Burns
You would give it IV because you don't know if they can swallow or airway status
What is the nutrition for hepatic cirrhosis?
- I & O
- small frequent meals
- sodium restriction
- protein modified
What is the number 1 indicator for fluid loss or gains?
weight
progressive loss of lung compliance and increase hypoxia
What type of spinal injury location requires mechanical ventilation and causes quadriplegia?
C4 or higher
What is the number 1 thing we can do as nurses?
Prevention is key: good teaching to parents
What is the liver function studies labs?
AST: 10-34
ALT: 10-130
Bilirubin
Clotting factors
lipids
GGT: alcoholics
What are complications associated with kidney failure?
- Kyperkalemia
- pericardial effusion
- HTN
- pericarditis
- anemia: epoetin given
- bone disease
What are signs and symptoms of ARDS?
- tachypnea
- tachycardia
- retractions
- hypoxia
What is autonomic dysreflexia?
medical emergency caused by pain or other stimulation below injury: usually from bowel or bladder
BP is priority need to regulate it: will severely increase
What happens in the emergent phase?
time
vitals
priority
fluid
electrolytes
first 24 hours
decrease BP, increase HR
ABC priority
interstitial space
U.O decrease, NA+ decrease, K+ increase
What is ascites and what is a procedure done to treat it?
low albumin: fluid into the perineal cavity usually from alcoholics
Paracentesis: remove fluids: get coagulations labs before
What type of diet would someone be on for kidney failure?
smaller portions with high calorie content
take them off vent and use ambu bag
If someone suspected of cervical spine injury what do you do?
c-collar: immobilize them then worry about airway don't want to cause complication
What is the rule of nine's?
What is considered a major burn in % ?
Entire head 9%
Entire arm 9%
Entire leg 18%
Anterior trunk 18%
Posterior trunk 18%
Genitalia 1%
Major burn is considered 30%
What happens with hepatic encephalopathy and a medication given to treat it?
high levels of ammonia in the brain, body can't break it down
>100 levels is mental changes
>200 coma
Lactulose given: diarrhea to get it out: intended goal of medication
What do you feel and hear for with dialysis? if you don't hear or feel it what could be the problem?
feel thrill
hear bruit
if neither one then blockage
To wean someone off vent what does their FIO2 and PaO2 need to be?
FIO2 less then 60%
PaO2 over 60
Who is at risk for spinal cord injury?
young, male, alcohol and drug use
Solve this equation
18% BSA
patient weights 54 kg
4ml x BSA % x weight kg
first 8 hours give half
16 hours give second half
1,944 in 8 hours
What do you monitor for liver failure?
- watch for rejection
- can't get another one if rejected
- immunosuppressed for life
- increase risk of infection
Dialysate: sits in peritoneum for hours
Drainage after
What are the standards of practice for someone being intubated?
- admin breath sounds via ambu bag
- auscultate lung sounds
- assess color change: gold is good CO2
What are some complications from a SCI?
- pneumonia
- DVT
- autonomic dysreflexia
- GI/GU disturbances
- spinal shock
- neurogenic shock