how do we diagnose a PE? what is the definitive diagnostic?
Correct Answer VQ scan (ventilation perfusion scan) is the
definitive diagnostic
-ABGs to assess oxygenation, CT scan, labs (d-dimer to assess
fibrin and coag studies to assess PT-INR)
how do we prevent atelectasis? Correct Answer o Encourage
deep breathing
o Mobilize patients
o Incentive spirometer (10x an hour)
o Chest therapy
how do we treat hypercalcemia? Correct Answer -loop diuretic
-increased fluid
-dialysis
-calcitonin
how do we treat hyperchloremia? Correct Answer -treat
underlying cause
-LR to correct any acidosis
-diuretics
-restrict NaCl fluids
how do we treat hypermagnesmia? Correct Answer -loop
diuretics
-LR
-do NOT give mag sulfate
,how do we treat hyperphosphatemmia? Correct Answer -
reduce dietary intake of phosphate
-dialysis if kidney failure
-meds: phosphorous binder, calcium acetate + calcium carbonate
how do we treat hypocalcemia? Correct Answer oral calcium
and vit D
how do we treat hypochloremia? Correct Answer -0.5-0.9% NS
-treat underlying cause
-high Cl- foods: bananas, dates, eggs, cheese
how do we treat hypomagnesmia? Correct Answer -mag sulfate
PO or IV
-treat underlying cause
how do we treat hypophosphatemia? Correct Answer -correct
underlying cause
-replace phosphates in body
how long should a patient have an ET tube in place? Why?
Correct Answer o 2-3wk (14-21 days)
o Risk of irritation + infection
how much fluid is typically between the layers of the pleural
space? Correct Answer 5-15mL
is we suspect someone has atelectasis, how will they present?
Correct Answer o Diminished lung sounds
o Dyspnea
, what 4 situations would stimulate RAAS? Correct Answer low
sodium
low volume
low oxygen level
low blood pressure
What anion gap indicates acidosis? Correct Answer >16
what are causes of hyperkalemia? Correct Answer -kidney
injury
-decreased renal secretion
-meds like ARBs, beta blockers, K+ sparing diuretics
-addison's disease
-metabolic acidosis
what are causes of hypernatremia? Correct Answer -fluid
restriction
-loss of H2O
-hypertonic IV
-diaphoresis w more water loss than sodium
-tube feeding without adequate free water
-diabetes insipidus
-Cushings
what are causes of hypokalemia? Correct Answer -loop or
thiazide diuretic
-vomiting
-dehydration
-kidney dysfunction
-metabolic alkalosis
-low suction NG tube
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