Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Respiratory > Respiratory Diseases > Flashcards

Respiratory Diseases Flashcards

1
Q

ARDS

A

Adult Respiratory Distress Syndrome

  • Sudden onset of progressive pulmonary disorder
  • REDUCED PERFUSION TO THE LUNGS caused by different factors
  • Caused by LUNG FLUID and leads to EXTRAVASCULAR LUNG FLUID
  • FLUID BUILD UP in ALVEOLI when surfactant production falls causing collapse of alveoli
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Causes of Adult Respiratory Distress Syndrome

A
  • Aspiration of gastric contents
  • Chest ( VIRAL and BACTERIAL PNEUMONIA)
  • Fractured bone with emboli
  • Smoke and chemical inhalation
  • O2 toxicity
  • Drug overdose
  • Shock
  • Trauma
  • DIC
  • Burns
  • Neuro injuries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Signs/Symptoms of ARDS and Care Mgmt

A
  • Dyspnea and Tachypnea
  • RAPID/SHALLOW BREATHING
  • Restlessness/Apprehension
  • Increased pCO2 and Decreased SpO2

Care Mgmt:
- SEDATIVES to REDUCE RESTLESSNESS
- May need mechanical vent with PEEP ( Positive End Expiratory Pressure) for severe hypoxemia
PEEP may cause DECREASE CARDIAC OUTPUT, HYPOTENSION, and TACHYCARDIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Date Collection for ARDS

A
  • Tachypnea
  • Dyspnea
  • Decreased breath sounds
  • Deteriorating ABG levels
  • Hypoxemia despite high concentrations of delivered oxygen
  • Decreased pulmonary compliance
  • Pulmonary infiltrates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Asthma

A
  • Known as Respiratory Airway Disease (RAD)
  • Narrowing/inflammation of airway (bronchi or bronchioles)
  • Respiratory disorder characterized by wheezing, chest tightness, dyspnea and cough with recurrent episodes of precipitated allergens, infections, strenuous exercise, and exposure to cold environment or emotional stress
  • No CURE can only be controlled
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Treatment for Asthma (meds) and side effects

A
  • Bronchodilators ( inhaler or nebulizer)
  • S/E
    Jittery, nervousness, tachycardia, palpitations, nausea, diarrhea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Acute Bronchitis

A
  • An inflammation of the bronchi resulting from BRONCHIAL TISSUE IRRITATIONS secondary to smoking, chemicals, and pollens
  • Often follows a cold or URTI ( Upper Respiratory Tract Infection )
  • Viral or bacterial
  • Radiology film reveals no infiltrates or consolidation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Signs and Symptoms of Acute Bronchitis

A
  • Productive cough ( clear to purulent )
  • Fever ( Mild to Moderate )
  • Dyspnea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Diagnostic Tests for Acute Bronchitis/ Treatments

A
  • Chest X Ray
  • CBC
  • Pulse Ox
  • Pulmonary function test using PEAK FLOW
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Chronic Bronchitis

A
  • Inflammation or irritation of one or more bronchial tubes
  • Productive cough for at least 2-3 continuous months for 3 years
  • CIGARETTE SMOKING is the the MAIN CAUSE of chronic bronchitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Signs and Symptoms of Chronic Bronchitis

A
  • Chest tightness
  • Exertional dyspnea
  • Diminished breath sounds with wheezing
  • Activity intolerance
  • Recurrent respiratory infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Acute Bronchitis (Meds)

A

Benzonatate ( Tessalon Perles ), Guaifenesin ( Robitussin) , Promethazine ( Phenergan)

( These are cough and antihistamines )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Cor Pulmonale

A
  • CHANGE IN STRUCTURE OF HEART as a result of respiratory disorder
  • COPD PRODUCES PULMONARY HYPERTENSION
  • RIGHT SIDED HEART FAILURE ( enlargement of the right ventricle due to high BP in the lungs usually caused by chronic lung disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Signs and Symptoms of Cor Pulmonale

A
  • Shortness of breath on exertion

- Easy fatigability, chest pain, palpitations, ankle, leg, and abd swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Emphysema

A
  • Chronic obstructive disease of the lungs with significant over distention of the alveoli
  • Bronchitis and Emphysema = COPD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Primary factors of Emphysema

A
  • SMOKING
  • Air pollution
  • Environmental exposure
  • Allergy
  • Infection
  • AGING and GENETIC PREDISPOSITION
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Signs and Symptoms of Emphysema/COPD

A
  • Dyspnea, worse on exertion ( prolonged exertion )and exercising
  • Coughing
  • Excessive mucous production
  • Shortness of breath and tightness of chest
  • Wheezing
  • Use of accessory muscles
    * Tripod posture
    * Barrel chest
  • Inward movement of the lower chest with inspiration ( associated with severe hyperinflation)
  • PROLONGED EXPIRATORY PHASE
  • PULSUS PARADOXUS may be present ( Heart sounds heard precordium when radial pulse is not felt )
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Nursing Interventions for Emphysema/COPD

