Respiratory Emergency
what is ARDS and what change would you expect
acute respiratory distress syndrome presents with severe hypoxemia and initially respiratory alkalosis, later progressing to respiratory acidosis as fatigue worsens.
what is a hallmark sign of thyroid storm?
high fever, tachycardia, and hypertension
medical emergency
excess thyroid hormone - infection, surgery, medication
Treatment: supportive care, antithyroid drugs like PTU, methimazole, potassium iodide, beta blockers, glucocorticoids, cooling blankets.
What condition is characterized by RUQ pain and gallstones?
Cholelithiasis
Labs: increased amylase, lipase, bilirubin
what class of drugs does gentamicin belong to?
aminogycosides
auditory changes, hypersensitivity, veritgo, ataxia, loss of balance = neurotoxicity
nephrotoxic
what is the role of epinephrine in anaphylaxis?
What major complications can results from pulmonary embolism? And what puts someone at risk for developing a clot?
Death by hypoxia or cardiac arrest
R/F: prolonged immobility, birth control, smoking, afib, diabetes, cancer, obesity, surgery
What electrolyte imbalance is the most concerning in DKA?
potassium
What lab changes are seen in acute AKI?
Increased BUN and creatinine, decreased GFR and urine output
what is the difference between tolerance and addiction
tolerance refers to the body getting used to a substance and doses may need to be adjusted.
addiction refers to someone being unable to control their use of a substance
What are expected signs of sepsis?
fever, chills, tachypnea, tachycardia, hypotension, rash, confusion/disorientation, decreased urine output, dizzy, nausea, vomiting, muscle pain
What is the initial symptom of a pneumothorax?
sudden onset of shortness of breath, decreased breath sounds on affected side, tracheal deviation (away from affected side), unequal chest rise,
Pneumo: collapsed lung -chest tube
Hemo: Blood
Tension pneumo: buildup of air or blood in chest cavity which cannot escape - needle decompression
Remember ABC's
What is the key difference between Addison's and Cushing's disease
Addison's = low cortisol
Cushing's = High cortisol
What are the key signs of sickle cell crisis?
severe pain, fever, joint swelling
Treatment: pain medication, oxygen, fluid resus
signs and symptoms of digoxin toxicity
nausea, vomiting, anorexia, vision changes, irregular heartbeat, bradycardia and dysrhythmias
long term symptoms of R side stroke
L sided deficits, loss of spatial awareness, judgment, problem solving, impulsivity, emotional outbursts
what is a key clinical sign of pulmonary edema?
frothy pink sputum
what should a nurse include in patient teaching for adrenal insufficiency
Medication Adherence: Take prescribed corticosteroid medications (like hydrocortisone or prednisone) exactly as ordered, even if feeling well.
Never stop steroids abruptly — sudden discontinuation can cause an adrenal crisis.
Carry an emergency injection (like injectable hydrocortisone) if prescribed.
Recognizing Signs of Adrenal Crisis:
Report symptoms like severe weakness, confusion, low blood pressure, severe vomiting, diarrhea, or dehydration immediately.
Adrenal crisis is life-threatening and requires emergency treatment.
Stress Dosing:
Increase corticosteroid doses during periods of physical stress (e.g., infection, surgery, trauma).
Maintain adequate salt intake, especially in hot weather or during vigorous exercise (patients with Addison’s disease may need extra sodium).
Drink plenty of fluids to avoid dehydration.
Avoid excessive physical stress without preparation.
Learn ways to manage emotional stress through relaxation techniques.
what is the ultimate underlying problem in DKA and the treatment
lack of insulin
Treatment: insulin
long term symptoms of L side stroke
R sided deficits, difficulty maintaining balance, difficulty with speaking, reading, and writing, difficulty understanding language, slurred or unclear speech, difficulty with reasoning, planning, and memory, depression
Which is the only type of insulin that can be given IV
Regular insulin
how should the nurse assist with chest tube insertion for pneumothorax?
A sterile water seal system is essential to maintain negative pressure and prevent air from re-entering the pleural space.
The client should be positioned in a semi-Fowler’s or high Fowler’s position or with head of bed elevated, life the arm on the side of insertion
Connections should be tightly secured and taped to prevent leaks, not loosely taped.
Clamping the chest tube is contraindicated after insertion because it can cause tension pneumothorax.
Suction should be turned on only after confirmation of placement