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Nursing Respiratory Test Flashcards

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1
Q

pathophysiology of epistaxis

A

aka a nosebleed. Anterior region is most common and originate from vessels called Kiesselbach plexus. Blood vessels of the posterior nose are larger and bleeding can be severe and difficult to control

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2
Q

etiology of epistaxis

A

nosebleed. most common cause is dry cracked mucous membranes. trauma, blowing nose, nose picking, increased pressure on fragile capillaries from hypertension. hemophilia, leukemia, regular aspirin use, anticoagulant therapy, chemotherapy, cocaine use

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3
Q

therapeutic measure for epistaxis

A

nosebleed. sit in chair and lean forward (avoid aspirating or swallowing blood.) place pressure on nares for 5-10 min. ice pack (constricts vessels.) decongestants (vasoconstrictors) cauterize. gauze to pack it. IV fluid replacement for a lot of blood loss.

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4
Q

nursing care for pt with epistaxis

A

monitor bleeding, note amount and color. monitor vital signs and hemoglobin levels. swallowing repeatedly sign of bleeding. If bleeding does not stop in 10-15 minutes notify RN or MD immediately. monitor for airway blockage if packing is used. teach pt to avoid bending over

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5
Q

pathophysiology and etiology of nasal polyps

A

grape like clusters of mucosa in nasal passage. usually benign, can obstruct nasal passages. related to chronic inflammation and people with allergies.

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6
Q

what is the aspirin triad asthma

A

three components

asthma, allergic to aspirin, nasal polyps

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7
Q

therapeutic measures for nasal polyps

A

control of allergy symptoms. oral antihistamines or nasal corticosteroid sprays to control inflammation. can be removed. avoid aspirin products.

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8
Q

pathophysiology and etiology of deviated septum

A

septum dividing nasal passages is slightly deviated. result from trauma. can block sinus drainage, interfere with breathing

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9
Q

signs and symptoms of deviated septum

A

chronically stuffy nose. discomfort from blocked sinus drainage. headaches and nosebleeds

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10
Q

therapeutic interventions for deviated septum

A

decongestants, antihistamines, intranasal cortisone spray to reduce inflammation. nasoseptoplasty

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11
Q

nursing care for pt after nasoseptoplasty

A

monitor vitals and bleeding. swallowing sign of bleeding, check for blood running down back of throat. will have mustache dressing. maintain semi-Fowler’s position. avoid sneezing, coughing, straining to move bowels. stool softeners and cough suppressants can be ordered. aspirin is avoided. antibiotics can be given. ice to reduce swelling.

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12
Q

pt education for pt after nasal surgery

A
  • your nose will feel stuffy and may drain
  • change mustache dressing as often as needed
  • do not blow your nose
  • if you must sneeze, do it with mouth open
  • drink plenty of fluids
  • use cool mist vaporizer to humidify hair(prevent nasal drying)
  • keep head elevated or sleep in recliner
  • ice pack to reduce swelling
  • pain med as prescribed
  • call physician if temp is higher than 101
  • return to see physician as directed
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13
Q

pathophysiology and etiology of sinusitis

A

inflammation of the mucosa of one or ore sinuses. can be acute or chronic (symptoms for more than 2 months and unresponsive to treatment)
Most common are maxillary and ethmoid sinus. often result of bacterial infection and may follow a viral upper respiratory illness. most common organism are Streptococcus pneumonia and Haempophilus influenza. also caused b allergies, nasal polyps, fungal infection, intubation

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14
Q

signs and symptoms of sinusitis

A

pain over region of affected sinus.
if maxillary-pain over cheek and upper teeth.
ethmoid-between and behind the eyes
frontal-forehead
fever may be present, fatigue, foul breath

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15
Q

complications of sinusitis

A

can spread to surrounding areas causing osteomyelitis, cellulitis of orbit, abscess, meningitis, trigger asthma symptoms

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16
Q

diagnostic tests for sinusitis

A

based on symptoms alone. x-ray, nasal endoscopy, CT, MRI, culture nasal discharge

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17
Q

therapeutic measures for sinusitis

A

aimed at relieving pain and promoting sinus drainage. nasal irrigation with normal saline solution. corticosteroids, adrenergic nasal sprays (up to 3 days). hot moist packs. expectorants, fluids, room humidifier. antihistamines, antibiotics

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18
Q

why should adrenergic nasal sprays be used cautiously in pt with heart disease/hypertension

A

vasoconstriction increases blood pressure

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19
Q

nasal sprays for more than 3 days causes what

A

rebound congestion

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20
Q

nursing care for the patient with sinusitis

A

uncomplicated sinusitis are cared for at home. increase water intake. maintain semi-Fowler’s position. hot moist packs, analgesics, prescribed meds. finish antibiotic.

