Topic 3: Respiratory & ABGs Flashcards
respiratory acidosis risk factors
*Neuromuscular disorders
*CNS depression
*Hypoventilation
*Decreased respiratory rate
respiratory acidosis s/s
*Kussmaul breathing
*Chest pain
*Nausea /vomiting
*Abdominal pain
*General muscle weakness
respiratory acidosis interventions
*Bronchodilators
*Assisted ventilation
*Respiratory stimulants
metabolic acidosis risk factors
*Diabetic ketoacidosis
*Lactic acidosis
*Resp., renal, or heart failure
*Diarrhea, laxatives
metabolic acidosis s/s
*Vertigo
*Neuro changes
*Dyspnea
*Tachypnea
*Hyperpnea
metabolic acidosis interventions
*Monitor vitals
*Monitor respiratory status
*Monitor blood gases
*Correct cause
*Give bicarbonate
respiratory alkalosis risk factors
*Extended periods of hyperventilation
*Extreme anxiety
*Fever
respiratory alkalosis s/s
*Lightheadedness
*Agitation
respiratory alkalosis interventions
*Encourage patient to take slow deep breaths
*Decrease patient anxiety
*Monitor ABG
metabolic alkalosis risk factors
*Vomiting
*NG suctioning
*Hypokalemia
*Excess antacids/bicarb
*Steroids
metabolic alkalosis s/s
*Lightheaded; N/V
*Confusion; stupor
*Muscle twitching; tremors
*Numbness/tingling face or extremities
*Electrolyte imbalance, dysrhythmias
metabolic alkalosis interventions
*Monitor: Vitals, neuro status, I & O, ABGs,
*Warn/teach about taking too many antacids
what is the onset fro influenza
abrupt, usually 3-6 hours
what are the signs and symptoms of influenza
Þ Chills
Þ Fever (usually high 102-104 that lasts 3-4 days)
Þ Generalized myalgia
Þ Headache
Þ Cough
Þ Sore throat
Þ Fatigue
what are the diagnositc studies for influenza
Þ Viral cultures can be taken (throat swab, nasopharyngeal swab, sputum, ect.)
Rapid influenza diagnostic test (RIDTs)
when should antiviral drugs be given
can be given if its within 24-48 hours of onset
what can nurses instruct patients to do if they have influenza
Þ Rest
Þ Hydrate
Þ Take acetaminophen or ibuprofen for HA, aches, pain
Þ Antipyretics for fever
when should a pateint not get the flu vaccine
if they have already had it that year
or
egg allergy
prevention of influenza
Þ Hand washing
Þ Annual vaccination (best time to get the vaccine is in September or October, before flu exposure)
Þ Antiviral drugs
Avoid close contact with anyone who has the flu
what are the s/s of acute sinusitis
Þ Significant pain over affected sinus
Þ Purulent nasal drainage
Þ Nasal obstruction
Þ Congestion
Þ Fever
Þ Malaise
Þ Halitosis (bad breath)
how can sinusitis get diagnosed
X-rays or CT scan of sinuses
(sinuses are filled with fluid or thickened mucous membrane)
what are treatments for the SYMPTOMS of sinusitis
Þ Oral or topical decongestants (to promote drainage)
Þ Intranasal corticosteroids (decrease inflammation)
Þ Analgesics (reduce pain)
Þ Saline spray (relieve congestion)
what is important to teach patients when using topical decongestions
to use the medication for no longer than 4 to 5 days to prevent rebound congestion
Management of sinusitis
Þ Get plenty of rest to help body fight infection and promote recovery
Þ Hydrate to loosen secretions
Þ Take hot showers or steam inhaler
Þ Apply warm damp towels around sinuses
Þ Sleep with head elevated
what are the s/s of pneumonia
Þ Cough (can be productive or not productive)
Þ Sputum (may be green, yellow or rust colored-bloody)
Þ Fever, Chills
Þ Dyspnea, Tachypnea
Þ Pleuritic chest pain
Fine or coarse crackles may be auscultated over the affected region
what are the diagnostic tests for pneumonia
Þ Chest X-ray
Þ Sputum: Gram stain, culture and sensitivity test
Þ Pulse oximetry or ABGs
Þ CBC: WBC differential and routine blood chemistries (if indicated)
Blood cultures (if indicated)
what are some interventions for pneumonia
Þ Increased fluid intake (at least 3L/day), IV fluids
Þ Balance between activity and rest
Þ O2 therapy
Þ Physiotherapy
Þ VTE prophylaxis
Þ Critical care management, with mechanical ventilation as needed
nutritional therapy for pneumonia
Þ Hydration to prevent dehydration and to thin and loosen secretions
Þ Small, frequent meals are easier for dyspneic patients to tolerate
Þ Offer foods high in calories and nutrients
health promotion for pneumonia
Þ Frequent handwashing
Þ Proper nutrition
Þ Adequate rest
Þ Regular exercise
Þ Cough or sneeze into the elbow rather than hands
Þ Avoid cigarette smoke
when does a follow up x ray need to be done for pneumonia
in 6 to 8 weeks to evaluate resolution of pneumonia
what are the symptoms for active TB
Þ Productive cough
Þ Night sweats
Þ Afternoon temperature elevation
Þ Weight loss
Þ Pleuritic chest pain
Þ Crackles over apices of lungs
Þ Fatigue
Þ Malaise
Þ Anorexia
Þ Dyspnea (late symptom)
renal TB symptoms
dysuria and hematuria
bone and joint TB symtoms
may cause severe pain
meningitis TB symtoms
HA, vomiting, lymphandenopathy
what indicates a positive PPD (tuberculin skin test)?
induration; a palpable raised, hardened area of swelling (NOT REDNESS at the injebtion site
what is considered positive PPD in low risk individuals
> 15mm induration