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Respiratory mtc 265

respiratory lecture for mtc 265

Bronchography is radiopaque dye covers the bronchial mucosa. It enables visualization of the tracheobronchial tree It is used to identify bronchiectasis
Angiography is IV radiopaque dye, visualize the pulmonary vessels. Pulmonary angiography may be done on patients with suspected pulmonary embolism when the lung scan is inconclusive.
What diagnostic test is used to identify bronchiectasis? bronchography
What diagnostic test is helpful in making the diagnosis of pulmonary embolism? lung scan
Lung scan is performed, how? by injecting technetium IV (nuclear tracer dose)
Lung perfusion scan- is use to visualize clots and check if circulation to carry oxygen to the cells is present
Sputum cytology -cell studies that identify malignancy in cell structure
signs and symptoms of hypoxia restlessness, increased pulse and respiration
signs and symptoms of hypercapnia headache, confusion, bounding pulse, warm sweaty extremities
Signs of increased work of breathing accessory muscles, flaring nostrils, sternal retraction, increased respirations, expiratory grunt
risk factors for COPD cigarette smoke, environmental, genetic factors, secondhand smoke, infection
COPD pathology chronic bronchitis and Emphysema
Emphysema is destruction of the walls of the overdistended alveoli which results in impaired gas exchange
Chronic bronchitis is xcessive accumulation of mucous secretions block the airway
Primary Symptoms of COPD: include dyspnea, chronic cough, and sputum production
Auscultation of a COPD patient; would be what? Dry crackles may be heard at the bases and wheezes may be heard with forced expiration
Typical clinical picture of a COPD patient increased respiratory rate, rapid shallow respirations, use of accessory muscles (in abdomen or neck), limited diaphragmatic excursion (the diaphragm is flattened)
What is the typical oxygen therapy for a COPD patient? oxygen flow of 2-4 liters via nasal cannula or 40% Venture mask
What type of diet does a COPD patient have? high calories and high protien
Bronchodilators Medications for COPD Albuterol (Proventil,Ventolin) Theophyllines-reduces smooth muscle bronchospasm (Aminophylline by IV infusion, elixophylline PO). Theodur
How is tuberculosis transferred (route)? airborne
what are some of the ways you can transfer Tuberculosis (TB)? by laughing, coughing, sneezing, whistling or singing
what is the percent of people that actually become infected from TB? 5-15 percent
What are the factors that influence TB disease after exposure? Virulence of the strain, health of the individual, and the lenght of exposure
what type of people body's resistance is low with TB? malnutrition, aging, and people with infectious diseases (HIV)
Why does Bacillus calmette guerin (BCG) vaccines cause a false positive? Live virus vaccine
what type of TB test is used for first screening of healthcare workers 2 step TB TB skin test
What type of mask does healthcare workers wear when entering a respiratory isolation room? HEPA filter mask
Where can TB spread to within the body? Brain, meninges, liver, kidney or Bone marrow
When does infected people, become infectious? when the manifestations of disease occurs
What are the symptoms of TB? cough with hemoptosis, weight loss, anorexia, night sweats, fever, chills, shortness of breath, progressive fatigue and dulling aching chest pain.
What confirms the diagnosis of TB? sputum culture
What does it mean when the TB skin test measures 10 mm in diameter or more? Exposure the TB
What is a positive skin test measurement for a HIV patient? 5mm or more
How long should a patient with TB be on medication? 6 months
How many sputum test for TB needs to be done before patient is no longer infectious? 3 negative sputum specimens
How can TB grow and spread within the chest cavity? tracheobronchial lymph nodes
What other parts of the body can TB spread too? brain, meninges, liver, kidney or bone marrow
How long is the treatment for a TB patient? 6 month to 12 month
How many negative sputum test a TB patient need to have in order to be no longer infectious? 3 negative sputum specimens
What are the first line of medication for TB patients? Isoniazid (INH), Rifampin, Ethambutol, Pyrazinamide
Which TB medication will turn your urine red or orange? Rifampin
What TB medication causes problems with visual acuity? Ethambutol
When does a TB patient become non-infectious on medication? after 2-3 weeks
what population should be treated with a nine month course of NH (Isoniazid)? HIV
Bronchiectasis means A disorder characterized by permanent, abnormal dilation of one or more of the large bronchi
What are the predisposing factors for bronchiectasis? obstructive processes such as lung masses, thick secretions found in cystic fibrosis or bronchitis, and aspirated foreign bodies
S/sx bronchiectasis chronic cough and production of thick (copious mucopurulent) sputum, hemoptysis recurrent pneumonia accompanied by crackles, rhonchi, and wheezing
Treatment for bronchiectasis Antibiotics, bronchodilators, and expectorants
TB skin test: indicates exposure, when it measures? "10 mm or more
What is the next test given, when you have a positive TB skin test? chest x-ray, to determine active lesions
Symptoms of TB cough with sputum that may be streaked with blood, weight loss, anorexia, night sweats, fever, chills, shortness of breath, crackles or wheezes, progressive fatigue, dull aching chest pain
Why can't a patient with total laryngectomy aspirate because the airway has been completely separated from the esophagus
What are the risk factor for TB? close contact with someone who has not been
Major risk factors for cancer of the larynx? smoking and alcohol
What are the diagnostic test to determine laryngeal cancer? CAT for location or MRI for invasion
