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NUR390 Med Surg 1 Exam 1 > Mod 4: Oxygenation > Flashcards

Mod 4: Oxygenation Flashcards

1
Q

Cause of Influenza

A

Viral infections

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2
Q

Signs and symptoms of Influenza

A

High fever, secondary infection (bronchitis pneumonia), acute respiratory failure, ARDS

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3
Q

Labs for Influenza

A

Viral culture

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4
Q

Interventions for Influenza

A

Relief of symptoms, prevention of secondary infection, hand washing, encourage rest and hydration, encourage annual influenza vaccine for prevention.

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5
Q

Orders anticipated for Influenza

A
  1. Antiviral drugs if given within 24–48 hrs of onset.
  2. Acetaminophen or ibuprofen for headache, aches, and pains.
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6
Q

Cause of Bronchitis

A

Inflammation of the bronchi in the lower respiratory tract
Caused by viruses, air pollution, dust, inhalation of chemicals, smoking, chronic sinusitis, and asthma.

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7
Q

Signs and symptoms of Bronchitis

A

High fever, secondary infection (bronchitis, pneumonia), acute respiratory failure, and ARDS.

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8
Q

Labs for Bronchitis

A

Generally, none needed - may have a CBC or CXR to rule out an infection.

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9
Q

Interventions for Bronchitis

A

Provide symptoms relief and prevent secondary infection – cough suppressants, bronchodilator, encourage fluids, use of humidifier, avoid smoke, and good hand washing.

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10
Q

Orders anticipated for Bronchitis

A

Dextromethorphan for cough suppression
Albuterol inhaler for bronchodilation.

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11
Q

Causes of Pneumonia

A

Acute bacterial or viral infection of the lung parenchyma. Community-acquired or Hospital-acquired. Pathogens that cause pneumonia reach the lung in 3 ways:
1. Aspiration of normal flora from the nasopharynx or oropharynx. Many organisms that cause pneumonia are normal inhabitants of the pharynx in healthy adults.
2. Inhalation of microbes present in the air. Examples include Mycoplasma pneumoniae and fungal pneumonias.
3. Hematogenous spread from a primary infection elsewhere in the body. Examples are streptococci and Staphylococcus aureus from infective endocarditis.

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12
Q

Signs and symptoms of Pneumonia

A

Atelectasis, pleurisy, pleural effusion, bacteremia, pneumothorax, sepsis, and septic shock.

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13
Q

Labs for Pneumonia

A

CXR, sputum culture, pulse oximetry, CBC, and blood cultures.

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14
Q

Interventions for Pneumonia

A

Increased fluid intake (at least 3 L/day), administer IV fluids, balance between activity and rest, monitor vital signs including pulse oximetry, provide O2 therapy, physiotherapy, VTE prophylaxis, critical care management, with mechanical ventilation as needed.

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15
Q

Orders for Pneumonia

A
  1. IV fluids – 0.9% sodium chloride for hydration.
  2. O2 therapy
  3. Antipyretics for fever.
  4. Analgesics for pain.
  5. NSAIDS for pain and fever.
  6. Antibiotics to treat the infection – based on sputum culture results.
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16
Q

Metabolic Acidosis

A

pH = less than 7.35 and HC03 = less than 22

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17
Q

Metabolic Alkalosis

A

pH = more than 7.45 and HC03 = more than 26

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18
Q

Respiratory Acidosis

A

pH = less than 7.35 and PaC02 = greater than 40

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19
Q

Respiratory Alkalosis

A

pH = more than 45 and PaC02 = less than 40

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20
Q

Causes of Metabolic Acidosis

A

DKA, Renal Failure, lactic acidosis from sepsis, excessive diarrhea or liver failure

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21
Q

Symptoms of Metabolic Acidosis

A

COMA; hypovolemic shock (from osmotic diuresis) and potassium disturbances (Hyperkalemia)

22
Q

Labs for Metabolic Acidosis

A

If DKA, glucose and potassium
If renal failure, BUN, Creat/eGFR, and potassium
If liver failure, liver enzymes, ABGs, and potassium

23
Q

Interventions for Metabolic Acidosis

A

If DKA, administer fluids and insulin (REGULAR) IV. Assess for rapid, deep respirations (Kussmaul respirations)
If renal failure –> dialysis

24
Q

Orders for Metabolic Acidosis

A

DKA: Regular Insulin & Fluids
Renal Failure: Dialysis & Potassium Protocol

25
Q

Cause for Metabolic Alkalosis

A

Clients who have vomiting and diarrhea or an NG tube suction (loss of gastric acid) – loss of hydrogen
Clients who have consumed too many antacids; Potassium depletion (thiazide diuretics)

26
Q

Symptoms of Metabolic Alkalosis

A

Electrolyte imbalances & fluid volume deficit (hypovolemic shock)

27
Q

Labs for Metabolic Alkalosis

A

Electrolytes, ABGs, BUN, Hct, Na, and Creatinine

28
Q

Interventions for Metabolic Alkalosis

A

Treat the underlying cause

29
Q

Orders for Metabolic Alkalosis

A

If GI losses –> antiemetics, fluids, and electrolyte replacements
If r/t potassium depletion –> stop diuretics

30
Q

Cause for Respiratory Acidosis

A

COPD, any client with respiratory depression (think opioids/narcotics), clients with inadequate chest expansion (think respiratory trauma like pneumo or flail chest), clients with PE and clients with brain injury

31
Q

Symptoms of Respiratory Acidosis

A

Lethargy, confusion, headache, dizziness, coma, hypotension, ventricular fibrillation related to hyperkalemia, warm, flushed skin, and seizures

32
Q

Labs for Respiratory Acidosis

A

ABGs

33
Q

Interventions for Respiratory Acidosis

A

Treat underlying cause

34
Q

Orders for Respiratory Acidosis

A

Bronchodilators, oxygen, and treat the underlying cause so if it is opioid/narcotic overdose, stop the PCA, if it is PE, treat or pneumothorax

35
Q

Cause for Respiratory Alkalosis

A

Any process that causes prolonged tachypnea or hypoxemia

36
Q

Symptoms for Respiratory Alkalosis

A

Assess for circumoral numbness and tingling or numbness and tingling of the fingers

37
Q

Labs for Respiratory Alkalosis

A

ABGs

38
Q

Interventions for Respiratory Alkalosis

A

Oxygen therapy, anxiety reduction and rebreathing techniques (breathing into a paper bag)

39
Q

Orders for Respiratory Alkalosis

A

Anti-anxiety medications and oxygen

40
Q

priority problem for pneumonia

A

impaired gas exchange –> respiratory acidosis

41
Q

S&S for Atelectasis

A

Collapsed lung and airless alveoli
S&S: Decreased/absent breath sounds, dullness in percussion on affected area

42
Q

Cause of atelectasis

A

Airway obstruction

43
Q

Interventions for atelectasis

A

Interventions: deep breathing, coughing, incentive spirometry, early mobility

44
Q

S&S of Pleural Effusion

A

chest pain, SOB, pleural friction rub

45
Q

Interventions for pleural effusion

A

thoracentesis –> drains fluid out

46
Q

normal wbc

A

4,500-11,000

47
Q

urine output bad if its

A

less than 0.50

48
Q

normal calcium

A

8.5-10

49
Q

normal magnesium

A

1.7-2.2

50
Q

normal BUN

A

6-20
6=hypervolemic (low-wet)
20=hypovolemic (high-dry)

51
Q

normal hematocrit

A

M: 42-50
W: 37-47

52
Q

normal albumin

A

3.5-5

NUR390 Med Surg 1 Exam 1 (2 decks)

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