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SPECON LEC > LEC 2.1 (ACUTE CARE) > Flashcards

LEC 2.1 (ACUTE CARE) Flashcards

1
Q

PAGE 3

A

-

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2
Q

PAGE 4

A

-

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3
Q

Medical conditions associated with falls:

A

neurologic, orthopedic, cognitive, postural/orthostatic
hypotension

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4
Q

Either allergic to the natural rubber in latex, or the chemicals used to
produce latex

Includes gloves, stethoscopes, cuffs, airway and IV tubing, electrodes;
etc.

A

Latex Allergy

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5
Q

State of being unhealthy for a particular disease or situation

A

Morbidity

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6
Q

number of deaths that occur in a population.

A

mortality

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7
Q

Page 6-11

A

-

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8
Q

It is a place of intensive medical-surgical care for patients who require
continuous monitoring, usually in conjunction with other therapies or
medical interventions such as vasoactive medications, sedation, circulatory assist devices, and mechanical ventilation

May be PICU, CCU, SICU depending on patient distributio

A

Intensive Care Unit

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9
Q

Page 14-15

A

*ICU Delirium or syndrome

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10
Q

Increased with MV, emergency surgery, polytrauma, organ failure uM
metabolic acidosis, coma, dementia, or advanced age

A

ICU delirium or syndrom

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11
Q

A.) Blood Urea Nitrogen (BUN), Plasma creatinine reduced in patients with HE
levels, and urine output
B.) Creatine kinase MB subunit (CK-MB)
C.) B-type natriueretic peptide (BNP)
D.) Hemoglobin and Hematrocrit levels

  1. Assess biomarkers of heart failure
  2. Assess renal function, reduced in HF
  3. Assess the oxygen carrying capacity within the system
  4. Isoenzyme, released into blood and elevates with acute MI
A
  1. C
  2. A
  3. D
  4. B
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12
Q

Other possible risk factors

A

include hypoxemia, use of certain benzodiazepine and narcotic
medications, infection, immobilization, and pain

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13
Q

A.) Troponin I
B.) C-reactive protein
C.) Electrolyte asessment

  1. most frequently used to assess MI
  2. Appropriate levels of K, Ca, Mg allow fornormal electrial conduction through the heart
  3. Measures amount of protein blood
  4. Isotype in myocardium
    5.Signals acute inflammation
  5. 100% cardiac specific
  6. determine risk of heart disease –> high sensitivity C-reactice protein assay is available
A
  1. A
  2. C
  3. B
  4. A
  5. B
  6. A
  7. B
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14
Q

SYSTEMIC EFFECTS OF PROLONGED BED REST

CARDIAC

A

° Increased heart rate at rest and with submaximal exercise
° Decreased stroke volume, VO2 Max, Left ventricular volume, and
cardiac output
° Myocardial thinning
° Orthostatic hypotension

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15
Q

RESPIRATORY

A

° Decreased lung volumes and capacities, (FRC, FVC, FEVI)
° Decreased mucocilliary clearance
° Increased risk of pneumonia, atelectasis, and pulmonary embolism
° Decreased arterial oxygen saturation

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15
Q

HEMATOLOGIC

A

° Decreased total blood volume, red blood cell mass, and plasma
volume
° Increased hematocrit
° Venous stasis, hypercoagulability, blood vessel damage

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15
Q

GASTROINTESTINAL

A

° Decreased appetite, fluid intake, bowel motility, and gastric
bicarbonate secretion
o GERD
° Difficulty swallowing

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16
Q

GENITOURINARY

A

° Increased mineral excretion, kidney stones, difficulty voiding, and
urinary retention
°Increased risk of urinary tract infection

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17
Q

ENDOCRINE

A

° Altered temperature and sweating responses, circadian rhythm,
regulation of hormones, increased cortisol and glucose intolerancg
° Decreased overall metabolism

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18
Q

MUSCULOSKELETAL

A

° Increased muscle weakness (especially antigravity muscles),
atrophy, decreased muscle endurance, risk of contracture,
weakened myotendinous junction
° Disuse osteoporosis
° Degeneration of cartilage, synovial atrophy, and ankylosis

