Adult Health 1 Exam 1 PDF

**[Fluid and Electrolytes ]** **[The ABGs ]** - Used for pH balance, examine gas exchange and acid/base - Dx and monitor acute illnesses ABGs and their ranges - pH → acid 7.35 to 7.45 base - HCO3 → acid 22 to 26 base - PaCO2 → base 35 to 45 acid - PaO2 → 80 - 100 mm HG - O2 st...

**[Fluid and Electrolytes ]** **[The ABGs ]** - Used for pH balance, examine gas exchange and acid/base - Dx and monitor acute illnesses ABGs and their ranges - pH → acid 7.35 to 7.45 base - HCO3 → acid 22 to 26 base - PaCO2 → base 35 to 45 acid - PaO2 → 80 - 100 mm HG - O2 stat = 94% or higher How to do ABG problems 1. Look at the pH for acid or base 2. PaCO2 issue = respiratory 3. HCO3 issue = Metabolic 4. Ignore PaO2 **[The Lab Values]** - Used for pH balance, examine gas exchange and acid/base - Dx and monitor acute illnesses Hematocrit → 38 to 45% BUN → 10 to 20 Creatinine → 0.6 to 1.2 Osmolality → 275 - 295 Specific gravity → 1.003 to 1.030 Cl → 97 to 110 WBC → 5,000 to 10,000 Glucose → 70 to 110 - Low number → FVE - High number → FVD **[The Electrolytes ]** Na → 135 to 145 K → 3.5 to 5.3 Ca → 9 to 11 Mg → 1.8 to 3 Phos → 2.5 to 4.5 **[The CVP ]** High → FVE Low → FVD **[IV fluid types and shifts\ ]**Isotonic → enter cell evenly - 0.9 NS, LR Hypotonic → into cell - 0.45% NaCl - 0.225 NaCl Hypertonic → out of cell - D5NS, D5LR, 3% and 5% NaCl **[Seizure Safety]** Lower the bed, cushioning, remove tight clothing **[How the body regulate Fluid ]** Cause → water/blood fluid in body decreases Effect → decrease BP, decrease blood flow Result → thrist factor increase, ADH hormone Insensible fluid loss ---\> sweating **[Trousseau / chvostek sign ]** Trousseau → t-rex hand when tapping on hand Chvostek sign → twitching smile/grin when tapping on the face **[Meds for Fluid + electrolytes]**\ Loop Diuretics → Furosemide (lasix) - Effects the ascending limb of loop of Henle - Removes liquid Thiazide Diuretics → Hydrochlorothiazide (hydrodiuril) - inhibits sodium chloride reabsorption - Remove liquid Potassium-Sparing Diuretics → spironolactone (aldactone) - Increase nephron reabsorption of potassium by interrupting sodium reabsorption in the collect duct - Increase potassium decrease sodium Renagel → removal of phosphate Kayexalate → removal of potassium        **[Respiratory ]** **[Anatomy and structures of the respiratory system ]** **Bronchi + alveoli** - **Bronchi carry oxygen** - **Alveoli oxygen exchange** **Aortic + Cortaid bodies sensory organs used to monitor O2 and CO2 in body** **Chemoreceptors vs baroreceptors** - **Pons, Medulla oblogata,** - **Chemoreceptor sensitive to acidosis and produce vasoconstriction** - **Baroreceptor pressure receptor that reacts to changes in blood pressure** **Pleural space space between viscera and parietal that allows you to breathe without pain/friction** **[Effects of Zinc in the body]** **Decrease of Zinc results in olfactory nerve damage or chronic inflammation** - **Zinc is a mineral used for smell** **[Inspiration and expiration mechanisms ]** **Exhalation is longer** **Inspiration 1 to 1.5 seconds** - **Muscle used diaphragm and external intercostals** - **Diaphragm contracts + external muscles and moves down, allow air to go in** **Exhalation 1.5 to 2 seconds** - **Muscle used Diaphragm abdominal muscles** - **Diaphragm relaxes + abdominal muscles and moves up, pushing air out** **[Factors that affects respiration ]** **Aging less effective cough, immobility** **Lung compliance Distensibility of lung** - **Elasticity of lung tissue** - **Flexibility of rib cage** **Surfactant stabilizes alveoli** **[Normal/abnormal breath sounds (assessment sounds) ]** **Fine crackles popping** **Coarse crackles bubbling** **Pleural friction rub gritting** **Wheezes musical** **Rhonchi snoring** **Stridor honking** **Bronchial, bronchovesicular, vesicular sounds good sounds** **[Diagnostic exams ]** **Biopsy taking piece of lung to send to lab for testing** **CXR/CT/MRI taking picture of lungs** **VQ (ventilation/perfusion) looks at air exchange vs perfusion** **PET scan using dyes to visualize lungs\ pulmonary function test test how well your lungs work** - **Lung volume, capacity, flow rates, gas exchange** **Peak flow monitoring measures air flow out of the lung; pt is breathing out** - **Green 80% to 100%** - **Yellow 50% to 80%** - **Red under 50%** **Culture and