A
  • VS
  • OXYGENATION USUALLY BY NASAL CANNULA at 1-2 L,
  • VENTURI- MASK ALLOWS MORE PRECISE O2 ADMINISTRATION ( maintain PaO2 between 55- 65
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

MEDS on COPD/ EMPHYSEMA

A

BRONCHODILATORS

 * Aminophylline 
 * Terbutaline ( Brethine )

INHALED ANTICHOLINERGIC
* Ipratroprium ( ATROVENT)

INHALED BETA AGONISTS

 * ALBUTERTOL 
 * METAPROTERENOL ( Alupent )

CORTICOSTEROIDS
* Inhaled or Oral ( Prednisone )

BROAD SPECTRUM ANTIBIOTICS

INCREASE IN FLUID INTAKE to 3 L A DAY TO THIN SECRETIONS or give MUCOLYTICS

PURSE- LIP BREATHING

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Nursing Alert/Pt Teaching (COPD)

A
  • NO CURE
  • Ensure adequate rest periods
  • Monitor pulse ox ( continuous or periodically)
  • Teach Pt. how to control breathing pattern and PURSE LIP EXHALATION to AVOID TACHYPNEA and EXCESSIVE HYPERVENTILATION
  • TRIPOD POSITION to maximize respiratory muscles
  • TEACH AND ENSURE CORRECT USE OF BRONCHODILATOR INHALERS TO PROMOTE BRONCHODILATION
  • O2 inhalation usually by NASAL CANULA at (1-2 L) USE VENTURI ALLOWS MORE PRECISE O2
  • AVOID IRRITANTS ( CIG SMOKE, PERFUMES) might trigger BRONCHOSPASM
  • USE OF INHALED or ORAL PREDNISONE corticosteroid as prescribed. TEACH PURSE-LIP BREATHING

QUIT SMOKING by using prescribed
- Zyban ( buproprion) or Chantix ( varenicline) or Nicotine patch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Pursed- Lip Breathing

A

Pursed- lip breathing works by helping your air passages STAY OPEN LONGER ( lengthening expiration ) to allow for more normal oxygen exchange. PROMOTES CARBON DIOXIDE ELIMINATION (prevents early airway collapse)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How to do Purse- Lip breathing ?

A
  1. Relax your neck and shoulder muscles and inhale slowly through your nose for at least 2 counts
  2. Pucker your lips as if to blow out a candle
    Exhale slowly and gently through your pursed lips for at least twice as long as you inhaled ( count to 4 )
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Histoplasmosis

A
  • SYSTEMIC FUNGAL INFECTION
  • Inhalation of dust contaminated by Histoplasma capsulatum ( transmitted through bird manure )
  • Lungs almost infected but can affect other internal organs
  • Fungus is found in Southern parts of the US and South America
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Signs and Symptoms of Histoplasmosis

A
  • Similar to pneumonia or TB ( Cough, fever, chills)
  • Anorexia, nausea, vomiting, generalized weakness, body aches, and joint pains
  • Amphoterecin B ( Fungizon ) administration
  • Meds: Tylenol, steroids, antiemetic
  • Monitor BUN and Creatinine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Aspergillosis

A
  • Caused by opportunistic fungal infection called aspegillus causing pulmonary infection when inhaled
  • Aspergullius LIVES IN SOIL, AIR, and WATER
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Aspergillosis Pt Teaching

A

Avoid cool and wet places and household dust

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Aspergillosis

Symptoms/ Treatment/ Nursing considerations

A
  • Fever, cough, chest pain, and hemoptysis
  • Systemic Antifungal Fungizone
  • Premedicate with Benadryl and Tylenol 30 min prior to the start of Amphotericin B IV treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Pneumonia

A
  • An infection of the pulmonary (lung) tissue including interstitial spaces, the alveoli, and the bronchioles
  • Caused by viruses bacteria, Protozoa, mycobacterium, mycoplasma, and rickettsia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Right middle lobe lung is the most common site of what ?

A

Aspiration pneumonia as the right main bronchus is shorter and wider ( easily catching foreign body or patient’s own secretions)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What type of isolation and PPE does pneumonia require

A
  • DROPLET

- Surgical mask, gloves, and gown

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How long can a surgical mask be worn ?

A

20-30 minutes (if greater), moisture will build up and make the mask ineffective against maintaining sterility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Data Collection for Pneumonia

A
  1. Fever
  2. Chills
  3. Headache
  4. Muscle pain
  5. SOB
  6. Non- productive cough to productive cough
  7. Use of accessory muscles for breathing
  8. Rhonchi and wheezes
  9. Mental status changes
  10. Sputum production
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Diagnostic Tests for Pneumonia

A
  • Chest x- ray
  • Blood tests ( CBC and basic metabolic panel )
  • Sputum culture and sensitivity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Diet for Pneumonia/ Interventions

A
  • Admin O2
  • Provide CPT
  • Semi Fowler’s position
  • Monitor/record color, consistency, and amount of sputum
  • Provide a balance of rest and activity, increasing activity gradually
  • High protein
  • High calorie ( unless overweight )
  • Increase fluid intake ( Avoid milk because it thickens secretions)
  • Fluids ( up to 3 L) such as
    Water
    Cranberry
    Pineapple
    Grapefruit juice
    If not contraindicated because it may help cut mucus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Pulmonary Edema

