Respiratory

Question 1

Asthma

Answer 1

Albuterol
Terbutaline: monitor respiratory depression . Cannot give terbutaline to patient with hypertension, hyperthyroidism, diabetic Mellitus or history of seizures and hyperkalemia

Question 2

Pulmonary Embolism

Answer 2

dyspnea, rapid heart rate, and pleuritic chest pain ( usually describes as sharp stabbing pain) is found in most clients diagnosed with PE, breath sounds may be normal; with presenting S/S. Nursing actions
CALL RAPID 😨😨😨😨😨😨

Question 3

Pneumonia signs/symptoms

Answer 3

P: productive cough, pleuritic pain
N: neuro changes ( fatigue, ⬆️rate)
E: elavated labs 
U: usual breath sound
M: mild fever
O: oxygen sat decelerate
N: N/V
I: ⬆️RR⬆️HR
A

Question 4

Tuberculosis: post op teaching

Answer 4

The client is continued on medication therapy for 6 to 12 months, depending on the situation. The client generally is considered noncontagious after 2 to 3 weeks of medication therapy. The client is instructed to wear a mask if there will be exposure to crowds until the medication is effective in preventing transmission. The client is allowed to return to work when the results of three sputum cultures are negative.

Question 5

High pressure alarm on chest tube

Answer 5

When the high-pressure alarm sounds on a ventilator, it is most likely because of an obstruction. The obstruction can be caused by the client’s biting on the tube, kinking of the tubing, or mucus plugging requiring suctioning.

Question 6

Low pressure alarm

Answer 6

Disconnection or a cuff leak

Question 7

COPD

Answer 7

Do not exceed 2L of oxygen

Question 8

Stridor

Answer 8

Airway edema : obstruction of airway. Notify PCP

Gasping for air and wheezes but in and out

Question 9

Suctioning

Answer 9

Adverse effect of suctioning: cyanosis, excessive breathing or slow heart rate, sudden development of Bloody secretions

Question 10

Left side heart ❤️ function

Answer 10

Breath sound is a perfect indicator

Question 11

Surfactant

Answer 11

Surfactant is a phospholipid produced in the lungs that decreases surface tension in the lungs. This prevents the alveoli from sticking together and collapsing at the end of exhalation. When alveoli collapse, the lungs become “stiff” because of decreased compliance. Common causes are ARDS and atelectasis.

Question 12

Removal of endotracheal tube

Answer 12

Once the client has been weaned successfully and has achieved an acceptable level of consciousness to sustain spontaneous respiration, an ET tube may be removed. The ET tube is suctioned first, and then the cuff is deflated and the tube is remove

Question 13

Rib fracture

Answer 13

Either blunt or fall. Typical S/s: pain and tenderness localized at the fracture site that is exacerbated by inspiration and palpation, shallow respirations, splinting or guarding the chest protectively to minimize chest movement, and possible bruising at the fracture site.

Question 14

Chest tube removal

Answer 14

When the chest tube is removed, the client is asked to perform the Valsalva maneuver (take a deep breath, exhale, and bear down). The tube is then quickly withdrawn, and an airtight dressing is taped in place. Another technique is asking client to take a deep breathe and hold the breathe

Question 15

Simple silicosis

Answer 15

Inhalation of silica. Patient at risk include: construction worker, chemical factory work.
A symptomatic and shows mild ventilation restriction and fibrosis on chest x ray

Question 16

Flail chest

Answer 16

Flail chest results from multiple rib fractures. This results in a “floating” section of ribs. Because this section is unattached to the rest of the bony rib cage, this segment results in paradoxical chest movement. This means that the force of inspiration pulls the fractured segment inward, while the rest of the chest expands. Similarly, during exhalation, the segment balloons outward while the rest of the chest moves inward. This is a characteristic sign of flail chest.

Question 17

Theophylline ( Methylanxthines- group name) ( Theo-Dur)

Answer 17

Normal level <20mcg/ml
Early signs of toxicity include restlessness, nervousness, tremors, palpitation and tachycardia, hypotension, nausea and vomiting

Question 18

ANTICHOLINERGICS ( ends in tropium) 
E.g
Ipratropium ( inhaled atrovent) 
Tiotropium ( inhaled spiriva) 
I thirst opium so fast, so I cannot see, I cannot shit, I cannot pee, I cannot thirst .

Answer 18

Blocks muscarinic receptors in bronchi, which results in bronchodilation.
S/effects: dry mouth 👄, pharynx irritation( suck on sugarless candy 🍭- helps relieve symptoms.), blurred vision, tachycardia, urinary retention and constipation.

CAUTION
Do not take ipratropium with peanuts.

Question 19

Aminoglycoside ( kenamycin, vancomycin, seromycin, streptomycin, gentamicin) “ends in mycin”
(Am in My VANN) pneumonic

Answer 19

S/effects:
Nephrotoxicity
Neurotoxicity ( tremors, seizures, tingling, twitching) vestibular toxicity ( dizziness, clumsiness, unsteadiness), auditory toxicity ( ototoxicity- ringing in the ears, loss of hearing, a feeling of full in the ears)

Question 20

Fluoroquinolones (levofloxacin-levaquin, moxifloxacin-avelox) ends in “floxacin”

Answer 20

No need for blood work
Photosensivity
Drink plenty of water ( help prevent stone formation)
Do not take multivitamin
Do not take milk or yogurt alone-decrease absorption
May or may not take with meal

Question 21

Cephalosporins

Answer 21

S/E: diarrhea

Question 22

Ventilator alarm 🚨 alarm 🚨

Answer 22

Regardless of whether it low or high pressure alarm 🚨, always check on the clients or patient first before attending to the alarm

Question 23

Opioids withdrawal

Answer 23

Nausea, vomiting, restlessness, abdominal cramping

Question 24

PICC ( a portion of the catheter breaks) what to do first

Answer 24

Apply a tourniquet to upper right arm, it prevents piece from advancing into the right atrium, after the tourniquet is applied, check for presence of radial pulse, next keep in place until x-ray obtained and surgical retrieval is attempted.

Question 25

Pyrazinamide

Answer 25

TB Medications:

Question 26

Epiglottis

Answer 26

Treatment include:

Moist air and Iv antibiotics helps decrease epiglottis swelling.

Question 27

Inspirational wheezes

Answer 27

Indication of aspiration or a block airway

Question 28

Expirational wheezes

Answer 28

Indications of an asthmatic attack

Question 29

Asthma attack

Answer 29

asthma attack produces dyspnea, audible wheezing, coughing, chest tightness, feeling of suffocation, So with severe spasm or obstruction, breath sounds and crackles may become inaudible.