Nursing Respiratory Test

Question 1

pathophysiology of epistaxis

Answer 1

aka a nosebleed. Anterior region is most common and originate from vessels called Kiesselbach plexus. Blood vessels of the posterior nose are larger and bleeding can be severe and difficult to control

Question 2

etiology of epistaxis

Answer 2

nosebleed. most common cause is dry cracked mucous membranes. trauma, blowing nose, nose picking, increased pressure on fragile capillaries from hypertension. hemophilia, leukemia, regular aspirin use, anticoagulant therapy, chemotherapy, cocaine use

Question 3

therapeutic measure for epistaxis

Answer 3

nosebleed. sit in chair and lean forward (avoid aspirating or swallowing blood.) place pressure on nares for 5-10 min. ice pack (constricts vessels.) decongestants (vasoconstrictors) cauterize. gauze to pack it. IV fluid replacement for a lot of blood loss.

Question 4

nursing care for pt with epistaxis

Answer 4

monitor bleeding, note amount and color. monitor vital signs and hemoglobin levels. swallowing repeatedly sign of bleeding. If bleeding does not stop in 10-15 minutes notify RN or MD immediately. monitor for airway blockage if packing is used. teach pt to avoid bending over

Question 5

pathophysiology and etiology of nasal polyps

Answer 5

grape like clusters of mucosa in nasal passage. usually benign, can obstruct nasal passages. related to chronic inflammation and people with allergies.

Question 6

what is the aspirin triad asthma

Answer 6

three components

asthma, allergic to aspirin, nasal polyps

Question 7

therapeutic measures for nasal polyps

Answer 7

control of allergy symptoms. oral antihistamines or nasal corticosteroid sprays to control inflammation. can be removed. avoid aspirin products.

Question 8

pathophysiology and etiology of deviated septum

Answer 8

septum dividing nasal passages is slightly deviated. result from trauma. can block sinus drainage, interfere with breathing

Question 9

signs and symptoms of deviated septum

Answer 9

chronically stuffy nose. discomfort from blocked sinus drainage. headaches and nosebleeds

Question 10

therapeutic interventions for deviated septum

Answer 10

decongestants, antihistamines, intranasal cortisone spray to reduce inflammation. nasoseptoplasty

Question 11

nursing care for pt after nasoseptoplasty

Answer 11

monitor vitals and bleeding. swallowing sign of bleeding, check for blood running down back of throat. will have mustache dressing. maintain semi-Fowler’s position. avoid sneezing, coughing, straining to move bowels. stool softeners and cough suppressants can be ordered. aspirin is avoided. antibiotics can be given. ice to reduce swelling.

Question 12

pt education for pt after nasal surgery

Answer 12

• your nose will feel stuffy and may drain
• change mustache dressing as often as needed
• do not blow your nose
• if you must sneeze, do it with mouth open
• drink plenty of fluids
• use cool mist vaporizer to humidify hair(prevent nasal drying)
• keep head elevated or sleep in recliner
• ice pack to reduce swelling
• pain med as prescribed
• call physician if temp is higher than 101
• return to see physician as directed

Question 13

pathophysiology and etiology of sinusitis

Answer 13

inflammation of the mucosa of one or ore sinuses. can be acute or chronic (symptoms for more than 2 months and unresponsive to treatment)
Most common are maxillary and ethmoid sinus. often result of bacterial infection and may follow a viral upper respiratory illness. most common organism are Streptococcus pneumonia and Haempophilus influenza. also caused b allergies, nasal polyps, fungal infection, intubation

Question 14

signs and symptoms of sinusitis

Answer 14

pain over region of affected sinus.
if maxillary-pain over cheek and upper teeth.
ethmoid-between and behind the eyes
frontal-forehead
fever may be present, fatigue, foul breath

Question 15

complications of sinusitis

Answer 15

can spread to surrounding areas causing osteomyelitis, cellulitis of orbit, abscess, meningitis, trigger asthma symptoms

Question 16

diagnostic tests for sinusitis

Answer 16

based on symptoms alone. x-ray, nasal endoscopy, CT, MRI, culture nasal discharge

Question 17

therapeutic measures for sinusitis

Answer 17

aimed at relieving pain and promoting sinus drainage. nasal irrigation with normal saline solution. corticosteroids, adrenergic nasal sprays (up to 3 days). hot moist packs. expectorants, fluids, room humidifier. antihistamines, antibiotics

Question 18

why should adrenergic nasal sprays be used cautiously in pt with heart disease/hypertension

Answer 18

vasoconstriction increases blood pressure

Question 19

nasal sprays for more than 3 days causes what

Answer 19

rebound congestion

Question 20

nursing care for the patient with sinusitis

Answer 20

uncomplicated sinusitis are cared for at home. increase water intake. maintain semi-Fowler’s position. hot moist packs, analgesics, prescribed meds. finish antibiotic.

