problem: hypoventilation is causing CO2 retention
causes: anything that causes hypoventilation of affects ventilation, diffusion, or perfusion: pneumonia, atelectasis, COPD, sedative overdose, respiratory muscle weakness (GBS), obesity
labs: low pH and high CO2
s/s: "depression session": confused, dizzy, hyperkalemic (risk for v-fib and dysrhytmias), hypotension, hypoventilation
treatment: correct hypoventilation, O2 100% NON-rebreather mask, bronchodilators, expectorants, monitor lytes, fluids
problem: hyporventilation is causing excessive loss of CO2
causes: any hypermetabolic state or hyperventilatory state that stimulates respiratory center: infection, fever, anxiety, fear, pain, PE
labs: high pH and low CO2
s/s: anxious, confused, hypokalemic (risk for PVCs), tachycardic, hypocalcemic (tetany and tremors), hyperventilation
treatment: paper bag, rebreather mask, calm patient down
problem: body is losing HCO3 or has too much acid buildup
causes: severe diarrhea (loses HCO3), lactic acidosis, DKA, renal disease (cannot keep HCO3), starvation, GO fistulas, shock
labs: low pH low HCO3
s/s: drowsy, confused, hyperkalemia, hypotension, Kussmaul's to compensate
treatment: IV sodium HCO3, dialysis, rehydration, anti-diarrheals, treat hyperkalemia
problem: body has too much HCO3
causes: loss of acids, ingestion of HCO3: severe vomiting, prolonged NGT suctioning, diuretics, excess mineralocorticosteroids
labs: high pH high HCO3
s/s: irritable, tachycardia, hypokalemia, hypocalcemia (tetany, tremors), hypoventilation
treatment: K-sparing diuretics, fluids to rehydrate, anti-emetics, IVFs likee 1/2 D5W, K protocol, Is and Os
Cetirizine hydrchloride(Zyrtec), Chlopheniramine maleate(Aller-Chlor, Chlor-Trimeton), Chlorpheniramine/pseudoephrdrine(allerest Maximum Strength), Clemastine Fumerate(Tavist), Desoratidine(Clarinex), Dimenhydrinate(Dramamine), Diphenhydramine(benadryl), Doxylamine succinate(Unisom), Fexofenadine(Allegra), fexofenadine/pseudoephedrine(Allegra-D), Loratadine(Claritin), Loratadine/pseudoephedrine(claratin-D), Tripolidine/pseudoephedrine(actifed cold and allergy) A client has undergone a left hemicolectomy for bowel cancer. Which activities prevent the occurrence of postoperative pneumonia in this client?
a) Administering oxygen, coughing, breathing deeply, and maintaining bed rest
b) Coughing, breathing deeply, maintaining bed rest, and using an incentive spirometer
c) Coughing, breathing deeply, frequent repositioning, and using an incentive spirometer
d) Administering pain medications, frequent repositioning, and limiting fluid intake
Inspection: Cyanotic, Tripod position, big belly, pursed lip breathing, barrel chest, use of accessory muscles, Blue Bloater
Palpation: decreased mvmt
Percussion: Hyperresonance or dull over consolidation
Auscultation: Crackles, rhonchi, wheezes, distant breath sounds
-cough, sputum, dyspnea and/or history of exposure of risk factors of disease (smoking)
occurs with or after upper respiratory tract infection.
Symptoms: cough 10-20 days, clear, mucoid sputum, or purulent sputum, headache, malaise, SOB on exertion and low grade fever.
Elevated temp, resp rate and pulse, normal or wheeze breath sounds with expiration and exertion.
Differentiate btwn pneumonia= CXR
Treatment: rest, fluids, antiinflammatory agents, cough suppressants or bronchdilators.