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167 Cards in this Set
- Front
- Back
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What is an epitaxis?
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Nosebleed
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What do you do if someone has an epitaxis episode?
A. B. C. |
A. Pinch nose (soft portion)
B. Insert gauze C. Insert pledget |
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What is a pledget?
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Nose "tampon"
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What could clear, high glucose drainage from the nose indicate for a face trauma?
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inflammation
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What precautions should a patient with facial trauma take?
A. B. |
CSF
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Contraindications for influenza vaccines:
A. B. |
A. Don't take ASA/NSAIDs
B. Sneeze with mouth open |
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What is an alternative to an influenza vaccine?
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A. Allergy to eggs
B. Gullian-Barre syndrome |
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T/F: Sinusitis is an easy cure.
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Antiviral; Tamiflu
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What at home treatment can a patient with sinusitis use?
A. B. |
F: 4-6 weeks ABX
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Acute streptococcal pharyngitis can result in:
A. B. |
A. Saline flush; 1/4 tsp salt per 8 oz tap water, 2-4 puffs TID
B. Bulb syringe lavage over sink |
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T/F: Suctioning a tracheotomy is a sterile procedure.
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A. Rheumatic fever
B. Glomulernephritis |
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T/F: A patient with a trach can learn to talk.
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T
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T/F: Surgery is needed to close trach stoma.
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T: Uses a Passy-Muir one way valve
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Care for a closing stoma:
A. B. |
F
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What type of cancer is at high risk for smoking?
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A. Steri strips
B. Splint when coughing, swallowing, talking |
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Head/neck radiation for cancer causes xerostomia. What is xerostomia?
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Head/neck
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What can a patient do for xerostomia?
A. B. C. |
Dry mouth
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What causes Pertussis?
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Collection of serous fluid in pleural space
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What is empyema?
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Purulent matter in pleural space
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What causes empyema?
A. B. |
A. Trauma
B. Infections |
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Treatment for empyema:
A. B. |
A. ABX
B. Chest tube for drainage |
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What is a bleb?
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Pneumothorax; air in the pleural space
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What does a bleb cause?
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Lung collapse
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Symptoms of a bleb:
A. B. C. |
A. Absent breath sounds
B. Cyanotic C. Subcutaneous emphysema |
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Tx for a bleb:
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Chest tube
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What is a tension pneumothorax?
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Deviated trachea
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Symptoms of a tension pneumothorax?
A. B. C. D. |
A. Air hunger
B. Absent breath sounds C. Cyanotic D. Subcutaneous emphysema |
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What is a hemothorax?
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Blood
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What is atelectasis?
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Alveoli in affected part of lung is airless and collapsed
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What is pulmonary fibrosis?
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Excessive amount of connective tissue in lung
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What is IRDS/ARDS?
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Infant/Acute respiratory distress
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What is a cute bronchitis brought on by?
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Viral infections
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What is another name for chronic bronchitis?
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"Blue bloater"
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What is the onset for bronchitis?
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20-30 years
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What causes bronchitis?
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Inflammation of bronchi by irritants or infection
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Productive or non-productive cough in bronchitis:
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Productive
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T/F: Bronchitis can lead to R sided HF.
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T
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T/F: Bronchitis will cause an increased Hgb, respiratory acidosis, hypercapnia, cardiac enlargement, and digital clubbing.
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T
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T/F: Bronchitis is in high incidence in heavy cigarette use.
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T
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How can pathogens be introduced into lungs to cause pneumonia?
A. B. C. |
A. Aspiration
B. Inhalation C. Circulation spread |
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Who is at risk for PNA?
A. B. C. D. E. F. G. |
A. Smokers d/t reduced ciliary action
B. Immobile d/t decreased air flow C. Immunosuppressed D. Steroid use D. Sedated patients E. Depressed gag reflex F. Alcoholics |
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What is the usual onset of nosocomial PNA?
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48 hours
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What is the major cause of bacterial PNA?
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Streptococcus pneumoniae
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Symptoms of bacterial PNA:
A. B. C. D. |
A. Fever
B. Cough C. Pleuritic pain D. Rusty colored/blood-streaked sputum |
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Complications of bacterial PNA:
A. B. C. D. |
A. Empyema
B. Pleuritis C. Lung abscess D. Bacteremia |
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Dx for PNA?
A. B. C. |
A. Chest XR
B. Increased WBC C. Sputum cx |
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Tx for bacterial PNA:
A. B. C. D. |
A. ABX
B. O2 C. Vaccine D. Turn/cough/deep breathe |
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What causes mycoplasmal PNA?
