Exam 2 - Respiratory Alterations

Question 1

most common reason for seeking healthcare

Answer 1

URI

Question 2

where are URI treated?

Answer 2

community settings, doctors offices, long-term care facilities, self-care at home

Question 3

goal when working within the community for URI

Answer 3

education - hygiene, meds, adverse effects

Question 4

URI pt teaching

Answer 4

prevention

health promotion

Question 5

inflammation of the paranasal sinus and nasal cavities

Answer 5

URI / Rhinosinusitis

Question 6

cause of Rinosinusitis

Answer 6

alleriges
viral
bacterial

streptococcus pNA
haemophilus influenza

Question 7

acute rhinosinusitis last how long

Answer 7

< 4 weeks

Question 8

subacute rhinosinusitis last how long

Answer 8

4-12 weeks

Question 9

chronic rhinosinusitis last how long

Answer 9

> 12 weeks

Question 10

s/sx of viral and bacterial rhinosinusitis

Answer 10

HA
cough
hoarseness
fever
stuffiness
generalized discomfort/fatigue

Question 11

viral and bacterial rhinosinusitis diagnostics

Answer 11

physical exam

XR, CT, MRI

Question 12

viral sinusitis usually follows ___

Answer 12

URI

Question 13

how long does it for viral sinusitis to resolve on its own

Answer 13

14 days

Question 14

what additional s/sx is present with bacterial rhinosinusitis

Answer 14

blood tinged - purulent sputum
worse after 3-5 days
fever 39C/102F
s/sx > 10 days

must tx with abx

Question 15

rhinosinusitis interventions

Answer 15

elevate head
ice collar to reduce inflammation
hot packs to reduce congestion
warm shower
analgesics
gargles for sore throat
2-3L liquid daily
soft, bland diet
rest

Question 16

how long should you use decongestants?

Answer 16

no more than 3-5 days

Question 17

rhinosinusitis med group symptom relief

Answer 17

analgesics
antipyretics
nasal corticosteriods
saline nasal spray
antihistamines

bacterial: abx therapy 2-4 weeks, up to 12 weeks; PCN, cephalosporins, fluroquinolines

Question 18

how to prevent rhinosinusitis

Answer 18

hand hygiene

flu vaccine

Question 19

what occurs with obstructive sleep apnea (OSA)?

Answer 19

uvula blocks the airway

Question 20

mild apnea

Answer 20

5-10 per hour

Question 21

severe apnea

Answer 21

15-30 per hour

Question 22

apnea periods

Answer 22

10-90 seconds

Question 23

3 S’s of OSA

Answer 23

sleepiness (daytime)
snoring
significant other - reports

Question 24

OSA risk factors

Answer 24

obesity
neck size > 17"
male
> 65 y/o
post menopausal
high PPD hx

Question 25

OSA hypoxia and hypercapnia s/sx

Answer 25

``` sleep disturbances early morning HA irritability HTN dysrhythmias ```

Question 26

how to dx OSA

Answer 26

sleep studies PSG Stop Bang quiestionnaire

Question 27

OSA treatment/management

Answer 27

lose weight side lying, HOB elevated CPAP BiPAP

Question 28

caution which meds with OSA

Answer 28

benzo | opiates

Question 29

what is CPAP

Answer 29

continuous positive airway pressure

Question 30

what is BiPAP

Answer 30

bilevel positive airway pressure

Question 31

surgical management of OSA

Answer 31

ablation

Question 32

CPAP, BiPAP education

Answer 32

how to use | keeping the device clean

Question 33

Four serotypes to the flu

Answer 33

A - can also effect animals B - Avian (H5N1) Bird C - Swine (H1N1) Pig, GI complication D

Question 34

Flu precautions

Answer 34

droplet, contact

Question 35

flu incubation period

Answer 35

1-4 days

Question 36

when are you most contagious with the flu

Answer 36

1 day before symptoms occur

Question 37

contraindications to the INACTIVE (?) flu shot

Answer 37

``` previous vaccine rxn allergy to eggs, chicken pregnancy hx Guillian Barre < 2, > 50 y/o immunocompromised chronic illness HCP, caregivers of those with severe health problems ```

Question 38

s/sx of flu

Answer 38

``` abrupt fever 102-104 chills, aches HA sore throat cough fever fatigue, exhaustion ```

Question 39

gold standard test for the flu

Answer 39

throat culture can take 7-10 days for results

Question 40

most convenient flu test

Answer 40

rapid takes 30 minutes; occasional false positive or miss

Question 41

how is the live attenuated flu vaccine administered

Answer 41

nasal spray

Question 42

age range for nasal spray

Answer 42

healthy ages 2-49 no as effective in older adults

Question 43

how to administer inactivated vaccine

Answer 43

IM - deltoid in all individuals 6 months and older

Question 44

individuals who must have the flu shot

Answer 44

``` > 65 y/o caregivers of infants < 6 months old; immunocompromised cancer pts heart disease, stroke DM HIV/Aids children with neuro deficits HCP ```

Question 45

complications from the flu

Answer 45

``` secondary infection PNA bronchitis/ear infection hospitalization death ```

Question 46

PNA vaccine prevents ___ PNA

Answer 46

bacterial

Question 47

viral PNA is best prevented by the ___ vaccine

Answer 47

flu

Question 48

care of the flu

Answer 48

rest; stay home 34 hours until fever is gone wash hands antipyretics

Question 49

anyone less than __ y/o should not receive salicylates including pepto d/t possibility of ___ ___

Answer 49

18; Ryes syndrome

Question 50

What can help reduce severity and duration of the flu if administered within 24 hours?

Answer 50

zinc

Question 51

zinc nursing considerations

Answer 51

``` intranasal = loss of smell lozenges = bad taste, nausea oral = caffeine, dairy reduce absorption ```

Question 52

how long to be on droplet precaution for the flu?

Answer 52

7 days or 24 hours after fever has resolved