Progressive Care Questions and Answers with verified solutions

Progressive Care Questions and Answers with verified solutions Pericarditis - Inflammation of the pericardium, CP that goes away w/ mvmt and relieved w/ NSAIDS; ST elevation; Sharp, stabbing CP Pericardial Effusion - Accumulation of fluid in the pericardium (the sac around the heart); complication of pericarditis; -SOB, orthopnea, tachycardia (sx of HF) -TX: NSAIDS---- Pericardiocentesis (depending on severity) Pericardiocentesis - surgical puncture to aspirate fluid from the sac surrounding the heart Cardiac Tamponade - acute compression of the heart caused by fluid accumulation in the pericardial cavity -s/sx: decreased CO, tachycardia, dyspea -ECHO -Pericardiocentesis Hallmark of tamponade: Beck's triade - Muffled heart sounds, Distended jugular neck veins, hypotension Carotid Endarterectomy - The surgical removal of the lining of a portion of clogged carotid artery leading to the brain. This is done to reduce the risk of a stroke caused by a disruption of blood flow to the brain. Carotid Endarterectomy RN - -Frequent neuro checks -Close BP monitoring -Airway monitoring -Monitoring for hematoma formation IVC filter - Hemodynamically stable management for PE if anticoagulation contraindicated; recent trauma -Placed just below renal arteries Abdominal aortic aneurysm - Monitor control BP Surgery/repair Emphysema (COPD breakdown) - destruction of the alveoli, over time they become constricted and lose their ability to expand Bronchitis - Increased mucous and inflammation; narrowing of bronchi, scar damage (becomes chronic after 3 cases of acute) Pulmonary Embolism - A blood clot that breaks off from a large vein and travels to the blood vessels of the lung, causing obstruction of blood flow. Virchow's Triad - Risk factors for PE: Stasis of Blood flow (immobility), hypercoagulability, injury or damage (postop pts), CA pt's, Hemothorax - Blood in the pleural space Tx: Chest tube or IR/OR for embolization pneumothorax - air in the pleural cavity caused by a puncture of the lung or chest wall; air between lung tissue and lining -Lung can't expand -Tx: Chest tube Tension pneumothorax - A life-threatening collection of air within the pleural space; the volume and pressure have both collasped the involved lung and caused a shift of the mediastinal structures to the opposite side. Causes: blunt trauma, BiPAP Tx: needle decompression Pulmonary contusion - severe blunt chest trauma (MVA). Dyspnea, chest pain, hypoxemia worse with IVF, patchy alveolar infiltrates. Rhonchi - sound of mucous rolling around in the bronchioles/bronchi stridor - Harsh or high-pitched respiratory sound, caused by an obstruction of the air passages (often after extubation) Friction rub - described as grating, scratching sounds of the heart indicative of pericarditis pleural effusion - an abnormal accumulation of fluid in the intrapleural spaces of the lungs. pulmonary edema - Fluid in the lungs flash pulmonary edema - very restless hypoxemia, Blood tinged sputum, Feeling of doom, suffocation; nurse should elevate HOB, put patient on oxygen, put pulse ox. on, stay with patient, you may have to call RRT; patient may need to go to dialysis to pull the extra fluid out