Exam 4 Flashcards
(151 cards)
1
Q
nasal congestion, runny nose, sneezing, sore throat, h/a, general malaise are symptoms of what?
additional symptoms include bad breath, watery eyes, cough, muscle aches lasting 1-2 weeks.
A
rhinitis & viral rhinitis
2
Q
how to manage rhinitis & viral rhinitis
A
rest, hydrate, warm salt water gargles, NSAIDs like aspirin or ibuprofen for pain relief
antihistamines to help w/ sneezing, congestion while expectorants like guaifenesin helps w/ learning secretions
caution w/ nasal decongestants to avoid rebound rhinitis
**antbx are not executive agents viruses
can also use alternative remedies like echinacea & zinc but limited evidence
3
Q
how to prevent rhinitis & viral rhinitis
A
educate pt on proper hand hygiene
avoid allergens
get your annual flu vaccine in high risk populations
4
Q
purulent nasal discharge, facial pain/pressure/fullness, and possibly high fever persisting over 10 days are s/s of what?
A
s/s of acute bacterial rhinosinusitis
4
Q
how to manage viral rhinosinusitis
A
focus on symptom relief w/ nasal salve lavage, decongestants, pain relievers like acetaminophen or NSAIDs
topical decongestants like oxymetazoline (Afrin) up to 3-4 days
intranasal corticosteroids to help improve s/s in pts w/ hx of allergic rhinitis
5
Q
how to manage bacterial rhinosinusitis
A
antbx like amoxicillin or amoxicillin-clavulanic acid are first line choices
nasal saline lavage & decongestants help alleviate symptoms
intranasal corticosteroids may be used for allergic rhinitis or nasal polyps
6
Q
how to prevent rhinosinusitis
A
educate on hand hygiene & respiratory etiquette to prevent viral infections
avoid exposure to environmental hazards
**immunocompromised individuals should follow strict preventative measures
7
Q
sudden onset of symptoms such as sore throat, fever, swollen tonsils w/ exudate, enlarged tender lymph nodes, malaise are s/s of what?
A
s/s of acute pharyngitis
8
Q
how to manage acute pharyngitis
A
supportive care including rest & pain relief.
antbx may be prescribed for bacterial infections
9
Q
how to prevent acute pharyngitis
A
good hang hygiene, avoid close contact w/ sick individuals, maintain healthy lifestyle
10
Q
persistent inflammation of the throat, often accompanied by symptoms like persistent sensation of a lump in throat, chronic cough, hoarseness are symptoms of what?
A
s/s of chronic pharyngitis
11
Q
how to manage chronic pharyngitis
A
find underlying cause such as allergies, GERD, smoking cessation
symptomatic relief w/ analgesics & throat lozenges may also be recommend
12
Q
how to prevent chronic pharyngitis
A
focus on managing underlying conditions & avoid irritants like smoking or environmental pollutants.
encourage regular medical check ups for early detection & treatment of potential causes
13
Q
severe sore throat, fever, difficulty opening mouth (trismus), drooling
painful swallowing, bad breath, ear pain, swollen lymph nodes
in an emergency, airway obstruction can occur, leading to life threatening complications….
these are s/s of what?
A
s/s of peritonsillar abscess
14
Q
how to manage peritonsillar abscess
A
early antbx treatment (ex penicillin) to control infection
if abscess persists, needle aspiration or incision/drainage may be needed
hospitalization for severe cases; immediate airway management if necessary
15
Q
how to prevent peritonsillar abscess
A
assist w/ airway procedures, administer meds, provide comfort
educate on self care, hand hygiene, completion of treatment
monitor for complications & provide support
16
Q
hoarseness, cough, sore throat, & tickle sensation in throat are s/s of what?
