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386 Cards in this Set
- Front
- Back
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A deflection of the normally straight nasal septum. Caued by trauma to the nose or congenital disproportion, a condition in which th size of the septum isnot proportional to the size of the nose
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Deviated septum
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Medical managment of deviated septum includes nasal allergy control as in allergic rhinitis. For pts. with severe symptoms, a nasal ____ is performed to rescontrusct and propoerly align the deviated septum
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septoplasty
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Nasal fractures account for approximately40% of bone injuries in cases of facial trauma.
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info
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nasal fractures can be classified by 3 ways. this fracture typically produces little or no displacement.
a. bilateral b. unilateraly c. complex |
b. unitlaterally
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the most common fracture, gives the nose a flattented look.
a. bilateral b. unilateraly c. complex |
a. bilaterraly
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this fracture of the nose causes other subsequent damage to adjacent facial structures such as teeth, eyes, or other facial features
a. bilateral b. unilateraly c. complex |
c. complex
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Ecchymosis involving both eyes is often termed?
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raccoon eyes
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In assessing a nasal fracture, we need to note presence of edema bleeding or hematoma. In the presence of Clear drainage which suggests CSF. We may do a bedside test to determine if what is present? this indicates csf is present.
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glucose
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This is the surgical reconstruction of the nose, is performed for cosmetic reasons or to improve airway function owhen trauma or developmental deformities result in nasal obstruction.
a. septoplasty b. rhinoplasty |
b. rhinoplasty
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Nasal septal splints may be inserted to help prevent scar tissue formation between the surgical site and lateral nasal wall.
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info
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IN a surgery with rhinoplasty, septoplasty and nasal fracture reductions. Pts should not take aspirin containing drugs or NSAIDS for 2 weeks reducign risk for bleeding
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.info
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anoter name for nosebleeds
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epitaxis
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Epitaxis is most evident in children less than 10 and over tha ge of 50.
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info
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Wtih epitaxis, keep pt. quiet, place in sitting position leaning forward or in high folwers position. Apply direct pressure to soft lower portionof hte nose 10 to 15 minutes. Apply ice compresses. insert small gauze pad into nose.
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info
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Nasal packing is left in place for a minimum of 3 days. After removal the nares may begently cleaned and lubricated with water soluble jelly?
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True
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This is the reaction of the nasal mucosa to a specific allergen.
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Allergic rhinitis
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Two types of allergic rhinitis: this one is the symptoms are present less than 4 days a week or less than 4 weeks per year.
a. ingtermittent b. persistent |
a. intermittent
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This allergic rhinitis means that the symptoms are present more than 4 days a week or more than 4 weeks per year.
a. ingtermittent b. persistent |
b. persistent
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Sensitization to an allergen, re3elts in the production of this antigen-specific immunoglobulin.
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IgE
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These are clinical manifestations of what: sneezing, watery itchy eyes and nose, altered sense of smell, thin watery nasal discharge, h/a, congestion, pressure, nasal polyps, and postnasal dripe as the most common cause of cough.
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allergic rhinitis
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The most important step in managing allergic rhinitis what?
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Identifying and avoiding triggers of allergic reactions
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The goal of medciation therapy is to reduce inflammation associated with allergic rhinitis and reduce nasal symptoms so that the pts hs no adverser effects and can sleep well at noight to avoidy datime somnolence.
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info
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Drug therapy:
inhibits inflammatory response: beclomethasone, rhinocort, flonase, nasonex, nasacort a. corticosteroids b. mast cell stabilizer c. LTRAs d. anticholinergic nasasl spray e. 1st and second gernation antihistamines f. decongestants g. topical nasal spray |
a.
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drug therapy:
Inhibits degranulation of sensitized mast cells, which occurs after exposure to specific antigens: nasalcrom a. corticosteroids b. mast cell stabilizer c. LTRAs d. anticholinergic nasasl spray e. 1st and second gernation antihistamines f. decongestants g. topical nasal spray |
b.
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drug therapy: antagonize or hinhibit leukotriene activeity, theryby inhibiting airway edema and bronchoconstriction and decreasing inflammatory process: accolate, singulair, zyflo
a. corticosteroids b. mast cell stabilizer c. LTRAs d. anticholinergic nasasl spray e. 1st and second gernation antihistamines f. decongestants g. topical nasal spray |
c
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Drug therapy:
blocks hypersecretory effects by competing for binding sites on the cell. Reduces rhinorrhea in the common cold and nonalergic rhinitis: Atrovent, ipratropium bromide a. corticosteroids b. mast cell stabilizer c. LTRAs d. anticholinergic nasasl spray e. 1st and second gernation antihistamines f. decongestants g. topical nasal spray |
d.
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Drug therapy:
binds with H1 receptors on target cells, blovcking histamine binding. Relieves acute symptoms of allergic response. Tavist, benadryl, claritin, zyrtec, allegra, clarinex a. corticosteroids b. mast cell stabilizer c. LTRAs d. anticholinergic nasasl spray e. 1st and second gernation antihistamines f. decongestants g. topical nasal spray |
e
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Drug therapy:
Stimulate adrenergic recptors on blood vessels, promotes vascoconstriction, and reduce nasal edema and rhinorrhea: sudafed a. corticosteroids b. mast cell stabilizer c. LTRAs d. anticholinergic nasasl spray e. 1st and second gernation antihistamines f. decongestants g. topical nasal spray |
f
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Thisi called the common cold and is caused by an adenovirus that invades the upper respiratory tract and often accompanies an acute URI
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acute viral rhinitis
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This upper respiratory problem is the most prevalent infections disease and is spread by airborne droplet sprays emitted by infected person. This virus can suriveve on inanimate objects for up to 3 days.
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acute viral rhinitis
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For people with actue viral rhinitis rest, fluids, proper diet, antipyretics and analgesics are recomended
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info
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Pts should be caustioned to use intranasal decongestant sprays for no more than _ days.
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3
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The most comon complication of finluenze is ?
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pneumonia
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Two types of flu vaccines available
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live-attenuated, inactivated
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Any adult over 50 yoa, with cronich cardiac or pumonary disease, residents in long care facilities, immunocompromised adults should receive which flu vaccine
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inactivated
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This develops when the ostia (exit) rom the sinuses are narrowed or blocked by inflammation or hypertrophy of hte mucosa. The secretionsthat accumulate behind the obstruction provide a rich medium for growth of bacteria, viruses and fungi
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sinusitis
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When someone has sinusitis, antihistamines should be avoided? t or F
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true
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These are benign mucous membrane masses that form slowly in response to repeated inflammation of the sinus or nasal mucosa. They appear as bluish, glossy projections in the nares.
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nasal polyps
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Inorganic foreign bodies may lay undiscovered till routine examination. however organic causes more problems
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true
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This is an accute inflamation of hte pharyngeal walls. Tonsils, palate, uvula can be caused by viral bacterial or fungal infection.
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actue pharyngitis
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The symptoms of this upper respiratory problem is a scratchy throat or sallowing difficulty
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acute pahryngitis
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The goals of nursing managment are infection control, symptomatic relief, and prevention of secondary complications.
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acute pharyngitis
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Strep throat is treated with____ and candida infections of phayngitis is treated with _____
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antibiotics. nystatin
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This is a compliation of acute paryngitis or actue tonsilitis when bacterial infectoins invades one or both tonsils.
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peritonsillar abscess
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The patient in this type of acute pharyngitis experiences high fever, leukocytosis, "hot potato voice" and chills.
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peritonsilar abscess
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This is a condition characterizzed by partial or com plete upper airway obstruction during sleep.
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Obstructive sleep apnea
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This term is the cessation of spontaeous respirations lasting longer than 20 seconds
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apnea
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this is a condition characterized by shallow respirations
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hypopnea
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during apneic period the patient can expierienc severe ____ (decreased pao2 or sao2) and ____ (increased paco2)
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hypoxemia, hypercapnia
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Clinical manifestations of this include, awakening at night, insomnia, ecessive daytime sleepiness and witnessed apneic episodes. H/A, personality changes, and irritability.
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Sleep apnea
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The pt. with sleep apnea, should be instructed to avoid sedatives and alcoholic beverages for 3 to 4 hours before sleep
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sleep apnea
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This is used to help sleep apnea, the patient applies a mask that is attached to a high-flow blower. The lbower is adjusted to maintain sufficient positive pressure in the airway during inspiration and expiration.
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CPAP
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In the even the patients cannot adjust to exhaling against the high pressure, this machine can deliver a higher inspiration pressure and a lower pressure during expirations
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BiPAP
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This is a surgical incision into the trachea for the purpose of establishign an airway.
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tracheotomy
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This is the stoma that results from the tracheotomy
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tracheostomy
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A trachesotomy tube with an inflated cuff is used if the patient is at risk for _____ or needs ventilation.
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aspiration
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If a tube is accidentally dilodged the nurse should immediately attempt to replace it.
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true
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The patient with a tracheostomy who cannot protect the airway from aspiration requires an inflated cuff.
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treu
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An inflatedcuff may result in swallowing dysfunction because the cuff interferes with the normal function of muscles used to swallow
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info
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Two ways to evaluate aspiration with tracheostomy.
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Adding blue food coloring to clear liquid or testing of treacobroncial secretions for glucose
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Food coloring method for risk of apirations
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have pt swallow with a deflated cuff. if pt doesn't cough anything up or you suction and none of the coloring comes up they are good
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The spontaneously breathing patient may be able to talk by deflating the cuff, which allows echaled air to flow upward over the vocal cords. Obtructing the tube can enhance this.
