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Test 1

Terms in this set (69)

A patient has been admitted to the MedSurg unit with an influenza dx. What precautions will you follow?
droplet
A patient is admitted after showing flu sx for less than 48 hours, what tx will they most likely be prescribed?
Tamiflu
A patient has been admitted to the hospital for over 48 hours. What kind of pneumonia are they at risk for?
hospital aquired
The medical team is in the process of diagnosing a patient with pneumonia. What diagnostics will be done?
chest x-ray and WBC count
A patient with pneumonia states they are feeling chest pain. What do you say to educate them?
This is most likely due to infection and inflammation causing resistance in that area
A person is dx with TB. What precautions do you follow?
droplet
A person with TB starts sneezing and coughing into the air. As a nurse you know this is a concern because...
it can stay in the air for several hours
How long is treatment for TB?
6-9 mo
A person is dx with rhinosinusitus. What sx do you monitor?
pain, pressure, fullness, obstruction sx
A person is admitted to the ED with orbital cellulitis and abscess, and osteomyelitis. You know they are most likely suffering adverse sx from what dx?
rhinosinusitis
As a nurse you know sleep apnea is dangerous due to what physiological sx?
resistance of airflow due to narrow airway, collapse of airway
What is the tx for sleep apnea?
CPAP (continuous positive airway pressure)
A person with laryngitis asks you how long their cough, fatigue, and hoarseness will last.
7-10 days on average
How do you dx asthma?
pulmonary function test, chest xray, pulse ox, ABGs
Antiinflammatories for asthma include...
steroids and corticosteroids such as prednisone, QVAR, and flovent
Bronchodilators for asthma include...
beta-adrenergics such as proair, xopenex
anti-cholinergics for asthma include...
Atrovent such as spiriva
A person is dx with both asthma and COPD. What medication are they likely to be prescribed?
Atrovent
What primary diseases is COPD composed of?
emphysema and chronic bronchitis
What are the goals are treating COPD?
decrease risk factors and stabilize
What arteries are ABGs drawn from?
radial, brachial, femoral
Breathing problems, lung disease, HF, and KF are dx using what lab?
ABG
In a PE when the pulmonary artery is affected what are the results?
decrease gas exchange and increase pulmonary vascular resistance leading to hypertension
A patient is admitted who is obese, smokes, has hx of CHF and is going to surgery for a fractured femure. What are they at greatest risk for?
PE
A patient is admitted to the PACU. Suddenly they begin coughing and say that their chest hurts. Their cough results in bloody sputum. They are tachy and turn grey. What adverse effect are they suffering from?
PE
What labs will you run to dx a PE?
D-dimer, BNP and troponin, ABGs, EKG, and xray
How will you begin to treat a PE?
isotonic fluids, and anticoagulants such as heparin or coumadin
A patient is admitted to MedSurg with hx of DVT. What medication could help decrease the risk of a reoccuring DVT or PE?
Coumadin or warfarin
When a patient is placed on coumadin or warfarin to decrease risk of DVT or PE, what adverse effect must you monitor for?
increase risk of bleeding
A patient is dx with a PE and is put on anticoagulants and thrombolytics. What must you monitor for as their nurse?
blood in stool, urine, and at venipuncture sites; chest pain, oxygen and labs
What position should a PE patient be placed in?
elevate head of bed
A patient is admitted with Type 1 respiratory failure. As a nurse you know this means what?
gas exchange is not occurring and the pt. is hypoxemic
A patient who was in type 1 respiratory failure begins to tank, and the doctor tells you they are now in type 2 respiratory failure. As a nurse you know this means what?
The patient is experiencing hypercapnia and is in respiratory acidosis
When a patient is on coumadin or warfarin why is it so important to get the IV right the first time?
because they will continue to bleed at each site tried
A patient is becoming septic, in regards tot he ABCs what do you monitor for?
acute respiratory failure
When a patient is not breathing due to trauma, brain injury, OD, pneumonia, or pancreatitis what are they at risk for?
acute respiratory failure
Diagnostics for acute respiratory failure
ABG, H/H, chest xray
What type of respiratory intervention devices are appropriate to treat respiratory failure?
