Notes for AI Quiz PDF

Gas Exchange Meds DMUSTnumm USES : CROUp sideeffects: Osteoporosis , & glucose WK...

Gas Exchange Meds DMUSTnumm USES : CROUp sideeffects: Osteoporosis , & glucose WK , , fluid urinary retention , immunosuppression Never Ribavirin Antiviral Viral Replication use for Uses : CRMP severe RSV side effects : headache, irritated , Acute LTB , watery eyes runny not , VIRAL ! teaching reducation : do notgiveto pregnant Report unusual fatigue. Follow. dosing schedule. Ceftriaxone ↓ fever Antibacterial Kills bacteria wrot Uses : CROUD-epiglottitis side effects: Gl upset diarrhea, mild rash , teaching +ed : finish full course report watery diarrhea, avoid alcohol , MaksvDatese teaching +ed : Report ringing in ears complete full course , RED MANSYNDROME Nebulized Racemic EPI-Bronchodilator dairway Swelling uses : Severe crmp side effects , strider bronchospasm : tachycardia tremors anxiety ,BP teaching ted: effects wear off in shars- , , , may need repeat doses moniti report , worsening S/5 Epoetin alpha Cause bone Marrowto make& RBCs uses : Aplastic Anemia side effects : ↑BP headache fever ↓ , , fatigue adverse effects HF M1 VIE : , , , stroke , seizures, tumor , teaching 2 Lwksto see full effects +ed : may need iron supplements , , report sys blood clots IronSupplements "iron/ferrms" prevent/tx Iron- black stools Deficiency uses iron-deficiency anemia side effects constipation greent hypotensio, : : , , teaching red : takew/out food Arcid Milk +antacids. Nausea , , diarrhea adverse : Iron toxicity , ↑ Fiber + fluids. Liquid iron stainsteeth use straw anaphylaxis seizures BuppmRB , ylaxis teaching+ed : PA requires lifelong injections report tingling / numbness , , dizziness FOLLApouchergyaee uses : Aplastic + Iron Deficiency side effects flushing , nausea : , mild irvitability adverse : Can mask Bideficiency I drive if they need themto help their resp drive G never withold meds that may resp. MORPHINE-uses trouble breathing ex Pneumothemothorax etc :. : , ↓ work of breathing doesn't hurt as : much to breathe don't struggle as much to brea the Pancreatic Enzymes"-lipase" Digestive uses : CYSTIC FIBROSIS side effects a digestion, I weight gain , Enzyme Replace- : Take you teachinged : Semia ment Breaks AcetysteinMMy m Mum teaching+ ed : use before chest ↑ airway physiotherapy adverse : Branchospasm + may smell bad but it works clearance sty hydrated Report wheering ~ Anaphylaxis dcough severity Thoracentesis uses : Pleural effusion-removes third from pleural teachingted : situpright infront of tablemathwaxmetSpace-needle goes in po a could also do side lying if pt Can't situp: lay on Abypresmeeptymigheelastingburn unaffected side BAD LUNGUP !.. from lidocane : numbs before procea Normally only Nurse should take out 1 ,000 mL at a time. provide support COMFORT Procedure done Monitor for these while by provider provider does procedure : Shock Encourage posture, · : diaphoresis · · pain · all VS incentive cyanosis deep breathe · · , nausea tachyphea · · · pallor/ashgray skin · dyspnea complications Needle : punctures lung- pneumothorax tension Subcutanems emphysema pneumothorax air leaks into tissues under skind : Opperfumed after Thoracentesis putty crackly ,feeling crepitus , , ChestTube uses : Pneumothora Hemothorax PletalEffulim Campstone Serene interrupted ~ Keep padded is teaching +ed : pleura vac machine connected to tubezt in : * Vagal maneuvers = EXPECTED visible mumt of finidintube Tidaling when removing tube - should be Continuous If air leak Bubbling BAD-Indicates air leak *DarKRedBlod-GO = placed below! chest level suspected L 1st look at. : pt Ausculate/palpate insertionsite : work way down tube to NOTIFY find leak. PROVIDER If Check dressing tomake sure it's secure. Nurse allowed to reinfreetape AIR leaKfound DO NOT undress site!: Provider does this complications TUBE becomes DISLODGED FROM PTCHEST : Use : If 3 corner occlusive so air canescape but dressing Measure fluid nothing can get in. If TUBE is disconnected from pneumo vac sterilize tube using sterilewater - :. every rfor ist 24 hrs + keeps water seal.  ↓ N ↓ Chest Tube - When to notify provider ! tracheal deviation from midline sign of tension pheumothorax Suddenonset or dyspnea O2 Sat < 90% visible eyelets on chest tube chest tube fulls out of pts chest or disconnects from system drainage in tube stops in 15t 24 his Nursing Care-Chest Tubes Ensure on chest around tube is dressing + tight intact RN can reinforce + - Assess for difficulty breathing pulseox breath sounds in each lung , : , , alignment of trached Check skin a insertion site : subcutaneous emphysema/crepitus puffiness skin cracklingsite - + signs of infection redness warmth pumlent drainage , , signs of excessive bleeding check to see if tube eyelity are visible they shouldn't be Assess for pain + administer pain meds PRN Assist pt w/ coughing + deep breathing , sustained inhalations incentive spirometer + If pt reports burning in Chest - reposition them Nursing Care DrainageSystem Milk tube only if instructed/ordered If ordered to not sti - by provider. : secure tube & insertion site to prevent dislodgement + other hand to milk tube use handovera Keep drainage system below level of pts. Chest-GRAVITY Keep tube as straight as possible w/out kinks. Extratubing + can be loosely coiled onbed Ensure tube is securely taped to all sites Assess bubbling in water-seal chamber : gentle bubbling-normal w/exhalation, cough , I mumt ! indicates air leak excessive bubbling-bad Assess fr tidaling w/ breathing normal - Keep clamp by bedside but only clamp for short periods to change drainage system or when checking for air leaks Document all fluid characteristics : Bright Red Blood-BAD ! Dark Red Blood - normal ! Empty drainage by level reaches tube  3 Exemplar Review Module Bacterial Epiglottitis inflammation/ swelling of the epiglottis blocking the airway : Infection 3/5 : drooling , dysphagia, strider , tripod position high , fever, emergent HiB-Haemophilus & Risk Factors : 1-Tyrs lack of vaccinations , Cause : Complications : airway obstruction , resp arrest Influenza Type B ! DX : lateral neck X-Ray (thumb sign/Cherry Meds Corticosteroids Dexamethasone Epinephrine Antibiotics a Ceftriaxone : , , th Nursing Care Keep pt calm prepare for intubation , Do Not put anything : , in pts month monitoro - sat do Not lay ptflat no cral fluids , , , Pt Education seek. : emergency care if having difficulty breathing leave Do not child Keep pt + family informed + calm alone ! Additional Measures : cool mist humidification IV fluids TrachTube Keep avail , , Laryngotracheal- AcuteLTB Branchitis Viral Infection causing upper airway obstruction : S/S Gradual cuset barking cough inspiratory strider low fever, : , , , occurs b night hoarseness, irritability , dyspnea , Risk Factors 3mo-3yrs viral infection : , Complications : severe resp distress , hypoxia DX Clinical presentation X-Ray Steeple sign-narrowing trachea : , Meds Nebulized Racemic EPI Dexamethasone Ribavirin Humidified : , , , Oxygen w/mist Heliox Fluids , , Nursing Care : Monity for strido, Admin humid Oxygen allow child worsening , caregiverlap Calm environment avoid resp distress to sit in , , Pt. Education MildLTB can be handledhome - cool air go outside, : : open fridge cool basement. Encourage rest fluid intake. + , RSV/Branchiolitis Viral infection causing lower airway inflammation + mucus buildup : Position babylintantw/RSV S/S Wheering tachypnea rhinorrhea fever Can be severe Cyanosis, Head + Chest & 30-400 angle : : , , , , : Checkslightlyextenda cough sneeze ↓ breath sands Napetite diaphragm hypoxia grinting , , , , RiskFactors : infants , prematurity , not-breastfed babies, on pressure daycare exposure ↓ , underlying astuma 2nd hand smoke , Complications Severe resp. distress apnea : , DX : RSV antigen test Chest X-Ray Antipyretic Tylenol , - Meds : Ribavirin if severe , Bronchodilators, Palvizumab RSV prevention Nursing care : Suction w/bulb syringe - betrefeeding ,bedtime + PRN ~ Assignonly 1 Hydration formula/breast milk & 10 mins : 5-10mL Contact nurse to prevent Humidifier Nebulizer cool-humidified air Oxygen , , + Droplet ( spreading. DO NOT Give COUGH Suppressants Codeine - Precautions Pt Educatio :Handhygeinetmabarmhapnotsmokearmndbase. - ~ see crmp babies Give Palirizumab to prevent RSV 64 RsV babies Avoid sick ppl bloodsugaa ser ↓Monitor  Average Life Expectancy : 3Tyrs NOCURE PROGRESSIVE DISEASE Cystic Fibrosis