acute this is worsened by cold air or liquids
chronic this is persistent hoarseness
A
s/s of laryngitis
17
Q
how to manage laryngitis (usually viral)
A
rest voice, avoid irritant like smoking, & use of meds (corticosteroids)
antbx for bacterial infections; proton pump inhibitors for reflux related cases
instruct on voice rest, humidified environment, and med use
monitor for complications/provide support
18
Q
how to prevent laryngitis
A
maintain vocal hygiene, avoid irritants, stay hydrated
educate on hand hygiene to prevent transmission is essential
FU care ensures proper evaluation & treatment of complications
18
Q
s/s of epistaxis
A
bleeding from nose, commonly originating from anterior septum
pts may experience anxiety due to blood loss and discomfort during examination & treatment
19
Q
how to manage epistaxis
A
initial treatment involves applying direct pressure & having the pt sit upright w/ head tilted forward to prevent aspiration
vasoconstrictors may be used, cauterization or packing w/ gauze of balloon catheters may be necessary if bleeding persists
nursing care includes vital signs, bleeding control, pt reassurance
20
Q
how to prevent epistaxis
A
avoid nasal trauma (nose blowing, picking, exposure to dry air)
pts advised to avoid hot or spicy foods, tobacco use, illicit drugs that may increase bleeding
adequate humidification of nasal passages can help prevent drying & subsequent bleeding
21
Q
risk factors for epistaxis
A
- Local infections (vestibulitis, rhinitis, rhinosinusitis)
- Systemic infections (scarlet fever, malaria)
- Drying of nasal mucous membranes
- Nasal inhalation of corticosteroids (e.g., beclomethasone) or illicit drugs (e.g., cocaine)
- Trauma (digital trauma, blunt trauma, fracture, forceful nose blowing)
- Arteriosclerosis
- Hypertension
- Tumor (sinus or nasopharynx)
- Thrombocytopenia
- Use of aspirin
- Liver disease
- Rendu-sler-Weber syndrome (hereditary hemorrhagic telangiectasia)
21
Q
this is used for early stage glottic area cancer involving one vocal cord
high cure rate w/ removal of portion of larynx & tumor
airway remains intact, swallowing typically not affected
voice quality may change, pt may sound hoarse
A
partial laryngectomy
22
this is used for curative for advanced laryngeal cancers or recurrence after radiation
removal of laryngeal structures, requires permanent tracheostomy
permanent loss of voice, swallowing typically normal
complications include salivary leak, infection, stomal stenosis, dysphagia
voice preservation possible w/ near total laryngectomy & post op therapy
total laryngectomy
23
who is at risk for atelectasis
- Those post-thoracic or upper abdominal surgeries.
- Immobilized pts w/ shallow breathing patterns.
- Pts with chronic airway obstruction, such as lung cancer.
- pts w/ conditions causing increased abdominal pressure.
- pts w/ altered breathing patterns.
- Pts experiencing pain.
- pts w/ retained secretions.
- pts w/ neurologic disorders impairing cough reflex.
24
how to prevent atelectasis
-frequent position changes
-encourage early mobility to enhance lung expansion & prevent secretion buildup
-educate to deep breathe / cough
25
how to manage atelectasis
-administer opioids / sedatives carefully to prevent respiratory depression
-suction / use nebulizer treatments to maintain airway pateny
-surgery for chronic atelectasis
-PEEP (positive end-expiratory pressure) or bronchoscopy for unresponsive cases
-treat bronchial obstruction or lung compression through procedures like bronchoscopy or chest tube insertion
26
nursing care for pt w/ endotracheal tube
-monitor vitals / resp status frequently
-use suctioning for secretions
place pt in swim-fowler's position to aid ventilation, drainage, prevent strain on suture lines
-administer analgesics / sedatives cautiously due to risk of suppressing cough reflex
-provide communication like paper/pencil at all times
-educate about self care/infection prevention.. provide list of community contacts for support
-ensure suction/equipment are available at all times at home
-refer for ongoing assessment of pt and family ability to manage care
27
principles of chest drainage (neg pressure maintenance)
chest drainage systems maintains neg pressure within pleural space, allowing lung to re-expand.
