Health Alt -> TB, Sepsis and HTN

Latent

______ TB: Lays dormant in nerve cells

Doesn’t make person have symptoms or feel sick

Can’t spread from person to person

Tuberclusosis Hallmarks

________ ______: Night sweats and coughing up blood

Other common S&S include: chest pain, fever, persistent cough, fatigue, loss of appetite, weight loss

Rifampin

______: 1st line treatment for TB. Turns secretions orange

Active

_______ TB:

• Grows in body

• Can make person feel sick and have symptoms

• Can spread from person to person

• Can cause death if not treated

Tuberculosis Treatment

_________ _________: Long term combo ABX therapy

Isoniazide → Can cause neuropathy, take with B6. 8-12 month duration to cure latent TB

Directly observed therapy

Treatment longer than 6 months

Reportable

Airborne percautions and negative pressure rooms

Sepsis

____ criteria:

Systolic under 100

Resp rate above 22

GCS less than 15

Some obvious or supposed site of primary infection

Severe sepsis

_____ ______: Induced organ dysfuction or hypotension along with sepsis

Septic shock

_____ ____: Severe sepsis along with arterial pressure of <90mmHg or MAP of under 65

SIRS

_____ indicated by +2 of these symptoms:

1. Temp above 38.5 or under 35.5

2. HR + 90 or under 50

3. RR +25 or under 10

4. WBC +12,000/mm or under 4000/mm

5. Lactate >4mmol/L

4 weeks

Any infection in neonates under _ ____ is emergency.

Premies → From due date

Fluids

Gold standard treatment for sepsis ______ bolus of 20/mL/kg 30-60 mins after ER arrival

Colloids or crystalloids

Vasopressors

________ for sepsis. 1-6 hrs after onset:

Levophed

Norepi

Epi

Vasopressin

Circulatory

________ system of heart. 1/3 required for proper functioning:

Continous network of blood vessels which heart mechanically pumps blood through, force in which heart has to pump to keep blood moving

Conductive

________: 1/3 systems of heart required for proper functioning

Electirical impulses that cascade through heart that causes heart to contract and beat

SA → AV → Bundle of His → Right and left bundles

Coronary

_______: 1/3 systems of heart required for proper functioning. Vessels that feed heart

Occlusion of these vessels = MI

Hypertension

__________: Defined as elevation of systemic arterial BP

Most significant modifiable RF for CV disease in canada

1/5 canadians

83% aware, 17% aware

>140/90

Persistent elevation of _____: HTN criteria for non-diabetics

>130/70

______HTN criteria in diabetics

Lasix

_____: Diuretic that acts on cardiac output by reducing output through fluid reduction

Nitroglycerin

_________: Acts on BP by reducing SVR through vasodilation

BP = CO x SVR

Blood pressure equation _____________

Isolated systolic

______ ______ HTN: Sustained elevation of SBP >140 and DBP still under 90

WIdening pulse pressure → Does not impact venous return in same way. Diastolic stays normal.

Product of age r/t loss of elasticity in large arteries

Primary

_____ HTN: 90-95% of clients

High fat diet, air pollution, smoking, family history

Lifestyle, genes, environment. Years to develop

Secondary

________ HTN: 5-10% in adults, over 80% of HTN in children

Tx aimed at treating underlying cause such as renal tumour

Clinical findings:

• Unprovoked hypokalemia

• Abd bruit (AAA)

• Family hx of renal issues

Kidney disease

______ _____ largest cause of secondary HTN, especially with children

Nephrosclerosis

_________: Kidney damage from turbulent blood flow

HTN either pre or intra AKI cause

Farmingham Risk

______ ____ score: Tool to assess risk of CAD, MI, or death in hypertensive client in next 10yrs

135/85

____: At home target BP for hypertensives on medication

Regular at home monitoring same time each day

Beta blocker

____ _____: first line tx for HTN in those under 50. Slows down HR and increases contractility

-lol

ACE’s and ARB’s

____________: Do NOT use these two meds together. Do same thing

RAS

_____ inhibitors storongly contra’d in pregnancy