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Illness and Patho 1 > Respiratory 2 > Flashcards

Respiratory 2 Flashcards

1
Q

What are the five top priorities of a patient with a broken nose?

A

Airway, halo test, vision test, facial xray, and crepitus

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2
Q

Why are fractured noses so dangerous?

A

The airway could be obstructed and it can be a potential source of infection

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3
Q

Which type of epistaxis is more serious?

A

Posterior bleed

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4
Q

Which patient populations are more likely to develop epistaxis?

A

Patients with hypertension, leukemia, and those who snort cocaine

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5
Q

Why are sinus infections so painful?

A

Sinus infections are accompanied by pressure because they are very small spaces to begin with

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6
Q

What is battle’s sign?

A

A bruise behind the ear

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7
Q

Benign, grapelike clusters of mucous membranes and connective tissue

A

Nasal Polyps

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8
Q

How is CSF identified?

A

Glucose and halo tests

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9
Q

After a rhinoplasty, how often should vitals be taken?

A

Every 4 hours

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10
Q

What is the treatment of choice for nasal polyps?

A

Polypectomy

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11
Q

What is the nursing priority for patients with non-infectious URI?

A

Promote oxygenation by ensuring a patent airway

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12
Q

What would a posterior epistaxis look like?

A

Frank blood emesis

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13
Q

What interventions should be done for a patient with a broken nose?

A

Closed reduction, rhinoplasty, and nasosetoplasty

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14
Q

If giving two units of blood, what should also be administered?

A

FFP

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15
Q

What does CSF dripping from a broken nose indicate?

A

A skull fracture

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16
Q

What are carcinogens for nose and sinus cancer?

A

Wood dust, textiles, leather, flour, nickel, chromium, mustard gas and radium

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17
Q

What is dangerous about large nasal polyps?

A

They may obstruct the patient’s airway

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18
Q

What can a bruise behand the ear signify?

A

A fractured skull

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19
Q

What are cancers of the nose and sinuses so rare?

A

Because their cells are very fast growing

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20
Q

After a rhinoplasty, what should be observed?

A

Edema and bleeding

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21
Q

How are cancers of the nose and sinuses usually diagnosed?

A

Local lymph node enlargement on the side of the tumor often alerts doctors to the problem

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22
Q

What is done for a patient with epitaxis?

A

Pack the nose and possible cauterization of the affected capillaries

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23
Q

What is the priority action for a patient with facial trauma?

A

Airway assessment

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24
Q

What are cancers of the sinuses and nose so hard to diagnose?

A

Because they have a slow onset and their manifestations resemble sinusitis

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25
Q

How much fluid should a patient who has just had a rhinoplasy drink?

A

2500 mL/day

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26
Q

If giving blood rapidly, what extra step must be taken?

A

Warm the blood

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27
Q

What are the priority nursing intervention for patients with epistaxis?

A

Make sure the airway is patent, assess for respiratory distress and tolerance of packing or tubes, humidification, oxygen, bedrest, antibiotics, and pain medication

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28
Q

What are the clinical manifestations of nasal polyps?

A

Obstructed nasal breathing, increased nasal discharge, and a change in voice quality

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29
Q

How should a patient who has had a rhinoplasty be positioned?

A

WIth the head elevated

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30
Q

How are nasal polyps managed?

A

Inhaled steroids

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31
Q

What are the other names of the Le Fort III fractures?

A

Craniofacial disjunction or floating face fracture

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32
Q

Maxillary and nasoethmoid complex fracture

A

Le Fort II

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33
Q

What are the manifestations of facial trauma?

A

Stridor, dyspnea, anxiety, hypoxia and hypercarbia, decreased O2 saturation, cyanosis, LOC, sternal retractions, and echymosis behind the ear

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34
Q

Why are wire cutters so important to have for patients with facial trauma?

A

Incase of vomiting

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35
Q

How are cancers of the sinuses and nose treated?

A

Surgical removal generally, and that may be combined with radiation

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36
Q

Breathing disruption during sleep

A

Obstructive sleep apnea

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37
Q

What should the diet of a patient with a facial fracture be?

A

High calorie, proteins, and lipids

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38
Q

What are the signs and symptoms of obstructive sleep apnea?

A

Excessive daytime sleepiness, inability to concentrate, and irritability

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39
Q

What interventions should be done for patients with facial fractures?

