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How do you manage a stoma with bubbling secretions Suction the stoma with the correct tube - measure lenght from stoma to crina - then bag with stoma attachment When is it appropriate to apply positive pressure ventilation? When a patient's pulse ox is below 89% and needs a bag mask What is cardiogenic shock? And what signs and symptoms should you expect to see? Inadequate function of the heart, or pump failure. Signs and symptoms: chest pain, irregular/weak pulse, low BP, cyanosis, cool clammy skin, anxiety, pulmonary edema Caused by; pump failure (heat damaged by disease or injury), low fluid volume (bleeding), blood vessels dislate excessively so that blood within them is inadequate to fill the system. What is Hypvolemic Shock? What causes it? Inadequate amount of fluid in the circulatory system. Caused by loss of blood and fluid Signs and symptoms: Rapid, weak pulse, low bp, change in mental status, cyanosis, cool clammy skin, increased respiratory rate. By what atomic structure does the air enter the nose from? Nasal pharyngeal Where do all arteries branch off from? The aorta What is the appropriate respiratory rate for adults and children? 12-20 breaths per minute and 12-
What is minute volume? Amount of air moved into and out of lungs per minute What is tidal volume? amount of air inhaled and exhaled during a normal breathing cycle. When is it appropriate to apply a nasal cannula? When the patients pulse-ox is 90-94% and they are conscious ____ When it is appropriate to suction a patients airway? When there is a fluid obstructing the airway What defines good ventilation and respiration? adequate & continuous ventilation & a continuous supply of O2 and a means of disposing of waste What is the definition of diffusion? movement from area of high concentration to low concentration What should be done during auscultation? Suction the airway What is respiration at the cellular level? Internal respiration; gas perfusion into the cells to meet the needs of the tissues What is respiration at the lungs? External respiration; gas exchange at the alveoli How does the sympathetic nervous system produce Epinephrine? hormone released from the adrenal medulla in response to stress Signs and symptoms of hypovolemia? Vitals: orthostatic bp, hypotension, decreased central venous pressure, tachycardia, tachypnea, thready pulse, hypoxia, and hyperthermia. Physical: thirst, cool clammy skin, flattened neck veins, dizziness, nausea/vommiting, oliguria (decreased urine production), and diminished capillary refill What is a V/Q mismatch? (Ventilation/Perfusion ration)
What is the diaphragms function? bring air into the lungs upon contraction and expel it via relaxation What happens when the right ventricle contracts? deoxygenated blood moves through the pulmonary arteries where it is sent to the lungs to be oxygenated When do you apply suction to the suction catheter? as you withdraw the catheter, in a circular motion. Measure depth like OPA What is the primary function of the autonomic nervous system? to control functions that occur autonomously; involuntary actions What is the first step when recognizing that the patient has inadequate breathing? shallow or labored breathing at slow rate, tripod position, Which airways adjunct are appropriate for the unresponsive patients? NPAs and OPAs What is neurogenic shock? Usually caused by spinal injury; all blood vessels below the injury site dislate widely increasing the size/capacity of vascular system. The 6L of blood in our body can no longer fill the enlarged system. What blood cell fights infection? White blood cells; leukocytes What airway device do we use for the patient without a gag reflex? Oropharyngeal airway What part of the brain controls the rate of breathing? medulla oblongata What is anaerobic metabolism? Metabolism is the absence of O2, produces lactic acid and CO What organs are hollow?
Gallbladder, Intestine, Appendix, Stomach, intestines, bladder, heart, lungs... What organs are solid? Liver, Spleen, Pancreas, Kidneys What is a late sign of inadequate breathing? Cyanosis What are early signs of shock in adults? Agitation, Anxiety, Restlessness, Feeling of impending doom, Altered Mental status, Marked Thirst What indicators would a patient in respiratory distress experience? Rapid shallow breathing, low O2 levels, tachycardia, low BP What is the carbonic drive? Aka the hypoxic drive, the chemoreceptors measure CO2 levels in the spinal fluid to trigger breathing when CO2 levels get too high What method do we use to open the airway of a trauma patient? Jaw thrust maneuver What structures are distal to the elbow? Everything from the elbow down; radius, ulna, all bones in the forearm, hands and fingers. What structures are part of the central nervous system? Brain stem, spinal cord... What is a chemoreceptor and what does it do? a chemical receptors that monitor the level of O2, CO2, H ions, pH, and CFS & then provide feedback to respiratory system to modify rate/depth of breathing to meet the body's needs What word defines low respiratory rate? Hypoxia... What vessels supply the myocardium? Coronary arteries supply blood to the myocardium and other components of the heart
