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Problems with VentilationMedical-Surgical Nursing-7th edition

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_______ has cultures from human source materials and carries a potential to transmit infectious agents when used as a thrombolytic.
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Urokinase; Load: 4,400/10 min. and Maintenance: 4.400/kg/12hours
How is status asthmaticus treated?
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Short acting bronchodilaters (albuterol), anticholinergic (ipratropium), oral or IV steroids (solumedrol), and 1 gm magnesium sulfate (MgSO4).
_______ has a high accuracy for detecting emboli in the main or lobar pulmonary arteries.
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Helical CT
What test is considered the definitive test/reference standard for a diagnosis of a PE?
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Pulmonary angiography/aortography
If a patient is on PEEP, which part of the lung is primarily aerated?
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Anterior (causes V/Q mismatch in ARDS)
What are the 4 signs a patient has ARDS?
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Refractory hypoxemia, CXR with bilateral interstitial or alveolar infiltrates, PAWP of 18 or lower with no heart failure, Predisposing condition for ARDS within 48 hours of clinical manifestations.
Acute Lung Injury = P/F _______ and ARDS = P/F _______.
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ALI = 300 Hg or lower, ARDS = 200 Hg or lower
Why are sedatives cautiously used for patients with a PE?
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They blunt catecholamine responses which causes peripheral vasoconstriction and increases BP (which we want).
What are the 3 classic signs of a PE?
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Acute onset dysnpnea, hemoptysis, and chest pain.
What are the limit recommendations for (+) lung ventilation in ARDS?
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Limit (+) pressure to 30 cm H2O.
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_______ can be used to thin secretions but it can cause erythema and bronchospasms.
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Acetylcysteine/Mucomyst (with a bronchodilator)
Where do PEs most commonly originate from?
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Lower extremities, pelvis and kidneys.
_______ is a triangular wedge-shaped pleural infiltrate seen on x-ray with a PE.
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Hampton Hump
What surgical interventions may be used for patients who have a PE and are unstable?
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Aspiration embolectomy, mechanical embolectomy, and vena cava filter. *ECMO for circulatory collapse.
What are the 3 major goals for circulatory support in a patient with a PE?
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Maintain BP, maintain airway, and prevent new thrombi formation.
When the D-dimer level is less than _______, the patient doesn't have a PE.
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500 mg/L
_______ is a dilation of pulmonary vasculature near an embolus in contrast to decreased vascular markers in the affected regions on x-ray.
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Westermark sign
To prevent a fungal infection related to inhaled corticosteroids, a nurse should instruct the client to...
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rinse mouth and/or brush teeth
Type of inhaler that requires a test spray prior to 1st use...
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MDI (metered dose)
  
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