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EXAM 1 Review Flashcards

1
Q

What are the normal lab values for cholesterol?

A

Total Cholesterol <200mg/dL
HDL > 60mg/dL
LDL < 70mg/dL IF PT IS HIGH RISK, <100mg/dL for females, < 150mg/dL for males
TG < 135mg/dL for females, < 150mg/dL for males

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2
Q

What are the non-modifiable risk factors for CAD?

A

age, gender (men tend to develop earlier), ethnicity (African American at greater risk), family history (primary relative w/ MI before the age of 55/65), diabetes

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3
Q

What are the modifiable risk factors for CAD?

A

smoking, obesity, sedentary lifestyle, metabolic syndrome, hyperlipidemia, DM, HTN, proper management of diabetes/prediabetes, unhealthy diet, stress, sleep apnea

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4
Q

What are important health promotion points for CAD?

A
  • ID at risk patients
  • physical activity –> FITT(150 min/wk or 75min/wk of vigorous exercise)
  • Nutritional therapy –> TLC diet: decrease sat fat/ cholesterol, increase complex carbohydrates, fat <30% daily intake, high soluble fiber
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5
Q

What is the pharmacological management of CAD?

A

statins, antiplatelets/anticoagulants, BB, CCB, nitroglycerin

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6
Q

What are possible procedures for treatment of CAD?

A

angioplasty, stent placement, CABG

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7
Q

What are the main patient education points for CAD?

A 
quite smoking
stay active
eat healthy diet
control stress
manage diabetes
***drugs alone will not be effective, pt must combine pharm interventions with healthy lifestyle modifications
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8
Q

What is Acute Coronary Syndrome?

A

Occurs when a plaque breaks off and blocks the coronary artery, concern for cardiac arrest. May present as STEMI (complete blockage), NSTEMI (partial blockage), or unstable angina

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9
Q

How will a patient present with ACS?

A

chest pain (may radiate to left arm), arrhythmias, SOB (at rest or on exertion), elevated BP (which will continue causing damage to vessel walls)

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10
Q

What Dr orders can the nurse anticipate in treatment of the patient with ACS?

A

EKG, cholesterol levels, CT to check for vessel occlusion or stenosis, angiogram, stress test (walk or pharmacological using dobutamine, adenosine, dipyridamole)

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11
Q

What are potential complications of a stress test?

A

MI, HF, cardiac arrest, dysrhythmias —> have a crash cart on hand!

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12
Q

What is an echocardiogram used to examine?

A

heart size, ejection fraction, valve function, pericardial fluid, masses/thrombi

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13
Q

What is angina pectoris?

A

chest pain that occurs intermittently over a long pd w/ the same pattern of onset, duration, and intensity of symptoms, caused by decreased blood flow through coronary arteries

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14
Q

What can cause an episode of angina?

A

physical exertion, exposure to cold, eating heavy metal, stress/emotion causing release of catecholamines

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15
Q

What are the different types of angina and how are they characterized?

A

stable angina: predictable pain that occurs on exertion, relieved by rest and exertion
Unstable angina: pain that increases in frequency or intensity, NOT relieved by rest/ NG
Silent ischemia: significant myocardial ischemia w/o associated symptoms —> elderly, diabetics (diabetic neuropathy), men aged 45-65
Prinzmetal’s or Variant angina: d/t coronary spasm at rest; frequent during REM sleep, r/t hyperactivity of SNS, ST segment elevation but only DURING the episode
Intractable Angina: severe incapacitating chest pain

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16
Q

What are the interventions for a patient experiencing angina?

A

NG —> SL tablets, one every 5 minutes up to 3 doses (0.4mg)
Oxygen: 2-3L nasal cannula
Antiplatelets, anticoagulants: ASA (180-325mg), Clopidogrel [Plavix] 75mg, Heparin (therapeutic at 2-2.5x normal aPTT –> CAUTION HIT); blood thinners: enoxaparen [Lovenox], Dalteparin [Fragmin], Eptifibatide [Integrillin]; BB (metoprolol), CCB

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17
Q

What are the general MOA of NG, BB, and CCB?

