Intro to Med Surg Wk4

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Questions and Answers

Which of the following is a priority education component for a patient scheduled for a total laryngectomy?

  • Use of room vaporizers or steam inhalation
  • Alternative communication methods (correct)
  • Dietary restrictions
  • Importance of frequent hand washing

What type of education is essential to help prevent upper respiratory infections?

  • Use of analgesics
  • Dietary restrictions
  • Alternative communication methods
  • Frequent hand washing (correct)

What is an appropriate nursing intervention to reduce inflammation and bleeding in a patient with an upper respiratory infection?

  • Use hot packs to reduce congestion
  • Encourage fluids and use of vaporizers
  • Ice collar application (correct)
  • Elevate head

What is a clinical manifestation of an upper respiratory infection?

<p>Fatigue (D)</p> Signup and view all the answers

Which of the following interventions is crucial for airway management in a patient with an upper respiratory infection?

<p>Maintaining a patent airway (B)</p> Signup and view all the answers

Which of the following is a potential complication of a laryngectomy?

<p>Aspiration (A)</p> Signup and view all the answers

What is an appropriate intervention to help reduce anxiety in a patient scheduled for a laryngectomy?

<p>Preoperative teaching (B)</p> Signup and view all the answers

Which of the following is a priority consideration for effective communication strategy post-laryngectomy?

<p>Support alternative communication (D)</p> Signup and view all the answers

What is a factor that can impact communication post-laryngectomy?

<p>Literacy level (D)</p> Signup and view all the answers

Which of the following is a nursing intervention to assist with maintaining a patient's self-esteem after a laryngectomy?

<p>Promote positive body image (D)</p> Signup and view all the answers

What is the most common reason people seek health care related to upper respiratory tract disorders?

<p>Upper respiratory infections (B)</p> Signup and view all the answers

Which of the following describes how the common cold is typically treated?

<p>Managed with over-the-counter medications and rest (C)</p> Signup and view all the answers

What is essential for avoiding complications from upper respiratory infections?

<p>Early detection and appropriate interventions (C)</p> Signup and view all the answers

Which of the following is characterized as a potential complication of upper respiratory infections?

<p>Acute sinusitis (A)</p> Signup and view all the answers

For which group of individuals should special considerations in management of upper respiratory infections be made?

<p>Older adults (B)</p> Signup and view all the answers

What is the most common site for epistaxis?

<p>Anterior septum (B)</p> Signup and view all the answers

Which of the following methods can be used to manage epistaxis?

<p>Cauterization with silver nitrate (B)</p> Signup and view all the answers

What is a potential serious complication of epistaxis?

<p>Airway compromise (D)</p> Signup and view all the answers

Which action should a patient take if epistaxis does not stop after 15 minutes?

<p>Seek medical attention (C)</p> Signup and view all the answers

Which of the following is a recommended patient teaching for epistaxis management?

<p>Avoid tobacco use (D)</p> Signup and view all the answers

What should be monitored in a patient with epistaxis?

<p>Vital signs and pulse oximetry (B)</p> Signup and view all the answers

Which of the following is NOT a risk factor for epistaxis?

<p>High humidity (B)</p> Signup and view all the answers

Which complication is associated with upper respiratory infections (URIs)?

<p>Acute otitis media (A)</p> Signup and view all the answers

Which of the following is a true statement regarding the treatment of tuberculosis?

<p>Treatment usually lasts for 6 to 12 months. (A)</p> Signup and view all the answers

What is the primary purpose of a TB skin test?

<p>To identify individuals who have been exposed to TB. (D)</p> Signup and view all the answers

Which of the following is a nursing intervention that is NOT directly related to the management of tuberculosis?

<p>Monitoring the effectiveness of analgesics. (D)</p> Signup and view all the answers

What is the term used to describe the calcified fibrous mass that forms after a patient recovers from tuberculosis?

<p>Ghon tubercle (A)</p> Signup and view all the answers

Which of the following is MOST likely to be a significant symptom of tuberculosis?

<p>Low-grade fever (D)</p> Signup and view all the answers

Which of the following is a diagnostic test used to diagnose BOTH lung abscess and pleural effusion?

<p>Chest x-ray (C)</p> Signup and view all the answers

A patient with sarcoidosis may experience which of the following symptoms?

<p>Dyspnea (B)</p> Signup and view all the answers

Which of these is a potential complication of a lung abscess?

