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| a filter placed in the inferior vena cava under fluoroscopic guidance. It is used in patients who are particularly vulnerable to pulmonary embolism, such as those diagnosed with deep venous thrombosis with contraindications to anticoagulation, to prevent venous emboli from entering the pulmonary circulation. |
green filter |
0 |
sue524 Mon, 13 Feb 2012 01:51:51 GMT |
 |
CREATING ADHESIONS BETWEEN VISCERAL AND PARIETAL PLEURA
USED FOR RECURRENTS PNEUMOTHORAX
INSTILING CHEMICAL AGENT (DOXYCYCLINE)
INFLAMMATORY RESPONSE CREATES SCAR TISSUE AND ADHESIONS |
PLEURODESIS |
0 |
sue524 Sat, 11 Feb 2012 06:00:47 GMT |
|
| Never do what to a chest tube |
NEVER CLAMP THE CHEST TUBE IF THERE IS AN AIR LEAK FROM THE PATIENT |
0 |
sue524 Sat, 11 Feb 2012 05:59:20 GMT |
|
1 chest tube make suer the dressing is
2 the connection are
3 is the tubing
4 is the drainage
5. In the first chamber in the chest is
6 how much and is it and does the unit need
7wall suction on and bubbling in the |
1 Is the dressing airtight and dry?
2 Are all the connections taped securely?
3 Is the tubing lying on the bed coiled without any dependent loops hanging down on the floor?
4 Is the drainage flowing freely down the tubes?
5 In the first chamber in the chest drainage setup--the drainage collection chamber--what is the nature of the drainage?
6 How much per hour? Is it marked? Does the unit need to be changed?
Is the wall suction only gently bubbling in this chamber? |
0 |
sue524 Sat, 11 Feb 2012 05:59:20 GMT |
|
| Nursing management of client with chest tube |
Look and listen for signs of respiratory distress and adequate level of oxygenation
Have patient turn from back to affected side to promote drainage
control pain so that the patient will cooperate
Encourage arm exercises |
0 |
sue524 Sat, 11 Feb 2012 05:59:20 GMT |
|
chest tubes do what to the lungs
1 2
3 they areplaced in the
4. sealed withe
5 suction level is
6 the drainage system is |
1 Re-expand the lung
2 Reestablish negative pressure
3 Placed in pleural cavity
4 Sealed with Heimlich valve (one way)
5 Low level suction
6 Closed drainage system |
0 |
sue524 Sat, 11 Feb 2012 05:59:20 GMT |
|
| treatment of choice for pneumothorax is |
placement of a closed chest catherter allwoing the lung to reexpand chest tube |
0 |
sue524 Sat, 11 Feb 2012 05:52:02 GMT |
|
| creation of adhesion between the parietal and viseral pleura may be used to prevent recurrent pneumothorax. This procedure invloves instilling a chemicla agent such as soxycycline into the pleural space. The subsequent inflammaroty response creates scar tissue and adhesion between teh pleural layers. is called |
Pleurodesis treatemtn (controversial) |
0 |
sue524 Sat, 11 Feb 2012 05:52:02 GMT |
|
| TREATMENT OF PNEUMOTHORAX |
CHEST TUBES
PLEURODESIS
SURGERY
OXYGEN
PAIN MEDICATIONS |
0 |
sue524 Sat, 11 Feb 2012 05:52:02 GMT |
|
| DIAGNOSIS OF PNEUMOTHORAX |
CHEST X-RAY
ABG’s |
0 |
sue524 Sat, 11 Feb 2012 05:52:02 GMT |
|
thers are symptoms of
DYSPENA
TACHYCARDIA
CARDIAC OUTUT AFFECTED
HYPOTENSION
DISTENDED NECK VEINS
DIMINDHED BREATHING SOUNDS
PAIN
CHEST WALL MOVEMENT DIMINSHED ON AFFECTED SIDE
