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D.O.P.E. acronym means? When do we use it?
Dislodgement, obstruction, pneumothorax, equipment
Name the 3 stages of repair for a single ventricle patient
Norwood, Glenn, Fontan
On an intubated patient with a BT shunt, what is one sign (besides hypoxemia) of shunt obstruction?
drop in end tidal CO2 - With an obstruction there is little to no blood going to the lungs. No oxygen/CO2 exchange. So O2 saturations and end tidal goes down.
What is protamine?
Heparin reversal
This medication is used for: chylothorax and GI bleeds
Octreotide
What temperature is blood supposed to be kept at in the bedside cooler?
<6 degrees Celsius. Above 6 is quarantined for clots, and above 10 is thrown out. SO monitor the temperature of the cooler when you check it more so than that
True/False - Breathing stimulates the closure of the PDA?
True
Does intubation help the right or left side of the heart?
Left
What am I?
Jackson Reese. Be careful because potential for unlimited PEEP. MD should use.
If your patient is having a pulmonary hypertensive crisis & is intubated, what will your end tidal do & why?
Decrease. Lack of blood flow through pulmonary vasc. Low flow, little to no CO2 exchange happening
Your patient has an EVD/bolt. Per our policy, (a) what should we do prior to moving the patient, and (b) how long can it be (the answer for A) for?
(A) Clamped (B) 30 minutes
You have a s/p day 3 Glenn patient who started trophic feeds the shift prior. Pt is de-escalating and sedation is being weaned. Chest tube output increases & changes to cloudy serous/white from serosanguinous. What do you suspect?
Chylous effusion
Your pt is post-Glenn, and starts breathing over the vent (tachypnea). Starts to desaturate first and then becomes hypotensive. Why?
CO2 levels drop d/t tachypnea. CO2 dilates vessels in brain. Glenns require permissive hypercapnia for blood flow into the lungs.
You’re patient is post-op Norwood and PD cycling. After dwelling time is complete, you put your PD to drain, but nothing drains. While troubleshooting, your chest tube output increases & changes from bloody to serous.
Notify your provider, chest tube sample should be drawn and sent for glucose check (don’t test using glucometer). In this scenario, the patient needed an x-ray.