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NUR 150 test 3

Chronic test 3

pH 7.35-7.45
CO2 35-45
HCO3 22-28
PO2 80-100
SaO2 95-100
Compensated pH normal, everything else outta whack
Emphysema S&Sx DOE, progresses to continual dyspnea, scant or absent sputum, barrel chest, accessory muscle breathing, ^respir rate, prolonged expiratory phase, pink puffer/blue bloater
Chronic Bronchitis S&Sx cough, sputum production, DOE
Chronic Bronchitis-prevention smoking cessation, prompt tx of respire inf, vacc for flu & pneumonia
COPD-Improving Gas Exchange continuous low-flow 02, 2-4L/nc, if too ^ respire will decrease
COPD-Why prone to weight loss ^ work of breathing
Theophylline Levels check for toxicity, 5-20mcg/mL is therapeutic, >20 is toxic, may see CNS/cardiac effects w/ toxicity
Potassium/K 3.5-5mEq/dL
Albumin 3.5-5.5g/dL
BUN 10-20mg/dL
Creatinine 0.7-1.4mg/dL
Bronchodialators-3 types Beta-agonists, Anticholinergics, Theophyllines
Short-acting beta-adrenergics Albuterol/Proventil & Ventolin, Levalbuterol/Zopenex
Long-acting beta-adrenergics Salmeterol/Serevent
Anticholinergics Ipratropium/Atrovent, Tiotropium/Spiriva
How Tiotropium/Spiriva administered? pill into pop case, inhale
Corticosteroids effects reduce inflammation, reduce airway swelling, reduce mucus
Corticosteroid SE loss of bone-mineral density, thrush
To prevent Thrush rinse out mouth after admin Corticsteroids
Corticosteroid Methylprednisolone/Solumedrol
w/ Mucolytics & Expectorants(Guaifenesin/Humibid) ^fluids
Leukotriene Inhibitors Zafirlukast/Accolate, Montelukast/Singulair
Insentive Spirometry place in mouth-breathe in-hold-exhale slowly, 10x/hr
Definitive Dx of TB based on sputum cultures
TB Infection Control in hosp neg pressure rm, airborne prec, N95 mask
TB Medications Izoniazid(INH), Rifampin, Pyrazinamide, Ethambutol, Streptomycin
INH SE peripheral neuropathy->give pyridoxine
TB-Physical Assessments low grade fever, cough, night sweats, fatigue, weight loss
PPD or TST Interpretation 0-4mm-neg, 10mm-significant exposure pos, 5mm-pos in HIV inf
Positive Reaction followed up w/ CXR
TB Blood Test QuantiFERON-TB Gold(QFT-G)-rapid test
TB-Why take Meds strict adherence to med regimen is critical to suppressing disease
CD4#s-Normal 300-2000/cubic mm blood
Concern w/ CD4# <200
HIV-NNRTI’s Sustiva, Atripla-block activity of reverse transcriptase so can’t make DNA
HIV-EIA enzyme immunoassay detects presence of antibodies that indicate HIV inf
Tx for Thrush Nystatin/Mycostatin, Clotrimazole/Mycelex troche or magic mouthwash
Antiretroviral SE of NRTI’s nausea, diarrhea, lipidystrophy
Antiretroviral SE of NNRII’s rash during 1st week of tx, liver function change
Antiretroviral SE of PI’s nausea, diarrhea, lipidystrophy
Nutrition Concerns for HIV diarrhea, malabsorption, protein energy malnutrition, futher impairment of immune sx, SE of antiretrovirals, food safety concerns, wasting syndrome-hypermetabolic state
Nutrition Therapy for HIV high calorie, easily digestable protein, low-fat easily digestable fats, lactose free if lactose intolerant, nutritional supplement
Physical Assessments poor wound healing, skin lesions, night sweats, SOB, cough, diarrhea, weight loss, N&V, visual changes
Opportunistic Infections bacterial, fungal candida, fungal, viral, protozoal, malignancies
COPD-wheezing stops->good or bad BAD-constricted airway
Created by: neffielewis