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21
Q

pathophysiology and etiology of rhinitis/common cold

A

rhinitis (aka coryza) is inflammation of the nasal mucous membranes. release of histamine and other substances causes vasodilation and edema. may occur as reaction to allergens like pollen, dust, mold, some foods, viral or bacterial infection

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22
Q

s/s of rhinitis

A

nasal congestion, localized itching, sneezing, sore throat, nasal discharge. viral/bacterial rhinitis can be accompanied by fever and malaise

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23
Q

diagnostic tests for rhinitis

A

if allergic rhinitis is suspected-skin testing

a blood test for IgE antibodies

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24
Q

therapeutic measures for rhinitis

A

antihistamines inhibit histamine response. allergy shots. antibiotics not effective for viral rhinitis. tylenol. decongestants.

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25
Q

why should cough syrup and cold medicine be used with caution for pt with rhinitis/common cold

A

do not treat underlying cause of the cold, and contain different medications which are often not needed.

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26
Q

pathophysiology and etiology of pharyngitis

A

inflammation of the pharynx. usually related to bacterial r viral infection. may occur as result of trauma to the tissues. most common bacterial is beta-hemolytic streptococci (strep throat)

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27
Q

if strep throat is not treated with antibiotics it can lead to what

A

rheumatic fever, glomerulonephritis, or other serious complications

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28
Q

s/s of pharyngitis

A

most common symptom-sore throat

dysphagia, throat red and swollen, exudate (drainage or pus) may be present. fever, chills, headache, malaise

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29
Q

differentiating respiratory tract infection

A

onset= cold:slow–influenza: sudden
fever= cold:non/low grade–flu:common
headache= cold:rare– flue:common
muscle ache= cold:less common–flu: common, severe
cough= cold:present– flu: present, usually dry
chest pain= absent– flu: common
fatigue=cold: slight– flu: common, prolonged, severe
runny nose= cold: common– flu:less common
sore throat= cold:common– flu:less common
complications= cold:rare– flu:pneumonia
treatment= cold: rest/fluids– flu:rest, fluids, antiviral

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30
Q

nursing diagnosis for pt with an upper respiratory infection

A

impaired comfort
hyperthermia
risk for infection

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31
Q

diagnostic tests for pharyngitis

A

throat culture and sensitivity test

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32
Q

therapeutic measures for pharyngitis

A 
if bacterial-antibiotics
tylenol or throat lozenges
saltwater garles
honey and lemon mice with warm water
encourage fluids and rest
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33
Q

pathophysiology and etiology of laryngitis

A

inflammation of the mucous membrane lining of the larynx (voice box.) caused by irritaion from smoking, alcohol, chemical exposure, GERD, viral, fungal, bacterial infection. often follows an upper respiratory infection.

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34
Q

s/s of laryngitis

A

most common symptom is hoarseness.
cough
dysphagia
fever

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35
Q

diagnostic tests for laryngitis

A

tiny mirror to view larynx. laryngoscopy and biopsy to rule out cancer

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36
Q

therapeutic measures of laryngitis

A

rest, fluids, humidified air, aspirin or tylenol. antibiotics if bacterial. med to control GERD. avoid speaking. whispering strains the voice even more.

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37
Q

pathophysiology and etiology of tonsillitis/adenoiditis

A

filtering function becomes overwhelmed with a virus or bacteria and infection results. more common in children.

38
Q

function of the tonsils

A

filter microorganisms to protect the lungs from infection

39
Q

s/s of tonsillitis/adenoiditis

A

usually begins suddenly with sore throat, fever, chills, pain on swallowing. headache, malaise, myalgia. tonsils appear red and swollen, may have yellow or white exudate on them. may mention snoring, nasal obstruction, nasal tone to voice

40
Q

diagnostic tests for tonsillitis/adenoiditis

A

throat culture
WBC and differential
chest x-ray

41
Q

therapeutic measures for tonsillitis/adenoiditis

A

antibiotics for bacterial infection. tylenol, lozenges, saline gargles.
After tonsillectomy: semi-Fowler’s (reduce selling and promote drainage.) monitor for bleeding, airway latency, provide comfort measures. fluids for hydration. room humidifier. suction available for emergencies

42
Q

pathophysiology and etiology of influenza

A

flu. viral infection of respiratory tract. new strains each year. elderly at particular risk. transmitted via droplets. incubation period is 1-3 days

43
Q

s/s of flu

A

abrupt onset of fever, chills, myalgia, sore throat, cough, malaise, headache

44
Q

complications of flu

A

most common: pneumonia

45
Q

diagnostic tests for flu

A

viral cultures, nasal swabbing.

