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NUR-210 > Exam 3 > Flashcards

Exam 3 Flashcards

(104 cards)

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1
Q

What is ventilation

A
  • inflow & outflow of air from the aveoli
  • chest wall movement
  • work of breathing
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2
Q

What drug is an example of oral steroid therapy?

A

Cortisone

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3
Q

what are the general uses of oral steroid therapies like cortisone?

A

Rheumatoid Arthritis
systemic lupus erythematosus
inflammatory bowel disease
allergies
prevention of allograft rejection

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4
Q

What is compliance referring to ineffective airway slearance

A
  • ability to expand bronchioles & let air in
  • ability to expand alveoli & bronchioles
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5
Q

Primary - anti-inflammatory uses for cortisone?

A

Immunosuppressive actions
sodium retention
potassium loss

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6
Q

Cortisone- Adverse Effects

A

-adrenal insufficiency
-osteoporosis
- infections
- diabetes
-muscle wasting
-cushing’s syndrome
-fluid retention
-growth retardation
-mood swings
-cataracts/glaucoma
-peptics ulcers
-hypokalemia

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7
Q

Nursing interventions for cortisone Adverse effects

A

-monitor K+ levels, blood sugars, fluid retention, osteoporosis,
gastric ulcers, infection
-nursing actions- increase k+ intake, prevent infection, increase calcium intake
- teaching- DO NOT STOP ABRUPTLY, inform ab mood swings, take with food, no NSAIDS, may need to increase dose during times of increased physiological stress

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8
Q

What factors affect compliance?

A
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9
Q

What factors affect ventilation

A
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10
Q

What is diffusion

A

movement of gases from GREATER pressure to DECREASED pressure

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11
Q

What factors affect diffusion

A
  • decreased surface area
  • thickness of alveoli membrane
  • perfusion to the alveoli
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12
Q

What is a methylxanthine?

A

bronchodilator that relaxes smooth muscle of bronchi

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13
Q

Describe transportation of Co2 & Co2

A

O2 combines w/ hemoglobin & carried to the tissue

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14
Q

What factors affect transportation of O2 & Co2

A
  • decreased cardiac output
  • decreased hemoglobin
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15
Q

What are you looking for when you are assessing respiratory status

A

chest wall expansion, breathing pattern & lung sounds

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16
Q

Considerations for methylxanthine administration

A

remember caffeine is in this category (their cousin)
-not administered by inhalation, not active via this route
- theophylline: oral
-aminophylline: IV

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17
Q

Symptoms of acute hypoxia

A

vital sign changes

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18
Q

What is total lung volume

A

volume of air the lungs can move

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19
Q

What is total lung capacity

A

how much more air you can get in if you try

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20
Q

what is the narrow TI (therapeutic index) and toxicity of methylxanthines?

A

don’t give very often due to narrow TI

NTI: plasma level 10-20mcg/ml, as low as 5 mcg/ml
toxicity: above 30 mcg can have arrhythmias& seizures

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21
Q

What is an xray looking for

A
  • fluid in chest
  • mass
  • broken ribs
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22
Q

What is normal body flora?

A

bacteria inhibit healthy humans- bowel, upper respiratory, skin, vaginal vault

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23
Q

What are the lung scans?

