Pn2 Case D

Front 1

Pco2

Back 1

changes indicate there is a respiratory problem.

Front 2

Hco3

Back 2

indicates there is a change in the metabolic system like with kidneys

Front 3

pH levels

Back 3

acidosis<7.35->7.45 alkalosis

Front 4

Respiratory (pCO2) levels

Back 4

high > 45 acidosis
low < 35 alkalosis

Front 5

Metabolic (HCO3) Levels

Back 5

low < 22 acidosis
high > 26 alkalosis

Front 6

Respiratory Acidosis s/s

Back 6

hypoventilation
shallow breathing
headache
drowsy, dizzy
muscle weakness

Front 7

Respiratory Acidosis Causes

Back 7

COPD, PNU, atelectasis

Front 8

Respiratory Alkalosis s/s

Back 8

seizures
deep rapid breathing
hyperventilation
hypokalemia
numbness or tingling
lethargy
confusion
light headed
nausea, vomiting

Front 9

Respiratory Alkalosis causes

Back 9

Hyperventilation due to anxiety or fear, PE, mechanical ventilation

Front 10

Metabolic Acidosis s/s

Back 10

Headache
hyperkalemia
muscle twitching
warm, flush skin
deep gasping

Front 11

Metabolic Acidosis Causes

Back 11

Diabetic Keto Acidosis
sever diarrhea
renal failure
shock

Front 12

Metabolic Alkalosis s/s

Back 12

restlessness followed by lethargy
dizzy, irritable
compensatory hypoventilation
tremors

Front 13

Metabolic Alkalosis causes

Back 13

sever vomiting
excess GI suctioning
Diarrhea

Front 14

Heart Sounds

Back 14

valve opening and closing;
first heart sounds is s1
second sound is s2
normal sounds are whooshing sounds

Front 15

Clubbing fingernails

Back 15

it is a sign there is something wrong with your body. It results from low oxygen levels in your blood and could be a sign of lung disease.

Front 16

patho of CHF

Back 16

Preload is the pressure
Afterload is what is left in the heart that it didn't get rid of.

Front 17

s/s of CHF

Back 17

fatigue
Increased HR
loss of appetite
edema in legs, feet and ankles
sudden weight gain

Front 18

What is the difference between TB and CHF

Back 18

Edema

Front 19

TX of CHF

Back 19

Surgery, medication, medical devices (pace makers) and lifestyle changes

Front 20

r/c of CHF

Back 20

increased risk for elderly and obese

Front 21

Classes of CHF

Back 21

Class 1- the heart is weakened but no physical limitations
Class 2- no heavy overload of the heart, such as extreme exercis or heavy lifting
class 3- some limitation of everyday activities, climbing stairs or long walks
class 4- total limitation bed rest with no physical activities

Front 22

Patho of COPD

Back 22

airflow limited, exhange happens in alveoli. Aveoli sacks lose elastisticy cant go in and out(expand) Its like a balloon.

Front 23

s/s of COPD

Back 23

SOB, wheezing, barrel chest, chronic chest, production of mucus/sputum, fatigue

Front 24

What color is sputum?

Back 24

CLEAR/WHITE=normal, but could indicate asthma, viral infection, or pulmonary edema
BLACK=black lung, chronic bronchitis
BROWN/RUSTY=TB, smoker's lung
YELLOW=acute bronchitis, acute pneumonia, asthma
GREEN=pneumonia

Front 25

Stage 1 of COPD

Back 25

Lung function of 80% of normal or higher

Front 26

Stage 2 of COPD

Back 26

Chronic cough with lot of mucos
shortness of breath
Lung function of 50-79%

Front 27

Stage 3 of COPD

Back 27

Weight loss, SOB
repeated and sometimes severe COPD flare-ups
Lung fuctions 30-49%

Front 28

Stage 4 of COPD

Back 28

Blue skin color, especially in lips, fingers, and toes
Fluid buildup in the legs and feet
Feeling of fullness and tightness in the belly
Confusion which can happen when there is too much CO2 and not enough oxygen in the blood
Life-threatening COPD flare-ups

Front 29

Tx of COPD

Back 29

no cure. Treatment and lifestyle changes can help the pt feel better, stay more active and slow the progress of the disease. Quiting smokin is the most important step to take in treating COPD.

