Crisis/Respiratory
50 Q/A
Multiple choice
T/F
Case study (multiple choice)
Define crisis -
Primary goals/considerations
What would you do in the following situations: Crisis
Long term illness
Rehab process
Palliative care
Clinical manifestations of a client in crisis
Anxiety increase
Increase HR
Body language/ verbal
Diaphoresis
withdrawn
Increase BP
Life is out of their control
Hopelessness
Suicidal ideation
Increase RR
Confusion
Associated interventions
Rx anxiety
Connect to resources: crisis team
Someone to listen to
Time to think
Keep them safe
Encourage self care
Asking “has this happened before/ what did you do in the past/ did it work”
Support?
How/what looking for when assessing someone in crisis
Determine the level of crisis – suicide/other harm
Medical crisis? Psych?
Approach family members to discuss the situation
Calm, controlled, clear
Don’t reinforce anger
Swiftly take control
Compassion
Decrease distractions – turn tv off
Upper resp:
What do you know about Sinusitis – inflammation of the sinuses, painful, sputum is a brown/green colour, Tonsillitis – inflammation of the tonsils, can lead to otitis media Tonsillectomy – completed when there 3x prior of tonsillitis, removal of the tonsils Laryngectomy – removal of the larynx, cancer of the larynx/trauma Bronchoscopy – scope of the bronchioles/bronchi,
What can you comm about:
Pulmonary edema – excess fluid in the lungs, caused by CHF, ARDS, kidney failure, swelling of the lungs – alveoli are filling up with excess fluid that has seeped out of the vessels in the lung, causes O2 exchange problems = dyspnea, hypoxemia,
Tx: diuretics, O2 2L,
Dx:
Risk Factors:
CHF – congestive heart failure – decreased cardiac output/ impaired perfusion to vital organs/ decreased tissue perfusion, anemia. S&S: dry hacking cough, swelling of lower extremities SOB, orthopnea, tachycardia, wheezing, fatigue, weakness, distention/ acsites.
Tx: sit head of bed up, O2 2L, assess V/S and lungs (crackles), check for central cyanosis, monitor I&O
Dx:
Risk Factors:
COPD – chronic obstructive pulmonary disease – decreased O2 exchange – a/w swollen and blocked with mucus, alveoli loose surface tension b/c of scar tissue, includes emphysema, and chronic bronchitis
S&S: long lasting cough, can be productive/ non, can become acidotic, expiratory wheeze, barrel chest, CO2 retainers, dyspnea on exertion, wt loss, accessory muscles to breath, expiration = active process
Tx:
Risk factors:
Dx:
ARDS VS ARF
ARDs
ARF
Tx:
Tx:
S&S
S&S
Dx:
Dx:
Risk Factors:
Risk Factors:
TB/PE – pulmonary embolism – similarities
TB
PE
Droplet inhalation
Blood clot in the lung
Bacteria enters alveoli and multiply
Can be re-activated
Tx: antibiotics, for 6-12 months
Tx: anticoagulant therapy (heparin drip) for 24 then warrafin, TEDs, pain management, O2 2L, self-care, relieve anxiety,
S&S – take 2-10 weeks to appear, hemoptysis, fever (low grade), night sweats, fatigue, wt loss, cough, chest pain
S&S: hemoptysis, fever, cough, chest pain (OPQRST), dyspnea, tachypnea, anxiety, diaphoresis, syncope