11/16/15: Chs 20 and 15 and Beyond!

Question 1

Drug Therapy with Exogenous corticosteroids: Used to treat disorders of ???

Answer 1

adrenal cortex or endocrine system

Question 2

What do you do as a nurse if a patient has Emphysema?

Answer 2

increase tidal lung capacity

Question 3

What is pulmonary hypertension?

Answer 3

Abnormal elevation of pressure in pulmonary circulation, most is secondary.

Question 4

Who is at risk for pulmonary hypertension?

Answer 4

COPD patients are at risk for this.

Question 5

What do you do with post-op patients (with pulmonary problems)?

Answer 5

get them breathing and moving

Question 6

What are you expecting (diagnosis) as a nurse if patient has pain when breathing just on one side?

Answer 6

Plueritis

Question 7

Where do you get passive immunity from?

Answer 7

from mothers

Question 8

What is a Type II Hypersensitivity Disorder?

Answer 8

Antibody-mediated disorders: compliment and antibody mediate cell destruction, complement and antibody mediated inflammation, antibody mediated cellular dysfunction

Complement and antibody mediated cell destruction- example hemolytic disease in newborns due to ABO or Rh incompatibility (blood transfusion reaction) pg 349
Pg 351 scenario- type 4

Question 9

What are dendrite cells?

Answer 9

Found in the skin, have finger like processes and capture and transport foreign antigens to B and T lymphocytes, antigen- presenting cells that initiate adaptive immune responses,

Release communication molecules, intermediary between innate and adaptive immunity. Initiate immune response!!!!!!!!!!!!!!

Question 10

What is a major cause of pulmonary embolism?

Answer 10

Major cause DVT (from venous stasis)

Question 11

What is the “key” for pulmonary embolism?

Answer 11

Prevention is key- prevention DVT, prophylactic measures include early ambulation post-operative/postpartum, compression stockings, intermittent pneumatic compression boots,

Question 12

What causes a pulmonary embolism (PE)?

Answer 12

Caused by thrombus, air, fat, amniotic fluid.

Question 13

What are the clinical manifestations of PE?

Answer 13

may be clinically silent, shortness of breath, pleuritic pain, apprehension, slight fever, cough, tachycardia, weakness/rapid pulse, low BP.

Question 14

What is cystic fibrosis? What does CF affect?

Answer 14

lacking digestive enzyme, disorder involving fluid secretions (salt depletions), affects epithelial lining of respiratory, gastrointestinal and reproductive tracts. Excessive loss of sodium in sweat.

Question 15

What is Bronchiectasis?

Answer 15

permanent dilation of bronchi caused by destruction of bronchial muscle wall and elastic supporting tissue

Question 16

What are the two different types of obstructive airway disorders? How are they different from each other?

Answer 16

1. Emphysema (loss of lung elasticity, hyperinflation of lungs).
2. Chronic bronchitis (increased mucus production, obstructed small airways).

Question 17

What is bronchial asthma?

Answer 17

chronic inflammatory disease caused by airflow obstruction and bronchial hyper-responsiveness.

Question 18

What are signs of bronchial asthma?

Answer 18

Signs are episodic wheezing, difficulty breathing, chest tightness

Question 19

What is pneumothorax?

Answer 19

Presence of air in pleural space

Partial or complete collapse of affected lung

Question 20

What are the 3 types of pneumothroaxes? How is each one defined?

Answer 20

Spontaneous- rupture of air filled blister or bleb on surface of the lung

Traumatic- caused by penetrating or non-penetrating chest injuries, most commonly fractured or dislocated ribs

Tension- intrapleural pressure exceeds atmospheric pressure, occurs when injury to chest allows air to enter but not leave

Question 21

What is the prototype corticosteroid?

Answer 21

Prednizone

Question 22

Do exogenous corticosteroids control or cure?

Answer 22

Used to control symptoms but not cure underlying disease processes

Question 23

What is likely to occur when using exogenous corticosteroids?

Answer 23

initial weight gain is likely to occur. Later weight gains may be caused from fluid retention

? decreased inflammation and alters the immune response produced by non-endocrine disorders ?

Question 24

What is a side effect of Rifampin?

Answer 24

causes orange color of body fluids and permanent staining of soft contact lenses

Question 25

What is the Mantoux Skin Test?

Answer 25

intradermal injection of 5 TB units- used for people at high risk for getting TB because they have been in contact with someone who has had TB, or for people who have high risk to progression from latent to active TB because of medical conditions

How to interpret results: positive in HIV infected pts, recent contact with TB, people with changes in chest radiograph, people with organ transplants or are immunosuppressed

Induration: 10 mm- 15 mm consider positive. (15mm induration consider everyone as positive)

INH- for active TB, very hard on the liver so keep an eye on hepatic function (jaundice) 354-356 adverse effects