Medications, Diet and screening

Front 30

Risks of COPD

Back 30

Exposure to tobacco smoke, occupational exposure, age, genetics

Front 31

Complications of COPD

Back 31

Resp. Infections, High blood pressure, heart problems,depression

Front 32

Patient teaching of COPD

Back 32

Get vaccinated against flu and pneumonia
Avoid temperature extremes as severe cold and hot humid air
Eat healthy to stay strong and boost the immune system.
Not too much 02
Drink lots of water

Front 33

O2 in COPD

Back 33

Start with arm exercises and start slowly.
Can't be on 15 liters of o2
Dont give too much o2 stay in low 90's

Front 34

Patho of TB

Back 34

an acid-fast bacillus that usually affects the lungs. It is highly contagious and is transmitted by airborne droplets. Associated with HIV and Aids
BACTERIA IN LUNGS IS CURABLE BUT THE DAMAGEABLE IS NOT REVERSIBLE

Front 35

S/S of TB

Back 35

Latent TB means the person has a TB infection and the bacteria is inactive state. is not contagious.
Active TB makes a person sick and can be spread to others.

Front 36

Signs of TB in the lungs

Back 36

fatigue, weight loss, lethargy, low-grade fever, night sweats, chills.
Cough that produces purulent sputum develops slowly and becomes more frequent
chest pain
coughing up blood

Front 37

Ways to tell you have TB

Back 37

Sputum test

Front 38

Tx of TB

Back 38

Medications (INH, RIF, PZA, EMB)
starts with 4 drugs for 8 weeks

Front 39

Why people dont wanna continue taking TB medications?

Back 39

the side effects (reddish orange body fluids, sweat, saliva and urine) compliance with the medications, gov pays for it.

Front 40

Risks for TB

Back 40

People with weakened immune system; AIDS, chemo, advanced age, malnutrition

People that live or travel to the following countries:
africa, india, china, mexico
High population areas

others: Health care workers, shelters, nursing homes

Front 41

Complications of TB

Back 41

the disease enters the blood and starts affecting the Bones, brain, liver, kidneys,heart

Front 42

Pursed-Lip breathing

Back 42

Inhale through nose exhale through mouth

easiest way to control SOB, causes relaxation, improves ventilation, keeps the airway open longer

Front 43

Altitude and Respiratory Function

Back 43

Pressure only changes with altitude
Run better at a lower elevation

Make sure and drink plenty of water, take it easy, less tobacco, alcohol and salty foods

Front 44

Corticosteroids what it is?

Back 44

Antiasthmatics, anti-inflammatories
tx for asthma

Front 45

Corticosteroids desired effects

Back 45

decreased frequency and severity of asthma attacks

Front 46

corticosteroids s/e

Back 46

headache, dysphonia, hoarseness, agitation, depression, dizziness, gatiuge,dry mouth

Front 47

corticosteroids pt teaching

Back 47

advise pt to take as directed.
use bronchodilator first and allow 5 mins to elapse before corticosteroid

Front 48

Corticosteroids (inhalation) generic names

Back 48

Qvar, pulmicort, aerobid, flovent, asmanex

Front 49

Solu-Medrol Class

Back 49

Intermediate-acting corticosteroids

anti-inflammatories steroidal, ummunosuppressants.