neg pressure is crucial for proper lung function
28
principles of chest drainage: fluid & air removal
system removes excess fluid, air, blood from plural space, preventing complication such as pneumothorax or compromised cardiopulmonary function
29
principles of chest drainage: prevention or re-entry of air
mechanisms w/ chest drainage system prevents air from re-entering the chest cavity during inspiration, ensuring effective lung expansion
30
nursing responsibilities for chest tube
-assess vitals before and after insertion
-monitor drainage (should be less than 70/hr)
assess pt's respiratory status
-inspect insertion site for infection
-look for air leaks such as continuous bubbling
-keep system below level of chest
31
what to do if chest tube gets disconnected from drainage system
place open end of tube in bottle of sterile water to establish temporary water seal to prevent pneumothorax
notify provider immediately
32
sudden chest pain, dyspnea, tachypnea, decreased breath sounds on affected side, tracheal deviation, cyanosis, hypotension, tachycardia
s/s of pneumothorax
33
signs of shock (hypotension, tachycardia), decreased breath sounds on affected side, dullness to percussion, respiratory distress
s/s of hemothorax
34
this is paradoxical chest wall movement, severe pain exacerbated by breathing, tachypnea, respiratory distress, cyanosis (2 or more ribs side by side are broken)
what is this and what to do for it
Flail chest (complication of blunt trauma)
need to provide vent support, possible intubation / mechanical ventilation needed ... manage pain... monitor resp status for resp failure
35
this is why pt has decreased breath sounds, tachypnea, chest pain, hypoxemia, cough w/ blood tinged sputum, respiratory distress
what is this and what to do for it
pulmonary contusion
administer oxygen...
assist w/ bronchoscopy or other procedures to remove secretions...
monitor resp status for resp failure
35
this is beck's triad (hypotension, distended neck veins, muffled heart sounds), dyspnea, tachycardia, pulsus paradoxus
what is this & what to do for it
cardiac tamponade
monitor vitals, assist w/ pericardiocentesis or other procedure to drain fluid from pericardial sac...administer fluid resuscitation & vasopressors
36
this pt has palpable crepitus under the skin, swelling of the face, neck, chest, or scrotum (feels like rice crispies!)
what is this & what to do for it
subcutaneous emphysema
monitor for signs of airway compromise
provide reassurance to pt & fam about benign nature
in severe cases, colab w/ healthcare team for interventions like a tracheostomy
37
how to manage a pt on a vent
suction q 2-4hrs prn
administer prescribed meds, reassess pain & sedation level q1-2 hrs
assess lung sounds & resp effort q 4 hrs or prn
oral care q 2 hrs, check for VAP signs
reposition q 2 hrs
passive ROM
communicate thought alt methods like writing, gestures, comm boards
38
what to do w/ a pt who has ARDS
they will be intubated... use PEEP (positive end expiratory pressure) to help recruit collapsed alveoli & improve oxygen
adjust PEEP levels to optimize oxygenation without compromising hemodynamics
39
what do you have to do w/ a pt w/ ARDS
& what position to put them in
intubate, sedate, & paralyze!
