Immobility in Post-operative Care

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Questions and Answers

What should post-operative patients do if there are no movement restrictions?

Avoid any physical activity until cleared.

Remain completely still to recover.

Walk or perform range of motion exercises. (correct)

Only perform breathing exercises.

What effect can unbearable pain have on vital signs?

Vital signs improve significantly.

Pain has no significant effect on vital signs.

Vital signs remain unchanged.

Vital signs become chaotic and may affect lung function. (correct)

What is encouraged for patients who have undergone surgeries in the upper half of the body?

Deep breathing exercises only.

Complete bed rest with no movement.

Ambulation and range of motion exercises. (correct)

Avoiding any physical activity.

What is a nursing responsibility for patients with CNS dysfunction or coma?

Passive range of motion exercises. Signup and view all the answers

What is recommended for patients who have undergone surgery with general anesthesia?

Engage in deep breathing exercises. Signup and view all the answers

Which condition can alter breathing and impede air passage to the lungs?

Atelectasis. Signup and view all the answers

What should be provided to the patient prior to an operation with general anesthesia?

Full disclosure regarding the effects of anesthesia. Signup and view all the answers

How is atelectasis typically observed?

Only observed through imaging techniques. Signup and view all the answers

Which of the following symptoms is NOT commonly associated with pulmonary tuberculosis?

Swelling of feet Signup and view all the answers

What is the reason for collecting three early morning sputum specimens for diagnosing pulmonary tuberculosis?

To increase the likelihood of accurate findings Signup and view all the answers

Which classification of pulmonary tuberculosis indicates a latent infection?

Class 2 Signup and view all the answers

Which of the following is a sign of hepatotoxicity?

Jaundice Signup and view all the answers

What can be seen on a chest x-ray that supports the diagnosis of pulmonary tuberculosis?

Ghon tubercle Signup and view all the answers

Which class of pulmonary tuberculosis suggests that the disease is suspected but not yet diagnosed?

Class 5 Signup and view all the answers

Which symptom is least likely to indicate clinically active pulmonary tuberculosis?

Pruritis Signup and view all the answers

What is the main function of a chest x-ray in the context of pulmonary tuberculosis?

To provide supportive evidence for the diagnosis Signup and view all the answers

What type of sputum is commonly associated with bronchopneumonia?

Rusty sputum Signup and view all the answers

Which of the following is NOT a sign of pneumonia?

Increased appetite Signup and view all the answers

What is a primary diagnostic tool for detecting pneumonia?

Chest X-ray Signup and view all the answers

Which treatment is indicated for severe cases of pneumonia with impending alveoli collapse?

Mechanical ventilation Signup and view all the answers

What is a common symptom indicating the presence of an infectious agent in pneumonia?

Fatigability Signup and view all the answers

What indicates a high white blood cell count in pneumonia patients?

Above 10,000 cells/cu mm Signup and view all the answers

Which statement correctly describes bronchopneumonia?

Infection is patchy and can affect both lungs. Signup and view all the answers

What is an effective nursing management technique for pneumonia?

Reinforcing compliance with the therapeutic regimen Signup and view all the answers

Which of the following symptoms is commonly associated with pulmonary edema?

Productive cough with frothy and blood-tinged sputum Signup and view all the answers

What is the primary cause of pulmonary edema related to heart function?

Congestive Heart Failure Signup and view all the answers

Which method is NOT typically used in the medical management of pulmonary edema?

Antibiotics Signup and view all the answers

How does fluid overload contribute to pulmonary edema?

It leads to excess fluids accumulating in the lungs Signup and view all the answers

What effect does hypertension (HPN or HTN) have on pulmonary edema?

It can lead to fluid accumulation in the lungs Signup and view all the answers

Which of the following describes arrhythmias in relation to pulmonary edema?

They lead to excessively high oxygenated blood flow Signup and view all the answers

What is a primary symptom of central cyanosis associated with pulmonary edema?

Blue discoloration on oral and nasal mucosa Signup and view all the answers

Which complication might arise from multiple blood transfusions related to pulmonary edema?

Increased risk of fluid overload Signup and view all the answers

What is the primary function of osmotic diuretics like mannitol?

Increasing urinary flow through osmotic retention Signup and view all the answers

In what scenario is mannitol typically used?