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Very small fungus; smaller than bacteria
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What is the tx for mycoplasmal PNA?
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Tetracycline/erythromycin
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What is the most common viral cause of PNA?
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Inlfuenza type A
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Who can become incredibly ill from viral PNA?
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Children
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Symptoms of viral PNA:
A. B. C. D. E. |
A. HA
B. Low grade fever C. Achey D. Fatigue E. Dry cough |
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Tx for viral PNA:
A. B. C. D. |
A. Symptom care
B. Palliative care C. Antivirals; ABX not effective |
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Tx for aspiration:
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ABX
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What causes TB?
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Mycobacterium tuberculosis
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What is latent TB?
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Bacteria has been breathed in but immune system keeps it under control
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What test is used to determine presence of TB?
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Tuberculin/Mantoux: PPD intradermal
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How much PPD is inserted for TB test?
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0.1 mL
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When should the TB test be read?
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48-72 hours
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What indicates a + test for TB?
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Induration larger than 10 cm
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Common TB symptoms:
A. B. C. D. E. F. G. |
A. Productive cough
B. Fatigue C. Night sweats D. Hemoptysis E. Fever F. Chills G. Anorexia |
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Tests for TB after + induration:
A. B. |
A. XR
B. Acid fast sputum test |
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How many specimen are wanted for TB testing?
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3 on 2 different days
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Tx for TB:
A. B. C. D. |
A. Isoniziad (9 mo, watch liver)
B. Rifampin (4 mo, orange-tinged body fluids) C. Ethambutol-pyranzimade-strepomycin |
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TB tx barriers:
A. B. C. |
A. Money
B. Insurance C. Access |
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How do we know if someone is cured of TB?
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3 negative sputum tests from 3 different days
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Hospital precautions for TB:
A. B. |
A. Negative air pressure in room
B. Heppa mask |
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Causes of COPD:
A. B. C. |
A. Smoking!!
B. Lung infections C. Genetics (alpha 1 antitryspsin deficiency) |
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When do smoking-induced COPD symptoms start?
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After age 50
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Late symptoms of COPD:
A. B. C. D. |
A. Dyspnea at rest
B. Weight loss and anorexia C. Prolonged expiratory phase D. Barrel chest |
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Why does pursed lipped breathing help a patient with COPD?
A. B. C. D. |
A. Facilitates descent of diphragm
B. Increase small airway pressures, preventing collapse C. Increase vital capacity D. Improve airflow by changing position of trachea |
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What are COPD exacerbations brought on by?
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Bacterial/viral infections
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Tx for exacerbations:
A. B. |
A. Bronchodilators/oral system corticosteroids
B. CPAP |
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Collaborative care for COPD:
A. B. C. D. E. F. |
A. Prevent progression
B. Relieved symptoms and improve exercise tolerance C. Prevent and tx complications D. Promote patient participation in care E. Prevent and tx exacerbations F. Improve QOL |
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What 2 breathing mechanisms should a COPD patient be taugh?
A. B. |
A. Pursed lip breathing
B. Effective coughing (huff) |
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Symptoms of a PE:
A> B. C. D. E. F. G. H. |
A. Chest pain suddenly
B. Dysnpea C. Cough D. Tachypnea E. Fever F. Occasional hemoptysis G. Pleuritic paing H. Tachycardia |
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Dx of PE:
A. B. C. D. |
A. ABG's
B. Pulmonary angiography C. Lung scan D. V/Q |
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Tx for PE:
A. B. C. D. E. |
A. O2
B. Anticoagulatns C. Heparin D. Filtering device in vena cavae E. Thrombolytic drugs |
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Fat embolus is a frequent event after what kind of trauma?
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Long bone
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Symptoms of fat emboli:
A. B. C. D. |
A. 24-48 hours after trauma
B. Progressive resp distress C. Ptechiae over neck, trunck, and conjuctivae D. (If in brain) CNS |
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Tx for fat emboli:
A. B. C. |
A. Fx management
B. Pulmonary support C. Steroids |
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What causes pulmonary edema?
A. B. |
A. L ventricular failure
B. Valvular disorder |
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Main symptom of pulmonary edema
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Blood stained frothy sputum
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Tx for pulmonary edema:
A. B. C. D. |
A. Morphine
B. Bronchodilators C. Diuretics D. Digitalis (HF) |
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What is cor pulmonale?
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RV hypertrophy from lung disease
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What is the prerequisite for cor pulmonale?
