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sav NUR 334 - Exam 1 Content > week 1 content COPY > Flashcards

week 1 content COPY Flashcards

1
Q

Labs can be taken from: SATA
- Blood
- Vein
- Finger stick
- Artery (ABG)
- Urine
- Stool
- Sputum
- Xray
- Scans

A
  • Blood
  • Vein
  • Finger stick
  • Artery (ABG)
  • Urine
  • Stool
  • Sputum
    X- Xray - dx
    X- Scans - dx
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2
Q

labs or diagnostic tools?

  • Xray
  • CT/MRI Scans
A

diagnostic tools

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3
Q

Oximetry – measures the amount of __________ that is carrying ____________

_________ (and hgb and iron within it) carry oxygen

_________ = tells how many hgb within RBC are carrying oxygen

Hct = total volume of________ in ________ (%)

A

Oximetry – the amount of hemoglobin that is carrying oxygen

RBC (and hgb and iron within RBC) carry oxygen

O2 sat = tells how many hgb within RBC are carrying oxygen

Hct = total volume of RBC in blood (%)

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4
Q

which of these could cause low O2 levels SATA
- Hypoventilation
- Atelectasis
- Pneumothorax
- Other lung problems

A

ALL
- Hypoventilation - lungs do not breathe in enough oxygen or breathe out enough CO2
- Atelectasis – collapsed lung
- Pneumothorax - air leaks into the space between the lung and the chest wall.
- Other lung problems

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5
Q

which of these could you place Pulse ox on
- Finger – no nail polish
- Finger - nail polish
- Earlobe
- Toe

A
  • Finger – no nail polish
    X- Finger - nail polish
  • Earlobe
  • Toe
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6
Q

sputum studies:

  • Culture and sensitivity – identifies ________
  • gram stain – identifies_________
  • Cytology – identifies ________
  • AFB – identifies __________
A
  • Culture and sensitivity – identifies bacteria
  • gram stain – identifies bacteria
  • Cytology – identifies cancer
  • AFB – identifies TB
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7
Q

When collecting sputum T/F
- Collect deep sputum, not mouth saliva
- Sterile container
- Send to lab asap
- Night sputum specimen is best
- suction sputum if pt cant cough productively

A

When collecting sputum
- Collect deep sputum, not mouth saliva
- Sterile container
- Send to lab asap
X- Morning specimen best when sputum has settled overnight
- If pt cant cough productively – suction

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8
Q

radiology consists of CXR, CT, MRI, and PET scan

T/F

A

true

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9
Q

CXR, CT, MRI, and PET scan?

  • 3D image of lung
  • Remove metal from neck to waist
  • Views are posterior, anterior, lateral
A

chest xray CXR

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10
Q

CXR, CT, MRI, and PET scan?

  • Shows structures
  • Typically preferred for lungs
  • May require sedation for comfort purposes
  • With or without iodine based contrast
A

CT

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11
Q

CT scan with contrast: T/F

  • With contrast – injected into IV, highlights internal structures
  • Assess liver function – BUN/creatinine if elevated let HCP know
  • contrast is not iodine based - assessment of allergies is not needed
  • Teach – warm flush feeling
  • Force fluids afterwards to flush contrast out
A
  • With contrast – injected into IV, highlights internal structures
    X- Assess renal function – BUN/creatinine if elevated let HCP know
    X- Assess allergy to shellfish – contrast is iodine based
  • Teach – warm flush feeling
  • Force fluids afterwards to flush contrast out
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12
Q

CXR, CT, MRI, and PET scan?

  • Used to assess things that are difficult to assess by other scans – lung apex
  • Used to distinguish vascular and nonvascular structures
  • Uses IV contrast – not iodine based
  • May require sedation for comfort purposes
  • Remove anything metal
A

MRI

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13
Q

CXR, CT, MRI, and PET scan?

