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Nursing 1 > Exam 2 (W5&6 Respiratory) > Flashcards

Exam 2 (W5&6 Respiratory) Flashcards

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1
Q

Prolonged obstruction of nasal passage (NG tube or intubation is linked to what

A

sinusitis

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2
Q

Why is Endotracheal intubation also at risk for nosocomial sinus

A

because of pooling of nasopharyngeal secretions

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3
Q

Why are patients with artificial airway at high risk for infection

A

no cilia - cant catch cilia

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4
Q

What is the most common sign of meningitis

A

sinusitis

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5
Q

What are s/s meningitis

A

s/s photophobia, seizers, stiff neck (nucalrigidity), fever

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6
Q

neuroanatomy related to respiration is controlled by what

A

medulla and pons

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7
Q

What do Central chemoreceptors in the medulla do?

A

respond to change in PCo2 and ph levels in csf –> alter rate and depth of respirations

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8
Q

What do peripheral chemoreceptors do in relation to the respiratory system?

A

respond first to po2 (less than 60), then will respond to ph and pco2 by altering rate and depth

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9
Q

Describe what happens to the central chemoreceptors in patients with COPD

A

No longer respond to CO2 or pH in patients with COPD

elevated CO2 does not get a response; these people rely on peripheral chemoreceptors

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10
Q

Hering-breuer reflex

A

prevents overinflation of the lungs

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11
Q

Why do we not want to give patients with COPD too much o2?

A

their O2 will get too high ; if we give them too much they will stop breathing

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12
Q

What are the components of external respiration?

A

Ventilation (act of breathing)

Perfusion (blood flow to alveoli)

Diffusion (Movement of gases from high concentration to low concentration)

– between environment and lungs

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13
Q

Describe internal respiration

A

Oxygen is supplied to and co2 is removed from body cells by way of circulation
- between blood and cell

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14
Q

Describe the flow of air from the environment into the lungs

A

trachea, bronchi, bronchioles, alveoli

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15
Q

Airway resistance of determined by what?

A

The size of the airway through which the air is flowing

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16
Q

Bronchospasm

A

Airway resistance in which there is contraction of bronchial smooth muscle

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17
Q

Obstruction of airway

A

Airway resistance in which a foreign object is in airway preventing adequate CO2

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18
Q

What diseased is related to thickening of bronchial mucosa?

A

COPD, asthma

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19
Q

Compliance

A

ability of lungs to return to normal - expandability and elasticity

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20
Q

What contributes to compliance of the lungs?

A

a. Surfactant (surface tension)

b. CT

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21
Q

What happens to the lungs with increased compliance?

A

causes lungs to not return to normal elasticity (emphysema)

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22
Q

What happens to the lungs and with decreased compliance?

A

They are stiff ARDS, pneumothorax, pulmonary edema, pleural effusion

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23
Q

What is the tidal volume normal range?

A

500mL (5-10mL/kg)

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24
Q

What is vital capacity and what is its range?

A

the amount of air you can move out

4800mL (20-40mL/kg)

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25
Q

What needs to happen with vital capacity less than 20mL/kg?

A

patient needs ventilatory assistance

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26
Q

What is pulmonary perfusion?

A

Blood flow through the pulmonary circulation

– 2% of blood flow pumped by the rv does not perfuse the alveolar capillaries (doesn’t enter pulmonary circulation)

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27
Q

What is pulmonary artery pressure value?

A

20-30mmHg

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28
Q

Describe effects of gravity on pulmonary circulation?

A

Lower areas receive more blood flow than upper areas

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29
Q

Describe the functions of RV and LA

A

Right ventricle into pulmonary circulation, picks up o2, left atrium to be projected out into body by

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30
Q

Ventilation vs perfusion and their ratios

A

Ventilation is flow of gas in and out of lungs (normal 4 L/min)

Perfusion is filling of the pulmonary capillaries with blood (normal 5 L/min)

Perfusion ratio is 4:5 or 0.8

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31
Q

What is shunting?

