Diagnostics and URI Flashcards
(15 cards)
A sputum study will help diagnose which condition?
1-Asthma
2-Lung cancer
3-Bacterial lung infection
4-Chronic obstructive pulmonary disease
3-Bacterial lung infection
A sputum study is often used to diagnose bacterial lung infection via culture and sensitivity results. Sputum studies are not used to diagnose asthma, lung cancer, or chronic obstructive pulmonary disease.
Palpation is used to determine which respiratory assessment finding?
1-Lung density
2-Tracheal position
3-Adventitious sounds
4-Bronchovesicular sounds
2-Tracheal position
Palpation is used to determine tracheal position. Auscultation is used to determine breath sounds, both normal (bronchovesicular) and abnormal (adventitious). Percussion is used to assess lung density.
Which diagnostic procedure is used to remove pleural fluid for analysis?
1-Lung biopsy
2-Thoracentesis
3-Bronchoscopy
4-Sputum studies
2-Thoracentesis
Thoracentesis is a diagnostic procedure used to remove pleural fluid for analysis or to instill medication. A lung biopsy is used to obtain specimens for laboratory analysis. A bronchoscopy involves the use of a flexible fiberoptic scope for diagnosis, biopsy, or specimen collection. Samples for sputum studies are obtained by expectoration and tracheal suction.
Which patient findings indicate inadequate oxygenation? Select all that apply.
1-Anemia 2-Cyanosis 3-Tachypnea 4-Diaphoresis 5-Hypertension
2-Cyanosis
3-Tachypnea
4-Diaphoresis
The symptoms of inadequate oxygenation in the patient include cyanosis, diaphoresis, and tachypnea. Cyanosis indicates inadequate perfusion due to compromised oxygenation. Diaphoresis and tachypnea occur due to sympathetic stimulation to compensate for inadequate oxygenation. Anemia occurs gradually and does not suddenly cause inadequate oxygenation. Hypertension does not indicate inadequate oxygenation in the patient.
Following a bronchoscopy, a patient must present with which assessment finding before beginning oral intake of food and fluids?
1-Stable vital signs
2-Return of gag reflex
3-Brisk pupil reaction to light
4-Clear bilateral breath sounds
2-Return of gag reflex
A patient who is given food or fluid before the gag reflex returns may aspirate food or drink and possibly experience respiratory distress as a result. Vital signs, pupil reaction, and breath sounds are routine assessments after a procedure such as a bronchoscopy, but they are secondary to assessing the patient for the return of the gag reflex.
Following a bedside thoracentesis, the nurse will continue to assess the patient for signs and symptoms of which condition?
1-Bronchospasm
2-Pneumothorax
3-Pulmonary edema
4-Respiratory acidosis
2-Pneumothorax
Because thoracentesis involves the introduction of a catheter into the pleural space, there is a risk of pneumothorax. Thoracentesis does not carry a significant potential for causing bronchospasm, pulmonary edema, or respiratory acidosis
Which test can determine the efficiency of air transfer in lung and tissue oxygenation in a patient in respiratory distress?
1-Chest x-ray
2-Pulse oximetry
3-Respiratory rate
4-Sputum analysis
2-Pulse oximetry
Pulse oximetry and the analysis of arterial blood gases (ABGs) are the two methods used to determine how well air is transferred. A chest x-ray has no direct effect on the transfer of air effectiveness. A patient’s respiratory rate does not affect air transfer. Sputum analysis can help diagnose many respiratory conditions but is not involved in assessment of air transfer.
The nurse would perform which assessment prior to a patient undergoing a CT scan? Select all that apply.
1-Serum creatinine 2-Blood sugar levels 3-Blood hemoglobin levels 4-Blood urea nitrogen (BUN) 5-Hypersensitivity to shellfish
1-Serum creatinine
4-Blood urea nitrogen (BUN)
5-Hypersensitivity to shellfish
The CT scan involves administering a contrast agent, so the nurse should assess the renal function to determine the safety of contrast administration. The renal function can be assessed by checking the laboratory values of BUN and serum creatinine. The contrast agent is usually an iodine-based compound; therefore the nurse should also check if the patient is hypersensitive to shellfish, because it contains iodine. Checking blood sugar levels and hemoglobin levels are important, but not necessary prior to a CT.
A patient with sinusitis will appropriately use topical decongestants for which length of time?
1-Less than four days
2-Less than a week
3-Less than 10 days
4-Less than a month
1-Less than four days
Teach patients using topical decongestants to use the medication for no longer than four to five days to prevent rebound congestion caused by vasodilation. If used longer than three days, the patient’s symptoms may be made worse.