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info
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This type of tracheostomy tube has openings on the surface of hte outer cannula that permits air from the lungs to flow over the vocal cords.
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fenestrated tube
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A disadvantage for this tube is the potential for development of tracheal polyps from tracheal tissue ranulating into the fenestrated openings
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fenestrated tube
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This type of traheostomy tube has two pigtail tubings. On tubing connnects to the cuff and is used for cuff inflation and the second connects to an opening just above the cuff. When the second tubing is connected to a low flow air source, air moves up over the vocal cords to permit speach. The patient can speak while the cuff is inflated.
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speaking tracheostomy tube
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These polyps develop on the vocal cords from vocal abuse or irritation. The most common symptomsis hoarseness. Voice rest and adequate hydration. Surgical removal may be indicated for larger polyps, whcy may cause dsypnea and stridor.
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Laryngeal polyps
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Most head and neck cancers occur in individuals 50 years or older after prolonged use of tobacco and alcohol
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info
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The stages of head and neck cancers are determined b ased on the TNM
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tumor size, nodes involved, extent of metastasis
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This is the partial removal of one vocal cord, is used when there is superficial tumor involving one cord
a. cordectomy b. hemilaryngectomy c. supraglottic laryngectomy |
a.
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this involves removal of one vocal cord or part of a cord and requires a termporary tracheostomy.
a. cordectomy b. hemilaryngectomy c. supraglottic laryngectomy |
b.
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involves removing structures above the true cords0 the false vocal cords and epiglottis. The patient is at high risk of aspiration following this surgery and requries a termporary racheostomy.
a. cordectomy b. hemilaryngectomy c. supraglottic laryngectomy |
c.
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Advanced lesions of the layrnx requires this surgery which is ther entire removal of the larynx, and preepiglottic region and a permanent tracheostomy is performed.
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laryngectomy
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After a laryngectomy this is the surgery that follows to decrease the risk of lympatic spread. The following structures may be transected: sternoclediomastoid muscle, internal jugular vein, mandible, submaxillary gland, part of the thryoid and parathryoid glands and spinal accessory nerve
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radical neck dissection
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After a layrngectomy this dissection is opeformed whenever possible as an alternatibve to a radical neck dissection. This type spares as many structures as pssiblt to limit a disfigurment.
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modified neck dissection
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Take a deep breath
Perform valsalve maneuver swallow cough swallow breathe |
supraglottic swallow
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Radiation therapy nursing interventions. Dry mouth (xerostomia) give salagen, or have them chew sugarless gum. Take frequent rest periods to prevent fatigue. should be encouraged to seat small bland foods. Skin over the radiated area is sensitive. Should use only prescribed lotions and to not use any lotions within 2 hours piror to treatment. Exposure to sun must be avoided
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info
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teaching, support and maintenance of good patent airway should be an intervention of radical neck dissection.
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info
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The most commonly used voice prosthesis is the _____ ____. This device is inserted into a fistula made between the esophagus and the trachea. It is a one way valve, so food water or air does not get into the trachea via the moouth. when the person plugs up the stoma and air passes through the esophagus where the lips and tongue forms words
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blom singer
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This is a handled battery powered device that creates speech with the use of sound waves.
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electrolarynx, Cooper rand
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T or F. A major deviation in the nasal septum that causes obstruction of nasal airflow is usually corrected by a rhinoplasty?
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false. septoplasty
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in the patietn who has suffered a major frontal blow with a nasal fracture, the nurse should monnitor for leakage of cerebrospinal fluid.
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true
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preoperatinve teaching for the patient planning an elective rhinoplasty for cosmetic effects includes informing the patietn to avoid aspirin containing prodcuts for 2 weeks before and immediately following the the srugery
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true
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an individual who has nasal reactions to pollens that last 3 to 4 weeks, several times a year is said to have intermittent allergic rhinitis
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false. persistent
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nasal polyps are a complication of long-term allergic rhinitis.
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true
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A pt develops epistaxis upon removal of a nasogastric tube. the nurse should?
a. pinch th soft part of hte nose b. position the pt on the side c. apply an ice pack to the back of the neck |
a.
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Pt who underwent posterior nasal packing for epistaxic earlier in teh day. The first assessment of the pt a nurse would make is
a. patients temperature b. position the patient on the side c. have the patient hyperextend the neck d. the o2 saturation by pulse oximetry |
d.
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The nurse teaches the pt. with allergic rhinitis that he most effective way to decrease allergic symptoms is to
a. undergo weekly immunotherapy\ b. identify and avoid triggers of the allergic reaction c. use cromolyn nasal spray prohylactically year round |
b.
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during assessment of the patient with a viral upper respiratory infection, the nurse recogonizes that antibiotics may be indicated based on the finding of
a. coufh and sore throate b. coious nasal discharge c. dyspnea and purulent sputum d. 100 degree temp |
c
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A 36 year old pt asks the nurse whether an inflenza vaccine is necesary every year. The best response by the nurse is
a. you should et the live attenuated flu vaccine that is inhaled nasally every year b. only health care workers should be immunized each year c. annual vaccination is not necessary because previous immunity will protect you for several years. |
a.
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A pt tells the nurse that he uses echinacea and goldenseal throughout the winter to prevent the flue. the best response by the nurse is.
a. these products work best when combined with antibiotic therapy b. Zinc is the best agent to stimulate the imune system and relieve symptoms of the flu c. both of htese products should be used only for a limited time as immunostimulants. |
c.
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The nurse identifies a nursing diagnosis of altered health maintenance related to lack of knowledge of therapeutic regimen for a pt with acute sinusitis who
a. continues to take antibiotics for a week after symptoms are relieved b. uses asprin or o aspirin containing products to relieve h/a and facial pain c. uses over the counter antihistamines to relieve symptoms of congestion and drainage |
c. Antihistamines are not recommended with sinusitis
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The nuse anticipates that collaborative management of a patient with accute pharyngitis (fever, throat pain, reddened and dematous patchy yellow exudates)
a. treatment with antibiotics b. treatemtn wit antifungal agents c. a throate culture or rapid strep antigen test |
c.
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Additianl information that the nuse should collect about obstrcutive sleep apnea includes history of
a. evening H/A b. sleeping on a soft mattress c. frequent awakening at night. |
c.
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To help pt tolerate the BiPAP the nurse teaches the patient to
a. to sleep with head of bed elevated b. use the device only on nights when insomnia occurs c. that although ti is uncomfortable, it is very effective in relieving sleep apnea |
c.
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an advantage of a tracheostomy over an ET for long-term managment of an upper airway obstruction is that a tracheostomy
a. is safer to performm in an emergency b. allows for more comfort and mobility c. has a lower risk of tracheal pressure necrosis |
b.
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pt can speak with attached air source with cuff inflated.
a. cuffless Trach tube b. speaking trach c. fenestrated trach d. trake tube with foam filled cuff |
b
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pt can swallow without apsiration but requires suctioning of secretions
a. cuffless Trach tube b. speaking trach c. fenestrated trach d. trake tube with foam filled cuff |
a.
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cuff pressure monitoring not required
a. cuffless Trach tube b. speaking trach c. fenestrated trach d. trake tube with foam filled cuff |
a.
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two tubings, one opening just above the cuff
a. cuffless Trach tube b. speaking trach c. fenestrated trach d. trake tube with foam filled cuff |
b
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most likely to cause airway obstruction if exact steps aren not followed to produce speech.
a. cuffless Trach tube b. speaking trach c. fenestrated trach d. trake tube with foam filled cuff |
c.
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Pilot tubing is not capped
a. cuffless Trach tube b. speaking trach c. fenestrated trach d. trake tube with foam filled cuff |
d
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airflow around tube and through window allows speaking when the cuff is deflated and the plug is inserted.
a. cuffless Trach tube b. speaking trach c. fenestrated trach d. trake tube with foam filled cuff |
c
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pt does not require mechanical ventilation and can protect airway.
a. cuffless Trach tube b. speaking trach c. fenestrated trach d. trake tube with foam filled cuff |
a
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cuff fills passivelly with air
a. cuffless Trach tube b. speaking trach c. fenestrated trach d. trake tube with foam filled cuff |
d
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during care of a pt witha cuffect tracheostomy, the nurse notes that the trachesotmy tube has an inner cannula. TO care for the trach appropriately, the nurse.
a. deflates the cuff and removes and suctions the inner cannula b. removes the inner cannula nad cleans the mucus fromt he tube c. keeps the inner cannula in place at all times to prevent dislodging the trach tube. |
b.
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Nursing care of hte pt with a cuffed tracheostomy tube in place includes
a. changing hte tube every 3 days b. recording cuff pressure every 8 hours c. performing mouth care every 12 hours. |
b.
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a pt's trach tube becomes dislodged with vigorous coughing. the first action by trhe nurse is to
a. attempt to replace the tube b. notify the health care provider c. place the pt in high folwers position |
a
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To determine when the pt with a trach tube can effectively swallow the nurse deflates the cuff and
a. checks for gag reflex b. asks the pt to drink 30 ml of milk and suctions the tube for colored secretions c. have the pt drink smallamounts of blue colored water, observing for coughing and colored secretions |
c.
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when obtaining a health history from a pt with mouth cancer, the nurse would expect the pt to report
a. long-term denture use b. heavy tobacco and alcohol use c. persistent swelling of neck and face. |
b.