  • Uses radioactive substance – tracer, to look for lung disease/cancer
  • Looks at body function (CT/MRI looks at structure)
  • Blood flow
  • Use of O2
  • Uptake of sugar
A

PET scan

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14
Q

CXR, CT, MRI, and PET scan?

remove metal =

iodine based contrast =

not iodine based contrast =

with or without contrast =

with contrast =

looks at structures =

looks at body function =

A

remove metal = MRI, Xray

iodine based contrast = CT

not iodine based contrast = MRI

with or without contrast = CT

with contrast = MRI

looks at structures = CT, MRI

looks at body function = PET

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15
Q

tb test

__________ = intradermal skin test

__________ = interferon gamma release assay

blood test

mantoux

A
  • Skin - TB skin test/Mantoux – intradermally
  • Blood - Interferon-gamma release assay blood test (IGRA)
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16
Q

___________oscopy
- Scope bronchi via mouth
- Visualize bronchi
- Can obtain biopsy specimen or provide treatment (remove secretions)
- Nasopharynx or oropharynx is anesthetized

A

Bronchoscopy

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17
Q

Pre nursing care or Post nursing care: bronchoscopy
- Consent – invasive procedure
- Sedative
- NPO until gag reflex returns
- Blood tinged mucus – expected finding
- monitor for Hemorrhage (increased HR) (if biopsy)
- monitor for Pneumothorax (SOA) (if biopsy)
- NPO 6-12 hours

A

Pre nursing care
- Consent – invasive procedure
- NPO 6-12 hours
- Sedative

Post nursing care
- NPO until gag reflex returns
- Blood tinged mucus – expected finding
- If biopsy done – monitor for
- Hemorrhage – increased HR
- Pneumothorax – SOA

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18
Q

Lung biopsy can be done: T/F
- Bronchoscope – uses scope to perform biopsy
- Transthoracic needle aspiration - needle to lung
- Open lung biopsy – incision over site, lung tissue removed
- Video assisted thoracic surgery/VATS – uses camera and forceps

A

true

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19
Q

Thoracentesis - Large bore needle into pleural space

T/F
- Obtain fluid for dx
- Remove pleural fluid
- Instill medication
- pulmonary function test

A
  • Obtain fluid for dx
  • Remove pleural fluid
  • Instill medication
    X- pulmonary function test
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20
Q

Pre nursing care or Post nursing care: Thoracentesis - Large bore needle into pleural space

  • Consent
  • Sit upright with legs off side of bed and elbows on overhead table
  • Pt should not talk/move
  • CXR
  • Assess for hypoxia and pneumothorax
A

Pre nursing care
- Consent
- Sit upright with legs off side of bed and elbows on overhead table
- Pt should not talk during procedure

Post nursing care
- CXR
- Assess for hypoxia and pneumothorax

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21
Q

Pulmonary function test - Measures ________________ in seconds

Forced expiratory volume - Max amount of air__________ in 1 sec

Low FEV seen in pts with __________

A

Pulmonary function test
Measures lung function in seconds

Forced expiratory volume
FEV
Max amount of air expired forcefully in 1 sec

Low FEV seen in pts with COPD – difficult to push air out

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22
Q

Treatment - Posterior or Anterior epistaxis?
- Position upright/lean forward
- Pressure/pinch nose
- Ice
- Nasal tampons
- Avoid blowing nose

A

anterior

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23
Q

Treatment - Posterior or Anterior epistaxis?

  • Emergency
  • Balloon cath
  • Assess resp status
  • Saline spray/Humidification
  • Oxygen
  • Bed rest
  • Pain control – avoid ASA/NSAIDS
  • Oral care
  • Avoid strenuous activity
A

posterior

  • Emergency bc location makes it hard to pinch to stop bleeding
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24
Q
  • nose Irritation
  • nose Trauma
  • nose Infection
  • Foreign bodies in nose
  • Tumors in nose
  • Systemic disease – hypertension
  • Systemic treatment – chemo, anticoagulants

all causes of _________

A

Epistaxis
nose bleed

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25
Q

Risk factors for OSA
- Increased age
- Female
- Obese
- Nasopharyngeal structural abnormalities
- Smoking

A
  • Increased age
    X- Male
  • Obese
  • Nasopharyngeal structural abnormalities
  • Smoking
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26
Q

OSA
potentially 3 issues during sleep caused by collapse of upper airway
1.
2.
3.

