Final Exam Study Guide (75 questions) Spring 2017

Ethical and Legal End of life  Ethical dilemmas o Dilemma: choice between two unpleasant, ethically troubling alternatives o Confidentiality: personal safety o Patient rights: right to refuse treatment o Death and dying: quality of life, death with dignity  Focus is on healing, possibly neglecting the needs of older adults  Palliative care  High-tech and high-touch, think quality of life for adults at the end of life! Pain Types of Pain  Somatic: skin, subcutaneous tissue, bones, muscle, blood vessels  Visceral: internal organs or body cavity linings, intestinal distention  Neuropathic: direct injury to a peripheral nerve, spinal cord, or the brain Assessment  Must be easy to use, easy to document, and easily understood by patient!  Use self-reporting tools whenever possible!  Pain history  Visual analog scale  Numeric rating scale  Verbal descriptor scale  Faces scale  FLACC scale o Score is 1-10  CPOT scale o Used for people on a ventilator o Score is 0-8 Pulmonary ARDS  Most severe form of acute lung injury  Acute inflammation, sudden onset of pulmonary edema and respiratory failure  Many factors can directly and indirectly cause ARDS o Pneumonia, gastric aspiration, near drowning, chest contusion, inhalation injury, sepsis, acute pancreatitis, drug overdose  Does not have to be lung related ARDS Diagnosis  Pulmonary artery wedge pressure (PAWP) less than 18  Bronchoalveolar lavage fluid (BAL) protein rich and contains inflammatory cells  Brain natriuretic peptide (BNP) less than 100  Chest radiography: diffuse pulmonary infiltrates ARDS Pathology  Not a disease, pathophysiologic lung changes resulting in a pattern of clinical manifestations  xthe interstitial spaces of pulmonary tissue  Fluid and proteins then flood into the alveoli