first line of defense:
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skin: provides a physical barrier to bacteria through sweat and sebaceous
glands that secrete toxins, epithelial cells that shed constantly, an acidic
pH, fatty acids, and enzymes that inhibit bacterial growth.
mucous, nasal hairs, cough, and sneeze reflexes protect the respiratory
tract.
tears: contatin antibodies and enzymes that destroy bacteria
normal flora: in the intestines inhibit growth of pathogens
urine flow/acidic urine and immunoglobulin work together to impeded
bacterial growth
,pupil testing
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testing cranial nerve III (oculomotor function) (pupil reaction)
Shape of pupils:
Keyhole: slightly oval --> indicates intracranial hypertension and represents
an intermidate phase between a normal pupil (round) and a fully dilated
pupil - early sign of transtentorial herniation
Keyhole: like a keyhole, see in patients who have had an iridectomy
(cataract surgery)
Irregular: jagged, seen in Arglyy-Robertson pupils and traumatic orbital
injuries.
Abdominal assessment - auscultate
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- bowel sounds (present or absent and character)
- bruits over arotic area
- fetal heart rate if applicable
Systemic infections
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spread through the bloodstream to the entire body, and associated
symptoms may include shakiness, chills, weakness, nausea, vomiting, and
, aches in the joints. Systemic infections can vary in severity.
Chest x rays
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help to differentiate if the lungs are the site of infection. They give
information regarding severity of sepsis and MODS in relation to excessive
fluid in lungs. CXRs are also used to assess the cardiac silhouette for
enlargement.
Venous Blood Gas (VBG)
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Assesses the same information as ABG but is less painful, less invasive and,
therefore, less risky. There is a good correlation between pH, HCO3, and
base excess of VBGs and ABGs. Making VBGs a preferred diagnostic in the
emergency department for metabolic presentations.
Diastolic Heart Failure
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In diastolic heart failure, the cardiac muscle cells are thickened and the
heart "bulks up" in response to chronic conditions such as hypertension and
left ventricular hypertrophy.
--> Diastole is the cardiac phase of filling and relaxation. In diastolic heart
failure, the heart is unable to relax and fill appropriately as the ventricles
become stiff and non-compliant. The cardiac muscle attempts to
, compensate for the decreased cardiac output by increasing contractility.
This results in an increase in pressure in the atria and pulmonary
vasculature. Diastolic heart failure represents a problem with filling.
Respiratory buffering
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A change in pH will activate respiratory buffering next. The respiratory
center, located in the medulla, is sensitive to changes in pH and begins
buffering within seconds to minutes by increasing or decreasing respiratory
rate and depth in response to CO2 level. Although this buffering response
occurs quickly, it cannot be maintained indefinitely.
family centered care
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Family-centered care is characterized by collaboration among patients,
family, and health care professionals, and recognizes families as constants
in patients' lives. Therefore, this approach recognizes the integral role of
family in the health and well-being of patients.
Extremities (Bilateral)
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skin: provides a physical barrier to bacteria through sweat and sebaceous
glands that secrete toxins, epithelial cells that shed constantly, an acidic
pH, fatty acids, and enzymes that inhibit bacterial growth.
mucous, nasal hairs, cough, and sneeze reflexes protect the respiratory
tract.
tears: contatin antibodies and enzymes that destroy bacteria
normal flora: in the intestines inhibit growth of pathogens
urine flow/acidic urine and immunoglobulin work together to impeded
bacterial growth
,pupil testing
Give this one a try later!
testing cranial nerve III (oculomotor function) (pupil reaction)
Shape of pupils:
Keyhole: slightly oval --> indicates intracranial hypertension and represents
an intermidate phase between a normal pupil (round) and a fully dilated
pupil - early sign of transtentorial herniation
Keyhole: like a keyhole, see in patients who have had an iridectomy
(cataract surgery)
Irregular: jagged, seen in Arglyy-Robertson pupils and traumatic orbital
injuries.
Abdominal assessment - auscultate
Give this one a try later!
- bowel sounds (present or absent and character)
- bruits over arotic area
- fetal heart rate if applicable
Systemic infections
Give this one a try later!
spread through the bloodstream to the entire body, and associated
symptoms may include shakiness, chills, weakness, nausea, vomiting, and
, aches in the joints. Systemic infections can vary in severity.
Chest x rays
Give this one a try later!
help to differentiate if the lungs are the site of infection. They give
information regarding severity of sepsis and MODS in relation to excessive
fluid in lungs. CXRs are also used to assess the cardiac silhouette for
enlargement.
Venous Blood Gas (VBG)
Give this one a try later!
Assesses the same information as ABG but is less painful, less invasive and,
therefore, less risky. There is a good correlation between pH, HCO3, and
base excess of VBGs and ABGs. Making VBGs a preferred diagnostic in the
emergency department for metabolic presentations.
Diastolic Heart Failure
Give this one a try later!
In diastolic heart failure, the cardiac muscle cells are thickened and the
heart "bulks up" in response to chronic conditions such as hypertension and
left ventricular hypertrophy.
--> Diastole is the cardiac phase of filling and relaxation. In diastolic heart
failure, the heart is unable to relax and fill appropriately as the ventricles
become stiff and non-compliant. The cardiac muscle attempts to
, compensate for the decreased cardiac output by increasing contractility.
This results in an increase in pressure in the atria and pulmonary
vasculature. Diastolic heart failure represents a problem with filling.
Respiratory buffering
Give this one a try later!
A change in pH will activate respiratory buffering next. The respiratory
center, located in the medulla, is sensitive to changes in pH and begins
buffering within seconds to minutes by increasing or decreasing respiratory
rate and depth in response to CO2 level. Although this buffering response
occurs quickly, it cannot be maintained indefinitely.
family centered care
Give this one a try later!
Family-centered care is characterized by collaboration among patients,
family, and health care professionals, and recognizes families as constants
in patients' lives. Therefore, this approach recognizes the integral role of
family in the health and well-being of patients.
Extremities (Bilateral)
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