Nursing 105

Essentials of Nursing Study Guide

©2018 Achieve Page 80 of 160 Ineffective breathing pattern related to anesthesia • Activity intolerance related to compromised oxygen transport system as evidenced by dyspnea • Ineffective health maintenance related to denial of the effects of smoking The Heimlich Maneuver is an emergency technique for preventing suffocation when a person's airway (windpipe) becomes blocked by a piece of food or another object. Correct practices include: • For a conscious person who is sitting or standing, position yourself behind the person and reach your arms around his or her waist. • Place your fist, thumb side in, just above the person's navel and grab the fist tightly with your other hand. • Pull your fist abruptly upward and inward to increase airway pressure behind the obstructing object and force it from the windpipe. • If the person is conscious and lying on his or her back, straddle the person facing the head. Push your grasped fist upward and inward in a maneuver similar to the one above. Medications • Antitussives: given to suppress hyperactive or dry cough; this is a codeine-based cough syrup; contraindications are allergy, acute asthma, COPD, increased intracranial pressure, liver or renal dysfunction, and acute alcoholism; assess for adverse reactions such as respiratory depression, hypotension, bradycardia, sedation, confusion, and headache; educate patient on sedative effects, ensure adequate hydration to assist in raising mucus; patient should avoid alcohol and other depressants • Metabolic alkalosis: Metabolic alkalosis is defined as a bicarbonate level greater than 26 mEq/liter with a pH greater than 7.45. Either an excess of base or a loss of acid within the body can cause metabolic alkalosis. Excess base occurs from ingestion of antacids, excess use of bicarbonate, or use of lactate in dialysis. Loss of acids can occur secondary to protracted vomiting, gastric suction, hypochloremia, excess administration of diuretics, or high levels of aldosterone. o Signs and symptoms: respiratory depression, dizziness, lethargy, disorientation, seizures, coma, weakness, muscle twitching, muscle cramps, tetany, nausea and vomiting o Treatment: Metabolic alkalosis is one of the most difficult acid-base imbalances to treat. Bicarbonate excretion through the kidneys can be stimulated with drugs such as acetazolamide (Diamox), but resolution of the imbalance will be slow. In severe cases, IV administration of acids may be used. It is significant to note that metabolic alkalosis in hospitalized patients is usually iatrogenic in nature. Nursing Procedures Check the patient for the following: •