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Pulmonary HTN
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Causes of cor pulmonale:
A. B. C. D. E. |
A. All types of pulmonary disease
B. Kyphoscoliosis C. Pickwickian D. Neuromuscular disease E. Extreme obesity |
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Most common cause of cor pulmonale:
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COPD
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Symptoms of cor pulmonale:
A. B. |
A. Enlarged RH
B. Signs of RHF |
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Tx for cor pulmonale:
A. B. C. |
A. Improve alveolar ventilation
B. Digitalis C. Control edema |
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What is cystic fibrosis?
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A chronic respiratory disease of children
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What causes CF?
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Autosomal recessive genes
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How is CF tested?
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A sweat test; test how much Na and Ch is in sweat as CF+ have much more Na and Ch
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What glands are included in CF?
A. B. C. |
A. Respiratory
B. GI C. Reproductive tracts |
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Symptoms of CF:
A. B. C. |
A. Viscous mucous in bronchi
B. Steatorrhea C. Abdominal pain |
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What organ is usually dysfunctional in CF and what must the patient do about it?
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The pancrease; patient will need amylase and lipase enzymes
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Tx for CF:
A. B. C. |
A . Lung care (percussions)
B. Prevent infection C. Pancreatic enzymes |
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Average lifespan of someone with CF:
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32 years
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Tx of choice for PE:
A. B. C. D. |
A. Surgical removal of clot
B. Ambulation C. Anticoagulants D. Fluids |
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T/F: Lung cancer is the #1 malignancy in US
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T
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What cells do bronchogenic carcinomas arise from?
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Epithelium of respiratory tract
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T/F: Most of primary lung tumors are malignant.
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T
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T/F: Lung cancer is more common in smokers than non-smokers.
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T
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Etiology of lung cancer:
A. B. C. |
A. Smoking
B. Industrial hazards/air pollution C. Passive smoking |
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Types of lung cancer:
A. B. C. D. |
A. Squamous cell
B. Small cell C. Adenomacarcinoma D. Large cell |
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T/F: Squamous cell lung cancer is more common in men and smokers and occurs in bronchial epithelium.
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T
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Small cell is also called:
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Oat cell
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Who is most at risk for oat cell cancer?
A. B. |
A. Men
B. Smokers |
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T/F: Oat cell cancer has a good prognosis.
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F
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Where does oat cell occur?
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Main stem bronchi
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T/F: Adenomacarcinoma risk factors include smoking.
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F
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Where does adenomacarcinoma occur?
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In peripheral segmented bronchi and spread via bloodstream
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T/F: Adenomacarcinoma has a good prognosis.
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F
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T/F: Adenomarcarinoma is an equal risk for both sexes and all ages.
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T
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Where does large cell occur?
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Peripherally and centrally and can grow to distort trachea
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T/F: Lung cancer can imitate many other pulmonary diseases.
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T
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Where can lung cancer metastasize?
A. B. C. D. E. |
A. Adrenals
B. Liver C. Brain D. Bone E. Kidneys |
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Dx of lung cancer:
A. B. C. |
A. Radiology
B. Bronchoscopy with biopsy C. Cytology |
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Tx of lung cancer:
A. B. C. |
A. Surgery
B. Chemo C. Radiation |
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What causes adult respiratory distress syndrome?
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Increased permeability of alveolocapillary membrane
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T/F: ARDS leaves no or little permanent damage if patient recovers.
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T
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T/F: There are many causes of ARDS.
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T
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What happens in ARDS?
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Fluid in the lung interstitium
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Dx of ARDS:
A. B. C. |
A. ABG's
B. Pulmonary artery cath C. Chest XR |
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Tx for ARDS:
A. B. C. D. E. |
A. Humidified oxygen through tight-fitting mask
B. CPAP C. Ventilatory support D. Fluid restrictions E. Acid-base balance |
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What causes OSA?
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Tongue and soft palate fall backward and block pharynx
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Risk factors for OSA:
A. B. C. D. |
A. Obesity >28
B. Age >65 C. Neck circumference >17 D. Men |
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Symptoms of OSA:
A. B. C. D. E. F. G. |
A. Insomnia
B. Excessive daytime sleepiness C. Loud snoring D. Morning HA E. Irritability F. HTN G. Pulmonary HTN |
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Dx of OSA?
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Polysomnography: + = 10 events in one hour with oxygen below 90%
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Tx of OSA:
A. B. C. D. E. F. |
A. Avoid sedatives and ETOH before sleep
B. Weight loss C. Oral appliance D. CPAP E. BiPap (higher insp and lower ex) F. Surgery |
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Types of surgeries for OSA:
A. B. |
A. Uvulophalatopharyngoplasty (UPPP)
B. Genioglossal advancement and hyoid myotomy (GAHM) |
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What is CPT?
