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68 Cards in this Set
- Front
- Back
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Normal intracranial pressure (ICP)
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less than 10mmHg
clinical goal to keep the ICP less than 20mmHg |
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What can be done to lower the ICP?
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place the patient on a mechanical ventilator and hyperventilate them to a PaCO2 of 25 to 30 torr while maintaining normal oxygenation
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What is insensible loss?
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from breathing and sweating
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Normal oral body temp?
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98.6 F
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What causes a patient to breathe more rapidly?
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Hyperthermia (fever), acidemia, hypoxemia, fear, anxiety and pain
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What causes a patient to breathe slowly?
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Hypothermia, alkalemia, hyperoxia in the patient breathing on hypoxid drive, sedation, and coma
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Normal adult blood pressure?
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120/80 mmHg
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Normal infant and children less than 10 blood pressure?
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60-100/20-70 mmHg
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Hypotension in an adult
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systolic pressure less than 80 mmHg
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Hypertension in an adult
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systolic pressure greater than 140 or greater and/or diastolic pressure of 90mmHg or greater
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Normal pulse rate for adults
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60-100 beats/min
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Normal pulse rate for neonate?
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120-140 beats/min
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Normal pulse rate for 1 year old?
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80 - 140 beats/min.
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Potassium (K+) Normal levels?
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3.5-5.5 mEq/L
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What is hyperkalemia?
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It is a high blood level of potassium and causes high, peaked T waves and depressed S-T segments, widening QRS complex and bradycardia
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What is hypokalemia?
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is a low blood potassium level - and may be caused by the use of diuretic medications such as Lasix
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What is hyperchloremia?
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a high blood level of chloride (Cl-) that causes significant prolongation of the S-T segment and the Q-T interval on the ECG
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What is hypernatremia?
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High blood level of sodium (Na+) that might be seen in the patient who is dehydrated or has been given excessive amounts of sodium intravenously.
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What is hyponatremia?
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is a low blood sodium (Na+) that might been seen in a patient who has lost a lot of GI secretions because of vomitting, nasogastric tube drainage, or diarrhea
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What is a urinalysis done for?
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routinely from every patient admitted to the hospital
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What is Leukopenia
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a low absolute WBC count of 3,000 to 5,000/mm3 or less
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What is Leukocytosis?
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A mild to moderate increase in the leukocyte count. It is seen as a WBC count of 11,000 to 17,000 per cubic millimeter
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What does a WBC count of more than 17,000/mm3 indicate?
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It is seen in patients with severe sepsis, miliary tuberculosis, and other overwhelming infections.
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Normal hemoglobin for Adult Male?
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13.5 - 18.00 g/dl
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Normal hemoglobin for Adult Female?
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12.0 to 16.0 g/dl
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Normal Red Blood Cell Count Adult Female
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4.2-5.4 millions/mL
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Normal RBC for Adult Male
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4.6 - 6.2 millions/mL
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Normal White blood cell count Adult
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4500-11,000 (mm3)
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Normal coagulation study results
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Normal 1 to 9 min.
critical value >15 min |
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Test for possible bacterial infection:
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Gram's stain and culture and sensitivity study (C&S)
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What is the most commontype of bacteria that cause bronchitis and pneumonia?
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Gram + (g+) bacteria are stained violet. In general penicillin or related drugs and sulfa-type anti-biotics kill these bacteria
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What bacteria are stained pink
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Gram - (g-) these organizims are found in the sickest patients. specific antibiotics kill these bacteria . broad spectrum antibiotics may also be used.
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Can a virus be identified with gram stain?
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No
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What are signs and symptoms of a pneumothorax?
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sudden chest pain with an increase in dyspnea and shortness of breath, absent breath sounds over a lung field, tracheal deviation, asymmetrical chest movement, sudden increase in peak or plateau pressure on the patient's ventilator
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When should an upper-airway radiograph be recommended?