A

Airway assessment, anticipate need for emergency intubation, tracheotomy, cricothyroidotomy, fixed occlusion, and debridement

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40
Q

What should be assessed for patients with facial trauma?

A

The mechanism of injury and any injuries occuring due to bracing the fall

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41
Q

Nasoethmoid complex fracture

A

Le Fort I

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42
Q

What is the nonsurgical management for obstructive sleep apnea?

A

Change of sleep position, weight loss, and positive pressure ventilaiton

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43
Q

What are the common disorders of the larynx?

A

Vocal cord paralysis, vocal cord nodules and polyps, and laryngeal trauma

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44
Q

What teaching should be done for patients with facial trauma?

A

Use of wire cutters, sleeping with the head of the bed elevated, nutrition, and appearance

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45
Q

Interruption in airflow through the nose, mouth, pharynx, or larynx

A

Upper airway obstruction

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46
Q

What are the intervention for upper airway obstruction?

A

Assess cause and mainatain a patent airway and ventilation

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47
Q

What is the surgical management for obstructive sleep apnea?

A

Adenoidectomy, uvulectomy or uvulopalatopharyngoplasty

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48
Q

Why is a high protein diet so important for patients with facial trauma?

A

They need albumin to heal

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49
Q

What is the clinical sign of aspiraction?

A

Coughing after swallowing

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50
Q

Facial fracture in which the bones are completely lifted off the face and no longer attached

A

Le Fort III

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51
Q

What is the priority for patients with neck trauma?

A

Assess for and maintain patent airway

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52
Q

If a patient has a neck injury, what should immediately be done?

A

Stabilize the neck

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53
Q

If a patient’s upper airway is obstructed, how can a patient airway be maintained?

A

Cricothyroidotomy, endotracheal intubation, or tracheotomy

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54
Q

What can obstruction occur from in a patient with neck trauma?

A

The initial injury or resultant swelling

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55
Q

What are the inital signs of head and neck cancer?

A

Mucous that is chronically irritated, becoming tougher, thicker, and harder to expectorate

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56
Q

What is the number one way upper airway obstruction occurs?

A

Foreign objects

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57
Q

What kind of lesions are seen in patients with head and neck cancer?

A

Leukoplakia and erythroplakia

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58
Q

What are the clinical manifestations of head and neck cancer?

A

lumps in the mouth, throat and neck that cause difficulty swallowing, color changes in the mouth or tongue, oral lesions, persistent, unilateral ear pain, unexplained oral bleeding, numbness of the mourth, lips, or face, change in the fit of the dentures, a burning senstation when drinking citrus or hot liquids, hoarseness or change in voice quality, persistent sore throat, SOB, and anorexia and unexplained weight loss

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59
Q

After airway, what should be assessed for a patient with neck trauma?

A

Carotid artery and esophagus and cervical spine injury

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60
Q

What kind of cancer cell is usually seen in head and neck injury?

A

Squamous cell carcinoma

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61
Q

After a laryngectomy, how can a patient communicate?

A

With a white board

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62
Q

What teaching should be done for a patient post laryngectomy?

A

Stoma care, communication, and smoking cessation

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63
Q

What should the diet of a patient post laryngectomy not include?

A

Spicy foods, citrus, or acidic foods

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64
Q

How is head and neck cancer treated?

A

Radiation therapy, chemotherapy, cordectomy, and laryngectomy

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65
Q

How can aspiration be prevented in a patient with head and neck cancer?

A

Sit up in chair for meals

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66
Q

Why do the signs and symptoms of head and neck cancer not appear until late?

A

Because there is a lot of potential space

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67
Q

What should a nurse give to a patient with radiation therapy of the throat to aleviate discomforts?

A

Vicous zylocaine

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68
Q

In older patients with dementia, what can be done to prevent airway obstruction?

A

Maintain head of bed at or above 45 degrees

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69
Q

What post operative care should be done for a patient who had a laryngectomy?

A

Airway maintenance and ventilation, hemorrhage, wound breakdown, pain management, nutrition, speech and language rehabilitation, and dopplar pulses on wound and reconstructed tissue

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70
Q

What causes an asthma attack?

A

Specific allergens, general irritants, microorganisms, aspirin, NSAIDs, exercise, and URIs

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71
Q

What are the clinical manifestations of asthma?