Corticosteroids

Front 50

solu-medrol desired effects

Back 50

Suppresses inflammation

Front 51

solu-medrol s/e

Back 51

depression, euphoria, hypertension, nausea, acne, lower wound healing, muscle wasting, osteoporosis

Front 52

solu-medrol pt teaching

Back 52

Stopping the medication suddenly may result in adrenal insufficiency (anorexia, nausea, weakness, fatigue, dyspnea, hypotension, hypoglycemia)

Glucocorticoids cause immunosuppression and may mask symptoms of infection

Review side effects with patient. Instruct patient to inform health care professional promptly if severe abdominal pain or tarry stools occur. Patient should also report unusual swelling, weight gain, tiredness, bone pain, bruising, nonhealing sores, visual disturbances, or behavior changes

Front 53

Ndx for black lung disease

Back 53

industry evaluation, coal, not reversable

Front 54

Pulmonary function tests

Back 54

determinnes the cause of breathing proglems, lung disease, to evaluate a ptient's lung function before a major surger, monitor progression of a lung disease and determine the effectiveness of pulmonary medications.

Front 55

Isoniazid generic names/class

Back 55

INH, Antituberculars

Front 56

Isoniazid desired effects (antituberculars)

Back 56

Resolution of s/s of tuberculosis, negative sputum cx
prevention of activation of tb in persons known to have exposed.

Front 57

isoniazid s/e (antituberculars)

Back 57

seizures, visual disturbances, drug-induced hepatitis, nausea vomiting, rashes, fever PEURPHIAL NEURITIS

Front 58

isoniazid pt teaching (antituberculars)

Back 58

continue therapy even if symptoms go away

Advise patient to notify health care professional promptly if signs and symptoms of hepatitis (yellow eyes and skin, nausea, vomiting, anorexia, dark urine, unusual tiredness, or weakness) or peripheral neuritis (numbness, tingling, paresthesia) occur. Pyridoxine may be used concurrently to prevent neuropathy. Any changes in visual acuity, eye pain, or blurred vision should also be reported immediately

avoid alcohol, swiss or cheshire cheeses, fish, and tyramine containing foods.

Front 59

isoniazid drug to drug interactions (antituberculars)

Back 59

BCG vaccine may not be effective during therapy because other countries make people get it which makes them positive for TB.

Front 60

Rifampin class

Back 60

antitubercular

Front 61

Rifampin s/e (antituberculars)

Back 61

ataxia, confusion, drowsiness, fatigue, headache, weakness,red discoloration of tears,abdominal pain, diarrhea, flatulence, heartburn, nausea, vomiting, drug-induced hepatitis, red discoloration of saliva

Front 62

Rifampin pt teaching (antiTB)

Back 62

Advise patient to notify health care professional promptly if signs and symptoms of hepatitis (yellow eyes and skin, nausea, vomiting, anorexia, unusual tiredness, weakness) or of thrombocytopenia (unusual bleeding or bruising) occur

Inform patient that saliva, sputum, sweat, tears, urine, and feces may become red-orange to red-brown and that soft contact lenses may become permanently discolored

Advise patient that this medication has teratogenic properties and may decrease the effectiveness of oral contraceptives. Counsel patient to use a nonhormonal form of contraception throughout therapy

Front 63

Pyrazinamide class/ d/e

Back 63

antituberculars

Used in combination with other agents in the treatment of active tuberculosis

Front 64

pyrazinamide s/e (antiTB)

Back 64

HEPATOTOXICITY, anorexia, diarrhea, nausea, vomiting,acne, itching, photosensitivity, skin rash, use caution in gout, diabetes

Front 65

pyrazinamide pt teaching (antiTB)

Back 65

Inform diabetic patients that pyrazinamide may interfere with urine ketone measurements

Advise patients to notify health care professional if no improvement is noticed after 2–3 wk of therapy or if fever, anorexia, malaise, nausea, vomiting, darkened urine, yellowish discoloration of the skin and eyes, pain, or swelling of the joints occurs

Advise patients to use sunscreen and protective clothing to prevent photosensitivity reactions

Front 66

Ethambutol class d/e

Back 66

antituberculars

inhibits the growth of mycobacteria

Front 67

Ethambutol s/e (antiTB)

Back 67

confusion, dizziness, hallucinations, headache, malaise,optic neuritis, abdominal pain, joint pain, fever

