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Complex comprehensive Flashcards

1
Q

What is pneumonia?

A

Infection/ fluid in the lungs

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2
Q

What is the most common manifestation in older adults with pneumonia?

A

Confusion from hypoxia

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3
Q

What are some common manifestations of pneumonia?

A

Chest discomfort
Sharp chest pain due to coughing
Anxiety
Fatigue & weakness

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4
Q

What does an X-ray show in pneumonia?

A

Areas of consolidation

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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

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6
Q

What position increases breathing and drainage in pneumonia?

A

High Fowler’s position

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7
Q

What should the nurse encourage the patient to do to remove secretions?

A

Coughing

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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

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9
Q

What should the nurse encourage the patient to do while in bed with pneumonia?

A

Turn cough, deep breath and incentive spirometer

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10
Q

How much fluid should a person with pneumonia consume?

A

2-3L/day to thin secretions

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11
Q

When should a patient get their pneumonia vaccine?

A

Every 5 years

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12
Q

How many times does a pt 65+ years old need their pneumonia vaccine?

A

One time unless they have underlying conditions.

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13
Q

What is tuberculosis?

A

Infection in the lungs

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14
Q

How long does your cough need to last to be diagnosed with tuberculosis?

A

Longer than 3 weeks

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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

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16
Q

When might a person with tuberculosis have a fever?

A

Low-grade fever in the afternoon

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17
Q

What person is most at risk for tuberculosis?

A

A person who has recently traveled out of the country.

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18
Q

What kind of oxygen therapy should be administered to a patient with tuberculosis?

A

Heated and humidified

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19
Q

What kind of transmission is tuberculosis?

A

Airborne

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20
Q

How do you prevent infection transmission with tuberculosis?

A

`N95 mask
HEPA filter
Surgical mask when transporting

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21
Q

What kind of airflow room does a patient with tuberculosis need?

A

NEGATIVE airflow room (DOOR CLOSED)

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22
Q

What test should the nurse do every 3-4 weeks?

A

Liver tests because the meds can cause hepatotoxicity.

WATCH FOR JAUNDICE

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23
Q

What kind of culture should the nurse get every 2 weeks?

A

AFB sputum culture

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24
Q

How many consecutive negative AFB smears must a patient have to not be contagious?

A

3 consecutive

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25
Q

How long should you continue TB treatment?

A

Continue treatment until TB is gone and when you are no longer contagious you can go back to social activities.

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26
Q

What is metabolic alkalosis?

A

Losing acids

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27
Q

What is the pH and HCO3 for metabolic alkalosis?

A

pH above 7.45
HCO3 above 26

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28
Q

What is metabolic alkalosis caused by?

A

Loss of gastric juices (excessive vomiting)
Overuse of antacids
Overuse of potassium-wasting diuretics
Laxative overuse
Prolonged nasogastric suction
Cushing syndrome

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29
Q

What is metabolic acidosis

A

excess acids

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30
Q

What is the pH and HCO3 for metabolic acidosis

A

pH is below 7.35
HCO3 is below 22

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31
Q

What is Metabolic acidosis caused by?

A

Diabetic ketoacidosis
Severe diarrhea (elimination of bicarbonate)
Pancreatitis
Kidney/liver failure

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32
Q

What is respiratory alkalosis?

A

Hyperventilation (loss too much CO2)

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33
Q

What is the pH and PaCO2 for respiratory alkalosis?

A

pH above 7.45
PaCO2 below 35

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34
Q

What is respiratory alkalosis caused by?

A

Fear and anxiety
hypoxemia
fever, pregnancy, high altitudes

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35
Q

What is respiratory acidosis?

A

Hypoventilation (retaining CO2)

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36
Q

what is the pH and PaCO2 for respiratory acidosis?

A

pH below 7.35
PaCO2 above 45

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37
Q

What is respiratory acidosis caused by?

A

COPD
asthma
sleep apnea
obesity
Infections (pneumonia and flu)\
Drug overdose
Pulmonary embolism
chest trauma
airway obstruction
stroke

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38
Q

What are some clinical manifestations of Asthma?

