주말족보 질문 답변드립니다

[sls도우미]

## LC 환자 가장 concern 해야할 증상은?
1)며칠동안 체중이 줄었다
2)배 주위에 혈관이 다 보인다
3)소변이 증가했다

다른 족보문제 중에 하나인데요, 문제를 잘못 갖고 나오신건지...

2번은 기대증상이라고 해야하나 나타날 수 있는 거고
1,3번은 LC증상과 반대로 가고 있어서요

2번은 확인이 필요한 증상입니다.

## chest pain 과 dyspnea 를 갖고 있는 pulmonary embolism 환자 즉각적인 중재로 보기 내용중에position 문제인데요
 

  Bed rest with active and passive range of motion.

-    Keep the patient with fowler position to enhance ventilation.

환자에게 bed rest & ventilation을 위해서 머리를 올린다 입니다.

Morphine are given to reduce chest pain and anxiety.

가슴의 통증과 불안감을 감소하기 위해서 morphine를 줍니다. 

   Assist with turning, coughing, and deep breathing to mobilize secretions and clear airway.
-    Assess respiratory status to detect respiratory distress.
-    Assess cardiovascular status. An irregular pulse may signal arrhythmia caused by hypoxemia. If cause of PE by thrombophlebitis, temperature may be elevated.
-    Administer O2 to enhance oxygenation.
-    Establish an IV line for fluids and drugs.
-    Monitor and record intake and output to detect fluid volume overload and renal perfusion.
-    ABGs monitoring to eval‎uate the need for mechanical ventilation.
-    Monitor laboratory studies because patient on heparin and need to eval‎uate electrolyte, CBC and Hct.
-    Anticoagulant drugs:
-    Heparin (IV): stop further thrombus formation and extended the clotting time, need adjustment for dosage to maintain the activated partial thromboplastine time (PTT).
-    Warfarine sodium (coumadin): may given simultaneously at the beginning or after 5-6  days of heparin therapy, dosage is controlled by monitoring of prothrombin time (PT) or after 5 of heparin therapy.
-    Thrombolytic agents
-    Streptokinase-  lyses thrombi in deep venous system and emboli in pulmonary circulation, causing more rapid resolution of the thrombi/emboli and restoring  pulmonary circulation to normal, improve circulatory and hemodynamic status.
•    Thrombolytic therapy usually followed with heparin and warfarin treatment to prevent additional thrombus formation.
•    Morphine are given to reduce chest pain and anxiety.
•    Diuretics: lasix if right ventricular failure develops.
•    Surgical intervention: embolectomy, inferior vena cava interruption
 
## SARS 는 droplet precaution 에 들어가나요? standard 인가요?

 How SARS spreads The main way that SARS seems to spread is by close person-to-person contact. The virus that causes SARS is thought to be transmitted most readily by respiratory droplets (droplet spread) produced when an infected person coughs or sneezes.

Droplet spread can happen when droplets from the cough or sneeze of an infected person are propelled a short distance (generally up to 3 feet) through the air and deposited on the mucous membranes of the mouth, nose, or eyes of persons who are nearby. The virus also can spread when a person touches a surface or object contaminated with infectious droplets and then touches his or her mouth, nose, or eye(s). In addition, it is possible that the SARS virus might spread more broadly through the air (airborne spread) or by other ways that are not now known.