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CHRONIC > Exam 2 > Flashcards

Exam 2 Flashcards

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1
Q

What symptoms raise a red flag for Tuberculosis?

A

Night sweats, unexpected weight loss, etc
Initially - a dry productive cough

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2
Q

How do you tell if a mantoux test is positive?

A

You palpate to feel for an induration.

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3
Q

In a regular low risk patient, how many mm of induration indicates a positive Mantoux test?

A

15mm or greater

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4
Q

If a client is a diabetic, immigrant, has end stage renal disease or an IV drug user (all high risk), how many mm of induration is considered a positive mantoux test?

A

10mm or greater

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5
Q

5mm or greater induration means a positive Mantoux test for what clients?

A

Immunocompromised people

  • with HIV, recent contact with TB, TAKING PREDNISONE 15mg/day
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6
Q

What is the best way to confirm a diagnosis of TB?

A

Sputum sample
- looking for acid fast bacillus in the sputum

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7
Q

In starting treatment for TB, what does a patient need to be aware of before starting treatment?

A

Patients need to know that TB treatment is LENGTHY.

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8
Q

In the initial phase of TB treatment, rifampin is one of the meds used. What should a client be aware of while taking this med?

A

red-orange discoloration of bodily fluids

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9
Q

The history part of TB assessment is important because if a patient has received the BCG vaccine, they can test positive for TB

True
False

A

TRUE
- BCG can result in a false positive for TB

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10
Q

If a client is suspected or currently has TB, what precautions are they on?

A

Airborne Precautions
- single, negative air pressure room with 6-12 air exchanges/hr
- nurses must wear N95 masks

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11
Q

A client suspected of TB wants to go use the restroom, what mask should he wear?

A

The patient can wear a regular SURGICAL FACE MASK

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12
Q

What are the risk factors for Tuberculosis?

A
  • poor underserved minorities
  • homeless
  • foreign-born persons
  • living/working in institutions
  • IV injection drug users
  • immunosuppression
  • overcrowded living
  • poverty, poor access to healthcare
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13
Q

What are some nursing management methods for a patient with TB?

A

clients may go home if cultures positive
- teach patient how to minimize exposure to others
- notify public health department (public health nurse follow up)
- educate patient to take meds
- smoking cessation

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14
Q

What are the most common symptoms of pneumonia?

A
  • productive or nonproductive cough
  • yellow, green or rust-colored sputum
  • fever, chills
  • dyspnea, tachypnea
  • pleuritic chest pain
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15
Q

In elderly patients that come in with an onset of confusion, what are our usual suspects?

A

UTI, Pneumonia, Hypoxia

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16
Q

What is a common symptom that can be seen in elderly patients with pneumonia?

A

Confusion or stupor, hypothermia

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17
Q

Pleural effusion is a complication in elderly patients with pneumonia. In this percussion, what is expected?

A

Dullness to percussion
- no breath sounds (due to fluid)

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18
Q

Atelectasis is the collapse of lungs (alveoli) which inhibits gas exchange. What are some interventions that can be done to prevent this?

A
  • incentive spirometry
  • early ambulation
  • Turn, cough and deep breathe
    same teachings for pneumonia or post op patients in pain,etc
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19
Q

This procedure is used to remove fluid from pleural effusion…

A

Thoracentesis
- if no improvement is seen, report to provider

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20
Q

What are some elderly complications of pneumonia?

A
  • pleural effusion
  • atelectasis
  • sepsis
    PAS
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21
Q

This test is ideally done before antibiotics are started for a client with pneumonia…

Study These Flashcards
A

Culture and Sensitivity test
sometimes a broad-spectrum antibiotic is administered

22
Q

Response to treatment for pneumonia is usually seen within…

Study These Flashcards
A

2-3 days
-decreased temp and chest discomfort
-improved breathing

23
Q

What is the usual inpatient med used to treat pneumonia?

Study These Flashcards
A

Vancomycin, floxacin

24
Q

What is an ADR of the pneumonia treatment floxacin (a fluroquinolone)?

