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102 Cards in this Set
- Front
- Back
What is sinusitis?
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What is sinusitis?
- Inflammation of the sinuses |
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How do you instruct pt to care for bloody nose?
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How do you instruct pt to care for bloody nose?
- sit upright - lean forward - squeeze - monitor for excessive swallowing - apply Ice |
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pt has posterior nose bleed packing (tampon) asks why she can’t take Motrin?
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pt has posterior nose bleed packing (tampon) asks why she can’t take Motrin?
- it will make her bleed (question the order) |
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What is another name for a bloody nose?
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What is another name for a bloody nose?
- Epistaxis |
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Pt with nose trauma with “excessive swallowing” what does that mean?
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Pt with nose trauma with “excessive swallowing” what does that mean?
- Bleeding requires immediate intervention |
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Where would a pt feel pain, if they are having maxillary sinusitis?
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Where would a pt feel pain, if they are having maxillary sinusitis?
- cheek bones |
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What is T&A?
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What is T&A?
-Tonsillectomy & Adenoidectomy (surgical removal of tonsils and adenoids) |
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pt complains of a cold and is now running high fever- what could be the cause?
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pt complains of a cold and is now running high fever- what could be the cause?
- BACTERIAL INFECTION- needs immediate intervention - Ex; Sinus infection- Bronchial infection |
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What test do we use to determine what type of a SOTH (sore throat) pt is having?
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What test do we use to determine what type of a SOTH (sore throat) pt is having?
Culture (the causative agent) and Sensitivity (determine what ABX to use) |
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Pt with strep throat if left untreated causes what?
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Pt with strep throat if left untreated causes what?
-Endocarditis -Rheumatic Fever -Acute Glomerulonephritis -Heart Valve Problems -Otitis Media (Middle Ear) - Scarlett Fever ( Peritonsillar Abscess, - Bronchitis, - Pneumonia, - Sinusitis, - Mastoiditis) |
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Q1. What is Peritonsillar Abscess?
Q2. What is the s/s of Peritonsillar Abscess? Q3. If tonsils get swollen and not watched carefully, what happens to you uvula? |
Q1. What is Peritonsillar Abscess?
Abscess on tonsils Q2. What is the s/s of Peritonsillar Abscess? Deviated Uvula (puss pockets on the tonsils) Q3. If tonsils get swollen and not watched carefully, what happens to you uvula? Deviates the Uvula Moves it over or smooches it. |
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What is the 1st sign of a problem?
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What is the 1st sign of a problem?
- restlessness |
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What is laryngitis?
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What is laryngitis?
- inflammation of larynx |
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What is the #1 cause or risk factor for Laryngeal Cancer?
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What is the #1 cause or risk factor for Laryngeal Cancer?
- ETOH (alcohol) & Smoking |
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Q1. What is a possible complication of T&A?
Q2. How would you know if your pt is hemorrhaging? Q3. what are the s/s your watching for in a pt who is post-op T&A hemorrhage (bleeding to death)? |
Q1. What is a possible complication of T&A?
- bleeding (hemorrhaging) Q2. How would you know if your pt is hemorrhaging? - Excessive swallowing Q3. what are the s/s your watching for in a pt who is post-op T&A hemorrhage (bleeding to death)? - decreased BP- rapid pulse - (Nausea, lethargy) |
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What do u advise pt w laryngitis for a rapid recovery?
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What do u advise pt w laryngitis for a rapid recovery?
- Rest vocal cords (voice box) |
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What do u do to prepare a patient prior to a total laryngectomy?
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What do u do to prepare a patient prior to a total laryngectomy?
- establish communication means With a chalk board, paper pencil ect.. |
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What is total laryngectomy?
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What is total laryngectomy?
Removal of the larynx |
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What is tracheostomy?
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What is tracheostomy?
- Surgical incision in the trachea to establish airway (stoma) |
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Prior to a tracheostomy what do u establish 1st?
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Prior to a tracheostomy what do u establish 1st?
establish form of communication first |
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Post radical neck procedure you’re looking for what sign of complication?
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Post radical neck procedure you’re looking for what sign of complication?
Restlessness & then DYSPNEA |
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Why do we refrain from cutting into a 4x4 gauze for a trach pt?
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Why do we refrain from cutting into a 4x4 gauze for a trach pt?
fibers can enter the airway (there is a special gauze made for trach.) |
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What is hypoxia?
