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Zoey NUR 111 Unit 2 > Zoey Unit 2 Study Guide > Flashcards

Zoey Unit 2 Study Guide Flashcards

1
Q

Where can a Pulse Oximetry be placed? (4)

A
  1. ear
  2. finger
  3. toes
  4. bridge of nose
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2
Q

what kind of disease is TB? (pg 465 table 24.4)

A
  1. Air born

2. Mycobacterium tuberculosis (bacteria)

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3
Q

Medication management with TB

A

it is important to make sure that client and family understands that all medication regiments should be completed.

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4
Q

what could a positve smear of TB after a client has been taking the regimen for several weeks indicate? (Pg 473)

A

noncomplience

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5
Q

why is a two step PPD used?

A

PDD is sone in a two step process for people who work in long term health care facilities because of the risk of false- negative responses

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6
Q

S/S of TB (SATA) (5)

A
  1. manifestations of tuberculosis often develop insidiously and are initially nonspecific.
  2. fatigue
  3. weight loss
  4. hemoptysis
  5. nigh sweats- this is the stage where the patient seeks medical attention
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7
Q

What is the nursing resposibility on reporting TB?

A

TB MUST be reported to state health care agencies

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8
Q

How do you read a TB test?

A

By induration

Induration is measured based on size of induration, NOT REDNESS.

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9
Q

How do you read a tb test on a HIV patient

A

When an HIV patient has a > 5 mm positive test is important to investigate over other risk factors

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10
Q

What is the care of a patient admitted with active TB (SATA) (pg 465 table 24.4)

A
  1. Single patient room/ roommate
  2. Use PPE
  3. Droplet precautions
  4. Airborne precautions
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11
Q

When do you use a beta-2 adrengic agonist?

What is the purpose and use of beta-2 adrengic agonist (bronchodialator)? (3)

A

You use it during fight or flight response,

  1. beta2- adrenergic receptor of the sympathetic nervous system are simulated,
  2. bronchiolar smooth muscle relaxes.
  3. bronchodilation occurs.
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12
Q

how will you instruct a patient on how to use Atrovent

A

only take the prescribed number of doses each day to prevent drug overdose.

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13
Q

What are the insturction of medication use with acute asthma attack

A

the patient who is experiencing wheezing and an impending attack is best treated with

  1. inhaled beta- 2 adrenegic such as albuterol (ventolin).
  2. oxygen corticosteroid may also be used
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14
Q

what are bronchiodoalatos called? how do they work? (2)

A

called= Beta-s adrengic agnist

  1. relax the bronchial muscle
  2. help open the airway and decrease obstruction.
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15
Q

define pneumonia

A

Altered alveolar gas exchange.

remember in assesmet that agitation, restless, axiety, lethargy, and fatigue are the result of decreased tissue perfusion from altered alveolar gas exchange and require immediate action by the nurse

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16
Q

schedule for the pneumonia vaccine (470

How many times is the vaccine administered?
When is revaccination recommended?

A

the pneumococcal vaccine is administered once.

revaccination is only recomended in persons with

  1. renal failure
  2. splenectomies
  3. malignancies
  4. HIV/AIDS
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17
Q

How do you position the patient with bacterial pneumonia (470)

A

patient positioning;

  1. side to side with turning assist
  2. Teach them recruitment strategies to ensure maximum ventilation perfusion.
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18
Q

What is a gerontological considerations with pneumonia patients

A

A consideration is that \manifestations of pneumonia are similar to the average adult, including anorexia, lathargy, hemoptysis

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19
Q

how would you teach an older patient how to manage COPD? (3)

A
  1. remember it is important to pace activities
  2. short walks are best
  3. walk 15-20 min a day at least 3 X a week
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20
Q

What are the risk for COPD (SATA)

(pg 504, table 26.1) (3)

A
  1. environmental exposure is being exposed continuously
  2. smoking history
  3. occupational exposure
    * 4. (emphysema= alpha- 1 antitrypsin deficiency)
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21
Q

How would you teach nutriton to some one who has COPD?

nutritional teaching with COPD

A

they should have small meals and snaks, and foods that are soft and easy to chew.