genetic disorder causing thick : mucus production , leading to lung + pancreatic dysfunction CFTR Mutation 3/5 Chronic cough thick mucus, recurrent infections failure to thrive constipa- : , , , Risk Factors genetic inheritance caucasian ↑ BS tim , : weight loss greasy , , , complications respfailure malnutrition wheezing RSHF foul smelling , : , , stook DX Sweat sodium Chloride test-genetic : testing Miconium Meds Dornase alfa bronchodilators pancreatic enzymes stoolsofteners, : lleus + , , , Acetylcystine Mucolytic , Insulin CFRD , antibiotics Nursing Care : Chest physiotherapy Postural drainage , , huff coughing , nebulizers antims done multiple times a day forHO,Handmygeine GivepanweezymalmanacSeeding , Educatio stay hydrated 1-2 hrs : Diet : Protein , Fat , Calories Vitamins ,, we A before CPT take pancreatic enzymes wall meals + snacks DO NOT take enzymes w/Milk Products * kids should get all typical vaccines+ Stay up to date on vaccines prevent infections ! yearly flushots*- Iron Deficiency Anemia Low iron levels - > ↓ : hgb synthesise impaired O2 transport 5/5 fatigue pallor brittle/spoon-shaped nails : , , , fissure in corner of Mouth PICA , SOB , tachycardia , RiskFactors: Lack of iron blood loss , pregnancy , , exclusively breastfed babies complications Hypoxia developmental delays in children : , Dx/Labs ↓ HgB ↓Het ↓ ferritin for MILD : , , Meds Irm supplements "ironlferrous" Folic acid iron-rich diet : , , Nursing Actions Iron-richfoods monitorfor 61 distress, : , Delay umbilical card clamping Do not give iron supplements WANTACIDS/milk/miducts Giving iron w/citrus is GOOD ! Severe IDA-IV Iron Pt Education :. liquid iron for infants Liquid stains teeth - so give /straw if old enough t brush teeth after Expected iron side effects- dark green/black stools constipation + Iron can be fatal to children onlykeep / month supply& home store in safe place Take as prescribed - should see increase in 1 month Give to breastfed babies they doit get enough solely Pernicious Anemia Lack of intrinsic factor preventing vit Biz absorption :. Autoimmune S/S neuropathy paleness n/V fatigue glossitis Chelitis weight : , , , , , , RiskFactors Autoimmune gastric by pass age > 60 Vegetarian diet : loss , , , Complications neurological impairment : , HE  DX/Labs : Low Biz + High HCV Meds Vit Biz Injections lifelong or Vit Biz capsules/supplements : Nursing Care Monit neuro status + provide supplements : Educate on Lifelong Biz & foods easily mplastic emabonmarosuppressionNopatet radiation thi bleeding gums Risk Factors blue damage cancer : marrow , , , chemo , immunocompro- Complications severe infectio hemorrhage : , mised Dx/Labs Pancytopenia CBC WRBCs ↓ WBCs ↓ platelets : , +. , , Meds Epoetin alpha immunosuppressants sterroids bone marrow : , , , in severe At when bone ↳ ATG used transplant Folic acid, marra transplant isn't an option NursingCare : Monitor for infection , provide transfusions it needed Address underlying cause + remove ex : meds ,toxins, infection Pt. Education Report signs of infections : Take meds as prescribed Pneumothorax air in pleural space leading to lung collapse. : S/S : absent breath sounds sudden dyspned tachyphed , , MEDEMERGENCY-tension tracheal deviation JVD, ↓ BP Chest pain : , , RiskFactors Chest trauma lung disease thoracentesis comp. underlying : , , Types Open closed Tension dir enters pleural space + can't leave : , , Complications Resp distress cardiovascular compromise open closed : - , , - complication - tension pneumothorax DX Chest X-Ray , Ultrasound : Meds O2 Pain Management Morphine Therapy : + Nursing Care Open sterile occlusive dressing-sided Oxygen ,Monitor Naccess : & S , , closed No dressing needed thoracentesis chest tube -> , , Tension Needle decompression + Chest tube - Optionfor all it needed : CHestTUBe Last Resort : Surgical + ! Proper Chest tube care + Pt Education : Avoid high-risk activities Repair monitoring. know signs of "hyperresonance" worsening symptoms amm-like Hollow , Haveptlean overtable during thracentesis Sign consent forms 64 any invasive procedure Hemothorax blood in pleural space leading to lung compression : S/S ↓ breath sounds hypoxia ↓ BP hyporesonance (dullness : , , , RiskFactors