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98 Cards in this Set
- Front
- Back
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Fluid accumulating within the pleural space is termed a ___.
a) pneumothorax b) hemothorax c) pleural effusion d) pericardial effusion |
c) pleual effusion
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Air in the pleural space is termed a ____?
a) pneumothorax b) hemothorax c) pleural effusion d) pericardial effusion |
a) pneumothorax
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Blood accumulating in the pleural space is called a ____?
a) pneumothorax b) hemothorax c) pleural effusion d) pericardial effusion |
b) hemothorax...duh!
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A pericardium distended with fluid is termed a ____?
a) pneumothorax b) hemothorax c) pleural effusion d) pericardial effusion |
d) pericardial effusion
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What is a thorocentesis?
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Removal of fluid by needle aspiration.
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What is purulent sputum?
a) blood filled b) pus filled c) bacteria filled d) fungus filled |
b) pus fulled
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What is described as an inflammation of the lung parenchyma and is known as the most common cause of death from infectious disease in the US?
a) asthma b) atelectasis c) pneumonia d) bronchitis |
c) pneumonia
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What occurs in the community setting or within the first 48 hours after hospitaliztion or institutionalization?
a) HAP b) CAP |
b) CAP
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What type of pneumonia occurs most often in older children and young adults and is spread by infected respiratory droplets through person-to-person contact?
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Mycoplasma pneumonia
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What type of pneumonia includes an onset of pneumonia symptoms more than 48 hours after admission in patients with no evidence of infection at the time of admission?
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HAP
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What is the most lethal nosocomial infection and is estimated to occur in 15-20% of intensive care patients?
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HAP
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What type of pneumonia would occur in a vented patient?
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ventilator-associated pneumonia
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Most patients with HAP are colonized with...
a) a single organism b) multiple organisms |
b) multiple organisms
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True or False: People with MRSA are isolated with contact precautions which involves wearing a gown and gloves, and an optional mask if splashing is anticipated.
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False: The mask is not optional. When MRSA is located in the respiratory tract, a mask is required, as the patient is likely to cough microbes into the air.
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What groups of people are at particular risk for the development of pneumonia?
Check all that apply: a) elderly b) alcoholics c) chronic lung diseased d) diabetics |
All of the above
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What is the most common cause of aspiration pneumonia?
a) aspiration of food b) aspiration of fluids c) aspiration of bacteria d) aspiration of saliva |
c) aspiration of bacteria
Sometimes bacteria that normally reside in the upper airways is aspirated into the lower airway and causes infection. |
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If a substantial portion of one or more lobes is involed in the pneumonia, what is it termed?
a) lobar pneumonia b) bronchopneumonia c) lobular pneumonia |
a) lobar pneumonia
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At what age are people recommended to get a pneumonia vaccination?
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65 years old
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What are the recommended steps a person should take when giving a sputum sample?
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1. Rinse your mouth
2. Breath deeply several times 3. Cough deeply 4. Expectorate the raised sputum |
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When does an empyema occur?
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When pus accumulates in the pleural space.
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What has likely occured if a patient with pneumonia improves and their fever decreases after initial antibiotic therapy, but a rise in temperature and increasing cough occurs?
a) a superinfection has occured b) the pneumonia has spread c) the wrong antibiotic has been perscribed |
a) a superinfection has occured
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What would alert the nurse that bacterial pneumonia has set in?
a) restlessness and hemoptysis b) muscle aches and insomnia c) fever or night sweats |
c) fever or night sweats
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What type of pain can signal pneumonia?
a) back pain b) kidney pain c) abdominal pain d) pleuritic pain |
d) pleuritic pain
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What infectious disease infects an estimated 1/3 of the world's population and remains the leading cause of death from infectious disease in the world?
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TB
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In what group of people does TB occur most in?
a) Indian b) Non-hispanic Blacks c) Non-hispanic Whites d) Latinos |
b) Non-hispanic Blacks
Born in the United States! |
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What additional diagnostic test is performed to confirm a positive TB skin test?
a) chest X-ray b) CT scan c) MRI d) Dopler |
a) chest X-ray
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Into what layer of the skin is a bacillus extract(TB PPD) injected into?
a) dermis b) epidermis c) subcutaneous |
a) dermis
i.e. the needle is inserted into the intradermal layer |
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In what direction should the bevel of a TB PPD test needle be?
a) facing down b) facing up c) facing sidways d) it does not matter |
a) facing up
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How long after injection, should the PPD be read?
