| Question | Answer |
| microalbumnuria | the presence of very small amounts of albumin in the urine that are not measurable by a unrine dipstick, usual urinalysis prcedures- specialized assay analyze freshly voided urine for microscopic levels of albumin |
| cystitis | inflammation of the blader |
| bacteriuria | bacteria in urine |
| urosepsis | the spread of infection from the urinary tract to the bloodstreem, resulting in systematic infection accompanied by fever, chills, hypotension, alter mental status |
| dysuria | painful urination |
| urethritias | inflammation of urethra that causes symptoms similar to urinary tract infections |
| uretheral strictures | narrowing of the uretha |
| stress incoontinence | the involuntary loss of urine during activities that increase abdominal and detrusor pressure |
| urge incontinence | the involutary loss of urine associated with a strong desire to urinate, patinent can not supress the sign from the bladder muscle to the brain |
| mixed incontinenec | a combination of stress, urge, and overflow incontinence. |
| overflow incontinence | the involuntary loss of urine associated with overdistention of the bladder (capacity=maximum) |
| functional incontinence | leakage of urine caused by factors other than diease of the lower urinary tract. |
| urosepsis | the spread of infection from the bladder to the blood stream - that can lead to organ failure, shock, and death. |
| etoglogy & genetics of incontinence | may have temporary or permanent causes - surgical trauma= radical urologic, prostatic, gynologic, (injury to S2 - S4 causes incontinence) chronic infections, stones, chemotherapy, radiation therapy, diabetes melitus, syphilis, |
| urinary incontienece in older adults | may have decreased mobiltiy, vision, and hearing impairments, (when using call light for assistance) getting out of bed to urinate is also a common cause of falls |
| nutrition therapy - incontinence | weigth reduction, avoid alcohol, nicotine, artifical sweeteners, citrus and caffeine, stress the need for adequate water intake |
| drug therapy incontinence | estrogen (menopausal women) increase blood flow and tone to the muscles. anticholinergics, tycyclic antidepressants |
| surgical managerment of incontinence | vaginal, abdominal or retropubic surgeries, (sucess varies between 50 - 90%) 2% collagen or silaxone injection, 50% bladder neck suspension |
| urolithiasis | the presence of calculi (stone) in the urinary tract |
| nephrolithiasis | the formation of stones in the kidney |
| uroterolithiasis | the presence of calculi (stone) in the urinary tract |
| hydroureter | abnormal distention of the ureters |
| renal colic | severe pain associated with distentions or spasm of the ureter, (stone) - radiations into parineal area, groin, scotum or labia, intermittent or continous pain, with pallor, diaphoresis, and hypotension |
| pyelonephritsis | a bacterail infection in the kidney and renal pelvis, (upper UT) |
| pyelonephritsis | can cause - tissue inflammation, tubular cell necrosis and possible abcess formations. usually cause by escherichia coli (fecalis) |
| fever can cause | dehydration - due to excessive fluid loss - diaphoresis |
| fever can also | increase metabolsim and the demand for O2 |
| a person with LOSS of consciousness | has depressed or absent gag reflexes and is suspeceptible to aspiration |
| risk factors for aspiration include | oropharyngeal secretion, including alcoholics, anetsthetized individuas, those with brain injury, with drug over-dose, and stoke victims |
| when feeding (at risk for aspiration patient) | raise HOB and position client on his or her side, not on the back!!!! |
| bronchial breath sounds | are heard over area of density ot onsolidation |
| sound waves are | easily transmitted over consolidated tissue |
| Hydration inables | liquefication of mucus trapped in bronchioles and alveoli, and faciliate expectoration |
| hydration is essential | for clients experienceing fever |
| 300 to 400 ml of fluid is lost daily due to | through the lungs through evaporation |
| Early signs of Cerebral Hypoxia | is irritability and restlessness |
| Cerebral Hypoxia = | the brain in not receiving enough O2 |
| Pneumonia prevention in older adults include | flu shots, pneumonia immunization, |
| pneumonia prevention in older adults inclue | avoiding sources of infection and indoor pollutants = dust, smoke, aerosols - no cig smoking!!!!!! |
| the primary cause of COPD | exposure to Tabacco Smoke (IN THE USA) |
| compensation occurs in time (Chronic Lung Dis) | altering ABG's |
| As COPD worsens | O2 in the blood decreases - hypoxemia
CO2 in the blood increases - hypercarbia |
| COPD causes | Chronic Respiratory Acidosis(increase in PaCO2)
which in turn creates Metabolic Aldalosis (increased blood Bicarbonate) |
| not all COPD patients are CO2 retainers | because (even with hypoxia) CO2 diffues more easily across lung membanes than O2 |
| in Advance Emphysema (alveoli are effected) | HYPERCARBIA is a problem |
| in Bronchitis | airways are affected |
| with COPD clients is is important to obtain | BASELINE data |
| With productive Cough and comfort | use semi-Fowler's or high Fowler's position to lessen pressure on diaphragm (from abdominal organs) |
