Last Modified: 2011-07-12
Tx w/ rapid cooling measures
Tx w/ warm waterbath (38-41 C), pain meds, and tetanus shot
= no pulse and no breathing
- initiate circ and resp support
- activate EMS
- use emergency equipment
- stabilize pt
- Dx and Tx
- early CPR/defib
- early ACLS
- hypoxia (low oxygen)
- hydrogen ion excess (acidosis)
- hyper-/hypo-kalemia (high/low K+)
- hypothermia (low body temp)
- taking drugs (overdose)
- tamponade (cardiac)
- tension pneumothorax (oneway valve in pleural cavity)
- thrombosis (pulmonary)
- thrombosis (coronary)
5 H's and 5 T's
- Magnesium sulfate
2. select energy lvl ~ 200 J
3. "lead select"
4. apply gel to paddles
5. position paddles on pt
6. check monitor display and assess rhythm
7. "Charging, Stand clear!"
8. press charge
9. "Shock on 3. One, I'm clear. Two, you're clear. Three, everybody's clear"
10. apply 25 lb pressure on both paddles and shock
11. check monitor for rhythm
2. call for help
3. position client
4. open airway
5. check for breathing
7. check circulation (pulse)
8. start compressions
9. check for spontaneous pulse
PaO2: 80-100 mmHg
PaCO2: 35-45 mm Hg
HCO3: 22-26 mEq/L
- compress both ulnar and radial arteries while client forms fist
- have client relax and let go of one artery, hand should turn pink
- repeat and let go of other artery
- resp distress
- cardiac dysrhythmias
- substernal pain
- nasal stuffiness
- sore throat
(similar to CHF in older adults)
- dull percussion sounds
- decreased chest wall expansion
- reflex bradycardia
- CHF, cirrhosis, nephritic syndrome
- empyema, pna
- lung/heart surgery, blunt/crushing injury
No coughing or talking
- need for suctioning
- kinks in tubing
- air leaks around cuff
(provides rapid relief for asthma)
Prepare for emergency intubation and potent systemic bronchodilators like epinephrine as well as systemic steroid therapy.
- chronic bronchitis
- resp acidosis
2. Alpha-antitrypsin (AAT) deficiency
3. air pollution
smaller ratio = worse COPD
- blood flow through lungs is hard
(resulting from alveoli stiffness or airway collapse)
- thickens right side of heart
- poor oxygenation
- chronic lung probs
- mechanical ventilators
- immunocompromised status
- fluid retention
- poor wound healing
- sputum smears (acid-fast) only shows how infectious it is.
- first morning specimens are the most accurate.
- watch for neurotoxicity
- take on empty stomach
- take Vit B6 to prevent toxicity
2 things about RIF?
- watch for hepatotoxicity
watch for what when taking this drug?
watch for what when taking this drug?
- Vit C
- extensive pulmonary edema (whiteout on x-ray)
(P waves are regular)
But thyroid hormones do not increase need for calcium.
So need less calcium supplementation.
- semen/vaginal fluids
- NOT by tears, urine, or sweat
It is permanent irreversible damage to CN VIII.
Traction pin sites should be covered initially, but then should be exposed to air. Rinsing with sterile saline is ok.
- DOES NOT darken skin.
Intermittent bubbling is normal.
Constant bubbling indicates air leak --> tension pneumothorax.
Salt substitutes contain high K+
- low Ca++
- fluid volume overload
- increased BUN & Cr
- metabolic acidosis (high H+)
- UO under 400ml/day (oliguria)
- Aminogylcosides (e.g. gentamycin)
- ACE inhibitors (e.g. catopril)
- autoimmune disorder that attacks mainly Schwann cells and destroys their myelin sheaths.
- loss of sensory function
- loss of DTR's
- weakness before paralysis
- loss of respiratory muscle control
- bladder/bowel retention
- sweating, sputum
CN II - optic
check pulse rate.
Complex seizures involve a change in awareness/consciousness.