46
Q

therapeutic measures for flu

A 
primarily symptomatic. 
tylenol for fever, headache, myalgia
aspirin is avoided-Reye's syndrome
rest and fluids essential
antiviral meds
47
Q

nursing care for pt with influenza

A 
closely monitored for complications
assess lung sounds and vitals q4h
monitor for dehydration
encourage rest and fluids
no aspirin in under 18
48
Q

summarize bird flu

A

aka avian influenza
infects wild and domestic birds
contract it form contact with infected bird or excrement
symptoms are similar to flue

49
Q

summarize SARS

A

severe acute reparatory syndrome
high fever, body aches, often progress to pneumonia
transmission from close contact with person or object

50
Q

H1N1 flu

A

aka swine flu

usually affects pigs

51
Q

west nile virus

A

transmitted from birds to humans by mosquitos.
use mosquito repellent
eliminate standing water where mosquitoes lay eggs

52
Q

pathophysiology of cancer of the larynx

A

usually develops in the squamous cells of the mucosal epithelium. evaluated based on TNM staging system. most often a primary cancer and can spread to lungs, liver, lymph nodes. prognosis is often poor.

53
Q

etiology of cancer of larynx

A

risk factors: Hx of alcohol, tobacco use, exposure to industrial chemicals, hardwood dust, chronic overuse of voice, diet low in fruits and vegetables. men more likely to be affected

54
Q

prevention of cancer of larynx

A

educate on relationship between cancer and alcohol/tobacco use. seek treatment when symptoms first occur. any hoarseness that lasts longer than 2 weeks should be investigated

55
Q

s/s of cancer of larynx

A

most common symptom is hoarseness because vocal cords are located in larynx
throat or ear pain, SOB, chronic cough, difficulty swallowing
stridor
weight loss and halitosis (foul breath)

56
Q

diagnostic tests for cancer of larynx

A

examined with mirror. laryngoscope examination. CT scan, MRI

57
Q

therapeutic measures for cancer of larynx

A

may be treatable with radiation therapy; will preserve patient’s voice. chemo as well. surgery (larynx will be partially or completely removed) parietal laryngectomy. radical neck dissection with total laryngectomy (loss of voice)

58
Q

nursing diagnoses for cancer of larynx

A 
risk for ineffective airway clearance
acute pain
impaired verbal communication
risk for imbalanced nutrition
impaired swallowing
grieving related to loss of voice
disturbed body image
59
Q

laryngal cancer: risk for ineffective airway clearance related to excessive secretions and new trach/laryngecotmy. What to do

A 
monitor and record amount, color, consistency of secretions
vitals, lung sounds, 
signs of respiratory distress
provide trach care
sterile technique
semi-Foweler's position
deep breathe and cough qh
avoid use of powders, sprays, airborne materials
60
Q

laryngal cancer: acute pain related to surgical procedure. what to do

A

assess pain level q4h and pen
assess sedation and reap status often
opioids given carefully
admin analgesics as prescribed

61
Q

which is the best explanation by the nurse for why a physician did not prescribe antibiotics for influenza?

A

influenza is caused by viruses. viruses are not treated with antibiotics

62
Q

acute bronchitis

A

inflammation of the bronchial tree. mucous membranes (that line the bronchial tree) become irritated and inflamed, excessive mucous is produced. result is congested airways. usually an isolated episode

63
Q

pathophysiology of bronchiectasis

A

dilation of the bronchial airways. dilated areas become flabby and scarred. secretions pool in areas and difficult to cough up. creates and environment when bacteria flourish. infection is common.