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The pt has been diagnosed with early vocal cord malignancy. the nurse explains that usual treatment includes
a. radiation therapy that preserves the quality fo the voice b. a hemilaryngectomy that prevents the need for a tracheostomy c. a radical neck dissection that removes possible sites of metastisis |
a
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During the preoperative teaching fo the pt scheduled for a total laryngectomy, nte nurse includes information related to
a. the postoperative use of nonverbal communication techniques b. techniques that will be used to alleviate a dry mouth and prevent stomatitis c. self help groups and community resources for pts with cancer of the larynx. |
a.
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when assess the pt upon return to the surgical unit following a total laryngectomy and radical neck dissection, the nuse would expet to find.
a. a closed wound drainage system b. a nasal endotracheal tube in place c. a trach tube and mechanical ventialation |
a.
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follwoing a supraglottic laryngectomy, the pt is taught how to swallow. in teaching the pt. the nurse instructs the pt to
a. perform valsalva maneuver immediately after swallowing b. breathe b/t each valsalva maneuver and cough sequence c. cough after swallowing to remove food fromt he top of the vocal cords d. practice swalling thin, watery fluids. |
c.
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Discharge teaching by th nurse for the pt with a total laryngectomy includes
a. how to use esopageal speech to communicate b. how to use a mirror to suction the trach c. the necssity of never covering the laryngectomy stoma. |
b.
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teh most normal fucntioning method of speech restoration int he pt with a total laryngectomy is
a. voice prosthesis b. esophageal speech c. an electrolayrnx held to the neck d. an electrolarynx placed in the mouth. |
a.
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a pt wa seen in the clinic for an episode of epistaxis, which was controlled by placement of anterior nasal packing. during discharge teaching the nurse instructs the pt to:
a. use aspirin for pain relief b. remove the packing later that day c. avoid vigorous nose blowing and strenuousactivity |
c.
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a pt with allergic rhinitis reports severe nasal congestion, sneezing, and watery, itcy eyes and nose at various times of the year. to teach the pt to control these symptoms the nuse advises the pt to
a. avoid all intranasal sprayes and oral antihistimines b. limit the duration of use of nasal decongestant spray to 10 days c. keep a diary of when the allergic reaction occurs and what precipitates it |
c.
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a pt with sleep apnea would like to avoid using a nasal cpap device if possible. to help him reach his goal. the nurse suggests that
a. loses excess weight b. take a nap during the day c. eat a high protein snack at bedtime |
a
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a type of trach tube that prevents speech is
a. a cuffless trach tube b. a fenestrated trach tube c. a tube with inflated foam cuff. |
c.
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to prevent excessive pressure on tracheal capillaries, pressure in the cuff on a trach tube should be
a. monitored every 2 to 3 days b. less than 20 mm or 25 mm c. less than 30 to 35 mm |
b.
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which of the following is a late symptom of head and neck cancer
a. hoarsness b. change in fit of dentures c. mouth ulcers that do not heal d. decreased mobility of the tongue |
d.
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In recovery room, a pt with a total laryngectomy is sunctioned and has bloody mucus with some clots. which of the following nursing interventions would apply.
a. notify the physician immediately b. place the pt in prone position to facilitate drainage c. continue your assessment of the pt, including o2 saturation, respiratory rate, and breath sounds |
c.
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when using a voice prosthesis, the pt
a. swallows air using a valsalva maneuver b. places a vibrating device in the mouth c. blocks the stoma entrance with a finger |
c.
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Primary purpose of the respiratory sytem is
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gas exchange
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name the components of the upper respiratory tract
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nose pharynx, adenoids, tonsils epiglottis, larynx trachea
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what does the turbinants do to the air
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surface area of warming and moistening air
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Teh nasal cavity connects 3 parts
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naso, oro, laryngo pharynx
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the U-shaped cartilage keeps trachea open but allows food to slide through esophagus
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true
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where the trachea goes into two branches.also known as the angle of louis. highly sensitive and touching causes vigorous coughing
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carina
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This is where the maintem bronchis enter the lung
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hilus
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Which mainstem is shorter wider and straighter and is at risk for aspiration
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right
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T or false. no exchange of o2 and co2 takes place until air enters the respiratory bronchioles
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true
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the area from the nose to the respiratory bronchioles is termed
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anatomical dead space
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volume of air exchanged with each breath about 500mL
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tidal volume
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small sacs that frorm the functional unit of the lungs about 300 milion in an adult
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alveoli
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a lipoprotein that lowers the surface tension in the alveoli. Normally a person takes a slightly larger breath (sigh) every 5 to 6 breaths. This stretches the alveoli and releases surfactant
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surfactant
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refers to collapsed, airless alveoli
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atelectasis
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blood supply to the lungs 2 different types
this provides the lungs with blood for gas exchange a. pulmonary b. broncial |
a.
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blood supply to the lungs 2 different types
starts with the bronchial arteries which arise from the thoracic aorta, bornical circulation provides o2 to the bronchi and pulmonary tissues blood returs thrut he azygos veins a. pulmonary b. broncial |
b.
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This is the membrane that lines the chest and has no senosry pain fibers
a. parietal pleura b. visceral pleura |
a.
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The lungs are lined with a membrane that has sensory fibers
a. parietal pleura b. visceral pleura |
b.
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How many mL of fluid is in the intraplerual space. Provides lubrication and is filled by the lympatic system
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20 to 25 ml
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accumulation of greater amounts of fluid in the intrapleraual space.
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pleural effusion.
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The major muscle of respiration
|
diaphragm
|
|
|
Complete spinal cord injuries above te level of __ results in total diaphragm payralysis, requiring mechanical ventilation
|
C3
|
|
|
This involves inpiration and expiration.
|
ventilation
|
|
|
Gas flows in and out of lungs from an area of ___ pressure (atomosphere) to area of ___ pressure (intrathroacic
|
higher, lower
|
|
|
the tendency for the lungs to recoil or reduce in volume after being streatched or expanded
|
elastic recoil
|
|
|
shortness of breath
|
dyspnea
|
|
|
t or f. Expiration is active
|
false
|
|
|
This is the measurement of the ease of expansion of hte lungs.
|
compliance
|
|
|
When compliance is decreased the lungs are more difficult to inflate
|
true
|
|
|
represents the amount of o2 dissovled in the plasma.
a. pao2 b. sao2 |
a.
|
|
|
the amount of o2 bound to hemoglobin in comparison with the amount of o2 the hemoglobin can carry
a. pao2 b. sao2 |
b.
|
|
|
This part of the brain controlls respiration. impulses are sent from the medulla to the respiratory muscles thru the spinal cord and phrenic nerves
|
brainstem of the medulla
|
|
|
These receptors responds to a change in the chemical composition of hte fluid around it. Central receptors are found on the medulla that reacts to acids and bases. Peripheral receptors are found in the carotid bodies and aortic arch
|
Chemoreceptors
|
|
|
These receptors are located in teh lungs, upper airways, chest wall and diaphram stimulated by irritants, muscle stretching adn alveolar wall distortion
|
mechanical receptors
|
|
|
which respiratory defense mechanisms is this?
nasal hariss filter the inspired air. The abrupt changes of airflow that occurs occurs between the nasopharynx and larynx increases air turbulence. Causing particles to be incontact with the mucosal lining a. filtration of air b. mucocilliary clearance system c. cough reflex d. reflex bronchoconstriction e. alveolar macrophages. |
a.
|
|
|
cilia cover the airways from the level of the trachea to the respiratory bronchioles
a. filtration of air b. mucocilliary clearance system c. cough reflex d. reflex bronchoconstriction e. alveolar macrophages. |
b.
|
|
|
this is the backup of the mucocilliary clearnance protective reflex action that cears the airway by a high-pressure, velocity flow of air
a. filtration of air b. mucocilliary clearance system c. cough reflex d. reflex bronchoconstriction e. alveolar macrophages. |
c.
|
|
|
which respiratory defense mechanisms
Bronchioles constrict when something foreign enters.. retricting it from entering the lungs.. same as asthma a. filtration of air b. mucocilliary clearance system c. cough reflex d. reflex bronchoconstriction e. alveolar macrophages. |
d.
|
|
|
Primary defense at the alveolar level
Rapidly eats up inhaled foreign particles such as bacteria a. filtration of air b. mucocilliary clearance system c. cough reflex d. reflex bronchoconstriction e. alveolar macrophages. |
e.
|
|
|
Gerontological considerations:
a. Decreased in elastic recoil b. Decrease in functional alveoli c. Decline in cellmediated immunity d. Mucous membrane tend to be dryer |
info
|
|
|
Vibration of the chest wall produced by vocalization. The vibrations are stonger adjacent to the sternum and between the scapulae and is less intense the further away from these areas
|
Fremitus
|
|
|
The denser the tissue or hte fluid filled area the fremitis is stronger or weaker?
|
stronger
|
|
|
low pitched sound heard over normal lungs
|
resonance
|
|
|
sound with medium intensity heard over mixed solid and lung tissue, like liver or partially consolidated lung tissue
|
dull
|
|
|
normal breath sounds:
soft, low-pitched gentle, rustling sounds. They are heard over all lung areas excp 3:1 ratio.. Heard on inspiration 3 x longer a. vesicular b. bronchiovesicular c. bronchial |
a.
