Cheyne-Stokes respirations - correct answer This respiratory pattern is characterized by periods of respirations during which the tidal volume starts
... [Show More] shallow and gets progressively deeper, and then gets progressively shallower. This shallow-deep shallow pattern is followed by periods of significant apnea that can last up to 30 seconds or longer, then the cycle starts over. Each cycle can take anywhere between 30 seconds and 2 minutes or longer.
What causes Cheyne-stokes respirations? - correct answer This pattern of respiration is often caused by strokes, traumatic brain injuries, brain tumors, carbon monoxide poisoning, and metabolic encephalopathy. This pattern of respiration can be seen in healthy patients experiencing first time high altitude sickness, and can also be a normal side effect of morphine administration.
Biot's breathing (aka cluster respiration) - correct answer A respiratory pattern characterized by periods or clusters of rapid respirations of near equal depth or VT followed by regular periods of apnea.
What causes Biot's breathing? - correct answer Caused by damage to the medulla oblongata by stroke (CVA) or trauma, pressure on the medulla due to uncal or tentorial herniation. This type of respiratory pattern can also be caused by prolonged opioid abuse.
Kussmaul's respirations - correct answer A type of labored or hyperventilation characterized by a consistently deep and rapid respiratory pattern.
What causes Kussmaul's respirations - correct answer This type of labored hyperventilation is usually seen in the late stages of a severe metabolic acidosis such as diabetic ketoacidosis. The patient becomes very "air-hungry" and the desperate gasping characteristic of breathing almost appears involuntary. Most of the time a respiratory pattern secondary to a metabolic acidosis is rapid and shallow and a true Kussmaul's respiration is rarely reached before the acidosis is corrected.
Apneustic respirations - correct answer have a prolonged inspiratory phase followed by a prolonged expiratory phase commonly believed to be apneic phases.
What causes Apneustic respirations? - correct answer is caused by damage to the upper part of the pons, which is the upper portion of the brain stem. The pons contains, among other things, the "respiratory center" of the brain.
Ataxia respirations - correct answer Completely irregular breathing pattern with irregular pauses and increasing episodes of apnea. As breathing continues to deteriorate these respirations begins to merge with agonal respirations.
What causes Ataxia respirations? - correct answer are most often caused by damage to the medulla oblongata secondary to trauma or stroke. This respiratory pattern usually indicates a very poor prognosis.
BUN - correct answer 10-25 or 5-25 Kaplan
Creatinine - correct answer 1.2-1.5 or 0.5-1.5 Kap
Creatinine Clearance - correct answer 85-135
Albumin, serum - correct answer 3.5-5.0
Potassium - correct answer 3.5-5.0
Specific Gravity - correct answer 1.010-1.030
Sodium, serum - correct answer 135-145
Calcium - correct answer 9-11
Magnesium - correct answer 1.3-2.1
Critical <0.5 or >3
Chloride - correct answer 95-105
Phosphate - correct answer 3.0-4.5
Serum Osmolarity - correct answer 285-295
Glycosylated Hemoglobin - correct answer 4-6%
3 month review of glucose
pH - correct answer 7.35-7.45
↓Acid ↑Alkaline
HCO₃ - correct answer 22-26
↓Acid ↑Alkaline
PCO₂ - correct answer 35-45
↓Acid ↑Alkaline
PO₂ - correct answer 80-100
O₂ saturation - correct answer 96-100
Metabolic Alkalosis - correct answer pH ↑, PCO₂ ↑, HCO₃ ↑
Metabolic Acidosis - correct answer pH ↓, PCO₂ ↓, HCO₃↓
Respiratory Alkalosis - correct answer pH ↑, PCO₂ ↓, HCO₃ ↓
Respiratory Acidosis - correct answer pH ↓, PCO₂ ↑, HCO₃ ↑
Phosphate - correct answer 3.0-4.5
CVP - correct answer 3-11 or 2-8
HGB, hemoglobin - correct answer 12-15
HCT, hemocrit - correct answer 36-45
Platelets - correct answer 150,000-450,000
Neutrophils - correct answer 2500-8000
Lymphocytes - correct answer 1000-4000
RBC - correct answer 3.2-5.2
WBC - correct answer 5000-10,000
ESR - correct answer 0-20
PTT - correct answer 20-45 sec. Max 112 sec.
Therapeutic 1.5-2.5 times
PT/INR - correct answer 10-14 seconds
Bilirubin - correct answer 0.1-1.0
AlT/AST - correct answer 8-20
Digoxin - correct answer 0.5-2
Toxic >2.5
Dilantin - correct answer 10-20
Toxic >30
Theophylline - correct answer 10-20
Toxic >20
Lithium - correct answer 0.5-1.2
Tylenol - correct answer Toxic >4000 mg/day
Addison's disease - correct answer Hyponatremia, hyptension, decreased blood col, hyperkalemia, hypoglycemia
Cushings disease - correct answer Hypernatremia, hyperension, increased blood vol, hypokalemia,hyperglycemia.