A

Audible wheezes, increased respiratory rate, increased cough, use of accessory muscles, barrel chest, long breathing cycles, cyanosis, and hypoxemia

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72
Q

In what ways does asthma occur?

A

Inflammation and airway hyper-responsiveness leading to bronchoconstriction

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73
Q

What laboratory assessments should be done on a patient with asthma?

A

ABGs

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74
Q

What would blood assessments show in a patient who had an allergic asthma attack?

A

There would be elevated serum eosinophil and IgE levels

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75
Q

What happens to the arterial CO2 levels of an asthma patient?

A

They decrease early in asthma attacks and increase later

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76
Q

Airway hyper-responsiveness leads to and over production of what?

A

Mucus

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77
Q

Where do the airway obstructions occur in asthma patients?

A

Lumen

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78
Q

What race is asthma more prevalent in?

A

African American

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79
Q

What is the hyper-responsiveness of asthma is cause by?

A

Exercise and URIs

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80
Q

What would the sputum assessment show in a patient who had an allergic asthma attack?

A

The sputum would have eosinophils, mucous plugs, and shed epithelial cells

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81
Q

The processes of asthma affect what part of the respiratory anatomy?

A

Airways only

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82
Q

When are pulmonary function tests most accurate?

A

When used with spirometry

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83
Q

What would happen to the arterial O2 levels of asthma levels?

A

They decrease during acute asthma attacks

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84
Q

What sex is asthma more common in?

A

Women

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85
Q

What does a yellow peak flow meter indicate?

A

50-79% of normal peak flow, indicates caution, may mean that respiratory airways are narrowing and additional measures may be required

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86
Q

Maximum amount of lung expansion

A

Forced vital capacity

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87
Q

How can a patient tell if their inhaler is full?

A

Float it in water

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88
Q

What do the arterial CO2 levels of an asthma patient indicate?

A

Poor gas exchange

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89
Q

What is the drug therapy for asthmatics based on?

A

It is a step category for severity and treatment

90
Q

In what patient population does asthma increase the odds of health care use?

A

Obese patients

91
Q

What interventions should be done for a patient with asthma?

A

Teaching for self management, use of peak flow meter twice daily, and a personal drug therapy

92
Q

What does a green peak flow meter value indicate?

A

80-100% of normal peak flow, asthma is under good control

93
Q

Drugs for asthma that change airway responsiveness to prevent asthma attacks

A

Preventative therapy or controller drugs

94
Q

What three tests are done in a pulmonary function test?

A

Forced vital capacity, forced expiratory volume in the first second, and peak expiratory flow rate

95
Q

Drugs used by asthmatics to stop attacks once they’ve started

A

Rescue drugs

96
Q

Why is finding a personal drug therapy for an asthmatic patient so difficult?

A

Because the symptoms are not consistent

97
Q

Besides drug therapy, what other treatments can be used for asthma?

A

Exercise and activity and oxygen therapy

98
Q

How often should controller drugs be used by asthmatic patients?

A

Everyday, regardless of symptoms

99
Q

What does a red peak flow meter value indicate?

A

Less than 50% of normal peak flow, indicates a medical emergency and severe airway narrowing may be occurring, immediate action needs to be taken

100
Q

Why is it important that asthmatics exercise?

A

To promote ventilation and perfusion

101
Q

What types of oxygen therapy are used for asthmatics?

A

Masks, nasal cannula, or ET Tubes

102
Q

Why are ET tubes sometimes useless for some asthmatics?

A

Because even though you can intubate, you can’t force the oxygen into constricted airways

103
Q

Why is status asthmaticus so dangerous?

A

Because it is unrelenting, intensifies once it begins, and does not respond to common therapy

104
Q

What is the treatment for status asthmaticus?

A

IV fluids, potent systemic bronchodilator, steriods, epinephrine, and oxygen

105
Q

Severe, life-threatening, acute episode of airway obstruction

A

Status Asthmaticus

106
Q

What complications can arise from stats asthmaticus?

A

Patient can develop pneumothorax amd cardiac/respiratory arrest

107
Q

What part of the lung does emphysema affect?

A

Alveoli

108
Q

Inflammation of the bronchi and bronchioles caused by chronic exposure to irritants

A

Chronic Bronchitis

109
Q

What is COPD characterized by?

A

Bronchospasms and dyspnea

110
Q

What are the clinical signs of emphysema?