A
  1. Obstructive apnea - blocked airway
  2. hypopnea - slow breathing
  3. respiratory effort related arousals - brain wakes person up to restore breathing
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27
Q

s/s

  • Daytime sleepiness
  • Morning headache
  • Obese
  • Large neck/waist circumference
  • partner c/o patient is Snoring, choking, gasping during sleep
A

OSA

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28
Q

Possible associated complications of what upper respiratory issue?

  • MVA
  • Neuropsychiatric dysfunction
  • HTN
  • Heart failure
  • Metabolic syndrome
A

OSA

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29
Q

the gold standard Diagnostic test for ___________ is polysomnography

A

OSA

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30
Q

treatment for _________ includes

  • CPAP
  • Bipap
  • Weight reduction and exercise
  • Avoid alcohol and smoking
  • Sleep on side
  • Improve sleep routine
  • Oral appliances – for mild to moderate cases
  • Surgery - Tissue removal, Jaw reposition, Implant, Tracheostomy
A

OSA

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31
Q

CPAP or bipap

  • Most common treatment for OSA
  • Simple
  • Cheap
  • Doesn’t augment ventilation other than to maintain upper airway patency
  • No supplemental o2 involved
  • Inhalation only pressure
A

CPAP

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32
Q

CPAP or bipap

  • Inhalation and exhalation pressure
  • Kind of like last step to prevent intubation
  • Used in more than just treatment for OSA pts – neuromuscular disease, chest wall deformity, COPD
A

bipap

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33
Q

Shiley or jackson trach

  • Disposable
  • Cuff
  • Obturator
  • Short term
A

Shiley

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34
Q

Shiley or jackson trach

  • Reusable
  • No cuff
  • Obturator
  • Long term
A

jackson

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35
Q

Trach tube dislodgement and accidental decannulation: put in order

  1. Keep obturator at bedside at all times
  2. Secure trach
  3. Insert obturator into outer cannula
  4. Insert outer cannula+obturator
  5. Extend neck and open tissue/ostomy
  6. Check bilateral lung sounds
  7. Remove obturator asap
A

1- Keep obturator at bedside at all times
3- Insert obturator into outer cannula
5- Extend neck and open tissue/ostomy
4- Insert outer cannula+obturator
7- Remove obturator asap
6- Check bilateral lung sounds
2- Secure trach

36
Q

Acute pharyngitis
Inflammation of _____________

A

pharynx or tonsils

37
Q

Pharyngitis types
- __________ – most common
- __________– caused by group a strep
- __________ – caused candida albicans

Bacterial, Viral, Fungal

A

Pharyngitis types
- Viral – most common
- Bacterial – caused by group a strep
- Fungal – caused candida albicans

38
Q

Treatment pharyngitis: viral, bacterial, fungal

  • __________ – antibiotics
  • __________– treat symptoms – warm/cool fluids, analgesics, antipyretics
  • ___________– nystatin swish and swallow
A
  • Bacterial – antibiotics
  • Viral – treat symptoms – warm/cool fluids, analgesics, antipyretics
  • Fungal – nystatin swish and swallow
39
Q

Differentiate Pharyngitis type via:

  • rapid streptococcal antigen testing
  • based on s/s
  • no test exists
A
  • rapid streptococcal antigen testing
40
Q

Head and neck cancers

Treatment
- Surgery
- Radiation therapy
- Chemotherapy

which one is first line?