|
|
|
medium pitched intensity over the mainstem bronchi
1:1 ratio on inspiration and expiration a. vesicular b. bronchiovesicular c. bronchial |
b.
|
|
|
i. Heard over the trachea
ii. 2:3 ratio iii. Louder high pitched sounds resembling air blowing through a hollow pipe a. vesicular b. bronchiovesicular c. bronchial |
c.
|
|
|
high pitched sounds heard just before the end of inspiration. Rolling hair between fingers
a. fine crackles b. coarse crackles c. rhonchi d. wheezes e. stridor f. plueral friction rub g. egophony h. bronchoscopy i. whispered pectoriloquy |
a.
|
|
|
low pitched sounds caused by air passing through mucous or water like a straw under water blowing bubbles
a. fine crackles b. coarse crackles c. rhonchi d. wheezes e. stridor f. plueral friction rub g. egophony h. bronchoscopy i. whispered pectoriloquy |
b
|
|
|
Continuous rumbling, snoring or rattling sounds from obstruction of large airways with secretions. Most prominent on expiration. Change evident after coughing
a. fine crackles b. coarse crackles c. rhonchi d. wheezes e. stridor f. plueral friction rub g. egophony h. bronchoscopy i. whispered pectoriloquy |
c
|
|
|
continuous high pitched squeaking or musical sound caused by rapid vibration of bronchial walls. First evident on expiration
a. fine crackles b. coarse crackles c. rhonchi d. wheezes e. stridor f. plueral friction rub g. egophony h. bronchoscopy i. whispered pectoriloquy |
d
|
|
|
continous musical or crowing sound of constant pitch- result of partial obstruction of larynx or trachea. CROUP
a. fine crackles b. coarse crackles c. rhonchi d. wheezes e. stridor f. plueral friction rub g. egophony h. bronchoscopy i. whispered pectoriloquy |
e
|
|
|
creaking or grating sound heard during inspiration and expiration. NO change with coughing
a. fine crackles b. coarse crackles c. rhonchi d. wheezes e. stridor f. plueral friction rub g. egophony h. bronchoscopy i. whispered pectoriloquy |
f
|
|
|
spoken “e” sound but when you auscultate the “e” sounds like “a”
a. fine crackles b. coarse crackles c. rhonchi d. wheezes e. stridor f. plueral friction rub g. egophony h. bronchoscopy i. whispered pectoriloquy |
g
|
|
|
spoken or whispered syllable more distinct than normal on auscultation. 99
a. fine crackles b. coarse crackles c. rhonchi d. wheezes e. stridor f. plueral friction rub g. egophony h. bronchophony i. whispered pectoriloquy |
h
|
|
|
positive when pt. whispers 123 and it is heard distinctly through auscultation
a. fine crackles b. coarse crackles c. rhonchi d. wheezes e. stridor f. plueral friction rub g. egophony h. bronchoscopy i. whispered pectoriloquy |
i
|
|
|
This is done for culture and senstivity
a. Sputum studies b. skin tests c. Chest Xray d. CT e. MRI f. VQ scan g. pulmonary angiogram h. Bronchoscopy i. Mediastinoscopy j. Lung biopsy k. Thoracentesis |
a.
|
|
|
To check fo TB. A postive test indicates tha the pt has been exposed to the antigen.
a. Sputum studies b. skin tests c. Chest Xray d. CT e. MRI f. VQ scan g. pulmonary angiogram h. Bronchoscopy i. Mediastinoscopy j. Lung biopsy k. Thoracentesis |
b.
|
|
|
Used to assess the progression of disease and resonse to treatment
a. Sputum studies b. skin tests c. Chest Xray d. CT e. MRI f. VQ scan g. pulmonary angiogram h. Bronchoscopy i. Mediastinoscopy j. Lung biopsy k. Thoracentesis |
c.
|
|
|
this diagnositc study is used to evalute areas that are difficult to asses by conventional xray.
a. Sputum studies b. skin tests c. Chest Xray d. CT e. MRI f. VQ scan g. pulmonary angiogram h. Bronchoscopy i. Mediastinoscopy j. Lung biopsy k. Thoracentesis |
d
|
|
|
Test used for diagnosis of lesions difficult to assess by CT scans
a. Sputum studies b. skin tests c. Chest Xray d. CT e. MRI f. VQ scan g. pulmonary angiogram h. Bronchoscopy i. Mediastinoscopy j. Lung biopsy k. Thoracentesis |
e
|
|
|
used to identify areas of the lung not receiving airflow or blood flow. Ventilationn without perfusion suggests a pulmonary embolus
a. Sputum studies b. skin tests c. Chest Xray d. CT e. MRI f. VQ scan g. pulmonary angiogram h. Bronchoscopy i. Mediastinoscopy j. Lung biopsy k. Thoracentesis |
f
|
|
|
study is used to visualize pulmonary vasculature and locate obstruction or pathologic conditions such as pulmonary embolus. Contrast medium is injected through a catheter into the pulmonary artery or right side of the heart
a. Sputum studies b. skin tests c. Chest Xray d. CT e. MRI f. VQ scan g. pulmonary angiogram h. Bronchoscopy i. Mediastinoscopy j. Lung biopsy k. Thoracentesis |
g.
|
|
|
Procedure in which the bronchi are visualized through a fiber optic tube
Used to obtain biopsy specimens and assess changed resulting from treatment a. Sputum studies b. skin tests c. Chest Xray d. CT e. MRI f. VQ scan g. pulmonary angiogram h. Bronchoscopy i. Mediastinoscopy j. Lung biopsy k. Thoracentesis |
h
|
|
|
scope is inserted through a small incision in the suprasternal notch and advanced into the mediastinum to inspect and biopsy lymph nodes
a. Sputum studies b. skin tests c. Chest Xray d. CT e. MRI f. VQ scan g. pulmonary angiogram h. Bronchoscopy i. Mediastinoscopy j. Lung biopsy k. Thoracentesis |
i
|
|
|
can be transbronchially, percutaneously, video-assisted thoracic surgery or open lung biopsy
a. Sputum studies b. skin tests c. Chest Xray d. CT e. MRI f. VQ scan g. pulmonary angiogram h. Bronchoscopy i. Mediastinoscopy j. Lung biopsy k. Thoracentesis |
j
|
|
|
i.Insertion of a large bore needle through the chest wall into the pleural space to obtain specimens
a. Sputum studies b. skin tests c. Chest Xray d. CT e. MRI f. VQ scan g. pulmonary angiogram h. Bronchoscopy i. Mediastinoscopy j. Lung biopsy k. Thoracentesis |
k
|
|
|
volume of air inhaled and exhaled with each breath
a. tidal volume b. expiratory reserve volume c. residual volume d. inspiratory reserve volume e. total lung capacity f. functional residual capacity g. vital capacity h. inspiratory capacity |
a
|
|
|
additional air that can be forcefully exhaled after normal exhalation is complete
a. tidal volume b. expiratory reserve volume c. residual volume d. inspiratory reserve volume e. total lung capacity f. functional residual capacity g. vital capacity h. inspiratory capacity |
b
|
|
|
amount of air remaining in lungs after forced expiration
a. tidal volume b. expiratory reserve volume c. residual volume d. inspiratory reserve volume e. total lung capacity f. functional residual capacity g. vital capacity h. inspiratory capacity |
c
|
|
|
maximum volume of air that can be inhaled forcefully after normal inhalation
a. tidal volume b. expiratory reserve volume c. residual volume d. inspiratory reserve volume e. total lung capacity f. functional residual capacity g. vital capacity h. inspiratory capacity |
D
|
|
|
maximum volume of air that lungs can contain
a. tidal volume b. expiratory reserve volume c. residual volume d. inspiratory reserve volume e. total lung capacity f. functional residual capacity g. vital capacity h. inspiratory capacity |
e
|
|
|
volume of air remaining in lungs at end of normal exhalation
a. tidal volume b. expiratory reserve volume c. residual volume d. inspiratory reserve volume e. total lung capacity f. functional residual capacity g. vital capacity h. inspiratory capacity |
f
|
|
|
Maximum volume of air that can be exhaled after maximum inspirationa. tidal volume
b. expiratory reserve volume c. residual volume d. inspiratory reserve volume e. total lung capacity f. functional residual capacity g. vital capacity h. inspiratory capacity |
g
|
|
|
maximum volume of air that can be inhaled after normal expiration
a. tidal volume b. expiratory reserve volume c. residual volume d. inspiratory reserve volume e. total lung capacity f. functional residual capacity g. vital capacity h. inspiratory capacity |
h
|
|
|
PaO2 is the amount of o2 bound to hemoglobin
|
false
|
|
|
Sao2 is the amount of o2 dissolved in plasma and is expressed as a percent.
|
false
|
|
|
If hemoglobin is desatruated of o2, more o2 is released from the hemoglobin and dissolved in the blood to provide o2 to the tissues
|
true
|
|
|
the oxygen hemoglobin dissociation curve indicates that a pt is adequately oxygenated when PAo2 is above 60 mm hg because at this point hemoglobin saturation remains above 90%
|
true
|
|
|
a pt has an oxyhemoglobin saturation of 90%. on the normal oxygen-hemoglobin dissociation curve with saturation, he would have an arterial o2 tension of 90mmhg
|
false
|
|
|
Lower respiratory tract infections are the most common cause of death in the world
|
info
|
|
|
An inflammation of hte bronchi in the lower respiratory tract usually due to infection.It usually occurs ias a sequela to an upper respiratory tract infection. The cause of most cases is viral
|
acute bronchitis
|
|
|
In acute bronchitis, persisten cough following an acute upper airway infection is the most common symptom.
