Jhaque

Exclusion criteria for tPA pregnancy, HTN- can be treated and then done, recent surgery, active bleeding, recent stroke Precautions with ITP and DIC bleeding Sudden cardiac arrest nursing interventions activate code and then chest compressions Torsade de pointe magnesium deficiency- treat electrolyte imbalance Afib meds amiodarone, anticoagulants SVT adenosine Vfib defib

An intensive care nurse is aware of the need to identify pt's who may be at risk of developing disseminated intravascular coagulation (DIC). Which fo the following ICU patient's most likely faces the highest risk of DIC? a. a patient w/ extensive burns b. a patient who has a dx of acute respiratory distress syndrome c. a patient who suffered multiple trauma in a. workplace accident d. a patient who is being treated for septic shock A patient is being treated for DIC and the nurs...

What do we do to treat ITP? -stop associated meds -immunosuppressants -corticosteroids -IVIG thrombopoietin receptor agonists -Romiplostim (Nplate) -Eltrombopag (Promacta) What is the nursing interventions for ITP? - avoid SULFA drugs - bleeding precautions -neuro assessment if WET PURPURA -no injections or rectal temps -NO PLATELETS, wont help What is HIT? -heparin induced thrombocytopenia -patients taking heparin create an antibody and that antibody sees platelets a...

Barotrauma can lead to pneumothorax subcutaneous emphysema pneumomediastinum pneumopericardium pulmonary edema Lung cancer risks smoking occupational chemical exposure asbestos Is crepitus expected after a chest tube placement? yes, but not good What do you do for symptomatic bradycardia give atropine How to treat a fib TEE then cardiovert to make sure they don't have any clots in the heart What do you do for VTACH with pulse cardiovert VTACH with...

What is the medical tx for chest contusion? - mechanical ventilation with PEEP - opioids - antimicrobials - Abx What is the medical tx for flail chest? It is life threatening 1. control pain first so they don't get a pneumothorax 2. bone takes 2-6 wks to heal 3. respiratory therapy (TCDB) In an emergency, how do we tx a pneuma/hemothorax? Plug the opening by sealing it with gauze impregnated with petrolatum Tall and fat white males are at risk for pneumothorax. Tru...

Cushing’s syndrome diagnosis -high cortisol all day -3x normal range in urine sample -anything can cause false high cortisol levels Normal cortisol levels 10-20 Normal urine cortisol levels 3.5-45 Cushing’s syndrome treatment -adrenalectomy (risk of CSF leak) -hydrocortisone post op can help adrenal insufficiency -insulin for peptic ulcer Cushing’s syndrome nursing interventions -reposition (risk for peptic ulcers) -monitor BG -monitor

What is DKA? a life-threatening complication of diabetes that occurs when the body doesn't have enough insulin to allow blood sugar into cells for energy. DKA is usually seen in patients with type-1 diabetes, but it can also occur in patients with type-2 diabetes. What are the three main clinical manifestations of DKA? -Hyperglycemia -Dehydration with Electrolyte loss -Acidosis (Metabolic) (Also: Polyuria, Polydipsia, and dehydration, Fruity Breath, Kussmaul Respirations [deep, and ...

Complications of macrovascular issues How does macrovascular disease develop? Risk factors for Cushing's patients True or false: Steroids must be weaned and not stopped abruptly Dietary recommendations for patients with Cushing's True or false: Long term steroid use can be a cause of Cushing's Adrenalectomy will increase the risk of which disorder? Cause of DI Which items are triggers of Addisonian Crisis? What should be include...

serum osmolality >295 hypertonic- DKA (hyperglycemia) potential causes of DKA illness, stress, poor BS control s/s of DKA metabolic acidosis (low ph and low bicarb), Kussmauls- deep rapid breathing, NOT Cheyne stokes, polyuria, polydipsia, GI upset, fruity breath what orders would you expect with a DKA pt fluids, regular insulin via IV regular insulin short acting. peak: 2-3 hours, duration: 4-6 hours intermediate insulin NPH. peak: 4-12 hours, duration: 16-20 h...

Cirrhosis which meds to hold if having ascites, melena Tylenol what to avoid with cirrhosis or portal hypertension ETOH exercising that increase abdominal pressure such as lifting causes of ascites portal obstruction causing back up in the spleen and GI protein-rich fluid, accumulates in the perineal cavity which pulls fluid into the peritoneal cavity. lack of protein in the liver Lactulose actions decreases ammonia by drawing it into the colon to be discreted Encephal...