<p>Empyema (B)</p> Signup and view all the answers

Which of the following is a key characteristic of pleuritic pain?

<p>It is worse on inspiration. (D)</p> Signup and view all the answers

Which of these management approaches is NOT indicated for lung abscess?

<p>Corticosteroids (A)</p> Signup and view all the answers

A patient with acute respiratory failure may present with which early sign?

<p>Restlessness (A)</p> Signup and view all the answers

Which of the following is a nursing intervention for a patient with a tracheostomy?

<p>Maintaining patency of the tracheostomy tube (C)</p> Signup and view all the answers

Which of the following conditions typically involves a thick, purulent fluid in the pleural space?

<p>Empyema (D)</p> Signup and view all the answers

Which of the following is a common assessment finding for a patient with pleural effusion?

<p>Decreased breath sounds (A)</p> Signup and view all the answers

A patient with sarcoidosis is likely to receive which of the following medical management?

<p>Corticosteroids (D)</p> Signup and view all the answers

Which of the following procedures is used to obtain a definitive diagnosis of sarcoidosis?

<p>Mediastinoscopy (C)</p> Signup and view all the answers

Which of the following is NOT a common clinical manifestation of acute respiratory failure?

<p>Hypertension (B)</p> Signup and view all the answers

What is the primary goal in the medical management of acute respiratory failure?

<p>Treating the underlying cause (D)</p> Signup and view all the answers

Which of the following is a potential complication of prolonged endotracheal intubation?

<p>Tracheal stenosis (B)</p> Signup and view all the answers

What is a potential complication of a patient with chest trauma due to blunt force?

<p>All of the above (D)</p> Signup and view all the answers

What is the primary function of a chest drainage system?

<p>To remove air and fluid from the pleural space (D)</p> Signup and view all the answers

Which of the following is NOT a preventable measure for occupational lung disease?

<p>Treating the condition with medication (A)</p> Signup and view all the answers

Which of the following is a method of positive-pressure ventilation that can be administered via a facemask?

<p>Continuous positive airway pressure (CPAP) (C)</p> Signup and view all the answers

What is a distinguishing characteristic of acute respiratory distress syndrome (ARDS)?

<p>Absence of an elevated left atrial pressure (C)</p> Signup and view all the answers

What is the recommended frequency for tracheal suctioning?

<p>Only when adventitious breath sounds or copious secretions are present (C)</p> Signup and view all the answers

What is the primary cause of lung cancer in over 85% of cases?

<p>Cigarette smoke (C)</p> Signup and view all the answers

Which of the following is NOT a complication associated with mechanical ventilation?

<p>Increased mobility (D)</p> Signup and view all the answers

Which of the following is NOT a common symptom managed in patients with lung cancer?

<p>Hypertension (B)</p> Signup and view all the answers

Which of the following is a nursing intervention for promoting effective airway clearance in a patient receiving mechanical ventilation?

<p>Suctioning only when excessive secretions are present (B)</p> Signup and view all the answers

What is the primary goal of postoperative management following a thoracotomy?

<p>Monitoring vital signs and managing complications (B)</p> Signup and view all the answers

Which of the following is a goal of nursing care for a patient receiving mechanical ventilation?

<p>Maintaining a patent airway (B)</p> Signup and view all the answers

Which of the following is a common cause of pneumonia among adults?

<p>Multidrug-resistant organisms (D)</p> Signup and view all the answers

Which of the following is a key nursing intervention to help alleviate breathing problems in a patient with lung cancer?

<p>Encouraging deep breathing exercises (A)</p> Signup and view all the answers

Hospital-acquired pneumonia develops within how many hours after hospitalization?

<p>48 hours (C)</p> Signup and view all the answers

What is a key consideration in preventing alarm fatigue in an ICU setting?

<p>Educating staff on alarm response (A)</p> Signup and view all the answers

What is the purpose of BiPAP (bilevel positive airway pressure)?

<p>To provide different levels of pressure during inhalation and exhalation (D)</p> Signup and view all the answers

Which of the following is NOT a risk factor for pneumonia?

<p>Healthy lifestyle (A)</p> Signup and view all the answers

Which of the following is a nursing intervention for enhancing gas exchange in a patient receiving mechanical ventilation?

<p>Frequent repositioning of the patient (C)</p> Signup and view all the answers

What is the role of a nurse in managing a patient with occupational lung disease?