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19
Q

NEUROLOGIC

A

° Sensory and social deprivation
° Decreased dopamine, noradrenaline, and serotonin levels
° Depression, restlessness, insomnia
° Decreased balance, coordination, and visual acuity
° Increased risk of compression neuropathy
° Reduced pain threshold

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20
Q

INTEGUMENTARY

A

° Increased risk of pressure injury formation

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21
Q

IMMUNE

A

° Increased risk of reactivation of latent viruses
° Reduced immune response and immunity

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22
Q

PSYCHOLOGICAL

A

° Impaired self worth and self esteem
° Increased risk of delirium, depression, and post-traumatic stress
syndrome

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23
Q

BODY COMPOSITION

A

° Increased sodium, potassium, calcium, phosphorus, and nitrogen
loss
° Increased body fat and decreased lean body mass
° Fluid shift from legs to abdomen/thorax/head, diuresis

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24
Q

-Patients may be confined to the hospital setting with an infectious
disease process or may develop one caused by the hospital environment.

-Therefore a basic understanding of these infectious disease processes
is useful in designing, implementing, and modifying physical therapy
treatment programs.

A

INFECTIOUS DISEASES

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25
Q

° Highly specific protein that is manufactured in response to antigens
and defends against subsequent infection

A

ANTIBODY

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26
Q

° Agent that is capable of producing antibodies when introduced into
a body of a susceptible person

A

ANTIGEN

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27
Q

The ability of an infective organism to be transmitted from persor |
person, either directly or indirectly

A

COMMUNICABLE

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28
Q

° Localized or systemic condition resulting from an adverse reaction
to the presence of an infectious agents(s) or its toxin(s); there must
be no evidence that the infection was present or incubating at the time of admission to the acute care setting

A

HEALTH CARE ASSOCIATED INFECTION

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29
Q

An immune system that is incapable of a normal response
pathogenic organisms and tissue damage

A

IMMUNOCOMPROMISED

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30
Q

° Decreased or compromised ability to respond to antigenic stimuli by
appropriate cellular immunity reaction

A

IMMUNODEFICIENCY

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31
Q

° The prevention or diminution of the immune response, as by drugs
or radiation

A

IMMUNOSUPPRESION

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32
Q

° Infection acquired in the hospital setting; note that this has b:
replaced by the term HAI (see above)

A

NOSOCOMIAL INFECTION

33
Q

o An infectious process that develops in immunosuppressed
individuals

A

OPPORTUNISTIC
(Opportunistic infections normally do not develop in
individuals with intact immune systems.)

34
Q

° A disease or condition that does not produce clinical symptoms, or
the period before the appearance of disease specific symptoms

A

SUBCLINICAL INFECTION

35
Q

PAGE 32-36

A

-

36
Q

Airborne droplet nuclei can stay for ___

A

More than an hr
travel >10 ft d/t small size (<5micrometers)

37
Q

A single patient room equipped c special air hand and ventilation capacity (e.g. negative pressure)

A

Airborne Infection Isolation Room (AIIR)

38
Q

Mask/faceshield required when___

A

Large particle >5micromter

if droplet transmiision <=3 ft is likely

spatial seperation of >= 3 ft

39
Q

Due to inappropriate antibiotic use in healthcare institutions and
hospitals

A

ANTIBIOTIC RESISTANT INFECTIONS

40
Q

At least one agent in three or more antimicrobial categories

A

MULTIDRUG-RESISTANT (MDR)

41
Q

At least one agent in all but two or fewer categories

A

EXTENSIVELY DRUG-RESISTANT (XDR)

42
Q

Nonsusceptibility to all agents in all antimicrobial categories’

A

PANDRUG-RESISTANT (PDR)

43
Q

Antibiotic Resistant Infections

A

-Methicilin Resistant Staphylococcus (MRSA)
-Vancomycin Resistant Enterococcus (VRE)
-Multi-drug resistant Acinetobacter baumannii (MDRAB)

44
Q

general indication: hypoxemia

Indications: severe trauma, shock, acute myocardial infarction, surgery, carbon
monoxide/cyanide poisoning