A
  • ACCUMULATION OF EXTRAVASCULAR FLUID IN THE LUNG OFTEN CAUSED BY CHF (Fluid build up in alveoli, fluid leakage into lungs )
  • FLUID BACK UP INTO PULMONARY VEINS when the heart’s pumping power on LEFT SIDE is weaker that normal
  • May cause respiratory failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Signs/Symptoms of Pulmonary Edema

A
  • Dyspnea
  • SOB
  • Gasping for air
  • Restlessness
  • Anxiety Tachycardia
  • Tachypnea
  • Pink-tinged frothy phlegm
  • Sweating
  • Inspiratory and expiratory wheeze
  • Neck vein distention ( RIGHT SIDE HF)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Diagnostic Test for Pulmonary Edema

A
  • Chest radiograph
  • Electrocardiogram
  • CBC
  • CMP ( comprehensive metabolic panel)
  • Echocardiogram
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Nursing Management for Pul Edema

A

M(orphine sulfate)

A(minophylline)

D(igitalis)

D(iuretics)

O(xygen)

G( ABG )

Monitor response to therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Why do you give morphine in Pulmonary edema ?

A
  • Promotes venous pooling
  • Reduces oxygen demand due to anxiety
  • Conserves oxygen to the myocardium
  • DO NOT GIVE TO STROKE PT WITH HEAD INJURY ( pupils constrict )
  • COPD
  • CARDIOGENIC SHOCK
  • There is NO CONSTIPATION when taking for FIRST FEW DAYS
  • MONITOR FOR RESPIRATORY DEPRESSION AND DROP IN BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What does Aminophylline do for Pulmonary Edema ?

A
  • May prevent bronchospasm associated with pulmonary congestion
  • Relax bronchospasm when if wheezing
  • SHOULD BE ATTACHED TO HEART MONITOR WHEN INFUSING THIS MED
  • MONITOR FOR TACHYCARDIA AND DYSRHYTHMIAS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Why do you give Digoxin to Pulmonary edema ?

A
  • It improves cardiac contractility increasing the output of left ventricle
  • Hold if pulse is <60/min
  • ASSESS FOR TOXICITY
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What Diuretics do you give to pulmonary edema ?

A
  • Lasix (furosemide) This causes vasodilation and peripheral venous pooling
  • Bumex (bumetanide)
  • Demadex (torsemide)
  • Edercin (ethacrynic)
  • Loop diuretics in acute pulmonary edema (given IV)
  • Indwelling cath may be inserted in acute condition
  • Upon discharge oral form is administered by LVN or RN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Causes for Pulmonary Edema

A

CARDIOGENIC

  • Congestive Heart Failure
  • Myocardial Infarction
  • Abnormal Heart Valves

NONCARDIOGENIC

  • Rapid infusion
  • Fluids or blood ( TRALI ) transfusion-related acute lung injury
  • cocaine
  • smoking
  • lung infection
  • trauma
  • severe infection
  • ARDS
  • kidney failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Pleural Effusion

A
  • Abnormal collection of fluid in the pleural space between the visceral and parietal pleura
  • 5-15 ml to prevent friction if greater than 25ml it is considered effusion
  • 300ml or more before becoming symptomatic
  • Thoracentesis is performed for therapeutic and diagnostic test
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Causes for pleural effusion

A
  • CHF
  • Pneumonia
  • Pulmonary embolism
  • Liver disease
  • ESRD
  • Cancer
  • Nephrotic syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Data Collection

A
  • Pleuritic pain that increases with inspiration
  • DYSPNEA
  • DECREASED MOVEMENT OF CHEST WALL ON AFFECTED SIDE
  • DRY NON- PRODUCTIVE COUGH CAUSED BY BRONCHIAL IRRITATION
  • TACHYCARDIA
  • INCREASE TEMP
  • DECREASED BREATH SOUNDS ON AFFECTED SIDE
  • CHEST X-RAY FILM SHOWS PLEURAL EFFUSION AND MEDIASTINAL SHIFT AWAY FROM FLUID IF EFFUSION GREATER THAN 250 mL
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

(Pleural Effusion) Pt. Teaching/Post procedure

A
  • Explain
  • POSITION SEMI- FOWLERS
  • CHEST X-RAY REQUIRED BEFORE PROCEDURE

POST

  • Monitor for signs of respiratory distress
  • Obtain a chest X-Ray Film
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Pleurectomy

A
  • Surgically stripping the parietal pleura away from the visceral pleura
  • Produces strong inflammatory reaction that promotes adhesion formation between the two layers during healing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Pleurodesis

A
  • Involves the instillation of a sclerosing substance into the pleural space via thoracotomy tube
  • Creates an inflammatory response that scleroses tissues together
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Empyema