A

CT, VT - airflow & blood flow in lungs

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24
Q

What is a lung scan looking for

A

embolism

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25
What is and endoscopy
- pt sedated - scope down trachea w/ camera - diagnostic or therapeutic
26
What is thoracentesis
removal of fluid in pleural space
27
What are ABGs (arterial blood gases) drawn for
to see how much oxygen & carbon are in the lungs
28
What are Sputum Specimens
- collected in AM - before eating - looking for bacteria causing the issue to see if theres an infection - can do sensitivity - which antibiotics to give pt - hard to obtain
29
What is the expected range of pulse oximentry
95-100%
30
What is an acceptable level of pulse oximetry
91-100%
31
What affects a pulse ox reading
- temp of pt - nail polish - poor perfusion to extremities
32
If pulse ox is below 91& what interventions should the nurse do
- check the pt - check the sensor
33
Nursing interventions for Respiratory System
- monitor & check S&S of hypoxia - check lung sounds - do diagnostic tests - check breathing pattern
34
what are the lines of defense against infection?
- individual immunity - nutrition - anatomical - biochemical - mechanical - immune system status
35
What is white blood cell function in infections?
WBC (leukocyte) = 6,000-9,000 neutrophils: first acute infections within 24hr eosinophils: allergies basophils: healing Lymphocytes: late (weeks) Monocytes: chronic (months)
36
What is the local reaction for an inflammatory (itis) reaction?
redness& warmth, edema, pain
37
What percentage is an emergency for pulse ox
below 86%
38
What percentage is life threatening for pulse ox
below 80%
39
Nursing actions for the Respiratory System
- airway maintenance : open airway - positioning pt: ambulate, elevate HOB
40
What pt teaching would you do to a patient who has decreased breathing pattern/lung sounds
- stop smoking - do breathing exercises - increased effective cough - med usage
41
What are the major causes of airway obstruction
- bronchial smooth muscle contraction - mucous hypersecretion - inflammation - infection
42
Meds that improve respiratory function
- antibiotics to treat bacterial infections - bronchodilators - glucocorticoid steroids
43
Bronchodilators: Beta-2 agonists
Route: metered dosed inhaler (MDI), nebulizer MOA: - dilate the bronchi for increased airflow "RELIVERS" - short acting beta agonists (SABA): albuterol (Ventolin) "CONTROLLERS" - long acting beta agonists (LABA): salmeterol (Serevent) Think B for BUTEROL for Brutal asthma attack ADR: 3 T's tachycardia, tremor, tossing & turning
44
Glucocorticoids routes
oral, IV, inhaled
45
Inhaled Glucocorticoids
MOA: - suppress bronchial inflammatory response - decrease airway mucus production ADR: - oropharyngeal candidiasis - dysphonia (hoarseness)
46
Patient education for inhaled glucocorticoids
- gargle after EACH admin - use a spacer - calcium supplement
47
Spacer Device Impact on Inhaled Med
WITH spacer 57% inhaler device 22% mouth & throat 21% lungs WithOUT spacer 10% inhaler device 81% mouth & throat 9% lungs
48
Define diffusion
exchange of oxygen & carbon dioxide from alveoli & RBC in the blood
49
Define perfusion
exchange of oxygen & carbon dioxide between RBC & tissues
50
What are the top 5 causes of antibiotic treatment failure
1. wrong diagnosis 2. resistance of pathogens 3. defective immune system of host 4. wrong dose or dosing interval (dose not high enough or interval not long enough) 5. interference of antibiotic absorption
51
-itis means
inflammation
52
LOCAL inflammatory reaction S&S
- redness - warmth - edema - pain
53
SYSTEMIC inflammatory reaction
- leukocytosis - general malaise & fatigue - fever - confusion especially in older adults - enlarged lymph nodes
54
What are health care associated infections caused by?
- invasive provedures - antibiotic admin - exposure to mutidrug resistant organisms - failure to adhere to infection - prevention control activities
55
What were health care associated infections previously called
- nosocomial or health care acquired infections
56
How do you select antibiotics
- identify the organism - drug sensitivity of organism - host factors - allergy - penetration to site of infection
57
General Principles of Antibiotic Therapy
- obtain cultures before starting antibiotic - given at regular intervals - continue even when symptoms subside
58
