185 Exam 1 Review PDF

**185 Exam 1 Review ❤︎** **Medications**: [Theophylline] -- bronchodilator, treats asthma, can cause dizziness and hypotension [DuoNeb] -- aerosol treatment, inhaler, treats COPD - Rinse mouth - Assess lungs before and after treatment - Watch for tremors, headaches, and stiffness [Acety...

**185 Exam 1 Review ❤︎** **Medications**: [Theophylline] -- bronchodilator, treats asthma, can cause dizziness and hypotension [DuoNeb] -- aerosol treatment, inhaler, treats COPD - Rinse mouth - Assess lungs before and after treatment - Watch for tremors, headaches, and stiffness [Acetylcysteine (Mucomyst)] -- antidote for acetaminophen overdose - Decreases the viscosity of mucous (thins mucous) - Have suction machine at bedside - Side effects -- nausea and vomiting - "Rotten eggs" smell [Midazolam (Versed)] -- antianxiety/benzos - Assess respirations - Decreases awareness and responsiveness [Famotidine (Pepcid)] - H2 blocker that treats peptic ulcers - Prophylactic to prevent ventilator associated pneumonia [Propranolol] -- beta blocker - Assess HR and BP - Can cause hypotension, tremors and palpitations [Prednisone] -- steroid that treats asthma and COPD - Decreases inflammation [Protonix] -- helps GERD and decreases stomach acid [Levothyroxine (Synthroid]) -- treats hypothyroidism by increasing production of hormone - Take on an empty stomach - Can cause hyperthyroidism [PTU (propylthiouracil)] -- treats hyperthyroidism, blocks replacement - Avoid anticoagulants - Monitor hepatic levels, can be given to pregnant women [Mitotane] -- chemotherapy for tumors of the adrenal gland [Iodides] -- treat hyperthyroidism, a solution of Iodine and SSKI [Hydocortisone] -- treats Addison's crisis, given IM, topical and IV [Florinef] -- treats Addison's disease, watch for hemoptysis and seizures [Zolpidem (Ambien)] -- sedative used for insomnia **Gas Exchange** [Types of 02 administration:] [Nasal canula] -- 2 to 6 L (20-40% of O2) [Simple face mask] -- 6 to 10 L (40-60% of O2) [Venti-mask] -- 4 to 8 L (60-80% of O2) [Non-rebreather] -- 10 to 15 L (80-100% of O2) **Ventilator Modes** [Pressure Support Ventilation (PSV)] -- lets the patient take their own tidal volume at their own rate [Assist-Control (A/C)] -- Provides a set total volume at a set respiratory rate [Synchronized Intermittent Mandatory Ventilation (SIMV)] -- delivers a set rate and allows clients to initiate their own breaths with the ventilator **Types of Ventilators** [Pressure Cycled] -- air is pushed into lungs till the present pressure is achieved [Volume Cycled] -- oxygenated air is delivered to the patient at a constant present amount [Timed Cycled] -- used frequently with children and infants, oxygen to deliver to patient at a present length of time **Preventing Ventilator Associated Pneumonia** Mouth care every shift and prn Keep airway clear Keep HOB elevated 30-45 degrees Antibiotics Peptic ulcer prophylaxis to prevent GERD Sedation vacations -- evaluate if patient is ready to be extubated **Care of the Ventilator Patient** Delivers percentage of O2 to assist in breathing Nutritional needs met by TPN or tub feedings IV antibiotics to prevent VAP Check vent setting according to orders Suction as needed Communication with patient and family **Artificial Airways** [Nasal airway] -- through nose to back tongue [Oral airway] -- insert into patient's mouth only [Tracheostomy tube] -- surgical opening in the neck to trachea [Endotracheal tube] -- long tube from mouth or nose into trachea **O2 Safety in the Home** "No smoking" signs Keep O2 in the canister Only use what is prescribed Does require a prescription **Trach Care (trach-anterior neck to create airway)** 1. Standard precautions 2. Suction before removing trach dressing 3. Don sterile gloves and remove inner canula 4. Only sterile water or normal saline to clean cannula 5. Replace cannula 6. Change trach dressing **Suctioning** 1. Standard precautions & sterile techniques 2. Lubricant suction catheter 3. Oxygenate before suctioning 4. Only intermittent suction when pulling catheter out 5. Suctions 10-15 seconds 6. Rinse catheter with normal saline 7. Oxygenate patient after suctioning **Chest Tube** Tube inserted into chest drain air or fluid from pleural space of the lungs Permits re-expansion of the lung Mark amount directly on pleu-evac Keep drainage system upright in floor and below patient **Respiratory** [CPAP] -- mask for sleep, prevents sleep apnea [Ventilator] -- machine which delivers predetermined % of oxygen [Asthma] -- assess lungs, assess ABG's and chest symmetry **Hormone glands** [Pituitary glands] -- below the hypothalamus [Adrenal gland] -- on top of the kidneys [Parathyroid glands] -- on surface of thyroid [Thyroid gland] -- butterfly shaped on trachea **Procedures** [Adrenalectomy] -- diseased adrenal gland on top of kidney is removed [Transsphenoidal microsurgery] -- pituitary tumor is removed from the nasal cavity [Tracheostomy] -- opening is performed on the anterior of the neck to create an airway [Thyroidectomy] -- removal of partial or entire thyroid gland through an incision to the anterior neck **Signs/Symptoms of Hypothyroidism** (Thyroid does not produce enough hormone) Constipation Depression Cold intolerance Thinning hair Weight gain Dry skin Fatigue **Interventions for Hypothyroidism** Assess vitals Medication Stool softener Low calorie diet Warm room Rest periods **Signs/Symptoms of Hyperthyroidism** (Not much thyroid hormone) Excessive sweating Palpitations Heat intolerance Bulging eyes Weight loss Hypertension Pretibial myxedema **Interventions of Hyperthyroidism** Increase calories Keep patient cool Thyroidectomy Radioactive Iodide 131 Medications **Care of Postop Thyroid Patient** Report hoarse voice, incisional swelling Report hematoma over incision site Watch for hypocalcemia (below 8.5) HOB elevated semi fowlers **Thyroid Storm** Elevated blood pressure Elevated temperature Agitation and delirium (altered mental status) Cardiac arrhythmias/tachycardia **Treatment for Thyroid Storm** Cooling blanket 1/3 NS Fluid Propylthiouracil Tylenol **Causes of Cushing's disease** Pituitary secretion too much ACTH Tumor of adrenal gland Tumor of pituitary gland **Signs of Cushing's disease** Hypokalemia Buffalo hump Hyperglycemia Moon face Weight gain **Post-op Adrenalectomy (Removal of Adrenal)** Glucocorticoid replacement therapy Assess vital signs Watch for bleeding Monitor electrolyte Monitor intake and output **Post-transsphenoidal Microsurgery** Tumor in pituitary gland removed No blowing nose Do no put anything in nose Report bleeding, signs of infection and poor POX **Causes Addison's Disease** Autoimmune and Radiation therapy **Signs/Symptoms of Addison's Disease** Hyperpigmentation Salt craving &thirst Hypoglycemia Hypoglycemia Weight loss Hyperkalemia **Signs of Addison's Crisis** (Can be caused by Adrenalectomy) Hypotension Tachycardia Arm & leg pain Confusion Hyperkalemia Cyanosis Nausea Vomiting **Treatment for Addison's Crisis** Electrolyte replacement Hydrocortisone IV Fluids