A

surgery

41
Q

Laryngectomy - removal of ___________

  • No longer a connection for air to get from __________ to _____________
  • Air must be breathed in through __________________
  • Difficulty orally communicating
A

Laryngectomy
removal of larynx (voice box)
- No longer a connection for air to get from mouth/nose to trachea
- Air must be breathed in through tracheostomy
- Difficulty orally communicating

42
Q

Restoring oral communication:
- Artificial larynx (electolarynx) =
- Tracheoesophageal (TE) voice restoration =
- Esophageal speech =

uses burp speaking, have to learn this technique, low quality

uses vibration speaking

uses a valve

A

Restoring oral communication
- Artificial larynx – electolarynx – vibration speaking
- Tracheoesophageal (TE) voice restoration – valve
- Esophageal speech – burp speaking, have to learn this technique, low quality

43
Q

Radial neck distention
Removal of all tissue on ___________
From mandible to clavicle
Includes muscles, nerve, salivary gland, major blood vessels

A

Radial neck distention
Removal of all tissue on side of neck
From mandible to clavicle
Includes muscles, nerve, salivary gland, major blood vessels

44
Q

Post op care: radial neck distention

  • Airway maintenance
  • Trach collar w o2 and humidification
  • Pulmonary toilet
  • Secretions – oral and tracheal – suction
  • 1-2 days expected blood tinged sputum
  • Stoma care
  • Pain mgt
  • Nutrition – feeding tube
  • PT
  • ST

which is priority?

A

airway maintenance

45
Q

Lower respiratory: Pneumonia, TB, Obstructive pulmonary disease, COPD?

_______________ = contagious bacterial infection that primarily affects the lungs.

_________________ = Acute infection of the lung parenchyma (alveoli)

_____________ = includes Asthma, Emphysema, Chronic bronchitis

_____________ = includes Emphysema and Chronic bronchitis

A

TB = contagious bacterial infection that primarily affects the lungs.

PNU = Acute infection of the lung parenchyma (alveoli)

OPD = includes Asthma, Emphysema, Chronic bronchitis

COPD = includes Emphysema and Chronic bronchitis

46
Q

these Risk factors would put a pt at high risk for developing what lower respiratory issue?
- 65 +
- Altered LOC = weakened cough
- Bed rest/prolonged immobility
- Debilitating illness
- Malnutrition
- Smoking
- Tracheal intubation

A

PNU

47
Q

PNU Classifications: Community acquired (CAP) or Hospital acquired (HAP)

  • Happens to people that haven’t been in a hospital or LTC facility within 14 days of s/s onset
  • Non-intubated patients - Happens to people that were admitted to hospital without PNU and begins 48 hours or more after admission
  • Intubated patients – ventilator associated pneumonia (VAP)
A

Community acquired (CAP)
- Happens to people that haven’t been in a hospital or LTC facility within 14 days of s/s onset

Hospital acquired (HAP)
- Non-intubated patients - Happens to people that were admitted to hospital without PNU and begins 48 hours or more after admission
- Intubated patients – ventilator associated pneumonia (VAP

48
Q

PNU Types - viral or bacterial?

_________________ =
- Most common
- Mild or self limiting, life threatening
- Usually resolves 3-4 days

________________ =
- May require hospitalization

A

Viral
- Most common
- Mild or self limiting, life threatening
- Usually resolves 3-4 days
Bacterial
- May require hospitalization

49
Q

PNU Types
_______________=
- Abnormal entry of material from mouth or stomach into trachea/lungs
- Risk factors – loss of consciousness, dysphagia, NG tubes
- May be silent (not always gagging, throwing up)
_______________=
- In immunocompromised pts

A

Aspiration
- Abnormal entry of material from mouth or stomach into trachea/lungs
- Risk factors – loss of consciousness, dysphagia, HG tubes
- May be silently aspirating (not always gagging, throwing up)

Opportunistic
- In immunocompromised pts

50
Q

s/s

  • Preceded by upper respiratory infection
  • Fever
  • Chills
  • Cough
  • Malaise
  • Chest pain with inspiration and coughing
  • Dyspnea
  • Fatigue
  • Myalgia
  • Confusion in elderly
  • Respiratory distress/failure
A

PNU

51
Q

PNU - bacterial or viral?

  • Cough productive (purulent – green, rusty, red currant jelly)
  • cough nonproductive/scant
A
  • Bacterial = productive (purulent – green, rusty, red currant jelly)
  • Viral = nonproductive/scant cough
52
Q

what would a diagnosis of pneumonia look like on CXR?