***pt should be in prone position!!! it redistributes lung ventilation improving oxygenation
for 12-16 hrs daily
40
how to diagnose PNA
chest x ray, blood bulture, sputum culture
41
nursing interventions for PNA
give antbx
provide oxygen
sit upright, tripod position
DBC
hydrate
vitals / resp assess
42
care of pt after thoracotomy (incision between ribs to assess thoracic / lungs in plural space)
-assess blood gases for signs of hypoxemia or CO2 retention
-evaluate pt's color for cyanosis
-vitals q 2-4 hrs
-elevate HOD 30 to 40 degrees when pt stable
-DBC & incentive spirometer
-assess chest drainage system (leaks, amt/characteristic of drainage).. **notify provider if over 150mL/hr
-use suction until pt can cough effectively
43
growth of tiny collections of inflammatory cells in different parts of the body
sarcoidosis (exact cause is unknown but is believed to involve a hypersensitivity response to exogenous agents in individuals with a predisposition)
44
symptoms of sarcoidosis
pulmonary s/s = dyspnea, cough, hemoptysis, and congestion
other s/s = uveitis (eye inflammation), joint pain, fever, skin lesions
complications = pulmonary fibers, resp failure, involvement of other organ complications
45
Inflammation of the tissues that line the lungs (pleura) and chest cavity
can result from infections like PNA, TB, URI or be associated w/ trauma, pulmonary infarction or PE
pleurisy
**seenon CXR
46
s/s of pleurisy
(Inflammation of the tissues that line the lungs and chest cavity)
Sharp, knifelike chest pain worsened by respiratory movements, localized or radiating to the shoulder or abdomen. unilateral. Pleuritic pain often increases as pleural fluid accumulates.. pleural friction rub
**thoracentesis may be needed... monitor fluid drainage / pain .. teach splint the rib cage when coughing
47
pus-filled pockets that develop in the pleural space
usually caused by complication of bacterial PNA or lung abscess, but can also result from chest trauma, hematogenous infection, non bacterial infections, or iatrogenic causes (mistake in medical treatment)
empyema
48
s/s of empyema
(pus-filled pockets that develop in the pleural space)
fever, night sweats, pleural pain, cough, dyspnea, anorexia, weight loss
nursing care- provide support, position for drainage procedure, monitor drainage/pain, assist w/ lung expanding breathing exercises
49
this often follows viral upper respiratory infections; bacterial culprits like Streptococcus pneumoniae, Haemophilus influenzae, or Mycoplasma pneumoniae can also contribute. Rarely, fungal infections or exposure to physical/chemical irritants trigger bronchial irritation
acute tracheobronchitis
50
acute tracheobronchitis s/s
Initially presents with dry cough and mucoid sputum, progressing to symptoms like chills, night sweats, fever, headache, and malaise. Noisy breathing, shortness of breath, wheezing, and purulent sputum may occur, with severe cases possibly leading to blood-streaked secretions.
nursing interventions - hydrate, cough, sit up, antbx, rest
***can lead to PNA, resp failure
51
Caused by Mycobacterium tuberculosis, transmitted via airborne droplets from infected individuals, especially in settings with factors like poverty, malnutrition, overcrowding, substandard housing, and inadequate healthcare
pulmonary tuberculosis
52
Symptoms include low-grade fever, chronic cough, night sweats, fatigue, and weight loss. Cough may produce nonproductive or mucopurulent sputum, with possible hemoptysis.
TB
**pt needs neg pressure too & N95 mask
**monitor LFT, BUN, CrT
53
this is the big sign of tension pneumothorax
tracheal deviation (on the unaffected side!)
54
this pt has chronic cough, sputum production, dyspnea, reduced exercise tolerance .. it's inflammation that leads to airflow limitation, air trapping, destruction of lung tissue
COPD
55
how to treat COPD
combo of bronchodilators (beta agonists & anticholinergics), cortiocosteroids, oxygen, pulmonary rehab programs to improve exercise tolerance & quality of life, smoking cessation programs
56
Characterized by irreversible dilation of the bronchi due to chronic inflammation & recurrent infections.
symptoms = chronic cough, copious sputum production, hemoptysis, and recurrent respiratory infections
what is this and what is the treatment
Bronchiectasis
treatment = Involves airway clearance techniques (e.g., chest physiotherapy, postural drainage), antibiotics to treat bacterial infections, bronchodilators to relieve symptoms, corticosteroids to reduce inflammation, and in severe cases, surgical intervention to remove damaged lung tissue or control bleeding.
