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46 Cards in this Set
- Front
- Back
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Level 1 |
Rate color patient history nail beds general appearance results hr 3 lead ekg sputum senserioum |
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Level 2 |
Temp bs vc percussion peak flow vt BP tracheal palpation(pnuemo) |
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Level 3 |
Cbc sputum culture abg xray electrolytes sputum c/s ekg 12 lead |
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Level 4 |
Cat scan sweat chloride vq scan pft DLCO acid fast sputum pulmonary aniogram bronchogram tracheal palpation tensolin challenge |
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MG |
Do tensolin challenge on to diagnose |
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If pt comes in with symptoms of the flu |
Gb |
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PDA |
Indocin, surgery if remains open, radial/brachial artery compared to UAC |
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Diaphragmatic hernia |
Surgery if unable to so quickly low ventilators pressures |
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Choanale atresia |
Surgical |
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Tetralogy fallot |
Surgery (Misshappened heart) boot shape |
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Meconium |
Consistent bronchial hygiene |
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Bpd |
Long exposure to ppv--treat symptomatically |
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Irds |
Underdeveloped lungs surfactant |
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Pneumothorax |
Do transillumination halo or finger like negative chest tubes |
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Pulmonary interstitial emphysema |
Keep pressures love lower pip when compliance improves good candidate for oscillator |
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What are 5 things you always want to try and get if time allows |
Ekg xray serum electrolyte abg cbc |
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Emergency |
Missing vital function no chest rise absent bs rr <6 vt <3ml one worded sentences "marked" |
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Signs of Vent distress for babies |
Retraction nasal flaring grunting |
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Ali |
Pao2/fio2 <300 |
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Ards Signs and tx |
Decreased compliance, ^plateau, ground glass honeycomb, diffuse infiltrates,rapid respiratory rate,cyanosis. Fixed by utilize PEEP!!!, after emergency keep fio2 <60, pc or oscillator keep vt <6 pao2/fio2 <200 |
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Emphysema |
Barrel chest accessory muscle use digital clubbing in nail beds smoker/occupational ^app diameter hyperlucency flattened diaphragms polycythemia ^wbc fef25-75 and fev1 are decreased wheeze s --o2 at 24-28% smoking cessation bronchodilation via mdi/aeosol on air,coricosteriods, sux, remove from vent early and go to niv |
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Chronic bronchitis |
Productive cough pulmonary irritants frequent infections dyspnea hyperlucency and diminished pulmonary markings on xray ^wbc fef25-75 and fev1 are decreased --CPT, hydration therapy, fluid if dehydrated, 02, bronchodilator, antibiotic (tetracycline) |
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Pulmonary edema/chf |
Tachypnea,tachycardia, anxiety, cold clammy, diaphoretic, pink frothy secretions,edema, butterfly/fluffy ^hemodynamic values --treat as emergency, 100% o2, give Lasix, digoxin/digital, cmv |
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Heart surgery |
Vital signs, history, pre-opt spirometry/bronchodilator studies, --possibly cmv and is |
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Mi/arrhythmia |
Chest pain,radiating pain down left arm, family history, diaphoretic,nausea, tachycardia, pronounced q wave --emergency 100%, then 40-60%,brady-atropine, PVC--lidocaine or o2 |
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Abdominal surgery |
Vitals, pre-opt vc vt fev1 visual assessment -- baseline pft flows and volumes IS.5 goal if can't achieve ippb |
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Laryngectomy |
Surgical entire larynx or cord removal med history of upper Airway cancer signs of airway obstruction after surgery --if larynx then tracheal if not radical then temporary laryngectomy placed but must be replaced 3-6 weeks and always prevent aspiration sux cool aerosol or ultrasonic neb |
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Thoracic surgery |
