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NCLEX > Respiratory > Flashcards

Respiratory Flashcards

(68 cards)

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1
Q

what is rhinitis

A

inflammation of the mucus membrane of the nose

marked by rhinorrhea (runny nose), nasal congestion, itching and sneezing

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2
Q

rhinitis manifestation

A

excessive nasal drainage
congestion
postnasal drip with sore throat

nasal itchiness, sneezing
itchy watery eyes if allergies are the cause

if viral:
sore thraot
general malaise
headache

bactericidal:
purulent nasal discharge
fever

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3
Q

rhinitis diagnostic studies

A

hx and note quality of drainage and color

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4
Q

rhinitis care

A

first step: determine whether cause is allergic, viral or bacterial
can use OTC antihistamines or decongestatns to manage symptoms

acetminophen or NSAID for minor aches and pians

if bacterial: anti-infectives

if allergic: avoid exposure to allergen

both viral and bacterial causes, encourage to;

  • increase fluid intake
  • rest
  • gargle with warm salt water

increase intake on Vit C and zinc

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5
Q

rhinitis management

A

reduce allegens
teach how to administer med properly

use good handwashing technique

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6
Q

what is sinusitis

A

inflammation of one or more of the paranasal sinuses

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7
Q

sinusitis manifestations

A

frontal hedache
tenderness over affect sinus

purulent nasal drainage and congestion

tooth pain
general malaise
fever

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8
Q

sinusitis diagnostic studies

A

X-ray or CT scan

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9
Q

sinusitis care

A

pharamcological interventions:
nasal saline
decongestants
nasal corticosteroids

mucolytics
antihistamines
analgesics
antipyretics
antibiotics
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10
Q

sinusitis management

A

take prescribed meds

intake fluids at least 6-8 glasses of non-carbonated, non-alcoholic beverages daily

nasal cleansing techniques:

  • hot showers
  • steam inhalation
  • nasal irrigation with saline spray
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11
Q

what is pharyngitis

A

inflammation of the mucous membranes of the pharync

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12
Q

pharyngitis manifestation

A

complain of a scratchy throat
throat pain that is severe and worsens with swallowing

pharynx can appear red and edmatous, with or without patchy white or yellow exudates

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13
Q

pharyngitis diagnostic studies

A

throat cultures

rapid strep antien test

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14
Q

pharyngitis care

A

pharmacologic interventions:
antimicrobial therapy
- penicillin for strep throat
- erythromycin if client is allergic to penicillin

antifungal - nystatin
analgesics - ibuprofen or topical anesthetic sprays or lozenges

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15
Q

pharyngitis management

A

administer prescribed medications as ordered

encourage increased fluid intake
eat cool, bland liquids
eat soft foods such as gelatin

avoid citrus juices and carbonated beverages
- you dont want something acidic to pass through the a=pharynx

take all antiinfective pills

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16
Q

what is tonsillitis and adenoiditis

A

inflammation and infection of the tonsils

adenoidits = inflammation of the adenoid tissue

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17
Q

tonsillitis and adenoiditis manifestations

A

sore throat
fever
difficulty swallowing

enlarged tonsils or even kissing tonsils

halitosis (bad smelling breath)
noisy respirations
recurring ear infections

throat cultures for causative microbes

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18
Q

tonsillits and adenoiditis care

A

anti-infectives
antipyretics
analgescis

increase fluid intake and rest

if infections are recurrent - tonsillectomy and adenoidectomy may be indicated

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19
Q

tonsillitis and adenoiditis management

A

meds

post op:

  • hemorrhage
  • airway obstruction
  • provide positioning that allows for comfrot and drainage of the mouth and pharync
  • HOB elevated, head turned to the side
  • apply ice collar/pack for comfort
  • prescribed mouthwashes and pain meds
  • should eat a clear or full liquid diet for 48-72 hours
  • frequent swallowing can indicate that bleeding is there
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20
Q

what is peritonsillar abscess

A

caused by group A hemolytic streptococci infection

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21
Q

peritonsillar abscess manifestations

A

difficulty swallowing
unable to swallow

will observe drooling
marked tonsillar enlargement, possible threatening the airways

muffled voice
high fever and chills

increased WBC, facial swelling

** monitor for airway patency and for resolution of infection

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22
Q

what is laryngitis

A

inflammation of the larynx

nurses should NOT use laryngoscope, but amy be asked to assist HCP

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23
Q

laryngitis care

A

resting voice
gargling with warm salt water

avoiding irritants:

