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aa Orgo > CT 2 > Flashcards

CT 2 Flashcards

1
Q

COPD adventitious breath sounds:

A

Wheezing and crackles

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2
Q

COPD patient, limbs and neck

A

thin limbs

thick neck

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3
Q

COPD: fingers and toes

A

clubbing

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4
Q

COPD: Dependent edema secondary to

A

right-sided heart failure

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5
Q

COPD: hematocrit

A

An increased hematocrit level is due to low oxygenation levels.

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6
Q

COPD: Hypoxemia as evidenced by

A

PaO2 less than 80

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7
Q

COPD: Hypercarbia as evidenced by

A

PaCO2 greater than 45

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8
Q

enzyme used to detect COPD

A

AAT (alpha1 antitrypsin)

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9
Q

Pursed lip breathing instructions

A

Take a breath in through the nose and out through the lips/mouth.

Don’t puff cheeks

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10
Q

COPD: Clients who have chronically increased PaCO2 levels usually require ___ L/min of oxygen via nasal cannula

A

1 to 2

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11
Q

Positive Expiratory Pressure Device assists client to

A

remove airway secretions

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12
Q

COPD: how much should the client walk

A

20 min daily 2 to 3 times weekly

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13
Q

Cholinergic antagonists (anticholinergic medications), such as ipratropium are used for

A

long acting prevention of attacks

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14
Q

COPD: a medication that requires close monitoring of serum medication levels due to narrow therapeutic ranges. Use only when other treatments are ineffective.

A

Methylxanthines,

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15
Q

COPD: instructions for steroids

A

take with food

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16
Q

Right-sided heart failure (cor pulmonale) is caused by

A

airways collapsing/stiff alveoli

this leads to blood backing up to the right side

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17
Q

Right-sided heart failure (cor pulmonale) sign: enlarged and tender

A

liver

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18
Q

Right-sided heart failure (cor pulmonale) sign: ___ edema

A

dependent

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19
Q

Right-sided heart failure (cor pulmonale) sign: distended

A

neck veins

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20
Q

Right-sided heart failure (cor pulmonale): Administer __ __ and ____ to maintain fluid balance.

A

IV fluids and diuretics

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21
Q

The continuum from angina to myocardial infarction (MI) is termed

A

acute coronary syndrome

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22
Q

Symptoms of acute coronary syndrome are due to

A

an imbalance between myocardial oxygen supply and demand

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23
Q

Research shows improved outcomes following an MI in clients treated with these 3 medications

A

aspirin, beta-blockers, and angiotensin-converting enzyme (ACE) inhibitors.

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24
Q

what causes the pain in an MI

A

When blood flow to the heart is compromised, ischemia causes chest pain

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25
Q

occurs with exercise or emotional stress and is relieved by rest or nitroglycerin

A

Stable angina

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26
Q

occurs with exercise or emotional stress, but it increases in occurrence, severity, and duration over time

A

Unstable angina

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27
Q

is due to a coronary artery spasm, often occurring during periods of rest.

A

Variant angina (Prinzmetal’s angina)

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28
Q

what differentiates an MI from angina

A

Pain unrelieved by rest or nitroglycerin and lasting for more than 15 min

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29
Q

Is ischemia and infarction reversible?

A

Ischemia is reversible. An infarction results in permanent damage.

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30
Q

2 Metabolic disorders that are risks for MI

A

(diabetes mellitus, hyperthyroidism)

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31
Q

Earliest marker of injury to cardiac or skeletal muscle

A

Myoglobin

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32
Q

Myoglobin levels no longer evident after

A

24 hr

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33
Q

Peaks around 24 hr after onset of chest pain

A

CKMB

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34
Q

Troponin I or T

A

Any positive value indicates damage to cardiac tissue and should be reported

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35
Q

ST depression and/or T-wave inversion indicates presence of

A

ischemia

36
Q

ST-segment elevation indicates

A

injury

37
Q

Thallium scan

A

Assesses for ischemia or necrosis (which appear as cold spots)

38
Q

coronary angiogram aka cardiac catheterization or Angiography

A

2 different diagnostic procedures to check for blocks

39
Q

Angiography: assess client for

A

iodine/shellfish allergy

40
Q

coronary angiogram aka cardiac catheterization or Angiography client instructions

A

NPO for 8 hours

41
Q

Nitroglycerin actions

A

prevents coronary artery vasospasm

reduces preload and afterload, decreasing myocardial oxygen demand.

42
Q

Beta-blockers decrease the imbalance between myocardial oxygen supply and demand by

A

reducing afterload and slowing heart rate

43
Q

In an acute MI, beta-blockers

A

decrease infarct size and improve short- and long-term survival rates.

