Respiratory System
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abnormal sounds superimposed on breath sounds | Adventitious
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collapse of alveoli, preventing the respiratory exchange of carbon dioxide and oxygen | Atelectasis
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visual examination of the larynx, trachea, and bronchi using a rigid or flexible fiber optic bronchoscope | Bronchoscopy
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acute inflammation of the mucous membranes of the nose and accessory sinuses, usually accompanied by edema of the mucus membranes and nasal discharge | Coryza
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short, discrete, interrupted crackling or bubbling sounds; most commonly heard upon inspiration | Crackles
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slightly bluish, gray, or dark purple discoloration of the skin resulting from the presence of abnormally reduced amounts of oxygenated hemoglobin in the blood | Cyanosis
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shortness of breath or difficulty in breathing; may be caused by disturbances in the lungs, certain heart conditions, and hemoglobin deficiency | Dyspnea
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obstruction of blood vessel by a foreign substance; blood clot, fat, or air | Embolism
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accumulation of pus in a body cavity, especially the pleural space, as a result of an infection | Empyema
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hemorrhage of the nose; nosebleed | Epistaxis
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an increase in the severity of a disease or disorder, marked by an increase in signs and symptoms | Exacerbation
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caused by external factors | Extrinsic
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greater than normal amounts of carbon dioxide in the blood | Hypercapnia
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an abnormal condition of the respiratory system that occurs when the volume of air inhaled is not adequate for the metabolic needs of the body | Hypoventilation
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an inadequate, reduced tension of cellular oxygen | Hypoxia
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caused by internal factors | Intrinsic
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an abnormal condition in which a person must sit or stand in order to breathe comfortable or deeply | Orthopnea
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low pitched, grating or creaking lung sounds that occur when inflamed pleural surfaces rub together during respiration | Pleural Friction Rub
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collection of air or gas in the pleural cavity which causes the lung to collapse | Pneumothorax
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musical, high pitched, squeaking or whistle like sound caused by rapid movement of air through narrowed bronchioles | Silibant Wheeze
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low pitched, loud, coarse, snoring sound | Sonorous Wheeze
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pertaining to respiratory effort that is strenuous and struggling; creates a snoring sound | Stertorous
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an abnormal rapid rate of breathing | Tachypnea
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surgical perforation of the chest wall and pleural space with a needle for the aspiration of fluid | Thoracentesis
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power of microorganism to produce disease | Virulent
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Subjective data in a nursing assessment for a respiratory disorder should include | shortness of breath, dyspnea with or without exertion, cough
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Objective data in a nursing assessment for a respiratory disorder should include | chest movement, expansion, signs of distress, nostrils flaring, accessory muscle use, retractions, orthopnea, adventitious lung sounds
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signs and symptoms of a respiratory disorder include | anxiety, decreased ability to concentrate, disorientation, fatique, vertigo, increased pulse
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normal pH range on ABG | 7.35 to 7.45
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normal PaCO2 range on ABG | 35 to 45
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normal PaO2 range on ABG | 80 to 100
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normal HCO3 range on ABG | 22 to 26
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normal Sa02 range on ABG | >92%
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surgical diagnostic procedure used when a sample of lymph tissue from the chest is needed for biopsy | mediastinoscopy
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endoscopic visualization of the larynx only performed under local or general anesthesia | laryngoscopy
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endoscopic visualization of the larynx, tranchea, and bronchi | bronchoscopy
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what instructions should a patient be given before an xray? | remove jewelry, wear hospital gown
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what instructions should a patient be given before collection of a sputum sample? | rinse mouth with water, inhale deeply three times, and cough forcefully and spit sample into sterile container
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what is the purpose of patient education before a CT scan? | to reduce patient anxiety
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this diagnostic lab is performed on sputum or pleural fluid to detect the presence of abnormal or malignant cells | cytology
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this diagnostic procedure is used to determine the severity or progression of a respiratory disease | pulmonary function test
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what kind of syringe is used to obtain an ABG sample? | heparinized
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how large of a sample is needed for an ABG? | 3 to 5 mL
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what test should be performed before an ABG to determine ulnar circulation? | Allen’s test
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how long should pressure be held following collection of an ABG sample? | 5 minutes
