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Med/Surg I
Respiratory System
| Question | Answer |
|---|---|
| Epistaxis | nose bleed. Position patient upright, leaning forward. Apply direct lateral pressure to the nose for 5 mins & ice or cool compresses to nose if possible. Nasal packing may be needed. To prevent rebleeding, instruct not to blow nose for several hours. |
| Normal RBC range | 4.2-6.1 million/mm |
| Normal Hemoglobin range | 12-18 g/dl |
| Normal Hematocrit range | 37%-52% g/dl |
| Normal WBC Range | 5,000-10,000 /mm |
| PCO2 | 35-45 mm Hg |
| HCO3 | 21-28 mEq/L |
| Obstuctive sleep apnea | breathing disruption lasts atleast 10 sec and occurs min of 5 x per hr. S/S-daytime sleepiness, inability to concentrate, change sleep positons TX-CPAP, change in sleep pos, weightloss, sur- adeniodectomy, uvulectomy, uvulopalatopharynoplasty Study-(PSG |
| COPD | Charac: Bronchospasms, dysphnea. Tissue damage is not reversible & increases in severity eventually leading to respiratory failure. |
| Asthma | 1. Inflammation in mucous membrane-allergens, irritants. 2. Hyperresponsviness occurs w exercise, uri, unknown. S/S-cough, chest tightness, cyanosis, hypoexmia. Lab-ABG, ^ eosinophil |
| Pulmonary function test (PFT) | Most accurate test for asthma. These tests evaluate lung volumes and capacities. Goal: Improve airflow. Test peak flow twice a day. Green=peak; Yellow=peak-50 (use rescue drugs) Red=below 50 (rescue drugs & emergency...serious res problem) |
| Bronchodilator | increase smooth muscle relaxation. NO affect on inflammation. Short acting-Venalin, zopinx Long acting-longer than short bc time is needed for drugs to build up. |
| Methylaxanthines | Lot of side effects; Hypertension, seizures. Drug levels need to be monitored. |
| Anti-inflammation Asthma drugs | Corticosteriods=use daily for severe asthma. NOT for rescue. Nsaids=preventive-reduce airway inflammation. Leukotriene=oral preventive-singular. Immundulators=prevent allergens for binding. |
| Status asthmaticus | Severe, airway obstruction that intensifies once begins & often doesnt respond to common therapy. If not reversed=cardiac arrest TX- Iv fluids, potent systemics, bronchodilators, steriods, epinephrine and oxygen. |
| Emphysema | loss of lung elasticity & hyperinflation of the lungs. S/S-dysphea & need for increase resp rate. |
| Rhinitis | inflammation of nasal mucosa. "allergies" TX-antihistamines, decongestants, antibiotics, anti pyretics, Vit C & zinc. |
| Sinuitis | Inflammation of mucous membrane. S/S-Sore throat, HA, fever. TX-Antibiotics, decongestants, hot showers and steam. Poss surgery-Endoscopic sinus |
| Pharyngitis | Inflammation of mucous membrane of pharynx. |
| Tonsillitis | Inflammation of tonsils. Penicellin 7-10days. Contagious. S/S-sore throat, fever, chills, ear pain, HA, thickened voice, tonsils swollen & red w pus. |
| Whats a complication of tonsilitis? | Peritosillar abcess=puss behind the tonsils. |
| Laryngitis | Inflammation of the mucous membranes of the larynx. S/S-Hoarseness, dry cough, aphonia (voice loss) TX-relief & prevention |
| Post op care following sinus surgery | Semi-fowlers position, perform gentle oral hygiene, ice compresses for 24 hrs, teach changing of mustache dressing, recommend to sleep upright in a chair, no coughing, blowing nose or straining for 2 weeks, temp for first week aft surgery. over 100 report |
| Thoracentesis | aspiration of pleural fluid or air from the pleural space: Patient preparation for stinging sensation & feeling of pressure Correct position-sitting up bend over a table, with nurse in front. Motionless patient Follow-up assessment for complicat |
| Lung Biopsy | Follow-up care: Assess vital signs and breath sounds at least every 4 hr for 24 hr Assess for respiratory distress Report reduced or absent breath sounds immediately Monitor for hemoptysis |
| CHRONIC AIRFLOW LIMITATION | Includes the chronic lung diseases: Asthma Chronic bronchitis Pulmonary emphysema Drug: Warfarin Calcium channel blockers Endothelin-receptor antagonists Natural and synthetic prostacyclin agents Digoxin & diuretics Oxygen therapy |
| SARCOIDOSIS | Granulomatous disorder of unknown cause that affects the lungs most often Autoimmune responses in which the normally protective T-lymphocytes increase and damage lung tissue Corticosteroids are the main type of therapy |
Created by:
hardin0918