Question 21

pathophysiology and etiology of rhinitis/common cold

Answer 21

rhinitis (aka coryza) is inflammation of the nasal mucous membranes. release of histamine and other substances causes vasodilation and edema. may occur as reaction to allergens like pollen, dust, mold, some foods, viral or bacterial infection

Question 22

s/s of rhinitis

Answer 22

nasal congestion, localized itching, sneezing, sore throat, nasal discharge. viral/bacterial rhinitis can be accompanied by fever and malaise

Question 23

diagnostic tests for rhinitis

Answer 23

if allergic rhinitis is suspected-skin testing

a blood test for IgE antibodies

Question 24

therapeutic measures for rhinitis

Answer 24

antihistamines inhibit histamine response. allergy shots. antibiotics not effective for viral rhinitis. tylenol. decongestants.

Question 25

why should cough syrup and cold medicine be used with caution for pt with rhinitis/common cold

Answer 25

do not treat underlying cause of the cold, and contain different medications which are often not needed.

Question 26

pathophysiology and etiology of pharyngitis

Answer 26

inflammation of the pharynx. usually related to bacterial r viral infection. may occur as result of trauma to the tissues. most common bacterial is beta-hemolytic streptococci (strep throat)

Question 27

if strep throat is not treated with antibiotics it can lead to what

Answer 27

rheumatic fever, glomerulonephritis, or other serious complications

Question 28

s/s of pharyngitis

Answer 28

most common symptom-sore throat | dysphagia, throat red and swollen, exudate (drainage or pus) may be present. fever, chills, headache, malaise

Question 29

differentiating respiratory tract infection

Answer 29

onset= cold:slow--influenza: sudden fever= cold:non/low grade--flu:common headache= cold:rare-- flue:common muscle ache= cold:less common--flu: common, severe cough= cold:present-- flu: present, usually dry chest pain= absent-- flu: common fatigue=cold: slight-- flu: common, prolonged, severe runny nose= cold: common-- flu:less common sore throat= cold:common-- flu:less common complications= cold:rare-- flu:pneumonia treatment= cold: rest/fluids-- flu:rest, fluids, antiviral

Question 30

nursing diagnosis for pt with an upper respiratory infection

Answer 30

impaired comfort hyperthermia risk for infection

Question 31

diagnostic tests for pharyngitis

Answer 31

throat culture and sensitivity test

Question 32

therapeutic measures for pharyngitis

Answer 32

``` if bacterial-antibiotics tylenol or throat lozenges saltwater garles honey and lemon mice with warm water encourage fluids and rest ```

Question 33

pathophysiology and etiology of laryngitis

Answer 33

inflammation of the mucous membrane lining of the larynx (voice box.) caused by irritaion from smoking, alcohol, chemical exposure, GERD, viral, fungal, bacterial infection. often follows an upper respiratory infection.

Question 34

s/s of laryngitis

Answer 34

most common symptom is hoarseness. cough dysphagia fever

Question 35

diagnostic tests for laryngitis

Answer 35

tiny mirror to view larynx. laryngoscopy and biopsy to rule out cancer

Question 36

therapeutic measures of laryngitis

Answer 36

rest, fluids, humidified air, aspirin or tylenol. antibiotics if bacterial. med to control GERD. avoid speaking. whispering strains the voice even more.

Question 37

pathophysiology and etiology of tonsillitis/adenoiditis

Answer 37

filtering function becomes overwhelmed with a virus or bacteria and infection results. more common in children.

Question 38

function of the tonsils

Answer 38

filter microorganisms to protect the lungs from infection

Question 39

s/s of tonsillitis/adenoiditis

Answer 39

usually begins suddenly with sore throat, fever, chills, pain on swallowing. headache, malaise, myalgia. tonsils appear red and swollen, may have yellow or white exudate on them. may mention snoring, nasal obstruction, nasal tone to voice

Question 40

diagnostic tests for tonsillitis/adenoiditis

Answer 40

throat culture WBC and differential chest x-ray

Question 41

therapeutic measures for tonsillitis/adenoiditis

Answer 41

antibiotics for bacterial infection. tylenol, lozenges, saline gargles. After tonsillectomy: semi-Fowler's (reduce selling and promote drainage.) monitor for bleeding, airway latency, provide comfort measures. fluids for hydration. room humidifier. suction available for emergencies

Question 42

pathophysiology and etiology of influenza

Answer 42

flu. viral infection of respiratory tract. new strains each year. elderly at particular risk. transmitted via droplets. incubation period is 1-3 days

Question 43

s/s of flu

Answer 43

abrupt onset of fever, chills, myalgia, sore throat, cough, malaise, headache

Question 44

complications of flu

Answer 44

most common: pneumonia

Question 45

diagnostic tests for flu

Answer 45

viral cultures, nasal swabbing.

Question 46

therapeutic measures for flu

Answer 46