A
  • COLLECTION OF PUS WITHIN PLERAL CAVITY
  • THICK, OPAQUE, FOUL SMELLING
  • Common cause is PULMONARY INFECTION and LUNG ABSCESS caused by thoracic surgery or chest trauma ( Bacteria introduced into pleural space)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Treatment ( Empyema)

A
  • Focuses on treating the infection and emptying empyema cavity
  • reexpanding the lung
  • Controlling infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Data Collection ( Empyema)

A
  • Recent febrile illness or trauma
  • CHEST PAIN
  • COUGH
  • DYSPNEA
  • Anorexia weight loss
  • Malaise
  • Night sweats
  • Pleural exudate on chest x- ray
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Interventions ( Empyema)

A
  • Monitor breath sounds
  • SEMI- FOWLERS or HIGH
  • Coughing/Deep breathing
  • Antibiotics as prescribed
  • Thoracentesis or chest tube insertion to promote drainage and lung expansion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Pulmonary Embolism

A
  • OBSTRUCTION TO PULMONARY ARTERY BY BLOOD CLOT
  • Blood is usually in the PERIPHERAL DEEP VEINS OF THE LEG
  • Blood is DISINTEGRATE AND CIRCULATED TO THE LUNG CAUSING OBSTRUCTION
  • Thrombus forms Detaches and travels to right side of heart and then lodges in branch of pulmonary artery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Risk Factors for Pulmonary Embolism

A
  • PROLONGED INACTIVITY or BED REST
  • CHF
  • MI
  • RECENT SURGERY
  • LEG INJURY
  • TRAUMA TO PELVIS
  • MALIGNANT DISEASE
  • CLIENT ON BC PILLS
  • HYPERCOAGULABLE CONDITION
  • OBESITY
  • PREGNANCY
  • HISTORY OF THROMBOEMBOLISM
  • FAT EMBOLI AFTER LONG BONE FRACTURE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Signs/Symptoms ( Pulmonary Embolism)

A
  • DYSPNEA
  • TACHYPNEA/TACHYCARDIA
  • SHORTNESS OF BREATH/ANXIETY
  • HYPOTENSION
  • HYPOXEMIA
  • FEVER
  • DECREASE Pa02 (partial pressure of 02 in ABG)
  • INCREASE Pc02 ( partial pressure in carbon dioxide in blood)
  • WEAKNESS/RESTLESSNESS
  • ALTERED LOC
  • CRACKLES/WHEEZES
  • BLOOD TINGED SPUTUM
  • DISTENDED NECK VEINS
  • CYANOSIS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Diagnostic Tests for Pulmonary Embolism

A
  • Chest X- Ray
  • Lung Scan ( V/Q scan )
  • ABG
  • D-Dimer ( < 250)
  • EKG
  • Pulmonary angiogram
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Treatments for Pulmonary Embolism

A
  • OXYGEN THERAPY
  • ANTICOAGULANTS (HEPARIN BOLUS AND DRIP)
  • TRAP EASE VENA CAVA FILTER or GREENFIELD VENA CAVA FILTER for recurrent pulmonary embolism
59
Q

Protime

A

10.6 - 12.9 seconds

60
Q

INR

A

2.0 - 3.0 Prophylaxis/ Treatment venous thrombosis, Pulmonary embolism

61
Q

On Heparin PTT or APTT

A

24 -37 seconds

62
Q

Surgical intervention for blood clot

A
  • Intraluminal
  • Vena Cava Filter (Garfield or Trap- Ease filter
  • Ligation
  • Plication
  • Clipping of vena cava and embolectomy
63
Q

What is the therapeutic time for prothrombin ?

A

1.5 - 2 times

64
Q

What does heparin do ?

A

It STOPS FURTHER THROMBUS FORMATION and EXTENDS the CLOTTING TIME of the blood

65
Q

What is S T A I R and what does this stand for ?

A

Thrombolytics

Streptase (streptokinase)

T-pA (Tissue plasminogen activator) * Must be stored in refrigerator*

Abbokinase (urokinase)

Integrilin (eptifibatide)

Retavase (retaplase)

Nurse Alert* Administer initial intravenous bolus over 1 min, follow by prescribed drip. Monitor for any bleeding

DO NOT INSERT after Clot buster has been given
Foley Cath
NGT
Digital exam

66
Q

Low- Molecular weight Heparin

A

Lovenox (Inoxaparine)

1mg/kg SubQ BID

Arixtra (fonduparanux)

SubQ ONCE DAILY

67
Q

Other Blood Thinners (PET PAX)

A

Pradaxa (Dibigatron) - PREVENT STROKE & BLOOD CLOTS WITH A-FIB. NO NEED TO MONITOR INR

Eliquis (Apixaban) - PREVENT DVT

Ticlid (Ticlopidine)

Plavix (Clopidrogel)

Aggrenox (Dipyridamole/ASA)

Xarelto (Rivaroxaban)

68
Q

Side Effects of Anticoagulants/Thrombolytics

A
  • Bruising
  • Hematoma
  • Gum bleeding
  • Epistaxis
  • Hemoptysis or Hematemesis
  • Back pain
  • Stomach pain
  • Increased abd girth
  • Black Tarry stools
  • Heavy periods
  • Vaginal bleeding
  • Internal Bleeding
  • Decreased BP
  • Altered Breathing
69
Q

Risk Factors for DVT

A
  • Venous Injury
    Surgery Trauma
- Poor Blood Circulation 
      HF
      Increased blood thickness
      Small blood clots 
      Prolonged immobilization 
Increased Blood Clotting 
      Anticlotting factor deficiencies 
      Autoimmune disorders 
      Certain cancers 
      Platelet disorders
70
Q

Is VENOUS OCCLUSION RED or BLUE ?