- hepatic failure
- PKU (phenylketouria) due to lack of a hepatic enzyme (genetic)
- nutritional deficits
- drug/alcohol w/drawal
- drug/alcohol use
- ulcerative colitis
- pernicious anemia
- neck weakness, head bob
- muscle weakness
- even respiratory failure/arrest
followed by what else?
followed CK-MB (1-2 days)
it's more specific than CK-MB, and remains elevated for 7-10 days.
or 4-10 cm Water
right ventricular end diastolic volume.
- blood sugar
- blood sugar
Addisons --> dehydration
- if produces increased specific gravity, then you have central DI.
- if produces no increase in sp gr, then it's nephrogenic DI
(to reverse membrane excitability)
give orally w/ Vit D.
- hold aspirin and anti-HTN meds
- maintain moderate acitivity
Clonidine (Catapres) is supposed to suppress catecholamine release.
- phentolamine (Regitine)
it is lifelong.
- anxiety, irritability, blurred vision
- weakness, seizures
- no sweating
- N/V, abd pain
- Kussmaul's breathing (fruity breath)
(to avoid disulfram-like rxn)
- monitor renal fxn
- monitor liver fxn
- oral contraception less effective
BS>600, dehydration, absence of ketosis. Life threatening.
(others include illness, surgery, trauma, and stress)
SIADH leads to renal reabsorption of water (ADH effects) and excretion of sodium (RAAS suppression)
- stupor (cerebral hypoxia)
- bradycardia (low CO)
They experience increased appetite, but their fast metabolism keeps their weight down.
- abd pain
- weight loss
- abd distension, bloating
- constipation, diarrhea, change in bowel habits
- Vit. C
- supine or
- upright with arms over bedside table and legs dangling
- perforated bladder
- viral hepatitis
- F&E imbalance
- visible peristaltic waves rather than significant abd distention
- sudden projectile vomiting that relieves pain rather than infrequent vomiting
10-18 x10^9/L for appendicitis
>20 x10^9/L for peritonitis
low fevers (<101) for appendicitis
higher fevers (>101) for peritonitis
- high fiber diet for diverticulitis
- Diverticulitis: usually over 50
- NEVER >1L/day
- other points include paresthesia, pallor, diminished pulses
- other signs include fever, edema, and erythema
(cotton swab soaked with peroxide or iodine)
paralysis of fingers/toes
pulses - weak
paresthesia - numbness or tingling
pallor - cap refill time >3 sec, blue fingers/toes
- RA pain after rest, OA pain with movement
- RA is autoimmune, OA is not
Prostate Cancer: hard, irregular
side effect = blurred vision
- harmful chemicals (chronic exposure)
(small cell or non-small cell?)
N = nodes
M = metastasis
- unilateral wheezing
- chest wall pain
2nd respiratory acidosis (due to hypoxemia)
Onset of S&S for PE is sudden and rapid.
- decreased O2 sat
PaCO2 >50 & pH <7.30
Client with ARF are always hypoxemic.
- decreased pulmonary compliance
- bilateral pulmonary edema that is noncardiac
- dense pulmonary infiltrates ("ground glass" on CxR)
PEEP increases intrathoracic pressure and leads to decreased cardiac output.
hemothorax = dull
Increased intrathoracic pressure with decreased CO resulting in HYPOtension is a possible complication of pneumothorax
Tidaling is expected, but continuous bubbling is a sign of air leak
Using lotions on the dry skin patches caused by radiation can further irritate the skin.
HYPOkalemia decreases GI motility.
Report to physician if >100ml/hr.
(Slow drainage can be used to take out >1L of fluid over several hours.)
- widened pulse pressure
- irregular respiratory rate
== indicates increased ICP
Remove only those pieces of clothing that is not sticking to the skin. If it sticks, don't remove.
(causes L ventricular dysfxn)
- tension and hemothorax: shift to contralateral (unaffected) side
GI tract cleansing and a clear liquid diet are interventions for a client having a lower GI tract procedure, not an upper GI procedure.
- the client should be NPO for 6-12 hours prior to an EGD
(due to hyperphosphatemia)
- instruct to intake lots of fluids to flush out fragments
- you monitor for LOC
- red-brown urine
- low Ca++
- intense headaches
- profuse sweating
- feeling of doom
- nasal stuffiness
- facial erythema
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