Monitor ches tubes drainage and watch out for hypovolemic shock, subcutaneous emphysema elevated vent pressures --is ippb ppv lower volumes if lobotomy and pneumonecyomy fluid therapy if volume is a problem |
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Asthma |
Tachycardia dyspnea wheeze accessory muscle use congested cough wet/clammy skin, hyperinflation scattered infiltrates flattened diaphragms esinophils will be ^ of allergic and yellow sputum one worded sentences decreased flows in fev1 but diffusion in normal -- o2 bronchodilator therapy, aminophylline (iv) pulmonary hygiene, corticosteroids via oral/iv (prednisone) |
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Status asthmaticus |
Bronchodilation therapy doesn't work for more than 24 hrs |
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Chest trauma |
Mva fast shallow respiration sharp chest pain pneumo possible paradoxical chest movement broken ribs xray -- Ippb, IS, coughing, cmv if impending vent failure tension pneumo needle, partial pneumo >20% chest tubes, hemothorax thoracentesis |
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Head trauma |
Acts sleepy hard to arouse mva trauma shallow/irregular rr, may see icp>20(mannitol), papillary response to light may be unequal/inadequate --paco2 25-30, ^o2, avoid ^ICP (minimize peep), Dilantin and establish airway if seizure is observed |
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Neck/spinal injury |
Mva, altered conscious, pulse must be palpable at brachial/femoral, VT vc pefr ---cmv if cmv use modified jaw thrust if option use bronchonoscope to intubate |
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Burn trauma/CO poisoning |
Visible about face signed hair cherry red face (CO poisoning) pt is confused, stridor/hoarseness wheeze r honcho rales xray may be clear then show pulmonary edema marked decreased compliance, cohb>20% --airway, if Co poisoning 100% o2, if cohb <10% hyperbaric meds, reverse isolation avoid using anectine (paralyzing agemt) |
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MG |
Droopy facial.muscles and eyelids (ptosis), slowly weak but better with rest, double vision (diplopia) dysghagia (trouble swallowing), shrinking vt vc Mip, tension challenge for diagnosing -- be prepared to cmv prior to tensolin challenge, vc <1.0L intubate, anticholinesterase (prostigmine,pyridostigmine) if symptoms worsen then reverse anticholinesterase |
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GB |
Influenza symptoms sluggish lower extremities shrinking vt vc Mip Spinal tap ^protein --be patient to cmv but cmv and rest to let syndrome run its course. |
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Pulmonary embolism |
Chest pain dyspnea ^vitals bs wheeze med rales peco2 decreased during normal paco2 v/q scan ventilation w/o perfusion, be okay 1 min then suddenly sob ---heperin/Coumadin (ptt>heperin and pt>Coumadin) clot busting meds streptokinase, cmv emergent 100% o2, inferior vena cava filter to prevent clots from.reaching the lungs |
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Aids |
HIV+, emciation, diarrhea night sweats low grade fever, drugs usage, htlv3+ Elisa test +, bronchonconstriction for lung wash --universal precautions aerosolized pentamadine(monthly) and use 1 way valve/filters |
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Pulmonary hypertension |
Pap values high --inhaled NO, BP meds |
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Drug OD |
History usage, poor.hygiene emaciated, low/shallow rr -- intubate narcan |
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Cf |
Emaciated, family history, thick/purulent secretions, barrel chested, decrease flow rates like fev1, sweat chloride>60 --pep therapy, CPT, heated aeosol/ultrasonic neb, o2, antibiotics(tobramycin) pulmozyme |
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Methemoglobinemia |
Central cyanosis fatigue sob headache chocolate colored blood --iv methylene blue |
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Pneumonia |
Fever dyspnea chills cyanosis rhonchi/rales ^wbc if bacterial decrease wbc if viral, scattered infiltrates -- o2, sux, antibiotics, penicillin for + mycin for - |
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Pleural effusion |
Chest pain medialstinal shift away from effusion,Obliterated costophernic angles, fluid shift --thoracentesis if small chest tubes if more than 20% collapsed |
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Pulmonary TB |
Night sweats, hemoptysis, expectorant during coughing, cavitation in lungs -- INH (rifampin,ethambutol,streptonycin), strict isolation |
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Diabetes |
History of diabetes, lethargy, confusion, unresponsive, kussumauls breathing, pedal edema, decreased urine output blood glucose >160 --administer electrolytes correct ketoacidois and provide fluid |
