneumothorax hemothorax pulmonary edema
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4 Pulmonary Embolism (PE) Other causes DVT Clot dislodges & floats down stream
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W 2010 5 Etiology : At greatest risk: Stasis of Endothelial DVT/VTE Other Risk Factors hx thromboembolism immobility surgery trauma advanced hormone therapy
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W 2010 6 2½ million cases/yr Sx Unilateral distal Localized DVT/VTE The most common complication of LE surgery or trauma Note: Homans sign is unreliable and is therefore no longer recommended
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W 2010 7 Dx lab test D-Dimer - Normal: ~ Low value High value may indicate Therefore a low value is _______________________ but a high value is not D-Dimer: global marker of coagulation activation; measures fibrin degradation products produced from fibrinolysis
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W 2010 8 Management of DVT SCDs Elevation of extremity Warm, moist compresses Anticoagulants Heparin (unfractionated heparin [UFH]) IV or SQ for Pts w/ confirmed clots SQ to prevent clots in high risk Pts Low-molecular weight heparins (LMWHs) / dalteparin / enoxaparin Selective factor Xa inhibitors / fondaparinux Oral anticoagulant / warfarin Thrombolytics - - Streptokinase
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W 2010 9 Promote circulation Early Leg Avoid Prolonged Constricting clothing Leg elevation Hose TED Pneumatic (SCDs) Foot pump Good Rx prophylaxis anti- anti- Prevention of DVT Preventing DVTs prevents PEs
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10 Sx of PE Resp Pleuritic Crackles Note: Sx & Tx of PE & fat embolism are virtually the same W - 2011 Cardiac JVD Other Low fever Petechiae See Chart 34-2 Pg. 679
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W 2010 11 Prevention of PE Same as prevention of DVT Management O2 PRN: Rx: Frequent assessment Monitor closely changes Labs Promote good Treat anxiety
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