A

Dyspnea
- use of accessory muscles
Chest tightness
Night sweats
Anxiety/stress
coughing
wheezing

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39
Q

What is a medical emergency for asthma?

A

SILENT CHEST!!!!

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40
Q

What position do you want to put someone with asthma?

A

High-fowlers position

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41
Q

When do you want to administer O2 therapy to someone with asthma

A

O2 saturation under 90%

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42
Q

What do you want to monitor for in someone with asthma?

A

Respiration rate and rhythm

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43
Q

What are some signs and symptoms of complications in asthma?

A

accessory muscle use
Loud wheezing
Fatigue

44
Q

What do you want to teach someone with asthma?

A

to avoid and recognize triggering agents like dust and pollen
how to use hot water to eliminate dust mites in bed linens

45
Q

When does someone with COPD exhibit dyspnea?

A

Upon exertion

46
Q

When is a productive cough most severe in a pt with COPD?

A

In the morning

47
Q

What color sputum might a pt with COPD have?

A

Rusty colored

48
Q

What happens when a pt with COPD experiences Hypoexemia?

A

Not enough O2= confusion

49
Q

What are other clinical manifestations of COPD?

A

crackles and wheezes
rapid, shallow respirations

50
Q

What are some late signs of COPD?

A

Clubbing of fingers and toes
Pallor and cyanosis
Decreased O2 sat (88%-92% is the expected range)
Barrel chest

51
Q

What position do you want to put someone in for COPD?

A

High- Fowlers

52
Q

How should you apply oxygen to a pt with COPD?

A

low-flow (2-4 L NC)
up to 40% via venturi mask

52
Q

MOC for COPD

A

encourage coughing and suction if needed
incentive spirometer
walking 2X/wk with rest periods

52
Q

What is a pt with COPD at risk for?

A

infections

53
Q

What kind of breathing should you teach a pt with COPD?

A

Diaphragmatic breathing (lie on back with knees bent)
Pursed-lip breathing

54
Q

what should a patient with COPD absolutely stop doing?

A

SMOKING

55
Q

What is stage 1 of HIV?

A

CD4 count above 500
rash, cough, fever, fatigue, chills, and weight loss can occur (flu-like symptoms)

56
Q

What is stage 2 of HIV?

A

CD4 count is 200-499
Asymptomatic, still weight loss
The body makes antibodies and shows HIV+

57
Q

What is stage 3 of HIV?

A

CD4 count is less than 200
AIDS-defying condition and major symptoms start

58
Q

What is stage 4 of HIV?

A

CD4 count below 200
AIDS and death (no immune system)
Wasting syndrome
Chronic weakness and fever for more than 1 month

59
Q

What are some diagnostics for HIV?

A

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
Q

What should a nurse assess in someone with HIV

A

Risk factors
pain
lung sounds/RR
Neurologic status (confusion, dementia)
Skin integrity (Rashes, open areas, bruising)
I&O
Vital signs
electrolytes

61
Q

What should a pt with HIV report?

A

Signs and symptoms of infection

62
Q

What should a person with HIV avoid?

A

crowds
raw/undercooked foods
sharing needles, razors, or toothbrushes

63
Q

Education for a pt with HIV?

A

Abstinence
Condom use
Antimicrobial soap use
Use gloves when dealing with bodily fluids
Bleach 1:10 ratio

64
Q

what is Lupus?

A

Auto-immune disease, the destruction of healthy tissue

65
Q

What are some early signs of lupus?

A

Weight loss
malaise stiffness
Joint pain
butterfly rash
photosensitivity

66
Q

what is usually the first complaint in a patient with lupus?

A

Fatigue

67
Q

what should a person with lupus avoid?

A

stressful activities
sunlight
caffeine
alcohol
getting sick

68
Q

What labs will be elevated in a patient with lupus

A

BUN
Creatinine
ESR

69
Q

What might you see in a CBC for a pt with lupus?

A

Low RBC, WBC, & PLTS
IMMUNE SYSTEM IS ATTACKING ITSELF

70
Q

What might a skin biopsy show in a pt with lupus?

A

confirms the presence of lupus cells

71
Q

what does an immunologic test show in a person with lupus?