Study These Flashcards
A

Achilles Tendon Rupture

25
Nursing interventions for patients with pneumonia include…
- administer prescribed antibiotics first (for infection) - auscultate breath sounds - monitor for symptoms of hypoxemia - position at semi-fowlers, HOB elevated - monitor ability to cough effectively - pulse ox should be 90% or greater
26
What does it look like when a patient with pneumonia is improving?
- effective RR, rhythm and depth - clear lung sounds - absence of infection
27
What are common things seen in a client with COPD?
- barrel chest - tripod position - pursed-lip breathing - weight loss or anorexia - prolonged expiratory phase - fatigue, etc
28
What are potential complications in clients with COPD?
- cor pulmonae (right-sided heart failure) - pulmonary hypertension
29
Spirometry confirms diagnosis of COPD. What other tests are used?
- chest xray -pulse ox <88% at rest - serum antitrypsin levels
30
Treatment for COPD includes…
- bronchodilators like albuterol or ipratropium for acute symptoms - LABA like salmeterol or formoterol or an anticholinergic like tiotropium are used for long term management - keep o2 sat above 90% -humidification/nebulization for dryness
31
Since COPD can cause weight loss due to energy being exerted while eating, what are some interventions to help with that?
- rest at least 30 minutes before eating - avoid exercise for 1 hr before and after eating - used bronchodilator before meals - encourage high calorie, high protein meals - eat 5 to 6 small meals and water BETWEEN meals - avoid foods that require a lot of chewing and fart forming foods
32
What are activity considerations for clients with COPD?
- walk 15 to 20 minutes 3 times a week - modify ADLs to conserve energy
33
What are the symptom relief methods for a client with sinusitis?
-decongestants like pseudoephedrine - corticosteroids like fluticasone - saline spray - antibiotics if worse symptoms or lasts greater than 1 week
34
What are some patient education for patients with sinusitis?
Rest, hydration, warm compresses, no smoking, take meds as prescribed, reduce exposure to allergens
35
Can a client with an egg allergy take the flu vaccine? If not, what can they use instead?
NO!!! A client with an egg allergy CANNOT take the flu vaccine. - they can take a nasal spray instead*
36
What are some asthma triggers?
- cockroaches - pet dander (hair) - pollen - smoke - weather - exercise - mold - strong smells - beta blockers (metoprolol,etc) can cause brochospasms also ace inhibitors, etc
37
A peak flow meter or PEFR is commonly used as a test for…
Asthma
38
Wheezing is the most common symptom of an acute asthma attack. Does that mean the disease is severe?
NO! The client is still moving air. - if they stop wheezing, that indicates a more severe problem
39
This IV corticosteroid is usually used for clients with asthma….
Hydrocortisone
40
This leukotriene modifier can be used for patients with asthma….
Montelukast
41
Montelukast is a medication that can be given to asthma patients. What are some important things to know about this medication?
- ADR can be suicidal ideations, depression - given 2 hrs before activity - usually taken once a day
42
The asthma action plan consists of a red, yellow and green zone. What is the peak flow of a client in the yellow zone?
50% - 79%
43
How do you administer an inhaler?
- I how deeply then exhale completely - place lips firmly around mouthpiece - breathe in deeply over 2-3 seconds while pushing down on the canister - hold breath for 10 seconds - exhale slowly through pursed lips *wait 6 seconds between each puff
44
What is status asthmaticus?
A severe life threatening asthma attack that does not respond to standard treatments.
45
Intubation is a possible intervention for a client experiencing…
Status Asthmaticus
46
Rifampin is a med used to treat TB. What organ is this med hard on?
Rifampin is hard on the LIVER - so check liver function tests!!!!
47
What is the general time frame for TB meds treatment??
6-9 months
48
What are our droplet precautions?
- PPE like mask - private room if possible - hand hygiene - client should sneeze or cough into sleeve, etc
49
How do you educate a client on pursed lip breathing?
- relax neck and shoulders - take a deep breath slowly through nostrils - exhale slowly through pursed lips
50
What do you do if a client starts to experience a rash, chills etc when on an IV?
STOP IV!!!

CHRONIC (8 decks)

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