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Pile Management Card
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CTA Chest
-diagnoses a PE by injection of contrast at a high rate (4ml/sec.)
-tracked at the pulmonary artery to highlight a PE
D-dimer
-a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis
-contains two crosslinked D fragments of the fibrinogen protein
-diagnose thrombosis
PE
-pulmonary embolism
-most significant risk factor is an untreated DVT
-blood clot in the lungs
-acute onset chest pain, SOB, diaphoresis, dizziness, hypoxia
Alerts:
Common concern for any CC of SOB, r/o w/ D-dimer --> if pos CTA Chest. If untreated, PE can be lethal.
venous doppler
provides pictures of the veins throughout the body
thrombophlebitis
blood clot in a superficial vein
DVT
-Deep Vein Thrombosis
-blood clot in any of the extremities
-Risk factors: long periods of immobilization/recent prolonged travel, recent surgeries, history of blood clots, cancer, pregnancy, and birth control + smoking
-Presentation: swelling, pain, tenderness
-diagnosed by venous doppler,
-treated with blood thinners
thoracentesis
procedure to remove excess fluid in the space between the lungs and the chest wall. This space is called the pleural space
Pleural Effusion
-Fluid in the pleural cavity
-Typically worse with laying down
-If minor, can be monitored
-If large, must be drained via thoracentesis
Bronchitis
inflammation of the bronchioles
Pneumothorax
-collapsed lung
-collection of air in the space around the lungs
-puts pressure on the lung
-spontaneous vs. trauma
CAP Protocol
community-acquired pneumonia (CAP) protocol
Pneumonia
fever, cough, CAP protocol
Nebulizer
device used to administer medication in the form of a mist inhaled into the lungs
Asthma
hospitalization, home nebulizer, inhaler
COPD
-emphysema
-chronic obstructive pulmonary disease
-refers to chronic bronchitis
-airways become narrowed
-shortness of breath
-smoker
-home O2
Chest Wall Pain
-muscular pain
-worse with movement
-may be the result of recent trauma
-pain with movement of the trunk, tenderness on exam, breathing limited by pain
Pleurisy
-inflammation of the pleura (thin layers of tissue covering the lungs) usually as a result of lower respiratory infection
-chest pain worse with deep breaths, coughing, sneezing or sudden movement
Costrochondritis
-inflammation of the cartilage around the ribs, typically pleuritic pain
-pain with inspiration, coughing or pain reproduced with movement
Ortho
"straight" or "correct"
Orthopnea
-shortness of breath (dyspnea) which occurs when lying flat
-relieved by sitting or standing
Paroxysmal
A sudden outburst of emotion or action
DOE
dyspnea on exertion
PND
-paroxysmal nocturnal dyspnea
-sudden, severe shortness of breath at night that awakens a person from sleep
-closely associated with CHF
CHF
-Congestive Heart Failure
-Pulmonary edema/congestion, low EF (ejection fraction), poor cardiac output and increased peripheral vascular resistance
-decreased efficiency of the body’s circulatory system
-commonly treated w/ diuretics supplemented w/ potassium
-PND
-Orthopnea
-DOE
Ways to do stress tests
Treadmill or Nuclear medication/Thallium/Adenosine
Angina
not a “disease” itself but rather a symptom of CAD
“heart pain”
Cath lab
coronary arteries are visualized, stents may be placed
STEMI
-ST Elevation Myocardial Infarction
-Active MI
-shown in morphological changes of EKG
-door to Cath-lab 60 min.
When is ASA given to cardiac patients?
Always, unless allergy
SL
sublingual
NTG
Nitroglycerin
opens up blood vessels
vasodilator
administered by SL spray or 1” patch (paste)
MI
Myocardial Infarction
hypercholesterolemia
-elevated cholesterol levels
hyperlipidemia
-commonly occurring form of hypercholesterolemia characterised by increased LDL and triglyceride concentrations, often accompanied by decreased HDL
CAD
-Coronary Artery Disease
-describes compromised coronary artery function causing an increased risk of MI
-Risk factors: age, hypertension, hyperlipidemia, history of smoking, obesity, diabetes, ethnicity, family history of cardiac disease
BKA/AKA
below/above the knee amputation
Pacemaker/AICD
-Automatic Implantable Cardioverter Defibrillator
-a small battery-powered electrical impulse generator
-implanted in patients who are at risk of ventricular fibrillation
-detects cardiac arrhythmia and corrects it by delivering a jolt of electricity
Stents
-artificial 'tube' inserted into a natural passage to counteract flow constriction
Angiogram
-medical imaging technique used to visualize the inside of blood vessels -injecting a radio-opaque agent into the blood vessel and imaging using X-ray (fluoroscopy)
-the film of the blood vessels is called an angiogram
CABG
-coronary artery bypass graft
-heart bypass
-arteries or veins from elsewhere in the patient's body are grafted to the coronary arteries to bypass atherosclerotic narrowings and improve the blood supply to the coronary circulation supplying the myocardium
Mastectomy
surgical removal of one or both breasts
Colectomy
surgical resection of any extent of the large intestine
Tonsillectomy
surgical removal of the tonsils
D&C
dilation and curettage
refers to the dilation of the cervix and surgical removal of part of the uterine lining by scraping
Tubal ligation
form of female sterilization, in which the fallopian tubes are severed and sealed
Salpingo-oophorectomy
surgical removal of a fallopian tube and an ovary
Oophorectomy
surgical removal of an ovary or ovaries
Hysterectomy
surgical removal of the uterus
Cholecystectomy
surgical removal of the gallbladder
Appendectomy
surgical removal of the appendix
MD/Scribe Notes
HPI: history of present illness
ROS: review of systems
PMH: past medical history
FSHx: family/social history
PE: physical exam
ED Flow
Triage (RN): vitals, CC, short hx, level of acuity assigned
Bed assignment
Primary nurse assessment
MD/Scribe
Waiting for labs and test results
Disposition
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