<p>Providing health education and advocacy (C)</p> Signup and view all the answers

Which of the following is a potential complication of mechanical ventilation?

<p>Barotrauma and pneumothorax (A)</p> Signup and view all the answers

Which of the following is a clinical manifestation of streptococcal pneumonia?

<p>Sudden onset of chills and fever (B)</p> Signup and view all the answers

What is the primary focus of nursing interventions for a patient receiving mechanical ventilation?

<p>Maintaining a patent airway and optimal gas exchange (D)</p> Signup and view all the answers

What is a key diagnostic tool used to assess pneumonia?

<p>Chest x-ray (B)</p> Signup and view all the answers

Which of the following nursing interventions promotes optimal communication for a patient receiving mechanical ventilation?

<p>Using nonverbal communication methods (D)</p> Signup and view all the answers

Which type of vaccination is recommended for adults 65 years of age or older to reduce the incidence of pneumonia?

<p>Pneumococcal (B)</p> Signup and view all the answers

What is a supportive treatment for pneumonia, besides antibiotics?

<p>Oxygen therapy (C)</p> Signup and view all the answers

Which of the following is a common symptom of COVID-19 pneumonia?

<p>Fatigue (A)</p> Signup and view all the answers

When assessing a patient with bacterial pneumonia, what is a key vital sign to monitor?

<p>All of the above (D)</p> Signup and view all the answers

What is a potential complication of bacterial pneumonia?

<p>Respiratory failure (B)</p> Signup and view all the answers

Which of the following is a nursing intervention for a patient with bacterial pneumonia?

<p>Encouraging deep breathing exercises (B)</p> Signup and view all the answers

What is the primary cause of aspiration pneumonia?

<p>Inhalation of foreign material (C)</p> Signup and view all the answers

Which of the following is a risk factor for aspiration?

<p>Loss of consciousness (A)</p> Signup and view all the answers

What is a key preventative measure for aspiration?

<p>Keeping the head of the bed elevated (C)</p> Signup and view all the answers

What is another name for tuberculosis?

<p>Consumption (B)</p> Signup and view all the answers

How is tuberculosis typically spread?

<p>Airborne transmission (D)</p> Signup and view all the answers

What is a characteristic of acute atelectasis?

<p>Often occurs in the post-operative setting. (C)</p> Signup and view all the answers

Which of the following is NOT a typical clinical manifestation of acute tracheobronchitis?

<p>Fever and chills. (B)</p> Signup and view all the answers

What is the primary distinction between community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP)?

<p>The location where the infection is acquired. (D)</p> Signup and view all the answers

Which of the following is a nursing intervention for atelectasis prevention?

<p>Promoting frequent coughing and deep breathing. (C)</p> Signup and view all the answers

Which of the following is a common medical management strategy for acute tracheobronchitis?

<p>Antibiotics. (C)</p> Signup and view all the answers

Which of these interventions is specifically designed to improve ventilation in patients with atelectasis?

<p>Incentive spirometer. (D)</p> Signup and view all the answers

Which clinical manifestation would most strongly suggest a diagnosis of atelectasis?

<p>Decreased breath sounds and crackles in one lung field. (C)</p> Signup and view all the answers

Which of the following is a key aspect of nursing management for acute tracheobronchitis?

<p>Encouraging rest and complete medication courses. (D)</p> Signup and view all the answers

What is the primary reason for using an incentive spirometer in the management of atelectasis?

<p>To increase lung volume and expand alveoli. (C)</p> Signup and view all the answers

Which of the following is a potential complication of pneumonia?

<p>Acute atelectasis. (C)</p> Signup and view all the answers

Which of the following actions is a priority nursing intervention to promote gas exchange and oxygenation in a patient with COPD?

<p>Administering oxygen therapy as prescribed (B)</p> Signup and view all the answers

Identify the correct statement regarding the administration of oxygen at greater than 21% concentration.

<p>It aims to increase oxygen supply to tissues and cells (B)</p> Signup and view all the answers

Which of the following is a potential complication of administering too high a concentration of oxygen for a prolonged period?

<p>Oxygen toxicity (B)</p> Signup and view all the answers

Which of the following nursing interventions is MOST directly related to reducing the risk of oxygen toxicity in a patient receiving oxygen therapy?

<p>Using the lowest effective oxygen concentration (B)</p> Signup and view all the answers

Which of the following interventions is a priority nursing action when providing education to a patient with COPD?

