Hole in the neck
Within how many hours after placement is it considered an emergency if a tracheostomy tube becomes dislodged?
What is 72 hours?
In short, what is happening with pulmonary edema
fluid accumulates in the alveoli, decreasing gas exchange
What is the most common cause of a pulmonary embolism
What is a venous thromboembolism? (VTE/DVT)
Name one of the three pharmacological interventions that are indicated for pulmonary edema
1.) diuretics
2.) nitroglycerin
3.) morphine
Name 3 of the 10 general symptoms of respiratory distress
- respiratory compromise
- dyspnea
- restlessness
-agitation
- cough
- abnormal breath sounds
- tachypnea
- tachycardia
- increased O2 demands
- EKG changes
Maximum suction time for a tracheostomy patient
10-15 seconds
The immediate priority interventions when a patient presents with pulmonary edema?
What is apply high-flow oxygen and raise the HOB?
The first nursing action if you suspect a patient has a PE
What is call a rapid response?
Gold standard pharmacological class for PE
anticoagulants
What should you check before removing the old ties from a trach tube
that the new ties are in place
How often is tracheostomy care performed in the first 24 hours?
Hourly
What is the hallmark sign of acute pulmonary edema
pink, frothy sputum
Name two risk factors for PE besides immobility?
What are obesity, sepsis, hypercoagulable state, central venous catheter, or IV drug use?
A patient with PE is started on IV heparin. Which lab values should the nurse monitor closely (only need 2 of 3)
aPTT, CBC, platelets
I couldn't think of this last category.
You can swap point values in one of two ways: swap your own points with another player, or swap the points between any two other players.
muwahahahaha
Two scenarios that indicate a patient with a tracheostomy needs suctioning
1.) the patient has mucus and/or secretion in the artifical airway
2.) the patient is restless with tachycardia and tachypnea
Name 2 of the many different causes of pulmonary edema
What are heart failure, renal failure, ARDS, high altitudes, brain trauma, and rapidly expanding lung?
This diagnostic test is the gold standard for confirming a PE
What is pulmonary angiography? (CT-PA)
What can be given to a patient experiencing hypotension as a complication of PE
IV fluids and vasopressors
This can be performed before suctioning and can help prevent atelectasis and hypoxia
What is pre-oxygenation
Name 2 important things to include at the bedside for a patient with a tracheostomy
1.) suction
2.) O2
3.) trach kit
4.) smaller extra trach (or one of same size)
in "flash" pulmonary edema (and any other respiratory issues), which intervention is the last resort before intubation?
What is non-invasive positive pressure ventilation (BiPAP)?
After calling a rapid response, name the two interventions that you would complete for a PE
What are elevate the head of the bed and increase oxygen to maintain SpO2 greater than 95%?
What two things are given to patients experiencing pulmonary hypertension as a complication of PE (one of these we are not tested on, but if you get both, you get an extra 200 points !!!!)
Positive inotropic agents and vasodilators
Name 3 of the many different things we can do for pulmonary hygiene
- IS
- deep breathing
- coughing
- mobility
- oral care