A

NG: dilates veins, decreasing preload
BB: decreases HR, myocardial oxygen demand, thus decreasing myocardial contractility; also controls pain
CCB: decrease SA node automaticity, AV node conduction, decreasing contractility; relaxes blood vessels, increasing CA perfusion; decreased workload = decreased myocardial demand

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18
Q

What goals should be met when evaluating effectiveness of angina. trx?

A

pt reports pain relief
avoid progression to MI
pt follows self care plan, completes follow up including exercise stress test

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19
Q

What are the common CM of angina?

A

pain
mild indigestion
choking/heavy sensation upper chest
feeling of impending death

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20
Q

What symptoms should you be alert for when a patient is experiencing angina (i.e. what indicates it may be progressing to MI)

A 
complaints of unusual fatigue
weakness, numbness in arms and wrists
SOB
pallow
diaphoresis
anxiety
dizziness
N/V accompanied by pain related symptoms
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21
Q

What is the process of diagnosing a patient’s angina?

A

pt hx
12 lead ECG
bloodwork
stress test

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22
Q

What is a myocardial infarction?

A

the IRREVERSIBLE necrosis of heart muscle, secondary to prolonged ischemia
c/b damaged myocytes (which will release cardiac enzymes), loss of contractility in affected tissue, and pain for longer than 30 minutes not relieved by rest

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23
Q

What s/s indicate an MI?

A 
palpitations, irregular HR, tachy or bradycardia, JVD, hypo or hypertension, S3, S4, new murmur
tachypnea, SOB,  crackles
N/V
decreased urinary. output
skin cool, clammy, diaphoretic, pale
anxious, light headed
FEELING OF IMPENDING DOOM
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24
Q

What s/s may indicate an MI in women?

A

neck, shoulder, upper back, and abdominal discomfort; SOB; N/V; sweating; lightheadedness; unusual fatigue

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25
Q

A patient presents in the ED with a suspected MI. As the nurse, when should you anticipate needing to draw labs?

A

Labs should be drawn initially then again at 4 hours (looking for elevated troponin, CK MB, myoglobin; remember, troponin is normally almost 0)

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26
Q

What medical interventions should the nurse expect to provide for a patient with an MI or suspected MI?

A

oxygen: 2-4L
aspirin: 325mg
nitroglycerin
morphine: 2-4mg
Beta blockers (Lopressor): 5mg
continuous monitoring, labs
establish 2-3 peripheral IV’s
May need to administer a stool softener —> prevent straining and vasovagal stimulation
keep pt on bedrest

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27
Q

After a patient arrives to the ED with a suspected MI, how long should it be before an ECG is completed?
What does T wave inversion imply?
ST Seg elevation?
Q wave?

A

10 minutes from arrival (time is muscle!)
ischemia
injury
infarction

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28
Q

What are potential complications of an MI?

A

dysrhythmias, HF, cardiogenic shock, papillary muscle dysfunction, ventricular aneurysms, pericarditis/dressler’s syndrome

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29
Q

After education, what should the patient with angina be able to do/verbalize an understanding of?

A

recognize s/s of angina
participate in activities to decrease possibility of further anginal episodes
avoid activities that precipitate anginal episodes
verbalize understanding of use of OTC meds (diet pills, decongestants)
maintain a healthy lifestyle: tobacco cessation, proper diet, normal BP/chol
verbalize an understanding of use of rx med: NG, BB, ASA

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30
Q

What is the difference between angiography and a PCI?

A

angiography is strictly a diagnostic tool to obtain information about the structure and function of the heart and its vessels (including any blockages)
a PCI is therapeutic, opening blockages and potentially placing stents

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31
Q

Prior to an angiography, what must be considered in preparing the patient?

A

ASSESS: allergy to shellfish?
EDUCATE: stop glucophage 3 days prior; if unable provide ample fluids to flush out and prevent renal damage

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32
Q

What are pre PCI interventions the nurse must perform?
during?
post?

