크램시트 Flashcards

(113 cards)

1
Q

환자들이 고통받을때, 약중재가 최선인 경우는 거의 드물다.

A

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2
Q

항상 항생제 사용하기 전에 알러지 체크 해야한다.

A

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3
Q

neutropenic patient(백혈구 감소증 환자)들은 백신, fresh fruit, flower 받지 않아야 한다.

A

.

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4
Q

NTG patch 최대 사용가능한 범위

A

최대 5분간격으로 3번까지 가능하다.

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5
Q

Morphine is contraindicated(사용이 금해진다)

A

pancreatitis.(췌장염)일때.
그것이 sphincter of oddi (오디괄약근.온쓸개관이 샘창자로 연결되어 있는 부분)에 경련을 유발하기 때문에.
대신 Demerol이 주어져야 한다.

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6
Q

K+은 IV push 하면 절대 안됨.

A

.

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7
Q

HIV positive 엄마에게 태어난 아이는 모든 immunization of schedule 받아야함.

A

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8
Q

informed consent form 사인하기 전에 환자에게 주어져야할 것들

A
  1. 선택가능한 다른 옵션이 있는지
  2. pre,intra,post OP 때 일어날 수 있는 경우의수
  3. 관련된 위험
  4. 가능한 부작용
  5. surgery로 부터 회복되는데 필요한 시간
  6. 질문할 기회
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9
Q

autonomic dysplexia(=Hyperreflexia,과다반사)를 처음 겪는quadriplegic Pt를 간호할 때는

A

머리를 가능한 높이 올려야함.

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10
Q

대체로 같은 infection 인 환자들은 병실 공유함.

A

/

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11
Q

clozapine(clozaril)(조현병의 치료에 이용되는 비정형적 항정신병 약물)이랑 관련된 심각한 독성 위험은?

A

blood dyscrasia (조혈장애.혈구 생성 장애)

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12
Q

haloperidol(haldol)의 부작용은?

A

drowsiness, insomnia, weakness, headache, extrapyramidal syndrome(EPS,추체외로증상)

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13
Q

ped- HR & RR

A
Remember 311
(fetal HR : 120-160)
30 90-130 Infant 30-60
10 80-120 Toddler 20-30
10 70-110 Preschooler 16-22
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14
Q

A

(1.8*℃)+32

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15
Q

Na

A

135-145

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16
Q

K

A

3.5-5.5 ( 6이상=우선중재필요)

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17
Q

Ca

A

8.5-11

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18
Q

Mg

A

1.5-2.5

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19
Q

Cl

A

95-106

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20
Q

P

A

2.5-4.5

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21
Q

BUN

A

7-22 (36이상이면 우선중재 필요)

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22
Q

Cr

A

0.5-1.5 (2.0이상이면 우선중재 필요)

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23
Q

USG

A

Urine specific gravity(요비중)

1.005-1.030

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24
Q

CPK

A

creatine P 크레아티닌 인산효소.

