Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
---|---|---|---|---|---|
Asthma Risk Factor | Risk factors for developing Asthma
â¢Genetics
â¢Immune response â hygiene hypothesisâ
â¢Allergens
â¢Exercise- exercise induced asthma
â¢Air pollutants- smoke ,climate,
â¢Occupational factors- 15% diagnosed are r/t job related exposure
â¢Respi
🗑
|
||||
Asthma side effects? | Can be severe & life threatening
odyspnea at rest
ocan speak in words not sentences
oSitting forward
oWheezing
oRR > 30
oPulse > 120
oAccessory muscle use
oAgitated
oPeak expiratory flow < 40% of personal best or < 150 L/minute
oNeck vein dissention
IN SE
🗑
|
||||
Asthma Symptoms | Can be severe & life threatening
odyspnea at rest
ocan speak in words not sentences
oSitting forward
oWheezing
oRR > 30
oPulse > 120
oAccessory muscle use
oAgitated
oPeak expiratory flow < 40% of personal best or < 150 L/minute
oNeck vein dissention
IN SE
🗑
|
||||
Nursing Management for Asthma | Teach patient to identify & avoid known personal triggers
⢠if triggers can not be avoided â teach the patient how to premedicate prior to exposure of known trigger
â¢Acute management â ASSESSMENT! Aggressive breathing treatments, and medications ,
🗑
|
||||
Medications for Asthma | inflammatory drugs
Corticosteroids â inhaled or oral
Leukotriene modifiers
Anti- IgE
Bronchodilators
Long acting B2 âadrenergic agonists
Long acting oral B2- adrenergic agonist
Methylxanthines ( rarely used)
Bronchodilators
Short acting inhaled B2 a
🗑
|
||||
COPD cause? | Occupational chemicals and dust, air pollution, infection, genetics, AAT deficiency. Cigarette smoking #1!!
🗑
|
||||
COPD Clinical Manifestations |
â¢Develops slowly
â¢Chronic intermittent cough may develop first
â¢Dyspnea is progressive , occurs with exertion
â¢Inability to take a deep breath
â¢Gradually symptoms interfere with ADL
â¢When COPD is advanced :
â¢Frequent experiences weigh
🗑
|
||||
COPD Exacerbation | Acute event
â¢Assess â increase in dyspnea, sputum volume, sputum purulence, malaise, insomnia, fatigue, depression, confusion, decrease exercise tolerance, confusion, increased wheezing, may have fever .
â¢Increase in exacerbation â poor outcomes
â
🗑
|
||||
COPD Respiratory Failure | COPD patients who have had exacerbations are @ risk to develop respiratory failure.
â¢Use of B- adrenergic blockers (atenolol)-may improve survival rate & â risk of exacerbations.
â¢If patient retains CO2 â carefully monitor when on oxygen or durin
🗑
|
||||
COPD Diagnostic testing | â¢Spirometry â must confirm airflow obstruction (PFT)
â¢Chest x-ray- usual findings- flat diaphragm hyper inflated lungs
â¢Serum á¾ antitrypsin levels
â¢ABG
â¢6 minute walk test
â¢COPD assessment test
🗑
|
||||
Collaborative Care COPD | cessation
â¢Drug therapy â reduce symptoms
â¢Bronchodilators
â¢LABA
â¢Inhaled corticosteroids
â¢Long acting bronchodilators
â¢Oxygen therapy
â¢Goal to maintain O2 > 90%
â¢Always start with a low liter flow
â¢Breathing Retraining
â¢Purse lipped
🗑
|
||||
COPD Nursing Management | Heath promotion
â¢Smoking cessation
â¢Early diagnosis and treatment âdecrease in progression of disease
â¢Family with history of COPD need to be aware of possible genetic link
â¢Acute intervention
â¢Bronchodilators, corticosteroids
â¢Position to m
🗑
|
||||
Tuberculosis | Infectious disease
â¢Caused by mycobacterium tuberculosis
â¢Usually involves lungs
â¢Leading cause of mortality in patients with HIV
â¢Worldwide problem
â¢Occurs more in the underserved, poor, and minorities
â¢Population @ risk in the US :
â¢Prison
🗑
|
||||
Risk Factor fo Tuberculosis | Latent TB vs TB disease
â¢Latent
â¢No symptoms
â¢Does not feel sick
â¢Cannot spread TB
â¢Skin test or blood test = positive
â¢Normal chest x-ray
â¢Needs treatment to prevent active TB
â¢TB Disease
â¢Symptoms present: bad cough >3week duration, pa
🗑
|
||||
Diagnostic testing for Tuberculosis | Skin test â mantoux is done
â¢Interferon ây release assays
â¢Chest x-ray
Bacteriologic studies
â¢sputum collection
â¢3 specimens must be taken on different days â usually first morning sputum .
🗑
|
||||
Tuberculosis Treatment | Usually as an outpatient
â¢If patient has positive sputum â they are considered infective for the first two weeks after starting treatment-
â¢Advise these patients to avoid travel, public transportations, limit visitors
⢠TB treatment involves medic
🗑
|
||||
Tuberculosis Drug Therapy | Initial phase
â¢4 drug regimen â INH, rifampin (Rifadin), pyrazinamide(PZA), ethambutol(Myambutol) â given daily for 8 weeks.