MEDIASTINAL SHIFT
SIGNS OF SHOCK MAY BE PRESENT |
TENSION PNEUMOTHORAX |
0 |
sue524 Sat, 11 Feb 2012 05:47:11 GMT |
|
this type of phneumothorax is
Air is allowed in only, trapped in the pleural space
Severely compromised ventilation
Shift of thoracic organs to the unaffected side
Venous return impaired
Medical emergency |
TENSION PNEUMOTHORAX |
0 |
sue524 Sat, 11 Feb 2012 05:47:10 GMT |
|
| symptoms of SYMPTOMS OF TRAUMATIC PNEUMOTHORAX |
PAIN
DYSPNEA
TACHYCARDIA
CHEST WALL MOVEMENT
ANXIETY
HEMORRHAGE |
0 |
sue524 Sat, 11 Feb 2012 05:47:10 GMT |
|
| reasons for TRAUMATIC PNEUMOTHORAX |
BLUNT OR PENETRATING INJURY
CLOSED PNEUMOTHORAX
-rib fracture, injury of esophagus, alveoli rupture
OPEN PNEUMOTHORAX –SUCKING WALL
-air moves freely between the pleural space and atmosphere
IATROGENIC PNEUMOTHORAX
-during central line placement, CPR, mechanical ventilation |
0 |
sue524 Sat, 11 Feb 2012 05:47:10 GMT |
|
| SYMPTOMS OF TRAUMATIC PNEUMOTHORAX |
PAIN
DYSPNEA
TACHYCARDIA
CHEST WALL MOVEMENT
ANXIETY
HEMORRHAGE |
0 |
sue524 Sat, 11 Feb 2012 05:43:04 GMT |
|
| SYMPTOMS OF SPONTANEOUS PNEUMOTHORAX |
DEPENDING ON : SIZE
EXTENT OF LUNG COLLAPSE
UNDERLYING DISEAS
Pleuritic chest pain (begins abruptly)
Shortness of breath ( while at rest )
Asymmetrical chest movement
Hyper resonant affected side
Tachycardia
Diminished breath sounds or absent
Hypoxemia |
0 |
sue524 Sat, 11 Feb 2012 05:43:04 GMT |
|
Underlying lung disease
Rupture of alveolus
Life threatening
this type of pneumothorax sysmptoms are
Risk factors: asthma
cystic fibrosis
ARDS
TBC |
SPONTANEOUS PNEUMOTHORAX SECONDARY- COMPLICATED |
0 |
sue524 Sat, 11 Feb 2012 05:43:04 GMT |
|
this type of pneumothorax sysmptoms are
Previously healthy people
Tall, slender men 16-24
Cause unknown
Risk factors: smoking high altitude
lying, diving scuba diving |
SPONTANEOUS PNEUMOTHORAX primary simple |
0 |
sue524 Sat, 11 Feb 2012 05:43:04 GMT |
|
| air is trapped inside what type of pneumothorax |
TENSION PNEUMOTHORAX |
0 |
sue524 Sat, 11 Feb 2012 05:38:13 GMT |
|
blunt or penetrating trauma (MVA,CPR)
what type of pneumothorax |
TRAUMATIC PNEUMOTHORAX |
0 |
sue524 Sat, 11 Feb 2012 05:38:13 GMT |
|
rupture of air-filled bleb, blister
what type of pneumothorax |
spontaneous pneumothorax |
0 |
sue524 Sat, 11 Feb 2012 05:38:13 GMT |
|
| Pneumothorax can occur |
spontaneoulsy without apparent cause as complication of preexisting disease as a result of blunt or penetrating trauma to chest or from an iatrogenic cause ( follwoing thoracentesis) |
0 |
sue524 Sat, 11 Feb 2012 05:38:13 GMT |
|
| ACCUMULATION OF AIR IN PLEURAL SPACE is |
Pneumothorax |
0 |
sue524 Sat, 11 Feb 2012 05:33:15 GMT |
|
| nursing diagnosis for inhaled injury is |
1.Impaired gas exchange
2.Ineffective airway clearance
3.Anxiety |
0 |
sue524 Sat, 11 Feb 2012 05:33:15 GMT |
|
| nursing management of inhaled injury |
Administer oxygen
Coughing
Suctioning
Medication administration
Fluid administration
Monitor ABG’s
Monitor Carboxyhemoglobin levels
Chest PT with percussion
Postural drainage
Observe for ARDS symptoms |
0 |
sue524 Sat, 11 Feb 2012 05:33:15 GMT |
|
| Hyperbaric oxygen therapy is |
( 100% oxygen |
0 |