sensitivity test** - **2-3 deep breaths before coughing** - **Sterile container** - **Collect in AM** **[Labs ]** - **BMP/CMP blood test that measures proteins and enzymes in blood** - **CBC blood test that looks at blood in body** - **ABGs** - **CRP/ESR find inflammation in body by looking at C-protein** **[Bronchoscopy used to look directly at airway with a tube ]** - **Confirm gag reflex, done before ANY feeding** - **HUGE Aspiration risk** - **Pt needs to be sedated** **[Prevention of respiratory disorders ]** **Lifestyle choices, work-related changes, annual flu shots, avoid noxious agents/triggers** **[Nursing responsibilities for respiratory system ]** **[Nursing dx of respiratory system ]** - **Ineffective airway, Impaired gas exchange, Risk for falls** **[What happens when a pt gets new onset of confusion ]** - **DO NOT IGNORE** - **Get O2 stat, pulse, call MD, document** **[How to care aspiration risk]** - **Remove food try at first sign** - **NPO, Swallow eval** **[Giving oxygen ]** - **Breathing devices** **O2 is flammable !!** - **Cannula 1-6L** - **Simple mask 4-8L** - **Aerosol 8-10L** - **Complications** - **Oxygen toxicity** - **Oxygen is flammable !!** - **Reduce as needed decreasing duration or concentration** **[How to use a Nebulizer]** [ ] **usually used for asthma** - **Pre-nebulizer lung assessment** - **Connect hose to air compressor** - **Insert medication** - **Turn on machine** - **Place mouthpiece in pt's mouth** - **Turn off machine when mist stops !!** **[Common cold and flu ]** **Common cold** - **Over 200 virus strains** - **Prob infected before first symptoms show** - **Direct contact** **Flu** - **18-72 hr from exposure** - **How is a vaccine made?** - **Inject the viral into chicken** - **Extract from chicken's eggs** - **Inactivate viral** - **CBC + CXR to diagnose** - **Encourage fluids** **[Medications to know ]** **Antbx** **Decongestants decongest, mobilize fluids** **Mucolytics anti mucus** **Antihistamines allergic reactions** **Broad spectrum antibiotics** - **Macrolide** - **Penicillin** - **2^nd^/3^rd^ gen. cephalosporin** - **Flouroquinolone** **Bronchodilator Beta adrenergic aka beta-2 agonists** - **Relaxes muscles around airway, dilates airway** - **Albuterol (Proventil), levalbuterol (Xopenex)** **Bronchodilator Anticholinergics** - **Blocks acetylcholine** - **Ipratropium (Atrovent), tiotropium (Spiriva)** **Bronchodilator Methylxanthines** - **Relaxes smooth muscles** - **Theophylline** **Corticosteroids methylprednisolone, prednisolone, prednisone** **[Pneumonia ]** **Types of acquired pneumonia** - **CAP** **community acquired** - **HAP** **hospital acquired** - **VAP** **ventilator acquired** **Legionnaire Disease → freshwater infection of lungs ** - **Symptoms** **Dry cough w/ bloody mucus, High fever/chills, weak/tired, , Muscle aches, Abdominal pain, anorexia, diarrhea ** **Atypical Pneumonia  large group of people** - **Symptoms dry nonproductive cough, headache/weakness, joint pain, systematic** **Viral Pneumonia → virus causing** - **Symptoms dry cough w/ yellow mucus, cold/flu like symptoms** **Pneumocystis Pneumonia → decreased immune system ** - **Symptoms Dry cough NO mucus, Decreased cough/gag reflex, silent regurgitation, Tachy/SOB** **Aspiration Pneumonia → choking on self ** - **Symptoms** **chest pain, SOB, wheezing, constant cough, signs of aspiration** **[Asthma ]** - **Cause genetic, triggers, etc** - **Symptoms wheezing coughing, SOB, Chest tightness** - **Treatment** - **short-acting beta2-adrenergic agonist dilate bronchial passage** - **Corticosteroids decrease inflammation** - **IV hydration replaces calories + glycogen** - **Magnesium sulfate relaxes smooth muscles** **[Sleep apnea] Stopping of breathing during sleeping** - **Causes age, narrowing of airways, genetics/Hx** - **Symptoms loud snort, stop breathing for at least 10 seconds, daytime sleepiness** - **Increase risk for Type II DM, HTN, Cardiac arrest** - **Treatment CPAP machine** A screenshot of a medical information Description automatically generated **[COPD Bronchitis/Emphysema ]** - **Cause low level alpha 1 antitrypsin break down elasticity and shape of alveoli** - **Treatment walk 3x a week, positioning** **fowler or high fowler, small frequent meals** **[Alpha 1 antitrypsin inhibits neutrophil elastase activity in the lung and protects it from proteolytic damage]**