57
genetic risk factor for COPD
alpha-1 antitrypsin deficiency
58
besides smoking and genetic risk factor alpha-1 anti trypsin deficiency, this can increase risk for COPD
respiratory infections, particularly during childhood
59
normal pH, PCO2, O2, HCO3
pH 7.35 - 7.45
pCO2 35 - 45
O2 80 - 100
HCO3 22 - 26
60
complications of ABGs
pain, infection, hematoma, hemorrhage
61
bacterial vs viral sputum
bacterial = purulent
viral = thin/mucoid (mucus)
62
tumor would should what sputum
pink / tinged sputum
63
PE would show what sputum
frothy / pink sputum
64
what sputum would present w/ abscess, bronchiectasis, infection
foul smelling sputum
65
barrel chest vs funnel chest vs pigeon chest
barrel chest = overinflated lung
funnel chest = depression in lower sternum
pigeon test = anterior displacement of sternum
66
abnormal breathing pattern; periods of dyspnea & apnea
cheyne-stokes
67
rapid & shallow respiration followed by 10-30 seconds of apnea
biots respirations
68
this measures lung volumes, ventilatory function, mechanics of breathing, diffusion, gas exchange
PFTs
***pt education = don't smoke or use inhaler 4-8 hrs prior to test
69
when to obtain sputum culture
1st specimen in morning
70
this is a live X ray image from camera to video screen
fluoroscopy
71
this investigates congenital abnormalities & PE
pulmonary angiography (test to see how blood flows through the lung)
**must educate pt to increase fluids after procedure due to the dye
72
complications of pulmonary angiography
AKI, acidosis, dysthymias, bleeding
72
what to do before pulmonary angiography?
check consent, allergies, PT/INR, PTT, BUN, Creat, NPO 6 -8 hrs, warm flushed feeling
73
what to do prior to lung scan (Assesses lung function, pulmonary vascular supply, gas exchange)
IV, inhalation of radioactive agents
**don't if pregnant
74
what to do prior to bronchoscopy
check consent, NPO 4-8 hrs prior, remove dentures, prophylactic meds
75
what to do post bronchoscopy
NPO until pt has gag reflux
check VS
bleeding, blood tinged sputum expected 24 hrs
76
complications of bronchoscopy
over sedation, fever, infection, spasm, pneumothorax, bleeding
77
this is when the pleural cavity is examined with endoscope and fluid and tissue biopsied; pleural effusion, pleural disease, tumor staging
thorascopy
78
this procedure is the removal of fluid or air, installation of meds into pleural space
thoracentesis
78
what to do prior to thoracentesis
check consent, VS, sitting position!!!
79
what to do post thoracentesis
pressure dressing, VS, resp status, CHR, fluid
80
complications of thoracentesis
mediastinal shift, pneumothorax, bleeding, infection
81
how to check placement of ET tube
CXR, CO2 level
82
what should cuff level be for ET tube
20-25mmHg
83
what can extubation cause
swelling, hypoxemia, bradycardia, hypotension, death
84
complications of tracheostomy
dislodgment, decannulation, bleeding, pneumothorax, air emboli, aspiration, emphysema, tracheal wall penetration, laryngeal nerve damage, obstruction, infection, fistulas, necrosis
85
complications of mechanical ventilation
VAP, pneumothorax, delirium
85
this is the collapse of alveoli
atelectasis
86
who is at risk for atelectasis (collapse of alveoli)
post op pts
87
s/s of atelectasis
dyspnea, cough, sputum, tachypnea, tachycardia, pleuritic pain, central cyanosis
88
this is inflammation of lung parenchyma
PNA
88
how to diagnose atelectasis , how to prevent
CXR
TCDB, incentive spirometer 10x an hr, secretion management
89
CAP vs HCAP vs HAP vs VAP
CAP - occurs in community, less than 48 hrs after admission
HCAP - health care associated PNA, medical workers, multi drug resistant
HAP- over 48 hours after admission
VAP- over 48 hrs after ET tube
90
this is required if pt has VAP
HOB 30-45, sedation, DVT prophylaxis, oral care
91
how to diagnose PNA
CXR, blood cultures, sputum C&S
92
when to get pneumococcal vaccine
q 5 years
93
complications of PNA
shock, resp failure, pleural effusion, delirium
93
meds for PNA
antitussives to decrease cough
antipyretics for fever
antihistamines for runny nose
decongestants for mucous
94
risk factors for TB
close contact w/ infected
immunocompromised
substance abuse
health care inadequacy
preexisting conditions
immigration
health care workers
95
how to diagnose TB
PPD, CXR, acid fast bacillus smear, sputum culture
96
PPD vs gold test
test for TB, read in 48-72 hours, intradermal, induration is positive
TB gold & T spot 24-36 hr result
97
meds for TB
RIPE
Rifampin, INH, pyrazinamide, ethambutol PO 8 weeks, then INH & rifapentine for 4-7 months
98
Side effect of Isoniazid & rifampin
isoniazid - peripheral neuritis, hepatitis, monitor LFTs. **take pyridoxin to prevent neuritis
rifampin - hepatitis, monitor LFTs, n/v, orange bodily fluids
99
s/s of lung abscess
productive cough, fever, leukocytosis, chest pain, dyspnea, weakness, anorexia, weight loss, pleural friction rub, crackles
this is complication of bacterial PNA
100
how to diagnose lung abscess & how to manage?
