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Peep
Bipap

Positive end expiration pressure. Prevents alveolar to collapse. And promotes oxygenation.

Biap given to pt who don't need intubation but requir more Oxygen and give. Cpap. Continues positive airway pressure Used at night for apnea.
Peep increase intrthoracix pressure resulting in decrease in cardiac output while increasing the risk of barotrauma.

1

Negative vsntialtor.

Creat behave kc pressure externally to draw the chest out word and air into the lungs. Micks Norma breathing. Past wt neur issues. Latelral sclerosis. Polio. People who need sleep.

2

Positive pressure. Vent

Used more often. Pt wt acute Resp failure. They push air into lungs rather than drawif it out.

3

Cpap. Continuous positive. airway pressure.

Positive pressure to the airways who is breathing spontaneous. Used with intubation or face mask. They are client trigged. The breathih.

Help maintain open air way and alveoli decreasing the work of breathing.

4

Disoriented. To place time and person.
Stupor. Responds to painful stimuli.
Obtundation. Verbal or tactic stimuli. Lethegic. Somnolent.
Semicoma. Doenst move. Moaning with painful stimuli.

Coma. Unarousable. Doesn't stair or moan. Non purpose movement.

Deep coma. Completely Unarousable. Absence of brain stem reflexes a
Locked in syndrome. Alert and fully aware of enviromwnt intact cong but palaryzwd. Cannt communicate.

5

Risk for brain attack

Age. Life style. Medical htn.
Race. Family history. Sex


Ischemia. Swelling tissue death and irreversible

6

Hemorrhagic stroke.

Increased Icp.

Suddwn bleeding into the brain tissue. Htn. Avm
Caused by smoking alcohol and diet and exercise.

7

Ischemic.
Thrombotic. Causes by atherosclerosis.

Embolitic caused by free flowing embolus from Af. cad.

Ischemic.

8

Tia.

Signs go away. Corarid plaque.
Resolved in 24 hours.

9

Left side. Responsive for

Language. Tlaking and understanding and readinf and writing so speech is affected in this case.

10

Righ side responsibwk for

Perception
Sense of what we see. Hear or touch. Spatial skills. Side speed distance and position.

11

Signs of brain attach

Swallowing problems.
Weakness. Paralysis. Dizziness. Unilateral sensory defficiet.

Headache. Slurred speech. Fatigue
Dysphasia. Receptive. Hard to understand what is being said. Left side damage.

Expressive Dysphagia. Finding words is difficult. Mostly left side.

12

High pressure alarm ventilator.

K

13

Low pressure alarm.

L

14

Risk for phothorax

Risks

15

Critical assessments.

Assemsnts.
Diminished breath sounds. Or Absent

Diagnostics. X-ray. Stay. Abg fio2

16

Chest tubes.

Tube. Local anesthetic. Antiseptics. Betadine. Sterlie gloves. Bottle of sterile water.

17

Suction chamber.

Higher the water. The higher the suction. The lower the water the lower the suction. Help remove air. By drowning it out.

18

Water seal. Continuous bubbling shows and confirms Persistant air leak

Connected to the collection chamber. Allows air to pass down though narrow tubes and bubble out through the boron of water seal. Prevents air from retuning to the pt.

19

Collection chamber.

Mark fluids each shift on the unit itself. And documented. And characteristics of the fluids.

Fluids drain from the pt directly to the this chamber. Plastic tube.

20

Chest tube maintaince. Know slide.

Take vitals. Water chamber control set. Suction control set. Ordersed.

Cardio assemsnts everj 4 hours.

Encourage cough and deep breath. Check insertions site evey 4 hours. Dressing change assess water levels. Correct fluids levels ordered.
Report any changes and complications immediately to the physican.
Check all tubing connections and retape even 4 hours. I and O marked on the collection unit. Monitor for air leaks. Coil tube on bed. Never allow tubing to dangle.

Collection unit never goes above chest level.
Never clamp a chest tube.

21

Check tube complications.

Air leak. Dislodgment and disconnection.

Subcutaneous emphysema. Collection of air leak or gas in the tissue under the skin.

Measure it and report to md. And documented.
Also by continuous bubbling in the water chamber. Bad. Bad. Bad.

22

Sources of air leaks.

Poor tubing connection.
Dislodgment of the tube

Cracked bedside collection unit.
Bed tube momentarily at various points along the tubing length.
If bubbling stops the air leak is btn the area bent. And the water seal.
Or a cracked collection chamber.

23

Dislodgment of chest tube

Cover the insertion side who Vaseline gaise at peak of pt inspiration.
Cover with 4 by4 tape on 3 side only. Notify provider. Stat.doc.

24

Disconnected tube or drainage breaks.

