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20 Cards in this Set
- Front
- Back
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Hemostasis Hypovolemia |
Restlessness Lethargy Confusion Dry skin and thirst Decreased skin turger Weight loss Oliguria, concentrated urine Postural hypotension Increased respiratory Increased pulse Decreased CVP |
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Hemostasis Hypervolemia |
Pitting edema, sacral edema Dyspnea, crackles (possible pulmonary edema) Bounding pulse, weight gain Lethargy, dizziness, headache, confusion Variable urine volume Increased CVP, JVD Increased Blood pressure |
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Hemostasis: Acid Base Balance What is the major clinical manifestation of acid base imbalance? Acidosis Alkalosis |
Affects CNS. Severity depends on how long the imbalance exist. Acidosis: (metabolic or respiratory) Symptoms are indicative of depression of the CNS. Pretty common Alkalosis: (metabolic or respiratory) Symptoms are indicative of increased stimulation of the CNS. Death is a rare occurance.
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Hemostasis: Acid Base Balance Respiratory Acidosis |
Rapid, shallow respiration (hypoventilation) Disorientation, decreased level of LOC Decreased blood pressure Venticular irritablity from Hyper K+ Hypoxemia (secondary to respiratory depression) |
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Hemostasis: Acid Base Balance Respiratory Alkalosis |
Deep, rapid breathing (hyperventilation) CNS stimulation, resulting in confusion, lethargy, seizures Hypokalemia Hyperreflexia, muscle weakness, tingling extremities |
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Hemostasis: Acid Base Balance Metabolic Alkalosis |
N/V Increased irritability, disorientation, restlessness Muscle cramping, tremors, seizures Shallow, slow respiration (hypoventilation) Dyshythmias (tachycardia) --> hypo K+. |
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Hemostasis: Acid Base Balance Metabolic Acidosis |
Drowsiness, confusion, headache, disorientation Deep, rapid respiration (Kussmaul conpensatory action by the lungs) GI problems (N/V/D) Dyshythmias --> hyperK+ Decease BP |
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Hemostasis: Inflammation What are the cardinal sign of inflammation? |
Redness --> vasodilation Heat--> increased metabolism, local vasodilation Pain Edema: Fluid shift Loss of function: decreased movement due to swelling and pain |
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Hemostasis: Signs of Infection Generalized ( |
Fever Localized inflammation Joint pain Fatigue Increased WBC |
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Hemostasis: Signs of Infection
GI Tract |
D/N/V |
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Hemostasis: Signs of Infection
Respiratory Tract |
Purulent sputum Sore throat Chest Pain Congestion |
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Hemostasis: Signs of Infection
Urinary Tract |
Urgency and frequency Hematuria Purulent discharge Dysuria Flank pain |
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Hemostasis Systemic Inflammatory Response Syndrome (SIRS) Multiple Organ Dysfunction Syndrome (MODS) |
Precipitating Event Respiratory: increased vascular permeability leads to alveoli collapse and development of ARDS Cardiac compromise, decreased systemic vascular resistance (SVR) and vasodilation lead to severe hypotension and decreased cardiac output. Neurologic problem of confusion, agitation and lethargy Acute renal failure secondary to decreased renal perfusion GI tract problems are abdominal distension and paralytic ileus Hypermetabolic response with hyperglycemia and insulin resistance Failure of the coagulation system leads to development of disseminated intravascular coagulopathy (DIC) |
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Hemostasis Spesis |
1) Compromised respiratory function a.Initially: hyperventilation occurs as a compensating mechanism b. Hypoventilation and respiratory acidosis occur when compensation fails c. Respiratory failure and development of ARDS 2. Compromised cardiac function a. Initially increased cardiac output with decreased systemic vascular resistance (SVR) secondary to hypermetabolic state. b. Cardiac decompensation with development of severe hypotension and MODS 3. Development of severe hypotension progressing to septic shock despite adequate fluid resuscitation 4. Development of SIRS progressing to MODS |
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Hemostasis: Electrolytes Hypokalemia |
Fatigue, muscle weakness, hyporeflexia Decreased muscle tone and reflexes Confusion, drowsiness, fatigue, bradycardia, weak irregular pulse ECG changes: flat T wave, ST depression, U waves, PVCs GI: decreased bowl sounds, development of ileus, N/V |
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Hemostasis: Electrolytes
Hyperkalemia |
Drowsinesss Muscle weakness and twitching paresthesia of hands and feet and around the mouth GI: diarrhea with hyperactive bowel sounds ECG changes: Peak T- waves Prolonged P-R interval Widended QRS complex Dyshythmia: Bradycardia with venticular ectopic beats (irregular pulse) Venticular fibrillation Cardiac Arrest |
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Hemostasis: Electrolytes
Hyponatremia |
Solution deficit (Na ions) CNS problems: chenges LOC, confusion seizures Weakness, restlessness Oliguria Abdominal cramps Postural hypotension Cold and clammy skin Dilutional hyponatremia (water excess) CNS problems: confusion, headache, seizures Hypertension Muscle twitching, cramping Increased urine Weight gain |
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Hemostasis: Electrolytes
Hypernatremia
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Fluid Excess (Na+ retention) Pitting edema Weight gain Flushed skin Lethargic Hypertension Decreased hematocrit Fluid deficit (hemoconcentration of Na+, water loss) Concentrated urine Dry mucus membrane Flushed skin, tachycardia increased temperature, weight loss, decreased CVP |
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Hemostasis: Electrolytes
Hypocalcemia |
Tetany: + Chvostek's sign; + Trousseau's sign Neuromuscular irritability Numbness and tingling in extremities or around the mouth Laryngeal stridor Seizures Abdominal cramping and distention Hyperreflexia Dyshythmia |
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Hemostasis: Electrolytes
Hypercalcemia |
Anorexia, Nausea, Constipation CNS depression Decreasing muscle tone, coordination Pathological fractures Dyshythmias: increases sensitivity to digitalis preparations |