Continuation phase
â¢INH and rifampin or INH and Rifapentine daily for 4 or 7 months.
🗑
|
||||
TB Nursing Management | â¢Health Promotion
â¢Ultimate goal wipe TB off the globe
â¢Screening programs for high risk populations
â¢Acute intervention
â¢Placed on air borne precautions (HEPA mask )
â¢Chest x-ray, sputum collection, receive correct drug therapy
â¢Teach patie
🗑
|
||||
TB Discharge teaching | Teach patient
â¢to minimize exposure to close contacts
â¢Homes should be well ventilated
â¢If still infectious â they should sleep alone
â¢Spend as much time outside
â¢Limit time in areas where people congregate.
â¢Teach importance of adherence to
🗑
|
||||
Pulmonary Emboli | Obstruction of pulmonary artery or branch by blood clot, air, fat, amniotic fluid, or septic thrombus
â¢Inflammatory process obstructs area, results in diminished or absent blood flow
â¢Bronchioles constrict, further increasing pulmonary vascular resist
🗑
|
||||
Risk Factors for Pulmonary Emboli | Immobility, venous stasis
â¢Hypercoagulability
â¢Venous endothelial disease
â¢Heart disease, trauma, postoperative/postpartum, diabetes, COPD
â¢Obesity, oral contraceptive use
â¢Previous history of thrombophlebitis
🗑
|
||||
Preventions and treatment for pulmonary emboli | Prevention
â¢Exercises to avoid venous stasis
â¢Early ambulation
â¢Sequential compression devices (SCDs)
â¢Anti embolism stockings
â¢Treatment
â¢Anticoagulation, thrombolytic therapy
🗑
|
||||
Atelectasis | Airless condition of alveoli caused by hypoventilation, obstruction to airways, or compression
â Postoperative patients at high risk
â Symptoms: insidious, include cough, sputum production, low-grade fever
â Respiratory distress, anxiety, hypoxia occur
🗑
|
||||
Atelectasis Nursing Management | Prevention
â Turn, cough, deep breathe
âEarly mobilization
âIncentive spirometer
âJudicious administration of opioids and sedatives
🗑
|
||||
Atelectasis Collaborative Care |
â Remove secretions: coughing exercises, suctioning, aerosol therapy, chest physiotherapy
â¢Oxygen therapy
âEndotracheal tube intubation
Mechanical ventilation
Bronchoscopy to remove obstruction
to relieve compression
🗑
|
||||
Pulmonary Infections |
â Severe acute respiratory syndrome (SARS)âviral, no cases reported since 2004, CDC
â Lung abscess
â Tuberculosis
â Tracheobronchitis
â Pneumonia
🗑
|
||||
Pulmonary infection lung abscess |
â Most are a complication of bacterial pneumonia
â Drainage achieved through postural drainage and chest physiotherapy
â IV antibiotic therapy for 3 to 5 days, followed by oral antibiotics for 4 to 12 weeks
â Diet high in protein to facilitate healin
🗑
|
||||
Pneumonia | Facts
Community acquired pneumonia (CAP) sixth leading cause of death for people over 65.
Risk factors:
abdominal or thoracic surgery
> 65 years old
air pollution
altered LOC
chronic disease
immunosuppressed
resident of long term ca
🗑
|
||||
Types of Pneumonia | â Community acquired (CAP)
âAcute infection of the lung, patients who have not been hospitalized or resided in a long-term care facility with 14 Days of onset.
â Medical care- associated pneumonia
âHospital acquired- occurs 48 hours or longer after
🗑
|
||||
Pneumonia Collaborative Care | â Vaccination â for patients > 65 years. Old.
â Prompt treatment
â Supportive measures â like bronchodilators, corticosteroids
â Rest but not too much â WHY? Improved diaphragm movement, chest expansion, mobilization of secretions & prevention
🗑
|
||||
Nursing care for pneumonia | Assessment :
âPast history
âMedication history
âPotential Objective findingâ
â fever, lethargy ,
â Tachypnea, â work of breathing, crackles , production of sputum
â Tachycardia
â Changes in mental statusGoal â reduce risk of pneumonia
â
🗑
|
||||
Evaluation for Pneumonia | Patient has received antibiotics â finished course of treatment
â Respiratory pattern has returned to normal
â Lungs are clear
â Fatigue has decreased
â Lab studies have improved
â No further need for oxygen
🗑
|
||||
Aspiration | â Risk factors
â Can cause pneumonia
â Nursing interventions:
âKeep HOB elevated >30 degrees
âAvoid stimulation of gag reflex with suctioning or other procedures
âCheck for placement before tube feedings
âThickened fluids for swallowing problem
🗑
|
||||
Pleural issues | Pleurisy: inflammation of both layers of pleurae
âInflamed surfaces rub together with each respiration, causes sharp pain intensified with inspiration
â Pleural effusion: fluid collection in pleural space usually secondary to pneumonia
âLarge effusio
🗑
|
||||
Pleural infection | Empyema: accumulation of thick, purulent fluid in pleural spaces
âAcutely ill patient; fibrin development loculated (walled-off) impairing lung expansion
âChest tube for drainage
âResolution is a prolonged process, 4 to 6 weeks of antibiotic therapy
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
feliciachoyce46
Popular Nursing sets