sue524 Sat, 11 Feb 2012 05:33:15 GMT |
|
| treatment of inhaled injury is |
Supportive
Endotracheal intubation
Mechanical ventilation
Oxygen therapy
Hyperbaric oxygen therapy ( 100% oxygen)
Bronchodilators
Fluid management |
0 |
sue524 Sat, 11 Feb 2012 05:29:33 GMT |
|
inhaled toxic chemicals causes
ards may develop in
sloughing of damaged mococsa leads to airway obstrucion and
___is common following smoke inhalation |
bronchospasm edema of the airway and alveili
1 - 2 days
atelectasis
Pneumonia |
0 |
sue524 Sat, 11 Feb 2012 05:29:33 GMT |
|
| diagnosistic test for inhaled injury's are |
ABG’s
CARBOXYHEMOGLOBIN LEVELS
Normal level - less than 5% (nonsmoker)
less than 10% (smoker) |
0 |
sue524 Sat, 11 Feb 2012 05:29:33 GMT |
|
| carbon monoxide sysmptoms are |
HEADACHE
DYSPNEA
DIZZINESS
NAUSEA
“CHERRY RED” COLOR OF THE MUCOUSA
CONFUSION
VISUALL DISTURBANCE
HYPOTENSION
SEIZURES
COMA
** permanent neurologic deficit can occur in survivoprs of severe, acute carbond monoxide posing |
0 |
sue524 Sat, 11 Feb 2012 05:29:33 GMT |
|
| Carbon monoxide reacts on the body by |
BINDS WITH HEMOGLOBIN
200 -500 times stronger
REDUCTION OF OXYGEN CARRIED BY HEMOGLOBIN
BRONCHOSPAMS
EDEMA OF AIRWAYS AND ALVEOLI
ARDS MAY DEVELOP IN 1-2 DAYS |
0 |
sue524 Sat, 11 Feb 2012 05:22:01 GMT |
|
| Steam inhalation can cause |
theraml damage to tissue to the lwoer respiratory tract |
0 |
sue524 Sat, 11 Feb 2012 05:22:01 GMT |
|
| Teh lower airway of he luns are typically protected from __ damage by cooling the inhaled gases in the uper airway and laryngeal spasm. Upper airway obstruction due to tissue edema and laryngeal spasm can occure quickly however causing ___ |
Thermal damage to lower airways
causing asphyxiation or oxygen deprivation |
0 |
sue524 Sat, 11 Feb 2012 05:22:01 GMT |
|
smoke inhaltation can significantly affect nromal respiratory functon in three ways
1. __ __ to airways leading to impaired ventilation
2__ __ or __ poisoning resultin in tissue hypoxia
3__ __ to the lung from nixious gases, which can lead to impaired gas exchange |
1 thermal damage
2 carbon monoxide or cyanide poisoning
3 chemical damage |
0 |
sue524 Sat, 11 Feb 2012 05:22:01 GMT |
|
pulmonary injury due to inhaltion the cause are
**smoke inhalation affects up to 1/3 of pt admited to burn units |
Smoke inhalation
-hot air
-toxic gases |
0 |
sue524 Sat, 11 Feb 2012 05:06:41 GMT |
|
| nursing diagnosis for pulmonary contusions are |
1.Acute pain
2.Ineffective airway clearance
3.Impaired gas exchange |
0 |
sue524 Sat, 11 Feb 2012 05:06:41 GMT |
|
| with pulmonary contusion monitor |
Monitor :
pain – administer medications very important
Breathing sounds
ABG’s
CBC
Vital signs
Sputum (color, amount)
Positioning for optimal lung expansion (elevate the head of bed)
Coughing, deep breathing, chest PT
Administer oxygen
Mechanical ventilation settings |
0 |
sue524 Sat, 11 Feb 2012 05:06:41 GMT |
|
| treatment of pulmonary contusion include |
Supportive treatment
Mechanical ventilation
PEEP
Bronchoscopy – remove sputum, cellular debris , preventing atelectasis
Fluid management
ABG’s measurement |
0 |
sue524 Sat, 11 Feb 2012 05:06:41 GMT |
|
| later manifestion of pulmonary contusion are |