``` primarily symptomatic. tylenol for fever, headache, myalgia aspirin is avoided-Reye's syndrome rest and fluids essential antiviral meds ```

Question 47

nursing care for pt with influenza

Answer 47

``` closely monitored for complications assess lung sounds and vitals q4h monitor for dehydration encourage rest and fluids no aspirin in under 18 ```

Question 48

summarize bird flu

Answer 48

aka avian influenza infects wild and domestic birds contract it form contact with infected bird or excrement symptoms are similar to flue

Question 49

summarize SARS

Answer 49

severe acute reparatory syndrome high fever, body aches, often progress to pneumonia transmission from close contact with person or object

Question 50

H1N1 flu

Answer 50

aka swine flu | usually affects pigs

Question 51

west nile virus

Answer 51

transmitted from birds to humans by mosquitos. use mosquito repellent eliminate standing water where mosquitoes lay eggs

Question 52

pathophysiology of cancer of the larynx

Answer 52

usually develops in the squamous cells of the mucosal epithelium. evaluated based on TNM staging system. most often a primary cancer and can spread to lungs, liver, lymph nodes. prognosis is often poor.

Question 53

etiology of cancer of larynx

Answer 53

risk factors: Hx of alcohol, tobacco use, exposure to industrial chemicals, hardwood dust, chronic overuse of voice, diet low in fruits and vegetables. men more likely to be affected

Question 54

prevention of cancer of larynx

Answer 54

educate on relationship between cancer and alcohol/tobacco use. seek treatment when symptoms first occur. any hoarseness that lasts longer than 2 weeks should be investigated

Question 55

s/s of cancer of larynx

Answer 55

most common symptom is hoarseness because vocal cords are located in larynx throat or ear pain, SOB, chronic cough, difficulty swallowing stridor weight loss and halitosis (foul breath)

Question 56

diagnostic tests for cancer of larynx

Answer 56

examined with mirror. laryngoscope examination. CT scan, MRI

Question 57

therapeutic measures for cancer of larynx

Answer 57

may be treatable with radiation therapy; will preserve patient's voice. chemo as well. surgery (larynx will be partially or completely removed) parietal laryngectomy. radical neck dissection with total laryngectomy (loss of voice)

Question 58

nursing diagnoses for cancer of larynx

Answer 58

``` risk for ineffective airway clearance acute pain impaired verbal communication risk for imbalanced nutrition impaired swallowing grieving related to loss of voice disturbed body image ```

Question 59

laryngal cancer: risk for ineffective airway clearance related to excessive secretions and new trach/laryngecotmy. What to do

Answer 59

``` monitor and record amount, color, consistency of secretions vitals, lung sounds, signs of respiratory distress provide trach care sterile technique semi-Foweler's position deep breathe and cough qh avoid use of powders, sprays, airborne materials ```

Question 60

laryngal cancer: acute pain related to surgical procedure. what to do

Answer 60

assess pain level q4h and pen assess sedation and reap status often opioids given carefully admin analgesics as prescribed

Question 61

which is the best explanation by the nurse for why a physician did not prescribe antibiotics for influenza?

Answer 61

influenza is caused by viruses. viruses are not treated with antibiotics

Question 62

acute bronchitis

Answer 62

inflammation of the bronchial tree. mucous membranes (that line the bronchial tree) become irritated and inflamed, excessive mucous is produced. result is congested airways. usually an isolated episode

Question 63

pathophysiology of bronchiectasis

Answer 63

dilation of the bronchial airways. dilated areas become flabby and scarred. secretions pool in areas and difficult to cough up. creates and environment when bacteria flourish. infection is common.

Question 64

etiology of bronchiectasis

Answer 64

usually occurs secondary to another chronic reps disorder (CF asthma, TB, bronchitis, exposure to toxin)infection and inflammation of airways weakens the bronchial walls and reduces ciliary function. airway obstruction from excessive secretions that predisposes the pt to development of bronchiectasis

Question 65

s/s of bronchiectasis

Answer 65

``` recurrent lower reap infection sputum is copious an purulent foul smelling sputum sputum can be bloody can experience dyspnea even with minimal exertion wheezes and crackles fever present if active infection cor pulmonale (right sided HF) clubbing of fingers ```

