clinical affil 5

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shmvii
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184543
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clinical affil 5
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2012-11-19 20:42:27
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clinical affil
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clinical affil 5
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  1. what to do if you're writing an IE and there's >1 of a type of x-ray (ex - chest x-rays)
    lump them - give the duration and the results of the most recent
  2. CAD
    • Coronary artery disease (CAD) is the most common type of heart disease. It is the leading cause of death in the United States in both men and women.
    • CAD happens when the arteries that supply blood to heart muscle become hardened and narrowed. This is due to the buildup of cholesterol and other material, called plaque, on their inner walls. This buildup is called atherosclerosis. As it grows, less blood can flow through the arteries. As a result, the heart muscle can't get the blood or oxygen it needs. This can lead to chest pain (angina) or a heart attack. Most heart attacks happen when a blood clot suddenly cuts off the hearts' blood supply, causing permanent heart damage.
    • Over time, CAD can also weaken the heart muscle and contribute to heart failure and arrhythmias. Heart failure means the heart can't pump blood well to the rest of the body. Arrhythmias are changes in the normal beating rhythm of the heart.
  3. COPD 2 main ingredients
    chronic bonchitis & emphysema
  4. obstructive vs restrictive lung disease
    • obstructive: narrowed airways, difficulty/slowly exhaling fully (so more CO2 remains)
    • restrictive: can't fill lungs - lungs are restricted from filling - seen in diseases and conditions that constrict or decrease compliancy of lungs (from pregnancy to fibrosis)
  5. the thing about giving O2 to COPD pts
    • bc the more they inhale the more they'll retain CO2 you don't want to give >4L
    • their SpO2 is ok ~90%
  6. a thing you've been forgetting to look up when doing IEs
    the problem list on the intake form
  7. word for "speed" in gait assessment
    cadence
  8. the thing to go buy when you're grading on the poor-good scale for ambulation
    the amount of assist, not the distance walked
  9. things a pt may be indep with that you should mention in the social hx sect of an IE
    pt I c ADLs, amb, no AD
  10. You've been forgetting to fill out the SENSATION sect of the IE. Unless there's something wrong, you need to fill it out. What shall we write?
    grossly intact or SILT (sensation intact light touch)
  11. how to note it if pt put a hand on a railing during stairs or amb
    "1 HR"
  12. a few things to note regarding gait
    amount of assist or indep, AD, portable O2, cadence, anything notably wrong with the gait pattern
  13. what to write in the edu sect of the IE
    • POC - almost every time
    • and can also say OOB activities, ther-ex, safety,
  14. what to write under "discharge needs" if you want to just d/c a pt
    "none anticipated"
  15. in the IE in the first sect you should include the medical dx   but where to find it??
    in the orders on the computer
  16. H&H values below which we carefully consider if exercise is ok
    • hemoglobin < 8
    • hematocrit < 24
  17. MAPs
    • mean arterial pressure -- seen on the upper R corner of the blue BP&SpO2 device
    • it's a kinda average of the DBP and SBP
    • you want it >80
    • worry if <60
  18. craniectomy
    • removal of a part of skull (keeping it off longer than you would for a craniotomy)
    • helps relieve pressure from swelling of brain, bleeding around brain,
    • lets you remove a clot that may be causing this
    • lets the brain swell upward if it has to swell, rather than downward where it would compress the brainstem
    • typically done just in really critical situations
  19. what happens to the bone removed in a craniectomy
    into the freezer or the fat of the abdomen
  20. 4 unfortunate results of a craniotomy
    • swelling of brain
    • excessive intracranial pressure
    • infection
    • seizures
  21. craniotomy
    • a procedure to remove a lesion in the brain thru an opening in the skull - tumor, clot, aneurism, AVM (arteriovenous malformation)
    • the hole is made, but much more temporary than in a craniectomy
  22. -otomy or -tomy
    surgical incision
  23. -ostomy or -stomy
    creating a new hole (mouth = stoma)
  24. -ectomy
    surgical removal
  25. -centesis
    surgical puncture
  26. -pexy
    to fix or secure
  27. hematocrit
    • ratio of RBCs to total blood volume
    • maybe don't treat if <24
  28. hemoglobin
    • the O2-containing pigment in RBCs
    • maybe don't treat if <8

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