Exam 4 Prep Flashcards
What is the primary clinical symptom of emphysema?
Wheezing
A patient is presenting with chronic obstructive pulmonary disease. The patient has a chronic productive cough with dyspnea on excretion. Arterial blood gases show a low oxygen level and high carbon dioxide level in the blood. On assessment, the patient has cyanosis in the lips and edema in the abdomen and legs. Based on your nursing knowledge and the patient’s symptoms, you suspect the patient suffers from what type of COPD?
Chronic bronchitis
The nurse concludes that a client has understood teaching about menopause when the client states:
“I know I have begun menopause and it will take awhile to finish.”
Signs and symptoms of andropause include all of the following except:
Decrease in intellectual capacity
S/S of Cystic Fibrosis:
- Cold
- Thick sticky mucus
- Steatorrhea {Fatty stools}
- Diarrhea
Pathophysiology of chronic bronchitis:
Air sacs in alveoli in the lungs do not work properly due to chronic irritation, chronic irritation, and reoccurring of larger airway
+ Cough and sputum production for at least 3 months in each of 2 consecutive years
+ Ciliary function is reduced, bronchial walls thicken, bronchial airways narrow, and mucous may plug airways
+ Alveoli become damaged, fibrosed, and alveolar macrophage function diminishes
+ The patient is more susceptible to respiratory infections
What is the primary nursing intervention for a pt with emphysema?
You assess O2 Saturation (Pulse Ox) before administering O2 if its too low
What are complications experienced in COPD?
Scar tissue that could lead to pulmonary hypertension (and airway narrowing)
Clubbing of fingers due to chronic hypoxemia
Barrel chest
Right sided heart failure {Cor Pulmonale)
What is the proper way of using a metered dose inhaler (MDI)?
Expel med in barrel and inhale
2 puffs of same med = wait 1 min between puffs
Bronchodilators will be administered before corticosteroids
What are discharge instructions for a pt with COPD?
+ Avoid smoking and irritants that would irritate or exacerbate their breathing activities
+ Pace to conserve energy
+ Seek help if they have a fever
+ Pursed lip breathing
+ Get vaccinations (influenza and pneumonia)
+ Compliance with medications
S/S of chronic bronchitis:
+ Color dusky due to cyanosis
+ Cyanosis is also seen in their nail beds
+ Peripheral edema (Edema of the limbs)
+ Hypercapnia
+ Increased Sputum production [Chronic productive cough]
What pt teaching will you offer for a pt to manage emphysema:
Stop smoking
S/S of Pulmonary Hypertension:
- JVD
- Fatigue
- Chest pain
- Palpations
- Lower extremity swelling
- Sleep apnea
- Daytime Hypersomnolence
- Light headedness/ dizziness
- Syncope
- Loud tricuspid regurgitation murmurs
- Dyspnea
- Abdominal swelling
- Peripheral edema
- Tachycardia
Normal AP lateral ratio:
1 - 2
Risk factors for child being born with cystic fibrosis:
+ Both parents carry the gene so the child has a 50% {1:4 chance} chance of being a carrier of cystic fibrosis
+ The mutated gene is = Chromosome 7
What is the priority assessment of a child with cystic fibrosis:
(Their pancreas is not functioning properly)
Malnutrition because the child will not be able to absorb Vitamins D, E, K, A {Fat soluble vitamins}
S/S of emphysema: (Will you see residual lung volumes decreased or increased)
- Increased residual lung volume
2. These pts., inhalation is not the problem, but exhalation is a problem (Trapped air)
Emphysema: What do you expect to see of their diaphragm on imaging?
Its flat because of the increased residual lung volume
Interventions to make for pts with asthma for prevention:
Teach them to avoid their triggers
By avoiding asthma triggers, if they are maintaining or managing their asthma properly, then what else will happen:
+ better airway
+ high PERF because they are able to exhale more efficiently
+ less visits to the ER / hospital visits / Drs office / sick visits
+ less use of rescue drugs
What is a consideration you would make in pt teaching with asthma:
+ Watching for status asthmaticus
+ medication compliance even without symptoms
+ Asthma is reversible
For patients with uncomplicated hypertension and no specific indications for another medication, what is the initial medication?
Thiazide diuretic
The nurse is preparing an education plan for a patient newly diagnosed with hypertension. What should be included in the education plan?
Engage in regular aerobic physical activity such as brisk walking (at least 30 min/day most days of the week).
What is an acceptable score for chest pain using a numeric scale?
0
The client is admitted with a diagnosis of angina caused by coronary vasospasm. The nurse recognizes this type of angina is classified as:
Variant (Printzmetal’s) angina
A child with CHD experiences hypercyanotic tet spells. The nurse would place the child in which position for relief?
Knee-to-chest
What is an expected assessment finding in a child with coarctation of the aorta?
Disparity in blood pressure between the upper and lower extremities
The nurse is caring for patients in an outpatient clinic. Which information should the teach regarding recommendations for early detection of colon cancer?
At age 50, a colonoscopy, then once at least every 10 years
The client is diagnosed with cancer of the head of the pancreas. When assessing the patient, which signs and symptoms would the nurse expect to find?
Clay-colored stools and dark urine
Mr. Gonzalez has been diagnosed with bone cancer. You know this type of cancer is classified as:
Sarcoma
Which of the following are the two main symptoms of osteosarcomas?
Pain and swelling
What is usually the first clinical manifestation of breast cancer?
Painless lump
What are the current guidelines for breast cancer screening?
Yearly mammograms starting at age 40
