L1

Question 1

Pneumonia sign and symptoms

Answer 1

Pleuritic chest pain which aggravated when deep breath

Rapid pulse

Soar throat

Shortness of breathe with using accessory muscles (1)scalene (2) sternocleidomastoid (3) trapezius (4)pectoralis major muscle

Question 2

Medical treatment for pneumonia

Answer 2

Antitussive

decongestant

Antihistamine

Antibiotic treatment

Question 3

Assesment of pneumonia

Answer 3

Vital sign, oximetry

Colour, thickness of secretion

Tachypnea, shortness of breath

Auscultate all lobes

Question 4

Intervention to improve pneumonia

Answer 4

Oxygen with humidification
Position change
Hydration
Chest PT

Question 5

Tuberculosis facts

Answer 5

Grow slowly
Open TB (spread faster)
Close tb (spread slower)
Sensitive to light and heat (light can kill)
AIRBORNE transmission

Question 6

Diagnosis of TB

Answer 6

Tuberculin skin test—inject—) >10mm then positive
Chest xray—) having lesion on upper lobe
Acide fast bacillus presents on sputum culture
Physical examination: assess breathing sound

Question 7

Nursing care

Answer 7

Promote airway clearance
1. Increase fluid intake
2. Correct positioning

Adherence to treatment
1. Treat tb as communicable disease
2. Most tb fail in treatment are because of non-regular treatment

Promote activity
1. Plan progressive acitivity schedule
2. Liquid nutritional supplement to help reaching nutrition goals

Preventing spreading of tb
1. Primary infectious control (tent)
2. Secondary infectious control (control airflow)(
(Air filter, UV)
3. Patient treatment

Question 8

Pathology of COPD

Answer 8

Chronic inflammation will damage tissues
Scar tissue decrease elastic recoil of tissue

Question 9

Risk factors of COPD

Answer 9

Smoking
Passive smoke
Air pollution
Genetic abnormality

Question 10

Care to client with COPD

Answer 10

Inspection
Test-) blood gas, chest x ray
Asses for symptoms-) chronic cough? Sputum? Dyspnea?

Question 11

Diagnoses of COPD

Answer 11

Impaired gas exchange
Impaired airway clearance
Ineffective breathing pattern
Activity intolerance
Respiratory inefficiency
Pneumonia
Pulmonary HT

Question 12

Planning for COPD

Answer 12

Smoke cessation 戒煙
Proper use of broncodilator
Use of supplementary oxygen
Exercise training

Question 13

Patient teaching of COPD

Answer 13

Avoid irritant or pollution
Prevent infection
Medication

Question 14

Oxygen therapy caution

Answer 14

Concentration>21%
<50% to avoid oxygen toxicity

Question 15

Chest physiotherapy

Answer 15

To remove bronchial secretions
1. Postural drainage—) remove secretion by gravity
2. Vibration/ percussion
3. Breathing exercise

Question 16

Postural drainage management

Answer 16

2-4 times per day
Water or broncodilators given before drainage to loosen secretion and reduce broncospasm

Question 17

Tb

Answer 17

Infectious disease affect lung parenchyma initially
Can infect meninges, kidneys, bones
Primary infectious disease is mycobacteria tuberculosis bacillus

Question 18

Pathophysi of tb

Answer 18

Susceptible host inhaled mycobacteria

Travel along airway into aveoli

Deposit and duplicate

Initiate inflammatory response to host

Question 19

Tb risk factors

Answer 19

Close contact to tuberculosis patient

Substance abuse

Special illness or treatment: diabetes, chronic renal failure, hemodialysis

Question 20

S/s of tb

Answer 20

Low fever
Nonproductive cough
Night sweat
Fatigue
Weight loss

Question 21

Treatment of COPD

Answer 21

Usage of antituberlosis agent for 6-12 months

Ensure organism is killed and not relapsing anymore

Medicine such as isoniazid

Question 22

Chest drainage

Answer 22

Use to treat pleural effusion

Re expand the lung removing excessive air, fluid and blood

The chest tube can produce the negative pressure in pleural space which they usually have