21-232

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25
bilirubin
1.0이하
26
protein
6.2-8.1
27
albumin
3.4-5.0
28
LDH
LDH 경우엔 혈액 세포나 심장 근육과 같이 여러 신체 조직에 분포. 조직이 손상되면 혈액 속 방출. 일탈 효소라고도 불립니다. LDH 종류에는 1~5가지가 존재하는데 위치가 조금씩 차이가 나며 LDH 정상수치가 높아졌을 때엔 어느 장기에 문제가 생겼는지를 가늠할 수 있게 됩니다. 100-245
29
Glucose
Normal= 80-110 fasting <110 infant 50-90 (<45 = hypo & high pitch cry) HbA1C = 4-6% (or <7%)
30
Thyroid
갑상샘 질환 선별검사로 TSH, Free T4, T3이 유용하다. 이 중 TSH가 젤 유용. T3 : 60-180 T4: 5-11 TSH [thyroid stimulating hormone갑상선자극호르몬] : 0.5-5 or 0.5-2 for hypothyroid Pts Free T4: 0.8-2.7 (8-2.8 easier to memorize) ``` #Hypothyroid: TSH; T3&T4 ↑ #Hyperthyroid: TSH ↑ ; T3&T4 ```
31
Uric acid
3.5-7.5
32
total cholesterol
130-200
33
Triglyceride
중성지방( TG) | 40-50
34
ABGA
- pH: 7.35-7.45 - HCO3(중탄산염): 22-26 - pCO2: 35-45 - pO2: 80-100% - SaO2: 95 % 이상
35
해독제 - Digoxin - Tylenol,Acetaminophen, Pacacetamol - Heparin - Benzodiazepine - Coumadine
- Digoxin (심방세동,울혈성심부전 치료) - >Digibandi - Tylenol (해열,진통제) - >Mucomyst (17doses+loading dose) - Heparin - >protamine sulfate - Benzodiazepine - >Flumazaenil - Coumadine - >Vit.K
36
``` Insulin> Rapid-acting short-acting Intermediate(NPH) long acting ```
-Rapid-acting : aspart(Novolog), Glulisine(Apidra), Lispro(Humalog) : onset 15분, peak 1-3h, duration 4h -short-acting :~R+RI (IV가능,only)(humulin/nobolin) : onset 30min, peak 2-4h, duration 8h -Intermediate(NPH) : ~N + levemir mix형, lente : onset 1.5h, peak 4-12h, duration 16-24h -long acting :Glargine(Lantus)= 절대 Mix 불가(단독사용) : onset 2-4h, peak none, duration 24h -peak time에 과한운동 자제 -같은 주사 부위는 2-3W 뒤에 사용 -주사부위에 heat,massage,exercise 금기(ㅈㅓ혈당유발) -인슐린 주사각도 45-90도(마른사람은 45-60도) _RI+NPH Mix= air는 NPH(혼탁)부터, 약물 재는건 RI(맑은)부터
37
``` vaccines> Hepatits B Hib(Hib균을 예방하는 백신인데 뇌수막염과 패혈증 등을 일으키는 위험 질병을 예방) pn Dtap(DPT 디프테리아, 백일해, 파상풍을 예방하기 위한 백신) IPV(injectable polio vaccine,소아마비) Varicella(수두, 대상포진 예방) MMR(홍역 볼거리 풍진을 예방) Hepatitis A Meningitis(뇌수막염) Rota(로타 바이러스 장염을 예방) Influenza ```
``` vaccines> #Hepatits B->0,1-2,6-18M #Hib(Hib균을 예방하는 백신인데 뇌수막염과 패혈증 등을 일으키는 위험 질병을 예방) -> 2,4,6,12-15M #pn-> 2,4,6,12-15 #Dtap(DPT 디프테리아, 백일해, 파상풍을 예방하기 위한 백신)-> 2,4,6,15-18, 4-6years, 11-12years, 이후 매 10년마다 추가 접종 권장 #IPV(injectable polio vaccine,소아마비)->2,4,6-18, 4-6years #Varicella(수두, 대상포진 예방)-> 12-15, 4-6yrs #MMR(홍역 볼거리 풍진을 예방)-> 12-15, 4-6yrs #Hepatitis A-> 12-23 months (2 dose, 6months apart =1차 접종하고 6~18개월 후 추가접종) #Meningitis(뇌수막염)-> 9-11yrs #Rota(로타 바이러스 장염을 예방)-> 2,4,6, #Influenza -> at 6 Mon and then.. yearly. 첫 회에는 1개월 간격으로 2회 접종 하고 이후 매년 1회 접종함. ```
38
TB meds
``` RISE Rifampin INH Streptomycin Ethambutol ```
39
GCS
Eye (4points) Verbal(5points) Motor(6points) Max=15 (<8=coma)
40
APGAR score
at 1-5min after birth (1st score is the transitional score and 2nd is planning care of newborn, 첫 번째 점수는 과도기 점수, 두 번째 점수는 신생아를 돌볼 계획) 8-10 = ok 2 1 0 Appearance [ all pink, pink&blue, blue/pale] Pulse[>100, <100, No response] Grimce[cough, grimace, no response] Activity[flexed, flaccid-탄력없는, limp- 축처진] Respiratory[strong cry, weak cry, no cry]
41
donning -감염예방도구 착용순서
1. gown 2. mask 3. goggle 4. glove
42
removing-감염예방도구 벗는순서
1. Glove 2. Goggle 3. Gown 4. Mask
43
임신시 decelation(하강)종류
