S1_L5_Obj - 4-6 Flashcards by Andre Neri Valencia

elevated; within the boundaries of scar

hypertrophic

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Beyond boundaries of scar

keloid

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CHECK THE EXTREMITIES for _

limb swelling

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Decreased amount of oxygen that’s why there’s swelling in the digits

digital clubbing

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ATTACHMENTS: INVASIVE MONITORING
OR MEDICATION/FLUID ADMINISTRATION (4)

Arterial Line (A line)
Peripheral Intravenous Catheters (IV Line)
Central Line / Central Venous Catheter
Pulmonary Artery Balloon Flotation / Swan-Ganz Catheter

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Commonly inserted on radial artery or femoral artery
as an invasive monitoring of BP

Arterial Line (A line)

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arterial or a line is commonly inserted on _ or _ as an invasive
monitoring of BP

radial, femoral

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Seen in patients in the ICU and if moved can
lead to inaccuracy in the BP monitoring

arterial line

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Used for therapeutic purposes such as administration of
medications, fluids and/or blood products as well as blood sampling

Peripheral Intravenous Catheters (IV Line)

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peripheral intravenous catheters is usually attached to the _

dorsal hand

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Commonly inserted through subclavian or jugular vein;
direct monitoring of central venous pressure (CVP)
or right atrial pressure (RAP)

Central Line / Central Venous Catheter

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Central Line / Central Venous Catheter is commonly inserted
through what vein

subclavian or jugular vein

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central venous catheter is for direct monitoring of _ or _

central venous pressure (CVP)
or right atrial pressure (RAP)

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CVP is seen in what part of the body

neck

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Determines mixed venous oxygen saturation (SvO2)
& cardiac output (CO)

Pulmonary Artery Balloon Flotation / Swan-Ganz Catheter

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swan ganz catheter indirectly measures what

Indirectly measures Left Atrial Pressure (LAP)

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swan ganz cathete is the calculation of _ and _

Calculation of systemic and pulmonary vascular resistance

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swan ganz Permits direct measurement of:

■ Right atrial pressure (RAP)
■ Pulmonary arterial pressure (PAP)

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Swan-Ganz Catheter is introduced via _

internal jugular or subclavian vein

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swan ganz catheter in the body:

internal jugular or subclavian vein →
vena cava →
R atrium →
tricuspid valve →
R ventricle →
pulmonary valve →
pulmonary artery

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ATTACHMENTS: NON-INVASIVE LIFE SUPPORT (2)

Non-Invasive Positive-Pressure Ventilation (NPPV)
Oxygen Delivery Devices

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Non-Invasive Positive-Pressure Ventilation (NPPV) (3)

Continuous Positive Airway Pressure (CPAP)
Bilevel Positive Airway Pressure (BiPAP)
Manual Resuscitators (Ambu Bag)

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Oxygen Delivery Devices (4)

Nasal Cannula
Simple Mask
Aerosol Mask
Venturi Mask

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Pt breathing through the mouth thru face piece at flow rates of 5-10 L/min

simple mask

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Used for aerosolized medications or >10 L/min

aerosol mask

Allows room air through a side port

venturi mask

Used for the administration of medicines

aerosol mask

O2 flow between 1-6 L/min for adults & 1/16 L for neonates; if >6 L = high-flow nasal cannula (HFNC)

Nasal Cannula

for nasal cannula o2 flow for adults is

1-6 L/min

for nasal cannula, o2 flow for neonates is

1/16 ;

if >6 L of airflow for nasal cannula this is called

high-flow nasal cannula (HFNC)

for simple mask what is the flow rates?

flow rates of 5-10 L/min

Side port in venturi mask allows _

exhalation

site port in venturi mask allows exhalation, but doesn’t allow air to go in other than O2 t or f

mask for protection from infection

venturi mask

INVASIVE VENTILATORY DEVICES

Oropharyngeal airway/tube Nasopharyngeal airway/tube Endotracheal tube Tracheostomy tube

