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68C/LPN

Respritory test 5

QuestionAnswer
PT presents to the emergency room s/p motor vehicle collision (MVC) with the complaint of shortness of breath decreased breath sounds on the left and you note a tracheal shift to the right. What would this patient most likely be diagnosed with? Pneumothorax
87% of all lung tumors are related to smoking
____________is very aggressive and occurs in approximately 20% of patients diagnosed with lung cancer: small cell Lung cancer
Which of the following are considered nursing interventions related to a patient who is post op Left upper lobe lobectomy DVT prophylaxis Assess vital signs frequently Assess chest tube for patency Cough and deep breathe
Central lesions within the lung originate from where and manifest with which symptoms? Large branch of bronchial tree; wheeze, hemoptysis, fever
Nursing interventions related to the nursing diagnosis “airway clearance, ineffective, related to lung surgery” include which of the following. HOB at 30-45 degrees Encourage early ambulation
examples of Pulmonary edema are from all of the following. except which one? Bleach inhalation Fluid resuscitation of 10L Normal Saline Opiate overdose *Right ventricular failure* (RT ventricle is not an example of PE)
All of the following are medications used in the treatment of pulmonary edema except: Morphine Lasix *Nifedipine belongs to a class of medications called calcium channel blockers (CCBs) that are used to treat angina (heart pain), high blood pressure, and abnormal heart rhythms
Which of the following are related to the patient teaching of a patient with pulmonary edema? Select all that apply: Answers: -Teach effective breathing techniques -Teach the importance of continuing to take all medications even when feeling better -Assess patients understanding of medication regimen
Which of the following is NOT a risk factor for the development of a pulmonary embolism? Patients with a history of thrombophlebitis Women taking contraception long term Recent surgery *History of asthma(asthma does Not put PT at risk for Pulmonary Emboli)
Which of the following diagnostic test is considered the “gold standard” used in the detection of PE? Pulmonary arteriogram
True or false? Heparin is given in the treatment of PE to facilitate the breakdown of the clot. False heprin helps prevent clots but not used to break them down.
Low molecular weight heparin (Lovenox) requires frequent laboratory monitoring of coagulation values such as aPTT. False
Altered sensorium in ARDS is related to which of the following ABG values: Increased PaCO2; Decreased PaO2
Initial clinical manifestations of ARDS usually manifest during what span of time? 12-24 hours post injury
The LPN is providing teaching for a patient who has a positive PPD (mantoux) test and has received a prescription for isoniazid (INH). Which of the following statements made by the patient indicates the need for further teaching? *I will take Vitamin B12 with this medication.(wrong)*B6notB12 Correct responses: I will not drink alcohol while on this med/I plan to be on this med for 6 months/schedule a follow up appointment with my doctor to evaluate for possible side effects.
Which of the following are considered nursing interventions related to a patient who is post op Left upper lobe lobectomy. Select all that apply: Cough and deep breath DVT prophylaxis *Encourage bed rest(NO/Wrong) Assess vital signs frequently *Send pleural fluid for lab analysis Q12(Wrong) Assess chest tube for patency
You are assessing a patient and the lab has called with the following ABG results: pH 7.32, PaCO2 55, PaO2 65, HCO3 24. The nurse interprests this ABG as: Respiratory acidosis
Interpret the following ABG: pH 7.30, PaCO2 33, PaO2 87, HCO3 18 Metabolic acidosis
You are caring for a patient who is undergoing a thoracentesis at bedside for a large left pleural effusion. You are aware that the recommended amount of fluid for removal at one time should be less than: 1300-1500ml
Normal ABG values pH: 7.35-7.45 PaCo2: 35-45 HCo3:21-28
instrinsic vs extrinsic for astma include what? internal factors vs external factors
what does a patient with stertorous breathing sound like and look? heavy snoring, straining to breath, effort of breathing
what is an Allen Test used for? occluding the ulna and radial artery and releasing the unla artery to assure that blood flow is proficiant. ABGs are drawn in the radial artery.
what is a Hypercapnic patient? a patient with HIGH Co2
how does Histamine 1(H1)receptor effect the body? Mediates smooth muscle contraction and dialation of capillaries.