A

Shunting (low v/q ratio)
Normal shunting is 2%
Secondary to airway obstruction
Blood is bypassing the alveoli without gas exchange
Severe hypoxia occurs when shunting is 20%

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32
Q

Dead space

A

(high v/q ratio)
Adequate ventilation but impaired perfusion
Pulmonary embolus

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33
Q

What is silent unit?

A

unit (absence of v/q)

Little to no ventilation and perfusion (ARDS)

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34
Q

Describe ventilation and perfusion with pulmonary embolism

A

clot siting in artery – ventilation is fine but the clot is blocking gas exchange (increase in shunts); RV not getting blood into pulmonary circulation

– hypoxic, cyanotic, dusky

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35
Q

Describe what happens when O2 saturation is below 70%.

A

vessels constrict

Start shunting O2 where it needs to be (heart, lungs, brain, kidneys)

Increased vascular resistance and pulmonary vasoconstriction

Increased pressure on right ventricle (Cor pulmonale)

Systemic vessels dilate

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36
Q

What is cor pulmonale

A

Right sided heart failure

Enlargement of the right ventricle due to high blood pressure in the lungs usually caused by chronic lung disease

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37
Q

What happens in the RV with COPD?

A

RV has to work against the pulmonary pressure; the pulmonary pressure increases the workload and the patient goes into heart failure (cor pulmonale)

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38
Q

How much blood is deoxygenated before we see change in skin color?

A

1/3

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39
Q

What are the gas % at room air?

A

78% nitrogen
21% oxygen
traces of CO2, water vapor, helium, argon

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40
Q

Describe what blood does in the body

A

Transported dissolved in blood in two forms

  • Dissolved in plasma
  • Combines with the hemoglobin of RBC
  • 100 ml of arterial blood carries 0.3 ml of oxygen dissolved and 20 ml combined with the hemoglobin
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41
Q

Hemaglobin

A

Hemoglobin rapidly releases oxygen into the tissues to satisfy metabolic needs

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42
Q

What happens when hemoglobin is present as methemoglobin

A

not carrying o2 –> hypoxic and cyanotic

drug reaction from local anesth.

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43
Q

What happens to hemoglobin when carbon monoxide is present

A

Causes hemoglobin to not combine with the oxygen

Resulting in tissue hypoxia and LACTIC ACIDOSIS

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44
Q

Gerontologic considerations for respiratory system: defense mechanisms

A

decreased cough reflex (increased infection risk); decreased pulmonary reserve, at risk for respiratory acidosis d/t hypoventilation

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45
Q

Gerontologic considerations for respiratory system: lung

A

Smaller alveolar space - impacts gas exhange

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46
Q

Gerontologic considerations for respiratory system: chest and wall muscle weakness

A

intercostal muscles are smaller which inhibits them from taking BIG deep breaths

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47
Q

Gerontologic considerations for respiratory system: skeletal changes

A

Kyphosis, scoliosis, lordosis –> Impact ability to take big deep breath

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48
Q

Respiratory assessment: dyspnea

A

difficult or labored breathing - SOB

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49
Q

Respiratory assessment: cough

A

Everyone w lung disease will have a cough –> ask if the cough is different than normal

Pneumonia or other rr conditions – don’t panic with little specks of blood – clots of blood = issue

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50
Q

Respiratory assessment: Sputum production

A

Color? Same or different color?

Yellow = indication of acute infection (on top of normal pathogens that they have in their sputum)

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51
Q

Respiratory assessment: hemoptysis

A

Blood in sputum

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52
Q

Respiratory assessment: chest pain

A

Accompanies cardiac events
Could be indicator of emboli

How do we know if chest pain is cardiac or pulmonary? Does this chest pain get worse when you breath (pulm. Issues gets worse with breathing)

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53
Q

Respiratory assessment: wheezing

A

Wheezing in someone with asthma = good
Stridor = never good (call provider)

Silent chest / no wheezing during acute asthma attack = not breathing

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54
Q

Respiratory physical assessment - color

A

Cyanosis = late indicator of hypoxia (not a reliable indicator of hypoxia)

polycythemia may always appear cyanotic

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55
Q

Where should you assess for physical assessment of skin for respiratory conditions of dark skinned individuals?

