Acute Study

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Gastro/GI
Interventions for GERD = low fat, no etoh, milk, tabacco, peppermint, carb beverage, avoid eating 2hours before bed, no tight clothes, elevate HOB. Meds are h2 antagonists famotidine (Pepcid), nizatidine (Axid) or ranitidine. Proton Pump inhibtor: - decrease gastric acid – Prevacid, Pilosec (omeprazole) Prokinetic agents: accelerate Gastric emptying – i.e Reglan

BMI = kg/ height ^2 or lbs x 703/height^2

Stoma assessment = check size, color, drainage, skin, should be shiny, moist, deep rich red

Pancreatitis = autodigestion of the pancreas from premature activation of the digestive enzymes. Chronic is from ETOH usage, acute is from autodigestion. In pancreatitis, the “ases” (aces) are high. Low calcium and magnesium.

s/s Ulcerative Colitis = in large intestine, ab pain/cramping right lower, anorexia, weight loss, fever, diarrhea 15-20x, mucus, blood, retal bleeding, ab tenderness, high pitch bowel sounds, anemia.

Endoscopy-teaching/interventions/postop care = conscious sedation, NPO, prep laxative, enema to clean bowel,

Cholcystectomy- post op complication = monitor drainage, care of t-tube, reporting increase in drainage or odor, clamp 1-2 hours before meals, low fat diet, stool should return to brown color in a week. Rigid board-like abdomen or rupture needs surgical intervention

Chron’s-treatment/interventions N = IT IS NON-SPECIFIC SPOTTY INFLAMMATION OF ANY GI PART. right low pain, diarrhea 5-10x, flatus, malabsorption, weight loss, blood in stool, high pitched, ab tenderness. Treatment is supplements, no etoh, use probiotics, surgery doesn’t cure it. Can give salicylates blocking prostaglandins and leukotrienes which decreases diarrhea. Azathioprine-imuran and infliximab-remicade, and bromide banthine all lower inflammation and diarrhea. From Immune System.

G tube -teaching

Respiratory
ABG = ph 7.35-7.45, Pa02 80-100, PaC02 35-45, HC03 22-26. ROME

Pneumonia s/s, two types noninfectious meaning chemicals or aspiration and infectious meaning from pneumococcal, fever, chills, cough, chest pain. Higher number on dyspnea scale is worse. Small frequent meals, high kcals,

Laryngectomy = for cancer, partial removes portion of larynx, 1 vocal cord, airway remains intact. Total removes everything, no voice, permanent tracheostomy.

Asthma s/s, chronic inflammatory disease of airway. Audible wheeze, coughing, use of accessory muscles, barrel chest, tachycardia

bronchospasm = sudden constriction

s/s Emphysema = alveolar walls destroyed; results in dyspnea on exertion, use of accessory muscles, barrel chest, thin, right heart strain.

COPD S/S = umbrella term that could refer to emphysema and chronic bronchitis combined. Hypoexemia, acidosis, respiratory infections, cardiac failure, cor pulmonale, cardiac dysrhythmias.

Resp distress = pulmonary embolism is the obstruction of pulmonary artery or one of its branches by a thrombus leads to sudden dyspnea, tachypnea, and chest pain. most likely from DVT.

Chest tubes

Thorocentesis = chest wall to pleural space needle. Performed with ultrasound. Deep breathing, tell pt to lie on unaffected side.

Cancer
BSE = breast self exam?

Chemo s/e, = anemia, neutropenia, thrombocytopenia, alopecia, mucositis, symptom distress side effects like anxiety, sleep disturbance.

labs to monitor = WBC 5k-10k, RBC, Platelet count 150,000-400,000

Know diagnosis fatigue, imbalanced nutrition, risk for infection, risk for injury electric razor. , altered body image, impaired oral mucous membrane

Bone Marrow Aspiration = lays on right side, biopsy, direct pressure for 5 minutes

Implanted Radiation-patient teaching = called brachytherapy the radiation source comes in direct contact with tumor for a specific amount of time. Save all dressing and bed linen til radioactive source is removed, no children or pregnant women, limit visitors, maintain 6 feet from radiation source. don’t remove ink marking or use...
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