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aspirated foreign body
laryngeal edema laryngeal tumor epiglottis |
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When should a CT scan be used?
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to identify abnormalities of the lungs and mediastinum
Tumor Hematoma Abscess and cyst Pleural effusion Aortic or other vascular abnormalities |
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When should a chest radiograph be taken?
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whenever there is a significant change in the patient's cardiopulmonary condition or invasive thoracic procedure (chest tube, ET tube, pulmonary artery inserted)
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What is a pneumothorax?
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air in the pleural space and is identified on the chest radiograph as an area of black
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What is a tension pneumothorax?
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When the air is under sufficient pressure to shift the lung and mediastinal structures to the opposite side
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What is subcutaneous emphysema?
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is air found in the soft tissues such as the skin, axilla, shoulder, neck, or breast of the affected side.
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Normal newborn heart rate
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>120 to < 160
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Blood pressure newborn
1000-2000 g birth weight |
55/30 mmHg
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Blood pressure newborn >3000 g birth weight
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65/40 mmHg
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Normal respiratory rate for newborn
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30-60 breaths/min
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normal temperature for new born
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abdominal skin temp at 36.5 C
rectal (core) temperature between 35.5 and 37.5 C |
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What is the first test of lung maturity?
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Lecithin/sphingomyelin (L/S) ratio. there is an increase in the lecithin level at about 35 weeks of gestation
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What is the second test of lung maturity?
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Determin the presence of phosphatidylgycerol (PG) in the amniotic fluid. it appears at about 36 wks of gestation. the presence of PG always indicates lung maturity
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What are the 5 parameters judged on the Apgar score?
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heart rate, respiratory effort, muscle tone , reflex response, and color
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When is the newborn evaluated with the Apgar score?
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1 minute and 5 minute
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What does an L/S ratio of 2:1 or greater indicate?
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Mature lungs, less than 5% chance of RDS
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What does an L/S ratio of 1.5:1 indicate?
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Transitional lungs; about a 50% chance of RDS
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What does an L/S ratio of 1:1 or less indicate?
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Immature lungs; about a 90% chance of RDS
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What does it mean when PG is present?
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Mature lungs
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What does it mean when PG is not present?
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Immature lungs
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Why is transillumination of the chest performed on a neonate?
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To identify the presence of a pneumothorax
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What are signs of dehydration?
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tachycardia, hypotension, high urine specific gravity, oliguria, (low urine out put), low central venous pressure (CVP), and pulmonary capillary wedge pressure readings (PCWP), tenting when the skin is pinched, and mental confusion
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What are signs of fluid overload?
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tachycardia, hypertension, low urine specific gravity, increased urine output, increased CVP and PCWP readings, peripheral edema, pulmonary edema and crackles/rales.
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What are the clinical findings for Respiratory acidosis/alveolar hypoventilation/ventilatory failure
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PaCO2 > 50 torr
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What are the clinical findings for Acute ventilatory failure?
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PaCO2 > 50 torr; pH < 7.30
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What are the clinical findings for Chronic ventilatory failure?
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PaCO2 >50 torr; pH 7.30 to 7.40
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What are the clinical findings for respiratory alkalosis/alveolar hyperventilation?
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PaCO2 < 30 torr
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What are the clinical findings for acute alveolar hyperventilation?
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PaCO2 < 30 torr; pH > 7.50
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What are the clinical findings for chronic alveolar hyperventilation?
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PaCO2 < 30 torr; pH 7.40-7.50
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What are the clinical findings for Acidemia?
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pH < 7.40
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What are the clinical findings for Acidosis?
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A pathophysiologic condition in which the patient has a significant base deficit (plasma bicarbonate below normal)
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What are the clinical findings for Alkalemia?
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pH > 7.40
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What are the clinical findings for alkalosis?
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A pathophysiologic condition in which the patient has a significant base excess (plasma bicarbonate above normal)
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What is the formula for PAO2?
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PAO2=[(PB-PH2O)FIO2]- PaCO2/.8
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