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how should an ABG sample be transported to the lab? | in ice water
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what procedure should always be performed following a throacentesis? | Chest xray
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risk for what condition is increased if more than 1500mL of fluid are removed during thoracentesis? | Pulmonary Edema
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Symptoms of this chronic obstructive pulmonary disease usually appear in the late forties; etiology includes changes in the alveolar walls and capillaries leading to decreased pulmonary surface area and inflammation of the bronchi, bronchioles, and alveol | emphysema
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signs and symptoms of emphysema | exertional dyspnea, sputum, use of accessory muscles, pursed lip breathing, barrel chest, wheezing, weight loss
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diagnostic tests for emphysema | PFT, ABG, chest xray, labs, CBC
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medications used to treat emphysema | bronchodilators, antibiotics, corticosteroids, diuretics, oxygen therapy, anti anxiety
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should patients with COPD be encouraged to drink more or less fluid daily and why? | more, to loosen and thin respiratory secretions
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because of issues with exertional dyspnea, emphysema patients should rest 30 minutes before these daily activities | meals
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patient teaching for emphysema should focus on | nutrition and smoking cessation
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Is COPD reversible? | not usually
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what is the clinical definition of chronic bronchitis? | recurrent productive cough for a minimum of three months for at least two years
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etiology of chronic bronchitis includes… | impaired cilia, hypersecretion of mucus, susceptibility to infection, chronic infections leading to scarring and airway obstruction
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signs and symptoms of chronic bronchitis | productive cough worse in the morning, dyspnea, cyanosis, right ventricle failure, polycythemia, cyanosis, dependent edema
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diagnostic tests for chronic bronchitis | CBC, ABG, Pulse Oximetry, PFT, Electrolytes
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medications used to treat chronic bronchitis | bronchodilators, mucolytics, antibiotics
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asthma caused by external factors occurring in response to allergens such as pollens, dust spores, feathers, or animal dander, food, etc. | extrinsic asthma
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asthma stemming from internal causes that are not fully understood, often triggered by URI or emotional upsets | intrinsic asthma
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these factors can influence recurrence of asthma attacks | mental and physical fatigue
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this disease is characterized by increased tracheal and bronchial response to various stimuli | asthma
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acute asthma attacks are caused by the release of …. | histamine
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diagnostic tests for asthma | ABG, PFT, chest xray, sputum culture, CBC, theophylline level
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medications used in the management of asthma | bronchodilators, corticosteroids, leukotriene inhibitors
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medications used for acute asthma attack | bronchodilators, corticosteroids, epinephrine, IV aminophylline, O2
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this manifestation of asthma is fatal if not reversed | status asthmaticus
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a gradual irreversible process of chronic dilation of the bronchi the eventually destroys the elastic and muscular properties of the lung | bronchiectasis
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signs and symptoms of bronchiectasis | dyspnea, weight loss, fever, cyanosis, finger clubbing, coughing, foul smelling sputum
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medical management of bronchiectasis includes | low flow O2, chest physiotherapy, hydration, mucolytics, bronchodilators, antibiotics
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Ringing in ears | tinnitus
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nosebleed | epistaxis
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diagnostic tests to consider in relation to epistaxis | HGB, HCT, Coag panel, Rhinoscopy
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treatments for epistaxis | packing with gauze saturated with epi, cautery, ice, direct pressure
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causes of deviated septum | injuries, infections, allergies, dyspnea
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diagnostic procedures to confirm deviated septum | xray, direct observation
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treatment for deviated septum | surgery, meds to reduce obstruction
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following nasal surgery what should the patient be instructed to avoid | nose blowing, coughing vigorously, valsalvas
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common complaints associated with a diagnosis of allergic rhinitis | sneezing, pruritis, congestion, lacrimation, edema, phontophobia, blurred vision
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exam findings associated with allergic rhinitis | edema, PND, excessive secretions
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diagnostic procedures for allergic rhinitis | skin test, serum radioallergosorbent test
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treatment for allergic rhinitis | antihistamines, decongestants
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uses for antihistamines | allergies, motion sickness, insomnia, reactions, cough
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side effects of antihistamines include | constipation, dry eyes and mouth, blurred vision, sedation
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what are some systemic antihistamines? | azatadine, brompheniramine, diphenhydramine, fexofenadine, loratadine