CXR, sputum, bronchoscopy, CT of chest
manage by high protein diet, bronchoscopy, CPT
give meds- clindamycin, ampicillin-sulbactam, carbapenem
101
this is fluid in the pleural space
& what causes it?
s/s?
pleural effusion
caused by PNA, HF, TB
s/s = SOB, crackles, decreased breath sounds
102
early sign and late sign of acute respitaroy failure
early - restless, tachycardia, hypertension, fatigue, h/a
late - confusion, lethargy, central cyanosis, diaphoresis, resp arrest
103
this is the sudden, progressive pulmonary edema, bilateral infiltrates, hypoxemia, severe dyspnea
& how to diagnose this
ARDS
diagnose by BNP, echo, pulmonary artery Cath
104
meds for ARDS
sedatives (lorazepam, midazolam, propofol)
neuromuscular blocking agents like pancuronium
105
s/s of this include dyspnea, chest pain, anxiety, fever, tachycardia, cough, diaphoresis, hemoptysis
how to diagnose
PE
diagnose by CXR, EKG, VQ scan, ABGs
106
how to prevent PE
& how to manage
prevent by exercise, ambulate, TEDs, SCDs, don't sit for long
manage with O2, IV line, EKG, catheter, mrophine, surgery
107
this is the alteration in lung from inhalation of mineral or inorganic dust
pneumoconoises "black lung disease"
caused from asbestos or coal miners or veterans exposed too
108
s/s of lung cancer
dyspnea, hemoptysis, cough, dysphagia, fever
109
this is when pleural space exposed to positive atmospheric pressure
what are s/s of this
pneumothorax
s/s = anxious, cyanotic, RR increased
110
treatment for tension pneumothorax
needle decompression
111
this is the presence of cough & sputum production for 3+ months in 2 consecutive years; worse in winter
bronchitis (blue boater!) pt cyanotic, big and blue. long term. unusual long sounds (rhonchi, wheezing, crackles), edema due to Right HF
**does NOT deal w/ aveoli exchange , only airway
112
this is the dissension of airspaces & destruction of alveoli walls
emphysema (pink puffer!) Pursed lip, pink skin, increased chest/barrel chest, no cough/minimal, keep tripod!
deals w/ aveoli exchange!!
113
this is chronic, irreversible dilation of bronchi resulting form destruction of muscles & connective tissue
what are s/s of this
bronchiectasis
s/s = chronic cough, purulent sputum, hemoptysis, clubbing
manage by CPT, smoking cessation, antbx, bronchodilators, mucolytics
114
what to do for viral rhinitis
Cough!!! – take Mucinex, other expectorants .. Get it out!!! Spit it up. Get it out of chest, move things out.