What is the purpose of a biopsy using a panendoscopy? to confirm the diagnoses and stage the cancer by the TNM method
What are the early S/S of laryngeal cancer? Hoarseness pain or burning in the throat when drinking hot liquids or citrus juices, lump in the neck
What are the later S/S of laryngeal cancer? difficulty swallowing or breathing (dyspnea), unilateral nasal obstruction or discharge, persistent hoarseness, or foul breath, weight loss, general debilitated state, and pain radiating to the ear
What is the major health problems of laryngeal cancer? risk for ineffective breathing patter related to impaired airway
What are the side effects of radiation for cancer of the larynx? hoarseness, sore throat, and difficulty swallowing, skin may get red and tender,
What is the partial laryngectomy? only one vocal cord is involved
Why is the Total laryngectomy done? performed for cancer that extends beyond that vocal cords or cancer that persists after radiation therapy
Nodal neck dissection is removal of the tumor, lymph nodes, the sternocleidomastoid muscle, the jugular vein, 11th craninal nerve and surrounding soft tissue
What is the affect of nodal neck dissection on the 11th cranial nerve? causes the shoulder to drop
What causes you to have a permanent tracheal stoma? total laryngectomy
What are the three types of communication after laryngectomy? esophageal speech, electric larynx, and tracheoesophageal
what is used to cleanse a stoma of a laryngectomy? saline
How long does a tracheal stoma heal? 3-6 weeks
What is the initial nutritional treatment for a laryngectomy patient? may have IV fluids, enteral feedings by PEG or NG or TPN
What should nurses assess frequently for, when new nutritional things are introduce for a laryngectomy patient? swallowing difficulties
What are the complications of laryngectomy surgery? hemorrhage, infection or wound breakdown
Why can't a total laryngectomy patient aspirate? airway has been completely separated from the esophagus
How long is the initial nutritional treatment for a laryngectomy patient 10-14 days
What are the risk factors for lung cancer? smoking, passive smoke and occupational exposure
What are the four types of lung cancer? small cell (oat cell), non- small cell (squamous cell), adenocarcinoma and large cell carcinoma
How is lung cancer spread? direct extension, the lymph system, or blood
Symptoms of lung cancer? Hoarseness, cough, sputum production, hemoptysis (later finding), shortness of breath or change in endurance, purulent or rust colored sputum
What is a late symptom of lung cancer? pleural effusion which is fluid in the pleural space
what are the Diagnostic tests for lung cancer? Chest x-ray, CAT scans, bronchoscopy, needle biopsy, and direct surgical biopsy, MRI
What is the purpose of radiation treatment in lung cancer patients? to shrink the tumor
After radiation treatment, how long should they avoid sun exposure? at least a year
How many chest tubes would be inserted after a Pneumonectomy? two
When a pleuravac is in place, how much drainage is to much? 100 ml/hr
What does it mean when there is no fluctuation in the second chamber of pleuravac? may indicate the chest tube is obstructed or no more air is leaking into the pleural space
What supplies are keep at the bedside, when a patient has a chest tube? sterile gauze and padded clamps
in a Pneumonectomy, what is a tissue flap used for? no air can leak through the stump.
what will happen with a pneumonectomy patient, if they lay on the operative side? erous fluid can go into the remaining lung and drown the patient
What is the best position for a pneumoectomy patient post op? supine and semi fowlers
When is the best to implement ambulation for a pneumoectomy patient post op? second or third postop day
When a lung scan is inconclusive at diagnosis of pulmonary embolism, what else can be used? pulmonary angiography
hypoxic patient PO2 level is consistently below, what? 50
What is the best delivery of oxygen? non rebreather
what is the most important things a nurse can impliment for a patient schedules for a bronchoscopy? pt is NPO
what does a pulmonary function study indicate evaulates lung function and breathing problems
what is the most accurate test for asthma pulmonary function test
what conditions is a COPD patient more at risk for? respiratory infections, hypoxemia, acidosis, and cardiac failure
what is the ratio of FEV/FCV need to be defined as a obstructive disease (COPD) less than 70%
what is hemoptysis blood in the sputum
crepitus is air trapped in and under the skin
what is the first nursing interventation for a COPD patient? improve gas exchange
how is smoking history expressed packs per day times the number of years
what do ronchodilators do? relieve bronchospasm, reduce airway obstruction and aid in secretion clearance
what is the purpose of mucolytics? liquefy and loosen thick mucous secretions so they can be expectorated.
what side effect can Theophylline cause for a COPD patient? lower BP and cause arrythmias
what is the therapeutic range for Theophylline? 10-20 ug/ml
cor pulmonale is right sided heart failure caused by pulmonary disease
what are the risk factors for a TB exposure? close contact with TB patient, immunocompromised people, living in crowded conditions, low socioeconomic group, foreign immigrats, older or homeless, IV drug abusers
what is the biggest nursing interventions for a TB patient on medications? patient teaching for drug therapy adherence and infection control
leukotriene antagonists used of COPD montelukast
what are the side effects of Isoniazid(INH) hepatitis, neurotoxicity, and peripheral neuropathy
what can be given to a TB patient on isoniazid to reduce peripheral neuropathy? vitamin B6
Created by: 597389573
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