- NR I304 IFinal IExam IReview
- Hypovolemic IShock
• Volume Idepletion; Iplasma Iof Ithe Iblood Iis Itoo Ilow
• S/s-
a. Dehydration
b. Dizziness
c. Fainting
d. Fatigue
e. Thirst
f. Weakness
g. Nausea
h. Vomiting
i. Tachycardia
j. Insufficient Iurine Iproduction
k. Mental Iconfusion
l. Pallor
m. Sleepiness
- Deep IVein IThrombosis
• Deep Ivein Ioccluded Iby Ia Ithrombus
• Inflammation, Iblocked Ivenous Ireturn, Icyanosis, Iedema
• Virchow Itriad- Istasis, Ihypercoagulability, Iendothelial Idysfxn
• Causes- Iprolonged Irest, Ihistory Iof Ivaricose Iveins, Itrauma, Iinfection, Icancer,
Iobesity, Iimmobility, Iheart Ifailure, Iestrogen Ihormone Iuse, Ismoking
• S/s- Iintense, Isharp, Ideep Icalf Ipain; Iwarmth, Iswelling, Iredness, Idependent Icyanosis,
Itender Ito Ipalpation
• Wells Icriteria
- Vitals Ion IInfants Iand IToddlers
• Respirations I Ipulse I Itemperature
• Rectal Itemperature Iw/ Iinfants
• Tympanic Ior Itemporal Iw/ Itoddlers
• Pulse- Ipalpate Ior Iauscultate Ian Iapical Irate
• Respirations- Iwatch Iinfants Iabdomen Ifor Idiaphragmatic Irespirations; Isleeping Irate
Imost Iaccurate
a. I Neonate I= I30-40 Ibpm
b. I 1 Iy/o I= I20-40 Ibpm
c. I I I 2 Iy/o I= I25-32 Ibpm
• Blood IPressure- Iannual IBP I3 Iy/o Iand Iup; Imost Icommon Ierror Iis Iwrong Isize Icuff;
Icrying Istopped Ifor I5-10 Imins Ibefore Imeasuring
- Peripheral IArtery IDisease
• Affects Inoncoronary Iarteries Isupplying Ithe Ilimbs; Iusually Icaused Iby
Iatherosclerosis
, 2
• More Imen Ihave IPAD Ithan Iwomen
• S/s- Icoolness Iin Iskin, Iweak Ithready Ipulse
• Ankle-Brachial IIndex Iof I0.9 Ior Ilower I= IPAD
• Beginning Ivs Iend Istage?
- COPD
• Obstruction Iof Iair Iflow
• S/s- Ibarrel Ichest, Iwheezing, Idecreased Ibreath Isounds, Iaccessory Imuscle Iuse,
Iclubbing, Iparadoxical Ipulse
• A-P Idiameter I= Itransverse
- Contact IDermatitis
• Local Iinflammatory Ireaction Ito Ian Iirritant Iin Ithe Ienvironment Ior Ian Iallergy
• S/s- Ierythema, Iswelling, Iwheals I(urticaria), Imaculopapular Ivesicles, Iscales,
Iintense Ipruritus
• Can Ibe Icaused Iby Ipoison Iivy
• Vaginal-
a. Red, Iswollen Ivesicles
b. Weeping Iof Ilesions
c. Crusts
d. Scales
e. Thickening Iof Iskin
f. Excoriations Ifrom Iscratching
g. Pruritus
• Diaper IDermatitis-
a. Red, Imoist, Imaculopapular Ipatch Iwith Ipoorly Idefined Iborders Iin Ithe Idiaper
area,
b. Extending Ialong Iinguinal Iand Igluteal Ifolds
c. History Iof Iinfrequent Idiaper Ichanges Ior Iocclusive Icoverings
d. Inflammatory Idisease Icaused Iby Iskin Iirritation Ifrom Iammonia, Iheat,
Imoisture, Iocclusive Idiapers.
• Atopic IDermatitis I(Eczema)-
a. Erythematous Ipapules Iand Ivesicles, Iwith Iweeping, Ioozing, Iand Icrust
b. Lesions Iusually Ion Iscalp, Iforehead, Icheeks, Iforearms, Iand Iwrist, Ielbows,
Iback Iof Iknees
c. Paroxysmal Iand Isevere Ipruritis
d. Family Ihistory Iof Iallergies
- Pursed ILip IBreathing
• Inhaling Ithrough Ithe Inose Iand Iexhaling Ithrough Ipursed Ilips
• Lips Iare Ipuckered Iwhen Iexhaling
• Helps Ithe Iairways Istay Iopen Iduring Iexhalation
- Emphysema
• Caused Iby Idestruction Iof Ipulmonary Iconnective Itissue; Ipermanent Ienlargement Iof
Ithe Iair Isacs Idistal Ito Iterminal Ibronchioles Iand Irupture Iof Iinteralveolar Iwalls;
Iincreased Iairways Iresistance; Ihyperinflated Ilung Iand Iincreased Ilung Ivolume