A

infiltrate (hazy) seen in lungs on CXR = infection

53
Q

what would a diagnosis of pneumonia look like on WBC with diff?

  • Elevated _____________ with bacterial
  • Shift to the __________ = indicates bacterial, acute, increased, immature neutrophils
A
  • Elevated WBC (leukocytosis) with bacterial
  • Shift to the left = indicates bacterial, acute, increased, immature neutrophils
54
Q

what would a diagnosis of pneumonia look like on Sputum for culture and sensitivity test?

A
  • Positive = infection
  • Test will identify specific bacteria and antibiotics that will kill the bacteria
  • Negative = could mean viral
55
Q

PNU nursing care: illness prevention
- Education
- Pneumococcal vaccine
- Stop smoking
- Sleep and diet
- Know who is at risk
- Pulmonary toilet
- Early ambulation
- Standard precautions
- Hand hygiene

getting an incentive spirometer for my patient that has
- Altered LOC = weakened cough
- Bed rest/prolonged immobility
- Debilitating illness
- Malnutrition
is an example of which PNU prevention tactic?

A
  • Know who is at risk
  • Pulmonary toilet
56
Q

PNU nursing care: acute interventions
- Monitor VS and pulse ox
- Lung auscultation
- Oxygen therapy
- Pulmonary toilet and CPT = Turn, cough, deep breath, ISO
- Increase fluids
- Ambulation
- Conserve energy
- Drug therapy
- Analgesics for ________
- Antibiotics for _________
- Antipyretics for ___________
- Education

A
  • PNU Drug therapy =
  • Analgesics – pleuritic pain
  • Antibiotics – bacterial PNU
  • Antipyretics - fever
57
Q

TB resistant to INH and rifampin is called

A
  • Multi-drug resistant tb =
58
Q

Risk factors for TB - T/F?
- Poor
- overweight
- Underserved
- Minorities
- IV drug users
- Poor sanitation and overcrowded living conditions
- Immunosuppression

A
  • Poor
    X- overweight
  • Underserved
  • Minorities
  • IV drug users
  • Poor sanitation and overcrowded living conditions
  • Immunosuppression
59
Q

Classifications of TB - latent, primary, Reactived/active?

  • Bacteria inhaled
  • Inflammatory reaction
  • Effective immune response which encapsulates organisms for life
  • Asymptomatic
  • Persistent immune response
  • Asymptomatic
  • Noncontagious
  • Positive skin test
  • Can be reactivated at any point
  • High risk groups – elderly, immunosuppressed
  • Contagious
A

Primary
- Bacteria inhaled
- Inflammatory reaction
- Effective immune response which encapsulates organisms for life
- Asymptomatic

Latent
- Persistent immune response
- Asymptomatic
- Noncontagious
- Positive skin test
- Can be reactivated at any point

Reactived/active
- High risk groups – elderly, immunosuppressed
- Contagious

60
Q

TB latent or active?

  • Asymptomatic
  • Positive tb skin test
  • CXR may have ghon nodule
A

latent

active = symptoms

61
Q

TB latent or active?

  • Sputum C&S test positive
  • Fever
  • Night sweats
  • Weight loss
  • Productive cough with purulent or bloody sputum for longer than 3 weeks
A

active

latent = asymptomatic

62
Q

TB diagnosis - Tb skin test/Mantoux test, CXR, Interferon gamma release assay blood test, Sputum?

  • ___________ – evaluate cell mediated immunity
  • ___________ – evaluate cell mediated immunity
  • __________ – looking for nodule
  • ___________ – looking for acid fast bacillus
A
  • Tb skin test/Mantoux test – evaluate cell mediated immunity
  • Interferon gamma release assay blood test – evaluate cell mediated immunity
  • CXR – looking for nodule
  • Sputum – looking for acid fast bacillus
63
Q

TB Skin test reaction - positive or negative?

patient with no known risk factors
- reaction size is 15 mm or bigger

A

positive

64
Q

TB Skin test reaction - positive or negative?

patient with no known risk factors

reaction size is 15 mm or bigger

A

positive

65
Q

TB Skin test reaction - positive or negative?

