Test 1- Semester 4 Clotting (13) Thrombocytopenia HIT (Heparin Induced Thrombocytopenia) ITP (Immune Thrombocytopenia Purpura) TTP (Thrombotic Thrombocytopenic Purpura) Blood Admin RH compatibility Acute Hemolytic Reaction Febrile Non Hemolytic reaction Allergic Reaction TRALI (Transfusion Related acute lung injury) TACo (Transfusion associated circulatory overload) DIC HELLP
Gas Exchange Review Three properties Diagnostic Tests Ventilation Radiographical Studies Oxygen moving into the lungs and Co2 CT- PE, pneumonia (3D image of lungs) out VQ scan- ventilation/perfusion (lets us Impaired: high altitude, lack of surfactant know how pt is ventilating and (newborns) narrowing airways from perfusion, a 2 day test) edema PET scan- can seen nodules (Cancer) that Transport could effect gas exchange Ability of Hbg in the cells to carry oxygen Endoscopy Impaired: anemia, blood loss Pulmonary Function test Perfusion Tells us how lungs capacity is Ability of circulating blood to move RBC Tidal Volume- How much vol our lungs Impaired: Mi, dysrhythmia can hold (Depends on Weight, Sex, Height) Risk Factors Lab Tests Age- infants (They are belly breathers so ABG's impacted bowls can decrease breathing) CBC, electrolytes Elderly- decreased elasticity, have more Sputum- fragile immune system Viral swabs Smoking Chronic medical- (Asthma, COPD, CF) Drug Therapy Immunosuppression- Cancer, chemo Reduce inflammation (Corticosteroids, Impaired cognition- drug OD bronchodilators) Brain injury Improve congestion (diuretic) Prolonged immobility Treat infection (IV antibiotics) Reduce Anxiety (Benzo start with LOWER Respiratory Assessment dose you can always give more) Inspection- accessory muscle use, cyanosis (fingers, gums, and tongue may be dusky or blueish) Auscultation VS Abnormal (High HR, Low Spo2, High BP or Low BP later which is worse, abnormal sinus rhythm) Cognition- anxious, agitation, somnolence is really bad sign
Respiratory Assessment 1.Inspection Chest movement symmetrically Accessory muscle use Color- pale 2.Palpation Lumps, bumps, pain Symmetrical expansion of lungs Crepitus- or Subcutaneous emphysema (feels like rice crispies)- from when air escapes into the tissues you can feel air it can be around chest tube site or it can travel to hips, forehead etc. Tactile Fremitus- listening for vibrations (ask them to say 99) Normal: not a lot of vibration. Abnormal- feel vibration means mucus, or fluid is in lungs 3.Percussion Use middle finger (tap tap) on both sides in rhythmic motion like a zig zag (let us know if tissue full of something) Normal: resonant low sound High pitch or dull: could be over bone Dull: pneumonia, pneumothorax, atelectasis Let us know if tissues are air filled, fluid filled or consolidated not deep seated lesions 4. Auscultation Anterior- supine or sitting up Posterior- sitting up or roll side to side If over clothes may sound like pleural friction rub
Interpersonal Relationship (17)
Crisis) A- Odd/Eccentric Paranoid 0 Schizoid Schizotypal B- Dramatic Erratic- Narcissistic Histrionic 0 Antisocial Borderline C- Anxious/Fearful Avoidant Dependent OCD Crisis Sex Trafficking Violence (8 questions on Violence/Incivility) Overview Intimate Partner Violence Sexual Violence - Rape Elder Abuse Child Abuse Shaken Baby Syndrome Incivility in Nursing practice
Gas Exchange (20) Respiratory Distress Syndrome* Respiratory Failure and ABGs Hypercapnic Respiratory Failure Hypoxemia ARDS Chest tubes Anemia Pul