What is hypoxemia? |
What is hypoxia?
Lack of oxygen in tissues What is hypoxemia? Lack of oxygen in blood |
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What is your first intervention to perform prior to trache care and why?
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What is your first intervention to perform prior to trache care and why?
Suction the trache and oxygenate them |
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what do you ask pt before you give a flu shot?
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what do you ask pt before you give a flu shot?
“Are you allergic to Chicken, feather or eggs? “ |
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What is the influenza vaccine?
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What is the influenza vaccine?
- flu shot |
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Beside vaccinating for the flu, what other advise would u give pt who is at high risk?
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Beside vaccinating for the flu, what other advise would u give pt who is at high risk?
avoid crowded areas |
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pt who had chronic bronchitis is having hypoxia- could large amounts of tenacious mucous be the cause?
why? |
pt who had chronic bronchitis is having hypoxia- could large amounts of tenacious mucous be the cause?
-YES why? Because it blocks access to the aveoli |
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Who is most at risk for pneumonia?
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Who is most at risk for pneumonia?
Old & young people Immunocompromised Hospitalized in ICU, mechanical ventilation, aspiration, immobility smokers or alcohol abusers post-op pt recent exposure to viral or influenza infection those with a chronic condition such as chronic lung disease (asthma) or cardiovascular disease |
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Q1. Who is least likely to be at risk for pneumonia in the hospital?
Q2. Who is most at risk? |
Q1. Who is least likely to be at risk for pneumonia in the hospital?
Pt who is able to ambulate frequently Q2. Who is most at risk? Pt post op hip |
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what group of people are encouraged to get pneumonia vaccines?
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what group of people are encouraged to get pneumonia vaccines?
Elderly Pre-Pregnant woman Children Hospital workers Immune compromised |
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What diagnostic tool is used most frequently to Dx pneumonia?
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What diagnostic tool is used most frequently to Dx pneumonia?
Chest (lungs) x ray |
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What type of lab test would be increased in a pt with pneumonia?
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What type of lab test would be increased in a pt with pneumonia?
WBC’s |
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What is pleurisy?
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What is pleurisy?
Inflammation of the parietal & visceral tissues (pleural space) |
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What are the s/s of pleurisy?
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What are the s/s of pleurisy?
Severe pain when breathing in (inspiration) and SOB |
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pt who has pneumonia has a chest x-ray how do you confirm on xray that it is pneumonia?
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pt who has pneumonia has a chest x-ray how do you confirm on xray that it is pneumonia?
white Patchy cloudy areas (CONSOLIDATION) |
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How is TB spread?
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How is TB spread?
- airborne/ droplets |
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What type of isolation would u have your TB pt on?
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What type of isolation would u have your TB pt on?
airborne /droplet precaution (negative airflow room) |
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What type of mask does nurse wear with TB pt?
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What type of mask does nurse wear with TB pt?
FIPS/HEPA/n95- MASK must be on |
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does pink frothy sputum indicate pulmonary edema?
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does pink frothy sputum indicate pulmonary edema?
YES (Because pink is blood tinged) |
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What is hystoplasmosis?
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What is hystoplasmosis?
Condition of fungal spores in the lungs (Caused from chickens bats and barns) |
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What does “cavities caused by caseation” mean?
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What does “cavities caused by caseation” mean?
- caseation (necrotic tissue is converted to cheese like material which forms cavities containing tubercle basilli) - spores that fall apart - without the chunk = cavity (egg) (cheesy like the egg via caseation) that (((fall apart))) and get cheesy pg. casseation softening of the spores |
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What evidence of TB is provided by chest xray?
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What evidence of TB is provided by chest xray?
“cavities caused by caseation” (egg looking spots with holes in them) |
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What tye of people are at risk more than any other for TB
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What tye of people are at risk more than any other for TB
- People living in crowded places - immigrants - homeless - health care providers - immuno compromised |
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what does PPD stand for?
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what does PPD stand for?
- Purified Protein Derivative - Mantoux skin test - intradermal test, 10-15 degree angle, bevel up |
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what does a positive skin test look like?
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what does a positive skin test look like?
-induration of greater than 10mm in diameter -in the immune compromised it is 5mm or greater |
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What is the most accurate way to diagnose TB?
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What is the most accurate way to diagnose TB?
- acid fast bacillus - Need 3 positive tests done on separate days- SPUTUM – this would indicate positive for TB |
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What type of mask do we use to protect us from TB?
