Respiratory System Flashcards
List four common symptoms of pneumonia the nurse might note on physical examination.
Tachypnea
Fever with chills
Productive cough
Bronchial breath sounds
State four nursing interventions for assisting the client to cough productively.
Encourage deep breathing.
Increase fluid intake to 3 L/day.
Use humidity to loosen secretions.
Suction airway to stimulate coughing.
What symptoms of pneumonia might the nurse expect to see in an older client?
Confusion
Lethargy
Anorexia
Rapid respiratory rate
How does the nurse prevent hypoxia during suctioning?
Deliver 100% O2 (hyperinflating) before and after each endotracheal suctioning.
During mechanical ventilation, what are three major nursing interventions?
Monitor client’s respiratory status and secure connections.
Establish a communication mechanism with the client.
Keep airway clear by coughing and suctoning.
When examining a client with emphysema, what physical findings is the nurse likely to see?
Barrel chest
Dry or productive cough
Decreased breath sounds
Dyspnea
Crackles in lung fields
What is the most common risk factor associated with lung cancer?
Smoking cigarettes and/or marijuana
Describe why preoperative nursing care is important to include for a client undergoing a laryngectomy.
Involve family and client in manipulation of tracheostomy equipment before surgery.
Plan acceptable communication methods.
Refer to speech pathologist.
Discuss rehabilitation program.
List five nursing interventions after chest tube insertion.
Maintain a dry occlusive dressing on chest tube.
Keep all tubing connections tight and taped.
Monitor client’s clinical status.
Encourage the client to breathe deeply periodically.
Monitor the fluid drainage, and mark the time of measurement and the fluid level.
What immediate action should the nurse take when a chest tube becomes disconnected from a bottle or suction apparatus? What should the nurse do if a chest tube is inadvertently removed from the client?
Place the end of the tube in a sterile water container at a 2 cm level.
Apply an occlusive dressing and notify health care provider stat.
What instructions should be given to a client after radiation therapy?
Do not was off lines.
Wear soft cotton garments.
Avoid use of powders and creams on radiation site.
What precautions are required for clients with TB when placed on respiratory isolation?
A mask for anyone entering room.
Private room.
Client must wear mask if leaving room.
List four components for teaching clients with tuberculosis.
Cough into tissues and dispose of immediately in special bags.
Long-term need for daily medication.
Good handwashing technique.
Report symptoms of deterioration, such as blood in secretions.