Which activity should be avoided while taking diphenhydramine for recurrent rhinitis?
1-Driving
2-Exercising
3-Sexual activity
4-Watching television
1-Driving
Diphenhydramine causes drowsiness and sedation. It can increase the risk of injury if the patient engages in activities like driving or operating machinery. Therefore the patient should be asked not to drive while on the drug. Watching television, exercising, and sexual activity do not pose any danger to the patient during the treatment.
The nurse anticipates a diagnosis of sinusitis for a patient who reports a headache, nasal congestion, and fever for the past three days as indicated by which assessment findings? Select all that apply.
1-Nosebleed 2-Swollen turbinates 3-Edematous mucosa 4-Clear nasal discharge 5-Tenderness over the sinuses
2-Swollen turbinates
3-Edematous mucosa
5-Tenderness over the sinuses
Clinical findings that indicate sinusitis include swollen turbinates, edematous mucosa, tenderness over the involved sinuses, and enlarged turbinates. The turbinates may enlarge due to congestion. The inflammation results in increased blood supply to the affected area, which leads to edematous mucosa. Due to the inflammation, there may be tenderness over the involved frontal and/or maxillary sinuses. Clear nasal discharge is not a sign of sinusitis. Nosebleed is not a manifestation of sinusitis. Patients with sinusitis usually have a purulent nasal discharge.
Which nursing interventions are appropriate to help control bleeding for a patient with epistaxis? Select all that apply.
1-Reassure the patient and keep him or her quiet.
2-Administer saline nasal sprays to relieve congestion.
3-Place the patient in a sitting position with the head tilted forward.
4-Ask the patient to blow the nose to remove all the collected blood.
5-Apply direct pressure by pinching the entire soft lower portion of the nose.
1-Reassure the patient and keep him or her quiet.
3-Place the patient in a sitting position with the head tilted forward.
5-Apply direct pressure by pinching the entire soft lower portion of the nose.
To control epistaxis, the patient should be reassured and kept quiet. In epistaxis, approximately 90% of nosebleeds occur in the anterior portion of the nasal cavity and can be easily visualized. The patient should be made to sit, leaning slightly forward, with the head tilted forward. Direct pressure should be applied by pinching the entire soft lower portion of the nose against the nasal septum for 10 to 15 minutes. If bleeding does not stop within 15 to 20 minutes, consult the health care provider. Saline nasal sprays should not be used because these can dislodge the clot that is needed to stop the bleeding. Nose blowing will also remove the clot, which could lead to further bleeding.
Which assessment findings correlate with a diagnosis of influenza? Select all that apply.
1-Muscle aches 2-Sore throat 3-Temperature of 102.4°F 4-Purulent nasal discharge 5-Difficulty breathing through the nose
1-Muscle aches
2-Sore throat
3-Temperature of 102.4°F
Influenza is an infectious disease caused by a virus that attacks the respiratory system. Myalgia, sore throat, fever, chills, cough, and rhinorrhea are symptoms of influenza. Purulent nasal discharge and nasal obstruction are symptoms of sinusitis.
When educating a patient about nonpharmacologic interventions to manage sinusitis, which instructions will the nurse include? Select all that apply.
1-Restrict fluid intake. 2-Use a steam inhaler. 3-Avoid exposure to smoke. 4-Sleep with your head elevated. 5-Apply a cold compress on your cheeks.
2-Use a steam inhaler.
3-Avoid exposure to smoke.
4-Sleep with your head elevated.
In the case of sinusitis, steam inhalation helps to promote drainage of secretions. Sleeping with the head elevated helps to drain the sinuses and reduce congestion. Smoke is an irritant and will worsen the symptoms of sinusitis. Adequate fluid intake will decrease the symptoms of sinusitis. Applying a cold compress on the cheeks is not recommended because this worsens the symptoms. A hot compress on the cheeks will help.
Which nursing interventions would be appropriate for a patient with anterior packing for treatment of epistaxis? Select all that apply.
1-Provide saline nasal spray. 2-Provide extra packing material. 3-Administer mild opioid medication. 4-Administer prophylactic antibiotics. 5-Administer nonsteroidal antiinflammatory drugs.
3-Administer mild opioid medication.
4-Administer prophylactic antibiotics.
Nasal packing is painful because of the pressure applied to stop the bleeding. Mild opioid medication should be given to the patient for analgesia. Patients with nasal packing are susceptible to staphylococcal infection, so prophylactic antibiotics should be administered. Extra packing material is no longer required because anterior packing is already done. Saline nasal spray is recommended after packing removal. Nonsteroidal antiinflammatory drugs are discouraged due to the risk of bleeding.