A

Pre: pt education (dye will be injected via peripheral IV, may feel. fluttering as catheter passes through heart); check for informed consent; assess allergies to idodine dye or shellfish; clipper and cleanse injection site; NPO 6-8 hours prior (Cardiac meds with sips of water ok); PIVs patent and infusions. running as ordered
During: monitor for occlusions, check pedal pulses; monitor ECG, VS; administer conscious sedation as ordered
post: maintain bedrest 4-6 hours as ordered, frequent assessment of VS including chest pain, assess color, distal pulses of affected extremity, assess site for bleeding, hematoma; if femoral must lay flat for 1-2 hours, no crossing legs; monitor I&O, assess bandage frex

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33
Q

What is the arrival time to ED to cath lab time?

A

under 60 minutes

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34
Q

In which situations should fibrinolytics be used?

A

If PCI/cath lab is unavailable

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35
Q

What important nursing considerations and interventions must be made in administration of fibrinolytics?

A 
all invasive procedures done prior to administering
frx eval of chest pain, VS
monitor for bleeding
assess heart rhythm for reperfusion DR
assess neuro fx
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36
Q

What are ABSOLUTE CI to fibrinolytic therapy?

A

active bleeding, known cerebral aneurysm, known intracranial neoplasm, previous cerebral hemorrhage, recent ischemic stroke, significant closed head injury or facial trauma w/i last 3 months, suspected aortic dissection

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37
Q

What are the normal ABG Values?

A 
pH: 7.35-7.45
pCO2: 35-45 mmHg
pO2: 80-100mmHg
O2 sat: 95-100%
HCO3: 22-26mEq/L
38
Q

What values are alkalotic?

A

pH 7.45 or >
CO2 35 or <
HCO3 > 26

39
Q

What values are acidotic?

A

pH 7.35 or <
CO2 >45
HCO3 <22

40
Q

By what organs/structures are H+ ions excreted?

A

bones, lungs, kidneys

41
Q

What is the primary problem of respiratory alkalosis, and what are associated lab values?

A 
alveolar hyperventilation:  anxiety, pain, hypoxemia, hypermetabolic states (fever, hyperthyroidism), overzealous mechanical vent, ascites, 3rd trimester pregnancy, early stage of salicylate intox
mnemonic: TACHYPNEA
  T- temp increase increases metabolic needs of body
  A- ASA tox stimulates resp center
  C- controlled mechanical vent 
  H- hyperventilation
 hYsteria
  P- pain, pregnancy
  N-neurological injury
  E- embolism and edema in lungs
  A- asthma
pH >7.45, paCO2>35
42
Q

What might you find in your assessment of a pt in respiratory alkalosis?

A

vasoconstriction, lightheadedness, decreased calcium ionization, inability to concentrate, numbness, tingling, tinnitus

43
Q

What are s/s of respiratory alkalosis?

A

confused, tired, fast HR; tetany; EKG changes; muscle cramps; positive Chvostek’s sign; HYPOCALCEMIA, HYPOKALEMIA

44
Q

NI for a pt in respiratory alkalosis?

A

breathing techniques
monitor K, Ca
if pt on mechanical vent —> watch for hyperventilation

45
Q

What is the primary problem of respiratory acidosis, and what are associated lab values?

A

alveolar hypoventilation: CNS depression (narcotics, anesthetics, barbiturates, sedatives); chronic respiratory disease (emphysema, severe asthma); pneumonia, pulmonary edema, aspiration, pneumothorax, atelectasis; NM disease: polio, MG, GB
mnemonic: DEPRESS
D- drugs, opiates
E- edema
P-pneumonia
R- respiratory center of brain damaged
E- emboli
S- spasm of bronchial tubes (think asthma)
S- sac elasticity of alveolar sac is damaged
pH <7.35, PaCO2>45

46
Q

What might you find in your assessment of a patient with respiratory acidosis?