64
Q

etiology of bronchiectasis

A

usually occurs secondary to another chronic reps disorder (CF asthma, TB, bronchitis, exposure to toxin)infection and inflammation of airways weakens the bronchial walls and reduces ciliary function. airway obstruction from excessive secretions that predisposes the pt to development of bronchiectasis

65
Q

s/s of bronchiectasis

A 
recurrent lower reap infection
sputum is copious an purulent 
foul smelling sputum
sputum can be bloody
can experience dyspnea even with minimal exertion
wheezes and crackles 
fever present if active infection
cor pulmonale (right sided HF) 
clubbing of fingers
66
Q

diagnostic test for bronchiectasis

A

chest x-ray
CT
bronchoscopy
sputum cultures

67
Q

therapeutic measures for bronchiectasis

A 
aimed at keeping airways clear of secretions, controlling infection, correcting underlying problem.
antibiotics 
vaccinations for prevention
bronchodialators
mucolytic agents and expectorants
chest physiotherapy
oral fluids encouraged
68
Q

pathophysiology of pneumonia

A

acute inflammation and/or infection of lungs. transmitted by the cough. when microorganisms multiply, they release toxins and induce inflammation in lung tissue, causing damage to mucous and alveolar membranes. leads to edema and exudate. this reduces surface area available for exchange of carbon dioxide and oxygen. also causes necrosis of lung tissue. can be confined to one lobe or scattered.

69
Q

etiology of pneumonia; bacterial pneumonia

A

most common cause of community acquired bacterial pneumonia is streptococcus pneumonia.

70
Q

etiology of pneumonia; viral pneumonia

A

influenza viruses most common cause. generally less ill with viral pneumonia than bacterial pneumonia, but usually sick longer

71
Q

etiology of pneumonia; fungal pneumonia

A

candida and aspergillus are two types. typically causes pneumonia in pts with AIDS

72
Q

etiology of pneumonia; aspiration pneumonia

A

aspiration of foreign substances. most often occurs in pt with decreased LOC or impaired cough or gag reflex. increases risk for subsequent bacterial pneumonia

73
Q

gas exchange occurs in which structures

A

alveoli

74
Q

while providing care a nurse notes the pts shoulders are rising with each breath. this is documented as:

A

the se of accessory muscles to aid breathing

75
Q

the nurse is auscultating a pt lungs but is unable to hear much air movement. what is the next step

A

have pt deep breath through the mouth

76
Q

the nurse notes a pt with periods of fast, deep respirations alternating with periods of apnea. this pattern is:

A

Cheyene-Stokes

77
Q

which term describes a loud crowing sound that results from obstruction of the airways by a tumor or foreign body

A

stridor

78
Q

a pt arterial blood gas analyzes shows a pH of 7.28 with high PaCO2. what does pt have

A

respiratory acidosis

79
Q

nurse is examining a chest drainage system on a pt with a pneumothorax and notes the water level in the water seal chapter fluctuating with each pt respirations. the nurse should

A

no action is necessary, this finding is expected

80
Q

a pt returns to SDS from surgery for a deviated septa. which of the following would most concern the nurse.

A

the pt swallows frequently

81
Q

what is most common complication of influenza

A

pneumonia

82
Q

which assessment finding does the nurse anticipate noting in a pt being evaluated for cancer of larynx

A

a hoarse voice

83
Q

antidote for narcotic overdose

A

(Narcan)

naloxone

84
Q

corticosteroids such as methylprednisolone (Solumedrol) are used in the pt with COPD for which purpose

A 
reduce airway inflammation 
will increase BS
will suppress immune system
aggressive behaviors
moon face (round puffy)
can't abruptly stop med
85
Q

s/s of pneumonia

A

fever, shaking, chills, cheats pain, dyspnea, fatigue, productive cough, sputum is purulent (rust colored or blood tinged) crackle and wheezes. can also experience fatigue, sore throat, dry cough, n/v.
elder can become confused or lethargic

86
Q

complications of pneumonia

A

pleurisy and pleural effusion, atelectasis, septicemia, meningitis, septic arthritis, pericarditis, endocarditis

87
Q

which med can help reduce acute dyspnea in pt with end stage COPD

A

IV morphine

small enough to ease respirations

88
Q

diagnostic test for pneumonia

A

chest x-ray. sputum and blood culture.

89
Q

therapeutic measures for pt with pneumonia

A 
broad spectrum antibiotics (oral or IV)
rest and fluids
antiviral medications
expectorants
bronchodialators
analgesics
nebulized mist treatment
O2
90
Q

term used to describe blood tinged sputum

A

hemoptysis

91
Q

TB pathophysiology and etiology

A

infectious disease. primarily affects the lungs, but can also affect kidneys, liver, brain, bone. acid fast bacillus.
spread by inhalation. once bacilli enter lungs, they multiply and begin to disseminate to the lymph nodes.

92
Q

priority nursing diagnoses for pt with pneumonia

A

impaired gas exchange
ineffective airway clearance
activity intolerance

NURSING LPN (11 decks)

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