1 pt eval

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Anonymous
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89836
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1 pt eval
Updated:
2011-06-08 17:11:36
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pt eval
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1 pt eval
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  1. pack years =
    # of packs/day X of years smoked
  2. normal urine output
    40 ml/hr
  3. what would you give to a pt with a loew urine output
    lasix/diuretics
  4. drowsy state, may have decreased cough or gag reflex
    obtunded
  5. difficulty breathing except in the upright position
    orthopnea (heart prob, CHF)
  6. run down feeling, nausea, weaknes, fatigue headache (electrolyte imbalance, dec potassium)
    general malaise
  7. difficulty swallowing and hourseness
    dysphagia
  8. excessive fluid in the tissue known as pitting edema
    peripheral edema
  9. peripheral edema occurs in
    arms and ankles (most likely ankles)
  10. peripheral edema is caused by
    • CHF
    • renal failure
  11. accumulation of fluid in the abdomen
    ascites
  12. ascites is caused by
    liver failure
  13. caused by chronic hypoxemia
    clubbing of fingers (pt with CF)
  14. neck vain sticking out
    increased venous distention
    venous distention
  15. indication of peripheral circulation
    capillary refill
  16. profuse/heavy sweating
    diaphoresis
  17. kussmauls is caused byu
    • metabolic acidosis
    • renal failure
    • diabetic ketoacidosis
  18. tachycardia indiaces
    hypoxemia
  19. bradycardia indiacates
    heart failure
  20. pulled to abnormal side (TOWARD)
    • atelectasis
    • fibrosis
  21. pused to normal side (AWAY)
    • pl effusion
    • tension pneumothorax
  22. normal air filled lung
    resonant
  23. fluid filled organs
    dull
  24. air filled stomach, extra air
    • tympanis
    • hyperresonant
    • (pneumothorax-emphysema)
  25. normal breath sounds
    vesicular
  26. pt is instructed to say E and it sounds like A- indicates consolidation
    egophony
  27. crackles- secretion/fluid
    rales
  28. adventitious b/s
    abnormal
  29. course rales- large airway secretions
    rhonchi (upper airway)
  30. pt with fine rales needs what kind of treatments
    • ippb
    • heart drugs
    • diuretics
    • o2
  31. wheeze is due to
    bronchosparm
  32. pt who wheezes needs a
    bronchodilator
  33. unilateral wheeze indicative of a
    foreign body obstruction
  34. stridor is due to
    upper airway obstruction
  35. supraglottice swelling -
    epigottitis
  36. subglottic swelling-
    • vroup
    • post extubation
  37. how to treat pleural friction rub
    steroids and antibiotics
  38. right hemi is slightly higher than the left before of the
    right liver
  39. radioluceny-
    lungs filled with AIR
  40. where is the film on a AP projection
    film behind back
  41. lateral decubitus postition is when pt ying on the
    affected side
  42. lateral decubitus is valuable for detecting
    small pl effusions
  43. the tip of the ETT should be positioned below the vocal codes and no closer than ___cm or ___inch ABOVE the CARINA
    • 2 cm
    • 1 inch
  44. whats the quickest way to determine adequate ventilation before a chest xray
    • observation
    • auscultate
  45. radiodense / opaque
    FLUID, organs, bones
  46. infiltrate
    ill defined- atelectasis
  47. consolidation-
    • solid white area
    • pneymonia
    • pl effusion
  48. fluffy infiltrates/ butterfly batwing pattern
    pulm edema
  49. ground glass appearance
    honeycomb patter
    diffuse bilateral radiopacity
    ARDS/IRDS
  50. air bronchogram
    pneumonia
  51. peripheral wedge shape infiltrate
    pulm embolus
  52. * an xray through a specific plane of the body part to be examined. images appear in slices of the organ
    computerized tomography CT scan
  53. scan with contrast dye may be used for diagnosis of pulm embolus
    spiral CT scan
  54. has the ability to determine the precise position of tumors and the involvement surrounding structures
    magnetic resonance imaging MRI
  55. scan that results indicate a normal ventilation scan but abnormal perfusion scan = pulm embolism
    v/q scan
  56. presense of cancer, brain disorders and heart disease
    PET scan positron emission tomography
  57. allow study of obstructing lesions and bronchiectasis
    bronchogram- injection of radio opaque contrast medium into the trachebronchial tree
  58. normal value for ICP
    5-10
  59. what is used to monitor asthma pt
    exhaled nitric oxide NIOX
  60. a decrease in FENO means a
    decrease in airway inflammation
  61. increase WBC =
    bacterial infection treat with antibiotic = penicillin
  62. dec WBC
    viral infection
  63. yellow sputum is a presense of
    WBC, bacterial infection
  64. green presense of
    gram neg bacteria (bronchiectasis, pseudomonas)
  65. pink prothy=
    pulm edema
  66. id the bacteria present and id what antibiotics will kill the bacteria
    culture and sensitivity
  67. id whether it is gram + or gram -
    gram stain (quickly identify)
  68. id mycobacterium tuberculosis
    acid fast stain
  69. the electrical impulse is generated by the
    SAnode
  70. V1= ____ intercostal space on ____ side of ____
    • 4th
    • right
    • sternum
  71. V2= ____ intercostal space on ____ side of ____
    • 4th
    • left
    • sternum
  72. V3= btwn ___ and ____ on ____ side
    • v2
    • v4
    • left
  73. V4= ____ intercostal space on ____ line
    • 5th
    • left mid clavicular
  74. V5= btwn ___ and ___ on the ____ side
    • v4
    • v6
    • left
  75. V6= ____ intercostal space, ____ line
    • 5th
    • left midaxillary
  76. if the 2 R waves are btwn 3-5 large boxes then the rate is
    normal
  77. if the 2 Rwaves are less than 3 then the rate is
    tachycardia
  78. if the 2 R waves are greater than 5 then the rate is
    brady
  79. v tach with pulse/ what should you do?
    cardiovert
  80. v tach with no pulse
    defibrillate
  81. how to treat vfib
    defib
  82. how to treat PVCs
    • o2
    • lidocaine
  83. how to treat asystole
    • confirm lead 2 first
    • epi
    • atropine
    • cpr
    • (DO NOT DEFIB)
  84. whats the normal axis through the heart
    DOWN and to the LEFT
  85. mothers history is also called
    perinatal history
  86. term infant
    born btwn 38-42 weeks
  87. apgar score of 0-3
    resuscitate
  88. apgar score of 4-6
    support- stimulate, warm, administer o2
  89. apgar score of 7-10
    monitor- routine care
  90. recommend when a pneumothorax is suspected
    transillumination
  91. what will cause the entire hemithorax to light up in a transillumination
    • pneumothorax
    • pneymomdediastinum
  92. what can u use to determine gestational age
    • dubowitz method
    • new ballard score NBS
  93. most common for lung maturity info
    l/s ratio = 2:1 higher is good