A

hypercapnia —> increased pulse rate, BP w/ reflex attempt to increase ventialtion
skin may be warm, flush d/t vasodilation from the CO2 increase

47
Q

s/s of a patient with respiratory acidosis?

A

neuro changes, confused, drowsy; HA; RR <12 bpm; decreased BP

48
Q

NI for the patient with respiratory acidosis?

A

administer O2; encourage coughing ,deep breathing; respiratory therapy and bronchodilators; watch K levels —> hyperkalemia —-> MONITOR EKG; if pneumonia antibiotics, spirometry; endotracheal intubation

49
Q

What is the major causative factor of the development of metabolic acidosis, and associated lab values?

A 
Major causative factor: increased acid or loss of bicarb creates a drop in bicarb: excessive acid intake (ASA, methanol, ethanol); GI loss of bicarb --> chronic diarrhea, biliary and pancreatic fistulas; hyperkalemia; increased acid production --> DKA or lactic acidosis; RF; starvation; shock; sepsis 
mnemonic: ACIDOTIC
    A- aspirin tox
    C- carbs not metabolized --> lactic acid buildup
     I- insuff of kidneys
    D- diarrhea, DKA
    O- ostomy drainage 
 fisTula
     I- intake of high fat diet
    C- carbonic anhydrase inhibitors
pH < 7.35, HCO3 <22
50
Q

What would you expect to find in your assessment of a ptient in respiratory acidosis?

A

HA, confusion, drowsiness, increased RR/depth (Kussmaul’s breathing), n/v, vasodilation –> hypotn, cool clammy skin

51
Q

What nursing interventions would you expect to implement for a pt in respiratory acidosis?

A

watch. for respiratory distress, watch elytes/K, neuro status/seizures, if RF –> dialysis; if DKA —> insulin

52
Q

What is the major causative factor of metabolic alkalosis and what are the lab values associated?

A

major causative factor: loss of acid and/or increase in bicarb: hypokalemia, vomiting or NG drainage/sx, increased HCO3 (e.g. from administration), potassium depletion, renal loss of H+ –> diuretics, steroid use
mnemonic: ALKALI
A-aldosterone prod
L- loop diuretics, hydrochlorothiazides
alKali ingestion
A- anticoag citrate –>. metabolized as bicarb (from
blood products, renal replacement therapy)
L- loss of fluids
I- increased sodium. bicarb admin in attempt to correct metabolic acidosis

53
Q

How would a patient with metabolic alkalosis present?

A

tingling in fingers and toes, dizziness, h ypertonic. muscles, depressed respirations (compensatory mechanism)

54
Q

NI. intervetnions of metabolic alkalosis?

A 
TREAT THE CAUSE 
if vomiting. --> antiemetic
stop sux, watch amount
stop diuretics
watch ABGs. 
watch for signs of respiratory distress
55
Q

What are the causes of FVD?

A

isotonic: trauma, diarrhea, vomiting, excess sweat
hypertonic: polyuria, DKA, ESRF, water deprivation
hypotonic: hyponatremia, blood has more water
third spacing
dehydration: increased sodium, LOSS OF WATER ONLY
hypovolemia: loss of water and solutes

56
Q

How will a patient with FVD present?

A

Assessment: hypotensive, increased HR, weak pulse, concentrated urine (USG > 1.030), THIRSTY, flattened neck veins, hemoconcentrations

57
Q

Therapeutic management and pt edu if FVD?

A

I/O should be maintained at or above 30mL/hr
daily weights
Elyte admin, IV fluid

stay hydrated and cool
remind elderly to drink
manage diabetes

58
Q

What are causes of FVE?

A

excess intake, excess Na intake

may be caused by a disease process: RF, CHF, liver failure

59
Q

What are complications of FVE?

A

HTN, increased hydrostatic pressure, b/u of fluid around lungs, hyponatremia

60
Q

How would a pt with FVE present?

