Pt Care

lethargic

drowsy but aroused

obtunded

depressed LOC

may not easily be aroused

stupor

semi-coma

coma

completely unresponsive to stimuli

normal body temp

97\.7 to 99.5 F (36.5 to 37.5 C)

pulse rate adults

60-100 bpm

pulse rate peds

70-120 bpm

respiration rate adults

12-20

respiration rate peds

20-30

systolic =

pressure within arteries during contraction

diastolic =

relaxation of heart

systolic BP

< than 120

diastolic BP

< than 80

pulse oximeter measures

pulse & respiratory

pulse oximeter rate

95% to 100%

how many stages are in cardiac cycle

3

atrial systole

contraction of LT/RT atria

p wave

ventricular systole

contraction of LT/RT ventricle

QRS complex

cardiac diastole

ventricular & atrial diastole

T wave

hypoxemia

low concentration of O2 in blood

hypoxia

low O2 of tissue

headache, nausea, dizziness

ataxia

loss of muscle coordination

nasal cannula

2 pronged tube inserted in noise

1 to 5 LPM O2

mask

covers face

6+ LPM O2

endotracheal

tube into pt trachea through mouth & nose

tracheostomy

tube into trachea through surgery

thoracostomy

chest tube

drain fluid from intrapleural space

BUN values

7-25 mg/dL

creatinine values

0\.5-1.5 mg/dL

BUN/creatinine ratio

6:1 to 22:1

GFR values

90-120 mL/min

below 90 bad

best accuracy of renal function

GFR can be calculated with

age, sex, race

GFR men

70 +/- 14

GFR women

60 +/- 10

PT does what

measures blood coagulation (prothrombin time)

PTT does what

detects blood abnormalities (partial thromboplastin)

PT values

12-15 secs

PTT values

25-35 secs

INR does what

compares pt PT with control sample for more accuracy

INR values

0\.8-1.2

platelet does what

assess pt clotting ability

platelet values

140k-440k

kidney damage with normal function (stage 1)

>90 GFR

mild loss of kidney function (stage 2)

60-89 GFR

mild to mod loss of kidney function (stage 3a)

44-59 GFR

mod to severe loss kidney function (stage 3b)

30-44 GFR

severe loss of kidney function (stage 4)

15-29 GFR

kidney failure (stage 5)

d-dimer causes

deep vein thrombosis

pulmonary embolism

liver function test (LFT)

screen for damage to pt liver via blood test

med reconciliation

review pt med record at all points of care

coumadin (wafarin)

anti-coagulation (blood thinner)

reduce heart attack/stroke

metformin (glucophage)

treats type 2 diabetes

pt cannot take before scan or 2 days after

anxiolytic (benzos)

anxiety meds

benzo medications

diazepam (valium)

alprazolam (xanax)

clonazepam (klonopin)

lorazepam (ativan)

positive contrast agent

RCM

iodine/barium

iodinated RCM/water soluble administered in what ways

IV

directly into targeted vein/artery

intrathecal space

joint space

oral

osmolality

describes agents propensity to cause fluid from outside blood vessel to move into bloodstream

iodinated contrast divided into 2 categories

ionic

nonionic

ionic contrast characteristics

salts consisting of sodium/meglumine

3 iodine atoms

higher toxicity/osmolarity (HOCM)

dissociate

examples of HOCM

iothalamate meglumine (conray)

diatrizoate sodium (hypaque)

nonionic contrast media

nonsalt compounds

don’t dissociate

less toxic/osmolarity (LOCM)

examples of LOCM

iohexol (omnipaque)

iopamidol (isovue)

ioversol (optiray)

which contrast is less likely to produce side affects

nonionic low-osmolar

iso-osmolar (IOCM) characteristics

same osmolarity as blood

improve pt comfort

reduced side effects

example of IOCM

iodixanol (visipaque)

water soluble iodine characteristics

benzene ring

safe for IV injection

enteral RCM

oral/rectal

30 to 90 min transit time

barium contraindictions

undergo surgery

perforation

negative contrasts

air, water, gas

barium sulfate (great attenuation)

negative contrast pros

pt comfort

demo bowel walls

no interference w 3D’s

water soluble oral contrast used if

pt has iodine allergy

neutral contrast agents used for

opacify SB during enteroclysis/enterography

distend GI tract with clear visuals

VoLumen

4 H’s

history

hydration

have equipment ready

head up

iodine allergy pretreatment

12-24 hours prior

breakthrough reaction

repeat reaction after undergoing treatment

processes that increase reactions

asthma

allergies

renal disease

anxiety

diabetes

sickle cell

central venous catheter types

subclavian

ports

PICCs

ex of oral con limited to abd

300mL 30 mins prior

150mL immediatly prior

ex of oral con of abd/pel

450mL 60-90 mins prior

300mL 30 mins prior

150mL immediately prior

sigmoid/rectum con

4-6 hours prior

150-300mL

intraarticular

con injected directly into joint space

sites for IV admin

ant recess of elbow (AC)

radial aspect of wrist

ant surface of forearm

posterior hand

aseptic technique

hand wash

gloves

cleaning site in circular motion (center to outside)

alcohol site after removal

drip infusion

slow rate over long period

bolus injection

con pushed into bloodstream over short period

more pronounced

auto injector pros

consistent

precise

higher rates

auto delays for multiphase

severe reactions occur

first 20 mins

2 types of reactions

allergic

physiologic

allergic reactions

urticaria

edema

sneezing

itchy throat

physiologic reactions

nausea

sweat/chills

anxiety

hypertension

what to do for mild reactions

no treatment

observe

mod reactions are

non-life threatening but may progress

mod allergic reactions

urticaria

wheezing

erythema

face edema

throat tightness

mod physiologic reactions

mod/severe nausea/vomiting

vasovagal

tachy

chest pain

treatment for wheezing

bronchodilator

treatment for hives

Benadryl

treatment for HBP

elevate legs & IV

severe allergic reactions

facial edema

anaphylactic

severe erythema

severe wheezing

hypotension

severe physiologic reactions

cardiac arrhythmia

seizure

hypertension

heart attack

death