Exam (elaborations)
CAPA REVIEW #1
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- Institution
Exam of 15 pages for the course ACE at ACE (CAPA REVIEW #1)
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CAPAREVIEW
#1
What
are
pediatric
otolaryngology
patients
considerations
for
surgery?
-
ANS-•Preprocedure>
fear
of
separation,
pain,
injury,
&
death.
establish
trust
reassure,
child
fears
'loss
of
control'>
allow
child
to
choose
scent
for
induction
anxiety>prepare
child
+parents,
support
parent-present
induction
if
allowed
•intaprocedure>airway
*
^
risk
of
laryngospasm
&
vomiting
if
induced
with
crying
maintain
body
temp
>
kids
lose
heat
faster
than
adults
Define
tympanoplasty
(myringoplasty)
and
care
of
patient
concerns
-
ANS--procedure
used
to
improve
hearing
-hearing
deficit
may
be
present
preop.
allow
pt.
to
wear
hearing
aids
to
DR.
hearing
may
be
worse
p/o
due
to
packing/dressing
>
warm
pt.
-monitor
facial
nerve
-Phase
I-HOB
^30°
to
minimize
Eustachian
tube
edema>clarify
with
surgeon.
position
with
operative
ear
upward
to
avoid
pressure.
treat
nausea/vomiting
&
vertigo.
avoid
excess
motion.
transfer
slowly
-Phase
II-teaching>no
wet
ears,
slow
moving,
sneeze,
with
mouth
open,
popping
ears
is
normal
D/C
instructions
of
patient
with
Septoplasty
-
ANS--change
mustache
dressing
PRN.
maintain
count
+
frequency
of
saturated
-use
humidifier
except
nausealtarry
stools
-avoid
nose
blowing;stif f
secretions
to
throat
&
swallow
or
spit
out
-avoid
bending,
straining
or
lifting
-sneeze
with
mouth
open
-avoid
straws
or
nasal
packing
used
1)
C1-C4
injury
2)
C5
injury
involves:
-
ANS-1-quadriplegia-complete
loss
of
motor,
sensory
functions
from
neck
down-including
respiratory
2-quadriplegia-loss
of
all
functions
decreased
upper
shoulder
level.
phrenic
nerve
intact,
but
not
intercostal
muscles
1)
C6
injury
2)
C7
injury
3)
C8
injury
involves:
-
ANS-1)
quadriplegia-loss
of
function
decreased
shoulders
&
upper
arms.
no
use
of
intercostal
muscles 2)
incomplete
quad
loss
of
motor
control
to
parts
of
arm
&
hand.
loss
of
sensation
decreased
clavicle
&
parts
of
arm/hand.
0
intercostals
3)
incomplete
quad
0
motor
to
parts
of
hand/arm.
0
sensation
deceased
chest/part
of
hand.
0
intercostal
1)
T1-T6
injury
2)
T6-T12
injury
3)L1-L4
injury
involves:
-
ANS-1.
paraplegia.
0
motor
function
decreased
mid
chest,
including
trunk
muscles.
0
sensation
from
mid
chest
decreased,
including
lower
limbs,
phrenic
nerve
functions
independently
some
use
of
intercostal
2)
paraplegia.
0
motor
control/sensation
decreased
waist.
0
interference
on
respirations
3)
paraplegia.
loss
of
motor
most
of
legs/pelvic
area.
0
sensation
to
lower
abd/legs
1)
L3-L4
injury
2)
L4-Sz
injury
involves:
-
ANS-1)
incomplete
para.
0
control/function
or
part
of
lower
legs/ankles/feet
2.
incomplete
paraplegia
varying
degrees
of
loss
can
walk
with
braces.
may
use
wheelchair
&
can
be
pretty
independent
Signs
of
autonomic
hyperretlecia
:
-
ANS--paraxysmal
^BP,
headache,
vasodilation,
flushing,
sweating,
goosebumps
^
with
SCI
-also
spasticity
of
muscles
&
orthostatic
hypotension
possible
myasthenca
gravis
patient
concerns:
-
ANS--chronic,
progressive,
causes
voluntary
weakness
-improvement
with
rest/anticholinesterasemeds
-myasthenia
crisis
can
be
from
exacerbation
or
too
much
anticholinesterase
meds
>
real.
difficulty
wracking
in
muscles
including
muscles
in
throat
-meds
&
pyndostigmin,
heostigmin
can
be
reversed
by
many
anesthesia
meds
-watch
for
real.
distress
aspiration,
difficulty
talking/swallowing
auscultate
lungs,
SPO2
-^risk
of
infection
Caring
for
autistic
patient
-
ANS--do
not
insist
on
eye
contact.
provide
language
tools-
-get
info
from
caregiver
about
likes/dislikes,
skills
&
abilities
-determine
it
from
vitamins/what
food
has
been
cut
from
diet
infancy
development
and
lifespan
care
-
ANS--oral
stage
(freud)
-trust
vs.
mistrust
(erickson)
-sensorimotor
period
(piagets)
-birth-12
months
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