Nurs int Resp
what to do is chest tube becomes dislodged from site and from suction
from site: occlusive dressing over site
from suction: clamp so air cannot get in lungs long enough to put in sterile water for water seal
DIGOXIN!!!! PEDS
apical pulse in infant to hold digoxin therapy
Serum digoxin levels theraputic
Signs and symptoms of dig toxicity
<90bpm
0.8-2ng/ml
nausea, vomit, diarrhea, halo aroung lights, dizziness
3 contractions in live vaccine therapy
pregnancy, immunosuppressed- (corticosteriod use, chemotherapy, radiation, AIDS/HIV) recent blood transfusion in the last 11 months
decreased pulmonary blood flow disorders shunting of blood see on echo
right to left
what is brochillitis caused by
RSV
3 teaching guidelines to edu on controlling exposure to allergens
1. avoid tobaco smoke
2. dust mites: use pillow and mattress covers, wash bedding in 130 degree water once a week, blinds instead of curtains, remove stuffed animals, reduce indoor humidity to < 50%
3. remove pets from home permanently or keep off furniture
4. avoid leaving food out
5. dehumidifier to prevent water damage
6.avoid outdoor pollen in spring
nursing management for hypercyanotic spells
1. calming approach, swaddle, moms smell
2. knee to chest to help blood flow return to lungs
3. o2 therapy for vasodilation
4. morphine for vasodilation 1mg/kg
5. propanolol to decrease rv spasms 1mg/kg
yeast
early compensatory response of hypoxia shown on CBC
polycythemia >6.1 (LOGAN THIS IS INCREASED RBC)
20 points to whoever can explain to me why this happens
laryngotracheobronchitis hallmark sign and tx
barking cough mainly at night
racemic epinephrine watch for rebound bronchospasm
treatment for asthma steps
step 1: short acting b2 agonist (albuterol) PRN
step 2: low dose inhaled corticosteriod
step 3: referal to asthma specialist, inhaled corticosteriod and long acting b2 agonist (sulmerodol)
step 4: medium dose inhaled corticosteriod and long acting b2 agonist (sulmerodol)
Step 5: high dose inhaled corticosteriod and long acting b2 agonist (sulmerodol)
Step 6: high dose inhaled corticosteriod and long acting b2 agonist (sulmerodol) and oral corticosteriod
most aat risk pt for infective endocarditis
pt with prostetic valves from previous valvular disorders
adverse effect of DtaP vaccine that can be linked to pertussis
encephalopathy within 7 days of recieving vaccine
3 questions. 100 pt each
1.toddlers BP
2.widened pulse pressure range for them
3.what would it be if the child had coarctaion of the aorta?
90-110/55-75
>50 mmhg
increased in upper extremities decreased in lower by 20 mmhg
oxygen therapy for epiglottis
Red zone peak flow rate and s/s
less than 50% of personal best, not responding to short acting medication, trouble walking or talking, difficulty breathing coughing and wheezing
providing adequate nutrition for infants with congenital heart disease
oral gavage feedings with breastmilk or formula with additives of polycose or vegetable oil to increase calories
feed orally for no longer than 20 min then give rest through ng tube
small frequent meals
live vaccines and where are they given
varicella- subq
MMR- sub q
rotavirus- oral
live flu- nasal 2 doses 1st time
aortic stenosis telll me everything esp what ventricle will by hypertrophed
patho:obstruction of blood flow from left vent to aorta leads to pulmonary congestion and left vent failure
echo- left ventricle hypertrophy
s/s: could be asymptomatic, hx of fatigue, chest pain when standing, narrowed pulse pressure, systolic murmur, thrill felt at base of heart
differences between croup and epiglottis
epiglottis is rapid onset high fever, no barking cough, dyphagia and toxic apperance caused by hib affecting 1-8yr old
croup is sudden onset at night, fever varies, barking cough, no dysphagia, no toxic apperance, coryza affecting 3mo-3yr age
5 steps to chest physiotherapy
1. Avoid doing after eating. provide percussion via cupped hand or an infant should hear hollow sound
2. percuss each segment of lung for 1-2 min
3. vibrate each lung segment for at least five exhalations
4. encourage the child to deep breathe and cough
5. change drainage positions and repeat percussion vibration
post op cardiac cath edu
- chang dressing day after
-avoid baths for 3 days use sponge bath or shower
-keep dressing dry and sterile for 3 days
keep leg straight for several hours after procedure
report redness, drainage, swelling at site
take temp q d for at least first 3 days and report 100.4 or higher
no strenous activity for 3 days
college students living in dorms, sickle cell pt, pts with HIV or traveling to country where menigitis is common
blalock- taussig shunt is tx for? and what are nursing int after
tx for: decreased pulmonary blood flow disorders: tetrolagy of fallot and tricuspid artresia
nursing int: no bp, pulse or venipunctures in the affect arm ever. monitor for arrhythmias
CF patho and tx
dysfunction of exocrine glands causing thickened secretions in sweat, gi, resp, pancreas. they produce high chloride levels causes electrolyte alterations
tx: minimize pulmonary complications: pulmonyze, CPT, aerosilzed abx
facilitating growth: pancreatic enzymes on high fat food, high calorie high protien diets, fat soluble vitamins: A,D,E,K