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What type of mask do we use to protect us from TB?
N95 or HEPA (only) |
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if pt has positive PPD skin test, what is the next test?
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if pt has positive PPD skin test, what is the next test?
- Then you do chest x ray and if that is positive, you would do a sputum test (AFB) |
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If you’re working in ER and pt presents with possible TB, what is your initial intervention?
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If you’re working in ER and pt presents with possible TB, what is your initial intervention?
- Isolation or provide them with a mask |
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What does the AFB stand for?
How many do you need? |
What does the AFB stand for?
-Acid Fast Bacillus How many do you need? - need 3 positive tests in a row on separate days to confirm TB - need 3 negative to confirm NOT have TB (after max drugs) |
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What is the minimal time you spend on TB drugs?
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What is the minimal time you spend on TB drugs?
6 Months (minimum) |
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If a pt is suspected of being exposed to inhalated Anthrax, what is you initial intervention?
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If a pt is suspected of being exposed to inhalated Anthrax, what is you initial intervention?
Isolate them, Culture them and get them on the antibiotic therapy |
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What does ARDS stand for?
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What does ARDS stand for?
- Acute respiratory distress syndrome (Syndrom=group of symptoms all related) |
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Does ARDS have a high mortality rate?
Is surfactant production reduced in ARDS pt’s? |
Does ARDS have a high mortality rate?
- yes Is surfactant production reduced in ARDS pt’s? - YES |
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What are normal SAO2?
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What are normal SAO2?
95-100% |
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Q1. pt on vents do they have alarms?
Q2. What is your initial response when the alarms go off? |
Q1. pt on vents do they have alarms?
Yes Q2. What is your initial response when the alarms go off? - if it goes off check your pt |
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what does intubate mean?
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what does intubate mean?
- tube into the airway |
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after finding the underlying cause in ARDS pt what is the next medical intervention?
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after finding the underlying cause in ARDS pt what is the next medical intervention?
- mechanical ventilator |
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what types of pts need intubation and ventilation? Who is at highest risk?
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what types of pts need intubation and ventilation? Who is at highest risk?
- respiratory distress pt- hypoxic pt- hypoventilated pt - PT WHO AREN’T BREATHING |
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what does PE stand for?
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what does PE stand for?
-Pulmonary Emboli |
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What is a Pulmonary emboli?
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What is a Pulmonary emboli?
Dislodged thrombi. Something blocking the vein including fat, air or blood clots Emboli is something moving (like fat or clot or air) |
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what group of people are at risk for PE?
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what group of people are at risk for PE?
Obese smoking DVT surgery pregnancy inactivity sickle cell pt people who fly lack of exercise |
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What does SARS stand for?
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What does SARS stand for?
-Severe Acute Respiratory Syndrome |
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what type of surgical procedures puts a pt at risk for PE?
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what type of surgical procedures puts a pt at risk for PE?
Abdominal surgery (bloody surgeries) Any type of orthopedic surg (there is blood in the bones) |
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What does sleep apnea mean?
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What does sleep apnea mean?
- Periods of no breathing during sleep |
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What is the primary role of nurse during SARS outbreak?
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What is the primary role of nurse during SARS outbreak?
- Preventing spread of infection to other pt (wash hands, PPE, resp isolation) - isolate pt- keep staff and rest of pts safe |
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Do pt who have sleep apnea - have excessive drowsiness during the day?
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Do pt who have sleep apnea - have excessive drowsiness during the day?
YES |
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What is the CPAP machine for?
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What is the CPAP machine for?
- delivers Continuous Positive Airway Pressure to pt with sleep problems (like sleep apnea) - breathing face mask – breaths for patient |
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What does wheezing sound like?
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What does wheezing sound like?
wheezing- sounds like high pitched whistles or squeaks |
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what’s your intervention for pt who are in respiratory distress due to asthma?
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what’s your intervention for pt who are in respiratory distress due to asthma?
- sit them up - breathing Tx (with nebulizer = aerosol medication w/ humidified O2) - oxygen |
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when you hear wheezing do you hear it on inspiration or exhalation?
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when you hear wheezing do you hear it on inspiration or exhalation?
- exhalation |
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What do we teach pt with asthma to keep a diary for asthma and triggers?
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What do we teach pt with asthma to keep a diary for asthma and triggers?