A

RED

71
Q

Arterial is ?

A

BLUE/COLD

72
Q

Why is Venous more common to have clots ?

A
  • Have Valves
  • Can NOT FLOW BACK
  • MOVE SLOW
73
Q

When it is WARM, RED, and/or pain in leg is this Arterial or Venous ?

A

Venous

74
Q

Majority of DVTs occurs in only one leg at a time. TRUE or FALSE

A

TRUE

75
Q

Can DVT in the thigh cause symptoms in both the thigh and leg ?

A

Yes

76
Q

What are the Diagnostic Tests for the Leg (DVT)

A
  • Doppler Ultrasound
  • Venogram
  • Impedance Plethsmography (IPG)
77
Q

How do you assess DVT ?

A
  • PAIN & TENDERNESS IN CALF of affected extremity
  • Pain ESPECIALLY ON DORSOFLEXION of FOOT also called HOMAN’S SIGN
  • Extremity will appear larger than the other caused by edema
  • Affected extremity will be WARM TO TOUCH
78
Q

Warfarin interaction with Herbals ( Can Increase INR )

A
  • Garlic
  • Ginger
  • Ginseng
  • Ginkgo
  • Guarana
  • Chamomile
  • St. John’s Wort
79
Q

What decreases INR ?

A
  • Antacids
  • Barbiturates
  • Corticosteroids
  • Grapefruit/ grapefruit juice
  • Oral contraceptives and estrogen
  • Quinidine ( this is an antiarrhythmic drug)
  • Rifampin (Antibiotic)
  • Tamoxifen ( Treats breast cancer )
  • Vitamin K rich foods
80
Q

What are substances that can increase INR ?

A
  • Alcohol
  • Aspirin
  • Cephalosporins (Antibiotic)
  • Fluconazole (Anti-Fungal)
  • GARLIC
  • GINSENG
  • GINGKO BILOBA
  • GINGER
  • GUARANA
  • Heparin
  • Macrolides (Antibiotics)
  • Penicillins ( HIGH DOSE)
  • Sulfa Compounds
  • Thyroxin (Synthroid)
  • Ticlopidine (Ticlid)
  • Clopidrogel (Plavix)
81
Q

How many days does it take before the therapeutic effect of warfarin is exhibited ? What should should you monitor ?

A

3-4 Days and monitor the INR

82
Q

What are the safety precautions when administering heparin ?

A
  • Convenient sites are the lower abd fat pad ( to avoid inadvertent intramuscular injection, injection near an incision and hematoma formation)
  • Common location site is the fatty area anterior to either iliac crest
  • AVOID INJ SITES WITHIN 2 IN. OF UMBELLICUS BECAUSE OF POSSIBILITY OF ENTERING A LARGER BLOOD VESSEL
  • AVOID THIN LAYERS OF SKIN
  • ALERT - Elderly begin to lose SubQ fat padding ( EXAMINE FOR SAFE SITES ON SKIN)
83
Q

Is Heparin safe in pregnancy ?

A

YES

84
Q

MNEUMONIC: COUMADIN

A

Contraindicated in lactating women, hemophilia, dyscrasias, active bleeding

Oral anticoagulant

Usual side effect is BLEEDING

Monitoring of PT/INR

AVOID GREEN LEAFY VEGGIES AND FRUITS WITH GREEN SKIN

DRUG ANTIDOTE IS VIT K

INSTITUTE BLEEDING PRECAUTIONS

NO TO MANUAL RAZOR

85
Q

What is the antidote for Heparin overdose ?

A

Protamine Sulfate

86
Q

How can Heparin be administered ?

A

SubQ, Bolus, IV Drip

87
Q

Is aPTT obtained before initiation of Heparin ?

A

YES, Every 6 hours thereafter until stable, the daily

88
Q

Pulmonary Hypertension

A
  • Abnormally high blood pressure in the arteries of the lungs
  • It makes the right side of the heart work harder than normal when blood is pumped through arteries in the lungs
89
Q

What may cause Pulmonary Hypertension ?

