Disorderly (Respiratory) conduct!
Arterial Blood Gas stuff! What does it mean if pH and PaC02 match?
What are potential complications for a patient with a cerebral bleed due to an aneurysm?
Vasospasm
Headache, dec responsiveness, aphasia or partial paralysis
Seizures
Hydrocephalus
Blood in subarachnoid space or ventricles impeded the circulation of CSF
Rebleeding
Hyponatremia
How do you position a patient after having thoracic surgery?
Elevate HOB 30-45 degrees
Change position from back to side frequently
Collaborate with surgeon for best post-op position
What is semi-fowler's position?
What is the difference for older patients that have pneumonia versus younger patients?
o Atypical presentation
o More difficult to treat
o Delicate fluid balance
o Dec physiologic reserve
o Pneumococcal vaccination
What are some late signs of elevated ICP?
Cushing’s triad
-Change in respirations (often irregular and deep)
-A widening pulse pressures
-Bradycardia
Projectile vomiting
Posturing
How do you care for a post-op kidney donor?
Monitor the incision site, monitor for infection, assess cardiac and respiratory status, pain management, monitor urine output and lab data, early ambulation
After brain surgery, this may occur!
Sodium retention may occur in the immediate post-op period
Why would you use a chest tube?
to re-expand lung, and remove excess air, fluid, and blood.
True or false, when a patient is undergoing brain surgery, it takes a large amount of hypoxia to increase cerebral ischemia
FALSE. it takes even a small degree!
What do you do you feed the patient when he isn't peeing as much? (decreasing urinary output)
Dietary precautions:
Know common foods high in potassium and high in sodium
o High in potassium: Bananas, oranges, melon, grapefruit, spinach, broccoli, sweet potatoes, mushrooms, peas, cucumbers
o High in sodium: Cured meat, pre-prepared/frozen meals, canned entrees, salted nuts
After having thoracic surgery, what are some self care measures ?
o Self-care management
Arm and shoulder exercises
Pain relief modalities
Activity-rest balance
Avoid bronchial irritants
Follow-up care
Smoke cessation
Induces skeletal muscle paralysis and facilitates incubation after induction of anesthesia in surgical procedures.
How do you access cerebral function?
Mental status, intellect, thought content, emotional status, language ability, level of consciousness
What is the treatment management for Nephrolithiasis?
Watch and wait is most common
Nutritional therapy
Invasive approaches
Shock wave lithotripsy
Percutaneous nephrolithotomy
Surgical removal
Relieve pain with opioid analgesics, NSAIDs, position changes and ambulation
How do you reduce the risk for VAP? (Ventilator Associated Pneumonia)
o Prevention with the pneumococcal vaccine
o Bundle care for prevention of ventilator associated pneumonia
o Routine oral care
o Elevate HOB 30-45 degrees
o Daily sedation vacation
o Pectic ulcer disease prophylaxis
What are the interventions to avoid spinal headache post Lumbar puncture?
o May occur a few hours to several days after the procedure
o Throbbing bifrontal or occipital headache that is dull and deep in character
o Caused by CSF leakages at the puncture site
o Can be avoided is a small-gauge needle is used and if the patient remains prone after
the procedure, then positioned supine for 4-8 hours
o The headache is managed by bedrest, analgesic agents and hydration
Why might you have a false reading on your pulse oximetry ?
Carboxyhemoglobin False high
High bilirubin False low
Melanotic skin Variable results
Poor tissue perfusion Low signal and unreliable results
Anemia Unreliable results