115
common nasal corticosteroids
beclomethasone
budesonide
mometasone
triamicolone
116
first line treatment for Acute bacterial (ABRS)
amoxicillin
117
this can be viral (mono, herpes) and bacterial (strep)
pharyngitis
118
first choice of treatment for pharyngitis (bacterial)
penicillin V potassium
then macrolide (arithoromycin aka Z pak) then cephalosporin
119
this is why a pt can't open their mouth
trismus
***if a pt can't swallow, they drool and can aspirate
this is a sign of peritonsillar abscess
120
risk factors of OSA
obesity, smoking, large tongue/large tonsils/large uvula, short neck
121
what happens during sleep apnea
not breathing for a second so gas exchange is decreasing..
CO2 increasing, pH going down "ppl on acid are low!"
122
s/s of OSA
daytime sleepy, nocturnal awakening, insomnia, loud snoring, morning h/a, intellectual deterioration, personality changes, arrhythmias, enuresis
Frequent, loud snoring with breathing cessation for 10 seconds or longer at least 5 times per hour .
123
meds for OSA
modafinil for daytime sleepiness
protriptyline for increase resp drive
medroxyprogesterone acetate & acetazolamide
124
medication for epistaxis
phenylephrine bc vasoconstrictor (& ice!)
125
most common cause of laryngeal obstruction?
scarlet fever/ angioedema
126
this is Emergent, reversible narrowing of the laryngeal opening
laryngeal obstruction
**will see use of accessory muscle
127
s/s of this = Hoarseness, cough, sore throat, pain and burning in throat
diagnosed by Fine Needle aspiration, CT/MRI, PET, barium swallow, endoscopy, laryngoscopy
Most common in patients 65+ and 4x more common in men
cancer of larynx
RF = smoking, alcohol, abestos, paint fumes, chemicals, wood dust, nutritional defeciences, men, AA & whites, weakened immune system
128
partial vs total laryngectomy
Partial Laryngectomy – removal of a portion of larynx, one vocal cord and the tumor .... Airway remains intact
Total laryngectomy – removal of entire larynx, vocal cords and epiglottis.... Permanent tracheal stoma and possibly laryngectomy stoma (can't aspirate w/ this) ... loose fitting clothes, don't use sprays, cover stoma when bathing & can't go underwater in pool
129
3 hallmark s/s for atelectasis
tachypnea, dyspnea, mild to moderate hypoxemia
130
ICOUGH
incentive spirometer
coughing & deep breathing
oral care
understand (pt education)
get out of bed 3x daily
head of bead elevated
130
how to prevent aspiration
HOB elevated
avoid stimulation of gag reflux w/ suctioning or other procedures
check placement before tube feed
soft diet, small bites, no straws
131
direct vs indirect injury of ARDS
Direct injury - aspiration, pulmonary infection, near drowning, thoracic trauma or toxic inhalation
Indirect injury – shock, sepsis, hypothermia, DIC, multiple transfusion eclampsia, pancreatitis, burns
132
prone position is best for what
ARDS!
133
when is tracheostomy required for pt that is intubated
when pt is intubated over 14-21 days then tracheostomy is required
134
what is bucking the ventilator
they’re more awake and coughing and don’t like it, so we sedate them more and give pain meds, make them more comfortable
135
when pt is on vent, when do we listen to lungs
q 2-6 hrs
136
types of pneumothorax (air gets into pleural space)
o Simple/spontaneous – air enters plural space
o Traumatic pneumothorax – air escapes from laceration in lung and moves into pleural space
o Tension pneumothorax – air drawn into pleural space through a small opening or wound in chest wall… causes a mediastinal shift (needs immediate intervention!)
137
how will labs look with COPD
H&H increased due to being hypoxic so body Is compensating... acidotic ! so will see electrolyte changes
138
this med helps w/ secretions .. it thins secretions
Acetylcysteine
139
this antbx treats lung abscess
clindamycin
140
what vitamin needs to be increased due to taking rifampin for TB
B6
*take pyridoxin to prevent neuritis as well
141
take this med in the morning w/ food
steroids
