Emergency Care In The Streets: Chapter 45 Acute Interventions In The Chronically Ill Patient

Front 1

The primary purpose of hospice care

Back 1

Increase quality of the pt's life through pain and symptom management.

Hint 1

45.4

Front 2

Benefits of home health

Back 2

Decrease cost when compare to institutional care. Pt stays in familiar surrounding, often results in fewer and shorter hospital visits.

Hint 2

45.5

Front 3

Hospice pt life span

Back 3

Pts admitted to hospice care have a life-threatening condition or terminal illness and are expected to die within 6 months.

Hint 3

45.4

Front 4

The Haddon matrix framework

Back 4

A framework for injury prevention. According to the Haddon injuries occur in a certain time sequence: the pre-event phase, event phase, and post event phase. Each phase has a host/person involved with injury and equipment involved. Prevention can be focus in any stage.

Hint 4

45.5

Front 5

Notes on crushing tablets

Back 5

Not all are meant to be crush, for instance extended-released tabled may enter the pt's blood stream too fast if crushed, causing an overdose.

Hint 5

45.7

Front 6

What two questions to be sure to ask about dementia pt

Back 6

What is the pts usual baseline function?
How does function today vary from baseline?

Hint 6

45.7

Front 7

Long-term issues encountered by pt with degenerative neuromuscular disease

Back 7

hypoventilation

Hint 7

45.9

Front 8

The purpose of an oxygen concentrator

Back 8

Concentrate the oxygen in ambient air and eliminate other gases.

Hint 8

45.9

Front 9

CPAP and how it facilitates effective breathing

Back 9

Continuous Positive Airway Pressure decrease work of breathing by keeping the air passages and alveoli open during expiratory phase. Keeps airway pressure slightly higher than atmospheric pressure.

Hint 9

45.10

Front 10

BiPAP

Back 10

BiLevel Airway Pressure exerts different levels of inspiratory vs expiratory pressure.

Hint 10

45.10

Front 11

tidal volume

Back 11

Volume of air breath in and out during normal breath.

Hint 11

45.10

Front 12

Side effects of positive pressure ventilation

Back 12

Alters hymodynamic of the body decreasing venous return to the heart; the thoracic pump pulls blood back when pressure in the chest is less than atmospheric pressure. The pump is not as effective and cardiac output can drop.

Hint 12

45.11

Front 13

Can a pt with a laryngectomy be bagged though the mouth and/or nose?

Back 13

No the larynx has been removed, you must use the stoma.

Hint 13

45.11

Front 14

The primary intervention consideration for tracheostomy tube pt

Back 14

A surgical airway in which an opening is placed in the trachea below the cricoid ring. Airway management with basic techniques including opening, repositioning, and suctioning.

Hint 14

45.11 & 12

Front 15

What should you do if the tracheostomy closes?

Back 15

Intubate as usual, cover tracheostomy site with occlusive dressing to prevent air loss.

Hint 15

45.12

Front 16

Considerations for the pt during cleaning the tracheostomy tube

Back 16

Have the pt deep breath, and consider preoxygenating using ventilator.

Hint 16

45.13

Front 17

Causes of cardiomyopathy

Back 17

(A condition in which the heart muscle does not work at optimal level.) Primary cardiomyopathy cannot be traced to one cause but is linked to hypertension, coronary artery disease, and viral infections might combine.
Secondary cardiomyopathy can be traced to a single cause.

Hint 17

45.14

Front 18

Key flag in cardiac deterioration in home heath care pt

Back 18

A change in the previous level of activity.

Hint 18

45.14

Front 19

Ways to minimize the risk of aspiration in the gastric tube pt

Back 19

Pt should be upright, at least 30 degrees when medication or nutrition is being infused. They should ideally be kept upright for 30 to 60 minutes after feeding.

Hint 19

45.18

Front 20

Common causes of large bowel obstruction (of colon)

Back 20

A growth within the bowel rather than an adhesion that connects bowel or encircles another segment.

Hint 20

45.18

Front 21

Causes of increased UTI in the chronic indwelling catheter pt

Back 21

The bladder is usually sterile, so the introduction of a catheter introduces bacteria, however there is usually low risk of infection except in immunocompromised pts. Indwelling catheters keep sphincter open providing continuous route for bacteria.

Hint 21

45.19-20

Front 22

Causes of shock in the indwelling catheter pt

Back 22

Urosepsis is likely to cause septic shock due to ongoing risk of an infection.

Hint 22

45.20

Front 23

iliostomy

Back 23

Surgical procedure to remove large portions of the small intestine.

Hint 23

45.30

Front 24

Ureterostomy

Back 24

Surgically placed catheter into the bladder.

Hint 24

45.20

Front 25

Most common sign of infection in the immunocompromised pt

Back 25

Fever

Hint 25

45.23

Front 26

Serous vs. purulent exudate

Back 26

Exudate-drainage from a wound consist of fluid and cells.
Serous exudate is clear and water drainage.
Purulent exudate is pus, which consist of white blood cells, liquefied dead tissue, and bacteria.

Hint 26

45.23

Front 27

Cases in which an apnea monitor is sent home with the infant

Back 27

-Has unresolved apnea or prematurity at the time of hospital discharge.
-Has severe gastroesophageal reflux.
-Has a history of apparent life-threatening event.
-Is the sibling of a baby who suffer SIDS.

Tx stimulate, oxygenate, ventilate, and keep baby warm!

Hint 27

45.26

Front 28

Causes of dementia

Back 28

Alzheimer's disease, Pick disease, Parkinson's disease, and stroke. Some nutritional disorders, such as Wernicke disease or Korsakoff psychosis, also. Mostly the cause is unknown.

Hint 28

45.26 class

Front 29

Locations of pain receptors in the body

Back 29

All nociceptor (ie. pain receptors) begin as free nerve endings and end in the dorsal (ascending) roots of the spinal cord.

Hint 29

45.27

Front 30

Side effects of chemotherapy

Back 30

Alopecia (hair loss), anorexia, fatigue, leukopenia (decrease in WBC), thrombocytopenia (decrease in platelets), anemia, and increased risk of infections, along with N/V.

Hint 30

45.27