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NUR 150 test 3
Chronic test 3
| Question | Answer |
|---|---|
| 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
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