Nursing Interventions for Antibiotic Therapy
- monitor for allergic reactions - monitor renal funtion - observe for superainfection - check for oral contraception use
59
Types of penicillin allergy
- immediate: will occur in 2-30 mins - accelerated: will occur in 1-72 hrs - late: will occur in days or weeks
60
Treatment for a Penicillin allergy
- stop the med - respiratory support Meds: epinephrine & antihistamines
61
MOA Peni"cillins"
- bactericidal - weaken cell wall - prone to bacterial resistance
62
MOA Cephalosporins (CEF-)
- Beta-lactam antibiotics/bactericidal - similar to penicillin structure - grouped in 4 generations
63
ADRs for Cephalosporin
- allergy - bleeding - thrombophlebitis
64
MOA Tetracyclines (-cyclines_
- BROAD spectrum antibiotic - bacterialstatic
65
Absorption elements for Tetracyclines
- calcium - iron - magnesium - aluminum - zinc
66
ADRs for Tetracyclines
- photosensitivity - stained teeth - contradicted in pregnant women & children less than 8 yrs old
67
MOA Macrolides
- BROAD spectrum antibiotic - use if allergic to penicillin
68
ADRs for Macrolides
- erythromycin - GI - CYP3!4: liver injury
69
MOA Aminoglycosides (mycin)
- NARROW spectrum antibiotic - bactericidal
70
Whats the typical use for Aminoglysides
- aerobic gram-negative bacilli
71
ADRs for Aminoglycosides
- nephrotoxicity - ototoxicity
72
MOA Sulfonamides & Trimethoprim (Bactrim)
- BROAD spectrum antibiotic - suppress bacterial growth - inhibiting of folic acid
73
Whats the typical use for Sulfonamides & Trimethoprim (Bactrim)
- UTIs caused by E.Coli - community acquired MRSA (CA-MRSA)
74
ADRs for Sulfonamides & Trimethoprim (Bactrim)
- hypersensitivity reactions - blood dycrasias - rash
75
What will you monitor with aminoglycosides (-mycin)
- blood levels (peak & trough)
76
Types of Aminoglycosides
- genta micin (Garamycin) - tobra mycin (Nebcin) - netil micin ( Netromycin) - neo mycin - kana mycin (Kantrex) - strepto mycin
77
Classification of Cephalosporins
1st Gen: Gram + - CEFazolin (aNcef) 2nd Gen: Gram +/- - CEFacllor (Ceclor) 3rd Gen: Gram -/+ CEFoperazone (Cefobid) 4th Gen: Gram + - CEFepine (Maxipime)
78
Antibiotics treat what
bacterial infections
79
Asthma appears when
it is triggered by an allergen
80
What med is for a chronic condition & whats the time it takes for it to take effect
- long acting beta agonists (LABA) 30-60 mins
81
What med is for acute condition & whats the time it takes to take effect
short acting beat agonists (SABA) 15 mins
82
What other med should ppl take if they are prescribed a glucocorticoid
calcium since it promotes bone loss
83
Why should a spacer be used
more med can reach your lungs instead of your mouth
84
Why no NSAIDs if someone is on a steroid
b/c it increases gastric irritation
85
What is normal body flora
probiotic health bacteria
86
What kills normal body flora (good bacteria)
antibiotics
87
What should you take if you take an antibiotic
probiotic or something like yogurt
88
Whats a microorganism
microorganism that can cause a disease
89
What cell is part of a CBC
leukocytes
90
If you have LESS than 6,000 WBC you have
leukopenia
91
If you have MORE than 9,000 WBC you have
leukocytosis
92
What do monocytes do
clean the site
93
What factors increased your changes of being a compromised host
- medical conditions: HIV, cancer, AIDS, - stress: cortisol levels increase...so does glucose - age - heredity - nutritional deficiencies
94
What do you do when a pt has an infection
targeting the pathogens getting a culture
95
Nursing Interventions for infections
-Monitor - LOC - decreased immune response - increase
96
Define bacteriocidal
- kill/destroy bacteria - lisis of the cell wall menbrane
97
Define bacteriostatic
limits growth of bacteria & body does the rest (growth suppression)
98
Define narrow spectrum antibiotic
affects SINGLE bacteria
99
Define specific spectrum antibiotic
affects VARIETY of bacteria
100
What differentiates gram + from gram -
gram - has an extra membrane meaning its harder to kill
101
How long should be extra careful with conception use while on antibiotics
- while on the antibiotic - 7 consecutive days after med has been finished
102
Which generation of Cephalosporins can reach CSF
4th generation
103
As you go further down in generations of Cephalosporins...
the less effective they are with gram+
104
What med should you not mix with penicillin
aminoglycosides

NUR-210 (5 decks)

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