|
info
|
|
|
This is an acute inflammation of hte lung parechyma caused by a microbial organism
|
pneumonia
|
|
|
Normal defense mecahnisms of the lungs: filtration of air, warming and humidification, epiglottis closure over the trache, cough reflex, mucociliary escalator, IgA, alveolar macrophages
|
info
|
|
|
Pneumonia is more likely a result when defense mechanisms become incompetent or overwelmed
|
info
|
|
|
Organsims that cause pneumonia reach the lung by 3 methods:
|
aspiration- from pharynx
inhalation of microbes from air hematogenous spread from a primary infection in the body |
|
|
defined as a lower respiratory tract infection of the lung parenchyma with onset in the community or during the first 2 days of hospitalization
|
cap
|
|
|
Specific antibiotics for treatment of CAP are all fairly similar and start with macrolide, clarithromycin, doxycycline
|
cap
|
|
|
This pneumonia occurs 48 hours or longer after hospital admission.
|
HAp
|
|
|
There is hap, vap and hcap
|
hospital aquired, ventilation aquired, health care associated
|
|
|
Hap is the second most common nosocomial infection behind the uti
|
true
|
|
|
True or false. HAP, VAP and HCAP are usually caused by a bacterial than a viral or fungal
|
true
|
|
|
Pneumocytis jiroveci and cytomegalovirus are what kinds of pneumonia
|
opportunistic
|
|
|
Pneumococcal pneumonia is the most commono cause of hte bacterial pneumonia and is cauesd by S. Pneumoniae
|
info
|
|
|
4 characteristics stages of the disease process pneumonia
Outpouring of fluid into alveoli that supports microorganism growth and spread a. congestion b. Red hepatization c. gray hepatization d. resolution |
a.
|
|
|
4 characteristics stages of the disease process pneumonia
massive dilation of capillaries with alveolar filling with organism, neutrophils and fibrin a. congestion b. Red hepatization c. gray hepatization d. resolution |
b
|
|
|
4 characteristics stages of the disease process pneumonia
blood flow decreases and leukocytes and fibrin consilidate in affected lung tissue a. congestion b. Red hepatization c. gray hepatization d. resolution |
c.
|
|
|
4 characteristics stages of the disease process pneumonia
exudate becomes lysed and processed by macrlphages, and normal lung tissue is restored. |
d.
|
|
|
Pts with pneumonia usually have a sudden onset of symptoms including fever, shaking chills, SOB, cough of productive purulent sputum.
|
info
|
|
|
Rust-colored sputum can be seen in pneumococcal pneumonia
|
info
|
|
|
4 reasons to take the pneumococcal vaccine: 1) one who has chronic illness 2) recovering from serious illness 3) 65 yoa 4) in LTC
|
info
|
|
|
E. choli
peudomonis aeurginsoa S. aureus enterobacter sp. klebsiella sp. a. CAP b. HAP c. opportunisitic |
b
|
|
|
peumocystis jiroveci
cytomegalovirus a. CAP b. HAP c. opportunisitic |
c.
|
|
|
legionella
strepto pneumoniae mycoplasma pneumoniae a. CAP b. HAP c. opportunisitic |
a.
|
|
|
when obtaining a health history from a pt at the clinic with suspected CAP, the nuse expects the pt to report
a. dry hacking cough b. recent loss of consciousness c. an abrupt onset of fever and chills |
c.
|
|
|
initial antibiotic treatment for pneumonia is usually based on
a. severity of symptoms b. history and physical examination and characteristic chest radiogrpahic findings c. gram's stain and cultures or sputum specimens |
b.
|
|
|
after the healt care provider sees a pt with a stroke who developed a fever and adventitious lung sounds the following orders are written. Which shall the nurse implement first?
a. anterior/posterior an lateral CXR b, Start IV levofloxacin c. sputum specimen for gram stain an cutlure and sensitivity |
c.
|
|
|
The class of antibiotics most commonly used to treat a previously helath pt with cap is:
|
macrolide
|
|
|
drug of chiose for treatment of P. Jiroveci pneumoniae is
|
trimethoprim
|
|
|
following assessment of a pt with pneumnia, the nurse identifies a nursing diagnosis of impaired gas exchange based on the findings of
a. spo2 86% b. crackles in lower lobes c. prodcution of greenis purulent sputum |
a.
|
|
|
A pt. is admitted to the hopsital with fever chills, a productive cough with rusty sputum and pleuristic chest pain. pneumococcal pneumonia is suspected.. and appropriate diagnosis would be
a. hyperthermia related to acute infections process b. crhonic pain related to ineffective managment c. ineffective airway clearance related to retained secretions. |
a.
|
|
|
a pt with pneumonia has a nursing diagnosis of ineffective airway clearance related to pain, fatigue and thick secretions. an appropriate nursing interventions is:
a.encourage a fluid intake of 3 l/day b. administer o2 as prescribed to mainteain sp02 95% c. place the pt in semi folwers postition to maximize lung expansion |
a.
|
|
|
The resurgence in TB resulting from the emergence of MDR strains of mycobacterium tuberuclosis is primarily the result of:
a. lack of effective means to diagnose TB b. poor compliance with drug therapy in pts with TB c. the increased |
b
|
|
|
a health care provider who has cared for a pit with clinically active TB has a 7 mm reaction to tuberculin skin testing. This individual has been (exposed to/infected with) tb
|
infected with
|
|
|
When a person who is taking corticosteriods for RA has a positive TST, treatment would include drugs for (clinical,latent) TB infecton
|
latent
|
|
|
A patietn who has HIV and clinical TB should receive combination drug tehrapy for a minimum of (9,12) months and (6,9) onths beyond culture conversion
|
9, 6
|
|
|
Latent TB infection is treated with (INH/combination) therapy
|
INH
|
|
|
The minimum treatment period for pt with active TB infection is (6,9) months
|
6
|
|
|
a diagnosis of TB is established with (CXR,postive smear and culture)
|
postive smear and culture
|
|
|
a pt diagnosied with class 3 TB 1 week ago is admitted to the hospital with symptoms of chest pain and a possible myocardial infarction. Initially the nurse gives the higher priority to.
a. administering the pts antitubercular durgs b. admitting the patient to an airbore-infection isolation room c. preparing the pts room with suction equipment and exra linens d. placing the pt in an open intensive care area where he can be closely monitored. |
b
|
|
|
When obtaining a health history from a pt suspected of having early TB, the nurse asks the pt about experiencing
a. chest pain, hemoptysis, and weight loss b. fatigue, low grade fever, and night sweats c. cough with purulent mucus and fever with chills |
b
|
|
|
INH, Rifampin, pyrazinamide, ethambutol.. what durgs are these for
|
TB
|
|
|
This occurs when the bacteria are inahled but there is an effective immune response and the bacteria become inactive.
a. TB infection b. TB disease |
a.
|
|
|
TB infection ni ap erson who doees not have the active TB disease, is not considered a case of TB is offten referred to as
a. TB disease b. Latent TB infection |
b.
|
|
|
Manifestations: fatigue, malaise, anorexia, unexplained weight loss, low- grade fever nigh sweats.
|
TB
|
|
|
Pts. strongly suspected of having TB should be placed on airbore isolation, receive appropriate drug therapy, CXR, sputum smear and culture
|
info
|
|
|
Fungal infections of hte lung therapy is usually what?
|
amphotericin B
|
|
|
Indigenous to the N. American river valleys.This is the inhalation of mycelila into the lungs infected individualsoften free of symptoms, generally self limiting, chornic disease similar to TB
a. histoplasmosis b. coccidiodomycosis c blastomytosis d. aspergillosis e. candida albicans |
a.
|
|
|
indgienous to the semi arid regoios of the southwest. Inhalation of arthrospores into lungs, suppurative and granulomatous reactions in the lungs, symptomatic infection in 1/3 of individuals
a. histoplasmosis b. coccidiodomycosis c blastomytosis d. aspergillosis e. candida albicans |
b.
|
|
|
Indigenous to the SE and midwestern US, inhalation of fungus into lungs, progression of idsase often insidious, possible involvement of skin
a. histoplasmosis b. coccidiodomycosis c blastomytosis d. aspergillosis e. candida albicans |
c.
|
|
|
TRue mold inhabiting mouth, widely distributed, invasion of lung tissue resulting in possible necrotizing pneumonia; individual with asthma, allergic bronchopulmonary aspergillosismay require corticosteroid therapy.
a. histoplasmosis b. coccidiodomycosis c blastomytosis d. aspergillosis e. candida albicans |
d.
|
|
|
Leading cause of mycotic infections in hosptialized and immunocompromised hosts, ubiquitous and frequent coloniation of upper respiratory and GI tracts infections often following broad-specrum antibiotic therapy.
a. histoplasmosis b. coccidiodomycosis c blastomytosis d. aspergillosis e. candida albicans |
e.
|
|
|
Fibrous inflammation of the lungs resulting from inhalation of dust.
|
pneumoconiosis
|
|
|
The best tratment for environmental lung disase is to decrease or stop expsoure to the harmful agent.