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22
Q

assessment of a client with COPD (CH 7 pg 83) (4)

A
  1. contradictions to O2 therapy w/ COPD pts,
  2. their drive for breathing is hypoxia so giving too much O2 may interfere with the hypoxic drive for breathing and lower their respiratory rate.
  3. also with core pulmonale you see JVD, dependent edema, enlarged liver, ascited.
  4. Remember tachypnea is an assessment priority due to the possible respiratory arrest
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23
Q

How do you identify orthopneic position aka tripod position?

A

a patient will sit up and lean over with there arms suported on their legs or over a table.

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24
Q

what is the purpose of the orthopeic position aka tripod position?

A

this allows for lung expansion and enables COPD patient to breath easier.

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25
Q

what is another name for the orthopeic position?

A

tripod position

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26
Q

what delegation can a UAP not perform?

A
  1. asses
  2. instruct
  3. Teach
  4. administer
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27
Q

s/s of sleep apnea (2)

A
  1. morning head aches related to hypercapnia

2. increased blood presure that causes vasodilation of cerebral blood vessels

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28
Q

How do you teach how to use a CPAP
(continuous positive airway pressure)
(3)

A
  1. proper fitting and size a
  2. keeping the straps tight
  3. teaching client to relax can reduce claustrophibic feelings.
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29
Q

what is the effect of CPAP on lower airway

A

CPAP doe snot give the patient oxygen, it keeps the alveoli from collapsing in the lower air way

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30
Q

Nursing diagnosis of ineffective airway clearance

A

inability to clear secretions or obstructions from the respiratory tract to maintain a clear air

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31
Q

distinguishing diffrent coughs; Hemoptysis

A

hemoptysis often occurs with tuberculosis

does not indicate airway irritation

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32
Q

distinguishing diffrent coughs; dry, hackingcough

A

indicated the patient is expiriencing airway irritation or obstruction

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33
Q

distinguishing diffrent coughs; harsh, barkey cough

A

suggest upper airway obstruction

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34
Q

distinguishing diffrent coughs; loose- sounding cough

A

indicated secreations

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35
Q

AAP what zone has no cough, wheeze, chest tightness/ shortness of breath during the day or night?

A

Green

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36
Q

AAP in what zone can you do casual activities?

A

green

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37
Q

AAP in what zone is the PFM 80

A

green

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38
Q

AAP in what zone do you take LABA wich include anti-inflamitory?

A

Green

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39
Q

AAP what zone do you have cough, wheeze, chest tightness/ shortness of breath?

A

yellow

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40
Q

AAP what zone do you have waking at night due to asthma?

A

yellow

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41
Q

AAP what zone can you do some but not all activities?

A

yellow

42
Q

AAP what zone is the PFM 50-79?

A

yellow

43
Q

AAP in what zone do you take Quick Relief medication?(SABA)

A

yellow

44
Q

AAP when you are in yellow how long should it take to go back to green?

A

1 hr.

45
Q

AAP what zone do you have very short/shortness of breath

A

red

46
Q

AAP what zone do quick relieve medications not work?

A

red

47
Q

AAP what zone can you not do usual activities?

A

red

48
Q

AAP what zone do symptoms stay the same or get worse after 24 in yellow zone?

A

red

49
Q

AAP what zone is the PFM 50>

A

red

50
Q

AAP treatment for green zone

A

take LABA 2 or 4 puffs 5 min before exercise

51
Q

AAP treatment for yellow zone

A
  1. take SABA 2-4 puffs every 20 min or nebu.
    *SABA to get you back up to green zone
  2. take SABA 2-4 puffs or nebulizer
    take oral steroid
52
Q

AAP treatment for red zone

A
  1. take SABA 4, 6 puffs or nebulizer

2. take oral steroid

53
Q

AAP Danger signs

A
  1. trouble walking and talking due to shortness of breath

2. lips/ fingernails blue

54
Q

what does a Pulse Oximetry do?

