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32 Cards in this Set
- Front
- Back
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What are the S/S of bronchitis?
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Productive cough, SOB, wheezing, fever, malaise, chest pain, mucosal hypersection |
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At what point is bronchitis considered chronic? |
Symptoms lasting >3 months per year for at least 2 consecutive years |
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In what order should the nurse administer bronchodilators and steroids? |
Bronchodilators first then steroids |
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How is asthma characterized? How is it triggered? What are some common symptoms of an attack? |
Characterized by airway inflammation/constriction, increased smooth muscle contractility, possible bronchospasm, airway obstruction. Can be triggered by irritants, allergens, exercise, and temperature extremes but symptoms may persist in absence of triggers Symptoms of an attack include wheezing, SOB, cough, chest tightness |
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What are short acting/long acting broncodilators? Considerations? |
-terol Short acting-Albuterol (proventil, ventolin) Monitor for tachycardia, tremors. Long acting- salmeterol, formoterol Formoterol increased mortality d/t user error |
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What are short/long acting anticholinergics? Considerations? |
-tropium Short-acting- ipratropium monitor for dry mouth Long-acting-tiotropium Not listed for asthma use- used for COPD |
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What are some methylxanthines? considerations? |
-phylline Theophylline, aminophylline many side effects, drug interactions, low therapeutic index. Monitor serum toxicity, n/v/d, tachycardia |
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What are some short/long acting corticosteroids? |
short-term-methylpredisolone, hydrocortisone Given IV during exacerbation Long-term- prednisone |
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How long before/after infection is a client with influenza contagious? |
24 hrs before s/s appear and 5 days after |
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When are antivirals for influenza effective? |
24-48 hours after onset of symptoms |
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What are the s/s of pneumonia? |
Cough (may be productive or non), fever, shaking chills, fatigue, anorexia, SOB, dyspnea, chest pain |
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Dx/tx for pneumonia? |
Assessment- crackles or absent lung sounds over consolidation, CXR which shows consolidation, sputum culture. tx- antibiotics, bronchodilators |
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How many negative sputum samples until a client with TB is considered not contagious? |
Three |
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How long is treatment time for TB? What are some drug regimens? Considerations? |
6-12 months Meds Isoniazide- take on empty stomach, hepato/neuro toxic, tetany, no alcohol use Rifampin- hepatotoxic--monitor jaundice, joint/pain swelling, anorexia, malaise, may interfere with oral contraceptives Ethambutol- vision changes. not used in children <13 years Pyrazinamide- Hepatotoxic, monitor liver func., encourage fluid intake, no alcohol Streptomycin- highly toxic, ototoxic (hearing), encourage fluids, monitor renal function, U/O |
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What is pulmonary edema? How does pulmonary edema present? How is it treated? |
Elevated hydrostatic pressure of draining pulmonary veins. Is an an acute response to left sided heart failure, MI, or chronic CHF Presentation: Frothy pink sputum, cough, SOB which increases while lying down, high BP/HR, bilateral basal crackles, Tx: Diuretics to clear fluid from lungs, lower BP, treat underlying cardiac issue |
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What is epiglottis? Presentation? Tx? Considerations? |
Inflammation of the epiglottis caused by bacterial infection. Presents as cough, hoarse voice, stridor (high-pitched breath sound, fever, tachypnea, tripod/tucked chin posture, red throat, difficulty swallowing Treated with aggressive antibiotics. Do not touch or attempt to examine throat may cause airway to close, often confused with croup--differentiate by cough with lack of drooling. |
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How is emphysema characterized? Presentation/assessment? |
Characterized by the destruction of alveoli and hyperinflation of the lungs. Usually caused by smoking or environmental toxins/irritants Presentation/assessment Barrel chest, pursed lip breathing, hypercapnia, ineffective cough, slight hypoxia, prolonged expiatory time, thin appearance, leads to right sided HF |
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What is a pneumothorax? Different types? S/S? Dx/tx? |
Loss of negative pressure in the pleural and visceral space. Primary (spontaneous) pneumothorax has no underlying cause--most common in tall, thin, male clients. Secondary pneumothorax is caused by underlying lung diseases (COPD, neoplasm, etc). Traumatic pneumothorax is caused by an external puncture of the membrane (broken rib, gun shot). S/S: SOB, dyspnea, chest pain, anxiety (or other mental status changes), tachypnea, decreased SaO2, absent breath sounds on affected side Dx- assessment and CXR Tx- Minor pneumothorax may resolve itself but in severe cases a chest tube will be required |
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What is a tension pneumothorax? |
A tension pneumothorax is caused by a dramatic increase of air trapped in the plueral space. Can cause a mediastinal shift which can cause heart failure. |
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What is flail chest? Symptoms? Monitor? Tx? |
Flail chest occurs when at least two neighboring ribs sustain multiple fractures causing an instability of chest wall. results in significant limitation in chest wall expansion S/S Unequal chest expansion (paradoxical movement), diminished breath sounds, tachycardia, hypotension, dyspnea, cyanosis, anxiety, chest pain Monitor/tx respiratory status, humidified O2, anxiety/pain control, high fowlers, PEEP, bed rest May cause pneumothorax |
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What are pulmonary function tests? Considerations?