|
true
|
|
|
This is risk factors of which kind of cancer:
Tobacco use and ETOH |
larynx
|
|
|
S/S- 1st sign persistent hoarsness, lesions of throat, dyspnea, dyspagic, cervical adenopathy, otalgia, feeling of lump in throat, change in vocie quality, Decreased tongue mobility, airway obstruction, cranial nerve neuropathies, thickening oral mucous, leukplakia
|
cancer of the larynx
|
|
|
Dx. MRi, larygoscopy, CT, Bx
Tx. surgical inteventions, cordectomy, hemilaryngectomy, supraglottic laryngectommy, total laryngectomy |
Cancer of hte larynx
|
|
|
Thi sis the most commonly used device. it is a safe and simple method that is realtively comfortable and acceptable. It is useful for a pt requiring low O2 concentrations. It allows pt. to move about in bed. pt can eat, talk or cough while wearing device.
a. nasal cannula b. simple face mask c. Partial rebreathing mask d. nono-rebreathing mask |
a
|
|
|
o2 can be given quickly fo short periods. Useful when transporting pts. o2 concentrations of 35-50% can be achieved with flow rates of 6-12 l/min. Mask provides adequate humidification of inspired air
a. nasal cannula b. simple face mask c. Partial rebreathing mask d. nono-rebreathing mask |
b.
|
|
|
Mask is light weight and eash to use. Reservoir bag conserves o2. Useful for short term therapy for pts needing higher o2 concentrations.
a. nasal cannula b. simple face mask c. Partial rebreathing mask d. nono-rebreathing mask |
c.
|
|
|
High concentrations of o2 can be delivered accurately. O2 flows into bag and mask during inhalation. Valve prevents expired air from flowing back into bag. Goof for short term therapy for pts needing higher o2 concentrations
a. nasal cannula b. simple face mask c. Partial rebreathing mask d. nono-rebreathing mask |
d
|
|
|
cannula has a built in reservoir that increases o2 cocnetrations delivered and allows pateint to use lower flow.
a. o2 conserving cannula b. transtracheal catheter c.face tent d. tracheostomy collar e. T bar f. venturi mask |
a.
|
|
|
Cathter is less visible. flow requirement may be reduced approximately 50-70% which greatly increases amoutn of time available from source of o2
a. o2 conserving cannula b. transtracheal catheter c.face tent d. tracheostomy collar e. T bar f. venturi mask |
b.
|
|
|
tent is ideal for providing moderate to high desnity aerosol.
a. o2 conserving cannula b. transtracheal catheter c.face tent d. tracheostomy collar e. T bar f. venturi mask |
c
|
|
|
Collar can deliever high humidity and o2 via tracheostomy
a. o2 conserving cannula b. transtracheal catheter c.face tent d. tracheostomy collar e. T bar f. venturi mask |
d
|
|
|
This allows a tigter fit better o2 and humidity delivery to a tracheostomy
a. o2 conserving cannula b. transtracheal catheter c.face tent d. tracheostomy collar e. T bar f. venturi mask |
e
|
|
|
this mask delivers a precise, high flow rate of o2. Lightweight plastic, cone shaped device is fitted to mask. 24, 28, 31, 35, 40, 50 % o2
a. o2 conserving cannula b. transtracheal catheter c.face tent d. tracheostomy collar e. T bar f. venturi mask |
f.
|
|
|
this gas stimulates the respiratory center.
|
co2
|
|
|
the normal percentage of o2 in room air
|
21%
|
|
|
Average number of sighs per hour
|
6-10
|
|
|
the most common sign and symptom of respiratory disorders
|
cough
|
|
|
when administering this drug IV for treatment of acute asthma the nurse can expect the client to experience tachycardia
a. aminophylline b. phenyleprhrine c. ventolin d. abuterol e. corticosteroids |
a.
|
|
|
vasoconstrictive drug used to promote drainage of the sinuses.
a. aminophylline b. phenyleprhrine c. ventolin d. abuterol e. corticosteroids |
b.
|
|
|
the first drug used for mild asthma with the stepped care approach.
a. aminophylline b. phenyleprhrine c. ventolin d. abuterol e. corticosteroids |
c.
|
|
|
Relazes bronchial airways. used in an acute asthma attack. This is an adrenergic.
a. aminophylline b. phenyleprhrine c. ventolin d. abuterol e. corticosteroids |
d.
|
|
|
This is administered ito clients in respiratory failure to reduce inflammation and mucus secretions
a. aminophylline b. phenyleprhrine c. ventolin d. abuterol e. corticosteroids |
e.
|
|
|
This is effectivve in preventing exercise induced asthma.
a. cromolyn b. atrovent c. antihistamines d. rifampin e INH f. sudafed g. mucomyst h. antitussives |
a.
|
|
|
used to treat chronic bronchitis and emphysema
a. cromolyn b. atrovent c. antihistamines d. rifampin e INH f. sudafed g. mucomyst h. antitussives |
b
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used to improve airway clearance in clients with COPD
a. cromolyn b. atrovent c. antihistamines d. rifampin e INH f. sudafed g. mucomyst h. antitussives |
c.
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this antitubercular drug should be taken on an empty stomach. causes a reddish orage discoloration of urine
a. cromolyn b. atrovent c. antihistamines d. rifampin e INH f. sudafed g. mucomyst h. antitussives |
d
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use of alcohol with this TB drug increases the risk of hepatotoxicity
a. cromolyn b. atrovent c. antihistamines d. rifampin e INH f. sudafed g. mucomyst h. antitussives |
e
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A nasal decongestant
a. cromolyn b. atrovent c. antihistamines d. rifampin e INH f. sudafed g. mucomyst h. antitussives |
f.
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A mucolytic, this drug liquifies mucous secretions
a. cromolyn b. atrovent c. antihistamines d. rifampin e INH f. sudafed g. mucomyst h. antitussives |
g.
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agents that suppress cough by depressing hte respiratory center
a. cromolyn b. atrovent c. antihistamines d. rifampin e INH f. sudafed g. mucomyst h. antitussives |
h
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this ventilation involves the use of chambers that encase the chest or body and surround it with intermittent subatmospheric or negative pressure
a. negative pressure ventilator b. positive pressure ventilator |
a.
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This is the primary method used with acutely ill patients. During inspiration the ventilator pushes air into the lungs under positive pressure
a. negative pressure ventilator b. positive pressure ventilator |
b.
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Breaths are deliverede at a set rate per minute and a set tidal volume. which are independent of the pts ventilation efforts. used when the pt has no drive to breathe
a. controlled mandatory venilation CMV b. ACV c. Syncrhonized intermittent mandatory ventilation SIMV d. pressure support ventilation PSV e. CPAP f. postive end expiratory preessurePEEP |
a
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the ventilaor delievers a preset tidal volume and at a preset frequency, and when the pt. initiates a spontaeious breath the presetVt is delivered.
a. controlled mandatory venilation CMV b. assited controlled ventilation ACV c. Syncrhonized intermittent mandatory ventilation SIMV d. pressure support ventilation PSV e. CPAP f. postive end expiratory preessurePEEP |
b.
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this venilator delievers a preset Vt at a preset frequenncy in syncrony with the pts. spontaneous breathing. B/t venitlator-delivered breaths, the pt is able to breathe spontaneously through the ventilator circuit
a. controlled mandatory venilation CMV b. ACV c. Syncrhonized intermittent mandatory ventilation SIMV d. pressure support ventilation PSV e. CPAP f. postive end expiratory preessurePEEP |
c.
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This ventilation is when positive pressure is applied to the airway only during inspiration and is used in conjunction with the pts. spontaeous respirations.
a. controlled mandatory venilation CMV b. ACV c. Syncrhonized intermittent mandatory ventilation SIMV d. pressure support ventilation PSV e. CPAP f. postive end expiratory preessurePEEP |
d.
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This ventilation is delivered continusously during spontaeous breathing, thus preventing the pts airway pressure from falling to zero.
a. controlled mandatory venilation CMV b. ACV c. Syncrhonized intermittent mandatory ventilation SIMV d. pressure support ventilation PSV e. CPAP f. postive end expiratory preessurePEEP a. CMV b. ACV c. SIMV d. PSV e. CPAP f. PEEP |
e.
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This is a ventilatory maneuver in which positive pressue is applied to the airway during exhalation
a. controlled mandatory venilation CMV b. ACV c. Syncrhonized intermittent mandatory ventilation SIMV d. pressure support ventilation PSV e. CPAP f. postive end expiratory preessurePEEP |
f
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Nursing cares:
check tube placement monitof for s/s of parital airway obstruction observe the sides of the mouth or nares for irritation monitor cuff pressure check connections for mechanical ventilation Make certain suction equipment is readily available assess and support managment of anxiety |
Endotracheal tube
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The placement of this chest tube goes into the 2nd inercostal space anteriorly, some use 4th and 5th anteriors or mid-axillary directed apically
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to remove air
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8th or 9th intercostal space posteriorly or 4th or 5th inferiorly and posterioly.
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to remove fluid and blood
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These are nursing cares of what:
assess RR auscultate lungs assess function of hte drainage system drainage system below levvel of the pts chest, free of kinks, secure connections not color, amount of drainage observe for fluctuation in the fluid level of water seal chamber look for bubbling in water seal chamber |
chest tube nursing care
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This is known as the common cold. Caused by rhinoviruses, RSV, adenovirus, inflenza, and parainfluenza.
MOre severe in infants and children than adults Treat clinical symptoms cough suppressants may be prescribed antihistamines largely inefective |
nasopharyngitis
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This can be viral ( influenza virus, RSV) or bactherial (strep). Untreated or not treated adequately sequelae of rheumatic fever and acute glomerulonephritis.
