Final exam

Question 1

COPD

Answer 1

respiratory disorder largely caused by smoking- progressive, irreversible

Question 2

COPD

assessment

Answer 2

Level of dyspnea (activity and rest), medication use and effectiveness, presence of cough and production of cough.

Question 3

COPD

Interventions

Answer 3

smoking cessation, ensure hydration, deep breathing, effective cough techniques, purse lipped breathing to prolong expiratory phase, nutrition related to poor appetite, high protein-calorie to prevent muscle wasting

Question 4

COPD

Interventions

Answer 4

rest before and after eating, monitor sleep pattern and periods of apnea. Avoid alcohol, caffeine before bedtime. Minimize risk for infection, hand washing.

Question 5

Asthma

Answer 5

Chronic inflammatory disorder of the airway.

episodic and reversible with tightness and dyspnea

Question 6

Asthma

Assessment

Answer 6

severity of symptoms, medication used, time. assess for confusion, leaning forward breathing, accessory muscle use, wheezing, crackles, absent sounds, tachycardia, hypertension o2 sats.

Question 7

Asthma intervention

Answer 7

position to allow for maximum chest expansion, administer medication, monitor O2 sats, auscultate lung after intervention. H/T to avoid triggers.

Question 8

Coronary Artery Disease

Nonmodifiable Risk Factors

Answer 8

Age, gender, ethnicity, family history

Question 9

Coronary Artery Disease

modifiable risk factors

Answer 9

elevated lipid levels

tobacco use, hypertension, inactivity, obesity

Question 10

CAD diagnostic

Answer 10

ECG, chest radiography, stress test, lab tests; lipid panel, CBC, troponin

Question 11

Stable Angina therapy

Answer 11

antiplatelet therapy= aspirin, warfarin, nitro (vasodilator to reduce afterload), ACE inhibitors ,Calcium channel blockers

Question 12

Unstable Angina therapy

Answer 12

nitro, heparin

Question 13

Angina

Answer 13

support with oxygen and morphine. Pain will cause vasoconstriction and worsen problem.

Question 14

Acute Coronary Syndrome

Answer 14

when ischemia is prolonged & not immediately reversible= MI
Coronary artery disease = angina -> acute coronary syndrome -> unstable angina
->MI

Question 15

Acute coronary syndrome

Answer 15

atherosclerotic plaque ruptures, stimulates platelet aggregation, vasoconstriction and thrombus formation, formation may partly occlude vessel=angina or totally occluded = MI

Question 16

Unstable Angina

Answer 16

unpredictable and represents an emergency

Question 17

acute coronary syndrome

nursing implementation

Answer 17

deal with pain, rest, anxiety, fear

Question 18

Heart Failure

Answer 18

impaired cardiac pumping/filling, not always associated with pulmonary congestion

Question 19

Heart Failure risk factors

Answer 19

coronary artery disease, aging, hypertension, diabetes, smoking, obesity, high cholestrol

Question 20

most common form of H/F

Answer 20

left sided failure from ventricular dysfunction, blood backs up into left atrium and into the pulmonary veins causing pulmonary congestion and edema

Question 21

Treatment of H/f

Answer 21

decrease preload and afterload with diuretics and ACE inhibitors will decrease pulmonary congestion, vasodilators to decrease peripheral resistance, morphine to decrease pain and provide sedative action>must watch for respiratory depression

Question 22

Nursing goals for managing HF

Answer 22

decrease peripheral edema, decrease shortness of breath, increase exercise tolerance.

Question 23

Stroke

Answer 23

ischemic brain attack or hemorrhagic stroke

Question 24

stroke nonmodifiable risks

Answer 24

age, gender,ethnicity and race, family history

Question 25

Stroke modifiable risks

Answer 25

hypertension single most important risk factor, heart disease, diabetes, cholesterol, smoking, excessive alcohol, inactivity

Question 26

motor defecits

Answer 26

• A stroke can have an effect on many body functions, including motor activity, bladder and bowel elimination, intellectual function, spatial-perceptual alterations, personality, affect, sensation, and communication.

Question 27

aphasia

Answer 27

total loss of comprehension and language

Question 28

dysphasia due to dominant hemisphere affected

Answer 28

difficult comprehension or use of language

Question 29

dysarthria

Answer 29

a disturbance in the muscular control of speech. Impairments may involve pronunciation, articulation, and phonation

Question 30

agnosia

Answer 30

inability to recognise object by sight, touch or hearing

Question 31

apraxia

Answer 31

inability to carry out sequential movements on command

Question 32

urinary and bowel

Answer 32

problems are usually initially and temporary

Question 33

Prevention

Answer 33

control; blood pressure, blood glucose, diet and exercise, smoking and alcohol consumption

Question 34

Acute phase of stroke

Answer 34

preserving life and preventing/reducing brain damage

Question 35

Acute phase of stroke elevated bp

Answer 35

common protective response to maintain cerebral perfusion

Question 36

Acute phase of stroke electrolyte

Answer 36

maintain fluid balance to promote perfusion

Question 37

Acute phase of ischemic stroke

Answer 37

antithrombolitic tPA

Question 38

length of acute phase

Answer 38

12-24 hrs care shifts from preserving life to lessening diability

Question 39

Acute phase of stroke

Answer 39

management of the respiratory system is a nursing priority. Stroke patients are particularly vulnerable to respiratory problems, such as aspiration pneumonia

Question 40

Acute phase of stroke

Answer 40

neurological status must be monitored closely to detect changes suggesting extension of the stroke