NC, venturi mask, nonrebreather, bipap
What type of medications are acceptable to treat respiratory failure?
antibiotics, steroids, bronchodilators, diuretics, and sedatives
A patient is experiencing respiratory distress with an acute onset of less than 7 days. They have refractory hypoxemia. Bilateral infiltrates and cardiac pulmonary edema has been ruled out. What is their dx?
Acute respiratory distress syndrome
An elderly patient who is recovering from pneumonia aspirates while drinking their morning coffee. Based off of their medical hx and this event what are they are greatest risk for?
Acute respiratory distress syndrome
A burn victim has been diagnosed with an infection. Based off of their medical hx and this new dx what are they at greatest risk for?
Acute respiratory distress syndrome
When a patient has an adverse to a medication that affects their airway what is this called?
Acute respiratory distress syndrome
A patient walks into the ED and tells you, "for the past day I just feel off, it feels like I am having an asthma attack." What phase of acute respiratory distress syndrome would they be in?
Exudative Phase
The patient is admitted to the hospital. Their ability to breathe deteriorates. The lungs sound stiff shallow with decreased ventilation. What phase of acute respiratory distress syndrome would they be in?
Proliferative phase
A patient who was dx with acute respiratory distress syndrome receives a chest xray. The xray shows scar tissue that is impairing gas exchange and causing hypoxia. What phase of acute respiratory distress syndrome would they be in?
Fibrotic phase
What radiology diagnostics can dx acute respiratory distress syndrome?
CT and xray
What labs assist with dx acute respiratory distress syndrome?
CBC and ABG
What medications assist with treating acute respiratory distress syndrome?
antibiotics and corticosteroids
What is the most serious complication of acute respiratory distress syndrome?
Multi-system failure
What organs or at risk for damage with acute respiratory distress syndrome?
liver, kidneys, lungs
What lab value can evaluate tissue damage with respiratory distress syndrome?
lactate
As a nurse what can you do in order to treat acute respiratory distress syndrome?
elevate head of bed, prevent infection, suction
A patient asks you how long they will be recovering from their acute respiratory distress syndrome. What is a true statement regarding this disease?
it can take months to years to heal, but most have a full recovery.
What is often the result of chest trauma?
flail chest, pneumothorax, hemothorax
A patient is admitted to the ED after a car accident where they were accelerated forward and hit the steering wheel. What kind of chest trauma is this?
blunt force
Two patients are admitted to the ED after one was shot, and the other stabbed during a mugging. What kind of chest trauma is this?
Penetrating
A patient is admitted to the ED after fracturing their ribs and cannot breathe. What kind of chest trauma is this?
Penetrating
A patient is admitted to the ED with broken ribs who is gasping and cannot expand chest fully. You note paradoxical chest movement. What is this patient suffering from?
flail chest
A chest trauma patient is admitted to the ED who is gasping and cannot expand chest fully. A chest xray verifies air collecting between the lungs and chest wall. What are they suffering from?
pneumothorax
A chest trauma patient is admitted to the ED who is gasping and cannot expand their chest fully. A chest xray verifies blood collecting between lungs and chest wall. What are they suffering from?
hemothorax
What radiological diagnostics can you run for a chest trauma?
chest xray and chest CT
What labs can be run for a chest trauma?
ABGs, serum lactate, H/H, coag, BNP, troponin, CK-MB
What labs do you run to check cardiac involvement with a chest trauma?
BNP, troponin, CK-MB
What is the nurse's job when caring for a chest tube?
make sure all connections are taped, collecting device is below chest, ensure fresh petroleum gauze is at the bedside
How often will you check your chest tube patient?
every two hours
How often will you practice deep breathing with your chest trauma patient?
every one hour
When is the best time to give PRN pain medication?
before activity
When should you ambulate you chest trauma patient?
as soon as possible
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