A

buccal mucosa and hard palate

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56
Q

What are early indicators of hypoxia?

A

tachycardia, agitation, confusion

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57
Q

What should you do if someones heart rate is greater than 100 (tachycardia)?

A

put oxygen on them

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58
Q

What can cause the trachea to NOT be midline?

A

Pressure in chest (air, blood) pushing trachea to be deviated = bad –> 3am phone call because patient cant breath long w this

Hard to put endotracheal tube w deviated trachea (almost impossible to intubate)

Neck surgery at risk for bleeding and can push trachea (thyroid, cervical fusion, carotid artery cleaning)

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59
Q

Physical assessment of lower respiratory structures and breathing - how do we asses?

A

Thoracic inspection
Thoracic palpation
Thoracic percussion
(correct order)

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60
Q

Describe the inspection of the lower respiratory structures and breathing

A

symmetrical rise and fall of chest wall

side vs front –> ppl w normal pulmonary status will have double width to length of chest;

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61
Q

Course vs fine crackles

A

Depend on the amount of water in the lungs

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62
Q

What does pleural friction rub sound like and when would you hear it

A

Leather

- Hear it with pleural effusion and pleurisy

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63
Q

What might we hear when someone has pneumonia?

A

fine crackles because bacterial are liquidy, wet when they dry up you hear course

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64
Q

Describe basilar crackles

A

Edema in bases of the lungs - insignificant

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65
Q

What should we be concerned about crackles?

A

When we hear them taking up 1/3 - 2/3 of the lungs

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66
Q

What medications might we administer with edema, stridor and wheezes?

A

Edema - diuetics
Stridor - albuterol, IV corticosteroids
wheezes - albuterol

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67
Q

Common assessment findings we here for…

a. consolidation (pneumonia)
b. emphysema
c. asthma
d. pulmonary edema
e. pleural effusion
f. pneumothorax
g. atelectasis

A

a. Consolidation (pneumonia): crackles
b. Bronchitis: wheezes decreased
c. Emphysema: decreased with prolonged expirations
d. Asthma: wheezes
e. Pulmonary edema: crackles at bases, possible wheezes
f. Pleural effusion: decreased to absent breath sounds
g. Pneumothorax: absent or diminished
h. Atelectasis: decreased to absent, fine crackles (cough and deep breath)

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68
Q

Diagnostic evaluation: PFT

A

PFT: pulmonary function test

  • never done in emergency
  • lot of deep breathing, prolonged
  • inhalation/exhalation and measuring that volume
  • done if c/o SOB –> inhaler and then do PTF to see how it is working

can be done Q6 months or annually w ppl who have chronic lunch disease to monitor how well disease is being controlled

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69
Q

What are some considerations for PFT tests?

A

don’t have to be NPO in preparation, no consent needed, don’t eat too much before, need to know if provider wants the test done w or w/o inhaler,

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70
Q

Chest xray

A

radiation to take pic

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71
Q

CT

A

computerized tomography - can use contrast dye with consent from patient

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72
Q

MRI

A

can not have metal

with or without contrast

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73
Q

PET scan

A

d/x metastatic cancer disease; give potive glucose isotope that attacked to the fast growing cancer cells

74
Q

Fluorscopic imaging

A

Watching lungs in motion

75
Q

Pulmonary angiography

A

Using dye; put dye into very large vessel; assess bleeding w this procure; after hold pressure artery tight enough to decrease hematoma and loose enough feet get perfused (foot pulses)

76
Q

What are considerations for contrast dye?