how does Histamine 2(H2)receptor effect the body? mediates acceleration of the the heart rate and gastric acid secretions
Diphenhydramin (Benadryl) Azatadine(Opimine) Dimenhydrinate(Dramamine) Promethazine(Phenergan) Brompheniramine(Dimetane) NON-SEDATING -Fexofenadine(Allegra) -Loratadine(Clairitin) are all examples of what? Traditional Antihistamines
apple juice, grapefruit juice,oragnge as well as ST. Johns Wart have potential to do what to antihistamines? effects may be potentiated excessively with interation
how high can you set an oxygen flow rate for a patient with COPD? no more then 3 liters
Adenergics topical corticosteriods and anticholinergic are all examples of 3 seperate types of what? Nasal Decongestants
Regulation of respiration originates from where? Nervous Control-medulla oblongata and pons of the brain; chemoreceptors-in the carotid and aorta
Reasons you may perform extensive respiratory assessment. Chronic respiratory or cardiac conditions. History of respiratory impairment related to trauma. Recent surgery or anesthesia.
Chest Radiographs (Roentgenogram) is a diagnostic test for what? To visualize the lungs and major thoracic vessels.Identifies lesions, infiltration, foreign bodies, or fluid Shows disorder involving the parenchyma or interstitial spaces. Confirms pneumothorax, pneumonia, pleural effusion, and pulmonary edema.
Computed Tomography (CT)is a diagonostic test that does what? Scans the lungs Requires patient teaching to decrease anxiety. Can be viewed diagonal or cross-sectional
Pulmonary Function Test (PFT)is a diagnostic test that is done for what? Performed to assess the large and small airways. Obtain information on lung volume, ventilation, pulmonary spirometry and gas exchange. Lung volume; inspiratory capacity; and total lung capacity
Mediastinoscopy is a diagnostic test done for what? Surgical endoscopic procedure to obtain lymph nodes for biopsy for tumor diagnosis. Performed under general anesthesia
Laryngoscopy is a diagnostic test done for what? Allows for direct or indirect visualization of larynx. Requires local or general anesthesia.
Bronchoscopy Diagnostic examination of the tracheobronchial tree for: Abnormalities. Tissue biopsy. Secretions for cytological or bacteriological studies. Patient treated as surgical patient
Sputum specimen is a diagnostic test done for what? Obtained for microscopic evaluation.
Thoracentesis is a diagnostic test done for what? Surgical perforation of the chest wall and pleural space with a needle for the aspiration of fluid *Risk for subsequent pulmonary edema due to fluid shifts if >1300 mL removed within a 30 minute period.
Medical managment for epistaxis Nasal packing with cotton saturated with Epinephrine 1:1000 Cautery Posterior packing ICE is always 1st to help control bleeding.
QUESTION: If the patient has an epistaxis, the correct nursing intervention(s) would be to: *Apply ice over nose* KNOW! keep patient quiet sitting position lean forward direct pressure to soft portion of nose 10-15 minutes
What are three possible diagnostic tests used to diagnose allergic rhinitis? Physical exam Skin testing Serum radioallergosorbent test (RAST)
what is the name of the diagnostic test done for sleep apnea Polysomnography.
medical managment for sleep apnea Mild sleep apnea – conservative management. Moderate to severe sleep apnea. Nasal continuous positive airway pressure (nCPAP). Bi-level positive airway pressure (BiPAP).
antihistamines do not treat what? hypertension
appropreiate for first 24 hour post nasal surgery. apply ice to decrease edema elevate HOB change drip/nasal dressing.
QUESTION: Antihistamines should be administered how long before an exposure? 45 to 60 minutes before exposure to an allergen
QUESTION: When assessing a patient who is to receive a decongestant, the nurse will recognize that a potential contraindication to this drug would be: glaucoma.
