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Increase in RBCs to deliver more 02 (Polycythemia)
Compensatory mechanism in COPD pts not getting enough 02
- Cold slow onset, contagious 3 days, treat the symptoms
- Flu - sudden onset, fever, body aches - tx symmetrel, tamiflu 1st 48 hrs
Difference between the cold and flu
- Monitor for frequent swallowing
- HOB elevated
- Monitor VS
- Monitor I&O
Post op nursing interventions for nasal or throat surgery?
Make sure the bag inflates - if it doesn't, increase the flow
What do you need to insure when a pt is on a non rebreather mask?
- Teach pursed lip breathing to prevent premature airway closure
Pt with chronic airflow limitation, what would you teach them?
Increase the flow until the bag inflates
What do you do when you switch from a NC to a non rebreather?
Rt sided HF & pulmonary edema leading to pulmonary HTN causing increased pressure in the liver=acites, sacral edema, JVD
What is cor polmonale?
Small frequent meals, supplements, oral care before meals, rest periods
What can you teach a COPD pt to increase appetite?
-Teach to avoid crowds during flu season
- hand washing
-02, TCDB, Chest PT
- Increase fluids to 2-3 L/day
Nursing implications for COPD pts
- 1/2 peroxide, 1/2 NS
- rinse with NS
- dry with pipe cleaner
How do you clean a double lumen trach?
- Need 2 people OR
- Put new ties on before removing the old ties
How do you change the ties of a trach?
Lay them on operative side to promote drainage and good lung expansion of the non operative lung
Pt has pneumoectomy. What does the nurse expect to do post op?
- Chest tube
- Occlusive dressing (don't change)
Pt has pneumoectomy. They will come to the floor post op with what?
Turn down the suction
Pt with chest tube, the water chamber is bubbling vigorously, what should the nurse do?
Milk the tube to break up the clots(Don't strip)
If the chest tube has clots, what should the nurse do?
Chamber 1 = Water
Chamber 2 = suction
Chamber 3 = Drainage (Connected to the pt)
What are the chambers of chest tube drainage system called?
- Monitor respiratory status, breath sounds
- Lay on unoperative side
Nursing implications post op throracentesis
- 3 AFB sputum collections on 3 consecutive days
- Tx with ING and rifampin up to a year
Pt has + PPD and + chest x-ray
By hyperventilating which can lead to respiratory alkalosis
How does the body compensate for metabolid acidosis?
The bag is inflated - if not, increase the flow
If the pt is on a non rebreather, what do you have to make sure?
- Exedutative drainage
Pt has pleural effusion and a thoracentesis is done. The drainage is milky and yellow. What is this called and what would the nurse suspect?
Deviated septum & polyps
Pt has stenorous respirations, dyspnea, and post nasal drips. What is this s/s of?
Upper airway obstruction
Pt has stenorous respirations, apnea, altered RR and chacter. What is this s/s of?
Alveolar disease caused by overinflation and other destructive changes of alveolar walls resulting in decreased lung elasticity and gas exchange
This is dx'd after a pt has had it for at least 3 months out of the year for 2 consecutive years
This is caused by an increased reactivity of the trachea and bronchi to stimuli resullting in increased mucus production and mucosal swelling
Caused b dilation of the bronchi and bronchioles that destroys bronchial elastic and muscular elements
- Chronic respiratory infections
- tuberculosis lesions
- Bronchial obstruction
Causes of bronchiectasis
Acute coryza (cold)
Inflammatory process of the upper airway respiratory tract resulting in sneezing, post nasal drip, HA, sore throat
Usually caused by other URIs and in children it occurs at night and is called croup
Pleuritic pain (Sharp, knife like pain on inspiration radiating to the shoulder or abd)
S/S of pleurisy?
Do a PPD test
Pt comes in complains of cough, fatigue, wt loss, night swets, what is the first thing the nurse should do?
This disease is highly transmissible from person to person and person to object and is r/t travel
This disorder is d/t an incease in pulmonary capillary pressure resulting from abnormal left heart function
Prevention: TED hose, scuds, early ambulation, no pillow under the knees, TCDB
Tx of pulmonary embolism?
Adult respiratory distress syndrome (ARDS)
Diffuse lung injury in people with no previous pulmonary problems
Collaps of part of the lung that starts in the alveoli and progress to involve a lobe or lobes
Rhonci (sonorous wheezes)
Low pitched, loud caused by congestion d/t asthma, emphysema, mucous plugs
Tell pt to cough. It if clears, then it was rhonci. If it does not, it was rales
How can you tell the difference between rhonci and rales?
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