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Med Surg 29-31
| Question | Answer |
|---|---|
| Methods of thinning out thick secretions | expectorant, coughing and deep breathing |
| Breath sounds associated w/ pneumothorax | Diminished or absent breath sounds. In a sucking chest wound, air can be heard as it enters or leaves the wound |
| Aging effects on the respiratory system | Weakened and atrophied respiratory decreased cough reflex, reduced elastic recoil of lung tissue, deteriorating cillia, decreased cough reflex, reduced effectiveness of alveolar macrophages. pg:511 |
| Rationale for the use of pursed lip breathing | Shortness of breath pg:501 |
| Positioning of a client w/ SOB | In bed PAtient can be in fowler or semi-fowler, sit in chair while leaning forward and placing elbows on their knees or over bed table. Patients with one -sided lung disease : side lying position with the good lung on dependent position PG:501 |
| How would you explain to a family memeber of a client why chest physiotherapy must be done | Helps move secretions out from deep inside the lungs. Indicated for pt who has weak or ineffective cough is at risk for retaining secretions. |
| Nursing care of a client w/ epistaxis | Intruct patient to sit in chair and lean forward slightly, pinch nares at the soft of the nose together for 15 minutes (5 mins)for a child, do not release pressure during this time. Ice packs to the nose and eye area may be used to constrict the bleedi |
| Manifestations of a client suffering from a flail chest | Restlessness, confusion, increasing dyspnea, worsening ABGs, lethargy, coma and death. |
| Client education for a client w/ TB and has been receiving medication for two weeks | Typically, no longer contagious but sputum culture must be done to confirm this. |
| What is the action of an expectorant | Help loosens and mobilizes secretions so they can be coughed up |
| What clients are at risk for DVT and potential for pulmonary emboli | Patients on anticoagulant meds, postop, immobile, hemophilia |
| Describe what a ventilation-perfusion scan is | A radioactive substance is injected via IV route. A scan is then done to view blood flow to the lungs (perfusion). Another radioactive substance is inhaled. Scanning then shows how well gas is distributed in the lungs (ventilation) PG; 499 |
| Treatment for clients w/ obstructive sleep apnea | Evidence-based guidelines involve three treatment recommendations: (1) weight loss, (2) continuous positive airway pressure (CPAP) and (3) use of a mandibular advancement device (a mouthpiece to advance the mandible). Exercise has been shown to lead to mo |
| Manifestations of a client w/ emphysema | Chronic cough, w/ or w/o sputum |
| Manifestations of an asthma exacerbation | Wheezing, chest tightness, dyspnea, coughing and difficulty moving air out of the lungs |
| Manifestations of a pleural effusion | Depends on how much fluid is present in pleural space. May not experience pleuritic pain. Increasing shortness of breath, cough, tachypnea, lung sound decreased or absent, friction rub, dull sound when affected area is percussed |
| What medication classification is contraindicated in clients w/ asthma and what is rationale | Propanol and other beta blockers |
| What are the risk factors for lung cancer | Smoking and other chronic respiratory disorders |
| Manifestations of bronchiectasis | Recurrent lower respiratory infections. Sputum is copious & purulent. Accompanying cough can produce up to 200 mL of thick, foul-smelling sputum in single episode. Bloody sputum, dyspnea w minimal exertion, wheezes and crackles and clubbing of fingers |
| Diagnostic tests used to confirm tuberculosis | Purified protein derivative (PPD) skin test |
| Manifestations of bacterial pneumonia | Cause atypical symptoms. May experience fatigue, sore throat, dry cough, or nausea and vomiting |
| Common risk factors for laryngeal cancer | History of alcohol and tobacco use. Exposure to industrial chemicals or hardwood dust, chronic overuse of the voice, and a diet low in fruits and vegetables, exposure to HPV |
| Postop septoplasty nursing concern | Monitor VS and bleeding until the patient is stable. Excessive swallowing should alert you to check for blood running down the back of the throat. |
| What medications should not be used w/ propanol | Use w/ care in patients w/ cardiac disease, overuse can cause rebound bronchospasm* (review later) |
| CPAP vs. BiPAP | CPAP- same amount of positive pressure is maintained throughout inspiration and expiration to prevent airway collapsed. BiPAP- a higher level of positive pressure is used on inspiration and a lower level on expiration. |
| Interventions for impaired gas exchange | Oxygen, intubation, mechanical ventilation, treat underlying care, sit pt up, administer meds as needed |
| Diagnostic testing of the respiratory tract in general (ch.29) | CBC, Arterial blood gas analysis, D-Dimer, sputum culture and sensitivity, throat culture, nasal samples, oxygen saturation, capnography |
| Adventitious breath sounds | (pg 498) Coarse crackles, Fine crackles, wheezes, stridor, plueral friction rub, diminished, absent |
| Aging changes of the respiratory system | (pg 492) Weakened & atrophied muscles, reduced elastic recoil of lung tissue, deteriorating cilia, decreased cough reflex, reduced number of aveoli, decreased force of cough, decreased gas exchange, higher chance of infection |
| Care for a client w/ a tracheostomy | Regularly monitoring pt's respiratory status and tube placement. Asculate lungs bilaterally, carefully secure the tube w tape or Velcro holder, reposition and secure oral tubes to the opposite side of the mouth every 24hrs. Apply skin barrier under tape |
| Lung CA | Most originate in the lining of the Bronchi and the 4 major types of lung cancer are identified by the affected cells ex. Small cell lung Cancer, Larg cell carcinoma, adenocarcinoma, and squamous cell carcinoma |
| Tuberculosis | Is an infectious disease caused by Mycobacterium tuberculosis that primarily effects the lungs |
| Manifestations, treatment and indications of pneumothorax | Sudden dyspnea, chest pain, tachypnea, tachycardia, restlessness, anxiety. Monitor ABG and respiratory status. Chest tube to water seal damage, pleurodesis for recurrent collapse. |
| Restrictive disorders | Pleuritis, pleural effusion, pulmonary fibrosis, atelectasis |
| Obstructive disorders | COPD, chronic bronchitis, emphysema. asthma (asthma can be reversible) |
Created by:
SamarhaP