NCLEX: Respiratory Disorders

• NCLEX questions assess critical thinking and knowledge application, not just memorization

COPD and Dyspnea

• Assess oxygen saturation is the priority initial intervention to determine dyspnea severity and guide treatment
• High-flow oxygen can suppress the hypoxic drive in COPD patients
• Pursed-lip breathing helps control breathing and improve oxygenation in COPD patients

Oxygen and Nasal Dryness

• A humidifier adds moisture to the air, alleviating nasal dryness

Acute Asthma Exacerbation

• Montelukast is a preventative medication, not for acute exacerbations
• Morphine is an opioid and respiratory depressant, contraindicated in acute asthma exacerbations

Cystic Fibrosis and Chest Physiotherapy

• Chest physiotherapy helps loosen and remove mucus from the airways

Long-Term Oxygen Therapy

• Long-term high oxygen concentrations can damage lung tissue

Pneumonia

• Antibiotic effectiveness varies, improvement may take several days
• Assessing breath sounds helps identify areas of decreased air entry, wheezes, or crackles, indicative of a respiratory exacerbation
• Typical signs of pneumonia typically cause tachycardia (increased heart rate) due to infection and inflammation

Respiratory Distress

• Bradycardia is not a sign of respiratory distress
• Nasal flaring, grunting, and retractions are signs a child is having difficulty breathing

Peak Flow Meter

• Peak flow meters measure the speed of air exhaled, indicating airway narrowing

CPAP Therapy

• The air pressure from CPAP can dry mucous membranes

Metered Dose Inhaler

• Coordinating actuation with inhalation ensures medication reaches the lungs effectively

Tuberculosis (TB)

• Completing the entire course of antibiotics prevents drug resistance and ensures eradication of the bacteria
• To prevent spread TB is spread through airborne droplets: use airborne precautions
• A sputum culture is the definitive diagnostic test for TB by identifying the bacteria
• Incomplete antibiotic treatment leads to drug resistance and relapse
• Importance of completing the entire course of antibiotics: Incomplete treatment leads to drug resistance and relapse

Pulmonary Embolism (PE)

• Respiratory rate and effort are crucial indicators of respiratory compromise in a suspected PE
• PE is life-threatening, oxygen is crucial, calf pain is a common symptom, and monitoring for heart failure is necessary due to the potential for right-sided heart strain

Healthcare-Associated Pneumonia (HAP)

• Strict adherence to hand hygiene is the most effective measure to prevent HAP transmission

Respiratory Exacerbations in CF

• Respiratory exacerbations in CF often require antibiotics to treat bacterial infections

Asthma

• A low peak flow reading indicates decreased airflow and worsening asthma control
• Silent chest or absence of wheezing in a severe attack is ominous, indicating complete airway obstruction
• All elements of patient education are crucial for effective asthma management: identifying and avoiding triggers, Using a peak flow meter, proper inhalter technique
• Short-acting beta-agonists (SABAs) provide rapid bronchodilation in acute exacerbations
• Important aspects of MDI use to optimize medication delivery and minimize side effects: Rinse their mouth; Drink water; hold their breath for 10 seconds

Ventilator-Associated Pneumonia (VAP)

• Oral care reduces bacterial load and risk of VAP

Incentive Spirometry

• Incentive spirometry encourages deep breathing to prevent lung collapse

Community-Acquired Pneumonia (CAP)

• Streptococcus pneumoniae is the most common bacterial cause of CAP

Pulmonary Arterial Hypertension (PAH)

• Reducing pulmonary vascular resistance improves heart function and quality of life

Lung Cancer

• Cigarette smoking is the leading cause of lung cancer
• Non-small cell lung cancer accounts for the vast majority of lung cancers

Tracheostomy

• Maintaining a patent airway is the highest priority
• Following tracheostomy placement, potential complications are Infection, Bleeding and Airway obstruction

Idiopathic Pulmonary Fibrosis (IPF)

• Shortness of breath is the most common and debilitating symptom of IPF

Postural Drainage

• Positioning assists in gravity-aided mucus drainage to promote drainage of mucus secretion

Oxygen Therapy

• Increased pulse oximetry reading is the most direct measure of oxygenation
• Decreased oxygen saturation indicates worsening oxygenation and potential respiratory failure
• All are essential assessments for patients receiving oxygen therapy: Respiratory rate and depth, Oxygen saturation, Skin color and capillary refill
• All parameters are crucial in monitoring a COPD patient on oxygen therapy, as changes can indicate respiratory distress or complications.

Worsening Respiratory Infection

• Decreased oxygen saturation indicates worsening oxygenation and potential respiratory failure

Pneumothorax

• Inserting a chest tube relieves pressure from the lung
• Decreased breath sounds in one lung field suggests a potential collapse or immediate attention is required
• All are common signs of a pneumothorax: Decreased breath sounds on one side, Increased respiratory rate, Chest pain

Lung Biopsy

• Accidental lung puncture commonly leads to pneumothorax

Nasal Fracture Assessment

• Periorbital ecchymosis or raccoon eyes suggests possible in presence of orbital fracture, a serious complication

Upper Air Support Obstruction

• Maintaining a patent airway is the immediate priority
• All of the above: These interventions help to clear the airways and improve breathing.

OSA and CPAP

• Consistent use is crucial for treatment efficacy to use the CPAP machine every night

Chest Tube

• The chest tube is kinked and would prevent air from escaping, halting bubbling
• A lung re-expansion would be expected to be a gradual decrease in bubbling, not sudden cessation

Oxygen Delivery

• Venturi masks deliver a precise FiO2 by mixing oxygen with room air through a calibrated valve

Anticholinergic Bronchodilators

• Anticholinergics block acetylcholine, leading to reduced secretions, including saliva which leads to dry mouth

Parkinson's Disease

• Thickened liquids prevent aspiration, a common risk with dysphagia (difficulty swallowing)

Multiple Sclerosis (MS)

• Shortness of breath can occur in MS due to complications, it is not a common primary symptom

Transient Ischemic Attack (TIA)

• A TIA is a transient ischemic attack, is a mini-stroke, increasing the risk of a full ischemic stroke.

Seizure

• Protecting the patient from injury during a seizure is the priority
• Restraining is not recommended, and placing anything mouth is dangerous
• Sudden loss of consciousness is not a typical symptom of a migraine; it's more indicative of other neurological events

Migraine Treatment

• Effective medications to treat migraine headaches commonly include Triptans (e.g., sumatriptan), NSAIDs (e.g., ibuprofen) and Anti-emetics (e.g., ondansetron)

Managing COPD

• Smoking cessation is paramount for managing COPD long-term, as smoking is the primary cause

Suspected Pneumonia

• All these assessments may be important to to evaluate severity and progression: Oxygen saturation, Breath sounds, Temperature

New Tracheostomy

• A patient with a new tracheostomy is at risk for all: Infection, Bleeding and Airway obstruction.

Chronic Cough and Sputum

• For a patient with COPD has a chronic cough producing thick sputum, all nursing interventions are helpful: Increase fluid intake; Encourage deep breathing exercises and Provide chest physiotherapy

Cystic Fibrosis and Nutrition

• CF affects the pancreas, leading to insufficient enzyme production, impacting nutrient absorption because of Pancreatic insufficiency

Sudden Onset

• Sudden unilateral weakness and slurred speech are classic signs of an ischemic stroke (CVA)

NCLEX practice questions covering respiratory disorders. Includes COPD and dyspnea, oxygen therapy, asthma exacerbation, cystic fibrosis, and pneumonia. Focuses on critical thinking and knowledge application for effective nursing interventions.