A

Dyspnea and the need for an increased respiratory rate

111
Q

Why does air get trapped in the lungs of a patient with emphysema?

A

Because of the loss of elastic recoil in the alveolar walls

112
Q

What is the goal of COPD management?

A

To minimize the damage that takes place

113
Q

What diseases does COPD include?

A

Emphysema and chronic bronchitis

114
Q

What complications can arise with chronic bronchitis?

A

Hypoxemia, tissue anoxia, ACIDOSIS, RESPIRATORY INFECTIONS, cardia failure, cardiac dysrhythmias

115
Q

What are the clinical signs of chronic bronchitis?

A

Inflammation, vasodilation, congestion, mucosal edema, and bronchospasms

116
Q

Loss of lung elasticity and hyperinflation of the lung

A

Emphysema

117
Q

What is the end result of COPD?

A

Respiratory failure

118
Q

What lab studies should be done to confirm a COPD diagnosis?

A

ABG, sputum samples, CBC, H&H, serum electrolytes, serum AAT, chest x-ray, and PFT

119
Q

Cor Pulmonale

A

Right sided CHF

120
Q

A bubble of air in a weak area of the lung that may pop and collapse that lung

A

Bleb

121
Q

What is important to teach patients with COPD about mucolytics?

A

They have to drink water every time they cough

122
Q

Which type of oxygen mask is best for patients with COPD?

A

Venturi mask

123
Q

What is the purpose of a serum AAT for COPD patients?

A

It looks for a hereditary component

124
Q

What types of drugs can be used to treat COPD?

A

Beta-adrenergic agents, cholinergic antagonists, methylxanthines, corticosteroids, NSAIDs, and mucolytics

125
Q

What interventions should be done for patients with COPD?

A

Improve oxygenation and reduce carbon dioxide retention, prevent weight loss, minimize anxiety, improve activity tolerance, and prevent respiratory infections

126
Q

What serum electrolytes will be raised in a patient with COPD?

A

Potassium and Magnesium

127
Q

Occurs in the absence of other lung disorders; cause unknown

A

Pulmonary Arterial Hypertension

128
Q

Genetic disease affecting many organs, lethally impairing pulmonary function

A

Cystic Fibrosis

129
Q

How can patients with COPD manage their dyspnea?

A

By resting before meals and eating 4-6 small meals a day

130
Q

What should the diet of a patient with CF include?

A

High fat and protein with low carbs

131
Q

What is the nonsurgical preventative therapy for patients with CF?

A

Chest physiotherapy, positive expiratory pressure, active cycle breathing technique, and exercise

132
Q

How can COPD be managed surgically?

A

Lung reduction surgery

133
Q

How does CF affect breathing?

A

There is an error of chloride transport, producing thick mucus with low water content; the mucus plugs up glands and leads to atrophy and organ dysfunction

134
Q

What are the home care needs for a patient with COPD?

A

Long term use of oxygen and pulmonary rehabilitation

135
Q

How can CF be prevented?

A

Genetic counseling

136
Q

What breathing techniques can a patient with COPD be taught?

A

Pursed lip breathing to maximize the amount of air in their alveoli

137
Q

What is the nonsurgical management for COPD?

A

Weight management, vitamin supplement, diabetes management, and pancreatic enzyme replacement

138
Q

What types of surgical management are available for patients with CF?

A

Lung and/or pancreatic transplantation

139
Q

What is the nonsurgical management for exacerbation therapy?

A

Avoid mechanical ventilation, supplemental oxygen, heliox, airway clearance techniques, drug therapy and prevention

140
Q

What are the clinical manifestations of CF?

A

Malnutrition, abdominal distention, GERD, rectal prolapse, steatorrhea, DM, osteoporosis, respiratory infections, chest congestion, cough and sputum production, use of accessory muscles, increased AP diameter

141
Q

How long does surgical management extend the life of a patients with CF?

A

10 to 20 years

142
Q

Restrictive disease in which the alveoli, blood vessels, and surrounding support lung tissue thickens and stiffens, reducing gas exchange

A

Interstitial pulmonary diseases

143
Q

Granulomatous disorder of unknown causes that most often affects lungs in which normally protective T-lymphocytes increase and damage lung tissue

A

Sarcoidosis

144
Q

High lethal, common restrictive lung disease in which there is extensive fibrosis and scarring

A

Idiopathic pulmonary fibrosis

145
Q

Caused by occupational or environmental exposure

A

Occupational pulmonary disease

146
Q

What do patients with pulmonary arterial hypertension die of?