tachycardia, tachypena, dyspena and cyanosis. |
0 |
sue524 Sat, 11 Feb 2012 05:00:00 GMT |
|
| Early manifestion of pulmonary contusion are |
increased sob, restlessness, apprehaension and chest pain and copius sputum |
0 |
sue524 Sat, 11 Feb 2012 05:00:00 GMT |
|
| Manifestation of pulmonary contusion may not be apparent unitl __ - __ hours after njury |
12 to 24 hours after injury |
0 |
sue524 Sat, 11 Feb 2012 04:58:36 GMT |
|
| in pulmonary contusion what happens |
aveloi and pulmonary arterioles rupture causing intravelor hemmorrhage and interstitial and bronchial edema. the inflamation and edema impair production of surfactant. Pulmary vascular ristance increases and blood flow decreases |
0 |
sue524 Sat, 11 Feb 2012 04:58:36 GMT |
|
| Pulmonary contusion are mostly likly from |
MVA
Significant fall or crush injury |
0 |
sue524 Sat, 11 Feb 2012 04:58:36 GMT |
|
| Treatment of Flail chest is |
Intercostal spinal block
Epidural anesthesia
Oxygen therapy
Internal or external fixation
Preferred treatment is intubation and PEEP ventilation |
0 |
sue524 Sat, 11 Feb 2012 04:58:36 GMT |
|
| flail chest caused |
1 dyspnea
2 pain espically during inspiration
3 paradoxic chest movement
4 palpalbe crepitus
5 unequal chest expansion
6 breath sounds are diminished and crackles may be heard |
0 |
sue524 Sat, 11 Feb 2012 04:54:19 GMT |
|
| flaif chest is frequesntly assiced with underlying |
pulmonary contusions |
0 |
sue524 Sat, 11 Feb 2012 04:54:19 GMT |
|
In flail chest the flail segment is sucked in during ___
and moves outward during
this is know as |
in during inhalation
outward during exhale
paradoxic movement |
0 |
sue524 Sat, 11 Feb 2012 04:54:19 GMT |
|
| multiple rib fractures may impair chest wall stability and normal chest function. Two ore more consecutive ribs are fractured in multiple places a free flating segment of chest wall this is known as |
flail chest |
0 |
sue524 Sat, 11 Feb 2012 04:54:19 GMT |
|
| Treatment of rib fracture |
Heal uneventfully - one rib
Providing analgesia
Promote coughing
deep breathing |
0 |
sue524 Sat, 11 Feb 2012 04:47:33 GMT |
|
symptoms of rib fracatures
1____ breathing pain
2___ coughing pain
3coughing
4___ respirations
5 ___ cough
6 skin can ___
7 under skin you can may feel and hear
8Breath sounds are ___
9 voluntary ____ |
1Inspiratory pain
2 Inspiratory coughing
3 Coughing
4 Shallow respirations
5 Inhibited cough
6 Bruising
7 Crepitus
8 Breaths sounds diminished
9 Voluntary splinting |
0 |
sue524 Sat, 11 Feb 2012 04:47:33 GMT |
|
1 Simple rib fracture-
2 Displaced rib-
3 First and second rib fracture can damage
4 Seventh- Tenth – can
5 complication of rib fractures can lead to |
1. one rib
2. can penetrate plura
3 intrathoracic vessels
4 liver spleen injury
5. (atelectasis, pneumonia, respiratory failure) |
0 |
sue524 Sat, 11 Feb 2012 04:47:33 GMT |
|
| in pe decreased urinary output is often and early indicator of |
decreased cardiac output |
0 |
sue524 Sat, 11 Feb 2012 04:47:33 GMT |
|
| postion to put person in if they have a pe |
fowlers or high fowlers pistion with lower extremities dependant |
0 |
sue524 Sat, 11 Feb 2012 04:37:00 GMT |
|
Hypoxemia often causes __ and __.