A

HTN, increased bounding pulse, peripheral edema, weight gain, crackles, SOB
USG < 1.010, hemodilution

61
Q

Management and education for the patient in FVE?

A

monitor I/O; daily weight
diuretics, restrict NA, fluid, high Fowler’s, compression stockings, dialysis (last resort)

educate patient on compliance, which s/s to report and be aware of

62
Q

Cause of hyponatremia (actual and relative)
Treatment
Assessment

A

ACtual: sweating, wound drainage, low Na diet, diuretics, hypoaldosteronism
Relative: SIADH, water intox, freshwater submersion, hypotonic fluids

SEIZURE PRECAUTIONS
increase NA intake, no free water; stop K wasting diuretics; administer 0.9% NaCl if hypovolemic, or hypertonic saline (3%), osmotic diuretics; replace slowly; avoid volume overload d/t fluid shifts; prevent neuro damage d/t overcorrection

SALT LOSS
S- stupor/coma/ increased ICP
A- anorexia, N/V/D
L- lethargy
T- tendon reflexes decrease
L- limp muscles
O- orthostatic hypotn
S- seizures, HA
S- stomach cramping

IF PT ON LITHIUM WATCH FOR TOXICITY

Na < 135

63
Q

Hypernatremia causes (actual, relative), treatment, assessment, education

A

actual: steroids, oral ingestion, hypertonic saline, Cushing’s
relative: NPO, fever, hyperventilation, dehydration, infection

SEIZURE PRECAUTIONS
decrease levels slowly, hypotonic fluids (o.45% NS, D5W), if hypervolemic Na wasting diuretics, consult dietician

Assessment: FRIED food is salty
F-flushed skin
R- restlessness, irritability
I- increased fluid ret, and increased BP
E- edema: peripheral and pitting
D- decreased urinary output, dry mouth

lethargy, confusion, drowsy, stupor; twitching, decreased DTR, muscle weakness, decreased contractility

Avoid salty foods: bacon, processed foods, lunch meats

Na > 145

64
Q

Causes, treatment, assessment, and education of hypokalemia

A

Cause: Your body DITCHes the K
D- drugs (laxatives, diuretics, corticosteroids
I- inadequate intake
T- too much water intake
C- Cushing’s syndrome increases aldosterone
H- heavy fluid loss via NGSx, V/D, wound drainage

Treatment: treat the cause; eliminate K sparing diuretics, administer K rich foods, cardiac monitor, assess respiratory fx; replace K IV or PO SLOWLY: NO > 10MEQ/L PER HR
NEVER GIVE PUSH OR BOLUS —> CAN BE LETHAL

Assessment: the 7 L's 
L- lethargy, AMS, decreased LOC
L- leg cramps
L- limp muscles
L- low shallow respiration
L- lethal cardiac DR
L- lots of urine
L- low BP and HR
hypoactive BS, N/V, constipation, depressed ST Segment
[EVERYTHING IS LOW AND SLOW W/ HYPOKALEMIA]
pt edu: dietary 
   P- potatoes, pork
   O- oranges
   T- tomatoes
   A- avocados
   S- strawberries
   S- spinach
  f-I-sh
mUshrooms
   M- musk melon
< 3.5
65
Q

Causes, treatment, assessment, pt edu of hyperkalemia

A 
Causes: mnemonic MACHINE
M- medications: K sparing diur., ace-I, NSAIDS
A- acidosis
C- cellular destruction: burns, tissue damage
H- hypoaldosteronism (Addison's) 
 I- intake excessive
N- nephrons (RF)
E- excretion impaired

if acidotic, treat this first
mnemonic for trx: AIRED
A- administer calcium gluconate
I- increase excretion via stool (kayexalate) and urine
R- remove sources of K
E- enhance K uptake into cells: insulin, glucose, sodium
bicarb, beta-adrenergic agonists
D- dialysis, EMERGENT RESPONSE FOR PTS WITH LETHAL HYPERKALEMIA

assessment: excess K can MURDER a pt
M- muscle weakness, paresthesias
U- urine oliguria/anuria
R- respiratory distress/ failure
D- drecreased cardiac contractility 
E- ECG changes: TALL PEAKED T WAVES 
R- reflexes: hyperreflexia/areflexia
hyperactive bowel sounds