44
Q

Streptokinase (Streptase) and alteplase (Activase) are used to

A

break up blood clots

45
Q

clopidogrel (Plavix) prevent

A

platelets from forming together (same effect as aspirin)

46
Q

should be administered with nitroglycerin at the onset of chest pain.

A

aspirin

47
Q

can be a sign of aspirin toxicity

A

Tinnitus, ringing in the ears

48
Q

MI patient: Encourage the client to use aspirin tablets with

A

enteric coating and to take with food

49
Q

Heparin and enoxaparin contraindication: h/o

A

CVA

50
Q

Injury to the left ventricle can lead to

A

decreased cardiac output and heart failure.

51
Q

Progressive heart failure can lead to

A

cardiogenic shock

52
Q

Heart failure/cardiogenic shock: IV administration of morphine, diuretics, and/or nitroglycerin to decrease

A

preload

53
Q

Heart failure/cardiogenic shock: IV administration of vasopressors and/or positive inotropes to increase

A

cardiac output

54
Q

An inferior wall MI may lead to an injury to the AV node, resulting in bradycardia and

A

second-degree AV heart block

55
Q

An anterior wall MI may lead to an injury to the ventricle, resulting in

A

complete heart block

56
Q

Diverticulitis is inflammation and infection of the bowel mucosa caused by bacteria or fecal matter trapped in one or more

A

diverticula

57
Q

Diverticulitis is not to be confused with diverticulosis, which is

A

the presence of many small pouches in the colon with or without inflammation

58
Q

Many clients who have diverticulosis never develop

A

diverticulitis

59
Q

Teach the diverticulitis client to avoid indigestable material, which can block diverticulum such as

A

(nuts, popcorn, seeds)

60
Q

Instruct the diverticulitis client to avoid irritating the bowel. For example

A

avoid alcohol, limit fat to 30% of daily calorie intake

61
Q

Provide client with instructions to promote normal bowel function and consistency: the only kind of enema they should take is

A

bulk-forming laxatives

62
Q

Provide client with instructions to promote normal bowel function and consistency: avoid use of

A

enemas

63
Q

Diverticulitis: H and H findings

A

decreased

64
Q

Diverticulitis: WBC findings

A

increased (it’s an infection)

65
Q

barium enema and diverticulitis

A

contraindicated due to the risk of perforation.

66
Q

Diverticulitis: abx dose should be decreased for client with ___ impairment

A

renal

67
Q

Diverticulitis: a side effect of abx tx that you don’t need to worry about

A

discolored urine

68
Q

A tension pneumothorax occurs when

A

air enters the pleural space during inspiration through a one-way valve and is not able to exit upon expiration

69
Q

tension pneumothorax: the increase in pressure compresses blood vessels and limits venous return, leading to

A

a decrease in cardiac output

70
Q

pneumothorax where death can result if not treated immediately

A

tension pneumothorax

71
Q

____ pneumothorax can occur when there has been no trauma

A

spontaneous pneumothorax

72
Q

A small bleb on the lung ruptures and air enters the pleural space.

A

spontaneous pneumothorax

73
Q

with pneumothorax, the BP can

A

decrease because of decreased cardiac output

74
Q

Chest Tube Insertion: Prep the insertion site with

A

povidone-iodine

75
Q

For pneumothorax, the chest tube tip is positioned

A

up toward the shoulder

76
Q

The chest tube is sutured to the chest wall, and an ___ dressing is placed over the puncture wound.

A

airtight

77
Q

Chest tube client: every 2 hours encourage

A

coughing and DB

78
Q

Chest tube client: Report excessive drainage (greater than ____)

A

70 mL in an hour

79
Q

continuous bubbling should only be

A

in the suction chamber

80
Q

What should be going on in the water seal chamber

A

tidaling

81
Q

Chest tube: If the tubing separates, the client is instructed to

A

exhale as much as possible and to cough to remove as much air as possible from the pleural space

82
Q

If the chest tube drainage system is compromised, the nurse

A

immerses the end of the tube in sterile water to restore the water seal

83
Q

Provide ___ medication 30 min before removing chest tubes.

A

pain

84
Q

Chest Tube Removal: Instruct the client to

A

take a deep breath, exhale, and bear down (Valsalva maneuver)

or to take a deep breath and hold it

85
Q

Chest Tube Removal: Apply airtight sterile

A

petroleum jelly gauze dressing

86
Q

The client does not need to wear a ___ following a pneumothorax

A

mask

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