``` VEAL CHOP(송아지고기) #Variable(변이성)-cord compression( 처치: 양수과소+variable 이면 즉시 vaginal exam-> cord 눌렸는지 확인하고 눌렸다면 즉시 제왕절개. 눌리지 않았다면 일단 position change 해보고 그래도 계속 나빠지면 fetal scalppH 측정하고 7.2미만이면 즉시 제왕절개) ``` #Early(조기)-Head compression ( 처치: lateral decubitus position & monitoring) #Aceeleration(가속화)-OK #Lately(후기)-Placental insufficiency 처치: oxytocin infusion 중단, O2 mask, 위 방법으로 안되면 제왕절개
44
Hypoventilation | Hyperventilation
``` #Hypoventilation(과소환기)-> resp acidosis(호흡성산증) "retain CO2" #Hyperventilation(과다환기)-> resp alkalosis(호흡성 알칼리증)"Below off CO2" ```
45
이뇨제와 K
``` #lasix, bumex-> K wasting (can cause hypokalemia) #aldactone-> K sparing (can cause hyperkalemia) ```
46
post mastectomy care
유방절제술후 케어: BREAST Bp not on affected side Reach recovery Elevate affected side Abduction & external rotation- no initial exercise (initial is extension/flection) Self breast exam (1x month-7day after period) Try to promote a (+) self-image
47
autosomal recessive
``` 상염색체 열성( 2개 가운데 어느 하나에 이상이 있는 단계에서는 발병하지 않지만, 양쪽 다 이상이 있으면 발병하는 유전형식) #Cystic fibrosis-낭성섬유증 #PKU-페닐케톤뇨증 #Tay-sachs-테이색스병. 지방분해효소가 부족해져서 뇌속에 지방이 쌓이게 되고, 마비, 경련, 흑내장 등이 생기며 결국 죽게됨. #albinism-백색증 #sickle cell anemia-낫모양적혈구빈혈 #alpha anti-trypsin difficiency #Galactosemia-갈라고스혈증. 모유와 일반우유에 포함되어 있는 당분인 갈락토스를 포도당으로 전환시키는 능력이 손상되어 나타나는 매우 드문 유전성 탄수화물 대사 질환 ```
48
autosomal dominant
``` 상염색체 우성(상염색체에서 한 염색체만 있어도 표현되는 유전자) #Huntington's dis-헌팅턴무도병. 근육간의 조정능력이 상실과 인지능력 저하 및 정신적인 문제가 동반되는 진행성의 신경계 퇴행성 질환 #Marfan's syndrome-마르팡증후군. 결합조직에 영향. 주요 증상= 팔 다리 긴뼈의 과다 성장/ 척추 만곡/ 가슴뼈 함몰 또는 돌출/ 수정체 탈구/ 근시/ 대동맥 확장과 변성/ 대동맥판 역류/ 승모판 탈출/ 승모판 역류 등 #Polydactyly-다지증. 손가락과 발가락의 수가 정상보다 많은 기형 #Achandroplasia(연골무형성증) -유전 질환의 하나로 왜소증(Dwarfism)을 유발. #Polycystic kidney dis ```
49
X-linked recessive
``` 성염색체 열성(남자에게만 증상이 나타나고,유전됨) #Duchenne's muscle Dystrophy(뒤시엔느,뒤센근육영양장애)-희귀 유전성 골격근 퇴행성 질환. 세계적으로 출생 남자 아동 3,500명당 1명꼴.근육이 쇠약해짐, 동요성보행, 척추측만증, 호흡기 감염 #Hemophilia A (Females are carries in these dis and males are affected by the dis-여자들은 병을 운반하고, 남자들은 영향 받고)(혈우병 A가 전체의 80%.혈우병 A는 혈장 내 제 8 응고인자가 부족한 병.)->수혈,데모프레신; DDAVP ```
50
Newborn at term
normal #Weight 6-9Ibs(파운드2.7-4.5kg),/ #head circumference 1/4 body length OR 13-14inch(33.2-35.54cm)/ #chest 12-13inch / #umbilcal cord falls off in 1-2 week / #Stool = 1st stool(Mecconium)-> black +tarry(passes w/in 12-24hrs), thin, green,brown->3days, #formula feedings (1-2 pale yellow/light brown stools) OR Breast feeding(loose golden yellow stools with sour milk odor) *1파운드=0.45kg * 1 inch= 2.54cm
51
HypoKalemia VS HyperKalemia EKG
#HypoKalemia : Flat T wave, Depressed ST, Prominant U wave #HyperKalemia : Tall T wave, Wide QRS, Long PR wave
52
5 P's of Fx
Pain, Pallor, pulseless, paresthesia, paralysis
53
Cushing's triad
두개내압이 증가되면서 나타나는 징후(ICP indication)terminal stages of acute head injury and may indicate imminent brain herniation : HR ↑, BP↑, RR(irregular)
54
단위계산
``` # 1ib = 16 oz ; 1T =3tsp =5ml # 1c = 8oz =240ml # 2c= 1pt =16oz # 1oz= 30ml= 8dreams / 1mg=1000mcg # 2pt= 1qt= 32oz /1g=15gr # 4qt= 1gal =128oz / 1gr= 60mg ```
55
Med trivia(약물상식)
``` #Talwan and Stadol(마취제) => Avoid (opioid agonist antagonist)- much less effective than opioid[아편제제] agonist[작용제] #No Tagamet(위산 분비 억제제 상품명. 성분명= cimetidine) with warfarin #Ergostat(Ergotamine)=> For migraine(편두통) #No quinolones/ Tetracyclines(항생제) with pregnancy #No ASA/NSAIDS in Hemophilia A Pt. #Lipitor(아토르바스타틴. 스타틴 계열 약물, 콜레스테롤 합성 억제->고지혈증 치료) =PM ONLY, no grapefruit juice #tPA(tissue plasminogen), Urokinase=dissolves clots. plasmin 활성화 ```