A

Heart failure within 2 years

147
Q

What is the main therapy for sarcoidosis?

A

Corticosteroids

148
Q

What are pharmacological interventions for patients with CF?

A

Warfarin therapy, calcium channel blockers, endothelin-receptor antagonists, natural and synthetic prostacyclin agents, digoxin, diuretics, and oxygen therapy

149
Q

What is the most common manifestation in patients with interstitial pulmonary diseases?

A

Dyspnea

150
Q

What are the clinical manifestations of pulmonary arterial hypertension?

A

Blood vessel constriction with increasing vascular resistance in the lungs

151
Q

How can occupational pulmonary disease be prevented?

A

Through special respirators and adequate ventilation

152
Q

What is the therapy for idiopathic pulmonary fibrosis?

A

Corticosteroids and other immunosuppressants

153
Q

Who is pulmonary arterial hypertension more common in?

A

Young women

154
Q

What exposures causes occupational pulmonary disease?

A

Fumes, dust, vapors, gases, bacterial/fungal antigens, allergens, and cigarette smoke

155
Q

Leading cause of cancer deaths worldwide, this disease is caused by bronchogenic carcinomas and paraneoplastic syndromes

A

Lung cancer

156
Q

What are palliative interventions for patients with lung cancer?

A

Oxygen therapy, drug therapy, radiation therapy, thoracentesis and pleurodesis, dyspnea, pain management, and hospice care

157
Q

What is the first chest tube chamber for?

A

Collects fluid draining from the patient

158
Q

What is the nonsurgical management for lung cancer?

A

Chemotherapy, targeted therapy, radiation therapy, and photodynamic therapy

159
Q

What are the nursing interventions for after a thoractomy?

A

Pain management, respiratory management, and pneumonectomy care

160
Q

Inflammation of nasal mucosa

A

Rhinitis

161
Q

Why is lung cancer staged?

A

To assess size and extent of the disease

162
Q

What are the clinical manifestations of rhinitis?

A

Headache, nasal irritation, sneezing, nasal congestion, and rhinorrhea

163
Q

What is the second chest tube chamber for?

A

Water seal to prevent air from re-entering the patient’s pleural space

164
Q

What is the surgical management for lung cancer?

A

Lobectomy, pneumonectomy, segmentectomy, and wedge resection

165
Q

What is the third chest tube chamber for?

A

Suction control of the system

166
Q

What kind of supportive therapy can be used for patients with rhinitis?

A

Drinking fluids, humidification, elevate the head of the bed, and staying away from the allergen

167
Q

Common inflammation of pharyngeal mucous membranes

A

Pharyngitis

168
Q

What are the nonsurgical interventions for sinusitis?

A

Broad spectrum antibiotics, analgesics, decongestants, steam humidification, hot/wet packs over sinus areas, nasal saline irritants, and increased fluids

169
Q

Screening process for group A bet-hemolytic streptococcal antigen

A

Rapid Antigen Test

170
Q

What complementary therapies can be used for patients with rhinitis?

A

Vitamin C ad zinc

171
Q

Inflammation/infection of tonsils and lymphatic tissues caused by contagious, airborne bacteria

A

Tonsillitis

172
Q

What are the symptoms of pharyngitis?

A

Odynophagia, dysphagia, fever, and hyperemia

173
Q

Inflammation of sinus mucous membranes usually caused by streptococcus pneumoniae

A

Sinusitis

174
Q

What drugs are used for patients with rhinitis?

A

Antihistamines, leukotriene inhibitors, mast cell stabilizers, decongestants, antipyretics, and antibiotics

175
Q

Complication of acute tonsillitis in which pus causes one-sided swelling with deviation of the uvula

A

Peritonsillar Abscess

176
Q

What is the problem with using decongestants for sinusitis?

A

A rebound effect

177
Q

What are the symptoms of peritonsillar abscess?

A

Trismus, difficulty breathing, bad breath, and swollen lymph nodes

178
Q

How long do the results from a rapid antigen test take?

A

15 minutes

179
Q

What is the surgical management for sinusitis?