Hypercapnia may reduce ___ .
Cyanosis indicates significatn ___ |
confusion and agitation
LOC
hopoxemia |
0 |
sue524 Sat, 11 Feb 2012 04:37:00 GMT |
|
PE results in ares of the lungs that are ventilated but not perfused; they receive no ___ blood flow. if the embolous is large and a major segment of the lung is unperfused __ __ is significantly affeced
Nursing intervention are directed towards |
capillary blood flow
gas exchange
impaired gas exchange |
0 |
sue524 Sat, 11 Feb 2012 04:37:00 GMT |
|
| Large PE can cause significant mismatch between pulmonary ___ and ___ |
pulmonary ventilation and circulation |
0 |
sue524 Sat, 11 Feb 2012 04:37:00 GMT |
|
| nursing interventions for PE |
Early ambulation
External pneumatic device ( SCD)
Anti-embolism stockings (TED’s) fitted
Exercise- legs
Physical therapy consult
Discouraging crossing legs, using pillows under legs |
0 |
sue524 Sat, 11 Feb 2012 04:28:29 GMT |
|
| if you notice the following what do you do hemathuria, Hemoptysis, bleeding gums, back or abdominal pain |
Promptly report |
0 |
sue524 Sat, 11 Feb 2012 04:28:29 GMT |
|
what type of therapy is used to treat massive PE and hypotension
name the durgs |
Fibrinolytic
Streptokinase, urokinase or plasminogen activator to lyse embolus |
0 |
sue524 Fri, 10 Feb 2012 15:11:42 GMT |
|
| what is used to stop anticoagulant effects in heparin if bleeding occurs |
protamine |
0 |
sue524 Fri, 10 Feb 2012 15:11:42 GMT |
|
| Risk associated with bleeding with heparin are |
cardiac, hepatic, renal disease and over age of 60 |
0 |
sue524 Fri, 10 Feb 2012 15:11:42 GMT |
|
| coumadin is iniated same time as heparin and alther the sythesis of vitamin __ and requires __ - __ days to be fully effective. Therapy is continued for __ - __ months |
K
5 -7 day
2-3 months |
0 |
sue524 Fri, 10 Feb 2012 15:11:42 GMT |
|
Heparin Therapy for PE Intially is bolus of __ to __ units followd by continous infusion at the rate of __ to __ units per hour
what is monitored
how long does heparin therapy last |
5000 to 1000 bolus
1000 to 1500 units per hour
aPTT or PTT monitored
5 days until oral anticoagulatn theray is effective |
0 |
sue524 Fri, 10 Feb 2012 15:06:55 GMT |
|
| Treatment of PE |
MEDICATIONS
-anticoagulant therapy
–HEPARIN
SURGERY
-venous trombectomy
Use of Filters - Venal caval filter,
Greenfield Filter |
0 |
sue524 Fri, 10 Feb 2012 15:06:55 GMT |
|
| PE manifestation usually develop __ over a period of ___. Most common symptom are __ ____ __ |
abruptly, with in minutes.