Tonsils and pharynx inflamed and covered with exudate, lymphadenopathy with tenderness, fever, lymph nodes may be enlarged. tx. oral penicillins combined with rifampin for 10 days |
pharyngitis
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can occur either as primary infection or secondary to URI
Group A strep is frequent caustive oragnism. Classic white patches present, tonsils reddened and swollen S/s fever, chills, h/a muslce aches, general malaise |
tonsilitis
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this is a complication of acute pharyngitis or acute tonsilitus. Absecess that develops above the tonsil in the tissues of hte soft palate. bacterial infection invades one of both tonsils. tonsils may elarge to the point of threatening airway patency.
s/s: high fever, leukocytosis and chills tx: iv antibiotics along with needl aspiration and biopsy |
peritonsilar absces
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The highes incidence of htis occurs from 6 months to 2 years
passive smoling and day care attendance are risk factors breast fed infants have decreased incidence Primarily result of dysfunctioning eustachian tubes. |
Otitis media.
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Inflammation of the epiglottis
may become cyanotic and require emergency trach may progress from wellnesss to complete airway obstructio in 2-6 hours |
epiglottitis
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Most common in children uder 3 yr of age
offending foods: hot dogs, round candy, peanuts ballons especially hazardous S/s: hcoking gagging wheezin and coughing, stridor and sternal retractions |
foreign body aspiration
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viral infection of the upper airway- rsv origin
may affect larynx, trachea, bronchi or epiglottis mucosal inflmmation narrowing and stridor of airways, sudden onset of harcsh cough, metallic, barky, brassy cough managment is cool mist vaporizor "croup tent" |
laryngtitis
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This is the abnormal accumulation of fluid in teh alveoli and intersitial spaces of he lungs. it interferes with gas exchange by causing an alteration in the diffusion pathway b/t the alveoli and pulmonary capillaries.
Predisposing factors most common cause is left sided CHF , overhydration alterred capillary permeabliity, pneumonia near drowning etc. |
pulmonary edema
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These are cllinical manifestations of what?
tachypnea SOB, anxious pale, severe dyspnea, use of accessary muscles, frothy pink sputum, enogrgemnt of pulmonary vasculature system. |
pulmonary edema
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Enlargement of the right ventricle
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cor pulmonale
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inability fo cardiac output to increase in response to increased o2 demand, anatomic and vascular changes cause increased intravascular resistance
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pulmonary hypertension
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increase in pulmonary artery pressure 5-10 mm hg above normal
pulmonary artery vasocontrsition increased vascular resistance leads to right sided heart failure an death most prominent symptom : exertional dyspnea EKG shows right ventricular strain and hypertrophy |
pulmonary hypertension
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Manifestations of this:
fever, shaking chills, SOB, cough productive of purulent sputum, pllerutic chest pain, confusion with hypoxxia, pulmonary consilidation, dullness to percussion, increased fremitus, bronchial breath sounds and crackles may be found. with viral onset, chills, fever, dry non-productive cough, achiness, malaise, low energy |
pneumonia
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Mangement of this:
antibiotics, macrolids, vanco, o2 terhapy, collection of sputum, bronchodilators therapeutic positioning, good lung down IS coughing and epp breathing chest physiotherapy exercise and early ambulation |
pneumonia
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This is an genetic autosoma recessie disorder. Altered function of excretory sweat glands with thick tenacious secretions. Cells that line passage ways of lungs, pancreas and other organs prodcue abnormally thick stcky mucus that clogs the glands and airways.
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Cystic fibrosis
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Treatmetn of this disease is:
diet high in claories and protein. pulmonary therapy postrual drainage, breathing exercises, aerosol therapy, Decrease sputum visicosity and increase airflow, bronchodiators, mucolytics, PEP devices CPT |
cystic fibrosis
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symptoms:
fatigue, crhonic cough, recurrent URIs, thick sticky mucus, chronic hypoxia: clubbing barrel chest, decrease absorption of vitamins and enzymes abdominal distention, rectal prolapse, fatty stinky stools, meonium ileus in new born |
cystic fibrosis
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Diagnositc tests:
sweat chloride, CXR, fecal analysis of fat, DNA analaysis and genotyping. |
cystic fibrosis
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DOT treatment considered in
|
tuberculoosis
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Clinical manifestations: fatigue, low grade fever, night sweats, weakness, malaise, productive cough, white frothy sputum, lymp node enlargement, unexplained wt loss.
|
tuberculosis
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The PFTs of this disease is
VC=normal or ↓ TLC=↑ RV=↑ FEV1=↓ |
COPD
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This is the presence of productive cough for 3 months in each of 2 consecutive years and other causes of cough have been excluded.. this is chronic _____. This chronic inflammation results in hyperplasia of mucus secreting cells and bronchial edema causing additional edema of previously narrowed airways, wheezing and hypoxemia
CPT to enahnce mucus clearing. High risk of respiratory acidosis particularly with development of pneumonia |
bronchitis
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The pathophysiology of this is alveoli loose elasticity, lungs stiffen, and compliance decreases loss of recoil
|
chronic bronchitis
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This is abnormal permaent enlargment of the air spaces distal to the terminal bronchiles, accompaned by destriction of their walls without obvious fibrosis.
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Ephysema
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first line of defense in asthma is adrenergics name some
|
atrovent, provental and albuterol
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longer term bronchodialtor are anticholinergics
|
atrovent
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PFTs with Restricitve respiratory disorders
VC ↓ TLC ↓ RV normal or ↓ FEV1 normal or ↓ |
info
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Inflammation of the pleura
Common c auses: TB pneumonia, chest trauma, pulmonary infacts, neoplasmas pain is abroupt and aggravated by inspiration managment: treatingh the underlying disease process and provide pain relief. |
pleurisy
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|
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Loss of volume in a segment of hte lung
resulting in air trapping in affected lung portion collapsed airless alveoli alveolar instability decreas in elastic recoil, results in shrinking |
Ateclectasis
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A collection of fluid in the pleural space
↓ bronchial sounds dullness to percussion ↓ decreased tactile femitus over hte fluid accumulation Egophony over the site of fluid heard Tx: thoracenthesis and chest tube placement |
pleural effusion
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A form of pleural effusion
fluid in the pleural spcace contains pus Fever unilateral pleuristic chest pain, dyspnea, and anorexia |
empyema
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A pt with active TB continues to have positive sputum cultures after 6 months of treatment because she says she cannot remember to take the mediation atll the time. the best action by the nurse is to.
a. schedule the pt to com to the clinic q day to take the med b. hav pt who has recovered from TB tel lthe pt about his successful treatment c. arrange for directly observed therapy (DOT) by a responsible family member or a public health nurse |
c.
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A patietn receiving chemothearpy for breast cancer develops a cryptococcus infection of the lungs and isty reated with IV amphtericin B. The nurse monitors the pt carefully during he drugs administration with the knowledge othat this drug increases the pt risk for
a. renal impariment b. immunosuppression c. N/V |
c.
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To reduce the risk for most occupational lung diseases the most important measure promoted by the occupational nurse is
a. maintaining a smoke-free work environment for all employees b. using masks and effective ventilation systems to reduce exposure to irritants c. insepection of monitoring of workplaces by national occupational safety agencies/ |
b.
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A pt with a 40 pack yyear history of smoking has recently stopped. The pt asks the nurse what he can do to learn about whteher he delvops lung cancer. The best response is
a you hsould get a cxr q 6 mo to screen for any new growths b. screening measures for lung cancer are controversial, but we can discuss the advantages and disadvanges of various measures. c. it would be very rare for you to devleop lung cancer now that you have stopped smoking |
b.
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A pt with a lung mass found on CXR is undergoing further testing. The nurs explains that a diagnosis of lung cancer can be confirmed by
a. ct scans b. lung tomograms c. pulmonary angiography d. id of malignant cells in sputum |
d.
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Considered standard treamtment for non-small cell lung cancer
a. surgical therapy b. radiation therapy c. chemotherapy d. prophylactice cranial radiaiont e. bronchosocpic laser |
c
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best proceure for cure of lung cancer
a. surgical therapy b. radiation therapy c. chemotherapy d. prophylactice cranial radiaiont e. bronchosocpic |
a.
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palliative treatment by bronchoscope to remove obstructing bronchial tumors
a. surgical therapy b. radiation therapy c. chemotherapy d. prophylactice cranial radiaiont e. bronchosocpic |
e
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improves survival when combined with chemotherapy and surgery
a. surgical therapy b. radiation therapy c. chemotherapy d. prophylactice cranial radiaiont e. bronchosocpic |
b.
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used to prevent metastasis to the brain.
a. surgical therapy b. radiation therapy c. chemotherapy d. prophylactice cranial radiaiont e. bronchosocpic |
d
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Dye activated by laser light atht destroys cancer cells
a. phototherapy b. airway stenting c. cryotherapy d. biologic and targeted therapy |
a
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freezes bronchial tumors with use of bronchoscope
a. phototherapy b. airway stenting c. cryotherapy d. biologic and targeted therapy |
c
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palliateive treatment for airway collapse or compreestion therapy
a. phototherapy b. airway stenting c. cryotherapy d. biologic and targeted therapy |
b .