A

monitor BUN and Creatinine (can cause kidney failure –> fluids and diuretics); shellfish allergy, IV administration; stop metformin 24-48 h before contrast dye (lactic acidosis)

77
Q

Pulse o2 considerations

A

not reliable –> only detects that the hemoglobin has something attached to it – but does not tell you WHAT

should be greater than 92%

if pt acting hypoxic and pulse o2 is high, something is going on

78
Q

Describe end tidal co2

A

CO2 level
co2 we breath out tested thru nose
can have a monitor attack to nasal canula o2
35-45
how we pick up someone holding onto Co2 in
operating room for developing malignant CO2

79
Q

What should you monitor when someone has a pulmonary angiography

A

s/s bleeding (tachycardia, hypotension)

80
Q

What are examples of endoscopy diagnostic evaluations for respiratory system?

A

Bronchoscopy and tharacentesis

81
Q

Describe thoracentesis

A

Sit in tripod position
Needle thru ribcage and sucking out fluid in pleural space
Yellowish fluid – plasma

must have consent

82
Q

Describe bronchoscopy

A

stick tube down throat to look inside trachea and pulmonary branches

Could go in to do biopsy, flush/suck out occlusion, foreign body

requires throat numbing, usually with a–caine drug which takes away numbing

Risk of of methamaglobin

83
Q

What are things to consider before and after bronchoscopy

A

After bronchoscopy patient could be hypoxic / cyanotic because of methamaglobin

Pt will not have gag reflex after, so no food until its back

NPO prior because we are getting rid of gag reflect with the anesthetic

84
Q

What is something to consider when spinal and epidural anesthesia and thoracentesis

A

when we take out the needle, we put hole in cerebral spinal fluid and 90% of time it closes, but
Sometimes we get a leak (post spinal or epidural)

patient might complain of HA

Lay flat to put pressure where hole was to prevent leak and help close hole

85
Q

What is Rhinitis?

A

Inflammation and irritation of the mucous membranes of the nose; contagious

can be acute, chronic or d/t allergies

do not have s/s and treatment

86
Q

rhinosinusitis

A

Inflammatory process involves sinuses
and nasal cavity
Acute bacterial
Acute viral

Symptoms?
Management?
complications?

87
Q

Pharyngitis

A

Sudden inflammation of the pharynx
Acute post streptococcal glomerulonephritis

Patho?
Manifestations?
Complications?

88
Q

Pharyngitis treatment

A

Keep airway patent

Fluids if they can drink

89
Q

What is the most common cause of pharyngitis?

A

Steptococcous

90
Q

considerations for streptococcal bug

A

potential for strep bug to land in other organs (kidneys common, hip, knee joints)

Kidney failure common w this bug

91
Q

Laryngitis

A

inflammation of larynx

Patho?
Manifestations?
management?

92
Q

Obstructive sleep apnea

A

Recurrent upper airway obstruction while sleeping

Reduction in ventilation — frequent arousals— periodic desaturation

93
Q

What does obstructive sleep apnea have a higher prevalence in?

A

hypertension

94
Q

what is someone at increased risk of if they have obstructive sleep apnea

A

MI, stroke, death, insulin resistance which can increase risk of vascular disease

95
Q

obstructive sleep apnea: diagnosis

A

sleep study

96
Q

obstructive sleep apnea: management

A

CPAP/BiPAP mask while sleeping, positive pressure that hold airway open (do not breath for patient or give patient o2) – apply pressure (positive pressure) to keep airway open (but you can get supplemental O2 for these if pt needs)

97
Q

cpap and bipap - teaching

A

clean to prevent infections

98
Q

What might cause obstructive sleep apnea?

