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NCM 118: Life Threatening Conditions > RLE: FINALS > Flashcards

RLE: FINALS Flashcards

1
Q

is a critical medical condition
characterized by an inability to adequately
remove carbon dioxide (CO2) from the
bloodstream, resulting in elevated levels of
CO2 in the blood (hypercapnia).

A

Acute Hypercapnic Respiratory Failure
(AHRF)

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2
Q

It is typically
marked by an increase in the partial
pressure of arterial carbon dioxide (PaCO2)
beyond the normal range of

A

35-45 mm Hg.
AHRF can be caused by various factors,

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3
Q

arises from bronchoconstriction and airway
inflammation, leading to impaired ventilation
and increased CO2 levels, causing
respiratory distress

A

In severe asthma exacerbation, acute
hypercapnic respiratory failure (AHRF)

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4
Q

complicates respiratory
status due to cardiac impacts on the lungs,
including pulmonary edema and
cardiovascular stress, indirectly affecting
breathing.

A

High-risk acute coronary syndrome,
especially NSTEMI,

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5
Q

TYPES of ACUTE HYPERCAPNIC RESPIRATORY FAILURE

A

HYPOXEMIC RESPIRATORY FAILURE

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6
Q

Represented by inadequate oxygenation of
the blood, resulting in diminished oxygen
levels throughout the body. Frequently, it
originates from underlying diseases such as
pneumonia or acute respiratory distress
syndrome (ARDS).

A

HYPOXEMIC RESPIRATORY FAILURE

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7
Q

COMMON SIGNS OF ACUTE HYPERCAPNIC RESPIRATORY
FAILURE: PCTAC

A

Pale conjunctiva
● Cyanosis
● Tachypnea
● Asymmetric chest expansion
● Crackles left

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8
Q

FIRST 3 NURSING MANAGEMENT for AHRF

A

RESPIRATORY SUPPORT
AIRWAY MANAGEMENT
CARDIOVASCULAR MONITORING

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9
Q

NURSING MANAGEMENT
RESPIRATORY SUPPORT
● Encompasses continuous monitoring of

A

respiratory rate and oxygen saturation,
administering oxygen therapy as prescribed,

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10
Q

AIRWAY MANAGEMENT
● Effective airway management include

A

assessing and maintaining airway patency,
administering bronchodilators as prescribed,

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11
Q

CARDIOVASCULAR MONITORING
● Cardiovascular management involves
closely monitoring the patient’s

A

heart rate,
blood pressure, and rhythm, administering
prescribed medications, and collaborating
with the healthcare team

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12
Q

Medication management involves
administering prescribed medications
including (AHRF)

A

bronchodilators, antibiotics for
pneumonia, and medications for
cardiovascular support, most significantly
monitoring for potential drug interactions and
side effects

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13
Q

medical management for the presented
patient, who is experiencing acute
hypercapnic respiratory failure (AHRF)
alongside severe asthma exacerbation,
pneumonia, and high-risk acute coronary
syndrome (NSTEMI),

A

Non-invasive
ventilation (NIV) emerges as a pivotal
component of the management plan

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14
Q

are administered
to manage severe asthma exacerbation

A

Expectorants Bronchodilators, such as
beta-agonists and anticholinergics,

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15
Q

is the buildup of extra
fluid in the space around the heart. If too
much fluid builds up, it can put pressure on
the heart. This can prevent it from pumping
normally.

A

Pericardial effusion

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16
Q

A little fluid won’t cause much of a problem.
But if too much fluid builds up, it can make it
hard for the heart to expand normally. This
condition is called

A

cardiac tamponade.

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17
Q

Chronic pericardial effusion occurs
when cardiac effusion happens more than
once over time. Some different types of
effusion are

A

transudative effusion
exudative effusion
hemorrhagic
effusion

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18
Q

due to
non-inflammatory causes (congestive heart
failure, myxoedema, nephrotic syndrome)

A

transudative effusion

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19
Q

: inflammatory or
malignant causes (tuberculosis, spread from
empyema, metastasis)

A

exudative effusion

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20
Q

high blood concentration (trauma,
rupture of aneurysms, malignant effusion).