  • smoking
  • spicy foods
  • citrus fruits
  • carbonated beverages

may use cool or moist air to bring relief

  • sitting in a steamy bathroom
  • outside in cool night air
  • next to a cool air vaporizer
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24
Q

chronic obstructive pulmonary disease

A

includes:
emphysema
chronic bronchitis

primary cause: smoking cigarettes

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25
COPD clinical manifestations:
purulent sputum production dyspnea on exertion - may occur with minimal activity or at rest must use accessory muscles to breathe restlessness, respiratory difficulty or distress, anxiety eating interference weight loss chronic bronchitis: edema cyanosis barrel chest
26
COPD diagnostic studies
spirometry chest x-ray sputum cltures increased PaCO2, low PaO2 low O2 levels
27
COPD care
quit smoking reduce second hand exposure to tabocco smoke pharmacological include: inhaled bronchodilator - albuterol, ipratropium inhaled oral corticosteroids - prednisone expectorant - guaifenesin supplemental oxygen therapy may be needed airway clearance techniques: - effective coughing - chest physiotherapy - vibration - postural drainage postural drainage: position that uses gravity to help move mucus from lungs up to the throat
28
COPD management
diaphragmatic breathing pursed lip breathing inspiratory muscle training controlled coughing pacing of daily activities physical conditioning small frequent meals, with nutritional supplments avoid temperature and humiditiy extremes, air pollution and high altitudes for hospitalized clients: monitor O2 sat administer oxygen at lowest dose- O2 sat of 90% monitor for complications
29
asthma manifestations
expiratory wheezing, often audible shortness of breath cough with sputum production normal or low oxygen saturation chest tightness tachycardia use of accessory muscles with resp distress high/normal PaCO2 and low PaO2`
30
asthma diagnostic studies
acute phase: - physcial exma and hx - ABGs - chest x-ray - pulmonary function tests chronic phase: - peak expiratory flow rate - allergy testing - pulmonary function tests - bronchoscopy
31
asthma care
``` pharmacological interventions: long acting control medications; - fluticasone - beclomethasone - salmeterol - montekulast - tiotropium - cromolyn sodium inhaler ``` short acting "rescue" medications: - albuterol - inhaler - nebulizer - prednisone - methyprednisolone
32
asthma management
same as COPD
33
asthma complications
low PaO2- hypoxemia hypercapnia - high PaCO2 recurrence of other resp infections resp failure absence of wheezing
34
what is pneumothorax
pleural space is filled with either air or lung or both which reduces lung capacity
35
open pneumothorax
air enters into pleural space due to a hole in the chest wall ex: gunshot wound
36
close pneumothroax
air enters into pleural space through a hole in the lung tissue ex: after lung resection
37
tension pneumothorax
closed pneumothorax with rapid accumulation of air into pleural space causes mediastinal and tracheal shift from the midline most types of pneumothorax are treated with chest tube insertion
38
pneumothorax manifestations
asymmetrical chest movement - unequal progressive dyspnea diminished or absent lung sounds on affected side low O2 levels fatigue activity intolerance tachycardia restlessness anxiousness ches pain progressive cyanosis
39
pneumothorax diagnostic studies
chest x-ray CT scan leukocytosis decreased hgb and hct
40
pneumothorax care
thoracentesis: | with or without chest turb drainage device
41
pneumothorax nursing management
monitor O2 sat and resp recumbent position for comfort maintain and monitor chest tube and closed chest drainage system ensure chest tube drainage is closed, has no leaks or kinks monitor volume and characteristic of drainage - notify if drainage exceeds 10mL/hr and/or bright red or free-flowing drainage suddenly appears keep collection device below chest level or insertion site at all times - should expect water level to fluctuate with respirations (tidaling) ensure that client has appropriate chest x-rays, daily
42
what is pneumonia
characterized by inflammation and consolidation of lung tissue
43
aspiration pneumonia
chemical irritation and inflammation associated with aspiration of food, stomach contents, or saliva
44
risk factors of pneumonia
``` preexisting pulmonary diease depressed immune function atelectasis mechnical ventilation advanced age ``` decreased ability to protect the airway, swallow safely
45
pneumonia manifestations
fever chills malaise SOB with decreased oxygen saturation productive cough with purulent sputum pleuritic chest pain crackles or ronchi in affected lobes
46
pneumonia diagnostic studies
