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What is a RRT?
Rapid Response Team. They save lives and decrease the risk of harm by providing care to patients before a respiratory or cardiac arrest occurs.
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Describe Nursing Case Management.
The goal is to provide quality and cost effective services and resources to achieve positive patent outcomes. Coordinates inpatient and community based care before discharge from a hopsital or other facillity.
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What is genetic counseling?
counseling before during and after genetic testing.
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It is important for a genetic counselor to be ?
Nondirective
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Autosomal Dominant
Require that the gene alleles controlling the trait be located on an autosomal chromosome. The trait appears in every generation without skipping. Risk of affected person passion to children is 50%.
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T or F. When a person is autosomal dominant the trait is found equally in males and females
True
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ADH
acts directly on kidney tubules and collecting ducts, making them more permeable to water. This makes the blood more dilute
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dehydration issues
nearly all systems are affected. HR increases, peripheral pulses weak, difficult to find, B/P dec, more severe hypotension, light-headedness, inc. respiratory rate, tenting, dry membranes, alterations in mental status, low grade fever, urine concentrated
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Priority care for a patient with dehydration
patient safety, fluid replacement and drug therapy
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Why is dehydration more common in the elderly?
older adults often use diuretics and laxatives which can disturb fluid balance.
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hypercalcemia concerns
level above 10.5 mg/dL. Causes faster clotting times, severe hypercalcemia depresses electrical conduction- slowing HR. Examine EKG tracings for dysrhythmias, especially shortened QT intervals
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What solution is normally given for patients with hypercalcemia?
normal saline because sodium increases kidney excretion of calcium
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hyperkalemia concerns
cardiovascular changes are the most severe problems from this. Bradycardia, hypotension, ectopic beats. Also neuromuscular-skeletal muscle twitching. Intestinal- increased motillity.
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Hypermagnesium concerns
cardiac- bradycardia and peripheral vasodilation, hypotension. CNS- lethargy. neuromuscular- decreased DTR's
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hypophosphate concerns
decreases cause increased serum calcium. Cardiovascular- decreased stroke volume and CO. muscle weakness, CNS- irritability, seizures
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Acidosis
pH is below normal <7.35
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What can cause Acidosis?
rentention of CO2
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Clinical manifestations of Acidosis
CNS depression, decreased muscle tone and DTRs, inc HR and CO, dec HR and abnormal EKG, shallow rapid respirations or deep and rapid
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What causes respiratory acidosis?
retention of CO2,respiratory depression, inadequate chest expansion, airway obstruction, reduced alveolar-capillary diffusion
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manifestations of respiratory acidosis
CNS depression, decreased muscle tone and DTRs, inc HR, CO, dec HR, abnormal EKG, hypotension, shallow rapid respirations, pale and cyanotic
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causes of respiratory alkalosis
excessive loss of CO2via hyperventillation
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assessment findings of someone with respiratory alkalosis
dizziness, agitation, confusion, hyperreflexia, seizures, hyperactive DTRs, muscle weakness, myocardial irritability, inc. HR, inc. RR
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What is metabolic alkalosis?
Increase in bases or decrease of acids. Can be caused by excessive use of antacids, prolonged vomiting or NG suctioning
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