Pneumothorax chest trauma : , complications hypovolemic shock infection : , DX : Chest X-ray CBC , Meds O2Therapy Blood it needed Morphine PRN : , ,  Nursing Care : Admin O2 prescribed + Meds as ChestTube by provider monit watch chest tube Pt. Education Monitor/Report signs of internal bleeding : seek care it worsened emergency Pleural Effusion fluid in pleural space impairing lung expansion : S/S dyspnea I breath sounds dullness hypressonance : , , backy non. , RiskFactors lung disease , HF infections : , productive Complications Resp distress: Corticosteradsmgh Dx Labs : Chest X-ray , Ultrasound , CT scan Loop Meds : diuretics thordcentesis pulls fluid off or Chest Tube it severe , Diuretice Nursing Care : Monithw/breath sounds , assist w/thoracentesis Pt Education: Monith fur resp distress seek help.. , Flailchest :Multiple rib fractures leading to paradoxical chest mumt. S/S severe chest pain resp distress chest caves in or bulges cut, : ,. , Risk Factors trauma~ can be mild or severe : pain that increases Dx/Labs Physical exam + CT scan : wimumt Meds : TX pain IV meds Epidural or Nerve Block Narcotics for pain Morphine - - , Nursing Care Mild-OxygenSevere mechanical ventilation ar shock : stande foot of bed to observe both sides of chest "floating section splinting or direct pressure or chest tracheal suctio of ribs" Pulmcuary hygeine + physiotherapy if needed Put pt on near monitor Help/educate them to clear secretions Pt Education teach splinting to mitigate pain w/ resp. : turn , cough + deep breathe could cause resp acidosis-watch report Blood Transfusion Reactions If any of these happen STOP1 : Hemolytic Reaction When pt is given blood that doesn't match their blood type :. pts immunesys usually occurs within 15 min of starting can even happen -. is attacking itself up to 24 hours after S/S : chills , dyspned fever , , flushing , infusionsite pain low back , pain shock tachycardia , tachyphed , , Nursing Care : If any of these symptoms start - STOP THE TRANSFUSION Admin diuretics IVNS insert catheter prepare tot shock+ DIC , , , Pt Education: Educate + explain in normal terms "Let me know if you. different than you do right now " feel anything > disconnect After stopping - tubing Keep IV open w/NS using + new tubing Notify provider-blood bank  Transfusion-Associated TACO Circulatory Overload: Too much fluid blood& once Fluid Volume overload/excess - S/S brunding pulse, cough , cyanosis Not sat 90%, dysphed , : , JVD , pulmonary edema , resp distress tachycardia , Nursing Care : STOP TRANSFUSION Put ot in High Fowler's Diuretics (PRN if ordered Monitor for fluid overload It Os slow transfusion rate in future Allergictransfusion severe Reaction(Anaphylactic immune system over reaction to transfusion : > - histamine release 6/ n/v anxiety losst , isness : severe respdistress - wheezing dyspnea , , ↓BP , , RiskFactors previous transfusions allergies : , Nursing Care : Monita fus/s STOP INFUSION ! Administer EPI antihistamines bronchodilators + steroids + , , Prepare for shock + CPR if needed * Used washed RBCs confirm allergies before to prevent * Premedicate pt befre transfusion ifthis reaction has occurred before : Antihistamines (Benadryl + Acetaminophen Tylenol) Pt Education Notify nurse/provider of any previous transfusion reactions. : & Tell nurse/provider of any allergies e Mild a Allergic TransfusionReaction : Sensitivity to down plasma proteins some S/S : Itching rash hires mild flushing , , , Nursing Actions : STOPTRANSFUSION ! Admin antihistamines Diphenhydramine Benadryl - - If symptoms resolve provider approves + ↳ transfusion may be restarted slowly still within same 4hrs  Resp Distress ! Watch/Monitor ! S/3 Drooling Nursing Actions Elevate HOB-High Fowlers or Tripod : : SoreThroat Diff Swallowing. Image deep breathinga at Grunting suction secretions if needed Nasal Flating Intubate if severe cyanosis Incentive spirometer Restlessness CPAP or BIPAP Hypoxia Pursed-lip breathing Tachycardia Bronchodilators, Corticosteroids, Diuretics Use of accessory Severe - alert Rapid Response : musclesto breathe Resp &cr > > 30 Stridor cyanosis Confusion Altered LOC Los changes Silent chest (no breath smnds Blue nails severe accessory muscle use Tachyphea