Question 66

diagnostic test for bronchiectasis

Answer 66

chest x-ray CT bronchoscopy sputum cultures

Question 67

therapeutic measures for bronchiectasis

Answer 67

``` aimed at keeping airways clear of secretions, controlling infection, correcting underlying problem. antibiotics vaccinations for prevention bronchodialators mucolytic agents and expectorants chest physiotherapy oral fluids encouraged ```

Question 68

pathophysiology of pneumonia

Answer 68

acute inflammation and/or infection of lungs. transmitted by the cough. when microorganisms multiply, they release toxins and induce inflammation in lung tissue, causing damage to mucous and alveolar membranes. leads to edema and exudate. this reduces surface area available for exchange of carbon dioxide and oxygen. also causes necrosis of lung tissue. can be confined to one lobe or scattered.

Question 69

etiology of pneumonia; bacterial pneumonia

Answer 69

most common cause of community acquired bacterial pneumonia is streptococcus pneumonia.

Question 70

etiology of pneumonia; viral pneumonia

Answer 70

influenza viruses most common cause. generally less ill with viral pneumonia than bacterial pneumonia, but usually sick longer

Question 71

etiology of pneumonia; fungal pneumonia

Answer 71

candida and aspergillus are two types. typically causes pneumonia in pts with AIDS

Question 72

etiology of pneumonia; aspiration pneumonia

Answer 72

aspiration of foreign substances. most often occurs in pt with decreased LOC or impaired cough or gag reflex. increases risk for subsequent bacterial pneumonia

Question 73

gas exchange occurs in which structures

Answer 73

alveoli

Question 74

while providing care a nurse notes the pts shoulders are rising with each breath. this is documented as:

Answer 74

the se of accessory muscles to aid breathing

Question 75

the nurse is auscultating a pt lungs but is unable to hear much air movement. what is the next step

Answer 75

have pt deep breath through the mouth

Question 76

the nurse notes a pt with periods of fast, deep respirations alternating with periods of apnea. this pattern is:

Answer 76

Cheyene-Stokes

Question 77

which term describes a loud crowing sound that results from obstruction of the airways by a tumor or foreign body

Answer 77

stridor

Question 78

a pt arterial blood gas analyzes shows a pH of 7.28 with high PaCO2. what does pt have

Answer 78

respiratory acidosis

Question 79

nurse is examining a chest drainage system on a pt with a pneumothorax and notes the water level in the water seal chapter fluctuating with each pt respirations. the nurse should

Answer 79

no action is necessary, this finding is expected

Question 80

a pt returns to SDS from surgery for a deviated septa. which of the following would most concern the nurse.

Answer 80

the pt swallows frequently

Question 81

what is most common complication of influenza

Answer 81

pneumonia

Question 82

which assessment finding does the nurse anticipate noting in a pt being evaluated for cancer of larynx

Answer 82

a hoarse voice

Question 83

antidote for narcotic overdose

Answer 83

(Narcan) | naloxone

Question 84

corticosteroids such as methylprednisolone (Solumedrol) are used in the pt with COPD for which purpose

Answer 84

``` reduce airway inflammation will increase BS will suppress immune system aggressive behaviors moon face (round puffy) can't abruptly stop med ```

Question 85

s/s of pneumonia

Answer 85

fever, shaking, chills, cheats pain, dyspnea, fatigue, productive cough, sputum is purulent (rust colored or blood tinged) crackle and wheezes. can also experience fatigue, sore throat, dry cough, n/v. elder can become confused or lethargic

Question 86

complications of pneumonia

Answer 86

pleurisy and pleural effusion, atelectasis, septicemia, meningitis, septic arthritis, pericarditis, endocarditis

Question 87

which med can help reduce acute dyspnea in pt with end stage COPD

Answer 87

IV morphine | small enough to ease respirations

Question 88

diagnostic test for pneumonia

Answer 88

chest x-ray. sputum and blood culture.

Question 89

therapeutic measures for pt with pneumonia

Answer 89

``` broad spectrum antibiotics (oral or IV) rest and fluids antiviral medications expectorants bronchodialators analgesics nebulized mist treatment O2 ```

Question 90

term used to describe blood tinged sputum

Answer 90

hemoptysis

Question 91

TB pathophysiology and etiology

Answer 91

infectious disease. primarily affects the lungs, but can also affect kidneys, liver, brain, bone. acid fast bacillus. spread by inhalation. once bacilli enter lungs, they multiply and begin to disseminate to the lymph nodes.

Question 92

priority nursing diagnoses for pt with pneumonia

Answer 92

impaired gas exchange ineffective airway clearance activity intolerance