symptoms are dyspnea, pleuritic chest pain, anxiety and a sense of impending doom, and cough are also commmone |
0 |
sue524 Fri, 10 Feb 2012 15:06:55 GMT |
|
| obstruction fo pulmonary blood flow by an embolus affects both __ and ___ |
perfusion and ventilation |
0 |
sue524 Fri, 10 Feb 2012 15:06:55 GMT |
|
| in large pulmonary artery PE the gas exchange is signifacantly reduced or preventd and cardiac out ___ as the blood fails to move through the pulmonary vasuclar systema nd retun to the __ __ |
falls
does not return to the left heart |
0 |
sue524 Fri, 10 Feb 2012 14:59:28 GMT |
|
| this type of test for pe are hightly specific to the presence of thormbus. the ___-___ is a fragment of fibrin formaed during lysis of blood clot; elevated blood levels indicate thrombus formation and lysis |
Plasma D-dimer |
0 |
sue524 Fri, 10 Feb 2012 14:59:28 GMT |
|
| diagnostic test for pe |
Chest CT scan
Pulmonary Angiography
Chest X-RAY
ECG
ABG’s
Plasma D-dimer |
0 |
sue524 Fri, 10 Feb 2012 14:59:28 GMT |
|
| Signs and symptoms of PE |
Dyspnea
Shortness of breath
Chest pain
Anxiety
Cough
Tachycardia
Tachypnea
Crackles ( rales)
Low grade fever
Diaphoresis
Hemoptysis
Cyanosis |
0 |
sue524 Fri, 10 Feb 2012 14:59:28 GMT |
|
reason for PE During child birth
Release of amniotic fluid in circulation |
AMNIOTIC FLUID EMBOLISM |
0 |
sue524 Fri, 10 Feb 2012 14:54:38 GMT |
|
Most common nonthrombotic emboli
Long bones typically femur
Release of bone marrow and fat in circulation |
Fat Embolism |
0 |
sue524 Fri, 10 Feb 2012 14:54:38 GMT |
|
| Patho for PE |
Thrombus formation
Embolus development
Entering Pulmonary Arterial System |
0 |
sue524 Fri, 10 Feb 2012 14:54:38 GMT |
|
Large pulmonary artery PE would cause?
Lung tissue PE would cause
Small segment obstruction would cause |
-large pulmonary artery – sudden death
-lung tissue infarction- significantly less flow
-small segment obstruction-no permanent injury |
0 |
sue524 Fri, 10 Feb 2012 14:54:38 GMT |
|
| PE is the ___ leading cause of death |
3rd |
0 |
sue524 Fri, 10 Feb 2012 14:51:19 GMT |
|
| Risk factors are for PE |
DVT(stasis of venous blood flow, vessel wall damage, altered blood coagulation)
Prolonged immobility
Trauma (hip, femur)
Surgery
MI, heart failure
Obesity
Age
Oral contraceptives
Pregnancy, child birth
and broken FEmur bone |
0 |
sue524 Fri, 10 Feb 2012 14:51:19 GMT |
|
Frequent cause of PE are
Other causes are |
Thromboemboli or blood clots that developt in the venous system dvt or right sid eof the heart are the most frequent causes of pe
Blood cloths
DVT
Tumors
Right side heart thrombus
Fat
Bone marrow
Amniotic fluid
Intravenous injection of air |
0 |
sue524 Fri, 10 Feb 2012 14:51:19 GMT |
|
OBSTRUCTION OF A BLOOD FLOW IN PART OF THE PULMONARY VASCULAR SYSTEM
by an embolus |
pulmonary embolism |
0 |
sue524 Fri, 10 Feb 2012 14:51:19 GMT |
|
| nursing diagnosis for ards would be |
IMPAIRED GASS EXCHANGE
INEFFECTIVE BREATHING PATTERN |
0 |
sue524 Fri, 10 Feb 2012 14:46:16 GMT |
|
| Nursing managment of ards would include |
PREVENTION
-early recognition
-preventing spread pathogens
-attention to line care
-preventing nosocomial infection
Sedated client or paralyzed client – care for sedated or paralyzed client