56
Fundal Height
``` 배길이 측정 #top of symphis pubis to top of fundus(아두골반 곡대기에서 자궁 밑까지) #Gross estimate of dates. #Use a non-stretchable tape measure #12-14 wks (at level of symphis[아두.아기머리]) #show after week 14 (can tell preg) #20wks (~20cm) at level of umbilicus #rises 1cm/wk till 36wks then varies. ```
57
Quickening
첫태동감. fetal movement ; 16-20wks
58
Fetal Heartbeat
8-12wks(By.doppler) and 18-20wks by ausculating with stethoscope[청진기]
59
preterm term postterm
``` preterm= 20-37 wks term= 38-42wks postterm= 42wks plus ```
60
Total preg wt gain
11-14kg ( 25-35Ib)
61
300cal during preg(Daily) and 200-500 cal during breastfeeding (daily)
.
62
caffeine
<300mg/day (500-750ml/day -> risk of spontaneous abortion or fetal intaurine growth restriction[자궁내태아성장지연])
63
Uterine contraction | Contraction
자궁수축. can be felt after 4th month = Braxton Hicks. 가진통. 배뭉침 Contractions facilitate uterine Blood flow through placenta and promote O2 delivery to fetus 자궁수축은 태반을 통한 자궁혈류를 촉진하고 태아에게 O2공급을 촉진한다.
64
Amniotic Fluid
``` #normal: 800-1200ml (transparent/ clear, no odor) #300ml 미만: oligoamnios (양수과소증). kidney problem. 아 기형이 있을 때 발생합니다. 태아는 양수를 먹고 소변으로 배출하고 하는데, 소변 보는 길에 문제가 생기면 양수가 감소하는 것입니다. 초음파 검사시에 양수 감소증이 발견되면 태아의 요로계에 무슨 문제가 있는 것은 아닌지 잘 관찰해야 합니다. #hydramnios (양수과다증) ```
65
Umbilical cord
2 artery, 1 vein
66
Placenta
Fetal lungs in utero. 태반이 자궁안에서 태아의 폐역할
67
alchol, caffeine, nicotine, meds
easily cross placenta (viruses can cross bacteria cannot; exs of viruses (HIV, AIDS, Herpes, Measles, Toxoplasmosis, Hepatitis)
68
AFP test
기형아검사. 알파 태아단백질이 간암 혹은 난황에서 유래된 생식세포종양에서 증가될 수 있는 것을 이용하여 이들 종양의 진단에 사용되는 검사법. 이는 진단뿐 아니라 종양의 병기 결정, 치료 효과 판정에 이용.
69
Fetal distress
``` #HR<110 OR 160< #fetal hyperactivity OR no activity #Fetal blood pH7.2 ```
70
Lesions of midbrain
중뇌 병변. decerebrate positioning.
71
Morphin toxicitty
pinpoint pupils
72
corticosteroid effects
acne,Hirituism, Mood swings, osteoporosis and adrenal suppression[부신기능억제] (in kids =delayed growth)
73
beta-blocker
Mask effect of hypoglycemia
74
somogyi effect
BG(blood-glucose) sometimes up and somnetimes down.
75
dawn phenomenon
새벽현상. | high BG in DAWN hrs(5-8AM) 인슐린 의존성 당뇨병 환자에 있어서 이른 아침에 혈당이 상승하여 인슐린의 투여를 필요로 하는 현상.
76
AFTER
``` #post tracheostomy = keep O2 and suction at bedside #post pleural Bx = chest tube and drainage system at bedside #post parathyroidectomy[부갑상선제거술]= trachestomy at bedside #tonic clonic seizure[간질전신발작] = suction apparatus[장치] at bedside #Paracentesis = BP cuff at bedside ```
77
PASS
``` to use a fire extinghuisher #P = pull pin #A = aim at base fire #S = squeeze handle. #S = sweep fire from side to side ```
78
FOL
``` folic acid rich foods(엽산 많은 음식들0 # F= fish # O= organ meats, oranges # L= Leafy green veggies ```
79
K+ Foods (ROYGBIV-Rainbow colors)
``` #Red - strawberries, tomatoes (not apples) #Orange - #Yellow - banana #Green - avocado, green veggies #Blue - Fish from the BLUE sea #Indigo[남색]/Violet - Raisens ```
80
PEDS
``` #toddler - fear of separation (give simple directions) #Preschooler - fear multilation (allow to play with equipment) #School agers - fear loss of control (allow to play with equipment) #adol - fear loss of independence ```