<p>Instructing them on the proper use of their inhalers (A)</p> Signup and view all the answers

A patient with COPD is receiving oxygen therapy. Which of the following assessment findings should be reported immediately to the provider?

<p>Sudden decrease in oxygen saturation (B)</p> Signup and view all the answers

Identify the key clinical manifestation of oxygen toxicity.

<p>Substernal discomfort and dyspnea (A)</p> Signup and view all the answers

Which of the following aspects is NOT a primary focus of patient education for individuals with COPD?

<p>Encouraging them to use complementary therapies such as aromatherapy (A)</p> Signup and view all the answers

What is a key characteristic of the Venturi mask compared to a non-rebreathing mask?

<p>Is designed for lower concentrations of oxygen (C)</p> Signup and view all the answers

What does an increase in PaCO2 levels indicate in a patient experiencing status asthmaticus?

<p>Worsening condition requiring intervention (A)</p> Signup and view all the answers

Which statement regarding home oxygen therapy is true?

<p>Safety measures for administration should be considered (C)</p> Signup and view all the answers

Which of the following statements is false regarding the Venturi mask?

<p>It delivers high levels of supplemental oxygen (D)</p> Signup and view all the answers

What is essential for a patient in status asthmaticus to ensure safety and effectiveness in therapy?

<p>Frequent monitoring of peak flow rates (A)</p> Signup and view all the answers

What is the primary characteristic of chronic obstructive pulmonary disease (COPD)?

<p>Abnormal inflammatory response leading to airflow obstruction (A)</p> Signup and view all the answers

Which of the following best describes the condition of chronic bronchitis?

<p>A disease characterized by reduced ciliary function and persistent cough (D)</p> Signup and view all the answers

What consequence does chronic inflammation have in patients with COPD?

<p>Causes scar tissue formation leading to airway narrowing (D)</p> Signup and view all the answers

What is a common respiratory complication associated with chronic bronchitis?

<p>Increased susceptibility to respiratory infections (C)</p> Signup and view all the answers

What effect does scar tissue in pulmonary vasculature have in chronic pulmonary disease?

<p>Thickened vessel lining and vascular smooth muscle hypertrophy (C)</p> Signup and view all the answers

Which of these findings would NOT typically be observed in a patient with chronic bronchitis?

<p>Clear ciliary function (C)</p> Signup and view all the answers

What role do alveolar macrophages play in the respiratory system, particularly in chronic bronchitis?

<p>They assist in destroying foreign pathogens. (B)</p> Signup and view all the answers

Which of the following is a key prevention strategy for managing COPD?

<p>Regular vaccinations against respiratory infections (D)</p> Signup and view all the answers

Which of the following symptoms is NOT a primary symptom of COPD?

<p>Fever (A)</p> Signup and view all the answers

What is a common complication associated with COPD?

<p>Respiratory insufficiency (C)</p> Signup and view all the answers

What is the primary purpose of pulmonary function tests in diagnosing COPD?

<p>To assess lung capacity and function (C)</p> Signup and view all the answers

Which of the following treatments is most beneficial for managing asthma symptoms?

<p>Long-acting beta-2 adrenergic agonists (B)</p> Signup and view all the answers

Which of these conditions is caused by a genetic mutation affecting chloride transport?

<p>Cystic Fibrosis (C)</p> Signup and view all the answers

Which of the following symptoms would likely indicate an exacerbation in a patient with asthma?

<p>Diaphoresis and wheezing (D)</p> Signup and view all the answers

What type of management involves airway clearance and antibiotics in Cystic Fibrosis?

<p>Acute management (A)</p> Signup and view all the answers

Which of the following is a typical medication used in the treatment of chronic bronchiectasis?

<p>Bronchodilators (C)</p> Signup and view all the answers

Which medication type is NOT typically used for asthma treatment?

<p>Mucolytics (D)</p> Signup and view all the answers

What is the primary goal of smoking cessation programs in the management of COPD?

<p>Prevent further lung damage (A)</p> Signup and view all the answers

Which of the following is a common clinical manifestation of bronchiectasis?

<p>Cough with purulent sputum (B)</p> Signup and view all the answers

What is considered a characteristic feature of a patient with emphysema?

<p>Barrel chest (B)</p> Signup and view all the answers

What role do corticosteroids play in managing asthma?

<p>Reduce airway inflammation (D)</p> Signup and view all the answers

Flashcards

Upper Respiratory Infections (URIs)

Common illnesses that affect the upper respiratory tract, such as the common cold.