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antihistamines should be administered how long before exposure to an allergen? | 45 to 60 minutes
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what are some risks with antihistamines? | increase risk of CNS depression, increase the action of anticholinergics, MAOI’s increase action and slow metabolism of antihistamines
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what is the mechanism of action of decongestants? | they are arteriole vasoconstrictors
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what are decongestants used for? | to decrease production of respiratory secretions
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what are some possible side effects of decongestants? | hypertension, dizziness, sedation, headache, tinnitus, thickened secretions, tachycardia, urinary retention
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what are the two most common administration routes for decongestants? | nasal and oral
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what are two nasal decongestants? | flonase, afrin
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what are two oral decongestants? | phenylephrine, pseudoephedrine
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what is an important point of patient education with decongestants? | don’t use more than three days
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what are some common symptoms of laryngeal cancer? | hoarseness, difficulty swallowing, “lump in throat”
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what are some diagnostic exams for laryngeal cancer? | visual exam, CBC, laryngoscopy, biopsy
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what are some treatments for laryngeal cancer? | radiation, surgery
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what is one area of ADL’s that can be severely affected by laryngeal cancer? | eating
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what are common complaints associated with rhinitis? | cough, watery nasal drainage, sore throat
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what are some diagnostic procedures appropriate for rhinitis? | visual exam, cultures
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what medications are commonly used to treat rhinitis? | analgesics, antipyretics, cough suppressants, antibiotics
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what are some common complaints with pharyngitis? | sore throat, fever, chills, malaise, dry cough
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what are some diagnostic procedures appropriate for pharyngitis? | visual exam, culture
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what medications are commonly used to treat pharyngitis? | antibiotics, analgesics, antipyretics
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what are some common complaints with adenoiditis? | sore throat, dysphagia, fever, malaise, noisy breathing
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what are some diagnostic procedures appropriate for adenoiditis? | culture, visual exam(patchy tonsilar exudates)
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what are some common treatments for adenoiditis? | antibiotics, analgesics, surgery
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what are some common complaints with laryngitis? | hoarseness, scratchy throat, persistant cough
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what are some diagnostic procedures appropriate for laryngitis? | visual exam, laryngoscopy
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what are some common treatments for laryngitis? | antibiotics, palliative medications
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what are some common complaints in sinusitis? | headache, sinus pain, tenderness, pressure, and prurulent discharge
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what are some diagnostic procedures appropriate for sinusitis? | xray, transillumination
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what are some common treatments for sinusitis? | surgery, antibiotics, analgesics, antihistamines, vasoconstrictors, warm moist heat
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what are some common complaints in tonsilitis? | sore throat, fever, chills, malaise, enlarged tonsils with prurulent discharge
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what is the most important diagnostic procedure to consider in tonsillitis? | culture (especially strep)
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what are some common treatments for tonsilitis? | surgery, antibiotics, analgesics, antipyretics
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what are some common complaints in peritonsilar abcess? | pain and difficulty swallowing, fever, malaise, ear pain, *****DIFFICULTY TALKING*****
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what are some diagnostic tests appropriate for peritonsilar abcess | visual exam, culture
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what are the treatments for peritonsilar abcess? | surgery, antibiotics
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what are some common complaints with bronchitis? | productive cough, low grade fever, ****rhonchi and wheezes****, dyspnea, chest pain, headache
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what are some diagnostic tests appropriate for bronchitis? | xray, sputum culture
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what are the treatments for bronchitis? | bronchodilators, andtibiotics, cough suppressants, antipyretics
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what are some common complaints in legionanaires’ disease? | high fever, headache, nonproductive cough, diarrhea, malaise
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what are some signs and sypmtoms of advancing legionnaires’ disease? | tachypnea, crackles and wheezing, shock, hematuria and renal failure
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what are some diagnostic tests appropriate for legionnaires’ disease? | cultures, xray
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what are the treatments for legionairres’ disease? | antibiotics, rifampin, anatipyretics, vasopressors and inotropes
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what type of environment does legionnaires’ usually live in? | moist (air conditioners, hot tubs, steam rooms)
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what is the most lethal type of anthrax? | inhalational