A
  1. mesures oxygen saturation.

2. uses wavelengths of light to measure the saturation of hemoglobin with oxygen

55
Q

what is a normal Pulse ox level?

A

95%-99%

56
Q

What conditions affects the bronchial airways NOT the alveoli?

A

Asthma.

57
Q

What is asthma? (pathophysiology)

What does it result from?

A

It is a chronic lung disease characterized by intermittent, reversible air way obstruction.
It results from inflammation of the lung’s airways and tightening of the muscles that surround the airways

58
Q

how do you treat a patient who is having an asthma attack? (2)

A
  1. with a inhaled beta-2 agonist like albuterol (ventolin)

2. Or oxygen and corticoid steroids.

59
Q

how do you use an aerochamber? (10)

A
  1. remove cap from MDI
  2. shake and insert in back of aerochamber
  3. breath out completely, place mothpice of chamber in mouthand tighly seal lips around it.
  4. press cannister once to release a dose of medication
  5. take deep slow breath in.( no whisteling sound should be heard)
  6. hold breath for 10 seconds, then breath our through th emouthpiece
  7. breath in again but do not press canister
  8. remove mouth piece from mouth and breath out
  9. wait 1 min or adbyhcp then repeate steps 2-8(rinseout mouth)
  10. replace the cap on MDI
60
Q

what are the discharge teachings/ avoidance risk factors for a patient with asthma? (8)

A
  1. Asthma Action Plan
  2. avoid risk factors
  3. pursed lip breathing
  4. medication education
  5. PFM
  6. smoking cessation
  7. proper inhaler technique
  8. clean respitory equipment
61
Q

what is pursed lip breathing?

A

keeps the airways open longer and it prolongs exhalation.

62
Q

what does pursed lip breathing allow for?

A

increased time for oxygen and carbondioxide to exchange.

63
Q

how do you do pursed lip breathing? (5)

A
  1. sit up right w neck an shoulders relaxed
  2. inhale trough the nose count 1-2
  3. exhale through pursed lips count 1-2-3-4
  4. exhalation should be 2X as long as inhalation
  5. continue until shortness of breath is controlled
64
Q

when assessing the affect that COPD has on the patient nutrition-metabolic pattern. what is the appropriate question to ask?

A

ask if they have experienced weight loss

65
Q

What can a UPA NOT do (4)

A
  1. assess
  2. teach
  3. instruct
  4. adminester
66
Q

what are the assessments of a client with COPD (5)

A
  1. cough
  2. increased mucus production
  3. tripod positioning
  4. pursed lip breathing
  5. changes in skin color
67
Q

With COPD what assessment is a priority due to the possibility of respiratory arrest?

A

If you see that the have Tachypnea rapid breathing

68
Q

what is a contraindication to oxygen administration?

A
  1. delivering too much oxygen may interfere with the hypoxic drive for breathing, this will lead to decreased respiratory effort and ultimately
69
Q

nursing diagnosis of Impaired gas exchange

A

relates to a deficit in oxygenation (low O2 “oxygen”saturation) or impaired elimination of CO2 “carbon dioxide”

70
Q

nursing diagnosis of ineffective airway clearance

A

inability to clear secretions or obstructions from the respiratory tract to maintain a clear airway.

71
Q

when is tracheostomy care provided?

A
  1. in each shift as needed or indicated by facility.
72
Q

why is tracheostomy care provided?

A

to maintain airway and prevent infection.

73
Q

What occurs as a result of decreased tidal volume and apnea?

A

acidosis and increased sympathetic vasoconstrictive activity.

74
Q

Manifestations of OSA (8)

A
  1. loud snoring
  2. gasping during sleep
  3. waking during sleep
  4. choking during sleep
  5. day time sleepiness
  6. naps
  7. falling asleep
75
Q

how many osbstruvtive sleep events per hr diagnose OSA?

