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22 Cards in this Set
- Front
- Back
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Define Pulsus Paradoxus
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During ventilatory failure, if there is an abstruction of the airway-- the systolic pressure falls during inspiration more than 10mm Hg.
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3 PVC's or more means what?
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Ventricular Tachycardia
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Sites to avoid when placing an EKG:
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joints, skin folds, breast tissue, significant muscle mass, apex of the heart, NEVER over a pacemaker.
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Atrial Flutter=
Atrial Fibrillation= |
Regular/ Irregular
Irregular/ Irregular |
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Never Give Lidocaine to whom??
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A patient who is having any rhythm problems. It will stop any activity the heart did have. (Lidocaine was replaced with Adenosine)
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Define Capture:
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A totally successful depolarization of the atria and/or ventricles by an artificial pacemaker. (get a good QRS complex)
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Signs of hypoperfusion:
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Pallor, Cool clammy skin, confusion, weak--thready pulse, increase heart rate, chest pain or chest pressure
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Describe Oral Care with a patient on a ventilator.
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Every two hours, dont use lemon or alcohol, throw away the Yankauer tube every 24 Hours, scrub and not just wipe off the teeth, use hydrogen peroxide and water, change bite blocks, make sure you get all the crap!!!
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For an emergency airway--with a trachea patient, what do you do??
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Take out the inner cannula.
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What are the EARLY signs of complications with a trachea??
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Bleeding, SubQ emphesema, pneumothorax, obstruction, tube displacment, cuff malfunction, skin breakdown
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What are the LATE signs of complications with a trachea??
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Pneumonia, apiration, tracheal stenosis, tracheomalacia, fistula
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What is VAP? What causes it??
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Ventilator Acquired Pneumonia-- microaspiration of orophangeal bacteria
(crappy oral care) |
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What do you need to remember about a tube feeding with a trach in??
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Semi recumbant position (30 degrees), the cuff inflated and leave inflated for at least 1 hour afterwards. Make sure and give free water for hydration.
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Things to look for in the assessment of a client with an artificial airway---
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Restlessness, anxiety, LOC, skin color, ABG's, CXR, effortless regular respirations, no accessory muscles, bilateral chest expansion, compare breath sounds (bilaterally), absence of retractions.
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Biggest assessment/concern with suctioning a patient:
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Watch for restlessness, anxiety, change in LOC.
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Reasons my air flow in my trach are occluded and wont suction:
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Misaligned, cuff is overinflated,inner cannula can become occluded with dried secretions.
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If they cough it out completely and it is extubated??
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Call for help, hyperextended the neck, assess for tracheal retention sutures and if they are there-- the top suture pull up and outward, the bottom suture pull downward and outward. Insert the dilator into the stoma to maintain airway , secure the tube, assess tube placement, insert inner cannula and reconnect to 02, if tube cannot be inserted in 1 minute--Call a Code!!!
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Need at bedside with any trach. patient:
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Extra trach tube and 1 smaller in size, obturator, tracheal dilator, 02 source, suction supplies, resuscitation bag, 10cc syringe, lubricant, sterile H20, and hydrogen peroxide.
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Suction Pressures for Adults and then for children
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Children 80-100 mmHg
Adults 100-120 mmHg |
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Suctioning can be intermittent or continuous with adults and for children??
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Adults: Intermittent and continuous
ONLY continuous on a child. |
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Complications of Suctioning:
( 7 of them) |
increased risk of atelectasis, trauma, infection, increase intercranial presure, hypoxia, cardiac dysrythmias, blood pressure fluctuations
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Cuff pressure should NOT EXCEED 20 cm/H20. What can happen if this is too high??
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It can cuase necrosis,and tracheomalacia
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