A

Soft tissue collapsing (overweight or lot of neck tissue)

99
Q

Epistaxis

A

Nose bleed - rupture of tiny distended vessels

100
Q

Epistaxis managemange

A

Do not lay down; lean forward so we don’t swallow blood (n/v can make nose bleed again d/t pressure)

Pressure on lower 1/3 of nose (not tip of nose)

Cauterize vessels

101
Q

Nasal obstruction: what, cause, management

A

Passage of air obstructed

Cause: foreign body or deviated septum

Management

  • Surgery to remove foreign body
  • Rhinoplasty to fix deviated septum
102
Q

Nasal fractures cause

A

direct assault

103
Q

Nasal fracture complications

A

hematoma, infection, abscess, vascular/ septic necrosis

104
Q

Nasal fracture management

A

rebreak nose to get septum straight

surgery

105
Q

Laryngeal obstruction cause

A

Caused from allergic reaction

106
Q

Laryngeal obstruction complication

A

edema ??

107
Q

management of upper airway obstruction (foreign body, allergic reaction)

A

Foreign body - heimlich, tracheostomy
allergic reaction - SQ epinephrine, corticosteroid

continous pulse ox
ensure patent airway

108
Q

Asphyxia

A

a condition arising when the body is deprived of oxygen, causing unconsciousness or death; suffocation.

109
Q

Cancer of larynx: s/s

A 
Hoarseness > 2 weeks   
harsh raspy and lower pitch 
Dysphagia   
dyspnea  
unilateral nasal obstruction 
discharge

Persistent hoarseness
persistent ulceration
foul breath

110
Q

Cancer of larynx management

A

Removal of larynx

111
Q

What is a tracheostomy

A

opening into the tracheostomy

112
Q

What are the types of tracheostomy

A

cuffed, uncuffed, fenestrated

113
Q

When might someone get a fenestrated trach

A

holes on tube; when we start to allow patient to talk and ween off ventilator

114
Q

Pulsating tracheostomy

A

BAD

115
Q

Why do people with long term ventilation do well with a trach

A

easier to ween off than ventilator

116
Q

what should nurse do if trach comes out in first 72 hours of administration

A

call provider - they must reinsert reinserts because fragile scar tissue. After 72 nurse can reinsert

117
Q

tracheostomy considerations

A

always make sure there is a replacement tube in room in case is comes out

might be bloody immediately after insertion. Patient might even be coughing clots up from it because the new tube is irritating the airway

118
Q

What is atelectasis

A

collapse of alveoli, loss of lung volume

119
Q

Atelectasis causes what? (external respiration)

A

Causes a mismatch of ventilation and perfusion causing deoxygenated blood reaching circulation

120
Q

Atelectasis risk factors

A

Hypoventilation: post op, pain, narcotics, chronic lung, obesity

121
Q

Atelectasis: clinical manifestations and assessment

A

Dyspnea, cough, leukocytosis, diminished breath sounds, sputum production

122
Q

atelectasis: medical management and nursing management

A

Incentive spirometer
Chest physiotherapy
Nebulizers
prevention

123
Q

Atelectasis: chest physiotherapy

A

cuffing hands and beating back of chest off the way up

124
Q

Atelectasis: postural drainage

A

affected lung up (laying on side) and beating on affected lung to loosen it up

125
Q

Pneumonia pathophysiology

A

Microorganisms reach the lower airways activate an inflammatory response

126
Q

Pneumonia clinical manifestations and assessment

A

fever and cough (productive or non productive), dyspnea, leukocytosis

127
Q

Pneumonia - medical and nursing management

A 
Pharmacologic therapy (dependent on culture)
Oxygen inhalation therapy
128
Q

Pneumonia prevention

A

oral care, hand washing, immunizations

129
Q

pneumonia gerontological considerations

A

encourage vaccine, teach to cough and deep breath on the own, incentive spirometer

130
Q

Pulmonary TB patho

A

airborne transmission

131
Q

Pulmonary TB clinical manifestations and assessment

A

Night sweats, low grade fever, cough, fatigue, weight loss

dyspnea, chest pain, hemoptysis as disease progresses

132
Q

Pulmonary TB: Sputum AFB test reading

A

confirmative is sputum afb smear indicating mycobacterium (acid fast bacilli will come back + when active)