Common Cold

Acute inflammation of the nasal cavity, typically self-limiting.

Symptoms of a Cold

Includes nasal congestion, rhinorrhea, sore throat, and malaise.

Treatment Settings for URIs

URIs are often treated in doctor's offices, urgent care, and at home.

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Prevention and Health Promotion

Focus on educating patients to prevent URIs and promote health.

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Secondhand Smoke

Airborne toxins inhaled by non-smokers from smoking products.

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Chronic Pharyngitis Avoidances

Patients should avoid alcohol, tobacco, and secondhand smoke.

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URI Symptoms

Headache, cough, hoarseness, fever, and fatigue are signs of URI.

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Airway Management Goals

Ensure airway is clear and minimize aspiration risk.

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Nursing Interventions for URI

Include elevation of the head and hydration support.

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Evaluation of URI

Assess for patent airway, pain relief, and hydration status.

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Patient Education for URI

Instruct on hand washing and completing antibiotic regimens.

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Laryngectomy Assessments

Evaluate health history and psychosocial factors pre-surgery.

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Potential Complications of Laryngectomy

Risk of respiratory distress, infection, and aspiration.

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Communication Support Post-Laryngectomy

Encourage alternative communication methods after surgery.

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Epistaxis

Hemorrhage from the nose, often from the anterior septum.

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Common site for Epistaxis

The anterior septum is the most common site for nosebleeds.

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Medical management of Epistaxis

Includes pinching the nose, using phenylephrine, cauterization, and packing.

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Nursing management for Epistaxis

Focus on monitoring vitals, reducing anxiety, and educating patients to avoid nasal trauma.

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URIs

Upper Respiratory Infections, including rhinitis, pharyngitis, and tonsillitis.

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Complications of URIs

Can include airway obstruction, sepsis, and dysphagia.

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Pharyngitis

Inflammation of the pharynx, often caused by infection.

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Patient Education for Pharyngitis

Advise to avoid smoking, spicy foods, and forceful blowing.

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Granulomas

Small clusters of immune cells formed in response to infection, like TB.

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Ghon tubercle

A calcified mass formed when TB bacteria become dormant in the lungs.

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TB Skin Test (Mantoux Method)

A method to check for TB infection through intradermal injection.

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Initial Treatment Phase of TB

The first 8 weeks of TB treatment where multiple medications are used.

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Reactivation of TB

When dormant TB bacteria become active again, leading to infection.

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Atelectasis

Closure or collapse of alveoli, can be acute or chronic.

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Acute Atelectasis

Most common type, often occurs postoperatively.

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Symptoms of Atelectasis

Symptoms include dyspnea, cough, and sputum production.

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Assessment for Atelectasis

Characterized by increased work of breathing and hypoxemia.

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Management of Atelectasis

Focus on improving ventilation and removing secretions.

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Acute Tracheobronchitis

Inflammation of the trachea's mucous membranes, often from a virus.

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Symptoms of Acute Tracheobronchitis

Starts with a dry cough, may progress to wheezing and purulent sputum.

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Pneumonia

Inflammation of lung tissue caused by microorganisms.

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Classification of Pneumonia

Types include community-acquired, healthcare-associated, and hospital-acquired.

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Management of Acute Tracheobronchitis

Includes antibiotics, analgesics, hydration, and bronchial hygiene.

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Types of Pneumonia

Pneumonia can be classified as hospital-acquired or ventilator-associated.

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Hospital-acquired Pneumonia

Develops after 48 hours of hospitalization and often caused by resistant organisms.

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Ventilator-associated Pneumonia

Occurs in patients on mechanical ventilation for at least 48 hours, prevention is crucial.

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Risk Factors for Pneumonia

Includes underlying diseases like heart failure, diabetes, COPD, and AIDS.

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Clinical Manifestations of Pneumonia

Symptoms vary by type and include chills, fever, and respiratory distress.

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Assessment for Pneumonia

Involves history, physical exam, chest x-ray, and sputum examination.

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Pneumonia Prevention

Includes pneumococcal vaccination and healthy habits to reduce incidence.

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Medical Management of Pneumonia

Use appropriate antibiotics, supportive treatments, and manage symptoms.

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COVID-19 Pneumonia Symptoms

Can range from asymptomatic to severe, including fatigue and respiratory distress.