A
  • Autoimmune diseases that damage the lungs ( such as scleroderma and RA
  • Birth defects of the heart
  • PULMONARY EMBOLISM
  • CHF
  • HEART VALVE DISEASE
  • HIV
  • COPD
  • Pulmonary fibrosis (scarring of lungs)
  • Obstructive sleep apnea
90
Q

Signs and symptoms of Pulmonary Hypertension

A
  • SOB
  • Light-headedness during activity is OFTEN FIRST SYMPTOM
  • Palpitations may be present
  • Over time, symptoms OCCUR with LIGHT ACTIVITY OR EVEN REST
    Other symptoms:
  • Swelling of ankle and leg
  • Cyanosis of lips or skin
  • Chest pain ( Usually front of chest)
  • Dizziness or fainting
  • Fatigue
  • Weakness
91
Q

Patient Teaching for Pulmonary Hypertension

A
  • QUIT SMOKING
  • AVOID PREGNANCY
  • AVOID HEAVY PHYSICAL ACTIVITIES AND LIFTING
  • Avoid traveling in HIGH ALTITUDES
  • Keep up to date with yearly flu and pneumococcal vaccines every 5 years
92
Q

Treatments for Pulmonary Hypertension

A
  • AmbrisenTAN( Letairis ); Prevents thickening of blood vessels ESPECIALLY THOSE IN LUNGS AND HEART, also LOWERS BP IN LUNGS
  • BosenTAN (Tracleer)
  • Calcium Channel Blockers AmlodiPINE (Norvasc), FelopiDINE (Plendil),
    NicardiPINE (Verapamil)
  • Diuretics
  • Prostacyclin or similar medicines ( Prostaglandin)
  • Sildenafil (Viagra) or other erectile dysfunction medications
93
Q

Sarcoidosis

A
  • An IMMUNE DISORDER AFFECTING ANY ORGAN
  • MAINLY LUNG CAUSING SCARING OF LUNG TISSUES
  • Bacteria produce VIT D and this condition may suffer VIT D TOXICITY
94
Q

What should you avoid in Sarcoidosis ?

A
  • AVOID BEING IN SUN ALOT

- AVOID VIT D FORTIFIED MILK

95
Q

Symptoms of Sarcoidosis

A
  • Cough that does NOT go away
  • Fever
  • Weight loss
  • reddish bumps or patches on the skin or under the skin
  • Swollen painful joints
  • Kidney stones
96
Q

Systemic or topical steroids for 1 - 2 years or life long

A

Symptomatic Sarcoidosis

97
Q

No Treatment Required

A

Asymptomatic

98
Q

Obstructive Apnea

A
  • WHEN MUSCLES AT THE BACK OF THROAT RELAX causing airways to NARROW or COLLAPSE
  • Oxygen levels DECREASED during DEEPER SLEEP causing apnea
  • CHOKING OR GAGGING
  • Being overweight can cause sleep apnea
99
Q

What are 3 non invasive breathing machines that deliver positive airway pressure support ?

A
  • APAP (Automatic)
  • BiPAP (BiLevel)
  • CPAP (Continuous)
100
Q

APAP

A
  • A machine that automatically adjusts the amount of pressure into the airway on a breath-by-breath basis
  • Allows least amount of pressure to keep the airway open while the user sleeps
  • this machine “SENSES” the amount of pressure needed per breath
  • Can also function as a CPAP machine with a preset pressure per breath
101
Q

BiPAP

A
  • Delivers TWO DIFFERENT PRESSURES
  • INSPIRATORY & EXPIRATORY ARE DIFFERENT AS MACHINE ALTERNATES BETWEEN PRESSURES
  • Able to provide DUAL PRESSURES INSPIRATORY AND EXPIRATORY
102
Q

What are common side effects with the BiPAP machine ?

A
  • THROAT/NASAL IRRITATION
  • Skin lesion
  • bloated stomach
  • Ear discomfort can lead to hearing difficulties or disrupt ability to sleep at night
103
Q

CPAP

A
  • Allows airways pressure to REMAIN OPEN while the person is sleeping to prevent apneic episodes
  • Most commonly used in to treat OBSTRUCTIVE APNEA
  • DELIVERS CONSISTENT PRESET PRESSURE BASED ON MD’S PRESCRIPTION, AFTER SLEEP APNEA STUDY
104
Q

What are common side effects of the CPAP machine ?

A
  • Dizziness
  • Nasal congestion
  • Runny nose
  • Worsening headache if with sinusitis and deviated septum
  • Noisy and uncomfortable
105
Q

Tuberculosis

A
  • HIGH CONTAGIOUS
  • ACUTE or CHRONIC disease caused by mycobacterium tuberculosis
  • An aerobic bacterium that PRIMARILY AFFECTS PULMONARY SYSTEM
  • ESPECIALLY HIGHER LOBES WHERE OXYGEN CONTENT IS
    HIGHEST
  • Radiograph film shows pulmonary infiltrates
106
Q

Can TB Effect other parts of the body ?

