2803NRS Acute Nursing

Primary survey To identify life-threatening issues (ABCDE = airway, breathing, circulation, disability, exposure) Vital signs Secondary survey -Brief but head to toe (systematic) examination -inspection, palpation, auscultation and percussion -Health history Pre-operative care includes Health history risk assessments (falls risk, pressure injury risk) Weight Specific observations as needed e.g. BSL / BGL Pre-op checklist Consent Patient education Allergy status - wristbands and labels on charts Post-op care includes Assessments - pain -IV fluids -urine output -surgical site and drainage -vital signs -level of consciousness Pain management Patient controlled analgesia - button pressing for when drug is required closely monitored by a locked closed unit that tracks needs verse administered drug into patient then monitoring the effect of the drug on the patient How is diabetes mellitus a surgical risk factor Increased risk of fluctuating BG levels leading to hypoglycaemia or ketoacidosis Can increase risk of cardiovascular disease Delayed wound healing Risk of wound infection What are some surgical risk factors for patients Advanced age Obesity Malnutrition Dehydration/electrolyte imbalance Renal and liver dysfunction Cardiovascular disorders Respiratory disorders diabetes mellitus Alcoholism Nicotine use Adolescence Medications Temperature variations Anticoagulants What is DVT Deep venous thrombosis - formation of a blood clot with inflammation in deep veins What can cause DVT Surgical trauma pressure under the knees sluggish blood flow and reduced mobility Who are at risk of DVT Over 40 undergone orthopaedic surgery to lower extemities history of varicose veins history of thrombophlebitis or PE Obese have an infection have a malignancy Name three anti-emetics (anti nausea) meds metoclopramide prochlorperazine ondansetron Types of IV Fluids Normal saline saline with glucose hartmanns Angina chronic, short episodes of chest pain due to shortage of blood supply to the heart Acute Coronary Syndrome reduced blood flow to the heart Acute Coronary Syndrome symptoms Angina, nausea and vomiting, indigestion, shortness of breath, sweating Acute Coronary Syndrome risk factors High BP, smoking, lifestyle (unhealth diet, lack of physical activity, obesity), diabetes, old age STEMI ST-segment elevation is abnormally detected. Blockage of a heart artery Non-STEMI severely narrowed artery, reducing blood flow but not completely blocked Cardiac Investigations ECG, Chest x-ray, blood tests, angiogram, Echocardiogram Echocardiogram External transducer to view and record waves that are bounced off the heart. Give view of direction and flow of blood through the chambers of the heart ECG produces a graphic representation of the hearts electrical impulses as they pass through the heart Chest Pain Treatment Medical management of signs and symptoms, surgical management to improve perfusion such as angioplasty to remove blockages and insertion of stent. Open heart surgery to repair damage or replace Chest Pain Prevention Health education to reduce modifiable risks and improve healthy lifestyle coronary angiography X-ray (catheter inserted into artery in the groin, inside elbow or wrist) of hearts arteries is taken to see if they are narrowed or blocked Influenza diagnosis symptoms and management Diagnosis: FBC, focused assessment Symptoms: fever, sore throat, dry cough, headache, tiredness Management: RIB, fluids, hand hygiene, vaccinations Petussis (Whopping Cough) Diagnosis: Culture, Serology Symptoms: runny nose, sneezing, tiredness, coughing Management: Antibiotics, vaccinations Diagnostic Tests include Chest X-ray, Full blood count, sputum sample, bronchoscopy COPD chronic obstructive pulmonary disease COPD management, symptoms and risk factors Management: quit smoking, medication, patient education, oxygen therapy Symptoms: ongoing cough, shortness of breath, wheezing, chest tightness Risk Factors: smoking, long term exposure to lung irritants Asthma management, symptoms and risk factors Management: inhaler, patient education, self-monitoring of asthma control based of symptoms, medication (Beta 2 agonists) Symptoms: coughing (especially at night), wheezing, shortness of breath, chest tightness or pain Risk factors: family history, viral respiratory infections, early allergen exposure, smoking, obesity, air pollution Oxygen Delivery rates per different masks Nasal prongs: 2-4L/min, 24-35% Venturi mask: 24-60% Hudson mask: 5L/min, 40-60% Non-rebreather mask: 15L/min, 60% Nebuliser COPD Oxygen Delivery No more than 4L/min via venturi mask or 2L/min nasal prongs. AIM for oxygen saturation 88-92% Upgrade to remove ads Only $35.99/year Bronchitis inflammation of the larger airways in your lungs, causing ongoing cough. Caused by viruses, bacteria, or breathing in smoke or dust. Emphysema over inflation of the alveoli causing shortness of breath Bronchodilators Dilate the airways of the lungs by relaxing bronchial muscles. Administered to people with asthma and COPD UTI management, symptoms Management: fluids, urinate after sex, wipe from front to back Signs and Symptoms: cloudy or dark urine, fever, burning or discomfort when passing urine, passing urine more frequently than usual, urge to urinate Renal Calculi (kidney stones) management, symptoms Management: pain relief, fluids, surgery for large stones Signs and symptoms: blood in the urine, vomiting, nausea, chills, fever, frequent need to urine Acute Kidney Injury build up of waste products in your blood which makes it hard for the kidneys to keep the right balance of fluid in your body Renal System Function eliminate urea (waste) and keep chemicals and water in balance Upper GI Disorders stomatitis, tumours, GI bleeding, nausea and vomiting, bowel cancer, Gall stones, Gallbladder cancer GI Medications: Antacids Proton Pump Inhibitors Histamine 2 Blockers Types of Haematomas Epidural Subdural Intracerebral Upgrade to remove ads Only $35.99/year Munroe Kellie Hypothesis sum of volumes of brain, CFS, and blood should be consistent. Increase in one should cause a decrease in one or both. Nontraumatic brain injuries anoxia, infections, strokes, tumours, metabolic disorders Hyperthyroidism excessive function of the thyroid gland and production of thyroid hormone Hyperthyroidism S&S and management Symptoms: appetite change, insomnia, fatigue, frequent bowel movements, heart palpitations, increase sweating, nervousness Management: Anti-thyroid medications, Beta blockers, Surgery (thyroidectomy) Hypothyroidism insufficient production of thyroid hormone. Thyroid gland enlarges in attempt to compensate Hypothyroidism S&S and management S&S: fatigue, weight gain, mood swings, lethargy, cold Management: thyroxine, hormone replacement Type 1 Diabetes pancreas does not produce insulin Type 2 Diabetes reduced insulin production and/or reduced insulin effectiveness or reduced response to insulin Endocrine Organs Hypothalamus, Piturtary Gland, Thyroid, Adrenal, Pineal Cervical Cancer growth of abnormal cells in the lining of the cervix cervical cancer s&s and treatments Symptoms: vaginal bleeding, bleeding after intercourse, pain during intercourse, unusual vaginal discharge, excessive tiredness, lower back pain, leg swelling or pain treatments: radiotherapy, chemotherapy STI and examples bacteria and viruses which can be and most commonly are transmitted through sexual contact chlamyda, genital herpes, genital warts, hep b, HIV, AIDS Male Reproductive Disorders prostates, cancer, testicular torsion Testicular torsions is.. twisting of the spermatic cord with scrotal pain, swelling, vascular engorgment and schema of the testes Testicular torsion diagnostic tests and treatment Diagnostic: physical examination, blood tests, imaging and biopsy Treatment: anti-inflammatory medications, antibiotics, surgical procedures