A

used to diagnose
antinuclear antibodies (ANA): antibodies produced against one’s own DNA

72
Q

Where does Ulcerative Colitis happen?

A

Primarily in the large intestine and rectum

73
Q

Where is the pain primarily located in ulcerative colitis?

A

Abdominal pain in the LOWER LEFT QUADRANT

74
Q

What are some clinical manifestations of ulcerative colitis?

A

Anorexia and weight loss
Rectal bleeding & stools containing blood/pus

75
Q

What kind of bowel movements might a patient with ulcerative colitis have?

A

Diarrhea (liquidy stools)
15-20 diarrhea/ loose stools per day

76
Q

When should a patient with ulcerative colitis seek emergency care?

A

Indications of bowel obstruction or perforation (fever, severe abdominal pain, and vomiting)

77
Q

What should a patient with ulcerative colitis do for extreme/long exacerbations?

A

NPO and admin of TPN to promote bowel rest while providing adequate nutrition.

78
Q

What should a person with ulcerative colitis avoid?

A

Alcohol and caffeine

79
Q

How often should a person with ulcerative colitis weigh themselves?

A

1-2 times a week

80
Q

What kind of diet should a person with ulcerative colitis be on?

A

High protein
low calorie

81
Q

what kind of vitamins should a person with ulcerative colitis take?

A

iron
b12

82
Q

How many/what kind of meals should a person with ulcerative colitis eat?

A

small frequent meals

83
Q

What should a pt with ulcerative colitis avoid?

A

High fiber (raw fruits)
hard to digest foods (popcorn, nuts)
High-fat foods
spicy foods
dairy
allergen-prone foods (wheat and fish)

84
Q

Where does Crohn’s disease happen?

A

Whole GI tract, from mouth to anus

85
Q

Where is the pain primarily located in Crohn’s disease?

A

Abdominal pain in the RIGHT LOWER QUADRANT

86
Q

What are some clinical manifestations of Crohn’s disease?

A

Anorexia and weight loss

87
Q

What kind of bowel movements does a person with Crohn’s disease usually have?

A

diarrhea but only 5 loose stools per day.

88
Q

When should a pt with Crohn’s seek emergency care?

A

Indications of bowel obstruction or perforation (fever, severe, abdominal pain, and vomiting)

89
Q

What should a patient with Crohn’s do for extreme/long exacerbations?

A

NPO and admin of TPN to promote bowel rest while providing alcohol and caffeine.

90
Q

What should a pt with Crohn’s avoid?

A

alcohol and caffeine

91
Q

how often should a person with Crohn’s weigh themselves?

A

1-2 times per week

92
Q

What kind of diet should a person with Crohn’s be on?

A

High protein
Low calorie
Low fluid
Low fiber

93
Q

what vitamins should a person with Crohn’s take>

A

iron and b12

94
Q

what should a person with Crohn’s avoid?

A

High fiber (raw fruits)
hard to digest foods (popcorn, nuts)
High-fat foods
spicy foods
dairy
allergen-prone foods (wheat and fish)

95
Q

What is cholecystitis?

A

Inflammation of the gallbladder wall

96
Q

What is cholelithiasis?

A

Stones in the gallbladder

97
Q

Where is the pain in someone with gallbladder disease?

A

Sharp pain in the RIGHT UPPER QUADRANT radiating to the RIGHT SHOULDER

98
Q

What is Murphy’s sign?

A

It is when the client holds their breath when palpating the RUQ.

99
Q

What are some other clinical manifestations of gallbladder disease?

A

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
Q

What is some health promotion/teaching for a pt with gallbladder disease?

A

NO SMOKING
Regular exercise to promote weight reduction

101
Q

What is some MOC for a person with gallbladder disease?

A

Extracorporeal shock wave lithotripsy
- shock waves can break up the stones
Cholecystectomy
-removal of gallbladder (laparoscopic)
- Minimally invasive or open approach

102
Q

What kind of diet should a person with gallbladder disease be on?

A

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
Q

What kind of vitamins should a pt with gallbladder disease take?

A

fat-soluble vitamins
-A, D, E, and K

104
Q

a patient with gallbladder must be ____ before surgery

A

NPO

105
Q
A

Complex Comprehensive exam (1 decks)

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