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Percussion, vibration to promote postural drainage
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T/F: Trach care is sterile.
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T
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Who is at risk for PNA?
A. B. C. |
A. Altered LOC
B. Depressed/absent gag and cough reflex C. Aspiration susceptibility |
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Pink Puffer:
A. B. C. |
A. Barrel chest
B. Indicative of emphysema C. Person works hard to breath but gets enough O2 |
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Blue Bloater:
A. B. C. D. E. F. |
A. RHF
B. Finger clubbing C. >3 second cap refill D. Cyanosis E. Caution giving oxygen to COPD patient, but not dangerous for ever patient |
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Who is at risk for emphysema?
A. B. |
A. Smoker
B. Environmental/occupational exposure |
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Emphysema signs:
A. B. C. |
A. Reduced gas exchange surface area
B. Increased air trapping C. Decreased capillary network |
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Symptoms of emphysema:
A. B. C. D. E. F. |
A. Pink puffers
B. Barrel chest C. Pursed-lip breathing D. Distant, quiet breath sounds E. Wheezes F. Pulmonary blebs on radiograph |
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Nursing for emphysema:
A. B. C. D. E. F. G. |
A. Lowest FIO2 possible to prevent CO2 retention
B. Monitor for fluid overload C. Keep PaO2 between 55-60 D. Baseline ABG E. Teach pursed lip breathing F. Diaphragmatic breathing G. Tripod position |
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What is asthma?
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Narrowing or closure of airway d/t stimulants
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Symptoms of asthma:
A. B. C. D. |
A. Dyspnea
B. Wheezing C. Chest tightness D. Medication hx |
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Tx of asthma:
A. B. C. D. E. |
A. Administer bronchodilators
B. Fluids and humidification C. Education D. ABG's E. Ventilatory patterns |
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What happens during asthma airway narrowing?
A. B. C. |
A. Bronchospasm
B. Mucosal edema C. Hypersecretion of viscous mucous |
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When is the usual onset of asthma?
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12 years old
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T/F: Asthma occurs more in males.
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T
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What constitutes an emergency for asthma?
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No response to tx in 30 minutes
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What is extrinsic asthma?
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Caused by allergen
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What is intrinsic asthma?
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Absence of clearly defined fctors
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What is the most common type of asthma?
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Mixed extrinsic and intrinsic
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Symptoms of asthma:
A. B. C. D. E. |
A. Sudden dysnpea after exposure
B. Difficulty with expiration C. Air trapped distal to obstruction so hyperinflation of lungs D. Prolonged wheezing on exp E. Usual for attack to last several minutes to hours followed by productive cough |
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Asthma tx:
A. B. C. D. E. F. G. |
A. Epi
B. Bronchodilators C. Decreased sense of panic D. Recognize triggers E. Avoidance of allergens F. O2 G. Steroids |
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T/F: IF COPD happens before age 30, its caused by genes.
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T
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Tx for status asthamticus:
A. B. |
A. Vent patient
B. IV meds, steroids |
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Tx for PE:
A. B. C. D. E. |
A. Pain meds; morphine
B. O2 C. Heparin IV D. Fowler's E. Doppler to determine if clots are in legs |
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tPA indications:
A B. C. D. E. F. G H. I. |
A. Acute PE confirmed
B. Persistent hypotension C. Severe hypoxia D. Large perfusion defect on VQ scan E. Extensive embolic burden on CT F. R vent dysfunction G. Free floating R A/V thrombus H. Patent foramen ovale I. Cardiopulmonary resuscitation |
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tPA contraindications:
A. B. C. D. E. |
A. Intracranial surgery
B. Intracranial neoplasm C. Recent internal bleeding (6 mo) D. Hx of hemorrhagic stroke E. Severe uncontrolled HTN |
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T/F: Menstruation is an indication of tPA.
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F
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Nursing indications for resp distress:
A. B. C. D. E. |
A. Fowler's
B. Oxygen C. Increased resp D. Call RT E. Anxiety (Ativan) |
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T/F: Respiratory distress occurs over several hours.
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T
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Normal superior vena cava pressure:
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2-8 mmHg
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Consideration for X-ray:
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Pregnancy
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T/F: Bronchoscopy can cause a vagal response.
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T; administer atropine
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What is a pleural rub?
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No pleural space between lung sacs.
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What is pleurisy?
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Inflammation of pleural membrane
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Tx for pleurisy:
A. B. |
A. Rest
B. ABX |
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What is a pleural effusion?
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Fluid accumulation
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