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health promotion - pulmonary edema - ANSWERS-physical activity
low sodium
refrain from tobacco
nursing care for pulmonary edema - ANSWERS-high Fowler's
- feet and legs dependent or sitting on side of bed
high flow O2
monitor vitals every 15 minutes
monitor I&Os
check ABGs, electrolytes, SaO2
maintain airway
restrict fluid intake
monitor hourly urine output
medications for pulmonary edema - ANSWERS-rapid acting diuretics
morphine
vasodilators
digoxin
,decompensated heart failure - ANSWERS-failing myocardium is no longer able to
propel sufficient blood to meet the needs of the body, even at rest
central venous pressure (CVP) - ANSWERS-measurement of the pressure in vena cava
or right atrium
reflects the filing pressure of the right ventricle
normal range is 2-6
preferred site is subclavian vein
CVP monitoring - ANSWERS-most valuable when it is monitored over time
greater than 6 mm Hg indicates elevated right ventricular preload
- usually from hypervolemia
less than 2 mm HG indicates hypovolemia
pathophysiology of aortic dissection - ANSWERS-commonly associated with poorly
controlled hypertension, blunt chest trauma, and cocaine use
- caused by a rupture in the intimal layer, typically in the aotrtic arch
manifestations of aortic dissection - ANSWERS-usually sudden onset
severe and persistent pain (tearing or ripping feeling)
pain in anterior chest or back
- extends to shoulders, epigastric area or abdomen
pale
sweating
tachycardia
BP elevated or different between arms
diagnostics of aortic dissection - ANSWERS-arteriography
TEE
, duplex ultrasonography
MRA
hemodialysis - ANSWERS-shunts blood from the body through a dialyzer and back into
circulation
- based on manifestations, not GFR
goal is to extract toxic nitrogenous substances from the blood and to remove excess
fluid
prevents death but does not cure kidney disease
indications for hemodialysis - ANSWERS-renal insufficiency
AKI
CKD
medication or drug toxicity
persistent hyperkalemia
hypervolemia that does not respond to diuretics
education for hemodialysis - ANSWERS-needed 3x/week
3-5 hour long sessions
two needles: one in vein & one in artery
avoid invasive procedures for 4-6 hours after
nursing actions: intra-procedure for hemodialysis - ANSWERS-monitor complications
during dialysis
- circuit clotting
- air bubbles
- temp of dialysate