133
Q

pulmonary TB: Skin test and quantiferon TB Gold reading

A

indicate the person has been infected and further testing is required to determine active or latent disease

134
Q

TB skin test reading procedure and reading

A

TB skin test read 48-72 hours (induration 5 mm significant for those at risk, 10 mm for those with normal immunity)

135
Q

TB meds

A

Isoniazid (INH) & rifampin

all hepatotoxic

136
Q

What is taken with Isoniazid to prevent peripheral neuropathy

A

Vitamin b (pyridoxine)

137
Q

What is recommended treatment for those whose sputum remains positive after the 1st two months of treatment for TB

A

30 week treatment recommended

138
Q

Side effects of TB meds: isoniazid

A

Avoid tyramine
HA, flushing, hypotension
Compliance is an issue r/t sfx of medications

139
Q

Side effects TB Rifampin

A

Orange urine
increased metabolism of many common medications
Compliance is an issue r/t side effects of medication

140
Q

What can we do to increase and assure compliance of TB meds

A

use direct observation treatment (DOB)

141
Q

Pulmonary Edema: Patho

A

Capillary fluid leaks into the alveolar spaces

The edematous alveoli are unable to participate in gas exchange

142
Q

Clinical Manifestations and assessment of pulmonary edema

A

Pink tinged frothy sputum

crackles

143
Q

Medical management and nursing management of pulmonary edema

A

O2, respiratory support, IV fluids, cardiac treatment aimed at improving LV function

144
Q

Pleurisy patho

A

inflammation of pleurae

145
Q

Pleurisy risk factors

A

Pneumonia, PE, cancer

146
Q

Pleurisy: clinical manifestations and assessment

A

Sharp knife-life pain

Taking deep breath makes pain worse

147
Q

Pleurisy: medical and nursing management

A

time and pain meds (intercostal pain blocks, opioids)

148
Q

Pleural effusion and empyema: patho

A

Collection of fluid in the pleural space

149
Q

Pleural effusion and empyema is often a complication of what?

A

pneumonia, chf, tb, pe, tumors, nephrotic syndrome, pancreatitis, cirrhosis

150
Q

Clinical manifestations and assessment of pleural effusion and emphysema

A

Severity depends on size of effusion

Decreased or absent breath sounds in area of effusion

151
Q

Pleural effusion and empyema: medical and nursing management

A 
Thoracentesis (drain)
TPA (breaks up fibrin surrounding empyema so we can treat it)
Pleurodesis
Decortication (scrape out "orange peel)
Pleuroperitoneal shunt
152
Q

Acute respiratory failure: patho

A

Sudden life threatening deterioration of gas exchange
Decreased respiratory drive
Dysfunction of the chest wall

153
Q

Acute respiratory failure cause?

A

Dysfunction of the lung parenchyma (pneumo, hemo, effusion, obstruction)
Cervical spine injury
Drowny, DIC

154
Q

Acute respiratory failure: medical and nursing management

A

Turning, mouth care, skin care, prevent contractures

be sure to do these when patient on ventilator

155
Q

Acute respiratory distress syndrome

A

Severe lung injury

Sudden and progressive pulmonary edema

Hypoxemia refractory to supplemental oxygen

Lung compliance and functional reserve capacity decrease

156
Q

Acute respiratory distress syndrome: risk factors

A

Direct injury to lungs (smoke, near drowning)
Transfusion related (TRALI), transfusion circulatory overload (TACO)
DIC
Shock
Fat or air embolism

157
Q

Acute respiratory distress syndrome: assessment

A

Pao2 to fio2 ratio (normal ratio is over 300)
– 200-300mild, 100-199 moderate and less than 100 severed