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what are the three types of anthrax? | cutaneous, gastrointestinal, inhalation
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what are the treatments for anthrax? | antibiotics (ciprofloxacin); previous vaccination increases survival rate
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through what route is tuberculosis transmitted? | inhalation
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a positive PPD with negative chest xray indicates what? | inactive tuberculosis infection
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what is a common factor in the conversion from inactive to active TB infection? | immunosuppression
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what type of room should a patient with TB be in? | negative pressure
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what are the treatments for TB? | isoniazid, rifampin, ethambutol, rifapentine
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what is an important point of patient education for rifambin? | turns body fluids red
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what common substance has a known drug interaction with isoniazid? | alcohol
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what are some common causes of pneumonia? | bacteria, aspiration, viral, fungal chemical
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what are diagnostic tests appropriate for pneumonia? | cultures, xray, cbc, pft, abg
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what are some treatments for pneumonia? | antibiotics, O2, analgesics, antipyretics, expectorants, bronchodilators, physiotherapy, humidification
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what are some factors that make older adults more susceptible to pneumonia? | drier mucous membranes, kyphosis, muscle weakness, reduced airway elasticity, inactivity, immobility
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what is the action of an antitussive? | suppresses cough reflex
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what is the action of an expectorant? | reduces viscosity of respiratory secretions
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inflammation of visceral and parietal pleura | pleurisy
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what are some symptoms of pleurisy? | pain on inspiration, fever, dry cough, dyspnea
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what are some diagnostic tests appropriate for pleurisy? | xray, auscultation(pleural friction rub)
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Empyema is another word for | pleural effusion
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how is pleural effusion treated? | thoracentesis, chest tube
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collapse of lung tissue | atelectasis
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what are some causes of atelectasis? | shallow breathing, copious secretions, aspiration, hypoventilation, tumors
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what are some diagnostic tests for atelectasis? | xray, ABG, Bronchoscopy
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what are some treatments for atalectasis? | chest tube, deep breathing and coughing, intubation
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edema of respiratory mucosa combined with excessive mucous production causing chronic airway obstruction | asthma
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drugs that produce bronchodilation by mimicking the effects of the sympathetic nervous system | adrenergics
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what are some commonly used bronchodilators? | albuterol, salmeterol, terbutaline
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drugs that reduce symptoms of asthma by reducing inflammation in the airways | corticosteriods
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beclomethasone, flunilolide, and triamcinolone are all examples of | corticosteroids
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these two antiasthmatic classes reduce the release of substances that can lead to bronchospasm | leukotriene receptor antagonists and mast cell stabilizers
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common side effects of antiasthmatics | tremors, anxiety, throat irritation
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when administering both a sympathomimetic and corticosteroid inhaler, what is the proper sequence? | sypathomimetic (bronchodilator) first, then wait five minutes and administer corticosteroid
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what is the minimum waiting time between aerosol inhaler administrations? | 1 minute
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you should wait three to five minutes between administrations of these two inhaled medications | isoproternol and epinephrine
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you should wait at least ten minutes after the administration of this inhaler before giving another | metaproternol
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this class of antiasthmatic is commonly used as a daily therapy for long term asthma management | leukotriene antagonists
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what are some examples of adrenergic bronchodilators? | albuterol, epinephrine, salmeterol, terbutaline
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what time of day should once daily doses of xanthines be administered? | morning
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air or gas in the pleural space, causing the lung to collapse | pneumothorax
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buildup of air in the pleural space, causing interference with the ability of the heart and lungs to fill | tension pneumothorax
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signs and symptoms of pneumothorax | decreased or absent breath sounds, abnormal chest movement
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diagnostic tests appropriate for pneumothorax | xray, abg
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most common type of lung cancer | non
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accumulation of serous fluid in interstitial lung tissue and alveoli | pulmonary edema
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hallmark symptom of pulmonary edema | pink, frothy sputum
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non cardiogenic pulmonary edema | ARDS
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flow setting for nasal cannula in a COPD patient | 2 to 3 LPM
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