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Little Notes for Exam #2
Terms in this set (15)
-give pain meds
-give sedatives too, to help cope with the paralysis
-reorientate the pt because they can hear, but can't see or move
for flail chest and MV
blood accumulates in the pericardial sac; this is a lethal complication, all of this fluid needs to be drained out ASAP; there is about 1500 mL in the pericardial sac, causes for an emergency
need chest tube or pericardialcentesis
Neck vein distention
Muffled heart sounds
blood is in the pleural cavity, this is going to cause
-diminished breath sounds and absence
-collapsed neck vein
What is status asthmaticus?
A severe asthma attack that fails to respond to conventional therapy with bronchodilators, which can result in ARF.
Patho for status asthmaticus:
Exposure to irritant or trigger, leads to bronchospasm, inflammation/edema, and mucus production, which causes increased airway resistance
Cardiovascular Effect of status asthmaticus:
What is pulsus paradoxus?
decreased CO and fall in SBP on inspiration
Diagnostics for status asthmaticus:
Initially-- respiratory alkalosis from hyperventilation
Then-- pt starts to become fatigued and lactate is overproduced by respiratory muscles, so respiratory and metabolic acidosis occurs
PEFR < 40%
FEI1 < 20&
-indicates severe airflow obstruction and the need for intubation with MV is imminent
Medical Management for SA:
Oxygen: high flow, need SaO2 > 92% & helium plus oxygen is new
Intubation with MV
What would you need Intubation with MV for SA?
-development of resp. or cardiac arrest
-resp. acidosis with high CO2
-failure to respond to BD
prone; on stomach
Positioning for V/Q mismatch and Intrapulmonary Shunting?
good lung down (dependent position)
What do we look at if the COPD pt has a high CO2 and a low O2?
pH < 7.35
O2 administration to avoid O2 toxicity?
25 or greater using .50 or 50% of oxygen or less
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