Enoxaparin (Lovenox)
- Inhibits Clotting Factors
- Factor Xa
- Clot Formation Prevention
- Heparin Induced Thrombocytopenia (HIT)
- Bleeding
- Medication Education
- Subcutaneous Injection
- 2 Inches from Umbilicus or Incisions
- Protamine Sulfate
Heparin Indications
- Acute Coronary Syndrome (ACS)
- Prophylaxis
- Pulmonary Embolism
- Atrial Fibrillation
- Used during Pregnancy
Warfarin
- Interferes with Vitamin K-dependent Clotting Factors
- Extrinsic Pathway
- Bridge with Heparin
- Chronic Anticoagulation
- Bleeding
- Necrosis
- Cytochrome P450
- Pregnancy
- FFP + Vitamin K
Asthma
- Obstructive lung disease
- Bronchial Hyperresponsiveness
- History of Atopic Disease
- Beta2 agonists
- Corticosteroids
- Curschmann's spirals
- Hypertrophy of smooth muscle
- Reversible
- Charcot Leyden crystals
- Methacholine challenge
- Wheezing
- Cough
- Initially decreased PaCO2
- Pulsus paradoxus
Restrictive vs. Obstructive Lung Diseases
- Restrictive Lung Disease
- Decreased Lung Volume
- FEV1/FVC Ratio Normal to Increased
- Obstructive Lung Disease
- Increased Lung Volume
- Decreased FEV1/FVC Ratio
Obstructive Lung Disease
- Blocked Airflow
- Increased residual volume
- V/Q Mismatch
- Decreased forced vital capacity (FVC)
- Decreased FEV1/FVC ratio
- Asthma
- Bronchiectasis
- Chronic bronchitis
- Emphysema
Restrictive Lung Diseases
- Poor Breathing Mechanics
- Interstitial Lung Diseases
- Goodpasture's Syndrome
- Eosinophilic Granuloma
- Granulomatosis with Polyangiitis
- Sarcoidosis
- Pneumoconiosis
- Idiopathic Pulmonary Fibrosis
- Drug Toxicity
- Acute Respiratory Distress Syndrome (ARDS)
- Neonatal Respiratory Distress Syndrome
Albuterol (Proventil)
- Short-Acting Beta-2 Agonist
- Bronchospasm
- Asthma
- Angina
- Tachycardia
- Tremor
Beta-2 Agonists
- Short-term Treatment
- Terbutaline
- Asthma
- Tocolysis
- Albuterol
- Asthma
- Long-term Treatment
- Salmeterol
- Asthma
- Chronic Obstructive Pulmonary Disease (COPD)
Bronchiectasis
- Obstructive Lung Disease
- Chronic Necrotizing Infection
- Permanent Airway Dilation
- Poor Ciliary Motility
- Kartagener's Syndrome
- Cystic Fibrosis
- Allergic Bronchopulmonary Aspergillosis
- Hemoptysis
- Increased Sputum
Cromolyn (Mast Cell Stabilizers)
- Mast Cell Stabilizer
- Asthma Prophylaxis
- Bronchial Inflammation
- Allergic Rhinitis
- Cough
- Bronchospasm
- Fixed Schedule Administration
Theophylline
- Asthma
- Inhibits Phosphodiesterase
- Increases cAMP
- Cardiotoxicity
- Neurotoxicity
- Blocks Adenosine Action
Emphysema
- Pink Puffer
- Exhale through Pursed Lips
- Barrel Chest
- Obstructive Lung Disease
- Increased Lung Compliance
- Centriacinar
- Panacinar
Sarcoidosis Characteristics and Labs
- Unknown Mechanism
- Immune-mediated
- Noncaseating granulomas
- Vitamin D activation
- Hypercalcemia
- Elevated ACE
- Asteroid bodies
- X-Ray shows Bilateral hilar lymphadenopathy
- Corticosteroids
Sarcoidosis Symptoms
- Black Females
- Asymptomatic
- Uveitis
- Interstitial Fibrosis
- Erythema Nodosum
- Hepatomegaly
- Myocardial Sarcoidosis
- Lupus Pernio
Acute Respiratory Distress Syndrome (ARDS) Assessment
- Damaged Alveolar-Capillary Membrane
- Restlessness
- Dyspnea
- Refractory Hypoxemia
- Decreased PaO2
- Diffuse Pulmonary Infiltrates
- Atelectasis
- Pulmonary Hypertension
Acute Respiratory Distress Syndrome (ARDS) Interventions
- Closely Monitor Patient
- ABG's (Arterial Blood Gases)
- Oxygen
- Assess for O2 Toxicity
- Mechanical Ventilation
- PEEP
- Assess for Pneumothorax
- Permissive Hypercapnia
- High Mortality Rate
Pulmonary Embolism Causes
- FAT BAT Mnemonic
- Fat
- Air
- Deep Vein Thrombosis (DVT)
- Bacteria
- Amniotic Fluid
- Tumor
- Hypercoagulable
- Central Venous Lines
- Immobilized
Pulmonary Embolism Presentation and Diagnosis
- Sudden onset Shortness of Breath (S.O.B.)
- Tachypnea
- Pleuritic Chest Pain
- Hemoptysis
- Hypoxemia
- Sudden Death
- Gold Standard: CT Pulmonary Angiography
- X-Ray
- D-Dimer
- V/Q Scan
Spontaneous Pneumothorax
- Accumulation of Air in Pleural Space
- Tall and Thin Young Males
- Bleb or Bulla Rupture
- Underlying Disease
- Hypoxemia
- Chest Pain
- Decreased Breath Sounds
- Hyperresonance
- Shortness of Breath (SOB)
Tension Pneumothorax
- Air Enters Pleural Space, but Can't Exit
- Trauma or Infection
- Decreased Breath Sounds
- Trachea Deviates Away from Affected Side
- Chest Pain
- Tachycardia
- Tachypnea
- Hypotension
- Hypoxemia
- Hyperresonance
- Emergency
Chest Tubes: Management and Care
- Confirm suction order
- Crepitus
- Kinking
- Shortness of Breath (SOB)
- Infection
- Excessive bubbling
- If tube dislodges from patient, use petroleum gauze taped 3 ways
- If drainage system is damaged, place disconnected drainage tube in sterile water
Deep Vein Thrombosis (DVT) Characteristics
- Virchow's Triad
- Venous Stasis
- Endothelial Damage
- Hypercoagulability
- Tenderness
- Homan's Sign
- Warmth
- Redness
- Swelling
- Asymptomatic
Deep Vein Thrombosis (DVT) Management
- Compression Ultrasound (CUS) with Doppler
- D-Dimer
- Contrast Venography
- IVC Filter
- Heparin for Acute Management
- Warfarin for Long-term Management
- Thrombectomy/Thrombolysis
- Stockings
- Walking