MEDSURG FINAL EXAM BLUEPRINT ALL DETAILS FOR THE WHOLE COURSE

ACE Inhibitors - Angiotensin-converting enzyme (ACE) inhibitors work against the renin-angiotensin-aldosterone (RAA) system to dilate arteries and decrease resistance to blood flow in the arteries (reduced afterload). In addition, less fluid is retained because aldosterone release is blocked. ACE inhibitors are prescribed for patients with HF, in some cases of hypertension, and in some cases after MI. Examples of these medications are captopril (Capoten), enalapril (Vasotec), and quinapril (Accupril). Some patients do not tolerate the ACE inhibitors. In these cases, angiotensin receptor blockers (ARBs) may be prescribed. Examples of ARBs are valsartan (Diovan), losartan (Cozaar), and telmisartan (Micardis). Acidosis and Compensatory Alkalosis - Metabolic acidosis (body retains too many H+ or loses too may (HCO3-) leads to hyperventilation because the lungs try to compensate by blowing off carbon dioxide and lowering PaCO2 levels, which raises the pH. Metabolic alkalosis is the opposite of metabolic acidosis. Age-Related Changes in Nose and Sinuses - • Nose: softening of the nasal cartilage may cause obstruction • Mucous membranes• Thinner and more fragile• Less mucus production• Increased risk of epistaxis (nosebleed) • Sense of smell declines • Pharynx and larynx• Muscles atrophy • Loss of elasticity of the laryngeal muscles and cartilages; vocal cords slacken • Esophageal sphincter: weakens • Trachea: may deviate from midline • Lungs • Decreased lung elasticity • Enlargement of the bronchioles • Decreased number of functioning alveoli • Respiratory defense mechanisms: less effective • Respiratory muscles: atrophy • Rib cage: more rigid • Diaphragm: flattens Anaphylaxis Assessment and Intervention - Assessment: -Assess what pt history of allergies and what they are allergic to Interventions: -Prevent anaphylaxis -If anaphylaxis occurs administer subcutaneous epinephrine per protocols per facility. -Minimize pt anxiety -Administer prescribed drugs including oxygen -Monitor IV fuids -Monitor respirations, color, heart rate, and oxygen saturation until the patient is fully recovered. Asthma: Respiratory Arrest - What happens in the late phase of an acute exacerbation in a pt with asthma?