A

OXYGEN THERAPY - Increase O2 levels in the blood and alveoli to improve oxygenation

45
Q

PAGE 39-40

A

-

46
Q

HYPOXEMIA

A

° SaO2 <90%
° Arterial blood O02 partial pressure is <60 mmHG

46
Q

VARIABLE OXYGEN DELIBERY FOR SBA

A

NASAL CANULA
OPEN FACE TENT
CLOSED FACE MASK
TRANSTRACHEAL OXYGEN CATHETER
TRACHEOSTOMY MASK/COLLAR
PARTIAL NONREBREATHER MASK
NONREBREATHER MASK

47
Q

A) Tracheostomy mask/collar
B) Parial non-rebreather mask
C) Non-rebreather mask

  1. Provides a high Fi02 to the patient while conserving the O2 supply
  2. Q2 available via a face mask in a variable-performance system
  3. One way valves control inflow of supplemental O2 and outflow of
    exhaled air so that the patient is only breathing the supplied 02
  4. Provides supplemental, humidified O2 or air at a tracheostomy site
  5. Fio2 - 28 to 100%
  6. Fio2 - 40 to 60%
  7. Fio2 - 60 to 80%
  8. Mix of supplemental 02 and RA
  9. Two-way valves in the mask allow for RA inhalation in addition
    supplemental O02.
  10. Provides the patient with the highest concentration of supplemental
A
  1. B
  2. C
  3. C
  4. A
  5. A
  6. B
  7. C
  8. B
  9. B
  10. C
47
Q

A) Nasal Cannula
B) Open Face Tent
C) Closed Face Mask
D) Transtracheal oxygen catheter

  1. Delivers supplemental O2 mixed with RA
  2. Fio2 - 24 to 44%
  3. Can also be used for nebulized medications
  4. Delivers supplemental O2 mixed with RA (21%), usually I-6 lpm
  5. Mask capacity is limited but does allow for the collection of O2 about the nose and mouth
  6. Fio2 - 30 to 55%
  7. Used for long-term O2 therapy
  8. Provides humidified, supplemental 02 mixed with RA
  9. Fio2 - 40 to 60%
  10. Indicated when there are complications with or suboptimal nasal
    cannula use, nocturnal hypoxemia despite nasal cannula
A
  1. C
  2. A
  3. B
  4. A
  5. C
  6. B
  7. D
  8. B
  9. C
  10. D
48
Q

PAGE 50

A

-

48
Q

FIXED PERFORMANCE OXYGEN DELIVERY
A) Air Entrapment Mask
B) BiPAP

  1. Fio2 - 24, to 50%
  2. Often used in the hospital or home setting for the managemeR
  3. Provides a specific concentration of supplemental O2 using color-
    coded diluter pieces to ensure accurate FiO2 delivery
  4. May be used to avoid intubation and mechanical ventilation
  5. Pressure-supported, noninvasive ventilation that provides positive
    inspiratory and end-expiratory pressure
  6. Fio2 21 to 100%
A
  1. A
  2. B
  3. A
  4. B
  5. B
  6. B

Both deliver air pressure when you breathe in and breathe out. But a BiPAP delivers higher
air pressure when you breathe in. The CPAP, on the other hand, delivers the same amount
of pressure at all times. So the BiPAP makes it easier to breathe out than the CPAP.

48
Q

PAGE 52

A

-

49
Q

Non-Invasive Medical Monitoring

A) BP cuff
B) Telemetry
C) Pulse oximeter

1.) Continuous monitoring of heart rate and rhythm and respiratory
2.) A noninvasive, transcutaneous method of monitoring the percentg
of hemoglobin saturated with O2 in arterial blood
3.) Measures arterial BP

A

BCA

50
Q

Invasive Medical Monitoring
A) Arterial Line
B) Central Venous Catheter

1.) Indicated for a patient with significant fluid volume deficit and is
used as a guide to overall fluid balance
2.) Measurement of CVP is a direct reflection of right heart function
3.) Direct and continuous monitoring of systolic, diastolic, and MAP;
source for repeated arterial blood gas
4.) Also provides vascular access for parenteral nutrition, large fluid
volumes, or noxious medications