A

YES

  • Brain
  • Intestines
  • Peritoneum
  • Kidney
  • Joints
  • Liver
107
Q

What type of transmission precaution is used for TB

A
  • AIRBORNE BY DROPLET INFECTION

- When an infected individual coughs, sneezes, laughs, or sings TB ENTERS AIR, MAY BE INHALED BY OTHERS

108
Q

How do you determine weather someone is infected with TB

A

X-RAY

109
Q

Disease progression (TB)

A
  • DROPLETS ENTER THE LUNGS, BACTERIA FORMS TUBERCLE LESION
  • Defense system encapsulate the tubercle, leaving a scar
  • If no encapsulation, bacteria may ENTER LYMPH NODES and CAUSE INFLAMMATORY RESPONSE (Granulomatous inflammation)
  • IF ACTIVE PHASE, TB can cause necrosis and cavitation in the lesions, leading to rupture, the spread of necrotic tissue, and damage to various parts of the body
110
Q

Client History (TB)

A
  • Past Exposure to TB
  • CLIENT’S COUNTRY OF ORIGIN AND TRAVEL TO FOREIGN COUNTRIES IN WHICH INCIDENCE OF TB IS HIGH
  • RECENT HISTORY OF FLU, PNEUMONIA, FEBRILE ILLNESS, COUGH, OR FOUL-SMELLING SPUTUM PRODUCTION
  • PREVIOUS (+) TESTS FOR TB
  • RECENY BACILLE CALMETTE-GUERIN VACCINE, THIS IS GIVEN TO PEOPLE IN FOREIGN COUNTRIES TO PRODUCE RESISTANCE TO TB
111
Q

If an individual who has received a bacilli Calmette Guerin vaccine what will their skin test result be ?

A
  • POSITIVE

- INDIVIDUAL WILL NEED A CHEST X-RAY

112
Q

When do individuals with TB begin to feel symptoms ?

A

Individuals will not feel symptoms until disease is well advanced

113
Q

Signs/Symptoms of TB

A
  • Fatigue/Lethargy
  • Weight loss
  • Anorexia
  • After rise of fever
  • Cough
  • Night sweats
  • Hemoptysis (Bloody Sputum)
  • Low- Grade Fever
  • PERSISTENT COUGH AND PRODUCTION OF MUCOID AND MUCOPURULENT SPUTUM ( BLOOD STREAKED SPUTUM)
  • CHEST TIGHTNESS
  • DULL, ACHING CHEST PAIN THAT MAY ACCOMPANY COUGH
114
Q

Does a physical exam of the chest provide conclusive evidence of TB ?

A

NO

115
Q

Does a chest X-RAY provide a definitive presence of TB ?

A

NO, But the presence of multinodular infiltrates with calcification in the upper lobes suggests TB

116
Q

If the disease is active, what may be seen on the chest x-ray ?

A

Caseation and inflammation

117
Q

How can you determine weather TB disease is in the advanced stage ?

A
  • Bronchial breath sounds
  • Dullness with percussion over involved parenchymal areas
  • RHONCHI
  • CRACKLES (ADVANCED)
  • Partial obstruction of a bronchus caused by endobronchial disease or compression by lymph nodes maybe produce localized wheezing and dyspnea
118
Q

Isolation Precaution

A

-AIRBORNE ( once inhaled, the TB bacilli will begin to multiply in 18-24 hrs)

119
Q

What PPE is used for TB ?

A
  • N-95 or called particulate mask
120
Q

What is HEPA Filtration ?

A
  • High- Efficiency Particulate
  • Negative Air Flow (NAF) room >12 of air changes per hour (ACH)
  • Usually 6-12 air exchange every hour
121
Q

Diagnostic Test for TB

A
  • Mantoux Test (PPD); A standard Tests for TB
  • Tine Test
  • QuantiFERON- TB Gold test
  • Sputum cultures
122
Q

Explain what is done in a Mantoux Test (PPD)

A
  • Administer 0.1 of 5 units tuberculin units PPD INTRADERMALLY
  • REACTIVE OR RAISED SKIN RAISED SKIN GREATER THAN 10mm AFTER (48-72 hrs) MEANS STRONG INDICATION OF TB
  • Looking for thickness and hardening of tissues ( NOT ERYTHEMA)
123
Q

What gauge needle is used for a PPD, what degree of angle, and how many inches ?

A
  • 26 60 27 gauge needle is used
  • 5 - 15 Degree angle INTRADERMAL
  • 1/4 - 1/2- inch needle with BEVEL UP
124
Q

Is redness without induration considered negative for a PPD test ?

A

YES

125
Q

How many mm of induration is considered POSITIVE in people with HIV, RECENT CONTACT WITH ACTIVE TB, ORGAN TRANSPLANTED, and IMMUNOCOMPROMISE ?

A

5mm or greater is CONSIDERED POSITIVE

126
Q

How many mm of induration is CONSIDERED POSITIVE for IV DRUG USERS, SUBSTANCE ABUSE, ALCOHOL, LEUKEMIA ?

A

10mm or more

127
Q

How many mm of induration is considered POSITIVE REGARDLESS OF MEDICAL CONDITION ?

A

15mm or more is POSITIVE

128
Q

If no induration, how will you record it ?

A

0mm
DO NOT RECORD AS “POSITIVE or “NEGATIVE”
ONLY RECORD MEASUREMENT IN MM

129
Q

Can anyone have a TB Test ?