Insert the uncontamknwd end into the bottle of Normal saline water. 2 cm deep. Until new unit can be set up. Notify md.

25

safety concerns.

Sealed taped tubing connexion.
Chest tube in pleural space.
Infection at the site.
Don't pull tubes or disconnected them.
Constant water and suction if ordered.
Beside 1000 c of Sterlie water. Continuously. For disconnection.
Vaseline gauze and hemastat at bed side always. For Dislodgment.

26

Skin cancer.
Neoplasm. New growth.

Skin

27

Colon

Cancwr

28

Lung cancer.

Cancer.

29

Breast cancer.
Fibrocystic. These are benign. Not at risk for cancer at all. Hyper plesia of the ep lining. Cyclic pain. Goes with menopause.

Fibroadenoma. Benign lamp. small painless wound mobile well delined masses. Btn 15 to 25.
Breast assessnt. Lump. Nipple discharge. Nipples retraction. Redness and tenderness. Dimpling Edema. I


Cancer. Second leading cause of death in women.
Risk. Age. Family. Long term horn use. Obesirt. Alcohol. Use of progesterone.

Mastectomy. Reduced cance by 90.
Oophorectomy. If nolonggee want kids. To reduce ovarian cancer.
Breast self exam at 18 monthly after period. Breast exam by Proff At 20 every 3 years. At 40 every year.
Mammogram every year at 40.
Axillary involved. Return is common.

30

Prostrate cancer

Cancer

31

Blood transfusion.

Order. 2 qualified personals. Must being in 30 minutes of obtaining from lab.
Vitals. Saline. Start infusion slowly. Check pr name. Type and band blood. Stay with pt fist 15 minutes.
Listen to lung sounds. IV monitor. Access and infection.

32

Blood allergic reaction

Jehovah. Right to refuse.
Flush with Norma saline. Inform doc. Time and date of reaction. Type and amount infused. Signs. Vitals.

Tackh. Fever.hypotension or hyper.resp distress. Oozing from the site.

Feeling some is wrong.
Flushing. Chills. Pain. Myalgia. N v. Pain in abdomen and flank chest pain.
Sob.

33

Critical care.
Pt are unstable. Vitals unstable. Compensatory failure. Need sophicatef judgment. Frequent titration of meds.

Asses for pulses. Vitals. Loc. cap refill. Skin.
Diagones. Fear. Ineffective tissue perfusion.

Assure adquate perfusion. Restore Bp. Organ function. Avoid complications. Monitor fliud balance. Hand washing.

Monitor physical and emo Status. Evaluate response to therapy emo support.

34

Shock. Decreased tissu perfusion and impaired cellar metabolism. Imbalance of o2 and nutrients.
Cap reff greater than 3 is sign of shock.

Stages. Normal Bp. Tachycardia. Tachpnea.
Stage 2 low Bp. Narrow pulse pressure. Taxhcafid tachpnea pulmonary endema.
Stage 3 irreversible.
Hypotension severe. Resp failure. Acidosi. Peripheral edema.

35

Cardiogenic.

Low blood flow coz of failure. Pin on

36

Hypovolemic shock.

Lack of fluids in the pipe n

Stop loss of blood. Or fluid. Fluids resuscitation. Hemodynamics monitoring.

37

Septic shock.

Treat cause and supportive care.

Edema everywhere. Infection. Mods.
Sirs. Systemic inflammation respond syndrome.

Lymphocytes. Stimulate. Cytokines.

Fever and hypothermia. Increase heart rate. rage. Increase rep 20 or more. Pcoz 32. Greater.
WBC > 12000 < 4000 cells.
Treat th cause.
Increase arterial oxygen
Imprint tissue perfusion.
Oxygen. Fluid replacement. Meds.

38

Anaphylactic.

Vasodilation. Pooling of the blood in the periphery. Hypovolemia.

Dyspnea. Stridors. Wheezing. Largo spams. Bronchospasm. Pulmonary edema.

Remove allergen. Monitoe Bp airtfical air way.

39

Neurologic.

Edema.

40

Triage.
Emergent need congruous reassessment. Cardiac are we. Resp distress. Major burns. Bleeding uncontrolled. Icp.

Urgent. Reassemwnt every 30 to 60 minutes. Abdominal pain. Non stem chest pain. Asthma. Moderate burns.

Delayed. Re asses eveh 2 hours. Rash. Cold. Sprains. Fracture.

Temp above 105. E. Stroke. E. MI. E. Trauma penetrating head or neck. E. Long bone fracture. E. Inadquate abc.

41

Assessment

Airway
Breathing.
Circulation
Disability.
Exposure to skin area of compliant.
F Fahrenheit. Tep.