81
Pneumothorax symp(P-Thorax)
``` #P - pleuritic pain(흉막염 통증) #T - trachea deviation (기관변위) #H - hyperresonance(과공명음) #O - onset sudden #R - reduced breath sounds (dyspnea) #A - absent fremitus(진탕음 부재) #X - x-rays show collapse(붕괴) ```
82
Pulmonary edema Tx (MAD DOG)
``` #M - morphine #A - amniophylline #D - digitalis #D - diuretics #O -O2 #G - Gasses in blood (ABGs) ```
83
Who needs Dialysis?
``` AEIOU #A - acid/base problems #E - electrolyte problems #I - intoxications #O - overload of fluids #U-uremic symptoms ```
84
Cushing's dx
``` cushing - too much steroids #3 S's =high steroid, high sugars(hyperglycemia), high sodium #Moon face, Buffalohump, truncal obesity, thin skinny extremities, slow wound healng osteoporosis, HTN, muscle wasting ```
85
Addison's Dx
``` need to ADD steroid #3S's = low steroid, low sugar, low sodium #low vascular volume (Not holding salt and H2O like in cushing's), low BP #Hyperkalemia #Bronze skin, Hyperpigmentation ```
86
Allens test
``` B4 drawing ABGs do an allen test #compress both radial and ulnaer arteries(wrist) at same time on 1 hand #Release the ULNAR side (pink) and hand should turn discolored and should be able to see blood flow back into it #Radial-is located on the thumb side and ulnar is on the pinky side #Minutes of press on the ABG site after drawing blood? #5-10 min or 15-20 min if on anti-coagulants #After a liver Bx place patients on the RIGHT side. ```
87
Mobility-cane
COAL Cane Opp Affected Leg
88
Mobility-2point gait
one leg and 1 crutch touch at the same time | weight bearing
89
Mobility-3 point gait
both crutches and 1 foot | non-weight bearing
90
Mobility- 4 point gait
Both legs and both cruches touch the ground | weight bearing
91
Swingthrough gait
``` #advancing both crutches, then both legs, and requires #weight bearing. #not as stable as other gaits. #laminectomy(척추후궁절제술)척추 뼈의 뒤쪽 구조물인 후궁을 제거하는 수술 = removal of 1 OR more vertebral laminae- need straight back after - LOGROLL (신체선열을 유지하는 것) ```
92
Keep back straight (so flat bed)
intususception(장중첩증) seen in Non-hodgkin's Lymphoma Hot dog mass in RUQ Red Currant Jelly Like mucus and bloody stool Macule =flat and round
93
ostomy?
(인공항문설치술) = pouch opening 1/8 in larger than (인공항문설치술) = pouch opening 1/8 in larger than stoma
94
Macule Papule Vesicle Impetigo
``` Macule= 반점. flat and round Papule= 구진. rounded and red Vesicle= 소수포. filled with fluid. Impetigo= 농가진. 1:20 Burrow's soln, honey colored crusts. 세균에 감염되어 물집과 고름, 딱지가 생기는 질환 ```
95
scabies
옴, 진드기 | mites bury under skin
96
RUQ pain
``` # Cholelithiasis (gallstones); 담석증. 담석 때문에 담낭관이나 총담관이 막히고 거기에 세균이 감염되어 일어나는 질환 #Cholecystitis (inflamm of galbladder) #Hepatitis #Pancreatitis (severe knifelike pain; worse with eating/ lying down; some relief with fetal position) ```
97
RLQ
``` #crohn's Dx (Ileus, Rt.colon; pain after meals) #Appendicitis(충수염) 맹장 선단에 붙은 충수에 일어나는 염증 #pain at Mcburney's point (1/2 b/w ubilicus and right iliac crest(장골능) ```
98
LLQ
``` #Ulcerative colitis[궤양성 대장염] (Rectum, left colon; pain pre-defecation) #Diverticulitis[게실염] 대장의 벽에 생긴 게실 내에 장의 내용물이 고여 발생하는 염증, Relieved by passage of stool/ flatus[위장내가스] ```
99
duodenal ulcer