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Measure lung volume and capacities, diffusion capacities, gas exchange, flow rate, airway resistance/distribution. FVC- forced vital capactiy--volume of air that can be expired after full inspiration FEV1- volume of air that can be expired in one second after full inspiration FVC/FEV1 ratio- Should be 75-80% in healthy adults FEF- Forced expiratory flow- speed of air coming out of the lungs in the middle of a forced expiration PEF- Peak expiratory flow- same as above Considerations- No smoking 6-8 hrs before test, no inhaler use 4-6 hours before test |
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What is a bronchoscopy? Nursing actions before/after? Monitor for? |
Through using a flexible or rigidfiberoptic bronchoscope, the physician can visualize the larynax, trachea, andbronchi & look for tumors, strictures, disease –lung CA- biopsy or aspiratedeep sputum or remove foreign bodies Nursing actions Before Check allergies/consent Remove dentures NPO 8-12 hours prior to procedure After Aspiration/pneumothorax risk, elevated HOB, LOC, RR, V/S, encourage cough/deep breathing Monitor for gag/cough reflex, hemmorage, fever, hypoxia |
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What are some rules for steroid use? |
Mouth care- rinse after each use to prevent ulcers Encourage fluids Monitor for hyperglycemia Watch for decreased immune function Report tarry stools Assess mouth for thrush Don't stop medication suddenly-taper Take prednisone with food- ulcer risk Watch for Cushing's Increased risk for thromboembolism |
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How is a PPD read? What signifies a positive result? Describe full TB testing procedures |
Positive- induration 10+mm is positive in healthy adults, 5mm for at-risk clients CXR follows positive PPD. If no legions are found disease is considered latent and treatment begins but client is not considered contagious Following positive PPD and CXR sputum cultures are taken on a contagious client. Three negative cultures must be obtained before client is considered non-contagious |
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What is bronchiolitis? S/S? tx? |
Inflammation of the bronchioles, typically viral, most common in children under 2. Can develop into pneumonia. S/S- coughing, wheezing, SOB developing over 1-2 days, poor feeding, lethargy, tachypnea, nasal flaring, gruning, accessory muscles, sternal retraction, cyanosis, adventitious lung sounds. tx- nebulized bronchodilators, humidified O2 |
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S/S of TB? |
Chronic cough w/ blood tinged sputum, fever/chills, night sweats, weight loss |
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What can cause a tension pneumothorax? |
Sucking chest wound, prolonged clamping of suction tubing, kinks or obstructions of tubing |
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What is pleural effusion? Common causes? Dx? |
A pleural effusion is an accumulation of fluid in the pleural space. Most commonly caused by heart failure, cirrhosis. Dx- diagnosed based on hx and CXR which will show accumulated fluid |
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What is pleurisy? Causes? S/S? Monitor/nursing actions? |
Pleurisy is inflammation of the visceral pleura and parietal membranes. Common causes- pulmonary embolism, chronic left sided HF, pneumonia, TB,lupus, rheumatoid arthritis, cancer, liver disease, chest injuries, drug reactions S/S- knife like pain upon deep breathing-usually unilateral, dyspnea- may have spasms, pleural friction rub auscultated early on Monitor- lung sounds, encourage coughing & deep breathing, lay on affected side may provide relief (splinting) |
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What is rhinitis? S/S? Nursing care? |
Rhinitis is inflammation of the nasal mucosa and sinuses caused by an infection or allergens S/S- Excessive nasal drainage, purulent nasal discharge, itching/watering eyes, sore/dry throat, low grade fever, red/inflamed/swollen nasal mucosa Nursing care- encourage rest, increased fluid intake, encourage humidifier |
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S/S of influenza? Nursing care? |
S/S- Severe headache/muscle, chills, fatigue/weakness, diarrhea, cough, fever, hypoxia Nursing care- droplet precautions, provide saline gargles, monitor hydration status (I/O), admin fluid therapy, monitor respiratory status |
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Nursing care for pneumonia? |
High fowlers to promote ventilation, encourage coughing/deep breathing, incentive spirometer, promote fluid intake, |