> 5

66
Q

Hypocalcemia cause, treatment, assessment, edu

A

Cause: RF, hypoparathyroidism, hyperphosphatemia, malnutrition/malabsorption d/t alcoholism or VIT D def

Trx: muscle relaxants, decreases stimuli, increase nutritional intake (broccoli, coconut milk), replace calcium with Vitam D or aluminum hydroxide to promote absorption

diet high in CA: cheese, collard greens, kale, milk, soy milk, rhubarb, sardines, tofu, yogurt

<8.5

67
Q

hypercalcemia cause, treatment, assessment, edu

A

Cause: hyperparathyroidism, malignancy, vit D tox, excess intake

Trx: IV Fluids (0.9% NaCl), cardiac monitoring, dialysis, monitor for fractures, monitor for flank or abdominal pain
Drugs: Ca+ binders, Ca+ reabsorption inhibitors, phosphorus, calcitonin, bisphosphonates, NSAIDS

Assessment: Groan (constipation), Moans (joint pain), Bones (loss of Ca), Stones (kidney stones) and Psychic Overtones (confusion, depression:)
weakness, decreased DTR, decreased LOC
decreased HR, cyanosis, DVT
decreased peristalsis

> 10.5

68
Q

Hypomanesemia cause, trx, assessment

A

causes: alcoholism, malabsorption, diuretics, RF, diarrhea, hypoparathyroidism

Trx: replace Mg via PO Mg hydroxide, treat cause: d/c diuretics, phosphorus, or aminoglycosides; monitor EKG, DTR

assessment: numbness, tingling, tetany, seizures, increased DTR, psychosis, confusion, decreased GI Motility, constipation, anorexia
PROLONGED QT INTERVAL
Caution: treat this before hypokalemia; K cannot be processed when Mg is low!

Mg rich foods: meats, nuts, legumes, oranges, bananas

<1.5

69
Q

Hypermagnesemia cause, trx, assessment

A

causes: RF, adrenal insuff., Mg trx for exlampsia, overcorrections w/ Mg supp

Trx: monitor CV, respirations, CNS, NM status

Assessment: severe bradycardia, cardiac arrest, vasodilation, hypotension, prolonged PR, wide QRS, drowsy/lethargic/coma, decreased DTR, slow weak muscles - WATCH RESPIRATORY MUSCLES

pt edu: avoid use of laxatives and mg containing antacids

> 2.5

70
Q

What is the purpose of a bronchoscopy?

A

Therapeutic and Dx- removes secretions, foreign object, and/or takes tissue samples

71
Q

What NI are related to bronchoscopy?

A

preprocedure: informed consent, NPO 4-8 hours before procedure, administer pre- procedure meds (propofol), remove dentures and store appropriately

post procedure: NPO until cough reflex returns, monitor VS/resp status, CXR, lab results w/i a week

72
Q

What is the purpose of thoracentesis?

A

procedure to remove excess air or fluid from the pleural space- diagnostic and therapeutic
It is also an invasive procedure, so informed consent must be obtained

73
Q

What is proper patient positioning for thoracentesis?

A

Pt should be upright, leaning on a table. Done from the back where pleural gutter is deepest and NV bundle is closer to the edge of the rib

74
Q

Appropriate nursing interventions for thoracentesis?

A

Pre: Informed consent, pre procedure check and timeout including labs (INR, PTT), confirm correct side, document performing MD, personnel present, premeds administered, positioning; baseline VS including pain; administer pre procedure meds: propofol, lidocaine, low dose xanax

During: walk pt through procedure as things occur to prevent flinching

Post: pressure after needle is WD, then airtight dressing (if not airtight –> pneumothorax –> chest tube); CXR; document: fluid removed, how pt tolerated procedure, characteristics of fluid removed

Monitor: RR and symmetry, for any dyspnea, diminished BS, anxiety/restlessness, tightness in chest, uncontrolled cough, blood tinged or frothy sputum, rapid pulse

75
Q

Symptoms and risk factors of Obstructive Sleep Apnea?