A 
YES
CAN BE GIVEN TO 
- Infants 
- Pregnant women 
- HIV Infected people with no potential problem
130
Q

How many months to treat uncomplicated TB ? And what kind of drugs are used ?

A
  • 2 Months
  • Using BACTERIAL DRUGS such as:
    ISONIAZID
    ETHAMBUTOL
    RIFAMPIN
    PYRAZINAMIDE
131
Q

How many times are Sputum smears done ?

A
  • EVERY 2 WEEKS until NEGATIVE

- DOES NOT become NEGATIVE IN 3-5 months

132
Q

Tine Test

A
  • MULTIPLE PUNCTURE TEST

- USED FOR SCREENING ONLY to detect if someone is infected

133
Q

Is a small reaction (5mm of firm swelling at site) considered to be positive ?

A
  • YES
  • POSITIVE IN PEOPLE WHO ARE HIGH RISK WITH:
    HIV
    RECEIVED AN ORGAN TRANSPLANT
    SUPPRESSED IMMUNE SYSTEM
    TAKING STEROID THERAPY ( about 15 mg of prednisone per day for 1 month)
    CLOSE CONTACT WITH PERSON WHO HAS ACTIVE TB
    CHANGES ON X-RAY THAT LOOK LIKE PAST TB
134
Q

10mm or greater is considered positive in ?

A
  • Known NEGATIVE TEST IN THE PAST 2 YEARS
  • Diabetes
  • Kidney failure
  • Or other conditions that increase their chance of getting active TB
  • Health care workers
  • Injection drug users
  • IMMIGRANTS who moved from a country (Latin America, Asia, Africa) with HIGH TB RATE in the PAST 5 YEARS
  • Students/Employees working in certain group living settings
    PRISONS
    NURSING HOMES
    HOMELESS SHELTERS
  • Children younger that 4 years ( Infants, children, adolescents exposed to adults in high risk categories
135
Q

15mm or greater is considered positive in ?

A
  • ANY PERSON

- PERSONS WITH NO KNOWN FACTORS FOR TB

136
Q

What are standard precautions when transporting patient with TB?

A
  • Patient MUST WEAR A MASK ( DROPLET OR AIRBORNE)
137
Q

PRECAUTION FOR AIRBORNE( DOORS ) for TB

A
  • Doors CLOSED AT ALL TIMES

- May COHORT WITH SAME MICROORGANISM

138
Q

PRECAUTION FOR DROPLET (DOORS) for TB

A
  • Door MAY REMAIN OPEN
  • SPACE BETWEEN PTs , Visitors, and staff
  • 3 FT or GREATER
139
Q

Latent TB Infection

A
  • A condition in which TB BACTERIA ARE ALIVE, BUT INACTIVE IN THE BODY
  • NO SYMPTOMS
  • DON’T FEEL SICK
  • CAN’T SPREAD TB TO OTHERS
  • USUALLY HAVE POSITIVE TB TEST
  • MAY DEVELOP TB IF NO TREATMENT IS GIVEN FOR TB INFECTION
140
Q

PATIENT TEACHING FOR LTBI

A
  • After taking medicine for about (2-3 WEEKS), you may NO LONGER BE ABLE TO SPREAD TB BACTERIA TO OTHERS
  • BE ABLE TO GO BACK TO DAILY ROUTINE
  • MAY RETURN TO WORK or SCHOOL
141
Q

QuantiFERON- TB TEST (QFT)

A
  • QFT MEASURES IMMUNE REACTIVITY TO MYCOBACTERIUM TB ( Bacterium that causes TB)
  • WHOLE BLOOD TEST for DIAGNOSING LTBI
  • If NOT DETECTED and TREATED, LTBI may later DEVELOP into TB DISEASE
142
Q

AIRBORNE PRECAUTIONS

A
  • KEEP DOOR CLOSED AT ALL TIMES
  • NEGATIVE AIRFLOW ROOM (NAF)
  • Airborne Infection Isolation Room (AIIR)
  • MAY COHORT ( SAME MICROORGANISM )
  • Transport ONLY WHEN NECESSARY
  • PLACE MASK WHEN TRANSPORTING
    Also for Measles
    TB
    Varicella (CHICKEN POX) until lesions are crusted
143
Q

DROPLET PRECAUTIONS

A
  • PRIVATE ROOM
  • CLOSE ASAP
  • May COHORT SAME MICROORGANISM
  • WEAR MASK WITHIN 5Ft of client
  • APPLY MASK WHEN TRANSPORTING
  • SPATIAL BETWEEN CLIENTS, VISITORS, STAFF
    3Ft or greater
144
Q

Sputum Cultures

A
  • SPUTUM SPECIMENS ARE OBTAINED FOR AN ACID FAST SMEAR
  • SPUTUM CULTURE IDENTIFYING TB (CONFIRMS) THE DIAGNOSIS!
  • AFTER MEDS ARE STARTED SPUTUM SAMPLES ARE TAKEN AGAIN TO DETERMINE EFFECTIVENESS OF THERAPY
  • Most clients have NEGATIVE CULTURES AFTER (3 Months)

Respiratory (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions