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Nicotine Replacements
- Nicotine Patch (nicotrol, Nicoderm)
- Nicotine-oral (nicorette)
- Nicotine nasal spray
- Nicotine inhaler
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Disinfection
Destroying vegative pathogeneic microorganism
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Steraliztion
Destruction all microorganisms
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Vegetative organisms
Growing microorganisms
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Contaminated
Disease causing microorganisms
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Cidal
Microorganisms killed
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Spore
Resistant form certain species of bacteria
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Steam under pressure (steam autoclave)
- Steralization 121 @15ps for 15 min
- Plastics or heat sensitive items
- Heat sensitive tap or biological indicators
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Pasteruization
- Disinfection uses moderate temps to kill vegetative organisms
- Submersed hot water bath 63-70 for 30 min
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Incineration
Best treating contaminated disposable items & supplies
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Alkaline gluteradehyde (cidex)
- Disinfection or sterilization process
- reusable plastics
- sterilizing flexible fiberoptic bronchsco
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Acid gluteradehyde (sonacide)
disinfection or sterilization process
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Alchol
- Disinfection process
- Not sporicidal
- Its bactericidal & fungicidal
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Chemical indicators
- Located packaging tape & will change color indicating conditions met
- Assures package been through sterilization process
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Biological indicators
package sterile
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Longer term benefits or goals pul rehab
- Remove severity dyspnea
- Improve ability ADL
- Increases physical capacity of efficiency
- skeletal muscle
- decreased frequency hospitalizations
- reduce resting heart rate
- improve sputum clearance
- improve diaphragmatic breathing
- improve appetite
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Pulse dose oxygen delivery system
- In place flowmeter w/ nasal cannula, reservoir cannula, transtracheal catheters
- Sense start inspiration & delivers oxygen during inspiration
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Liquid bulk oxygen systems
- Last longer than cylinders
- Liquid oxygen very cold, frostbite and other skin damage
- Connections can freeze up
- Not used as back up system
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Oxygen concentrators
- Molecular sieve removes nitrogen & other gases form RA to concentrate O2.
- Ow: 1-2 L/min continuously
- If not working check circuit breaker/fuse
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Myasthenia Gravis
- Auto immunize response
- slow, fatigue improves w/rest
- Descending (mind to ground)
- Positive tensilon test
- Monitor VC/MIP
- Drugs:neostigmine, pyridostigmine, intubation /mechan vent short term.
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Guillain Barre Syndrome
- Delayed reaction viral infection
- Acute sudden weakness
- Ascenidng (ground to brain)
- Spinal tap-protein spinal fluid
- Monitor VC/MIP
- Drugs: steroids, prophylatic antibotics, mech vent/trach longer term/ plasmapheresis
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What is ARDS ?
Series reactions leading to inflammation decease in lung compliance shunting & hypoxemia
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ARDS Treatment
- CPAP? PEEP-increase FRC & decrease WOB
- Titrate PEEP & FIO2
- Use IMV/SIMV w/PEEP
- Consider pressure control ventilation
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What is PNA
Infectious bacteria or virus enters lung inhalation or aspiraiton
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PNA Treatment
- O2 if needed
- Bronchial hygiene
- Antibiotcs
- Mechanical vent: PaCO2>45 torr, PaO2<60torr
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