patient is an
- Immigrant
- IV drug users
- High risk work/living conditions
- Children <4
reaction size is 10 mm or bigger

A

positive

66
Q

TB Skin test reaction - positive or negative?

patient is
- HIV +
- had Recent TB contact
- had Organ transplant
- Immunosuppressed

reaction size is 5 mm or bigger

A

positive

67
Q

Positive skin test: next steps
1. Positive skin test or blood test
2. Obtain _____
2a. if Negative _____ = _______
2b. if Positive ______ = _______ and further testing required to confirm tb

A

Positive skin test: next steps
1. Positive skin test or blood test
2. Obtain CXR
2a. Negative CXR = latent
2b. Positive CXR = active and further testing required to confirm tb

68
Q

Nursing care for ________ includes
- Health promotion
- Interpret dx study results
- Identify contacts
- Drug therapy

A

TB

69
Q

s/e of antimicrobials - Rifampin (rifadin), Isoniazid (INH), Ethambutol (myambutol)?
- ___________ – hepatoxicity (liver), peripheral neuropathy (numb fingers)
- ___________ – red/orange colored excretions
- ____________ – visual acuity, color blind to red and green

A
  • Isoniazid (INH) – hepatoxicity (liver), peripheral neuropathy (numb fingers)
  • Rifampin (rifadin) – red/orange colored excretions
  • Ethambutol (myambutol) – visual acuity, color blind to red and green
70
Q

TB Transmission prevention in hospital
- ____________ precautions
- Private room with __________ pressure ventilation
- ___________ mask
- Monitor HC workers TB status – annual
- Preventative drug therapy to high risk contacts

A

Transmission prevention in hospital
- Airborne precautions
- Private room with negative pressure ventilation
- HEPA mask – high efficiency particulate air
- Monitor HC workers TB status – annual
- Preventative drug therapy to high risk contacts

71
Q

TB Transmission prevention at home
- Preventative drug therapy to high risk contacts
- Cover mouth/nose
- Wear mask in crowd
- Sputum for _______ every 2 weeks

how many negative cultures until they are considered not contagious?

A

Transmission prevention at home
- Preventative drug therapy to high risk contacts
- Cover mouth/nose
- Wear mask in crowd
- Sputum for AFB every 2 weeks and after 3 negative cultures = not contagious

72
Q

Obstructive pulmonary disease is an umbrella term for which 3 conditions?

A
  • Asthma
  • Emphysema – alveolar damage
  • Chronic bronchitis - excessive secretion production
73
Q

Chronic Obstructive pulmonary disease is when which 2 conditions occur together?

A
  • Emphysema – alveolar damage
  • Chronic bronchitis - excessive secretion production
74
Q

chronic bronchitis or emphysema?

  • _____________ – alveolar damage
  • ______________ - excessive secretion production
A
  • Emphysema – alveolar damage
  • Chronic bronchitis - excessive secretion production
75
Q

COPD = emphysema + chronic bronchitis

is it Preventable and treatable?

is Chronic CPOD hospitalized?

is COPD exacerbations hospitalized?

what is the Most common cause of COPD exacerbations?

A

COPD = emphysema + chronic bronchitis
- Preventable and treatable
- Chronic CPOD = non hospitalized
- COPD exacerbations = hospitalized
- Most common cause is Respiratory infections

76
Q

s/s of COPD exacerbations
- __________ chest – from hyperinflation, problem with getting air out of body
- ___________ Breath sounds
- adventitious lung sounds = _______, _______, ________
- __________ respiration

Late signs
- ________ lip breathing
- Neck vein ________/_________ edema (may indicate pulmonary hypertension)
- Cachexia – excessive ___________

A

s/s
- Barrell chest – from hyperinflation, problem with getting air out of body
- Decreased Breath sounds
- Wheezing, rales, rhonchi
- Prolonged respiration
- Late signs
- Pursed lip breathing
- Neck vein distention/peripheral edema (may indicate pulmonary hypertension)
- Cachexia – excessive malnourished

