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Chest & lower #19
MS1 #19 Chest & Lower Resp. Mgmt
| Question | Answer |
|---|---|
| reduce the incidence of lung cancer and cardinal sign | Classes at community centers to teach about smoking cessation strategies and cough or change in chronic cough |
| bacterial pneumonia | Dyspnea and wheezing |
| suctions a patient through the endotracheal tube for 20 seconds and observes dysrhythmias | The patient is hypoxic from suctioning, maximum suction time should only be 15 seconds, after suctioning, re-oxygenate the patient and before beginning suctioning |
| how do we suction and how long | suctioning as you retract the catheter in a sweeping motion. |
| victim has sustained a blunt force trauma to the chest. A pulmonary contusion (bruised lung) is suspected. | Blood-tinged sputum |
| fluid in the pleural space and will need a thoracentesis (procedure to remove fluid or air from around the lungs) fluid type | Pleural effusion |
| Pleural effusion | sometimes referred to as “water on the lungs,” is the build-up of excess fluid between the layers of the pleura outside. |
| type of ventilator has a preset volume of air to be delivered with each inspiration | volume-controlled ventilation |
| What might be revealed by a chest radiograph for a client with occupational lung diseases | Fibrotic changes in lungs |
| petechiae (small red/purple spot caused by bleeding into the skin) over his chest What action should the nurse take first | Initiate oxygen therapy |
| closed chest drainage system has constant bubbling in the water-seal chamber what should the nurse do | The system has an air leak. the higher the number, the greater the air leak but normal functioning is when tidal movements or fluctuations |
| closed chest tube | The water in the water-seal chamber should rise with inhalation and fall with exhalation (this is called tidaling), which demonstrates that the chest tube is patent. |
| dietary for a client with a lung abscess | diet rich in protein, such as chicken, fish, and beans.” |
| lung abscess | type of liquefactive necrosis of the lung tissue and formation of cavities (more than 2 cm) containing necrotic debris or fluid caused by microbial infection |
| pulmonary embolus | a clump of material, most often a blood clot, gets stuck in an artery in the lungs, blocking the flow of blood |
| pulmonary embolus s/s | cough that produces blood-tinged sputum and chest pain |
| What assessment method would the nurse use to determine the areas of the lungs that need draining? | Auscultation |
| clients who are at the risk of pneumococcal and influenza infections encourage | Receiving vaccinations & hand antisepsis |
| You are an occupational health nurse in a large ceramic manufacturing company. How would you intervene to prevent occupational lung disease in the employees of the company? | Fit all employees with protective masks. |
| pulmonary embolus potential complication | Residual effects of compromised oxygenation |
| obstructive sleep apnea treatment | Continuous positive airway pressure (CPAP) #1, other treatments are weight loss, sleeping on one's side, and decreasing alcohol consumption can help |
| obstructive sleep apnea is | when something blocks part or all of your upper airway while you sleep it affects all age groups, but the frequency increases with age and obesity. |
| obstructive sleep apnea s/s | snoring and daytime sleepiness. |
| pleurisy | Inflammation of the tissues that line the lungs and chest cavity and Stabbing pain during respiratory movement |
| pleurisy s/s | Chest pain that worsens when you breathe, cough or sneeze. Shortness of breath |
| high-pressure alarm on the ventilator sounds what should the nurse do | Suction the client's artificial airway silenced as quickly as you can get to the bedside, but you should never turn your back on the patient look for potential problems, while a flashing light indicates the probable cause," he adds. |
| thoracic resection is being done Which study will be performed to determine whether the planned resection will leave sufficient functioning lung tissue? | Pulmonary function studies |
| pneumococcal pneumonia patient teaching | I should get the PPSV23 this year because I got the PCV13 last year, sleeping with a humidifier can help loosen secretions, I will seek medical attention if my cough worsens, I will rest and avoid overexertion, |
| Hashimoto's disease | an autoimmune disorder. The immune system creates antibodies that attack thyroid cells as if they were bacteria, viruses ... |
| client's need to have a tracheostomy? sign its needed | A client requires permanent ventilation |
| tracheostomy | an incision in the windpipe made to relieve an obstruction to breathing |
| pneumococcal pneumonia | an infection of the lungs caused by Streptococcus pneumoniae bacteria, or pneumococcus |
| complication of a low pressure in the endotracheal cuff | Aspiration pneumonia |
| paradoxical chest expansion and respiratory distress what chest disorders should be suspected? | Flail chest |
| endotracheal cuff (ETT) | designed to provide a seal within the airway, allowing airflow through the ETT but preventing passage of air or fluids around the ETT |
| What is the best way for the nurse to deliver 70% concentration of oxygen? | A partial rebreathing mask |
| In acute respiratory failure, | occurs Sudden onset of lung impairment in a client who had normal lung function The ventilation or perfusion mechanisms in the lung are impaired. |
| medications for tuberculosis | isoniazid (INH) therapy |
