Complex comprehensive Flashcards
1
Q
What is pneumonia?
A
Infection/ fluid in the lungs
2
Q
What is the most common manifestation in older adults with pneumonia?
A
Confusion from hypoxia
3
Q
What are some common manifestations of pneumonia?
A
Chest discomfort
Sharp chest pain due to coughing
Anxiety
Fatigue & weakness
4
Q
What does an X-ray show in pneumonia?
A
Areas of consolidation
5
Q
What are some physical findings of pneumonia?
A
Crackles
Wheezing
rhonchi/rales
yellow-green sputum
coarse cough
blood-tinged mucus
Dyspnea (SOB)
hypoxia (pulse ox below 95%)
Fever and chills
Cyanosis
6
Q
What position increases breathing and drainage in pneumonia?
A
High Fowler’s position
7
Q
What should the nurse encourage the patient to do to remove secretions?
A
Coughing
8
Q
When should oxygen therapy be used in pneumonia?
A
O2 saturation under 95% (with no COPD)
Worsened use of accessory muscles
Trouble breathing
9
Q
What should the nurse encourage the patient to do while in bed with pneumonia?
A
Turn cough, deep breath and incentive spirometer
10
Q
How much fluid should a person with pneumonia consume?
A
2-3L/day to thin secretions
11
Q
When should a patient get their pneumonia vaccine?
A
Every 5 years
12
Q
How many times does a pt 65+ years old need their pneumonia vaccine?
A
One time unless they have underlying conditions.
13
Q
What is tuberculosis?
A
Infection in the lungs
14
Q
How long does your cough need to last to be diagnosed with tuberculosis?
A
Longer than 3 weeks
15
Q
What are some clinical manifestations of tuberculosis?
A
Purulent sputum (possibly blood-tinged)
Fatigue and lethargy
unexplained weight loss and loss of appetite
16
Q
When might a person with tuberculosis have a fever?
A
Low-grade fever in the afternoon
17
Q
What person is most at risk for tuberculosis?
A
A person who has recently traveled out of the country.
18
Q
What kind of oxygen therapy should be administered to a patient with tuberculosis?
A
Heated and humidified
19
Q
What kind of transmission is tuberculosis?
A
Airborne
20
Q
How do you prevent infection transmission with tuberculosis?
A
`N95 mask
HEPA filter
Surgical mask when transporting
21
Q
What kind of airflow room does a patient with tuberculosis need?
A
NEGATIVE airflow room (DOOR CLOSED)
22
Q
What test should the nurse do every 3-4 weeks?
A
Liver tests because the meds can cause hepatotoxicity.
WATCH FOR JAUNDICE
23
Q
What kind of culture should the nurse get every 2 weeks?
A
AFB sputum culture
24
Q
How many consecutive negative AFB smears must a patient have to not be contagious?
A
3 consecutive
25
How long should you continue TB treatment?
Continue treatment until TB is gone and when you are no longer contagious you can go back to social activities.
26
What is metabolic alkalosis?
Losing acids
27
What is the pH and HCO3 for metabolic alkalosis?
pH above 7.45
HCO3 above 26
28
What is metabolic alkalosis caused by?
Loss of gastric juices (excessive vomiting)
Overuse of antacids
Overuse of potassium-wasting diuretics
Laxative overuse
Prolonged nasogastric suction
Cushing syndrome
29
What is metabolic acidosis
excess acids
30
What is the pH and HCO3 for metabolic acidosis
pH is below 7.35
HCO3 is below 22
31
What is Metabolic acidosis caused by?
Diabetic ketoacidosis
Severe diarrhea (elimination of bicarbonate)
Pancreatitis
Kidney/liver failure
32
What is respiratory alkalosis?
Hyperventilation (loss too much CO2)
33
What is the pH and PaCO2 for respiratory alkalosis?
pH above 7.45
PaCO2 below 35
34
What is respiratory alkalosis caused by?
Fear and anxiety
hypoxemia
fever, pregnancy, high altitudes
35
What is respiratory acidosis?
Hypoventilation (retaining CO2)
36
what is the pH and PaCO2 for respiratory acidosis?
pH below 7.35
PaCO2 above 45
37
What is respiratory acidosis caused by?
