Respiratory

Question 1

S+S of ARDs

Answer 1

SOB
Refractory hypoxemia
Compensatory tachypnea
Intercostal retractions, accessory muscle use
Anxiety
Tachycardia
Fever
Crackles on auscultation (pulmonary edema)

Question 2

Nursing interventions of ARDS

Answer 2

Administer oxygen
Fowler’s position
Prepare for intubation and mechanical ventilation w/ PEEP
Restrict fluids
Provide and monitor sedation and paralytic support
Provide enteral nutritional support
Implement prone therapy

Question 3

For ARDS, once intubated, what interventions?

Answer 3

Prevent DVT w/ anticoagulants and SCDs
Anticipate that severe hypoxemia may require high PEEP and prone positioning

Question 4

S+S of pneumonia

Answer 4

Difficulty breathing
Productive cough w/ purulent sputum
Increased RR
Chest pain on deep breathing (pleurisy)
Fever, chills, malaise
Tachycardia
Crackles

Question 5

Nursing interventions of pneumonia

Answer 5

Hydration to liquefy secretions
IS
Cough and deep breathe (every 2 hrs)
Collect sputum and blood cultures
Administer abx, antipyretics, IV fluids
Encourage vaxx
Proper position w/ affected lung up

Question 6

Pneumothorax (open)

Answer 6

Air enters through hole in chest wall
Gunshot wound

Question 7

Pneumothorax (closed)

Answer 7

Air enters through hole in lung tissue
After lung surgery

Question 8

Pneumothorax (tension)

Answer 8

Closed pneumothorax but air cannot escape
Lungs collapse
Trachea shifts to unaffected side
Hypotension

Question 9

S+S of pneumothorax

Answer 9

Progressive dyspnea
Restlessness, anxious
Progressive cyanosis
Chest pain
Hypotension and tachycardia
Low oxygen saturation
CXR in stable pts
Hyperresonance percussion
Diminished breath sounds
Decreased tactile vocal fremitus

Question 10

Nursing interventions of pneumothorax

Answer 10

Place 3 way occlusive dressing over chest wound
Fowler position
Insertion of chest tube

Question 11

Water seal chamber

Answer 11

Tidaling is expected
Bubbling = air leak

Question 12

Suction chamber

Answer 12

Gentle, continuous bubbling = expected

Question 13

Notify HCP about chest tube system if

Answer 13

Drainage exceeds 100 mL/hr
Sudden, bright red or free-flowing drainage

Question 14

Pulmonary embolism risk factors

Answer 14

Thromboembolism (Virchow’s triad)
Recent surgery
Inactivity/immobility
Pregnancy
C-section
Hx of DVT
Malignancy
Obesity
Oral contraceptives and hormone therapy
Smoking

Question 15

S+S of PE

Answer 15

Dyspnea
Pleuritic chest pain
Hypoxemia
Tachypnea
Cough
Hemoptysis

Question 16

Nursing interventions of PE

Answer 16

High Fowler
Administer: anticoagulants (heparin), analgesics, oxygen
Anticipate fibrinolytics or embolectomy w/ large PE
Long-term oral anticoagulation

Question 17

COPD S+S

Answer 17

Dyspnea
Wheezing
Chronic cough
Barrel chest
Fatigue
Extremity clubbing

Question 18

Interventions of COPD

Answer 18

Collect sputum sample
Request prescription for inhaled short-acting beta-adrenergic agonist
Monitor for changes in LOC

Question 19

Crackles vs. wheezing tx

Answer 19

Crackles: diuretics
Wheezing: albuterol

Question 20

CO poisoning tx

Answer 20

100% oxygen using nonrebreather mask w/ flow rate of 15 L/min

Question 21

Cystic fibrosis def and S+S

Answer 21

Genetic disorder which causes glands to produce thick and sticky secretions that plug small airways and GI tract
S+S: ineffective airway clearance, risk of infx, chronic lung dz, low baseline oxygen saturation

Question 22

COPD exacerbation

Answer 22

Wheezing
Worsening dyspnea
Altered mental status
Increased cough frequency
Increased sputum production
Decreased exercise tolerance and fatigue

Question 23

COPD exacerbation risk for what?

Answer 23

Air trapping for developing hypercapnic respiratory failure