| patients taking isoniazid (INH) therapy should avoid food such as | containing tyramine and histamine (tuna, aged cheese, red wine, soy sauce, yeast extracts, alcohol), because may cause headache, flushing, hypotension, lightheadedness, palpitations, and diaphoresis. |
| pursed-lip breathing | inhale through your nose, slowly count to 3, Exhale slowly through pursed lips, slowly count to 7 (It prolongs exhalation.) |
| tracheostomy tube care | Monitor the pressure in the cuff at least every 8 hours |
| endotracheal tube (ET) nursing intervention is contraindicated | Routine cuff deflation is not recommended because of the increased risk for aspiration and hypoxia. |
| acute bronchitis | A chest cold, often called acute bronchitis, occurs when the airways of the lungs swell and produce mucus in the lungs |
| left hemicolectomy for | bowel cancer |
| patient had a left hemicolectomy how to prevent the occurrence of postoperative pneumonia in this client | Coughing, breathing deeply, frequent repositioning, and using an incentive spirometer |
| weaned from the ventilator order | remove the ventilator, tube, and then oxygen but terminate the weaning if heart rate increase of 20 beats per minute, and systolic blood pressure increase of 20 mm Hg. |
| with acute respiratory distress syndrome (ARDS) patient is restless, has a low oxygen saturation level, condition does not improve and the oxygen continues to decrease, what procedure the nurse expect | Intubate the client and control breathing with mechanical ventilation |
| lobectomy s/s | respiratory complications |
| lobectomy | a removal of one lobe of the lung |
| Following the lobectomy procedure, the nurse will plan care based on the client | returning to the nursing unit with two chest tubes. |
| What may induce acute bronchitis | Chemical irritation |
| What is the reason for chest tubes after thoracic surgery? | |
| tracheobronchitis | |
| incentive spirometry | Breathe in deeply through the spirometer, hold your breath briefly, and then exhale. |
| chest tube disconnected, what should the nurse plan to do? | place end of the chest tube in a container of sterile saline or water to prevent air from entering the chest tube preventing negative respiratory pressure, apply an occlusive dressing if the chest tube is pulled out, not if disconnected, tape chest tube |
| Hyperbaric oxygen therapy increases the blood's capacity to carry and deliver oxygen to compromised tissues. This therapy may be used for a client with: | a compromised skin grafts |
| chest tube possible complication | The tissues give a crackling sensation when palpated. |
| we should not do what to a chest tube | do not clamp the chest tube because clamping increases the risk of tension pneumothorax. |
| Perform postural drainage | get into a position that helps drain fluid out of the lungs |
| post-thoracotomy is retaining secretions. What is the nurse’s initial intervention? | Encourage the client to cough |
| 2-year-old near drowning victim monitors | Acute respiratory distress syndrome |
| When do you perform postural drainage chest percussion? | used together to help loosen and remove mucus from the lungs. |
| A mediastinal shift occurs in which type of chest disorder (causes the lung to collapse and the heart, the great vessels, and the trachea to shift toward the unaffected side of the chest (known as) | tension pneumothorax |
| Cardiac tamponade | is compression of the heart resulting from fluid or blood within the pericardial sac. |
| Traumatic pneumothorax | occurs when air escapes from a laceration in the lung itself and enters the pleural space or enters the pleural space through a wound in the chest wall. |
| Simple pneumothorax | most commonly occurs as air enters the pleural space through the rupture of a bleb or a bronchopleural fistula. |
| mortality rate is high in lung cancer clients due to which factor | Few early symptoms |
| Which information would be considered occupational lung disease | Black-streaked sputum |
| Which thoracotomy finding requires immediate intervention by the nurse? | The nurse will notify the primary provider if drainage is 150 mL/hr or greater. The other findings are normal following a thoracotomy; no intervention is required. The nurse should monitor and document the amount and character of drainage every 2 hours. |
| thoracotomy | surgical procedure to gain access into the pleural space of the chest. to gain access to the thoracic organs, most commonly the heart, the lungs, or the esophagus, or for access to the thoracic aorta or the anterior spine. |
| reason for a chest tube insertion in treating a pneumothorax. | The tube will drain air from the space around the lung.” |
| Positive end-expiratory pressure (PEEP) | is used to optimize oxygenation by preventing alveolar collapse. PEEP can potentially decrease cardiac output through cardiopulmonary interactions. |
| Mantoux test for tuberculosis | skin test doesn't differentiate between active and dormant tuberculosis infection. |
| exposed to someone with tuberculosis doctor will request | Daily doses of isoniazid, 300 mg for 6 months to 1 year |
| Arterial blood gas analysis would reveal which of the following related to acute respiratory failure? | Acute respiratory failure is as a decrease in the arterial oxygen tension (PaO) to less than 50 mm Hg (hypoxemia) |
| hypercapnia | an increase in arterial carbon dioxide tension (PaCO) to greater than 50 mm Hg, with an arterial pH of less than 7.35. |
| and acute respiratory failure? | administering supplemental oxygen elevates the PaO2. the PaCO2 is elevated and the pH and HCO3- are depressed. |
| acute respiratory distress syndrome | elevation of the PaO2 requires positive end-expiratory pressure and the PaCO2 is elevated and the pH and HCO3- are depressed. |
Created by:
rosalyngreen