Final exam Flashcards
COPD
respiratory disorder largely caused by smoking- progressive, irreversible
COPD
assessment
Level of dyspnea (activity and rest), medication use and effectiveness, presence of cough and production of cough.
COPD
Interventions
smoking cessation, ensure hydration, deep breathing, effective cough techniques, purse lipped breathing to prolong expiratory phase, nutrition related to poor appetite, high protein-calorie to prevent muscle wasting
COPD
Interventions
rest before and after eating, monitor sleep pattern and periods of apnea. Avoid alcohol, caffeine before bedtime. Minimize risk for infection, hand washing.
Asthma
Chronic inflammatory disorder of the airway.
episodic and reversible with tightness and dyspnea
Asthma
Assessment
severity of symptoms, medication used, time. assess for confusion, leaning forward breathing, accessory muscle use, wheezing, crackles, absent sounds, tachycardia, hypertension o2 sats.
Asthma intervention
position to allow for maximum chest expansion, administer medication, monitor O2 sats, auscultate lung after intervention. H/T to avoid triggers.
Coronary Artery Disease
Nonmodifiable Risk Factors
Age, gender, ethnicity, family history
Coronary Artery Disease
modifiable risk factors
elevated lipid levels
tobacco use, hypertension, inactivity, obesity
CAD diagnostic
ECG, chest radiography, stress test, lab tests; lipid panel, CBC, troponin
Stable Angina therapy
antiplatelet therapy= aspirin, warfarin, nitro (vasodilator to reduce afterload), ACE inhibitors ,Calcium channel blockers
Unstable Angina therapy
nitro, heparin
Angina
support with oxygen and morphine. Pain will cause vasoconstriction and worsen problem.
Acute Coronary Syndrome
when ischemia is prolonged & not immediately reversible= MI
Coronary artery disease = angina -> acute coronary syndrome -> unstable angina
->MI
Acute coronary syndrome
atherosclerotic plaque ruptures, stimulates platelet aggregation, vasoconstriction and thrombus formation, formation may partly occlude vessel=angina or totally occluded = MI
Unstable Angina
unpredictable and represents an emergency
acute coronary syndrome
nursing implementation
deal with pain, rest, anxiety, fear
Heart Failure
impaired cardiac pumping/filling, not always associated with pulmonary congestion
Heart Failure risk factors
coronary artery disease, aging, hypertension, diabetes, smoking, obesity, high cholestrol
most common form of H/F
left sided failure from ventricular dysfunction, blood backs up into left atrium and into the pulmonary veins causing pulmonary congestion and edema
Treatment of H/f
decrease preload and afterload with diuretics and ACE inhibitors will decrease pulmonary congestion, vasodilators to decrease peripheral resistance, morphine to decrease pain and provide sedative action>must watch for respiratory depression
Nursing goals for managing HF
decrease peripheral edema, decrease shortness of breath, increase exercise tolerance.
Stroke
ischemic brain attack or hemorrhagic stroke
stroke nonmodifiable risks
age, gender,ethnicity and race, family history
Stroke modifiable risks
hypertension single most important risk factor, heart disease, diabetes, cholesterol, smoking, excessive alcohol, inactivity
motor defecits
• A stroke can have an effect on many body functions, including motor activity, bladder and bowel elimination, intellectual function, spatial-perceptual alterations, personality, affect, sensation, and communication.
aphasia
total loss of comprehension and language
dysphasia due to dominant hemisphere affected
difficult comprehension or use of language
dysarthria
a disturbance in the muscular control of speech. Impairments may involve pronunciation, articulation, and phonation
agnosia
inability to recognise object by sight, touch or hearing
apraxia
inability to carry out sequential movements on command
urinary and bowel
problems are usually initially and temporary
Prevention
control; blood pressure, blood glucose, diet and exercise, smoking and alcohol consumption
Acute phase of stroke
preserving life and preventing/reducing brain damage
Acute phase of stroke elevated bp
common protective response to maintain cerebral perfusion
Acute phase of stroke electrolyte
maintain fluid balance to promote perfusion
Acute phase of ischemic stroke
antithrombolitic tPA
length of acute phase
12-24 hrs care shifts from preserving life to lessening diability
Acute phase of stroke
management of the respiratory system is a nursing priority. Stroke patients are particularly vulnerable to respiratory problems, such as aspiration pneumonia
Acute phase of stroke
neurological status must be monitored closely to detect changes suggesting extension of the stroke
