Exam (elaborations)
Adult 3 exam 2.
- Course
- Institution
Exam of 22 pages for the course PSYC210 Exam 02 Review at PSYC210 Exam 02 Review (Adult 3 exam 2.)
[Show more]
Seller
Follow
modockochieng06
Content preview
Adult 3 exam 2pulmonary embolism - ANS-blockage of one or more pulmonary arteries by thrombus
fat or air embolus, or tumor tissue
-obstructs alveolar perfusion
-most commonly affects lower lobes
Pulmonary embolism risk factors - ANS-Deep vein thrombosis
Immobility or reduced mobility
Surgery
History of DVT
Malignancy
Obesity
Oral contraceptives/ hormones
Smoking
Heart failure
Pregnancy/delivery
Clotting disorders
Atrial fibrillation
Central venous catheters
Fractured long bones
pulmonary embolism clinical manifestations - ANS--varied and nonspecific
-dyspnea most common
-tachypnea, cough, chest pain hemoptysis, crackles, wheezing, fever, tachycardia,
syncope, change in LOC
-dependent on size and extent of emboli
pulmonary infarction - ANS-Alveolar necrosis and hemorrhage
Abscess
Pleural effusion
pulmonary hypertension - ANS--Results from hypoxemia associated with massive or
recurrent emboli
-Right ventricular hypertrophy
pulmonary embolism diagnostic studies - ANS-- ABG (important but not diagnostic; low
O2 levels)
- Troponin & BNP (frequently elevated; increased mortality)
,- chest x-ray
- spiral CT (most frequently used; requires IV contrast media - caution to kidney
patients)
- VQ scan (can't have contrast media; less invasive
- D-dimer (elevated with clot degradation) - present with PE or recent fall
- Pulmonary Angiography (most sensitive but invasive - use less)
interprofessional care: Prevention - ANS--sequential compression devices
-early ambulation
-prophylactic anticoagulation
care: goals of treatment - ANS--prevent further thrombi
-prevent further embolization to pulmonary system
-provide cardiopulmonary support
care: supportive care variable - ANS--oxygen or mechanical ventilation
-pulmonary toilet
-fluids, diuretics, analgesics
pulmonary embolism drug therapy - ANS-Anticoagulation:
-Low-molecular-weight heparin (LHWH) SQ (Enoxaparin)
-Unfractionated IV heparin
-Warfarin (Coumadin) - Goal INR 2-3.0
Fibrinolytic agents:
-Tissue plasminogen activator (tPA)
-Alteplase (Activase)
pulmonary embolism surgical therapy - ANS--pulmonary embolectomy for massive PE
(if thrombolytics are contraindicated)
-percutaneous catheter embolectomy
-inferior vena cava filter to prevent migration of clots (prevents migration of clots in
pulmonary system)
nursing management of pulmonary embolism - ANS-Semi-Fowler's position
IV access
Oxygen therapy
Frequent assessments
Monitor laboratory results. (INR 2-3)
Emotional support and reassurance
, patient teaching - ANS--review long-term anticoagulation
-measures to prevent DVT
-importance of follow up exams
acute respiratory failure - ANS-results from inadequate gas exchange
-insufficient O2 transferred to blood (hypoxemia)
-inadequate CO2 removal (hypercapnia)
-hypoxemic respiratory failure (PaO2<60)
-hypercapnic respiratory failure (PaCo2>45)
Hypoxemic respiratory failure causes - ANS-alveolar hypoventilation:
-restrictive lung disease
-CNS disease
-chest wall dysfunction
-neuromuscular disease
diffusion limitation:
-severe COPD
-recurrent pulmonary emboli
-pulmonary fibrosis
-ARDS
-interstitial lung disease
-hypoxemia present during exercise
ventilation-perfusion mismatch:
-COPD
-pneumonia
-asthma
-atelectasis
-result of pain
-pulmonary embolus
Hypercapnic respiratory failure - ANS-INCREASED CO2 (greater than 45mm Hg) and
DECREASED pH (less than 7.35), Telling us it's a VENTILATION problem, pt either not
breathing enough or has an air trapping diagnosis such as asthma or COPD
hypercapnic respiratory failure - ANS-airway and alveoli abnormalities:
-asthma
-COPD
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller modockochieng06. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $7.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
76449 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now