77
Q

COPD nursing problems
- Activity intolerance
- Poor nutritional status
- Anxiety r/t ineffective breathing pattern
- Ineffective breathing pattern =
- Ineffective airway clearance =
- Impaired gas exchange =

A

COPD nursing problems
- Activity intolerance
- Poor nutritional status
- Anxiety r/t ineffective breathing pattern
- Ineffective breathing pattern = too fast, slow, shallow, deep
- Ineffective airway clearance = cant clear congestion
- Impaired gas exchange = damaged alveoli

78
Q

Nursing care: COPD
- Stop smoking
- Influenza and PNU vaccine
- Early detection of respiratory infection
- Inhaler therapy
- Long acting beta agonist – main
- Long acting muscarinic antagonist
- Inhaled corticosteroids
- O2 therapy – target o2 sat 88-92%
- Tripod position and pursed lip breathing
- Cough techniques
- Energy conservation
- Extra calories bc of increased work of breathing
- Support

why is Early detection of respiratory infection important for COPD patients?

A

Most common cause of COPD exacerbations

79
Q

COPD patient reports
- Worsening of dyspnea
- Cough or sputum beyond pts normal
- Requires change in treatment

this is considered __________ and requires treatment/hospitalization

A

Acute exacerbation

80
Q

COPD Acute exacerbation treatment

give Oxygen if ________
Keep above ____%

T/F - since COPD people are CO2 retainers, Low O2 is their bodies stimulus to keep breathing. So if you give them supplemental oxygen, their body may give up breathing. This is why orders may say to withhold O2 therapy.

If COPD patient quits breathing what would we do next?

Noninvasive/positive pressure ventilation if _____________

Metered dose inhaler or nebulizer = ______________

would CPT be effective for these patients?
would antibiotics?

A

give Oxygen if hypoxemia
- Keep above 90%

FALSE
Never withhold O2!!!
- COPD people are CO2 retainers. Low O2 is their bodies stimulus to keep breathing. So if you give them supplemental oxygen, their body may give up breathing, this is not a reason to withhold O2!!!

If they quit breathing = intubation

Noninvasive/positive pressure ventilation – with hypercapnic (elevated CO2)

Bronchodilators
- Metered dose inhaler
- nebulizer

yes - CPT

Maybe - antibiotics

81
Q

s/s
- see mass on CXR
- Asymptomatic early
- Nonspecific s/s late
- Masked by chronic underlying cough
- Persistent productive cough

A

lung cancer

82
Q

diagnosis for lung cancer with CXR would be –

A

sees a mass or infiltrate in lungs

83
Q

diagnosis for lung cancer with CT/MRI would be used for

A

– looks for metastasis (spread)

84
Q

diagnosis for lung cancer with
Sputum would be used for

A

– looks for cancer cell in sputum

85
Q

diagnosis for lung cancer with Biopsy would be used for

  • Percutaneous fine needle biopsy – takes tissue from nodule cancer cell
  • bronchoscopy biopsy – scope through mouth
  • video assisted thoracoscopy VAT – scope through thorax incision
A

– looks for cancer cells in tissue (definitive dx test)

86
Q

nursing problems: lung cancer
- Activity ?
- nutriton?
- Anxiety ?
- breathing pattern?
- airway clearance ?
- Knowledge ?

A

nursing problems
- Activity intolerance and fatigue
- Poor nutritional status
- Anxiety r/t ineffective breathing pattern
- Ineffective breathing pattern = too fast, slow, shallow, deep
- Ineffective airway clearance = cant clear congestion
- Knowledge deficit

87
Q

Nursing care: lung cancer
- Stop smoking
- Reduce anxiety
- Surgery
- Pneumonectomy – remove ____
- Lobectomy – remove ____
- Segmental or wedge resection
- Radiation
- Chemo

A

Nursing care
- Stop smoking
- Reduce anxiety
- Surgery
- Pneumonectomy – remove lung
- Lobectomy – remove lobe
- Segmental or wedge resection
- Radiation
- Chemo

sav NUR 334 - Exam 1 Content (14 decks)

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