Front 68

ethambutol pt teaching (antiTB)

Back 68

Instruct patient to notify health care professional if no improvement is seen in 2–3 wk. Health care professional should also be notified if unexpected weight gain or decreased urine output occurs

Front 69

EF r/t CHF

Back 69

measures blood out of heart
LVEF- blood is being pumped out the of the left ventricle
RVEF Pumped out of the right side

Too low could mean heart failure, previous heart attack, problem with heart valves, uncontrolled high bp

tests for EF
ECG, MRI, CT, nuclear medicine scan

Front 70

ECG or EKG

Back 70

It records the electrical activity that results when the heart muscle cells in the atria and bentricles contract

P=atrial contraction
QRS= Ventricular contraction
T=ventricles are recharging

Front 71

Echo

Back 71

shows heart size: weakened or damaged heart valves, high blood presasure or other diseases causing the chambers to enlarge

pumping strength; EF and CO

damage to the heart muscle: can determine if all parts of the heart wall are normally working

valve problems: shows how heart valves move as your heart beats and can determine blood flow and blood leakage

Heart defects: monitor unborn baby's heart

Front 72

Types of echos

Back 72

transthoracic:
transesophageal: flexible tube down your throat into the esophagus
doppler:
stress: during physical activity

Front 73

Digoxin class/names

Back 73

antiarrhythmics, inotropics;
lanoxicaps, lanoxin

Front 74

digoxin s/e (antiarrhythmics)

Back 74

fatigue, headache, weakness, yellow or green vision,bradycardia, AV block, SA block, thrombocytopenia

Front 75

digoxin pt teaching (antiarrhythmics)

Back 75

Teach patient to take pulse and to contact health care professional before taking medication if pulse rate is &lt;60>100

Review signs and symptoms of digitalis toxicity with patient and family. Advise patient to notify health care professional immediately if these or symptoms of CHF occur. Inform patient that these symptoms may be mistaken for those of colds or flu

Caution patient to avoid concurrent use of other Rx, OTC, and herbal products without consulting health care professional. Advise patient to avoid taking antacids or antidiarrheals within 2 hr of digoxin

Front 76

Sputum Cx

Back 76

tells what pathogens, cancer cells or hypersensitivity cells are in the respiratory tract.

white:viral infection
yellow/green: sign of infection
black: caused by coal,smoke
rust:blood, tb, pneumonia
pink: pulmonary edema

foul smelling sputum means bacterial infections

morning is the best to obtain sputum cx's

Front 77

Theophylline class/name

Back 77

Theo-Dur:
Bronchodilators, Xanthines

Front 78

Theo-Dur d/e

Back 78

Bronchodilation

» CNS stimulation

» Positive inotropic and chronotropic effects

» Diuresis

» Gastric acid secretion

Front 79

Theo-Dur s/e (bronchodilators)

Back 79

SEIZURES, anxiety, headache, insomnia, irritability,ARRHYTHMIAS, tachycardia, angina, palpitations

Front 80

Lungs

Back 80

the lungs are like a balloon. if the lungs over inflate on inspiration and cont completely deflate on expiration.

Front 81

Labs

Back 81

RBC 4.7-9.1 million
Hgb 17-18 grams
HcT 42-52%
WBC 4500-11,000
platelets 150-400,000

Front 82

RBC

Back 82

They carry o2.
Decrease is excessive loss of cells, impaired bone marrow production of the blood cells

increase in smoking, carbon monoxide, long term lung disease, kidney disease, certain forms of heart diseases

Front 83

what should a patient not take before having a theo-dur lab draw?

Back 83

Caffeine

Front 84

What happens to the muscles when given Theo-Dur

Back 84

the smooth muscles open up

Front 85

what med do you give to decrease the side effects for INH

Back 85

Vitamin b6 for peurphial neuritis

Front 86

When you give a PPD injection what reaction should you see?