COPD
asthma
sleep apnea
obesity
Infections (pneumonia and flu)\
Drug overdose
Pulmonary embolism
chest trauma
airway obstruction
stroke
38
What are some clinical manifestations of Asthma?
Dyspnea
- use of accessory muscles
Chest tightness
Night sweats
Anxiety/stress
coughing
wheezing
39
What is a medical emergency for asthma?
SILENT CHEST!!!!
40
What position do you want to put someone with asthma?
High-fowlers position
41
When do you want to administer O2 therapy to someone with asthma
O2 saturation under 90%
42
What do you want to monitor for in someone with asthma?
Respiration rate and rhythm
43
What are some signs and symptoms of complications in asthma?
accessory muscle use
Loud wheezing
Fatigue
44
What do you want to teach someone with asthma?
to avoid and recognize triggering agents like dust and pollen
how to use hot water to eliminate dust mites in bed linens
45
When does someone with COPD exhibit dyspnea?
Upon exertion
46
When is a productive cough most severe in a pt with COPD?
In the morning
47
What color sputum might a pt with COPD have?
Rusty colored
48
What happens when a pt with COPD experiences Hypoexemia?
Not enough O2= confusion
49
What are other clinical manifestations of COPD?
crackles and wheezes
rapid, shallow respirations
50
What are some late signs of COPD?
Clubbing of fingers and toes
Pallor and cyanosis
Decreased O2 sat (88%-92% is the expected range)
Barrel chest
51
What position do you want to put someone in for COPD?
High- Fowlers
52
How should you apply oxygen to a pt with COPD?
low-flow (2-4 L NC)
up to 40% via venturi mask
52
MOC for COPD
encourage coughing and suction if needed
incentive spirometer
walking 2X/wk with rest periods
52
What is a pt with COPD at risk for?
infections
53
What kind of breathing should you teach a pt with COPD?
Diaphragmatic breathing (lie on back with knees bent)
Pursed-lip breathing
54
what should a patient with COPD absolutely stop doing?
SMOKING
55
What is stage 1 of HIV?
CD4 count above 500
rash, cough, fever, fatigue, chills, and weight loss can occur (flu-like symptoms)
56
What is stage 2 of HIV?
CD4 count is 200-499
Asymptomatic, still weight loss
The body makes antibodies and shows HIV+
57
What is stage 3 of HIV?
CD4 count is less than 200
AIDS-defying condition and major symptoms start
58
What is stage 4 of HIV?
CD4 count below 200
AIDS and death (no immune system)
Wasting syndrome
Chronic weakness and fever for more than 1 month
59
What are some diagnostics for HIV?
A positive result from HIV antibody screening
ELISA (antibodies) confirmed
- (+) result from supplemental HIV antibody test (western blot)
Home test kits (drops of blood)
60
What should a nurse assess in someone with HIV
Risk factors
pain
lung sounds/RR
Neurologic status (confusion, dementia)
Skin integrity (Rashes, open areas, bruising)
I&O
Vital signs
electrolytes
61
What should a pt with HIV report?
Signs and symptoms of infection
62
What should a person with HIV avoid?
crowds
raw/undercooked foods
sharing needles, razors, or toothbrushes
63
Education for a pt with HIV?
Abstinence
Condom use
Antimicrobial soap use
Use gloves when dealing with bodily fluids
Bleach 1:10 ratio
64
what is Lupus?
Auto-immune disease, the destruction of healthy tissue
65
What are some early signs of lupus?
Weight loss
malaise stiffness
Joint pain
butterfly rash
photosensitivity
66
what is usually the first complaint in a patient with lupus?
Fatigue
67
what should a person with lupus avoid?
stressful activities
sunlight
caffeine
alcohol
getting sick
68
What labs will be elevated in a patient with lupus
BUN
Creatinine
ESR
69
What might you see in a CBC for a pt with lupus?
Low RBC, WBC, & PLTS
IMMUNE SYSTEM IS ATTACKING ITSELF
70
What might a skin biopsy show in a pt with lupus?
confirms the presence of lupus cells
71
what does an immunologic test show in a person with lupus?
used to diagnose
antinuclear antibodies (ANA): antibodies produced against one's own DNA
72
Where does Ulcerative Colitis happen?