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48-72 hours
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What constitues a positive reaction to a PPD?
a) induration (hardening) b) erythemia (redness) c) both |
c) both hardening and redness must be present
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True or False: When measuring the results of a positive PPD, you measure the size of the induration(hardening) and NOT the size of the redness.
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True!
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Does erythema without induration indicate a positve result?
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No, this result is not positive and not considered significant.
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People who have normal or mildly impaired immunity, who present with a 9 mm induration with erythema are considered to have tested positive with the PPD test. True or False?
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False: They need to have 10 mm or greater!
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After a PPD, a reaction of 5 mm or greater may be significant in what group of people?
a) normal people b) HIV infected c) no people, this reaction is ok |
b) HIV infected
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A significant reaction occurs in people with past exposure to TB or the ____ vaccination.
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BCG
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What is primary drug resistance in terms of TB meds?
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Resistance to one of the first line antibuberculosis agents in people who have not had previous treatment.
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What is secondary or acquired drug resistance in terms of TB meds?
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Resistance to one or more autibuberculosis agents in patients undergoing therapy.
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What is mulitdrug resistance in terms of TB meds?
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Resistance to the two agents, INH and rifampin
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What group of people are most at risk for developing a multidrug resistance to TB meds?
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HIV +, institutionalized, or homeless
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What TB med will cause an orange discoloration of the urine?
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Rifampin(Rifadin)
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What TB med may cause discoloration of contact lenses?
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Rifadin
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What TB med may cause orange-red coloration of body secretions, contact lenses, and dentures?
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Priftin
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What TB medication would require the monitoring of visual acuity and color discrimination?
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Myambutol
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What 4 meds are given in the initial phase of a multiple medicaiton regimen for TB?
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INH, rifampin, pyrazinamide and ethambutol
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How long does the initial treatment with the 4 meds for the multi med regimen for the treatment of TB last for?
a) 2 weeks b) 4 weeks c) 6 weeks d) 8 weeks |
d) 8 weeks
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How long does the continuation course of treatment for TB last for?
1) 1-3 months 2) 2-5 months 3) 4-7 months 4) 5-8 months |
3) 4-7 months
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How long after taking TB meds are people considered non-infectious?
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After 2-3 weeks of continuous medication therapy.
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What is usually administered with INH to prevent INH-associated peripheral neruopathy?
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Vitamin B
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What tends to obstruct the airway in patients with TB, and interfere with adequate gas exchange?
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Copious secretions
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Would a patient taking TB meds be recommended to take their meds on an empty or full stomach?
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An empty stomach as food may interfere with the absorption of the meds
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People taking INH should avoid what foods?
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tuna, aged cheese, red wine, soy sauce and yeast extracts
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What is common to the following foods which people taking INH should avoid?
(tuna, aged cheese, red wine, soy sauce and yeast extracts) |
tyramine and histamine
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What effect on other medications can rifampin cause?
a) increased metabolism b) decreased metabolism c) increased acidity d) decreased acidity |
a) increase metabolism
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What would an enlarged spleen and reduced number of leukocytes indicate?
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Possible miliary TB
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What would the chest X-ray of a person with miliary TB reveal after a few weeks?
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small densities scattered diffusely throughout both lung fields.
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A localized necrotic lesion of the lung parenchyma containing purulent material that collapses and forms a cavity is termed a ____ ____.
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lung abscess
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Where are most lung abscesses found?
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Areas of the lung affected by aspiration.
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What signs and symptoms might a person with a lung abscess have?
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fever, productive cough with moderate to copious amounts of foul-smelling, somtimes bloody, sputum
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What might a person with an intermittent pleural friction rub have?
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a lung abscess
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What might a person want to do if they are having teeth extracted while their gums and teeth are infected?
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Take antibiotics prior to the dental procedure
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Why are large doses of IV antibiotics required for people with abscesses?
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Because the antibiotic must penetrate the necrotic tissue and the fluid in the abscess.