To find out what the cause is and to avoid and eliminate it |
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what is emphysema?
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what is emphysema?
-An aveoli disease – aveoli are hyper inflating |
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what does the chest of a emphysema pt look like?
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what does the chest of a emphysema pt look like?
-barrel chested |
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until you know pt respiratory status what is the amount of O2 the nurse can deliver. (standing order)
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until you know pt respiratory status what is the amount of O2 the nurse can deliver. (standing order)
2-3 Liters of O2 (pick one that is closest to the answer) |
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If pts with emphysema have a loss of surface area for gas exchange which is making them hypoxic.
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If pts with emphysema have a loss of surface area for gas exchange which is making them hypoxic.
-they have less capillaries on their surface area (alveoli) resulting in less O2 gas exchange - Hypoxic |
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what is O2 flow rate for people with emphysema?
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what is O2 flow rate for people with emphysema?
-1 or 2 Liters |
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what is the position you place your pt for the best O delivery?
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what is the position you place your pt for the best O delivery?
-orthopnic |
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pt has emphysema and has dyspnea while just brushing their hair- what are they at risk for?
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pt has emphysema and has dyspnea while just brushing their hair- what are they at risk for?
-RESPIRATORY ACIDOSIS |
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What is Respiratory failure
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What is Respiratory failure?
gas exchange failure |
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What is a Telephone Triage Nurse for ?
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What is a Telephone Triage Nurse for?
Decides Priority |
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what chemical exchange stimulate pt to breathe faster or slower?
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what chemical exchange stimulate pt to breathe faster or slower?
CO2 |
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CO2 is produced from?
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CO2 is produced from?
CO2 is from cellular metabolism. |
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if pt is deteriorated with COPD besides restlessness and decreased LOC what will happen?
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if pt is deteriorated with COPD besides restlessness and decreased LOC what will happen?
-they will be confused or loopy from lack of O2. |
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pH
PaO2 PaCO2 HCO3 |
pH - 7.35-7.45
PaO2 - 80-100 PaCO2 - 35-45 HCO3 - 21-28 |
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If pt is choking and coughing, what does the nurse do?
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If pt is choking and coughing, what does the nurse do?
-just watch pt because they can still breathe |
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If pt is choking......(what do you do?)......
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If pt is choking......(what do you do?)......
-find out what it is (ask them: “is a piece of meat stuck in your throat?”)... |
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What is Stridor?
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What is Stridor?
-Upper airway obstruction. High pitched squeaks |
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What do you monitor for pt with head and neck trauma?
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What do you monitor for pt with head and neck trauma?
-monitor for stridor |
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What is Atelectasis?
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What is Atelectasis?
-collapsed lung- will have diminished breath sounds |
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what would you expect to see in pt with tension pneumothorax?
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what would you expect to see in pt with tension pneumothorax?
-deviated trach- (lung pulled to side and trach shifts to other side) |
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what is hemothorax?
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what is hemothorax?
-blood in pleural space (chest cavity) |
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what would your findings be on pt with spontaneous pnuemothroax?
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what would your findings be on pt with spontaneous pnuemothroax?
-unilateral (one side) chest pain |
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what sound would you expect to hear when percussing a chest full of blood?
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what sound would you expect to hear when percussing a chest full of blood?
-dull sounds |
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what is flail chest?
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what is flail chest?
-unstable chest |
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What are s/s of a flail chest?
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What are s/s of a flail chest?
-broken ribs, isolated chest area moving in, bulging, on inspiration the chest blows out, Strange sounds |
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What is dyspneic?
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What is dyspneic?
-severe difficulty breathing |
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What is major risk factor for lung cancer?
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What is major risk factor for lung cancer?
-smoking |
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Bronchial asthma (asthma is Bronchials) is caused by what?
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Bronchial asthma (asthma is Bronchials) is caused by what?
-inflammation (narrowing of airway) and fluid (mucous and phlegm) |
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What is the early warning sign of the undiagnosed pt with Lung cancer?
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What is the early warning sign of the undiagnosed pt with Lung cancer?
-persistant cough (non-productive). |
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What does carbon monoxide poisoning do to a pt? (causes; car, house)
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What does carbon monoxide poisoning do to a pt? (causes; car, house)
-Carbon monoxide molecules attach (bonds) to red blood cells and hemoglobin instead of oxygen molecules (replacing the oxygen molecules) making the patient hypoxic. |