Prone positioning- Vollman prone positioner
- 30 minutes
Lubricate eyes before turning
Secure lines and drains |
0 |
sue524 Fri, 10 Feb 2012 14:46:16 GMT |
|
| PHARMACOLOGICAL SUPPORT for ards would include |
ANTI-INFLAMATORY –CORTICOSTEROIDS
VASODILATORS- NITRIC OXIDE inhalation
SURFACTANT AND BETA-AGONIST – via endotracheal tube
CYTOKININE INHIBITORS-Lisofylline |
0 |
sue524 Fri, 10 Feb 2012 14:46:16 GMT |
|
| Treatment of ARDS is |
OXYGENATION
VENTILATION
FLUID MANAGEMENT
PHARMALOGICAL SUPPORT
ANTI-INFLAMATORY MEDICATIONS
VASODILATOR MEDICATIONS
SURFACTANT AND BETA-AGONISTS
CYTOKINE INHIBITORS |
0 |
sue524 Fri, 10 Feb 2012 14:46:15 GMT |
|
In final stage of ards CArbon dioxide can not diffuse across the __ __
PACO2 levels
PAO2 levels |
Hyaline membrane
PACO2 rise
PA02 fall |
0 |
sue524 Fri, 10 Feb 2012 14:42:45 GMT |
|
More debris from damaged cells and hyaline membrane
Further reduced gas exchange
Carbon dioxide cannot diffuse across hyaline membrane
paCO2 level rise
paO2 level falls
Respiratory acidosis can develop
What stage of ards Without respiratory support respiratory failure will develop
Almost 50% of patients die even with aggressive treatment |
Final stage |
0 |
sue524 Fri, 10 Feb 2012 14:42:45 GMT |
|
this phase is
Fluid rich in protein accumulates in alveoli
Inactivation of surfactant
Further damage of surfactant producing cells
Alveoli stiffen and collapse
Atelectasis
Breathing effort increases
Gas exchange impairment
Blood oxygen levels fall
Carbon dioxide levels fall initially – because of tachypnea |
ALVEOLAR COLLAPS |
0 |
sue524 Fri, 10 Feb 2012 14:42:45 GMT |
|
what stage of ards is
Damaged capillary and alveolar walls are now more permeable
Plasma-Proteins-Red blood cells – enter the interstitial space- causing edema
Damage of surfactant producing cells
Pressure in interstitial space increases
Fluid leaks into alveoli
Balance disrupted between osmotic and hydrostatic pressure
Imbalance causes more fluid to enter alveoli |
Pulmonary Edema |
0 |
sue524 Fri, 10 Feb 2012 14:42:45 GMT |
|
This stage of ARDS is
Alveoli and capillaries are damaged with chemical released during inflammation process
Damaging chemical are released from macrophages (oxidants, inflammatory mediators, enzymes, peptides)
Lysosomes release lysosomal enzymes causing further damage |
Initation phase |
0 |
sue524 Fri, 10 Feb 2012 14:39:12 GMT |
|
Inflammation of lung ____
Leading to impair gas exchange
Causing hypoxemia
Resulting in multiple organ failure
Requiring mechanical ventilation
Disease is
Condition often fatal |
parenchyma
ARDS |
0 |
sue524 Fri, 10 Feb 2012 14:39:12 GMT |
|
Manifestation of cor pulmonale are those of underlying pulmonary disorders and right sided heart failure. the signs and symptoms are
the signs of right sided heart failure are |
chronic productive cough, progressive dyspnea and wheezing are common
pheripheral edema and distended neck vein skin is warm moist and both ruddy and cyanotic becaused of increased number of RBC and hypoxemia |
0 |
sue524 Fri, 10 Feb 2012 14:06:33 GMT |
|
a condition of right ventricular hypertorpy and failure resulting from long standing pulmonary hyptertions.
