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Asthma chronic lung disease where the air ways become swollen, narrow and more mucus
is produce. This drives to wheezing in exhale, shortness of breathe, chest tightness, pain.
It is not known the cause but it is supposed to be genetically determinated or triggered by
allergens (animal dander, dust, gases, perfumes) common cold, emotions, stress, smoke.
Tests: peak flow (how hard you breath out) and spirometry .
Medication: inhaled corticosteroids (rhinocort), beta agonists or anticholinergics ipatropium
(atrovent) oral corticosteroids (prednisone).
COPD obstructive lung disease cause characterized by long term poor airflow. Main
cause- smoke. Others: long exposure to irritants: chemicals, air pollution, dust.
Symptoms: shortness of breath with physical activities , cough sputum, chest tightness,
wheezing.
Tests: spirometry (FVC- forced vital capacity, FEV1 forced expiratory volume in 1 sec; x-
ray.
Treatment: bronchodilators. Anticholinergic- ipratopium, short-acting beta-agonist
salbutamol (ventolin), corticosteroids, pulmonary rehabilitation, stopping smoking.
Cardiogenic shock- heart is damaged to sustain blood supply. (AMI, acute mycarditis,
arrhythmias).
Symptoms- the same + distended jugular veins
Therapy: O2, cardiac drugs.
Septic shock: infections leads to low blood pressure and low blood flow.i.e ARDS. Same
symptoms but not in the first stage (fever). O2, restore intravascular fluid via IV, antibiotics.
Coagulation
PT (prothrombin time) measures the extrinsic clotting of blood (11-13 sec)
APTT (activated partial thromboplastin time) intrinsic pathway -25-38 sec
TT- thrombin time -9-35
Fibrinogen 2-4g/l
INR 0.9-1.3
Bleeding time 3-7 min
Altered urine ouput hypovolemia, bleeding, vomiting, diarrhea, burns, fever< output
-diabetes miellitus, hyperthyroidism, hypercalcemia, diabetes insipidus, hemochromatosis
polyuria
-deacreased muscle tone in obesity, multiple pregnancies, immobility, catheterization
-neurological injuries like stroke or spinal cord injury can cause retention of urine
- diuretics polyuria
- antidepressants, antihistamines, narcotics urinary retention
- kidney obstructions, prostatic hyperplasia oliguria
- sodium levels high oliguria
- heart failure oliguria
- AKI, CKD- oliguria
- UTI - oliguria
- high intake of food and fluids
-dehydration
- catheter blockage
Types of catheters:
Size- range form 8-18 Fr diameter
Types intermittent with one opening, single use
- foley inflatable balloon (5cc-30cc) known as indwelling has 2 openings
- continuous catheter with 3 openings 1 to drain urine, 1 inflate balloon 1 irrigate
bladder
- coude curved tip for men with enlarged prostate or for obstruction
- suprapubic
- condom catheter for those without obstruction or bladder condition. Rather for
dementia
PEG percutaneous endoscopic gastrostomy is a medical procedure in which a tube is
inserted in the stomach by endoscopic guidance. It is recommended in stroke, while
swallowing muscles are weak, and the feeding cannot take place. It is used an anesthetic for
the abdominal wall. The endoscope is inserted and shows the place where to insert the tube. A
canula is then inserted and a wire which is pulled through mouth, than the tube is attached to
the wire and pulled through abdominal wall. The push method is that one in which the tube is
pushed into the stomach.
Nursing care of peg- 360 daily rotation, 2 times/day clean the site with soap and water,
deflate./inflate every week, check the position, the leakage, infection signs, flushes.