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What is pleurisy?
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Inflammation of both the parietal and visceral pleurae.
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How is a patient with pleurisy recommended to lie?
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on the affected side
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Why is a person with pleursy told to lie on the infected side?
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To splint the chest wall and reduce the stretching of the pleurae(ie reduce pain).
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Inbalances of hydrostatic or oncotic pressures may cause the movement of ___ ____across the capillary walls and into the pleural space.
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plasma filtrate
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What is another name for transudate?
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plasma filtrate
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Do the findings of transudate effusions usually imply that the pleural membranes are diseased, or not diseased?
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not diseased
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What are transudative effusions most commonly caused by?
a) acid-base imbalances b) poor sodium ion reuptake c) excess sodium bicarbonate d) heart failure e) kidney failure |
d) heart failure
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What type of x-ray can be used to diagnose a pleural effusion?
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lateral decubitus
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How is the patient positioned during a lateral decubitus x-ray? Why?
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They are positioned in a side lying position, lying on the affected side. This allow the layering out of fluid so that an air-fluid line can be detected.
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Can a thorocentesis be used to relieve dyspnea and respiratory compromise?
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yes!
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What most commonly causes pulmonary edema?
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abnormal cardiac function
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How can abnormal cardiac function cause pulmonary edema?
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It increases microvascular pressure.
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What might a patient who coughs up pink froth or foam have?
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pulmonary edema
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How high is the mortality rate with Acute respiratory distress syndrome (ARDS)
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50-60%
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What part of the heart enlarges with cor pulmonale?
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right ventricle
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A patient getting discharged with cor pulmonale would be advised to monitor what?
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fluid retention, weight gain, and edema
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An obstruction of the pulmonary artery or one of its branches by a thrombus is termed a ____ ____.
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pulmonary embolism
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Where do most thrombi originate from?
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deep veins of the legs
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What heart condition causes PE?
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atrial fibrillation
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How long after the onset of symptoms of a PE does death usually occur in?
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1 hour
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What is the #1 choice for the diagnosis of a PE?
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pulmonary angiogram
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What is the #2 choice for the diagnosis of a PE?
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V/Q scan
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True or False: Administration of heparin helps to prevent the recurrence of emboli and to help dissolve any existing emboli.
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False: It has no effect on emboli that are already present, but it can help to prevent further ones.
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What lab test is used to monitor the effectivness of heparin in preventing PEs or blood clots? What is a therapeutic range?
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PTT: 1.5 to 2 times the normal level
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When a patient is taking Coumadin, what lab test should be done to monitor its effectiveness? What is a therapeutic value?
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INR: 2-3
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What is transvenous catheter embolectomy?
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An intervention to remove an embolism; A vacuum-cupped catheter is inserted and the embolism is sucked out.
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Why is sputum cytology used to make a diagnosis of lung cancer?
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It is NOT! Sputum cytology is rarely used to make a diagnosis of lung cancer.
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Does radiation or chemotherapy shrink the size of a tumor?
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Radiation
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As a rule of thumb, the chest wall is opened surgically if more than ____ mL of blood is aspirated initially by thoracentesis.
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1500 mL
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As a rule of thumb, the chest wall is opened surgically if chest tube output continues at greater than ____ mL/hour.
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200
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What is cardiac tamponade?
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The compression of the heart resulting from fluid or blood within the pericardial sac.
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What is status asthmaticus?
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Severe and persistent asthma that does not respond to conventional therapy.
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True or False: With Status asthmaticus, the louder the wheezing, the more severe the attack.
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False: the extent of wheezing does not indicate the severity of the attack. As the obsturction worsens, the wheezing may disappear.
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As a respiratory obstruction worsens, the wheezing may disappear, what can this be a sign of?
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Impending respiratory failure
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What is the most common finding in patients with asthma in terms of blood ph?
a) respiratory acidosis b) respiratory alkalosis c) metabolic acidosis d) metabolic alkalosis |
b) respiratory alkalosis
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True or False: A person in respiratory alkalosis with an increasing PaCO2 to normal levels or levels indicating respiratory acidosis frequently is a danger sign indicating impending respiratory failure.
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True!
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Is living in a rural or urban neighborhood a risk factor for asthma?
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urban
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