CSE - RRT
How to treat acute elevations in ICP in head trauma/surgery pts: - ANSWERS--
hyperventilation
-keep head of bed elevated
-mannitol
Cause for neck or spinal injury/surgery: - ANSWERS--traumatic injury
-tumors
-spine deformities
neck or spine deformities/surgery pathology: - ANSWERS--neck or spine will have
bruising over affected area
-may be apneic with severe damage to spine
-LOC may be altered
special tests for diagnosing neck or spinal injury: - ANSWERS--CT
-MRI scans
Treatment/management for neck or spinal injury/surgery: - ANSWERS--O2
therapy to treat or prevent hypoxemia
-Maintain patent airway
,-Support ventilation, oxygenation, circulation and perfusion as indicated by
bedside assessment and lab testing
How to maintain patent airway for neck or spinal injury/surgery: - ANSWERS--
utilize modified jaw thrust technique
-Intubation: recommend using flexible bronchoscope
_____/____ _____: decreased renal function secondary to diabetes mellitus or
renal insufficiency - ANSWERS--Diabetes/Renal Failure
Diabetes/Renal Failure pathology: - ANSWERS--history of diabetes mellitus, renal
disease
-may exhibit Kussmaul breathing
-BS: rales if CHF is present
-alert, lethargic, confused, comatose, unresponsive, pedal edema
Urine output for diabetes/Renal failure: - ANSWERS-decreased (<500 mL/day)
Bloof glucose level for diabetes/renal failure: - ANSWERS->160 mg (Diabetic)
Treatment/management of diabetes/renal failure: - ANSWERS--Renal failure:
carefully monitor intake & output, electrolytes, watch for signs of CHF
-Diabetes: closely monitor blood glucose levels, ABG, watch for signs or
respiratory failure
,Commonly performed procedures that fall under the scope of thoracic surgery: -
ANSWERS--lung repairs or resections
-tracheal/mediastinal repairs or resections
-pneumonectomy or lobectomy
-cardiac surgery (valve replacement, bypass grafts)
Thoracic surgery pathology: - ANSWERS--post operative incision
-tachypnea, decreased chest movement over affected area
-BS may be diminished over affected area
-chest percussion may be dull/flat over affected area
Pre-operative diagnostic testing for thoracic surgery: - ANSWERS--CXR may be
abnormal with lung pathology
-pulmonary function may be abnormal with lung pathology
Pre-op Treatment/management of thoracic surgery: - ANSWERS--hyperinflation
therapy (IS/SMI, IPPB)
Post-op treatment/management of thoracic surgery: - ANSWERS--hyperinflation
therapy (IS,SMI, IPPB)
-prevention of infection
-monitor chest drainage systems
, -observe for post op complications
-analgesics for pain
If mechanical ventilation is require for thoracic surgery pts you should consider: -
ANSWERS--may require reduced tidal volume for pts undergoing lung resections
or lobectomies
_______: marked cooling of core temperature (below 35 C [95 f]) - ANSWERS-
hypothermia
Pathology of exposure/accidental hypothermia: - ANSWERS--history of near
drowning or cold exposure; indigent, homeless or elderly persons
-shivering, confused, poor coordination, cyanosis, peripheral vasoconstriction
-decreased HR, RR, Qt, temperature
If pts body temp is < 37 C then the patients actual values will differ as follows: -
ANSWERS--pH increased
-PCO2 decreased
-PO2 decreased
Treatment/management of exposure/accidental hypothermia: - ANSWERS--
support ventilation, oxygenation, circulation and perfusion
-in mild cases, passive rewarming may be sufficient
-in moderate cases (core temp >30 C), active rewarming may be required
How to treat acute elevations in ICP in head trauma/surgery pts: - ANSWERS--
hyperventilation
-keep head of bed elevated
-mannitol
Cause for neck or spinal injury/surgery: - ANSWERS--traumatic injury
-tumors
-spine deformities
neck or spine deformities/surgery pathology: - ANSWERS--neck or spine will have
bruising over affected area
-may be apneic with severe damage to spine
-LOC may be altered
special tests for diagnosing neck or spinal injury: - ANSWERS--CT
-MRI scans
Treatment/management for neck or spinal injury/surgery: - ANSWERS--O2
therapy to treat or prevent hypoxemia
-Maintain patent airway
,-Support ventilation, oxygenation, circulation and perfusion as indicated by
bedside assessment and lab testing
How to maintain patent airway for neck or spinal injury/surgery: - ANSWERS--
utilize modified jaw thrust technique
-Intubation: recommend using flexible bronchoscope
_____/____ _____: decreased renal function secondary to diabetes mellitus or
renal insufficiency - ANSWERS--Diabetes/Renal Failure
Diabetes/Renal Failure pathology: - ANSWERS--history of diabetes mellitus, renal
disease
-may exhibit Kussmaul breathing
-BS: rales if CHF is present
-alert, lethargic, confused, comatose, unresponsive, pedal edema
Urine output for diabetes/Renal failure: - ANSWERS-decreased (<500 mL/day)
Bloof glucose level for diabetes/renal failure: - ANSWERS->160 mg (Diabetic)
Treatment/management of diabetes/renal failure: - ANSWERS--Renal failure:
carefully monitor intake & output, electrolytes, watch for signs of CHF
-Diabetes: closely monitor blood glucose levels, ABG, watch for signs or
respiratory failure
,Commonly performed procedures that fall under the scope of thoracic surgery: -
ANSWERS--lung repairs or resections
-tracheal/mediastinal repairs or resections
-pneumonectomy or lobectomy
-cardiac surgery (valve replacement, bypass grafts)
Thoracic surgery pathology: - ANSWERS--post operative incision
-tachypnea, decreased chest movement over affected area
-BS may be diminished over affected area
-chest percussion may be dull/flat over affected area
Pre-operative diagnostic testing for thoracic surgery: - ANSWERS--CXR may be
abnormal with lung pathology
-pulmonary function may be abnormal with lung pathology
Pre-op Treatment/management of thoracic surgery: - ANSWERS--hyperinflation
therapy (IS/SMI, IPPB)
Post-op treatment/management of thoracic surgery: - ANSWERS--hyperinflation
therapy (IS,SMI, IPPB)
-prevention of infection
-monitor chest drainage systems
, -observe for post op complications
-analgesics for pain
If mechanical ventilation is require for thoracic surgery pts you should consider: -
ANSWERS--may require reduced tidal volume for pts undergoing lung resections
or lobectomies
_______: marked cooling of core temperature (below 35 C [95 f]) - ANSWERS-
hypothermia
Pathology of exposure/accidental hypothermia: - ANSWERS--history of near
drowning or cold exposure; indigent, homeless or elderly persons
-shivering, confused, poor coordination, cyanosis, peripheral vasoconstriction
-decreased HR, RR, Qt, temperature
If pts body temp is < 37 C then the patients actual values will differ as follows: -
ANSWERS--pH increased
-PCO2 decreased
-PO2 decreased
Treatment/management of exposure/accidental hypothermia: - ANSWERS--
support ventilation, oxygenation, circulation and perfusion
-in mild cases, passive rewarming may be sufficient
-in moderate cases (core temp >30 C), active rewarming may be required