A

hemorrhagic
effusion

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21
Q

most commonly
results from heart failure. This usually results
from inflammation by bacterial products or
tumors involving the pleural surfaces

A

TRANSUDATIVE EFFUSION

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22
Q

n results from increased
capillary permeability due to an inflammatory
reaction. They most often occur with an
infection or cancer

A

EXUDATIVE EFFUSION

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23
Q

is caused by bleeding
into the pericardial space due to trauma or
rupture of a vessel in this area.

A

HEMORRHAGIC EFFUSION

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24
Q

Beck’s triad is

A

Hypotension
● Muffled heart tones
● Increase in CVP

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25
Q

Nursing Management one of the most
important aspects of care of the patient who
is experiencing Massive Pericardial Effusion

A

Assess vital signs,
assess for oxygenation and ventilation, input
and output

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26
Q

r medical management treatment depends
on the underlying cause and the severity of
the

A

e heart impairment

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27
Q

Fluid can be drained via needle

A

pericardiocentesis as discussed above or
surgical procedures, such as a pericardial
window

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28
Q

the choice of treatment
in unstable patients: it can be performed at
the bedside and in a timely manner

A

Pericardiocentesis

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29
Q

collision involving a
motor vehicle and another object, such as a
person, another vehicle, or a stationary
object.

A

vehicular crash

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30
Q

These occur when one vehicle strikes the
rear of another vehicle

most common

A

REAR-END COLLISIONS

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31
Q

These occur when two
vehicles traveling in opposite directions
collide.

A

HEAD-ON COLLISIONS

32
Q

These occur when one vehicle strikes the
side of another vehicle.

A

SIDE-IMPACT COLLISIONS

33
Q

Fixed object collisions: These occur when a
vehicle strikes a stationary object, such as a
tree, a light pole, or a building.

A

FIXED OBJECT COLLISIONS

34
Q

These involve only one vehicle. They can be
caused by a variety of factors, such as driver
error, mechanical failure, or adverse weather
conditions.

A

SINGLE-VEHICLE CRASHES

35
Q

These involve two or more vehicles. They
can be caused by a variety of factors, such
as driver error, inattentiveness, or distracted
driving

A

MULTIPLE VEHICLE COLLISIONS

36
Q

These involve a
vehicle and a pedestrian. They are often
caused by driver error, such as failing to
yield to pedestrians, speeding, or driving
under the influence of alcohol or drugs.

A

PEDESTRIAN VEHICLE COLLISIONS

37
Q

These involve a vehicle and
a bicycle. They are often caused by driver error, such
as failing to see a bicyclist, or by bicyclist error,

A

BICYCLE VEHICLE COLLISIONS

38
Q

Distracted driving crashes: These involve a
driver who is distracted from driving by
something else, such as using a cell phone,

A

DISTRACTED DRIVING CRASHES

39
Q

These can range from mild
concussions to severe brain damage. Head
injuries are the leading cause of death in
vehicular crashes, and can also cause
long-term disabilities

A

Head injuries

40
Q

These can cause
paralysis and other serious complications.

A

Neck and spine injuries:

41
Q

These can include collapsed
lungs, broken ribs, and internal bleeding.

A

Chest injuries:

42
Q

the most common type of injury
in vehicular crashes, and typically involve the
arms, legs, hands, and feet.

A

Extremity injuries

43
Q

These fractures are
the most common type.

A

Complete fractures:

44
Q

These fractures are common
in children. They occur when the bone is bent but
does not break completely.

A

Greenstick fractures

45
Q

These fractures occur from
repeated stress over time

A

Stress fractures

46
Q

These fractures are the
most serious type. They occur when the
bone breaks through the skin.

A

Compound fractures

47
Q

These fractures are
the most complex type. They occur when the
bone is broken into many pieces.

A

Comminuted fractures

48
Q

In a healthy individual, the pericardial sac contains
between

A

15 and 50 milliliters (mL) of serous fluid

49
Q

Transudative Effusion
Fluid Characteristics:

A

Protein-poor, cell-
poor, clear, pale yellow.