Question: A nurse is preparing to attempt to relieve an airway obstruction in a 43-year-old conscious male. The nurse performs this maneuver by placing the hands between the: Umbilicus and the xiphoid process
Question: A nurse is assisting in caring for a client with a newly inserted tracheostomy. The nurse reviews the care plan and nursing diagnosis of Ineffective airway clearance. The nurse should monitor for which item as the best indicator of an adequat a. Moderate amounts of tracheobronchial secretions b. Small to moderate amounts of frank blood suctioned from the tube c. Respiratory rate of 18 breaths per minute d. Oxygen saturation of 89% C is best answer
causes of Emphysema include: Causes Primarily cigarette smoking Air pollution Age May lead to cor pulmonale
Bronchodilators Antibiotics Corticosteroids Diuretics Oxygen therapy Anti-anxiety agents are medical managments of what? Medical Management and Medications for Emphysema
describe Chronic Bronchitis Recurrent chronic productive cough for a minimum of three months for at least two years Chemical irritants or bacterial or viral infection Smoking is the most common cause
these are examples of Clinical Manifestations to what? Productive cough most pronounced in the morning Dyspnea Cyanosis and right ventricle failure Polycythemia Cyanosis Dependant edema Chronic Bronchitis
medical managment and medication of Chronic bronchitis include: -Medical Management Aimed at minimizing disease progression and facilitating optimal air exchange -Medications Bronchodilators Mucolytics Antibiotics
these diagnostic tests are done for what respritory disorder? ABG PFT’s Chest x-ray Sputum culture CBC Theophylline level Asthma
what is Bronchiectasis? A gradual irreversible process of chronic dilation of the bronchi Follows repeated lung infections Secondary to failure of normal lung tissue defenses Complication of inflammation
Bronchodilators: Examples: albuterol (Proventil, Proventil HFA) salmeterol (Serevent) terbutaline (Brethaire) Corticosteroids: Examples: beclomethasone (Beclovent) flunisolide (Aerobid) triamcinolone (Azmacort are all examples of: Antiasthmatics
Leukotriene Antagonists are used for what? long-term control agent in the management of asthma Prevention and chronic treatment of asthma. Management of seasonal allergic rhinitis. Prevention of exercise-induced bronchoconstriction in patients 15 yr and older. -Med example (Singulair)
QUESTION: A patient has prescriptions for two inhalers. One inhaler is a bronchodilator, and the other is a corticosteroid. Which instruction regarding these inhalers is correct? The bronchodilator should be taken first.
Adrenergics are used for what? Used as a bronchodilator to control and prevent reversible airway obstruction Used as a quick-relief agent for acute bronchospasm Used as a long-term control agent
Adrenergics include what reactions? Action Binds to beta 2-adrenergic receptors in airway smooth muscle Relaxation of airway smooth muscle with subsequent bronchodilation. Relatively selective for beta2 (pulmonary) receptors. Therapeutic Effects: bronchodilation.
QUESTION: A patient is in an urgent-care center with an acute asthma attack. The nurse expects that which medication will be used for initial treatment? A beta2 agonist, such as albuterol (Proventil)
: A patient with an asthmatic attack is seen in the emergency room. The patient had been maintained on theophylline. A blood sample was drawn to obtain a theophylline level, which was subtherapeutic. This level indicates the patient is: noncompliant in taking the drug Subtherapeutic medication levels can result in an asthmatic attack.
Air or gas in the pleural space, causing the lung to collapse is a result of? Pneumothorax
Defined: Passage of a foreign substance into the pulmonary artery or its branches Blood clot, fat, air, amniotic fluid, shrapnel results in what? blood loss past the obstructed part.
risk factors for PE include Prior thrombophlebitis Recent Surgeries Contraceptives or recent pregnancy/childbirth. Hx of heart failure, obesity, or immobilization
Question: What are the antidotes for heparin and Coumadin? Answer: Protamine sulfate and vitamin K.
ARDS acute respritory distress syndrome Etiology/Pathophysiology include what? Also called non-cardiogenic pulmonary edema Secondary to an acute disease process, a syndrome of pulmonary shunting , hypoxemia, reduced lung compliance and parenchymal lung damage.
early manifestation of Larynx cancer include: persistant hoarseness in thrat
appropriate medication for Sinusitis Afrin
The following tests can confirm a diagnosis of legionnaires disease Blood and sputum cultures
what is used to determine past or present exposure to TB Mantoux skin test
Post Op patient vomites and aspirates emesis. what should the nurse be concerned for? aspiration pneumonia
most important infection control for you AND PATIENT is what? hand washing
elderly developing pneumonia is more likly because: loss of elasticity in diaphram and intercostal muscles.
what is PLEURISY? inflammation of visceral and parietal pleural
True or false hyperventalation is a cause of atelectasis. False HYPOventalation is a cause atelectasis.
