Exam (elaborations)
BLANKENSHIP FINAL EXAM LATEST WCU ACCURATE FALL-SPRING TERM GRADED A+
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- BLANKENSHIP
- Institution
- West Coast University
BLANKENSHIP FINAL EXAM LATEST WCU ACCURATE FALL-SPRING TERM GRADED A+
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BLANKENSHIP FINAL EXAM LATEST 2024-2025WCU ACCURATE FALL-SPRING TERM GRADED
A+
what are the surgical interventions for flail chest?
CXR, stabilize flair segment with positive pressure vent, possible surgical fixation
What is a Pulmonary Embolism
Blockage of pulmonary arteries by fat from long bone fractures or air embolus/dvt
S/S of Pulmonary Embolism
Mental status changes(LOC changes), impending doom, new onset SOB/dyspnea,
chest pain, Tachycardia, crackles, wheezing, hemoptysis (coughing blood), cough→
Afib
How do we medically manage a PE
- Semi-fowler’s,
,- intubation/mechanical vent, fluids
- vasopressors ( to increase BP),
Diuretics,
Opioids,
-Lovenox (heparin:prevents new clots from forming) -> aPTT: 30-40 seconds,
Warfarin- INR:0.7-1.8,
- tPA or alteplase (dissolves clots), IVC Filter if anticoag C/I
When someone is positive for PE what labs are we anticipating to order?
- Spiral CT Scan/CTA (Gold Standard) uses IV contrast determine shellfish or iodine
allergy,
- D-dimer ( does not tell us where clot is tho) normal: < 0.04, V/Q scan for those
can’t have CT scan ( not for intubated pts)
,who is at risk for developing Virchow's Triad
- venous stasis (immobility, fractured bone, obesity, pregnancy)
- Hypercoaguability (smokers, contraceptive users, sickle cell anemia)
- Vasculature integrity (IV drug use, varicose veins, diabetics)
what do you do if chest tube gets dislodged?
check resp status and cover with 3 sided occlusive dressing
What do you do if chest tube system breaks and gets disconnected
check resp status and put distal end of tube into 2 inches of sterile water. GET A
NEW SYSTEM
what do you do if chest tube has a blood clot?
Lift tube to see if gravity can drain, TPA to flush line-> if that deosnt work GET A
NEW TUBE
, What do we need to do to disocntinue a chest tube?
Pain meds 30 min before, have pt bear down. remove tube and seal with 4 sided
occlusive dressing -> Confirm with X-ray to ensure air hasn't returned
CMV
can breath FASTER not SLOWE. sense when pt wants to take a breath. need to
exercise pt in this mode to prevent atrophy and pt needs to be fully sedated
SIMV
delivers preset vT at a preset frequency in sync with the patient's SPONTANEOUS
breaths. GOOD FOR WEANING. can cause dyssynchrony
PSV
applied to airway only during INSPIRATION and is synched ot patients spontaneous
breaths but can lead to fatigue. GOOD FOR WEANING and MUSCLE EXCERCISE. Has
to be AAOx4 and able to initiate own breath
Vt (TIDAL VOLUME)
amount of gas inhaled on each breath -> calculated by weight
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