Med-Surg: Respiratory System/1 Flashcards
mantoux test induration
2
- 10 mm or more = positive
2. 5 mm may be considered significant if patient is immunocompromised
how to administer mantoux test
1
- administer 0.1 ml PPD ID to upper half inner surface of forearm
asthma meds for anti-inflammatory
2
- corticosteroids - fluticasone, prednisone
2. leukotriene antagonists - montelukast
asthma dx procedures
3
- abgs
- sputum culture
- pulmonary function tests
pulmonary emphysema manifestations
9
- dyspnea with productive cough
- difficult exhalation, pursed lip breathing
- wheezing
- crackles
- barrel chest
- shallow, rapid respirations
- respiratory acidosis with hypoxia
- weight loss
- clubbing fingers
CB manifestations
4
- productive cough
- thick, tenacious sputum
- hypoxemia
- respiratory acidosis
pre bronchoscopy NPO
8-12 hours
inflammation and hypersecretion of mucus in the bronchi and bronchioles caused by chronic exposure to irritants
chronic bronchitis
mantoux test - assess for reaction when
48-72 hours following injection
status asthmaticus - prepare for emergency what
intubation
mantoux test is positive but diagnosis must be confirmed how
sputum culture for presence of acid-fast bacillus (AFB)
cor pulmonale manifestations
7
- hypoxia and hypoxemia
- extreme dyspnea
- cyanotic lips
- JVD
- dependent edema
- hepatomegaly
- pulmonary HTN
thoracentesis - have what at bedside
chest tube
bronchoscopy is used to see or do what?
5
- larynx
- trachea
- bronchi
- obtain tissue biopsy
- foreign body removal
complications of COPD
cor pulmonale - right sided HF caused by pulmonary disease
pulmonary emphysema contributing factors
5
- cig smoke - passive smoke inhalation
- advanced age
- exposure to air pollution
- alpha-antitrypsin def
- occupational dust
COPD - assess cardiac for
signs of right sided failure
bronchoscopy post op observe what
5
- gag reflex
- bleeding
- respiratory distress
- VSs
- LOC
destruction of alveoli, narrowing of bronchioles, and trapping of air resulting in loss of lung elasticity
pulmonary emphysema
ABGs - how to take 4 -sample -keep -apply -monitor
- sample is drawn into a heparinized syringe
- keep on ice and transport immediately
- apply direct pressure min. 5 minutes
- monitor for hematoma
allows the most accurate method of assessing respiratory function
ABGs
dx procedures for COPD
5
- chest x ray
- pulmonary function tests - air remains trapped in lungs
- pulse ox - often less than 90
- abgs - chronic respiratory acidosis
- CT
WFT-GT and T-SPOT.TB
identify the presence of myocobacterium tuberculosis infection by measuring the immune response to the TB bacteria in whole blood
COPD - calories
encourage high calorie foods
pulmonary emphysema
destruction of alveoli, narrowing of bronchioles, and trapping of air resulting in loss of lung elasticity
COPD cor pulmonale nursing interventions
2
- encourage a low sodium diet
2. maintain fluid balance with possible fluid restriction
astham attack - positioning
high fowlers
ABGs - perform Allen test if
no arterial line
COPD cor pulmonale medications
2
- diuretics
2. digoxin
thoracentesis - max amount of fluid to be removed at one time
1 liter
ABGs puncture site
apply direct pressure for at least 5 mins
status asthmaticus - administer what as prescribed
3
- oxygen
- epinephrine
- systemic steroid
COPD - encourage immunizations for
2
pneumonia
influenza
asthma - late sign
cyanosis
cor pulmonale is to
complication of COPD
bronchoscopy consideration 4 -obtain -maintain -position -administer
- obtain informed consent
- maintain NPO 8-12 hours
- position upright
- administer meds are prescribed
thoracentesis - obtain what before and after
chest x ray
chronic bronchitis
inflammation and hypersecretion of mucus in the bronchi and bronchioles caused by chronic exposure to irritants
COPD - encourage how much liquid a day
2-3 L
asthma medication - bronchodilators
2
- short acting - albuterol
2. methylxanthines such as theophylline - monitor therapeutic range for toxicity
digoxin
antiarhythmic - increased cardiac output by increase the contraction but slowing the HR