Primarily in the large intestine and rectum
73
Where is the pain primarily located in ulcerative colitis?
Abdominal pain in the LOWER LEFT QUADRANT
74
What are some clinical manifestations of ulcerative colitis?
Anorexia and weight loss
Rectal bleeding & stools containing blood/pus
75
What kind of bowel movements might a patient with ulcerative colitis have?
Diarrhea (liquidy stools)
15-20 diarrhea/ loose stools per day
76
When should a patient with ulcerative colitis seek emergency care?
Indications of bowel obstruction or perforation (fever, severe abdominal pain, and vomiting)
77
What should a patient with ulcerative colitis do for extreme/long exacerbations?
NPO and admin of TPN to promote bowel rest while providing adequate nutrition.
78
What should a person with ulcerative colitis avoid?
Alcohol and caffeine
79
How often should a person with ulcerative colitis weigh themselves?
1-2 times a week
80
What kind of diet should a person with ulcerative colitis be on?
High protein
low calorie
81
what kind of vitamins should a person with ulcerative colitis take?
iron
b12
82
How many/what kind of meals should a person with ulcerative colitis eat?
small frequent meals
83
What should a pt with ulcerative colitis avoid?
High fiber (raw fruits)
hard to digest foods (popcorn, nuts)
High-fat foods
spicy foods
dairy
allergen-prone foods (wheat and fish)
84
Where does Crohn's disease happen?
Whole GI tract, from mouth to anus
85
Where is the pain primarily located in Crohn's disease?
Abdominal pain in the RIGHT LOWER QUADRANT
86
What are some clinical manifestations of Crohn's disease?
Anorexia and weight loss
87
What kind of bowel movements does a person with Crohn's disease usually have?
diarrhea but only 5 loose stools per day.
88
When should a pt with Crohn's seek emergency care?
Indications of bowel obstruction or perforation (fever, severe, abdominal pain, and vomiting)
89
What should a patient with Crohn's do for extreme/long exacerbations?
NPO and admin of TPN to promote bowel rest while providing alcohol and caffeine.
90
What should a pt with Crohn's avoid?
alcohol and caffeine
91
how often should a person with Crohn's weigh themselves?
1-2 times per week
92
What kind of diet should a person with Crohn's be on?
High protein
Low calorie
Low fluid
Low fiber
93
what vitamins should a person with Crohn's take>
iron and b12
94
what should a person with Crohn's avoid?
High fiber (raw fruits)
hard to digest foods (popcorn, nuts)
High-fat foods
spicy foods
dairy
allergen-prone foods (wheat and fish)
95
What is cholecystitis?
Inflammation of the gallbladder wall
96
What is cholelithiasis?
Stones in the gallbladder
97
Where is the pain in someone with gallbladder disease?
Sharp pain in the RIGHT UPPER QUADRANT radiating to the RIGHT SHOULDER
98
What is Murphy's sign?
It is when the client holds their breath when palpating the RUQ.
99
What are some other clinical manifestations of gallbladder disease?
Intense pain (High HR) w N/V
Rebound tenderness (Blumberg's sign)
Jaundice (clay-colored stools, fatty stools, pruritus (bile salts in skin)
Fatty poop (steatorrhea)
100
What is some health promotion/teaching for a pt with gallbladder disease?
NO SMOKING
Regular exercise to promote weight reduction
101
What is some MOC for a person with gallbladder disease?
Extracorporeal shock wave lithotripsy
- shock waves can break up the stones
Cholecystectomy
-removal of gallbladder (laparoscopic)
- Minimally invasive or open approach
102
What kind of diet should a person with gallbladder disease be on?
Low-fat diet
- avoid fried foods, chocolate, nuts, gravy
-reduce dairy
Rich HDL diet
-seafood, nuts, olive oil
High protein
Small frequent meals
NO GAS-FORMING meals
- beans, cabbage, cauliflower, broccoli
103
What kind of vitamins should a pt with gallbladder disease take?
fat-soluble vitamins
-A, D, E, and K
104
a patient with gallbladder must be ____ before surgery
NPO
105
