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Questions and Answers
What is the significance of the acronym 'BLUE' in chronic bronchitis?
What is a common sign of COPD known as 'clubbing hingers' caused by according to the text?
Which respiratory failure type presents with symptoms like restlessness, decreased LOC, and confusion?
What is the recommended initial intervention for a patient with hypercapnic respiratory failure?
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What is advised to patients experiencing dry mouth in terms of diet according to the text?
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What should patients avoid doing 1 hour before or after meals, as stated in the patient education section?
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What is a recommended fluid intake suggestion for thinning mucous in COPD patients?
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Which vaccine should be administered every year according to the text?
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What is a common complication that should be monitored for in patients with COPD?
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Study Notes
Patient Care
- Mobilize secretions and expand lungs through chest physiotherapy, turn, cough, and deep breath, using huff coughing technique.
- Avoid cough suppressants and position patient with head of bed (HOB) up.
- For unilateral pneumonia with hypoxia, position good lung down.
- Encourage fluid intake of 2-3L/day.
Post-Operative Care
- Promote early ambulation (within 8 hours after surgery) and provide analgesia.
- Encourage coughing with splinting and hand washing.
- Perform mouth care every 12 hours with chlorhexidine swab.
- Use an incentive spirometer every hour to expand lungs, without pursed-lip breathing.
Discharge Teaching
- Mobilize secretions by avoiding cough suppressants and using cool mist humidifier at night.
- Increase fluid intake to prevent reinfection.
- Finish oral antibiotics at home and receive pneumonia vaccine every 5 years.
- Promote smoking cessation and hand washing, and schedule follow-up for chest X-ray.
- Report any increase in fever or shortness of breath.
Atrial Fibrillation (AFib)
- Characterized by uncoordinated electrical activity in the atria, causing rapid, disorganized, and twitching of atrial musculature.
- This leads to pooling of blood in the atria, increasing the risk of clots.
- The heart's main pacemaker (SA node) goes "rogue," causing around 350-600 erratic beats, but the AV node blocks most of these beats, protecting the ventricles.
- Atrial musculature is not squeezing, resulting in less cardiac output and less oxygen delivery to the body.
Pharmacology for AFib
- Use ACE inhibitors (e.g., Lisinopril) or ARBs (e.g., Losartan) to lower blood pressure.
- Use beta blockers (e.g., Atenolol) to lower heart rate and blood pressure.
- Use calcium channel blockers (e.g., Nifedipine, Cardizem, Verapamil) to lower heart rate and blood pressure.
- Use digoxin to lower heart rate.
- Use dilators (vasodilators) such as nitroglycerin and diuretics.
Pneumonia
- Pathophysiology: Infection causes severe inflammation in the lungs, leading to alveoli filling with mucous, fluid, and debris.
- This causes dyspnea and impaired gas exchange, resulting in hypoxia and acidosis.
- Signs and symptoms include altered mental status, fever, and respiratory distress.
Chronic Bronchitis
- Signs and symptoms: big and blue skin (cyanosis), long-term cough and sputum, unusual lung sounds, and edema peripherally.
- Mnemonic: "BLUE"
Deadly Complications
- Respiratory failure: hypoxemic (low O2) and hypercapnic (high CO2) respiratory failure.
- Monitor for mental status changes, such as restlessness, decreased LOC, and confusion.
- Priority: BiPAP therapy.
COPD Exacerbation
- Pharmacology: Avoid opioids and benzodiazepines.
- Nursing care: Focus on patient education and diet.
Patient Education
- Diet: Eat small, frequent meals, high in calories and proteins, and avoid high-carb diet.
- Fluids: Increase fluid intake to thin mucous and avoid drinking fluids while eating.
- Infection: Report increases in sputum, fever, and worsening dyspnea.
- Vaccines: Receive pneumonia vaccine every 5 years and flu vaccine every year.
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Description
This quiz covers techniques for mobilizing secretions, expanding lungs, and post-operative care instructions including early ambulation, coughing with splinting, and hygiene practices. Test your knowledge on optimal patient care practices.
