complex final Flashcards
Pneumonia clinical manifestations
-Productive cough, pleuritic pain
-crackles and wheezes
-fever
-SOB
-O2 sat. less than 90%
Pneumonia nursing interventions
-collect sputum culture
-auscultate lung sounds
-monitor ABG’s
-suction as needed
-breathing treatments
-oxygen as needed
Pneumonia education
-Use incentive spirometer 10x Q1-2hrs
-Drink 2-3L fluid per day
-cough and deep breathe
Tuberculosis clinical manifestations
-cough lasting longer than 3 weeks
-purulent or bloody sputum
-weight loss
-night sweats
-lethargy
Airborne precautions
-N95 mask
-Gown
-Gloves
-Negative pressure room
-if client has to leave they need to wear a surgical mask
TB meds
RIPE orange
-Rifampin- orange secretions
-Isoniazid
-Pyrazinamide
-Ethambutol
What therapy for TB patients?
-heated and humidified oxygen therapy
What if pH less than 7.35 and HCO3 less than 22?
Metabolic Acidosis
What if pH less than 7.35 and PaCO2 greater than 45?
Respiratory Acidosis
What if pH greater than 7.45 and HCO3 greater than 26?
Metabolic Alkalosis
What if pH greater than 7.45 and PaCO2 less than 35?
Respiratory Alkalosis
Asthma clinical manifestations
-Dyspnea
-chest tightness, barrel chest
-anxiety or stress
-coughing, wheezing, mucus production
Asthma nursing interventions
-silent chest (no sounds)- very bad
-Raise HOB (high fowlers)
-administer Oxygen as prescribed
-monitor cardiac rate and rhythm during an acute attack
-monitor RR and rhythm
-incorporate rest into ADLs
-administer meds as prescribed
COPD clinical manifestations
-dyspnea
-productive cough
-crackles and wheezes
-rapid and shallow respirations
-use of accessory muscles, barrel chest
-enlarged neck muscles
-clubbing of fingers and toes
-pallor and cyanosis
COPD nursing care
-high fowlers
-encourage coughing to remove secretions
-2 to 4 L/min nasal cannula of oxygen
-monitor weight
-exercise walking for 20 min 3x a week
-drink 2-3L fluid a day
COPD meds
-Chronic Medications Save Lives
C- corticosteroids
M- methylxanthines and Mucolytics
S- short acting bronchodilators
L- long acting bronchodilators
Corticosteroids
-Fluticasone and Prednisone
-decrease airway inflammation
-can cause increased risk for infection, hyperglycemia, easy bruising
-rinse mouth after inhalational use
-don’t discontinue med suddenly
what medication is a Methylxanthine?
Theophylline
Mucolytic agents
-thin secretions
-acetylcysteine and dornase alfa are nebulizer treatments
-Guaifenesin is an oral agent
Short acting bronchodilators
-provide rapid relief
-albuterol
-can cause tachycardia and tremors
Long acting bronchodilators
-Ipratropium (anticholinergic)
-suck on hard candy
-palpations can occur
Complications of COPD
-respiratory infections
-Right sided HF (cor pulmonale)
HIV clinical manifestations
-Similar to flu
-night sweats, headache, sore throat, weakness, fatigue, chills, rash
HIV diagnostics
-enzyme linked immunosorbent assay test (ELISA)
- if positive, will be confirmed with a positive Western Blot test
-then if both positive= HIV
-Then viral load test done next
-also drug resistance and liver testing, Brain or lung MRI or CT scan
HIV nursing care
-Assess risk factors (sexual practices, IV drug use)
-monitor I&O’s, weight loss, nutritional intake, electrolytes
HIV education
-avoid crowds, cleaning litter boxes, RAW food
-conduct frequent CD4+ and Viral load counts
-no live vaccines
-clean needles with bleach
SLE findings
-Alopecia
-Fatigue/malaise/weakness
-blurred vision
-pleuritic pain
-anorexia/weight loss
-depression
-joint pain, swelling, tenderness
SLE physical assessment findings
-erythematous “butterfly” rash
-reynaud’s
-anemia
-lymphadenopathy
-fever
ulcerative colitis expected findings
-left lower quadrant pain
-rectal bleeding
-diarrhea: up to 15-20 liquid stools per day
Crohn’s disease expected findings
-Right lower quadrant pain
-anorexia and weight loss
-diarrhea: 5 loose stools per day
UC/Crohn’s nutrition
-High protein and calorie
-Low fiber
-vitamins and b12 injections
C and C findings
-sharp pain in right upper quadrant (often radiates to right shoulder)
-rebound tenderness (blumberg’s sign)
-Dyspepsia and eructation
-jaundice
C and C education
-low fat diet
-no gas forming foods (beans, cabbage, cauliflower, broccoli)
-regular exercise
C and C meds
-analgesics
-bile acid
Genital herpes manifestations
-Pain
-small red bumps
-blisters
-ulcers
-scabs
Genital herpes meds
-antivirals like acyclovir
Chlamydia manifestations
-females are often asymptomatic
-painful urination
-lower abdominal pain
-vaginal discharge
-penile discharge
-painful sexual intercourse
Chlamydia meds
-azithromycin and doxycyclin
-2x a day for 7 days
-no sex for 7 days, recheck in 3 months
Chlamydia complications
-other STI’s
-pelvic inflammatory disease
-infertility
-infection in newborns
Gonorrhea manifestations
-dysuria
-painful urination
-discharge from penis
-pain or swelling in testicles
-targets male urethra and female cervix
-infertility
-infections can spread to joints
-infants can have blindness
-vaginal bleeding
gonorrhea meds
antibiotics
BPH manifestations
-voiding difficulties
-incontinence
-intra-abdominal pressure increased
-infections
-Hematuria
BPH diagnostics
-Digital rectal exam (DRE)
-lab work (urinalysis, prostate-specific antigen test)
-cytoscopy
-transrectal ultrasound