A

Functional endoscopic sinus surgery

180
Q

How many days are antibiotics used for patients with tonsillitis?

A

7-10 days

181
Q

What is the treatment for laryngitis?

A

Voice rest, steam inhalation, increased fluid intake, throat lozenges, and reduce use of tobacco and alcohol

182
Q

Inflammation of mucous membranes lining the larynx with possible edema of the vocal cords

A

Laryngitis

183
Q

What are the symptoms of influenza?

A

Severe headache, muscle ache, fever, chills, fatigue, weakness, and anorexia

184
Q

What type of infection is laryngitis?

A

Viral

185
Q

When are antiviral agents effective?

A

Within 24 hours of flu symptoms

186
Q

What is the treatment for peritonsillar abscesses?

A

Percutaneous needle aspiration of the abscess, antibiotics, and IV fluids

187
Q

Which antiviral drugs treat influenza?

A

Oseltamivir and zanamivir

188
Q

Highly contagious acute viral respiratory infection

A

Influenza

189
Q

What are the symptoms of laryngitis?

A

Acute hoarseness, dry cough, difficulty swallowing, and temporary voice loss

190
Q

What types of precautions are used for patients with pandemic influenza?

A

Strict isolation

191
Q

What is the only way to differentiate between viral and bacteria pneumonia?

A

Chest x-rays

192
Q

What is pneumonia triggered by?

A

Infectious organisms or the inhalation of irritants

193
Q

What does the chest x-ray of bacterial pneumonia look like?

A

Consolidation

194
Q

How can Ventilator-Associated Pneumonia be prevented?

A

Hand hygiene, oral care, and head of bed elevation

195
Q

Excess fluid in lungs resulting from inflammatory process

A

Pneumonia

196
Q

Virus infection of respiratory tract cells, triggering the inflammatory response

A

Severe Acute Respiratory Syndrome (SARS)

197
Q

What are the symptoms of pneumonia?

A

Atelectasis, hypoxemia, a harsh, productive cough, pleuresy, and lung fractures

198
Q

What type of pneumonia is the most common?

A

Nosocomial

199
Q

What does the chest x-ray of viral pneumonia look like?

A

Mucus

200
Q

What type of isolation should a patients with SARS be in?

A

Strict airborne isolation

201
Q

How can the spread of SARS be prevented?

A

Hand washing

202
Q

What types of isolation should a TB patient have?

A

Negative airflow and droplet precautions

203
Q

What are the drug interventions for TB?

A

Isoniazid, rifampin, pyrazinamide, and ethambutol

204
Q

Localized area of lung destruction caused by liquefaction necrosis, usually relate to pyogenic bacteria?

A

Lung Abscess

205
Q

How is TB transmitted?

A

Aerosolization

206
Q

What does a positive PPD indicate?

A

Exposure to TB

207
Q

What are the clinical manifestations of TB?

A

Progressive fatigue, lethargy, nausea, anorexia, weight loss, irregular menses, low grade fever, night sweats, and cough with mucopurulent sputum and blood streaks

208
Q

How is TB ruled out?

A

Three negative morning sputum cultures

209
Q

Highly communicable disease caused by a mycobacterium

A

Pulmonary Tuberculosis

210
Q

What is the sign of a lung abscess?

A

Pleuritic chest pain

211
Q

What should the diet of a TB patient consist of?

A

Lots of protein

212
Q

Why is TB incidence increased in patients with HIV?

A

Because they have reduced T lymphocytes

213
Q

What does a positive PPD look at?

A

Induration of 10 mm or greater

214
Q

Why is there a recent upswing of TB?

A

Immigration

215
Q

What are the interventions for patients with lung abscess?

A

Antibiotics, drainage of abscess, and frequent mouth care

216
Q

Collection of pus in the pleural space commonly caused by pulmonary infection, lung abscesses, and infected pleural effusions

A

Pulmonary Empyema

217
Q

What interventions can be done for patients with pulmonary empyema?

A

Empty the empyema cavity, re-expand the lung, and control the infection

218
Q

Bacterial infection caused by contaminated soil

A

Inhalation anthrax

219
Q

What are the two stages of inhalation anthrax?

A

Prodromal stage and fulminant stage

220
Q

What drugs are used for inhalation anthrax?

A

Ciprofloxacin, doxycycline, and amoxicillin

Illness and Patho 1 (12 decks)

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