Exam 5 Flashcards
Pneumonia nursing interventions
Cough, deep breathe, semi fowlers position, incentive spirometer, clear secretions, pillow splint
Why is it important to educate patient on treatments for pneumonia?
To make sure patients know why it is important to finish antibiotics.
Why is it important to finish antibiotics?
To prevent resistance to the bacteria.
What are some pneumonia outcomes?
Prevent complications, improve breathing, not feeling fatigued.
Pneumonia nursing diagnosis-
- ineffective airway clearance,
- risk for fall ,
- impaired tissue integrity,
- impaired gas exchange
Signs of a bacterial infection
Green mucus, 10-14 days of symptoms, feeling better for 1-2 days then feeling worse
Most common communicable strain
streptococcus pneumoniae
What precaution should a nurse use for a pneumonia patient?
Droplet
Signs of hypoxia
Confusion, restlessness, cyanosis, wheezing and coughing, rapid heart rate, intercostal muscle breathing, inability to speak, dyspnea, anything below 90% O2 always check o2 levels THEN notify doctor to see if order can be given to give o2: Always start with 2L, titrate based on orders.
How should you position a patient with pneumonia?
High fowlers, semi fowlers
What should a nurse address in an assessment for a patient with pneumonia?
Crackles in lower lobes (classic sign) and diminished lung sounds (in more severe cases)
How long should a patient with TB be isolated for?
2-3 weeks, patient has to be on medication for two weeks in order to be said not contagious
Sputum test should be negative REMEMBER COVID,
What is important to teach to a patient with TB?
4 combo medication has to be taken the whole time of treatment, check liver levels, go to all lab and regular follow ups.
What is the length of treatment for a patient who has TB?
6-12 months, patient has to be isolated for 2-3 while being on medication and have a negative sputum THEN can go back to normal life.
What is the first thing to do when exposed to a TB patient?
Wear a N95, ING for whoever has been exposed
TB harbors what organ (specific)
Lower lung, alveoli
What precaution should a patient with TB be put on?
Airborne precautions
What are the 3 classic pre? symptoms for a patient with TB?
Night sweats, fever & unexplained weight loss
What is the treatment for a cold?
Antihistamines to manage symptoms, allow immune system to fight for 10 days, if more than 10 days with a cold, antibiotics will be given/
Are vital colds contagious?
Yes, it is in the body for up to 2 days without showing symptoms
What are the nursing interventions for someone with TB?
Prevent triggers (allergy, odor), elevate head, drink lots of fluids, hand hygiene, nasal decongestants to loosen mucus, drug rebound, preorbital edema
Nasal congestion used often causes-
Re bound effect
Why does nasal congestion cause rebound effect?
They cause symptoms and you need to use the medication more often
What is a major viral/bacterial URI complication and why?
Preorbital edema. Pressure will push on nerves
What 3 important things should you teach to a patient with influenza?
- importance of increased fluids to prevent dehydration
- importance of coughing or sneezing into tissues or the elbow, never the hands
- proper hand hygiene technique and tissue disposal to prevent the virus from spreading
How can we prevent flu for the elderly?
Vaccines, flu and pneumonia
Whats the most complicated situation from having the flu?
Pneumonia
How often can you get the flu and at what age can you start getting flu vaccines?
Every year; 6 months
How can we educate to prevent the flu?
Hand hygiene
What precaution should a nurse put a patient on if they have the flu?
Droplet precautions
What criteria makes someone diabetic?
Fasting over equal or higher than 126 mg/dL
2 hour post load glucose equal or greater than 200mg/dL
A1c equal or over 6.5%
Risk factors for type 1 & 2
Family history, obesity, race/ethnicity, 45 years of age or older, previously identified impaired glucose fasting or tolerance, HTN, high HDL cholesterol, history of gestational diabetes/delivered baby over 9lbs
Causes for hyperglycemia
Obesity, stress, not taking medication, surgery/procedures, illness
Complications of diabetes
DKA & HHS, fluid overload, pulmonary edema (acute)
How to prevent DKA when being sick
- Take insulin or oral antidiabetic agents as usual.
- Report elevated glucose levels as specified or urine ketones to your primary provider.
- Take supplemental doses of regular insulin every 3 to 4 hours, if needed, if you take insulin.
- Substitute soft foods (e.g., 1/3 cup regular gelatin, 1 cup cream soup, ½ cup custard, 3 squares graham crackers) six to eight times a day if you cannot follow your usual meal plan.
- Take liquids (e.g., ½ cup regular cola or orange juice, ½ cup broth, 1 cup sports drink [Gatorade]) every ½ to 1 hour to prevent dehydration and to provide calories, if vomiting, diarrhea, or fever persists.
- Be aware that if you are unable to retain oral fluids, you may require hospitalization to avoid diabetic ketoacidosis and possibly coma.
What can we teach to patients about type 2 diabetes
Food, exercise, medication, loosing weight
S/S of hyperglycemia
Excessive thirst, blurred vision, high temperature, hunger, tired, frequent urination
S/S hypoglycemia
Shakiness, dizziness, nervousness, hunger, headache, pale face, clumsiness, confusion, trouble paying attention, passing out
First line treatment for type t2 DM
Metformin
What are the types of insulin
Rapid acting, short acting, intermediate acting and long acting
For rapid acting insulin, patient should eat:
5-15 after injection
For short acting insulin, patient should eat:
15-20 min after injection
Long acting insulin is absorbed:
very slowly over 24 hours