Magans asthma is triggered by an upper respiratory infection and emotional upset. This is termed: Intrinsic asthma : from internal causes. it is not fully understood, but often it is triggered by URI's and emotional upset.
A severe for of asthma in which the airway is obstructed and the asthma is unresponsive to drug therapy is: Status Asthmaticus: is a severe, unrelentin, life threatening attack that fails to respond to usual treatment.
Dave is in an urgent-care clinic with an acute asthma attack. The nurse expects which of the following medications will be used for INITIAL treatment? Beta-agonists med and corticosteroids are commonly used durin the acute phase of an asthamatic attack to quicly reduce airway constriction and restore airflow to normal.
you are assigned a PT who has been placed on a bronchodilator. What are the 3 most common respiratory disorders bronchodilators are used to treat? Bronchial Asthma, chronic bronchitis, emphysema
How will a bronchiodilator going to help PT with emphysema? it causes relaxation of smooth muscles of bronchial tree
What is the emergency treatment of choice when treating a pneumothorax Thoracotomy chest tube placement
WHich factors can be associated w xanthine derivative medications (a bronchodilator) May cause seizures and or arrhythmias
primary lung tumors usually metasize to which structures? Bone and Esophagus
Which conditions can lead to pulmonary edema? Severe left ventricular failure and rapid administration of IV fluids
Medical Management of Pulmonary Edema IV Nitroprusside
Class of resp drug used for pt w/ acetaminophen overdose Mucolytic
O2 flow rate of Nasal Cannula 2L/min (standard 2-3L/min for COPD)
oxygen delivery systems which deliver 60-80% O2 concentration Partial Rebreather face mask
Goal of O2 therapy O2 therapy is given to increase the efficiency of the respiratory system
Bronchioscopy post-op care Observation of edema of the throat, NPO until gag reflex returns, placed in semi-fowlers position and sputum is monitored for s/sx of hemorrhage.
Nursing intervention related to sputum specimen collection collection of the sample should be done before antibiotics are started
O2 carried in blood stream in 2 forms PaO2 (o2 dissolved in plasma) and SaO2 (o2 combined with hemoglobin)
Epistaxis nursing intervention place to pt in sitting position with head positioned forward
Radial Neck Disseciton Surgery is...? Removal of cervical lymph nodes
ANtibiotic to treat anthrax ciprofloxacin
Purpose of closed chest tube drainage system Create a negative pressure to facilitate expansion of the lung
Atelectasis common posoperative complication. it results from shallow breathing.
How long between the 2 aerosol inhaler inhalation medications? 5 minutes
TRUE OR FALSE: Bronchiectasis is a gradula irrecersible process of chronic dialation of the bronchi that eventually destroys the elastic and muscular properties of the lung. TRUE
INH and Rifampin are what type of medications? Anti-tubercules
Hydrocodone and Dextromethorphan are what types of meds? Anti-tussives (cough medications)
what is CIPRO? Cipro is an antibiotic used to treat certain bacterial infections of the urinary tract, lower respiratory (lung) tract, skin, bone, joint, stomach, sinuses, and prostate
what is Nitroprusside? Nitroprusside is a vasodilator that works by relaxing the muscles in your blood vessels to help dialte.
MDI Use/Administration Abbreviation for metered-dose inhaler These devices attach to the MDI and hold the "spray" of medication. They make it easier to use the MDI and help get the medication into the lungs better. Broncho-dilator*
Mucosolytics; Mucolytic drugs are designed to help loosen and clear the mucus from the airways by breaking up the sputum. Name the Primary drug to treat the patient suffering from this: Acetylcystine; used primarily as a mucolytic agent
Nasal cannula 4-6 liters
where does the lower airway start, and the upper airway end? lower airway starts from the inferior end of the larynx.
Created by: charlie1010