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used when cancer has progressed despite other treatments.
a. phototherapy b. airway stenting c. cryotherapy d. biologic and targeted therapy |
d
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|
In assisting a pt to stop smoking, the nurse advises the pt that the most successful programs for smoking cessation include
a. hypnosis b. self help programs c. behavior therapies with nicotine replacement d. aversion terhapy and individual psychotherapy |
c.
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A patient with advanced lung cancer refuses pain medication, saying. "I deserve everhthing this cancer can give me.
the nurse best response to the pt is. a. would talking to a counselor help you b. can you tell me what the pain means to you c. are you using hte pain as a punsihment for your smoking |
b.
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Collaps of the lung from accumulation of air in the intraplerual space caused by a sucking chest wound is
a. open pneumothorax b. flail chest c. hemothroax d. closed pneumothorax e. tension f. chylothorax |
a.
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|
|
Multiple fracture ribs causing paradoxical movement isn known as
a. open pneumothorax b. flail chest c. hemothroax d. closed pneumothorax e. tension f. chylothorax |
b.
|
|
|
collapse of hte lung from accumulation of blood in the intrapleural space is a
a. open pneumothorax b. flail chest c. hemothroax d. closed pneumothorax e. tension f. chylothorax |
c.
|
|
|
collapse of the lung from accumulation of air in the intrapleural space caused by an injury to the lungs from closed rib fractures
a. open pneumothorax b. flail chest c. hemothroax d. closed pneumothorax e. tension f. chylothorax |
d
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|
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When air in the intraplerual space progressively increases intrathroacic pressure because it cannot escape during epxiration
a. open pneumothorax b. flail chest c. hemothroax d. closed pneumothorax e. tension f. chylothorax |
E.
|
|
|
accumulation of lympatic fluid in the pleural space from a leak in the htoracic duct is known as
a. open pneumothorax b. flail chest c. hemothroax d. closed pneumothorax e. tension f. chylothorax |
F.
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To determine whether a tension pneumothorax in a patient with chest trauma, the nuse assessses th pat for.
a dull percussion sounds on the injured side b. severe respiratory distress and tracheal deviation c. muffled and distant heart sounds with decreasing Bp d. decreased movement and diminished breath sounds on the affected side. |
b.
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This chamber collects air and fluid.
|
collectio chamber
|
|
|
this chamber allows escape of air but prevents air back into collection chanmger
|
water seal
|
|
|
this chamber controlls suction to the system
|
suction control chamber
|
|
|
The nurse should check for leaks in the chest tube and water seal system when
a. there is constant bubbling of water in the suction control chamber b. htere is continuous bubbling from the tube in the water seal chamber c. the water level in the water seal and suction control chambers are decreased |
b.
|
|
|
when caring for the pt. with a chest tube, the nurse should intevene with the nursing assistant is
a. looping the drainage tubing on the bed b. secruing the drainage container in the upright position c. stripping or milking hte chest tube to promot drainage d. reminding the pt to cough and deep-breathe every 2 hours. |
c.
|
|
|
Removal of a small lesion
a. thoractomy b. lobectomy c. wedge resection d. segemntal resection e. lung volume reduction surgery f. decortication g. pneumonectomy e. |
c
|
|
|
removal of a lung
a. thoractomy b. lobectomy c. wedge resection d. segemntal resection e. lung volume reduction surgery f. decortication g. pneumonectomy |
g
|
|
|
incision into the thorax
a. thoractomy b. lobectomy c. wedge resection d. segemntal resection e. lung volume reduction surgery f. decortication g. pneumonectomy |
a.
|
|
|
stripping of a fibrous membrane
a. thoractomy b. lobectomy c. wedge resection d. segemntal resection e. lung volume reduction surgery f. decortication g. pneumonectomy |
f
|
|
|
removal of one lung lobe
a. thoractomy b. lobectomy c. wedge resection d. segemntal resection e. lung volume reduction surgery f. decortication g. pneumonectomy |
b.
|
|
|
removal of lung segment
a. thoractomy b. lobectomy c. wedge resection d. segemntal resection e. lung volume reduction surgery f. decortication g. pneumonectomy |
d
|
|
|
removal of lung tissue by mmulitple wedge excisions
a. thoractomy b. lobectomy c. wedge resection d. segemntal resection e. lung volume reduction surgery f. decortication g. pneumonectomy |
e
|
|
|
Following a thoracotomy, the pt has a nursing diagnosis of ineffective airway clearance related to inability to cough secondary to pain and positioning. The best nursing inervention for this pt is to
a. have teh pt drink 16 ounces of water before attempting to deep breathe b. auscultate the lungs beore and after deep breathing and coughing regimens c. place the pt in the trendelenburg position for 30 minutes beofre the coughin exercises d. medicate th pt with analgesics 20 to 30 minutes before assisting to cough and deep breathe |
d.
|
|
|
Central depression of respiratory rate and depth
a. pleural effusion b. empyema c. pleurisy d. atelectasis e. Idiopathic pulmonary fiboris f. kyphoscoliosis g. opiod ad sedatibve overdose h. muscular dystrophy i. picwickian syndrome. |
g.
|
|
|
lung expansion restricted by fluid in pleuarl space
a. pleural effusion b. empyema c. pleurisy d. atelectasis e. Idiopathic pulmonary fiboris f. kyphoscoliosis g. opiod ad sedatibve overdose h. muscular dystrophy i. picwickian syndrome. |
a.
|
|
|
paralysis of respiratory muscles
a. pleural effusion b. empyema c. pleurisy d. atelectasis e. Idiopathic pulmonary fiboris f. kyphoscoliosis g. opiod ad sedatibve overdose h. muscular dystrophy i. picwickian syndrome. |
h
|
|
|
excess fat restricts chest wall and diaphragmatic excursion
a. pleural effusion b. empyema c. pleurisy d. atelectasis e. Idiopathic pulmonary fiboris f. kyphoscoliosis g. opiod ad sedatibve overdose h. muscular dystrophy i. picwickian syndrome. |
i
|
|
|
inflammation of the pleura restricting lung movement
a. pleural effusion b. empyema c. pleurisy d. atelectasis e. Idiopathic pulmonary fiboris f. kyphoscoliosis g. opiod ad sedatibve overdose h. muscular dystrophy i. picwickian syndrome. |
c.
|
|
|
lung expansion restricted by pus intrapleural space
a. pleural effusion b. empyema c. pleurisy d. atelectasis e. Idiopathic pulmonary fiboris f. kyphoscoliosis g. opiod ad sedatibve overdose h. muscular dystrophy i. picwickian syndrome. |
b
|
|
|
presence of collapsed , airless alveoli
a. pleural effusion b. empyema c. pleurisy d. atelectasis e. Idiopathic pulmonary fiboris f. kyphoscoliosis g. opiod ad sedatibve overdose h. muscular dystrophy i. picwickian syndrome. |
d.
|
|
|
spinal angulation restricting ventilation
a. pleural effusion b. empyema c. pleurisy d. atelectasis e. Idiopathic pulmonary fiboris f. kyphoscoliosis g. opiod ad sedatibve overdose h. muscular dystrophy i. picwickian syndrome. |
f.
|
|
|
exccessive connective tissue in lungs
a. pleural effusion b. empyema c. pleurisy d. atelectasis e. Idiopathic pulmonary fiboris f. kyphoscoliosis g. opiod ad sedatibve overdose h. muscular dystrophy i. picwickian syndrome. |
e.
|
|
|
Two days after undergoing pelvic surgery, a pt devlops marked dsypnea and anxiety. The first action the nurse should take is to
a. raise HOB b. notify the health care provider c. take the patients pulse and blood pressure d. deterine the pts SpO2 with an oximeter. |
a.
|
|
|
A pulmonary embolus is suspected in a pt with a deep-vein thrombosis who develops hemoptysis, tachycardia and pleuritic chest pain, and diagnostic testing is scheduled, the nurse plans to teach the pt about
a. chest radiographs b. venous ultrasound c. pulmonary angiography d. ventilation-perfusion lung scan |
d.
|
|
|
Stiffening of pulmonary vaculature
a. COPD b. pulmonary fibrosis c. pulmonary embolsim d. neuromuscular disorders |
b
|
|
|
obstruction of pulmonary blood flow
a. COPD b. pulmonary fibrosis c. pulmonary embolsim d. neuromuscular disorders |
c.
|
|
|
pulmonary capillary/alveolar damage
a. COPD b. pulmonary fibrosis c. pulmonary embolsim d. neuromuscular disorders |
a
|
|
|
local vasoconstriction and shunting
a. COPD b. pulmonary fibrosis c. pulmonary embolsim d. neuromuscular disorders |
d.
|
|
|
While caring for a pt with pulmonary hypertension, the nurs observes that the pt. has exertional dyspnea and chest pain, in addition to fatigue. the nurse knows these symptoms are r/t
a. decreased left ventricular output b. r ventricular hypertrophy and dilation c. increased systemic arterial blood pressure |
b
|
|
|
The primary treatment for cor pulmonale is directed toward
a. controlling dysrhythmias b. dilating the pulmonary and dilation c. strengthening the cardiac muscle d. treating the underlying pulomary condition |
d.
|
|
|
six days after a heart lung transplant, the pt develops a low grade fever and a decreased SpO2 with exercise. the nurse recognizes that this indicates
a. a normal response to extensive surgery b. a frequently fatal cytomegalovirus c. acute regjection that cann be treated with corticosteroids d. obliteravive bronchiolitis that plugs terminal bronchiles |
c.
|