Pao2 (abgs) and fio2 being administered

158
Q

Acute respiratory distress syndrome: medical and nursing management

A

Positive end expiratory pressure
Keep alveoli open 30 mmhg or less
Low tidal volume
May cause hypotension r/t leakage of fluid into interstitial spaces

159
Q

Acute respiratory distress syndrome: pharm therapy

A

Neuromuscular blockers

Pain and anti anxiety

***patient receiving aminoglycosides and/or steroids increased the chance of the client who is chemically paralyzed developing polyneuropathy (muscular atrophy and deconditioning: requires intensive physical therapy to correct)

160
Q

ARDs nutritional therapy

A

20-25 kcal/kg/day

Enteral is preferred

161
Q

ARDS - general measures (nursing management)

A

positioning - prone

rest is important

162
Q

ARDS: vent considerations

A

Pneumothorax can occur
Corneal abrasions
Skin breakdown
rom

163
Q

What is the mean PA systolic pressure?

A

12-15mmhG

164
Q

What is pulmonary artery hypertesion

A

mean PA pressure greating than 25mmHg

165
Q

Pulmonary artery hypertension cause

A

Idiopathic (no known cause) or secondary r/t to a known cause
— CHD, portal hypertension, pulmonary disease

166
Q

Pulmonary artery hypertension clinical manifestations and assessment

A

increased pressure leads to RV failure

167
Q

pulmonary artery hypertension medical and nursing management

A 
Goal is to treat underlying cause 
Oxygen therapy
Anticoagulant therapy
Calcium channel
Lung transplant
Prostacyclin
168
Q

What is prostacyclin?

A

Used for pulmonary artery hypertension

potent vasodilator direct into the pulmonary circulation: very short half life
Decrease pressure

169
Q

Pulmonary embolism

A

Blood clot or thrombus, air, fat, amniotic fluid, tumor cells, iv injected particulates and sepsis

Alveolar dead space: ventilation no perfusion

170
Q

PE clinical manifestations and assessment

A 
S4 and split s2 heart sound
Sudden onset of chest pain
SOB
Tachycardia 
Extra heart sound 
Saddle emboli refers to location of clot
Death commonly occurs within hours
D dimer positive 
Spiral ct
171
Q

PE medical and nursing management

A

Anticoagulant (PTT therapeutic 2-2.5 times normal, 70-90)

Thrombolytic
Surgical intervention
Minimize the risk of pe
Monitoring thrombolytic therapy
Bed rest
Close vital sign monitoring
172
Q

Lung cancer patho

A

Benign, malignant, metastatic
Leading cancer killer among women and men
Most caused by cigarette smoking
Staging T (extent of tumor) N (node involvement) M (Metastasis)

173
Q

Lung cancer Risk factors

A

Genetic, tb, copd, cigarette, environmental

174
Q

lung cancer: clinical manifestations and assessment

A

Dyspnea, hemoptysis, fever

175
Q

lung cancer: medical and nursing management

A

Surgical management
Radiation
Chemotherapy
Palliative therapy

176
Q

Tumors of mediastinum patho

A

Neurogenic tumor, thymus, lymphomas

177
Q

tumors of mediastinum: clinical manifestations and assessment

A

Symptoms result from pressure against intrathoracic organs

Cough, wheezing, dyspnea

178
Q

Tumors of mediastinum: medical and nursing management

A

Most are benign and operable

179
Q

Blunt and penetrating trauma: patho

A

MVA, falls, bicycle crashes

Gunshot, stab

180
Q

Blunt and penetrating trauma: clinical manifestations and assessment

A 
Airway obstruction
Tension pneumo: trachea not midline
Flail chest
Cardiac tamponade
Pulmonary contusion
181
Q

What is the MOST important thing to make sure of with blunt and penetrating trauma

A

CIRCULATION (only time circulation will be more important) then…
- airway, breathing

182
Q

Blunt and penetrating trauma: medical and nursing management

A

Blood transfusion
Crystalloids
Chest tube
surgery

Nursing 1 (6 decks)

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