Mouth to pharynx, just short

Oropharyngeal airway/tube

Nose to pharynx

Nasopharyngeal airway/tube

Oral or Nasal

endotracheal tube

endotracheal tube paths

mouth to trachea nose to trachea

Tracheostomy tube is directly to _

trachea

tracheostomy has incision in the _

neck

Used to be negative pressure but now uses positive pressure

mechanical ventilation

mechanical ventilation used to be _ but now _

negative pressure, positive pressure

be careful when we try to move the area is there is chest tube thoracostomy t or f

ATTACHMENTS: INVASIVE FEEDING DEVICES

Nasogastric Tube (NGT)

Nose to gastric area (stomach)

Nasogastric Tube (NGT)

For pt’s with difficulty swallowing, what tube to use

Nasogastric Tube (NGT)

CHEST DEFORMITIES (4)

Barrel chest Pectus carinatum / Pigeon chest Pectus excavatum / Funnel chest Flail chest

Barrel chest is seen in

COPD like emphysema

Barrel chest -->

○ Prominent chest forward ○ The entire diameter expanded ○ AP and mediolateral are enlarged

sternum projects _ in pectus carinatum

forward

pectus carinatum also called as _

pigeon chest

Prominent projection of the sternum

pigeon chest

Sternum projects backward in _

pectus excavatum

depressed sternum

funnel chest

pectus excavatum also called as _

funnel chest

Flail chest positive finding

(+) hoover's sign

flail chest happens in the _

lower ribs

normal rib position when we breathe

Normally when we inhale ribs go out then exhale ribs go in

when there is fx in ribs, when inhaling, ribs go _ and when exhaling ribs go _

inside, outside

paradoxical movement of the chest; hyperinflated

Hoover sign

in fx of ribs, what pulls the ribs inward

diaphragm

indentation that will retain is called _

pitting edeema

no indentation in

non pitting edema

Extra water inside: what edema

pitting edeema

Indication that it's not just fluid, there might be proteins found there in what edema

non pitting edema

tenderness gradings:

0 1 2 3 4

tenderness gradings: 0

no tenderness

tenderness gradings: 1

tender to palpation; no grimace

tenderness gradings: 2

pain with grimace

tenderness gradings: 3

withdrawal; (+) jump sign

tenderness gradings: 4

touch me not

t or f PERIPHERAL PULSES can be documented under palp or cardio pulmo ax

BREATHING PATTERNS can also be documented under _

vital signs, cardiopulmo ax

Take note of (4) in breathing patterns

○ Character ○ Rate ○ Rhythm ○ Amplitude

Eupnea

Normal=12-20cpm

Apnea with concomitant mouth opening & Closing

fishmouth

Apnea, rate depth rhythm?

- rate, - depth, - rhythm

Bradypnea, rate depth rhythm?

dec rate, N or S depth, R rhythm

Tachypnea, rate depth rhythm?

inc rate, shallow depth, regular rhythm

Hyperventilation (kussmaul), rate depth rhythm?

inc rate, deep depth, regular rhythm

Hyperpnea, rate depth rhythm?

normal rate, deep depth, regular rhythm

Apneusis, rate depth rhythm?

dec rate, deep depth, irregular rhythm

Biot (Meningitis), rate depth rhythm?

dec rate, shallow depth, irregular rhythm

Cheyne-Stokes (Periodic) (Critically-ill), rate depth rhythm?

variable rate, variable depth, regular rhythm

Doorstop, rate depth rhythm?

normal rate, no depth, normal rhythm

Absence of breathing

apnea

Issue with respiratory rate

bradypnea

Medical emergency; critically ill

cheyne stokes

○ respiration suddenly stops d/t pain ○ Seen in post-op pts

doorstop

“Buntong hininga”

fishmouth

N rate, S depth, R rhythm

dyspnea

dyspnea is associated with _

accessory muscle activity

Prolonged Expiration associated with _

COPD

Fast inspiration, Slow and prolonged expiration yet normal rate, depth and rhythm

prolonged expiration

N rate, regular intervals of sighing; associated with anxiety

Psychogenic Dyspnea

psychogenic dyspnea associated with _

annxiety

Art of listening to sounds produced by the body, especially on chest:

auscultation

Breath sounds classified as (3)

normal, abnormal, adventitious

Extrapulmonary sounds classified as (2)

pleural or friction rubs

Voice sounds (3)

egophony, bronchophony, whispered pectoriloquy

Heart sounds (2)

normal or abnormal