A

BBAB

51
Q

NORMAL VALUES SBP/DBP & MAP

A

Systolic: 90-140 mmHg
Diastolic: 60-80 mmHg
MAP: 70-100 mmHg

52
Q

CVP Normal value:

A

2-5 mmHg or 3-8 cm
water (H20)

53
Q

PAGE 56-57

A

-

54
Q

° Provides access for long-term hemodialysis

A

AV fistula/graft

55
Q

-Removes and prevents the reentry of air or fluid from the pleural or mediastinal space and provides negative intrapleural pressure

-Used to treat pneumothorax, hemothorax, pleural effusion

A

Chest Tube

56
Q

For feeding, gastric decompression and keeping the stomach em
after surgery

A

Nasogastric Tube

57
Q

PAGE 59-61

A

-

58
Q

MEDICAL SURGICAL MANAGEMENT DEVICE

A
59
Q

Delivers aerosolized water or medications to the respiratory tract,
lungs, throat, or nose

A

NEBULIZER

60
Q

Provides long-term access for nourishment to patients who are
unable to tolerate food by mouth or have a nasoenteral obstruction,
or for a patient with confusion/ agitation at risk for nasoents
tube dislodgement

A

PERCUTANEOUS ENDOSCOPIC GASTROTOMY/JEJUNOSTOMY

61
Q

PAGE 63-64

A

-

61
Q

° Provides temporary access for delivery of medications, fluids,
electrolytes, nutrients, or blood product transfusions
° It cannot be used to draw blood

A

PERIPHERAL IV LINE

62
Q

° Provides IV access for administration of total parenteral nutrition
(TPN), medications, fluid, blood products, or chemotherapy.
° Generally placed for midterm access (weeks to months)

A

PERIPHERALLY INSERTED CENTRAL CATHETER

63
Q

PAGE 66-67

A
63
Q

° Provides intermittent pressure to the lower extremities via gradual
and sequential inflation and deflation of the air-filled sleeves
° Promotes venous return and prevents deep vein thrombosis (DVT) and venous thromboembolism (VTE) secondary to prolonged or
postoperative bed rest or inactivity

A

SEQUENTIAL COMPRESSION DEVICES

64
Q

PAGE 69

A

-

65
Q

° Surgically placed catheter to drain the bladder temporarily or
permanently after some bladder or gynecologic surgeries in cases of
urinary retention (possibly caused by an obstruction tumor, stricture, periurethral abscess) or a severe voiding dysfunction
°May be used for SCI patients

A

Suprapubic catheter

66
Q

PAGE 71

A

-

67
Q

° Removes excess air, blood, or fluid (serum, lymph, bile, pus, or
intestinal secretions) from a surgical site that would otherwise
collect internally
° To control ecchymosis and to prevent deep wound infection

A

SURGICAL DRAIN (PENROSE, JACKSON PRATT, HEMOVAC)

68
Q

° Noninvasively collects urine via a sheath placed over the penis
° Does not assist with drainage of urine from the bladder

A

TEXAS CATHETER

69
Q

PAGE 73-74

A

-

70
Q

° Used for long-term (months to years) chemotherapy, hemodialysis,
TPN, or other intermittent infusion therapy

A

VASCULAR ACCESS PORT

71
Q

A catheter inserted through urethra in both M and W to drain and collect urine TEMPORARILY (<3 WKS)

Used for urinary incontinence/retention, to assist
postoperative bladder drainage, when accurate measurement in
urine output is necessary, to prevent contamination in patients

With stage 2,3,4 pressure injury on the buttocks/perineum

A

URINARY CATHETER

72
Q

PAGE 76

A

-

73
Q

Drains excess CSF from the ventricles into the abdominal
cavity/peritoneum (VP) or right atrium of the heart (VA)

A

VENTRICULOPERITONEAL SHUNT

74
Q

Clears secretions from the oral cavity or the oropharynx

A

Yankauer suction

75
Q

PAGE 78-88

A

SPECON LEC (6 decks)

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