십이지장 궤양 | pain 2-3hrs after meals and nighttime (relieve pain with FOOD INTAKE)
100
Gastric ulcer
위궤양 pain 1hr after meal/ when fasting ; relieve pain with vomiting, not with food intake (Starve the gastric ulcer and feed the duodenal)
101
Diverticular Dx
cramping[경련] in LLQ relieved by passage of stool and flatus[위장내가스] (constipation atlernates with dia [from def in diet fiber] high fiber diet)
102
Meckel's Diverticulum
메켈 게실 영아기, 학령전기에 많이 생기는 장출혈 congen sac or pouch in ileum, symp seen by age 2; painless rectal bleeding , abd, hematochezia,(currant jelly like stool), s/s of appendicitis (Tx = remove diverticulum)
103
Cirrhosis
``` 간경변 #biliary obstruction, alchol, hepatitis #early stage = high protein/ carbs and Vit.B #adv stage = low fiber / salt/ fat/ protein , high cal, fluid restriction ```
104
Esophageal varices
``` 식도정맥류 #sengstaken blackemore Tube or Minnesota tube #balloon on seophagus and stomach to apply direct press on bleeding veins #TIPS( transesophageal intrahepatic post systemic shunt) #balloon cath inserted via jugular vein with angiography to create a metal stent b/w portal vein to vena cava channel (provides a pathway for blood b/w portal vein and hepatic vein= bypass cirrhotic liver) and relieves press on esoph verices ```
105
Jaundice(Icterus)
``` 혈액 속의 빌리루빈이 이상적으로 증가하여 피부나 점액에 침착되어 노랗게 염색된 상태 #hemolytic : RBCs are destroyed (release bilirubin) #hemolytic transfusion rxn(용혈수혈반응) #Hemolytic anemia #Sickle cell crisis #Hepatocelluar(간세포의) : the impaired liver cjugated to the cell (hepatocyte) dosen't allow bilirubin to convert from the unconjugated to the conjugated form #obstructive : bile flow is obstructed #tumors ```
106
EKG- normal sinus
``` #60-100 #PQRST nml EKG strip ```
107
EKG- sinus brady
``` #<60 #Tx: atropine #can be nml in physically fit/trainer person = then n Tx 운동하는 사람들은 서맥이어도 Tx 필요없음. ```
108
EKG- 1st degree AV block
``` #prolonged PR interval #Nml PR interval : 0.12-0.20 #conduction problems #Drugs( dig, beta blockers,Ca chnnel blocker) can cause by slowing conduction system (slows conduction from SA node to AV node to purkingee fibers = see slowed PR (Atrial response) #Usu don't see sym-> not treated. Usu가 뭐람.. ```
109
atrial flutter
심방조동 #saw tooth appearance : atrium racing away, blood pools and can throw a clot->stroke : treat wuth caridversion 20-50 jules (nurse must hit Synchronize button)
110
Atrial fib
``` 심방조동. 심방이 1분간에 250∼350의 빈도로 규칙적으로 수축하는 상태. #ventricle beats are irregular #Atrium quivers[가볍게 떨림], not good pump #Cardiovert 50-100 jules #If in hospital and were stable b4 going into a fib = give cardizem drip and beta blockers b4 cardioversion. ```
111
V-tach
``` 심실성 빈맥 venticular tachycardia # wide QRS complexes # V Tach and awake drugs I must take (amiodarone or lidocaine) #V tach and a nap (unconscious) zap zap zap (defibrillate) # can only stay in for 2-3 min(can die) ```
112
V fib
``` 심실조동 #irreg makes no sense #only way to Tx= defibrillaate start at 360 jules #Epi (to HR) ```
113
Stroke
``` # right sided : impatient, easily distracted, impulsive, less concerned about life events, safety is a big issue (impulse) #Left sided : slow, cautious, particular, very aware of deficits, greater depression/anxiety (think Rt. brain = creative, Lt.Brain =logical, math, science) ```