A

15 or more

76
Q

what test is used to diagnose OSA?

what does this test consist of? (2)

A

polysomography
1 electrocatdiogram
2. pulse oximetry

77
Q

Surgical Management of OSA (7)

A
  1. tonsillectomy
  2. adenoidectomy
  3. uvulopalatophraryngoplasty
  4. septoplasty
  5. nasal polypectomy
  6. toung reduction
  7. epiglottoplasty
78
Q

instruction for treatment of OSA (4)

A
  1. CPAP- prevents collapse of the upper airway through the use of pressure delivered through the use of a nasal, oral, or oronasal mask during sleep.
  2. weight managment/ loss
  3. positioning during sleep
  4. avoid alchohol and sedatives before bed
79
Q

Management of OSA; what test is used to diagnose OSA? what does this test consist of? (5)

A 
polysomography
1 electrocatdiogram
2. pulse oximetry
3. respiratory air flow
4. eye and skeletal muscle movement
5. electroencephalogram
80
Q

name some complications of OSA (8)

A
  1. cardio vascular disease
  2. cardiac ischemia
  3. myocardial infraction
  4. erectile dysfunction
  5. stoke
  6. arterial fibtillation
  7. hear failure
  8. sudden cardiac death
81
Q

what are the respiratory assessment techniques? (4) and in what order?

A
  1. Inspection
  2. palpation
  3. percussion
  4. auscultation
82
Q

Where are oxygen and carbon dioxide exchanged?

A

alveoli

83
Q

Describe Inspection of respitory air ways(5)

A
  1. is there Hypoxia? - mucus membrane pale/cyanotic
  2. abnormalities in level of consciousness & orientation
  3. level of speach
  4. clubbing
  5. nose, mucusmembrain, mouth, neck, trachea, thorax
84
Q

Describe palpation of the lungs (2)

A
  1. listening for crepitus- air is trapped under skin; described as a crackling feeling
  2. equal expansion of the lungs
85
Q

Describe percussion of the lungs

A

done between the ribs

listen for for resonance=normal

86
Q

Describe auscultation of the lungs

A

listening to right and left lungs

listen for wheezes, ronchi, pleural friction rubs

87
Q

when a cough produces thick sputum what is it?

A

pnemonia

88
Q

when a cough is dry wha it is?

A

asthma

89
Q

what is PaCo2

A

carcon dioxide

90
Q

what is HcO3

A

biocarbonate

91
Q

what is PaO2

A

partial pressure of oxygen

92
Q

AP diameter
Normal=
Abnormal =

A 
normal= 1:2
abnormal= 1:1
93
Q

Nursing implications: what does the allen test asses for?

A

adequacy of ulnar artery circulation.

94
Q

Diagnostic Studies Nursing implications: what does capnography do?

A

continuously monitors the PaCo2 in the airway during inhalation and exhalation and provides a written tracing.

95
Q

Diagnostic Studies Nursing implications: what is a bronchoscopy

A

allow for visualization down to the second level of the bronci

96
Q

Diagnostic Studies Nursing implications: what is sputum analysis

A

check for migroorganisims and abnormal cell growth

97
Q

what does a positive sputum analysis indicate?

A

Tb or pneumonia

98
Q

Diagnostic Studies Nursing implications:
Bronchospy
Flexible=
Ridgid=

A 
flexible=  take tissue specimensn or replace an endotracheal tube
rigid= remove obstruction or large amounts of secreations from the respiratory tract
99
Q

Diagnostic Studies Nursing implications: what is thoracentesis?

A

used as a diagnostic test or treatment depending on the disease process. a needle is inserted into the pleural space to remove fluid/air

100
Q

Diagnostic Studies Nursing implivations: Pulmonary Function test, what does it do?

A

evaluate lung volumes to determine the functioning of the lungs.
do not smke or eat for 8 hrs before the test

101
Q

What type of room is appropriate fo a TB patient?

A
  1. Single patient room because of droplet precautions.

2. Placed together in the same room with other patients that have the sad symptoms/disease.

Zoey NUR 111 Unit 2 (14 decks)

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