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Aspiration Pneumonia

Caused by inhaling foreign material, leading to inflammation and infection.

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Aspiration Prevention Strategies

Includes keeping head elevated and screening swallowing ability.

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Complications of Pneumonia

May lead to sepsis, respiratory failure, and delirium.

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Expected Outcomes in Pneumonia Treatment

Goals include improved airway, hydration, and knowledge of care.

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Pneumonia in Immunocompromised Host

Common causes include pneumocystis, fungi, and tuberculosis.

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Suctioning Frequency

Suctioning should only occur when needed, not every 4 hours.

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Mechanical Ventilation

Device that assists with ventilation and oxygenation over time.

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Noninvasive Positive-Pressure Ventilation

Ventilation method using masks to avoid intubation.

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Continuous Positive Airway Pressure (CPAP)

Noninvasive ventilatory support for sleep apnea patients.

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Bilevel Positive Airway Pressure (BiPAP)

Ventilation providing two pressure levels for inhalation and exhalation.

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Assessment for Mechanical Ventilation

Systematic evaluation of patients and equipment during ventilation.

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Complications of Mechanical Ventilation

Potential issues include infections, barotrauma, and delirium.

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Nursing Interventions for Ventilation

Actions to ensure gas exchange and prevent complications.

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Airway Clearance Techniques

Methods to clear the airway, such as suctioning or CPT.

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Infection Control Measures

Protocols to prevent infection in ventilated patients.

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Alarm Fatigue

Desensitization to alarms causing slow nurse response, especially in ICUs.

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Acute Respiratory Distress Syndrome (ARDS)

Severe lung condition with high mortality; causes pulmonary edema and dyspnea.

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Occupational Lung Disease

Lung damage from inhaling dust, includes asbestosis and silicosis.

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Lung Cancer

Leading cancer death cause in the U.S., primarily from smoking.

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Nursing Care for Lung Cancer

Manage pain, symptoms, provide psychological support for lung cancer patients.

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Thoracotomy Management

Preoperative includes airway clearance and anxiety relief; postoperative involves monitoring.

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Chest Trauma Types

Includes blunt trauma (rib fractures) and penetrating trauma.

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Chest Tube Drainage System

Device to remove air/fluid from pleural space; prevents air reentry.

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Pneumothorax

Eruption of air in the pleural space causing lung collapse.

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V/Q Mismatch

Mismatch between ventilation and perfusion, often seen in ARDS.

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Lung Abscess

A localized collection of pus in the lung, often due to bacterial pneumonia.

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Symptoms of Lung Abscess

Includes cough with foul sputum, dyspnea, and weight loss.

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Assessment for Lung Abscess

Diagnosed via chest x-ray, sputum culture, and bronchoscopy.

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Sarcoidosis

An inflammatory disease impacting multiple systems, often with unknown cause.

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Symptoms of Sarcoidosis

May include cough, dyspnea, fatigue, and weight loss.

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Diagnosis of Sarcoidosis

Confirmed through chest x-rays, CT scans, and biopsies.

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Pleurisy

Inflammation of pleural layers causing sharp chest pain with breathing.

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Pleural Effusion

Fluid accumulation in the pleural space, often from infections or heart failure.

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Empyema

Accumulation of thick, pus-like fluid in pleural space, often a pneumonia complication.

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Acute Respiratory Failure

Sudden inability to maintain adequate gas exchange in lungs.

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Management of ARF

Involves intubation, mechanical ventilation, and nutritional support.

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Endotracheal Intubation

Placement of a tube to maintain airway and allow ventilation.

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Tracheotomy

Surgical creation of an opening in the trachea for ventilation.

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Nursing Management of Tracheostomy

Includes monitoring, suctioning, and patient education on care.

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Medical Management of Lung Abscess

Includes drainage, chest physiotherapy, and antimicrobial therapy.

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Venturi Mask

A high-flow oxygen delivery system that provides precise, but low concentrations of oxygen (less than 30%).

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Status Asthmaticus

A severe and persistent asthma exacerbation that does not respond to standard treatment, often requiring hospitalization.

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PaCO2 Levels in Asthma

Increasing PaCO2 levels indicate worsening respiratory function in status asthmaticus, not improvement.

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Home Oxygen Safety

Instructions for safe administration of oxygen at home, including understanding types and humidity needs.

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Peak Flow Monitoring

A method for patients with asthma to measure lung function and monitor their condition.