No Pee, No K - correct answer do not give potassium without adequate urine output
Do not delegate what you can eat - correct answer E -evaluate
A - assess
T - Teach
V, V - correct answer EleVate Veins for better perfusion
A,A - correct answer dAngle Artieries for better perfusion
APGAR - correct answer A = appearance (color all pink, pink and blue, blue [pale]
P = pulse (>100, <100, absent)
G = grimace (cough, grimace, no response)
A = activity (flexed, flaccid, limp)
R = respirations (strong cry, weak cry, absent)
Transmission based precautions: - correct answer Airborne:
My - Measles
Chicken - Chicken Pox/Varicella
Hez - Herpez Zoster/Shingles
TB
or
MTV = Airborne
Measles
TB
Varicella-Chicken Pox/herpes Zoster -Shingles
- Private room - negative pressure with 6-12 air exchanges/ hr Mask, N95 for TB
Droplet precautions (think spiderman) - correct answer S - sepsis
S - scarlet fever
S - Streptococcal pharyngitis
P - parvovirus B19
P - pneumonia
P - pertussis
I - influenza
D - diphtheria (pharyngeal)
E - epiglottitis
R - rubella
M - mumps
M - meningitis
M - mycoplasma or meningeal pneumonia
An - Adenovirus
- Private room or cohort mask
contact precaution - correct answer Mrs. WEE
M - multidrug resistant organism
R - respiratory infection
S - skin infections
W - wound infxn
E - enteric infxn - clostridium difficile
E - eye infxn - conjunctivitis
Skin infections - correct answer VCHIPS
V - varicella zoster
C - cutaneous diphtheria
H - herpez simplex
I - impetigo
P - pediculosis
S - scabies
Air / pulmonary Embolism - correct answer (S & S: chest pain, difficulty breathing, tachycardia, pale/cyanotic, sense of impending doom) → turn pt to LEFT side and LOWER the head of the bed.
Woman in labor w/ Un-reassuring FHR - correct answer (late decels, decreased variability, fetal bradycardia, etc )→ turn on LEFT side (and give O₂, stop Pitocin, increase IV fluids)
Tube Feeding w/ Decreased LOC - correct answer position pt on RIGHT side (promotes emptying of the stomach) with the HOB elevated (to prevent aspiration)
During Epidural Puncture - correct answer side-lying
After Lumbar Puncture - correct answer (and also oil-based Myelogram)→pt lies in FLAT SUPINE (to prevent headache and leaking of CSF)
Pt w/ Heat Stroke - correct answer lie FLAT W/ LEGS ELEVATED
During Continuous Bladder Irrigation (CBI - correct answer catheter is taped to thigh so leg should be kept straight. No other positioning restrictions.
After Myringotomy - correct answer position on side of AFFECTED EAR after surgery (allows drainage of secretions)
After Cataract Surgery - correct answer pt will sleep on UNAFFECTED SIDE with a night shield for 1-4 weeks.
After Thyroidectomy - correct answer low or semi-Fowler's, support head, neck and shoulders
Infant w/ Spina Bifida - correct answer position PRONE (on abdomen) so that sac does not rupture
Buck's Traction (skin traction) - correct answer elevate foot of bed for counter-traction
After Total Hip Replacement - correct answer don't sleep on operated side, don't flex hip more than 45-60 degrees, don't elevate HOB more than 45 degrees. Maintain hip abduction by separating thighs with pillows.
Prolapsed Cord - correct answer knee-chest position or Trendelenburg
Infant w/ Cleft Lip - correct answer position on back or in infant seat to prevent trauma to suture line. While feeding, hold in upright position.
To Prevent Dumping Syndrome - correct answer (post-operative ulcer/stomach surgeries) → eat in reclining position, lie down after meals for 20-30 minutes (also restrict fluids during meals, low CHO and fiber diet, small frequent meals)
Above Knee Amputation - correct answer elevate for first 24 hours on pillow, position prone daily to provide for hip extension.
Below Knee Amputation - correct answer foot of bed elevated for first 24 hours, position prone daily to provide for hip extension.
Detached Retina - correct answer area of detachment should be in the dependent position
Administration of Enema - correct answer position pt in left side lying (Sims) with knee flexed
After Supratentorial Surgery - correct answer (incision behind hairline)→elevate HOB 30-45 degrees
After Infratentorial Surgery - correct answer (incision at nape of neck) →Position pt FLAT and lateral on either side.
During Internal Radiation - correct answer on BEDREST while implant in place
Autonomic Dysreflexia/Hyperreflexia - correct answer (S&S: punding headache, profuse sweating, nasal congestion, goose flesh, bradycardia, hypertension)→ place client in sitting position (elevate HOB) first before any other implementation.
Shock - correct answer bedrest with extremities elevated 20 degrees, knees straight, head slightly elevated (modified Trendelenburg)
Head Injury - correct answer elevate HOB 30 degrees to decrease intracranial pressure
Peritoneal Dialysis when Outflow is Inadequate - correct answer turn pt form side to side BEFORE checking for kinks in tubing (according to Kaplan)
Lumbar puncture - correct answer After the procedure, the client should be placed in the supine position for 4 to 12 hours as prescribed
Pancreatitis give - correct answer demorol, NOT morphine sulfate [Show Less]