Perfusion-B Part 1
when does VSD occur...
What is 4-8 weeks gestation
Murmur is soft and hard to hear
what is..Grade 1
Pulmonary Perfusion is defined by...
what is..the actual blood flow through the pulmonary vasculature
What is the first nursing assessment/intervention when ventilator alarms low pressure?
check for tubing disconnection starting at patient
Identify 2 sedatives used for intubation
o Lorazepam (Ativan): Reduces anxiety, induces sedation.
o Midazolam (Versed): Short-acting sedative, amnesic effects.
o Dexmedetomidine (Precedex): Provides sedation without respiratory depression.
o Propofol (Diprivan): Rapid onset, short-duration sedative.
History & Symptoms: Fatigue, poor feeding, tachypnea, sweating during feeds, failure to thrive.
What is..VSD
_______is the most common complication requiring diuretics, digoxin, and oxygen therapy.
what is heart failure
Name two NMBs (paralytics) used in intubation...
what is...
o Pancuronium: Long-acting muscle relaxant.
o Vecuronium: Intermediate-acting, minimal cardiovascular effects.
o Rocuronium: Rapid onset, short duration.
o Succinylcholine: Depolarizing agent, used for rapid sequence intubation.
List 4 nursing interventions to prevent VAP
What is...
· Elevate head of bed 30-45°.
· Daily sedation vacations.
· Peptic ulcer and DVT prophylaxis.
· Oral care with chlorhexidine.
What is the first line vasopressor for septic shock?
what is norepinephrine
shunting leads to cyanosis d/t high pulmonary resistance
what is right to left shunting
shunting leads to heart failure (without cyanosis) d/t increased pulmonary blood flow
what is left to right shunt
List at least 4 symptoms of acute respiratory failure..
What is restlessness, fatigue, headache, dyspnea, air hunger, tachycardia, elevated BP, confusion, cyanosis, respiratory arrest.
What are the most common reasons the ventilator may alarm high pressure?
Displacement, obstruction, pneumothorax, equipment failure
Is there respiratory alkalosis (high pH) or acidosis (low pH) in Early ARDS?
what is.. respiratory alkalosis (high pH) hyperventilating to compensate
Primarily used to prevent recurrence of acute rheumatic fever...
What is...Penicillin G (injectable) and V (oral) are primarily used to prevent recurrence of acute rheumatic fever, which can cause or worsen rheumatic heart disease.
murmur is loud & holosystolic
What is...small VSD (restrictive)
Hypercapnia is characterized by a PaCO2 greater than...and hypoxemia is characterized by a PaO2 less than...
what is 50 and 80
FiO2 settings on vent...what %?
FiO2 setting may be set between 21% and 100% to maintain an optimal PaO2 level (e.g., greater than 60 mm Hg) or SpO2 level greater than 92%.
List at least 4 causes of acute respiratory failure
· Ventilatory Failure causes: Impaired function of the CNS (Drug Overdoses, head trauma, infections, hemorrhage, sleep apnea); Neuromuscular dysfunction (myasthenia gravis, Guillain–Barré syndrome, ALS, Spinal Cord Trauma); Musculoskeletal Dysfunction (Chest Trauma, kyphoscoliosis, Malnutrition); Pulmonary Dysfunction (COPD, Asthma, Cystic Fibrosis).
what are three interventions to repair VSD?
what is open heart surgery, transcatheter device closure, or patch closure
in infant, what is the apical pulse (stethoscope on chest for 1 full minute) parameter for digoxin administration to be held?
what is apical pulse <90-110?
List at least 6 clinical manifestations of ARDS...
What is....Vague-Restlessness, fatigue, H/A, dyspnea, air hunger, tachycardia, elevated BP
• As hypoxemia worsens-more obvious signs: confusion, lethargy, tachycardia and tachypnea, central cyanosis, diaphoresis, and finally-respiratory arrest.
6 P's for ARDS treatment
What is..
· Prevention: Early detection and risk management.
· PEEP: Positive end-expiratory pressure to improve oxygenation.
· Pump and Pipes: Circulatory support with fluids and vasopressors.
· Paralysis: Neuromuscular blockers for ventilator synchrony.
· Position: Prone positioning to enhance gas exchange.
· Protein: Adequate nutritional support to maintain muscle strength.
What is the difference between crackles and rhonchi lung sounds?
rhonchi may clear with coughing, crackles will not. Crackles are heard during inspiration whereas rhonchi are heard in inspiration and expiration.