413742
Description
Flashcards by Jenny Smith, updated more than 1 year ago
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Created by Jenny Smith
about 11 years ago
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| Question | Answer |
| Signs/sx of MI | Sub-sternal pain/pressure radiating to L arm Pain/discomfort in jaw, back, abd., or shoulder Happens without cause Relieved only by opiods >30 minutes WOMEN: ATYPICAL ANGINA |
| What hemodynamic changes occur with septic shock? | Hypodynamic changes in early sepsis and shock. SEVERE: hyperdynamic: ^HR, ^stroke volume, normal CVP. Progression to DIC->Clots, ischemia, and hypoxia |
| Superficial Burn | Pink-red Mild Edema Painful No blisters, eschars, or grafting 3-6days {Sun burn, flash burn} |
| Superficial partial-thickness burn | pink-red mild-moderate edema Painful Blisters No Eschar 2 weeks to heal No grafts { Scald, flames, brief contact with hot objects} |
| Deep-partial thickness burn | Red- white Moderate edema Painful Blisters rare soft and dry eschar 2-6wk healing Grafts for prolonged healing {scalds, flames, prolonged contact with hot objects, tar, grease, chemicals} |
| Full-Thickness | Black, brown, yellow, white, red Severe edema Blisters but not always hard and inelastic eschar weeks-months for healing Grafting necessary {Scalds, flames, prolonged contact with hot objects, tar, grease, chemicals, and electricity} |
| Deep-full thickness burns | Black No edema, Absent pain No blisters Hard and inelastic eschar Weeks-months with grafts to heal Flames, electricity, grease, tar, chemicals |
| fluid resuscitation for burns | Start and maintain large bore IV in area of intact skin Talk with Drs to determine fluid type and total volume for first 24hrs Give one half of total 24hr volume in first 8hrs(from time of burn) and the rest over 16hrs qhr check: IV site, infusion rate, and infused volume, VS, breath sounds, voice, o2sat, and end-tidal carbon dioxide levels, urine output, protienuria, watch for FVE |
| Parkland Formula | Crystalloid (LR) 4ml/kg/% TBSA burn |
| Early Shock | baseline MAP is <5-10mmHG ^sympathetic stimulation: mild vasoconstriction, ^HR slight increase in diastolic |
| SEPSIS WITH SIRS | Temp >100.4 or <96.8 HR>90/min RR > 20/min or Paco2 <32mmHG WBC: >12k/mm3 or <4k/mm3 or >10%segs or >10%bands Septic if 2+SIRS criteria with any infection or one or more of these: <BP, output less than intake, FVE, decreased cap refill, ^BG, unexplaind change in MS, rising serum creatinine |
| Med TX during Hyperdynamic phase of shock | Vasoconstrictors to to improve blood flow, ^venous return to hearn, and improving contractility Inotropic agents to stimulate adrenergic receptor sites on heart muscles improving heart muscle contraction[Caution-increase in heart o2 consumption] Sodium nitroprusside to improve blood flow to hear by dilating coronary arteries[ watch for systemic hypotension] |
| Hemoglobin | W: 12-16g/dl M: 14-18 g/dL |
| Hematocrit | W: 37-47% M: 42-52% |
| Urea Nitrogen | 10-20mm/dl |
| Glucose | 70-105mg/dL |
| Sodium | 136-145mEq/L |
| Potassium | 3.5-5 |
| Chloride | 98-106 |
| PaO2 | 80-100mm/Hg |
| PaCo2 | 35-45mmHg |
| pH | 7.35-7.45 |
| Carboxyhemoglobin | 0-10% |
| Total Protein | 6.4-8.3g/dL |
| Albumin | 3.5-5g/dL |
| cholelithiasis key features | Episodic/vague upper abd. pain/discomfort that can radiate to the R shoulder Pain triggered by high-fat/high-volume meal Anorexia N&V Dyspepsia Eructation Flatulance Feeling of abd. fullness Rebound tenderness (Blumbergs sign) Fever Jaundince, clay-colored stools, dark urine, statorrhea (Most common with chronic cholecystit) |
| Thoracentesis | Tell pt to expect stinging and explain imporatance of not moving Wear goggles and masks to prevent splashing Cleanse skin with antiseptic before local anesthesia Monitor for shock, pain, nausea, pallor, diaphoresis, cyanosis, tachypnea, dyspnea. After procedure apply pressure et monitor for pneumothorax et mediastinal shift |
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