| Gastric distentions,a major problem/CAL, because | it elevated the diaphragm which inhibits full lung expansion |
| Adult PH | 7.35 - 7.45 |
| Adult Pco2 | 35 to 45 mm Hg |
| Adult Po2 | 80 to 100 mm HG |
| Adults Hco3 | 21 to 28 mEq/L |
| Emphysema = | "Pink" puffers, barrell chest,use of assesory muscles (client work harder) |
| Chromic Bronchitis | "blue" bloaters, insufficent O2, generalized cyanosis, often right-sided heart failure(cor Pullmonale) |
| Lack of Arterial Oxygenation leads to | cyanosis and slow capillary refill(>3 sec) |
| Chronic lack of O2 leads to | clubbing of the fingernails, and a late sign is clubbing of the FINGERS! |
| COPD patients - | do not recieve more than 1-2L of O2/min !!! |
| COPD client's drive to breath is | bases on hypoxia (not hypercapnia)
too much O2 - client stops breathing !!!! |
| healthy patients drive to breath is | bases on hypercapnia (too much CO2) |
| look, listen, if breath sounds are clear, but patient is cyanotic oe lethargic | oxygenation is not occuring!!!!!! |
| Key to respiratory status is | assement of breath sounds as well as visualization |
| breath sound are better discribed (not named) | crackles,wheezes,high-pitched whistling sounds |
| o2 must buble through some type of water-humidification | if given at >4L min or Delivered DIRECTLY to the trachea |
| o2 given at 1 - 4 L or by mask/nasal prongs | DOES NOT need humidificaton - oropharynx and nasal pharynx provide enought |
| trachea care involves cleaning | inner cannula, suctioning, & applying clean dressing |
| air entering the lungs is humidified naturally | but is gone for the client who has had a laryngectomy |
| IF AIR IS NOT HUMIDIFIED BEFOR ENTERING THE LUNGS - | secretions tend to thicken and become crusty |
| laryngectomy tube has a larger lumen and is shorter than | the tracheostomy tube |
| observe for signs of bleeding or occlusion | which are greatest 24 hours postoperative |
| teach the patient who fears choking the glottal stop technique - | take a deep breath, momentraliy occlude the tracheostomy tube, cough and simultaneously remove the finger (from the tube) |
| A positive TB test is exhibited by | induration of 10 mm or more, 48 hoursa the skin test |
| Anyone who has a bacillus Calamette-Guerin (BCG) | will test positive for TB, and must be evaluated with a chest X-ray |
| TB drug therapy usually last | 9 month or longer |
| TB medications must be taken as prescribed because or t | skipping doses or terminating therapy could result in a public health hazzard!!! |
| if a chest tube becomes disconnected | do not clap, but immediately place the end of the tube in sterile saline water (until new system can be connected) |
| If chest tube is accidentally removed from patient | the nurse should apply pressure immedicately with an occlusive dressing and notify the health care provider |
| Nursing diagnosis of "inabiblity of air sacs to fill/empty" | Emphysema, or Cystic fibrosis) |
| Nursing diagnosis of "Obstruction of the air passages" | Asthma, or Chronic Bronchitis |
| Nursing diagnosis of "Acummulation of fluid in the air sacs | Pneumonia |
| Nursing diagnosis of "respiratory muscle fatigue" | COPD or pneumonia |
| Four common symptoms pneumonia the nurst might note with physical exam. | Tachypnea, fever with chills, productive cough, bronchial breath sounds |
| Four (4) Nursing interventions for assisting the client to cough productively | encourage Deep Breathing, increase fluids to 3L/day, use humidifier to loosen secretions, suction airyway to stimulate coughing |
| Symptoms of Pnuemonia found in Older Adults - | Confussion, Lethargy, anorexia, rapid respiratory rate. |
| what is the O2 flow rate for patients with COPD | between 1 - 2L per nasual cannula, (COPD client has hypoxia drive to breath) |
| How does the Nurse prevent Hypoxis during suctioning? | deliver O2 at 100% before and after suctioning endotrachea |
| What are the three (3) major nursing intervention with Mechanical Ventilation | Monitor respiratory status & scure connections
Establish a communication mechanism/client
keep airway clear with suctioning & coughing |
| what physcial findings if the nurse expected to see with Emphysema | Barrel Chest, Dry or productive cough, decreased breath sounds, dyspnes, crackles in lungs |
| Most common risk factor associated with lung cancer | SMOKING |
| what are pre-operative nursing intervention (care) for client undergoing laryngectomy | involve family and client in manipulating tracheostomy equip b/4 swurgery, plan acceptable communication, refere to speech therapist, discuss rehabilitation therapy |
| What are (5) five nursing interventions after chest tube insertion | maintain dry occlusive dressing; monitor VS; encourage client to breath deeply; monitor fluid drainage, mark fluid |
| sulfonamides - trimethoprim, bactrim,septra | use sun protection measures |
| quinolones - ciprofloxacin, levofloxacin, ofloxacin.... | swallow whole, do not crush; take pulse - cardiac dysrhythmias, keep out of sum |
| penecillins- amoxicillin.... | allergies, with food, use another oral contraceptive |
| cephalosporins - duricef, suprax | diarrhea develops? pseudomembraneous, |
| baldder analgesic | with or immediately after a meal |
| phenazopyridine | urine is orange or red |
