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Resp Med-Surg BOCES
Respiratory
| Question | Answer |
|---|---|
| What is a pneumonectomy? | Removal of a lung |
| What is epitaxis? | Nosebleed |
| What are s/s of pulmonary edema? | Pink, frothy sputum, dependent edema, weight gain, cyanosis, dyspnea, tachypnea, tachycardia, restlessness |
| What is a pleural effusion? | Collection of fluid in pleural space |
| What precautions are used when admitting a patient with TB? | Airborne precautions, negative pressure room |
| What is a thoracentesis? | Puncturing of the chest wall into the pleural space to drain fluid or air |
| What are s/s of lung cancer? | Hemoptysis, dyspnea, fever, chills, wheezing, fatigue |
| What are s/s of laryngeal cancer? | Hoarseness, pain that radiates to ears, dysphasia, enlarged cervical lymph nodes, dyspnea |
| How is TB diagnosed? | AFB's x3 |
| When should a nurse or resp therapist obtain a sputum sample? | Early morning before meals |
| What is cor pulmonale? | failure of the right side of the heart brought on by long-term high blood pressure in the pulmonary arteries and right ventricle of the heart. |
| What are s/s of cor pulmonale? | Shortness of breath or light-headedness during activity is often the first symptom. Fast, bounding heart beat,chest pain, dependent edema,distended neck veins,cyanosis |
| What could constant bubbling in the water seal chamber of chest tube drainage system indicate? | Air leak between pt and water seal |
| S/S flail chest | Inward movement of chest on inspiration, eneven respirations, severa chest pain, dyspnea,cyanosis, tachycardia, hypotension, shallow resp, tachypnea, monitor s/s and O2 SATs |
| Tx Flail chest | Cough, deep breath, Pain meds, Bed rest, High Fowlers's, O2, monitor s/s and O2 SATs |
| S/S pneumothorax | SOB, Asymetric resp, mediastinal shift, hypotension, tachycardia, cyanosis, AMS, Change LOC, crepitis |
| Tx pneumothorax | Pressure dressing over chest wound, O2,High Fowler's, chest tube, monitor s/s and O2 SATs |
| S/S Respiratory Failure | Dyspnea, headache, AMS, restlessness, tachycardia, cyanosis, dysrythmis, decreased LOC |
| Tx Resp Failure | Identify/Tx cause, O2, high Fowler's, deep breathing, bronchodiltors, prepare for mech vent |
| S/S ARDS | Tachypnea, Decreased LOC, Dyspnea, Decreased breath sounds, deteriorating ABG's, hypoxemia resistant to O2 tx |
| Tx ARDS | Diuretics and steroids, Tx cause, O2, High Fowler's, restrict fluid intake as prescribed, resp tx's as prescribed, prepare for mech vent |
| What is empyma? | Pus in pleural space |
| What group of diseases comprises COPD? | Emphysema, asthma, bronchiectasis, bronchitis |
| What is the hypoxic drive associated with COPD? | Stimulus to breath is low O2 instead of High CO2. |
| S/S COPD | Productive cough, exertional dyspnea, wheezing, crackles, weight loss, barrel chest (emphysema), use of accessory muscles, cyanosis, clubbing of fingers, orthopnea |
| Nursing interventions COPD | Monitor VS, Admin O2, resp tx as prescribed, assist P/T, monitor SATs, reposition, teach pursed-lip breathing, monitor sputum, suction prn, monitor weight, encorage small frequent meals/rest prior, High calories, encourage fluids, high Fowler's |
| Med Tx COPD | Steroids, bronchodilators, mucolytics, antibiotics with infections |
| Teaching for COPD pts | Smoking cessation, s/s hypoxia and infection, rest periods with activity and before meals, small frequent meals, proper diet, breathing techs, all meds and vaccines |
| What is status asthmaticus? | Asthma attack that doesn't respond to bronchodilators and is life-threatening. |
| S/S pneumonia | Fever, chills, decreased LOC, absence LS, productive cough (can be brown, green, yellow sputum). |
| What causes a pulmonary embolism? | Thrombus from deep vein breaks free and travels through right side of heart and lodges in branch of pulmonary artery. |
| What is a lobectomy? | Removal of lobe of lung |
| Describe post-op recovery for laryngectomy | Partial - voice temp hoarse but preserved, able to swallow Radical - refer to speech therapy for possible voice restoration to lesser degree, able to swallow, permanent stoma, pencil/paper for communication immediate post-op, caution with swimming/shower |
| Post-op care for tonsillectomy | Ice collar; no coughing, gargling or clearing throat; progress diet as tol - ice chips, popsicles; constant swallowing indicates bleeding |
| Tx epitaxis | Direct pressure 10 minutes, pack loosely with gauze, cold compress to nose, suck on ice chips, tilt head forward, topical epinephrine promotes vasocronstriction, cuterize |
| S/S CF | Salty-tasting skin, cough, frequent lung infections, SOB, poor growth/weight, greasy/bulky stool |
| How constitues a negative PPD (mantoux)? | Less than 5mm swelling at site |
| What do antipyretics do? | reduces fever |
| What do mucolytics do? | Loosens/thins secretions (lungs) |
| What do corticosteroids do? | Reduces inflammation and the bodies immune response. Similar to natural hormone cortisol produced by adrenal glands. |
| What do antitussives do? | Suppress cough |
| What do antihistamines do? | They block the ability of histamine to bind to receptors. Histamine causes a local reaction: swelling. Swelling in the nasal cavity causes mucus secretion. This response also causes hives )scattered skin swellings). |
| What do OTC's do for colds and pneumonia? | OTC's reduce symptoms but do not cure |
| What do decongestants do? | Constricts blood vessels thereby reduces swelling of mucous membranes. Contraindicated in hypertension, glaucoma and enlarged prostate. |
| What do bronchodilators do? | Relaxes smooth muscle in bronchiole airway to open up passages. Constricts arterioles. |
| What are the recommendations by the CDC for pneumo vacs? | Once before age 65 for populations at risk. Once over 65 for general population. If given prior to age 65, repeat after 65 with at least 5 year interval between vaccines. |
| S/S hypoxia | Restlessness, tachycardia, drowsiness, confusion, irritability |
| Need to know for suctioning | Hyperoxygenate, monitor O2 SATs, sterile procedure, no more than 3 passes, no more than 10 seconds each pass |
| What can be poor consequences of using nasal spray decongestants? | Rebound stuffiness |
| S/S pulmonary embolism | Pain and dyspnea, nursing assess O2 SATs and LS |
Created by:
shocklori
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