To decrease intracranial pressure and cerebral edema Signup and view all the answers

Why should mannitol be administered via a large central vein?

It can cause severe tissue damage as it is a vesicant Signup and view all the answers

Which of the following is NOT a symptom of Acute Respiratory Distress Syndrome (ARDS)?

Increased hemoglobin concentration Signup and view all the answers

What is the role of intubation in the management of ARF?

To maintain adequate ventilation and oxygenation Signup and view all the answers

Which pharmacologic treatment is commonly used in the management of ARDS?

Human recombinant interleukin – 1 receptor antagonist Signup and view all the answers

During the nursing management of ARF, which parameter is crucial to monitor?

Level of responsiveness and vital signs Signup and view all the answers

What are common ABG findings in a patient with ARDS?

Decreased PaO2 and increased PaCO2 Signup and view all the answers

Study Notes

Immobility and Post-operative Care

Post-operative patients without movement restrictions should ambulate to encourage lung expansion, especially those with lung diseases.
Chronic and excruciating pain can disrupt vital signs and hinder lung function by limiting full expansion.
Patients experiencing trauma or surgical procedures involving the lungs should be encouraged to ambulate and perform range of motion (ROM) exercises.
For patients with CNS dysfunction or coma, nursing responsibility includes delivering passive ROM exercises.

Pathophysiology of Atelectasis

General anesthesia can temporarily depress physiological functions, necessitating deep breathing exercises post-surgery.
Decreased airflow leads to atelectasis, detectable via specific symptoms rather than visually.
Indicators of active infections include cough with discolored sputum (greenish/yellowish), while a rusty sputum indicates late-stage pneumonia.

Pathophysiology of Pneumonia

Pneumonia can be caused by infectious agents (like Mycoplasma) and non-infectious agents (foreign matter).
Inflammatory responses release agents such as histamine and WBCs, resulting in mucus hypersecretion and significant consolidation due to WBC activity.
Symptoms include fever, chills, shortness of breath, cyanosis, and productive coughs with abnormal sputum colors.

Diagnostic Tests for Pneumonia

Chest X-ray and sputum examination are critical; sputum exam is the most reliable diagnostic option.
CBC reveals elevated white blood cell counts, typically above 10,000 cells/cu mm, indicating infection.

Medical Management for Pneumonia

Pharmacological treatments target symptoms and underlying infections.
Supportive treatment includes oxygen therapy and mechanical ventilation for severe cases or when alveoli collapse is imminent.

Signs and Symptoms of Pulmonary Tuberculosis

Common symptoms include low-grade fever, appetite loss, night sweats, dry cough progressing to hemoptysis, chest pain, and weight loss.
Morning sputum specimens are collected over three days to ensure accurate diagnosis of pulmonary tuberculosis due to overnight secretion buildup in the lungs.
Chest X-rays provide supportive evidence of PTB, with Ghon tubercle as a key indicator.

Classification of Pulmonary Tuberculosis (PTB)

Class 0: No exposure; no infection.
Class 1: Exposed; no infection.
Class 2: Latent infection; negative symptoms; positive PPD.
Class 3: Active infection; all tests positive.
Class 4: Clinically inactive infection; positive tests.
Class 5: Suspected disease; pending diagnosis.

Medical Management for Pulmonary Edema

Pulmonary edema results from conditions like congestive heart failure (CHF) and left ventricular failure, leading to fluid accumulation in the lungs.
Immediate treatment may involve vasodilators and inotropic drugs to enhance cardiac function.
Symptoms of pulmonary edema include productive cough with frothy sputum, central cyanosis, and altered mental status.

Signs and Symptoms of Acute Respiratory Failure (ARF)

Common indicators include tachypnea, difficulty breathing, retractions, central cyanosis, and altered consciousness.
Intubation and mechanical ventilation are primary interventions for managing ARF.

Medical Management of Acute Respiratory Distress Syndrome (ARDS)

Intubation and mechanical ventilation are critical for maintaining ventilation and oxygenation, coupled with pharmacologic treatments like human recombinant interleukin-1 receptor antagonist and neutrophil inhibitors.

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Description

This quiz explores the importance of mobility for post-operative patients, particularly those with lung disease. It covers strategies to encourage walking, deambulation, and range of motion exercises to prevent complications. Additionally, it addresses pain management in patients with chronic conditions.