The most common cause of this is |
COR pulmonale
COPD |
0 |
sue524 Fri, 10 Feb 2012 14:01:08 GMT |
|
1. in pulmonary htn cbc commonly show
2. ABGs and o2 saturation measures
3. chest xray shows
4. ECG shows |
1. polycythemia (increased number of red blood cells
2 hpoxemia
3 right heart enlargement and dilation of central pulmonary arteries
4 changes of right ventricular hypertrophy |
0 |
sue524 Fri, 10 Feb 2012 14:01:08 GMT |
|
| drugs to treat pulmonary hyptertinosion are |
Calcium channel blockers nifedipine, or diltiazem, epoprostenol or trepostinol or bosentan and coumadin |
0 |
sue524 Fri, 10 Feb 2012 14:01:08 GMT |
|
| signs of pulmonary hypertenstion are |
dyspnea, fatigue, angina and syncope with exertion |
0 |
sue524 Fri, 10 Feb 2012 14:01:08 GMT |
|
| Volume left in lungs after normal exhalation is and it is called |
2400 ml Functional risedual capacity FCR |
0 |
sue524 Wed, 08 Feb 2012 22:50:05 GMT |
|
| atrerial bloos is colled in a ___ ___ ___ . samples is placed on iceb ag and taken immediately to lab. apply presures on puccture site for __ -__ **do nto collect blood from the same arem used for an IV Infusion |
heparinized needle and syringe
apply pressure 2 - 5 minutes |
0 |
sue524 Wed, 08 Feb 2012 22:46:00 GMT |
|
1 If ph is less than 7.35 it indicates
2 if more than 7.45 it is
3 paco2 increased it is
4 paco2 decreseased |
1 acidosis
2 alkalosis
3 acidosis
4 alkalosis |
0 |
sue524 Wed, 08 Feb 2012 22:46:00 GMT |
|
ABGs normal values
Ph
PaCo2
pao2
HCo3
BE |
Ph 7.35 - 7.45
Paco2 35 - 45
Pao2 75 100
hco3 24 - 28
BE 2meq/l |
0 |
sue524 Wed, 08 Feb 2012 22:46:00 GMT |
|
| Active cells produce about how much carbon dioxide each minute. ***this is the exact amount that is excreated by lungs each minute |
200ml |
0 |
sue524 Wed, 08 Feb 2012 22:46:00 GMT |
|
| a lipoprotein produced by the aveolar cells interfers with this adheiveness of water molecules, reducing surface tension and helping expand the lungs is |
Surfactant |
0 |
sue524 Wed, 08 Feb 2012 22:34:30 GMT |
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| approx how much air never reaches the aveoli the amount remain in the passageways is called and the amt is |
Anatomic dead space volume 150 ml |
0 |
sue524 Wed, 08 Feb 2012 22:34:30 GMT |
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this si the sum of TV + IRV + ERV is called. It is approx.
how much Toltal lung capacity (TLC) is |
vital capacity VC 4500 ml notes have 4800
6000 ml |
2 |
sue524 Wed, 08 Feb 2012 22:52:15 GMT |
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| the volume of air that remains in the lungs after a forced expiration is called and the amt is |
Risidual volume 1100 ml to 1200 ml |
1 |
sue524 Wed, 08 Feb 2012 22:50:35 GMT |
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| Approximately the air that can be foreced out over the tidle volumne is called. the amount is |
Expiratory reserve volumne ERV
1000 ml notes have 1200 ml |
1 |
sue524 Wed, 08 Feb 2012 22:51:26 GMT |
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The amount of air that can be in haled forcibly over the tidle volume is ?
Amount is |
Inspiratory Reserve Volume IRV
2100 to 3100 ml notes have 3100 ml |
1 |
sue524 Wed, 08 Feb 2012 22:51:04 GMT |
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| the amount of air moved in and out of the lungs with each nromal, quiet breath is called? approxiamately how much air is moved |
1 Tidal volume TV
500 ml |
0 |
sue524 Wed, 08 Feb 2012 22:30:32 GMT |
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| Respiratory Volume and capacity are affected by |
gender, age, weight and health status |
0 |
sue524 Wed, 08 Feb 2012 22:30:32 GMT |
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