Back 86

Bubble or a wheel

Front 87

How does SIADH fit with COPD

Back 87

r/t water retention

Front 88

Demeclocycline class/ d/e

Back 88

Tetracycline antibiotic

inhibitis baterial protein synthesis in bacteria. inhibits the action of antidiuretic hormone SIADH.

Front 89

Demeclocycline s/e (tetracycline antibiotic)

Back 89

photosensitivity, rash, anorexia, nausea

Front 90

Demeclocycline pt teaching (tetracycline antibiotic)

Back 90

Birth control less effective, causes yellowing or graying of the teeth and can affect a child's growth.

Front 91

Fluid restriction amount

Back 91

depends on medical condition, fluid retention, patients output and on the the pts weight change. If intake is too low then BUN and cr will be elevated. call dr if more then 3lbs in 3 days

Front 92

Emphysema vs bronchitis

Back 92

emphysema occurs in the alveolis
bronchitis occurs in the airways of the bronch tubes.

Front 93

Lung sounds

Back 93

Wheezing: high pitch whistling sounds occurs when bronchs are narrowed in lower part of the trachea

crackles:rattling, bubbling or crackling when both lungs because air pushes open closed alveoli.

rhonchi:resembles snoring, occurs in the upper bronchial or lower part of trachea. blockage in the airway due to secretions or excess wetness.

Front 94

Tracheostomy

Back 94

provides air passage to help you breath
used to help a patient breath, preparation for major surgery and severe trauma

Front 95

Polycythemia

Back 95

excessive rbc production.
caused by decreased water intake, diarrhea, vomiting,
symptoms are weakness, fatigue,headache, blood cloting
tx: removing blood, asa, exercise

Front 96

Streptomycin class d/e

Back 96

anti-infectives

resolution of the signs and symptoms of infections

Front 97

streptomycin s/e (anti-infectives)

Back 97

ototoxicity, nephrotoxicity, muscle paralysis

Front 98

streptomcyin pt teaching (anti-infectives)

Back 98

reports signs of hypersensitivity, tinnitus, vertigo, hearing loss, rash
advise pt to drink plenty of fluids
give im administration into well-developed muscle. alternated sites

Front 99

diet with TB

Back 99

consumes all 5 food groups and enough calories to fight infection

Front 100

Diet with COPD

Back 100

eat healing protein such as increased iron with protein.

take lots of Vitamins A,C, and D

Eat 5,6 small meals a day

Front 101

COPD weight

Back 101

The are usually less than body weight since lack of oxygen cause fatigue and makes it difficult to have energy to make meals

Front 102

determining metabolic or respiratory acidosis or alkalosis

Back 102

pH
less 7.35----range----7.45 greater
acidosis--------------------alkalosis

PaCo=Respiratory
greater 45-------------------35 less
acidosis--------------------alkalosis

HCo3=Metabolic
less 22-------------------26 greater
acidosis--------------------alkalosis

Front 103

Beta-Adrenergic Agonists (Asthma) Names

Back 103

Albuterol (veentolin) formoterol (foradil)epinephrine, metaproterenol (Alupent), Salmeterol (serevent).

Front 104

Beta d/e (Albuterol)

Back 104

Relaxation of airway smooth muscle with subsequent bronchodilation

Front 105

Beta s/e (Albuterol)

Back 105

PARADOXICAL BRONCHOSPASM (EXCESSIVE USE OF INHALERS
chest pain, palpitations
nervousness, restlessness, tremor

Front 106

Beta pt teaching (Albuterol)

Back 106

Instruct patient to prime unit with 4 sprays before using and to discard cannister after 200 sprays. Actuators should not be changed among products

Inform patient that albuterol may cause an unusual or bad taste

Advise patients to use albuterol first if using other inhalation medications and allow 5 min to elapse before administering other inhalant medications unless otherwise directed

» Advise patient to rinse mouth with water after each inhalation dose to minimize dry mouth

Front 107

Corticosteroids endings

Back 107

-End in ONE