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Chronic Obstructive Pulmonary Disease (COPD)

A progressive respiratory disease causing airflow obstruction, often due to chronic bronchitis or emphysema.

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Chronic Bronchitis

A condition characterized by a cough and sputum production lasting for at least 3 months in two consecutive years.

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Inflammatory Response in COPD

COPD is associated with chronic inflammation due to harmful particles or gases leading to tissue damage.

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Scar Tissue Effects

Scar tissue in airways narrows them, reducing airflow and causing difficulty in breathing.

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Alveolar Macrophages Function

In chronic bronchitis, alveolar macrophages become less effective, increasing infection risk.

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Pulmonary Hypertension

Thickened vessel lining and muscle hypertrophy in lungs due to chronic inflammation in COPD.

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Respiratory Infection Susceptibility

Patients with chronic bronchitis are more prone to respiratory infections due to diminished macrophage function.

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Pathophysiology of COPD

Involves progressive airflow limitation linked to abnormal inflammatory responses and tissue damage.

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Primary Symptoms of COPD

Chronic cough, sputum production, and dyspnea characterize COPD.

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Barrel Chest

A chest shape associated with COPD due to air trapping.

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Complications of COPD

Includes respiratory failure, pneumonia, and cor pulmonale among others.

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Pulmonary Function Tests

Tests that measure lung function, critical for assessing COPD.

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Medical Management of COPD

Involves smoking cessation, risk reduction, and vaccinations.

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Bronchodilators

Medications that open the airways in COPD treatment.

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Bronchiectasis

A chronic dilation of the bronchi often caused by infections or blockages.

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Symptoms of Bronchiectasis

Chronic cough, copious purulent sputum, and finger clubbing.

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Asthma

A chronic inflammatory airway disease characterized by hyperresponsiveness.

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Asthma Exacerbations

Episodes of worsening symptoms such as coughing and wheezing.

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Medical Management of Asthma

Includes quick-relief and long-acting medications to control symptoms.

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Cystic Fibrosis (CF)

A genetic disorder leading to thick mucus and chronic infections in lungs.

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Acute Management of Cystic Fibrosis

Focuses on controlling infections and airway clearance techniques.

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Patient Teaching for Asthma

Educate on trigger avoidance and inhaler use techniques.

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Rinsing Mouth After MDI

Rinsing the mouth after using a metered-dose inhaler (MDI) with corticosteroid prevents thrush.

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Risk Factors for COPD

Common factors include tobacco smoke, older age, pollution, and genetics.

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Oxygen Therapy Purpose

Provides oxygen greater than 21% to improve blood transport and reduce breathing effort.

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Hypoxia vs. Hypoxemia

Hypoxia is low oxygen in tissues; hypoxemia is low oxygen in blood.

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Oxygen Toxicity Symptoms

Symptoms of oxygen toxicity include dyspnea, discomfort, and fatigue at high concentrations.

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Oxygen Administration Devices

Common devices include nasal cannula, masks, and transtracheal catheters.

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Education for COPD Patients

Includes smoking cessation, medication use, and breathing exercises for better health.

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Preventing Pneumothorax

Prevention involves careful handling of chest tubes and monitoring lung sounds.

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Study Notes

Management of Patients with Upper Respiratory Tract Disorders

  • Upper respiratory infections (URIs) are the most common cause of illness and absence from school and work.
  • URIs can range from minor to life-threatening, acute, chronic, or severe.
  • Treatment can occur in various community settings, including doctor offices, urgent care clinics, long-term care facilities, or self-care at home.
  • Early detection and appropriate interventions prevent complications.
  • Patient education focuses on prevention and health promotion.
  • Special considerations for older adults should be referred to Chart 18-1.

Epistaxis

  • Epistaxis is a hemorrhage from the nose.
  • The anterior septum is the most common site of bleeding.
  • Epistaxis can be a serious problem, potentially causing airway compromise or significant blood loss.
  • Risk factors for epistaxis are listed in Chart 18-5.

Medical Management of Epistaxis

  • Identify the cause and location of the bleeding.
  • Pinch the soft portion of the patient's nose for 5-10 minutes while the patient sits upright.
  • Use phenylephrine spray for vasoconstriction.
  • Cauterize bleeding with silver nitrate or electrocautery.
  • Insert gauze packing or a balloon-inflated catheter into the nasal cavity for 3-4 days.
  • Administer antibiotic therapy.

