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14 Cards in this Set
- Front
- Back
- 3rd side (hint)
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A positive Mantoux test is indicated by the presence of an induration that is ______ mm or larger. Immunocompromised patients are considered positive if an induration of at least ____ is present. |
A positive Mantoux test is evidenced by an induration (palpable, hard, raised area) of at least 10 mm
Immunocompromised patients with indurations of at least 5 mm are classified as testing positive. |
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What are the cardinal s/s of an active TB infection? |
Cardinal Signs/Symptoms: • persistent cough (> 3 weeks) • weight loss (due to anorexia) • low grade fever • night sweats • dyspnea |
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Do individuals who have positive TB skin test results but are negative for active TB require treatment if they have a negative CXR and negative sputum culture? |
Yes. Patients who have been exposed to mycobacterium tuberculosis create antibodies to TB (these antibodies are what cause a positive skin test to appear). The reason they do not have an active infection is because their body has been able to effectively keep the infection from causing illness. However these individuals still have a latent form of TB. As the individual ages or if they become immunocompromised for any reason - the TB will become active, causing damage to the body and making the individual contagious. |
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How soon after exposure to active TB will a person have a positive Mantoux skin test result? |
Within 2-10 weeks of exposure |
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A patient returns 48 after having an intradermal PPD test for tuberculosis. The nurse palpates a visibly reddened area on the patients forearm where the PPD was administered and she notes that the area is raised and hard. The nurse measures the induration and records it's size as 12 mm. What is the next step in diagnosis and treatment of this patient? |
The patient has tested POSITIVE for TB exposure (with an induration of > 10 mm). The next steps include:
1) CXR - to determine whether the patient has evidence of an active TB infection (lesions on the lungs)
2) Sputum Culture • requires collection of 3 early morning sputum samples • definitive diagnosis made by culture positive for myco tuberculosis. * positive culture = ACTIVE TB * negative culture = LATENT
3) Patient NEEDS anti-TB meds - regimen lasts for 6-12 months • INH - Isonazid • RIF - Rifampin • PZA - pyrazinamide • EMB - ethambutol |
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When can a patient admitted with acute (active) TB infection be discharged home and return to normal daily life? |
The patient is started on multiple anti-TB meds and progressively becomes less contagious over 2-3 weeks of taking meds. The patient is cleared once they have three consecutive negative sputum cultures. |
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This CXR shows what? |
Positive Chest X-Ray of patient with Tuberculosis.
Diagnosis: Active TB Infiltrates with classic "cracked-glass" appearance. |
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Peripheral IV sites should be changed/rotated every _____ hours. |
72 hours or according to facility protocol |
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The nurse should insure that IV fluids are discarded _____ hours after they are hung. Tubing should be changed every _____ hours. |
Fluids should be discarded and a new bag hung 24 hours after they are started. IV tubing should be changed every 96 hours. |
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After placing a new peripheral IV the nurse should document what in the patient's chart? |
• WHEN: insertion date & time • WHERE: location of the site on the patient (ex/ Left Forearm) • WHAT: size of catheter, type of dressing used. • HOW: pt response to insertion •WHY: Type of IV Fluid infusing, and rate. |
Example:
08/04/15, 1645, #22-gauge IV Catheter inserted into left wrist cephalon vein (1 attempt), sterile occlusive dressing applied. IV 0.9%NS infusing at 120 mL/hr via infusion pump. Site free from redness or edema, patient tolerated well. C. LaRosa, RN |
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Patient presses call light and reports that her IV site is painful and it looks swollen. The nurse assesses the site and notes pallor, localized swelling, and notices that the skin surrounding the IV site is cool to the touch. What does the nurse do next? |
Likely Issue: IV infiltration
Treatment: 1) stop the infusion 2) remove catheter 3) ELEVATE the extremity 4) apply ice or heat compress 5) Restart IV proximal to site or on opposite extremity. |
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Patients with COPD have a loss of lung elasticity & hyperinflation of the lungs. This pathophysiological issue causes what 3 issues? |
• alveoli destruction • Air trapping & CO2 retention • respiratory acidosis |
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Patients with COPD have a loss of lung elasticity & hyperinflation of the lungs. This pathophysiological issue causes what 3 issues? |
• alveoli destruction • Air trapping & CO2 retention • respiratory acidosis |
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What is the underlying pathophysiologic explanation for why patients with COPD experience respiratory acidosis? |
The loss of lung elasticity and hyperinflation of the lungs results in the trapping of air. CO2 is an acid, the build-up of this gas within lungs that are unable to expel it, decreases pH and puts the patient into a state of respiratory acidosis. |
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