    less than 2:1 high risk of HMD/IRDS
  94. exh co2 = purple =
    poor
  95. exh co2 = yellow =
    good
  96. noninvasive oximetry
    pulose oximeter SPO2 93-97%
  97. invasive oximetry
    co-oximeter/hemoximetery

    most accurate
  98. co-oximeter is used to diagnose
    carbon monoxide poisoning (>20 COHb)
  99. normal COhb
    1-3%
  100. COhb for smokers
    5-10%
  101. COHb for heavy smokers
    10-15%
  102. noninvasing way of measure po2 and pco2 measurement by electrodes placed on the skin instead of a single measurement with a blood sample
    transcutaneous / clark / severinghaus electrode
  103. mean arterial pressure MAP formula
    (2 X diastolic) + systolic / 3

    ex: 120/80

    2 x 80 = 160 + 120 / 3 = 93
  104. right heart problem is
    CVP
  105. lung problem is
    PAP
  106. left heart problem
    PWP
  107. CVP normal values
    • 2-6 mmhg
    • 2-12 cmhg
  108. pap normal value
    25/8
  109. pwp normal value
    4-12 mmhg
  110. ex of right heat failure
    • cor pulmonale
    • tricuspid valve stenosis
  111. ex of lung disorders
    • pulm embolism
    • pulm hypertension
    • air embolism
  112. ex of left heart failure
    • mitral valve stenosis
    • chf
    • high peep effects
  113. the difference btwn the systolic and diastolic
    pulse pressure

    sys - diastolic

    normal value = 40
  114. ** cardiac output QT
    fick equation

    QT= VO2 / C(a-v)o2 (10)

    c(av)o2 and vo2- o2 consumption
  115. cardiac index CL formula
    qt / bsa
  116. systemic vascular resistance formula
    MAP - CVP / cardiac output
  117. SVR normal value
    <20 or 1600 dynes

    multiply by 80 to get dynes
  118. stroke volume is qt also, what is the formula
    hr X stroke vol
  119. pulm vascular resistance PVR formula
    MPAP - PCWP / cardiac output
  120. PVR normal value
    < 2.5 or 200 dynes

    multiply by 80 to convert to dynes

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