Week 10 Flashcards

1
Q

What is a thoracic aortic dissection?

A

This is when there is a tear in the intimal layer of the vessel. This creates a false channel which leads to dissection due to shear force of blood entering this false channel.

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2
Q

What is ARF?

A

Acute respiratory failure. When the lungs do not provide sufficient gas exchange to meet the body’s need for oxygen consumption, CO2 elimination or both.

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3
Q

The Australasian Triage Scale (ATS) is the most commonly used 5 level triage scale being used. List the 5 levels.

A
  1. Immediately life-threatening (imminent risk of deterioration)
  2. Imminently life-threatening (high risk of deterioration)
  3. Potentially life threatening or situational urgency
  4. Potentially serious
  5. Less urgent
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4
Q

SOAPIE is an aid in triage assessment. List what this mnemonic stands for.

A
S= subjective data
O= objective data
A= assessment (to enable formulation of a)
P = plan (that is)
I = implemented (and)
E= evaluated (as to its success)
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5
Q

AMPLE is an aid used in triage assessment. List what this mnemonic stands for.

A
A = allergies
M = medications
P = past medical hx
L= last for food and fluids ingested
E = environmental factors and events leading to the presentation
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6
Q

PQRST is an aid used in triage assessment. List what this mnemonic stands for.

A
P = provoking or precipitating factors
Q = quality and quantity (severity) of the symptom
R= region/radiation
S= symptoms associated
T= time of onset and duration of episode, and treatment.
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7
Q

Indirect evidence of poor systemic perfusion in infants may include? (list at least 4)

A
  • feeding difficulties
  • abdominal distension
  • fluid imbalances
  • hypoglycaemia
  • hypocalcaemia
  • apnoea
  • lethargy
  • irritability
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8
Q

the paediatric airway is characterised and differentiated from an adult airway by? List 4

A
  • short maxilla and mandible
  • large tongue
  • floppy epiglottis
  • shorter trachea
  • smaller lower airways, less developed with fewer alveoli
  • more acute angle angle of airway
  • little smooth muscle present in airways
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9
Q

signs of respiratory distress in infants and children up to 8 years of age are?

A
  • head boobing (in infants)
  • nasal flaring
  • paradoxical chest movement (recessions)
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10
Q

strategies for promoting coping in children of all ages include?

A
  • facilitating parental presence at all times, including during invasive procedures and resuss
  • maintaining normal routines and rituals as much as possible, including story time, bedtime routines and presence of favourite toy
  • providing appropriate analgesia and sedation as well as non-pharmacological interventions
  • providing opportunities for play and activities unrelated to treatment.
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11
Q

why is heated humidification preferred in children?

A

They have limited respiratory reserve and are prone to airway blockage.

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12
Q

When providing paediatric care what do we need to take into account?

A
  • that the care has to be age and development appropriate

- the child’s primary care giver is included in all planning of care

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13
Q

Describe the needs when providing nursing care to a critically ill infant or child.

A
  • surface area = can lead to heat loss
  • volume ratio = risk of dehydration/hypothermia
  • they have lower glycogen stores
  • higher metabolic rate
  • o2 delvery requires adjustment based on age, size and o2 results
  • fluid requirements are based on body weight
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14
Q

what are assessing for in an airway/breathing assessment in children?

A
  • airway patency
  • talking or crying
  • adventitious sounds
  • resp distress
  • fatigue/flat child
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15
Q

How do we calculate a childs weight?

A

(age + 4) x 2

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16
Q

How do we manage a child pt who is in shock?

A
  • assessment ABCDE (rash)
  • cardio, resp monitoring, temp, urine outpu, ABG, U&E
  • fluid resuss (within the 1st hour)
  • o2 therapy
  • administration of inotrope/vasopressors (dopamine, dobutamine/adrenaline and noradrenaline)
17
Q

what are the most common admissions for elderly adults?

A
  • arrhythmias
  • heart failure
  • stroke
  • fluid and electrolyte imbalances
  • pneumonia
  • hip fractures
18
Q

List some considerations that may be required when nursing an older adult.

A
  • pain management (sensitive to opioids)
  • medication use (generally poly-pharmacology)
  • depression (often over looked)
  • nutrition
  • physical and social considerations.
19
Q

List some age related changes that occur in older adults.

A

Cardiovascular changes = CO, rate and rhythm, structural changes, circulation
Respiratory = lung compliance decreases
Urinary = functioning nephrons decreases, excretion of toxins decreased

20
Q

What is the normal resp rate for a child?

A

40 bpm

21
Q

What are the common O2 delivery device for infants?

A

-nasalprongs

  • headbox
  • BiPAP
22
Q

List the breathing components of an airway/breathing assessment of a child.

A
  • airway latency
  • child talking/crying
  • adventitious sounds are detected (intubation??)
23
Q

how is a child/infant ventilated?

A
  • ETT uncuffed
  • suction every 2-6 hrs
  • humidify airways
24
Q

what pulses are checked on children?

A

Brachial

25
Q

What is the urine output for a child?

A

0.5-2mls per hour

26
Q

What are some of the conditions that can affect a childs neurological function?

A
  • meningitis
  • seizure-encephalitis
  • encephalopathy
27
Q

What are the symptoms of septic shock

A
  • hypoxaemia
  • hyperthermia/hypothermia
  • cool skin