A

snoring, daytime sleepiness, significant report of sleep apnea episodes —> ask spouse

obesity, post-m women, large neck, mail gender

76
Q

NANDA for OSA and upper respiratory tract disorders?

A 
ineffective airway clearance
acute pain
impaired verbal communication
FVD
knowledge deficit r/t prevention, trx, surgical prevention, post-op care
77
Q

Nursing Interventions for upper respiratory tract disorders?

A 
elevate head
ice collar for inflammation
hot packs to reduce congestion
analgesics for pain
gargles for sore throat
use alternative communication if pt struggling
encourage liquids 
soft, bland diet and rest
78
Q

What are the four classification of pneumonia?

A

community acquired
health-care associated
hospital acquired (develops after 48 hours from time of admit)
ventilator associated

79
Q

Risk factors for developing pneumonia?

A 
conditions that cause obstruction, interfere with lung drainage
immunosuppressed
smoking
prolonged immobility
depressed cough reflex, aspiration, dysphagia
NPO, placement of tubes 
supine position
antibiotic therapy in critically ill
alcohol intox
general anesthesia
advanced age
poor infection control practices by HCP
80
Q

Nursing assessment for a pt with suspected pneumonia should include…?

A

VS, POX, ABG
secretions: color, thickness
cough: productive?
tachypnea, SOB
auscultate all lobes, note changes in air exchange or chest excursion
changes in MS: fatigue, edema, dehydration, concomitant HF

81
Q

NANDA for pneumonia?

A 
ineffective airway clearance
activity intolerance
risk for FVD
imbalanced nutrition
knowledge deficit
82
Q

Planning care for pt with pneumonia includes?

A 
improve airway patency
increase activity
maintain proper fluid volume
maintain adequate nutrition
pt edu in trx, prevention
absence of complications
83
Q

NI for pt with pneumonia?

A 
O2 with humidificaiton to loosen secretions
coughing techniques
chest PT
position changes, position to promote drainage by gravity
IS
nutrition, hydration
rest
activity as tolerated
84
Q

What should be considered for successful interventions for pneumonia?

A 
dyspnea not present
SPO2>95
no adventitious BS
clears sputum from airway
reports pain control
verbalizes causal factors
adequate fluid, caloric intake
performs ADLS
85
Q

Diagnostic procedures for pneumonia?

A

CXR, sputum C&S, gram stain, blood cultures, ABG, CBC with diff., BMP/CMP, bronchoscopty

86
Q

Compare/contrast viral and bacterial PNA

A

Viral: nonproductive cough, low grade fever, normal/low WBC, no consolidation, minimal change to XR, less severe, no antib

Bacterial: productive cough, higher fever, elevated WBC, consolidation, infiltrates on XR, more severe, trx antibiotics

87
Q

Classification of lung cancer?

A

small cell

non small cell: squamous cell carcinoma, large cell carcinoma, adenocarcinoma, bronchalveolar carcinoma

88
Q

lung CA RF?

A

tobacco smoke, secondhand smoke, environmental and occupation exposure, male gender, dietary deficits, respiratory disease: COPD, TB

89
Q

CM of lung CA?

A

cough/change in chronic cough– OFTEN THE FIRST SIGN
dyspnea, hemoptysis, chest or shoulder pain, recurring fever, repeated and or unresolved URI, weakness, anorexia, weight loss

90
Q

DX of lung CA?

A

CXR, chest CT, bronchoscopy, fine needle biopsy, scans for metastasis: PET, MRI, bone scan, liver ultrasound

91
Q

nursing management of lung CA?

A 
post op care
manage symptoms
relieve breathing problems
decrease fatigue
provide psych support

Adult Health (1 decks)

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