Respiratory

Question 1

COPD

Answer 1

1 cause smoking

• high CO2
• Low Sat 02 88-93% normal

air trapped in lungs
hyperresonance

Question 2

Emphysema

Answer 2

pink puffer
- pursed lip breathing
- barrel chest
- tripod postion
- No chronic cough*
dyspnea
-thin and pink
- clubbed fingers

• no benzo or opioids will decrease rr

Question 3

Chronic Bronchitis

Answer 3

Blue bloater
- big and blue
- chronic cough and sputum
- Unuusal lung sounds (crackles and wheeze)
- edema (from cor pulmonale, edema, Jed, and weight gain)
recurrent infections
elevated hemoglobin
- no benzo or opioids will decrease rr

Question 4

Nursing interventions for COPD

Answer 4

Oral hygiene before meals to wake up taste buds- mouth breathing makes food taste bad

Eat small, frequent meals (decreases stomach distention)
* HIGH calories & protein
* AVOID eating high amounts of carbohydrates Kaplan
* AVOID exercise 1 hour Before/After meals
- conserve oxygen for chewing & swallowing
* AVOID Gassy Foods: add pressure on diaphragm
* NO carbonated drinks
* NO high-fiber foods (broccoli, beans)
Fluids:
* Increase fluid intake 8 glasses (2 - 3L/day) to thin that mucous
* AVOID drinking fluids while eating
Infection: * Report increase in sputum

Question 5

LABS for COPD

Answer 5

• high RBC’s for compensation
• low oxygen
  -high CO2

Question 6

1 priority for hypercap

Answer 6

give bipod

Question 7

Meds for COPD

Answer 7

albueterol
Guaifenesin
cool humidifier
purse lip breathing: in through nose 2 sec, out through mouth 4 sec

Question 8

asthma s/s

Answer 8

inflammation in lungs
Accessory muscle use
- Critical Sign: Paradoxical Breathing- SOB & dyspnea
- Critical Sign: Single word dyspnea
Tight CHEST & Tachypnea
High-pitched wheezing
Minimal “diminished breath sounds”
3A’s
-Absent Breath Sounds (Silent Chest) PRIORITY
-Acidosis (CO2 retention)
- Air trapping - Prolonged exhalation

Question 9

Status asthmatics

Answer 9

severe asthma attack that pt can’t get out out

1st intervention is ET tube to stabilize airway
key sign: Pulsus paradoxus
Drop in Systolic Blood pressure
More than 10 mmHg

go into resp acidosis with hyper cap

Question 10

what triggers asthma

Answer 10

exercise, emotional stress, dust, dander, smoking, pollen

Question 11

What med should pt with asthma avoid

Answer 11

NSAIDs and beta blockers

Question 12

Green zone for asthma

Answer 12

lungs are working 80-100 %

Question 13

Yellow zone for asthma

Answer 13

Need additional rescue med q4
call provider

Question 14

Red zone for asthma

Answer 14

Emergency treatment needed if rescue drugs are given and it doesn’t turn yellow

Question 15

Pneumonia s/s

Answer 15

infection causing inflammation and mucus in the lungs
s/s: fever
yellow sputum
crackles
pleural friction rub (sharp chest pain on inspiration) - report means getting worse

Question 16

Complication of pneumonia

Answer 16

Pleural effusion, ARDS, septic shock

Question 17

Keys signs of worsening pneumonia

Answer 17

pleural chest pain
sob and decreased breathe sounds
paradoxical breathing

Question 18

Keys signs of worsening pneumonia

Answer 18

pleural chest pain
sob and decreased breathe sounds
paradoxical breathing

Question 19

Cystic Fibrosis

Answer 19

mucus buildup causing recurrent resp infections

Question 20

Nursing interventions for cystic fibrosis

Answer 20

high calorie meals and enzymes with meals to breakdown food
increased fluid to thin secretions
increased exercise and movement to move mucus

Question 21

Meds for cystic fibrosis

Answer 21

acetylcysteine to thin mucus

Question 22

TB s/s

Answer 22

terrible cough with blood tinged sputum

bad infection (fever, chills, night sweats, weight loss)

Question 23

Nursing interventions for TB

Answer 23

meds last 6-12 months
positive tb test with induration > 15mm
3 sputum cultures negative and then free from tb

Question 24

Meds for TB

Answer 24

Rifampin- causes red/orange secretions teach to wear glasses instead of contacts

Isoniazid - pt must take b6 (pyridoxine) to prevent peripheral neuropathy

Ethambutol- frequent eye exams