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Problems with VentilationMedical-Surgical Nursing-7th edition

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How is a personal best determined for an asthmatic?
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Test 3 different times on 2 good days between 12-2 pm. *Check every morning and during attack against this personal best .
_______ is a highly accurate diagnostic tool for PE, but requires the patient to cooperate and hold their breath for 20-30 seconds.
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Computed tomography (Helical/spiral)
A saddle embolus is one that occludes...
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the bifurcation of the pulmonary artery
What test is useful in differentiating between massive PE and other causes of hemodynamic compromise?
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Echocardiography. *Can see RV hypocontractility and dysfunction.
What are the specific PaO2 and SaO2 goals when providing O2 therapy?
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PaO2 at 55-60 and higher; SaO2 at 90% or more on the lowest O2 concentration possible.
How is polycythemia treated in patients with COPD?
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Fluids, heparin/coumadin, and phlebotomy.
What % of oxygen concentration is delivered via BVM (bag-valve-mask)?
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90-95%
For a patient with a PE, how frequently should neuro and vascular assessments be done to monitor therapy effects?
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Hourly
What is the determining factor for whether a patient has ARDS or a heart problem?
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With ARDS, the pulmonary artery wedge pressure is 18 or less. (PAWP 18 or less)
How can you tell an acute lung injury is progressing to ARDS?
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A patient's O2 requirements increases but their SaO2 decreases. P/F decreases. Refractory hypoxemia
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Patients with chronic hypercapnia (COPD) should get O2 delivered via _______ at a rate of _______.
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NC at 1-2 L/min; Venturi 24-28%
_______ echocardiography is useful for detecting thrombi in the central pulmonary artery.
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Transesophageal
Any abdominal or thoracic surgery lasting more than _______ increases the risk of PE.
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30 minutes
What is the most common heart rhythm seen in cardiac arrest and PE?
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Pulseless electrical activity
Patients with _______ are at increased risk for barotrauma from pressure ventilation because the lungs can overdistend.
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compliant lungs (COPD, emphysema), stiff lungs (ARDS), and lung abscesses
What are the characteristics of someone with advanced COPD?
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Barrel chest, chronic hypoxia, polycythemia, corpulmonale/PHTN, S3 sound, increased P-wave amplitude, weight loss, and tripod.
What are the 4 components of the National Asthma Education program?
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Assess current level/future risk, self-management education, control of environmental factors and co-morbid conditions, and drugs.
_______ are a class of drugs used to treat bronchospasms and inflammation.
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Corticosteroids
Asthmatics should measure their peak flow every _______.
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day
_______ is a major cause of pulmonary complications.
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Immobility (*influences perfusion distribution)
What EKG findings are suggestive of PE?
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Anterior T wave inversion; tall, peaked P waves; and PEA.
  
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