50
Q

Exudative Effusion
Fluid Characteristics:

A

Higher protein
content.

51
Q

(due to accumulation of
fluid around the heart)

A

Muffled heart sounds

52
Q

Left-Sided Heart Failure:
● Symptoms:

A

a) Dyspnea
b) Orthopnea
c) Tachycardia
d) Pulmonary congestion
e) Cyanosis
f) Fatigue
g) Cough
h) Crackles

53
Q

Signs of Pulmonary Edema
PACCS

A

● Pallor
Anxiety
● Cyanosis
● Clammy and cold skin
● Severe dyspnea

54
Q

Right-Sided Heart Failure:
● Fibrotic lungs, “stiff lungs”
● Symptoms:

SEWDA

A

a) Swelling in the legs, ankles, or
abdomen (edema)
b) Enlarged liver or spleen
c) Weight gain (3lbs in 1 day or 5lbs in 7
days)
d) Distended jugular vein
e) Ascites

55
Q

refers to the percentage of blood pumped out
of the heart’s left ventricle with each
contraction.

A

Ejection Fraction

56
Q

A S3 heart sound indicates

A

left ventricular failure
and is considered an emergency situation.

57
Q

Factors that increase the risk of heart failure:

A

● >65 years of age
● Hypertension
● Coronary Artery Disease (CAD)
● Diabetes
● Obesity

58
Q

GOLD standard diagnostic test for pericardial
effusion

A

2D ECHO

59
Q

GOLD standard diagnostic test for heart
failure

A

NT‐proBNP (N-terminal pro–B-type natriuretic
peptide)

60
Q

High levels of NT-proBNP are a sign that the heart

A

has
to work too hard to pump blood

61
Q

BNP Levels

A

<100 = Normal
300+ = Mild
600+ = Moderate
900+ = Severa

62
Q

First line management for pericardial
effusion

A

Pericardiocentesis or Pericardial window

63
Q

This procedure involves inserting a needle
through the chest wall into the pericardial space
to drain excess fluid that has accumulated
around the heart.

A

Pericardiocentesis

64
Q

creates a small opening or “window” in the
pericardium to allow ongoing drainage of fluid
from the pericardial space.

A

A pericardial window is a surgical procedure.

65
Q

FIRST LINE or NUMBER ONE CHOICE IN
MANAGING HEART FAILURE WITH REDUCED
EJECTION FRACTION (HFREF):

A

ACE Inhibitors (Angiotensin-Converting
Enzyme Inhibitors)
● ARBS (Angiotensin II Receptor Blockers)
● ARNI (Angiotensin Receptor Neprilysin Inhibitor)

66
Q

DIET for a patient with pericardial effusion with
heart failure

A

Low salt and low-fat diet, Low fluid intake

67
Q

A type of closed-suction medical device that’s
used to remove fluids from the pericardium.

A

Jackson-Pratt (JP) Drain

68
Q

This refers to the buildup
of fluid in the pericardial space around the
heart. It might be asymptomatic and can range
from mild to massive.

A

Pericardial Effusion:

69
Q

is a critical
condition and a potential complication of
pericardial effusion.

A

Cardiac Tamponade:

70
Q

A patient with left-sided heart failure is having
difficulty breathing. Which of the following is the
most appropriate nursing intervention?

A

Assist the patient into High Fowler’s position

71
Q

The client diagnosed with congestive heart failure
is complaining of leg cramps at night. Which
nursing interventions should be implemented?

A

Monitor the client’s potassium level

72
Q

Pericardial sac around the heart fills with fluid,
causing and increase in

A

intrapericardial
pressure, that compresses the heart so it can NO
LONGER FILL with blood

73
Q

Will show “enlargement of pericardial
sac”

A

CXR

74
Q

Will show moderate to large effusion
and/or swinging of heart in the chest
cavity

A

Echocardiogram

75
Q

QRS complexes, short & uneven height

A

ECG

NCM 118: Life Threatening Conditions (12 decks)

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