-
pack years =
# of packs/day X of years smoked
-
normal urine output
40 ml/hr
-
what would you give to a pt with a loew urine output
lasix/diuretics
-
drowsy state, may have decreased cough or gag reflex
obtunded
-
difficulty breathing except in the upright position
orthopnea (heart prob, CHF)
-
run down feeling, nausea, weaknes, fatigue headache (electrolyte imbalance, dec potassium)
general malaise
-
difficulty swallowing and hourseness
dysphagia
-
excessive fluid in the tissue known as pitting edema
peripheral edema
-
peripheral edema occurs in
arms and ankles (most likely ankles)
-
peripheral edema is caused by
-
accumulation of fluid in the abdomen
ascites
-
ascites is caused by
liver failure
-
caused by chronic hypoxemia
clubbing of fingers (pt with CF)
-
neck vain sticking out
increased venous distention
venous distention
-
indication of peripheral circulation
capillary refill
-
profuse/heavy sweating
diaphoresis
-
kussmauls is caused byu
- metabolic acidosis
- renal failure
- diabetic ketoacidosis
-
tachycardia indiaces
hypoxemia
-
bradycardia indiacates
heart failure
-
pulled to abnormal side (TOWARD)
-
pused to normal side (AWAY)
- pl effusion
- tension pneumothorax
-
normal air filled lung
resonant
-
-
air filled stomach, extra air
- tympanis
- hyperresonant
- (pneumothorax-emphysema)
-
normal breath sounds
vesicular
-
pt is instructed to say E and it sounds like A- indicates consolidation
egophony
-
crackles- secretion/fluid
rales
-
adventitious b/s
abnormal
-
course rales- large airway secretions
rhonchi (upper airway)
-
pt with fine rales needs what kind of treatments
- ippb
- heart drugs
- diuretics
- o2
-
wheeze is due to
bronchosparm
-
pt who wheezes needs a
bronchodilator
-
unilateral wheeze indicative of a
foreign body obstruction
-
stridor is due to
upper airway obstruction
-
supraglottice swelling -
epigottitis
-
-
how to treat pleural friction rub
steroids and antibiotics
-
right hemi is slightly higher than the left before of the
right liver
-
radioluceny-
lungs filled with AIR
-
where is the film on a AP projection
film behind back
-
lateral decubitus postition is when pt ying on the
affected side
-
lateral decubitus is valuable for detecting
small pl effusions
-
the tip of the ETT should be positioned below the vocal codes and no closer than ___cm or ___inch ABOVE the CARINA
-
whats the quickest way to determine adequate ventilation before a chest xray
-
radiodense / opaque
FLUID, organs, bones
-
infiltrate
ill defined- atelectasis
-
consolidation-
- solid white area
- pneymonia
- pl effusion
-
fluffy infiltrates/ butterfly batwing pattern
pulm edema
-
ground glass appearance
honeycomb patter
diffuse bilateral radiopacity
ARDS/IRDS
-
air bronchogram
pneumonia
-
peripheral wedge shape infiltrate
pulm embolus
-
* an xray through a specific plane of the body part to be examined. images appear in slices of the organ
computerized tomography CT scan
-
scan with contrast dye may be used for diagnosis of pulm embolus
spiral CT scan
-
has the ability to determine the precise position of tumors and the involvement surrounding structures
magnetic resonance imaging MRI
-
scan that results indicate a normal ventilation scan but abnormal perfusion scan = pulm embolism
v/q scan
-
presense of cancer, brain disorders and heart disease
PET scan positron emission tomography
-
allow study of obstructing lesions and bronchiectasis
bronchogram- injection of radio opaque contrast medium into the trachebronchial tree
-
normal value for ICP
5-10
-
what is used to monitor asthma pt
exhaled nitric oxide NIOX
-
a decrease in FENO means a
decrease in airway inflammation
-
increase WBC =
bacterial infection treat with antibiotic = penicillin
-
-
yellow sputum is a presense of
WBC, bacterial infection
-
green presense of
gram neg bacteria (bronchiectasis, pseudomonas)
-
-
id the bacteria present and id what antibiotics will kill the bacteria
culture and sensitivity
-
id whether it is gram + or gram -
gram stain (quickly identify)
-
id mycobacterium tuberculosis
acid fast stain
-
the electrical impulse is generated by the
SAnode
-
V1= ____ intercostal space on ____ side of ____
-
V2= ____ intercostal space on ____ side of ____
-
V3= btwn ___ and ____ on ____ side
-
V4= ____ intercostal space on ____ line
-
V5= btwn ___ and ___ on the ____ side
-
V6= ____ intercostal space, ____ line
-
if the 2 R waves are btwn 3-5 large boxes then the rate is
normal
-
if the 2 Rwaves are less than 3 then the rate is
tachycardia
-
if the 2 R waves are greater than 5 then the rate is
brady
-
v tach with pulse/ what should you do?
cardiovert
-
v tach with no pulse
defibrillate
-
-
-
how to treat asystole
- confirm lead 2 first
- epi
- atropine
- cpr
- (DO NOT DEFIB)
-
whats the normal axis through the heart
DOWN and to the LEFT
-
mothers history is also called
perinatal history
-
term infant
born btwn 38-42 weeks
-
apgar score of 0-3
resuscitate
-
apgar score of 4-6
support- stimulate, warm, administer o2
-
apgar score of 7-10
monitor- routine care
-
recommend when a pneumothorax is suspected
transillumination
-
what will cause the entire hemithorax to light up in a transillumination
- pneumothorax
- pneymomdediastinum
-
what can u use to determine gestational age
- dubowitz method
- new ballard score NBS
-
most common for lung maturity info
l/s ratio = 2:1 higher is good
less than 2:1 high risk of HMD/IRDS
-
-
-
noninvasive oximetry
pulose oximeter SPO2 93-97%
-
invasive oximetry
co-oximeter/hemoximetery
most accurate
-
co-oximeter is used to diagnose
carbon monoxide poisoning (>20 COHb)
-
-
-
COHb for heavy smokers
10-15%
-
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
-
mean arterial pressure MAP formula
(2 X diastolic) + systolic / 3
ex: 120/80
2 x 80 = 160 + 120 / 3 = 93
-
right heart problem is
CVP
-
-
-
-
-
pwp normal value
4-12 mmhg
-
ex of right heat failure
- cor pulmonale
- tricuspid valve stenosis
-
ex of lung disorders
- pulm embolism
- pulm hypertension
- air embolism
-
ex of left heart failure
- mitral valve stenosis
- chf
- high peep effects
-
the difference btwn the systolic and diastolic
pulse pressure
sys - diastolic
normal value = 40
-
** cardiac output QT
fick equation
QT= VO2 / C(a-v)o2 (10)
c(av)o2 and vo2- o2 consumption
-
cardiac index CL formula
qt / bsa
-
systemic vascular resistance formula
MAP - CVP / cardiac output
-
SVR normal value
<20 or 1600 dynes
multiply by 80 to get dynes
-
stroke volume is qt also, what is the formula
hr X stroke vol
-
pulm vascular resistance PVR formula
MPAP - PCWP / cardiac output
-
PVR normal value
< 2.5 or 200 dynes
multiply by 80 to convert to dynes
|
|