Nursing Management of Epistaxis

  • Monitor airway, breathing, and circulation.
  • Monitor vital signs and possibly cardiac monitoring and pulse oximetry.
  • Reduce patient anxiety.
  • Educate patients to avoid nasal trauma, nose picking, forceful blowing, spicy foods, tobacco, and exercise to avoid re-injury.
  • Educate patients on using adequate humidification to prevent dryness.
  • If bleeding doesn't stop in 15 minutes, seek medical attention immediately.

Upper Respiratory Infections (URIs)

  • Rhinitis and rhinosinusitis can be acute, chronic, bacterial, or viral (refer to Charts 18-2 and 18-3).
  • Pharyngitis can be acute or chronic.
  • Tonsillitis and adenoiditis are also categorized as URIs.
  • Peritonsillar abscess and laryngitis can also be caused by URIs.

Potential Complications of Upper Respiratory Infections (URIs)

  • Airway obstruction is a potential complication.
  • Hemorrhage is also possible.
  • Sepsis can occur.
  • Meningitis or brain abscess can develop.
  • Nuchal rigidity may be a symptom.
  • Cellulitis can be a potential complication.
  • Medicamentosa, Acute otitis media, Trismus, Dysphagia, Aphonia, and Cellulitis are potential complications.

Assessment of Patient with URI

  • Obtain a health history.
  • Note symptoms including headache, cough, hoarseness, fever, stuffiness, and generalized discomfort and fatigue.
  • Assess for allergies.
  • Inspect the nose, neck, throat, and palpate lymph nodes.

Planning and Goals for Patient with URI

  • Manage the airway to reduce the risk of aspiration.
  • Manage pain.
  • Implement effective communication strategies.
  • Ensure adequate hydration.
  • Educate patients on the prevention of URIs and the avoidance of complications.

Nursing Interventions for Patient with URI

  • Elevate the head of the bed.
  • Use ice collars to reduce inflammation and bleeding.
  • Apply hot packs to reduce congestion.
  • Prescribe analgesics for pain relief.
  • Apply topical anesthetics.
  • Monitor for severe complications.
  • Encourage gargling for sore throats.
  • Encourage alternative communication methods.
  • Encourage the use of liquids/steam inhalations to ease expectoration.
  • Encourage rest

Evaluation of Patient with URI

  • Evaluate airway patency.
  • Assess for pain relief.
  • Evaluate the patient's ability to communicate their needs.
  • Assess for evidence of adequate hydration.
  • Ensure that symptoms are no longer present.
  • Check for the absence of complications.

Patient Education for URI

  • Teach patients on preventing upper airway infections with frequent handwashing.
  • Educate patients on when to contact their healthcare provider.
  • Emphasize completion of antibiotic regimens.
  • Advise patients at risk to obtain annual influenza vaccines.

Assessment of Patient Undergoing Laryngectomy

  • Obtain a complete health history, including a physical, psychosocial, and spiritual assessment.
  • Assess nutrition, BMI, albumin, glucose, and electrolytes.
  • Evaluate literacy, hearing, and vision as these can affect communication after surgery.
  • Assess coping skills and available support systems for the patient and family.

Collaborative Problems and Potential Complications for Laryngectomy Patient

  • Respiratory distress can occur.
  • Hemorrhage may result from surgery.
  • Possible wound breakdown issues.
  • Infections can develop.
  • Aspiration is a concern.
  • Tracheostomal stenosis requires careful monitoring.

Nursing Interventions for Laryngectomy Patient

  • Provide pre-operative patient teaching.
  • Reduce anxiety before surgery.
  • Maintain a patent airway, managing secretions, and providing necessary support.
  • Support alternative forms of communication.
  • Promote adequate nutrition and hydration.
  • Promote a positive self-esteem and body image.
  • Monitor for potential complications.
  • Provide self-care management and instruction for homecare (refer to Chart 18-7).

Priority Education for Total Laryngectomy Patient

  • Clarify any patient misconceptions related to the procedure.
  • Discuss the effect of surgery on speech after recovery.
  • Explain methods for post-operative communication.
  • These three points are all critical components in the education of a patient undergoing a total laryngectomy.

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Related Documents

Chapter 18 Management of Patients with Upper Respiratory Tract Disorders (PDF)
Chapter 19: Management of Patients with Chest and Lower Respiratory Tract Disorders PDF
Chapter 20 Management of Patients with Chronic Pulmonary Disease PDF

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