chest x ray positive sputum culture leukocytosis low pH high PaCO2, low PaO2 ** bronchoscopy may be performed when an organism is difficulty to identify
47
pneumonia care
pharamcological interventions: antinfectives antipyretics and analgesics - acetaminophen or NSIADs expectorants - guaifenesin antitussives antitussives and cough suppressants are contraindicated in clients with a propductive cough
48
pneumonia management
monitor pulse oximetry titrate oxygen promote hydration to liquefy secretions effective coughing techniques should experience improvement within 48-72 hours of initation of therapy -contact HCP if not improving encourage influenza and pneumococcal vaccines for high risk clients
49
influenza
best prevention is to get vaccinated symptoms usually begin about 2 days after virus enters body - can range from 1-4 days is transmissble clients should be placed in a private room and droplet precautions
50
influenza manifestations
``` rapid onset of sever headache, muscle aches fever chills fatigue weakness ``` contagious from 24 hours before symptoms occur sore throat cough watery nasal discharge with strain B: - nausea - vomiting - diarrhea
51
influenza diagnostic studies
rapid influenza diagnostic test blood and sputum cultures chest x-ray
52
influenza care
get vaccinated rapid flu virus strict adherence to infection ctronl implementing droplet precautions start antivirals within 48 hours of onset of illness
53
influenza management
adequate fluid intake 2-3 L/day monitor resp status administer analgesics antibiotics cough etiquette hand hygiene avoid contact with infected persons receive flu vaccine encourage pneumococcal vaccine
54
pulmonary tuberculosis
chronic infection caused by acid-fast bacillus
55
pulmonary tuberculosis manifestations
weakness with fatigue anorexia with weight loss night sweats chest pain a cough usually begins dry and progresses toa productive cough with purulent and/or bood tinged sputum
56
pulmonary tuberculosis diagnostic tudies
interferon gamma release arrays aka Quantiferon TB nucleic acid amplification test GOLD STANDARD: TB culture - but can take up to 2-6 weeks to obtain alternative test --> acid fast bacillus smear other tests: chest x-ray Mantoux test - 48-72 hours after PPD injection
57
tuberculosis care
long term (6-24 months) antimicrobial therapy with at least 2 antitubercular drugs surgical resection of involved lung high carb, high protein diet, small frequent meals TB is a reportable disease - appropriate agency, family and close contacts
58
tuberculosis management
airborne precautions negative airflow N95 visitors can wear surgical mask client with surigcal mask when leaving room
59
tuberculosis health promotion
report bloody sputum DO NOT use OTC meds without HCP approval DO NOT wear soft contact lenses if taking rifampin - cause reddish-oragneish discoloration of saliva adherence to treatment regimen return at scheduled time common side effect of antitubercular: - increased in vit B
60
what is pulmonary embolism
blood clots that prevents blood from perfusing to the lungs
61
types of embolism
blood: DVT fat embolism: from fractured femur or bone amniotic fluid: post delivery air: from injection of large air bolus through a central venous or arterial catheter
62
pulmonary embolism manifestations
if its small, asymptomatic large: - sudden onset of dyspnea and cough with low O2 - pleuritic chest pain - anxiety apprehension - feeling of impending doom - cough productive or nonproductive - tachycardia and tachypnea
63
pulmonary embolism diagnostic studies
chest CT scan with contrast D-dimer will be elevated VP scan ABG - low PaO2, high PaCO2 ECG
64
pulmonary embolism care
prevention is best treatment oxygen and anticoagulants - may need non rebreather mask pharmacological interventions: anticoagulation -heparin IV - warfarin for chronic PE thrombolytics a filter surgically placed in vena cava may be needed for long term prevention DVT= primary cause of pulmonary embolism
65
what is acute respiratory distress syndrome
inflammatory response to a signficiant acute injury or inflammation process refractory hypoxemia = HALLMARK of ARDs
66
ARDs manifestations
restlessness atelectasis - use PEEP does not respond to oxygen tachycardia cyanosis (late sxs) intercostal retractions, accessory muscle use in early stage, lung tends to be clear in later stage, coarse crackles might be present
67
ARDs care
oxygenation to maintain greater than 88% correct respiratory acidosis use PEEP and ECMO - prevents alveoli from collapsing, improving oxygenation sedation may be required paralytic agents may be necessary corticosteroids fluid restrictions
68
ARDs management
bedrest with frequent position changes ROM exercise monitor O2 sat with ABGs observe for behavioral changes vitals

NCLEX (21 decks)

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