Module 5 Ch. 19

Question 1

What is Atelectasis

Answer 1

• Closure or collapse of alveoli

Question 2

Is Atelectasis acute or chronic

Answer 2

can be either one, acute is more common as it occurs in the post op setting

Question 3

What are some symptoms of Atelectasis

Answer 3

Insidious, increasing dyspnea, cough, sputum production

Question 4

What are symptoms of Acute Atelectasis

Answer 4

tachycardia, tachypnea, pleural pain, central cyanosis (if large areas are affected)

Question 5

What are symptoms of Chronic Atelectasis

Answer 5

tachycardia, tachypnea, pleural pain, central cyanosis, pulmonary infection can be present

Question 6

What is Atelectasis characterized by

Answer 6

increased work of breathing and hypoxemia

Question 7

What are some assessment findings of Atelectasis

Answer 7

• Decreased breath sounds and crackles over areas
• Chest x ray any suggest diagnosis
• Pulse ox may be less then 90%

Question 8

What are some nursing interventions to prevent Atelectasis

Answer 8

• frequent turning
• early moving
• strategies to expand lungs and manage secretions
• IS
• Deep breathing
• Secretion management
• Metered dose inhaler

Question 9

How can you manage Atelectasis

Answer 9

• Improve ventilation and remove secretions
• ICOUGH
• Bronchoscopy
• Chest PT
• Endotracheal intubation/vent
• Thoracentesis to relieve compression

Question 10

What is ICOUGH

Answer 10

-IS
- Coughing and deep breathing
- Oral care
- Understanding
- Getting out of bed atleast 3 times a day
- HOB elevate

Question 11

What does Positive end-expiratory pressure do

Answer 11

• ensures alveoli are getting enough O2

Question 12

What does a Continuous pressure airway breathing do

Answer 12

ensures airway stays open

Question 13

What is acute tracheobronchitis

Answer 13

Inflammation of the mucus membranes of the trachea usually after a viral infection

Question 14

What are some clinical manifestations of acute tracheobronchitis

Answer 14

• initially dry cough with mucoid (clear) sputum
• pregresses to dyspnea, inspiratory stridor, expiratory wheezes, purulent sputum
• Blood tinged sputum is possible

Question 15

What are some medical managements for acute tracheobronchitis

Answer 15

• ATBs
• analgesics
• increased fluid intake
• cool vapor therapy or steam inhalations
• suctioning

Question 16

What is some nursing management for acute tracheobronchitis

Answer 16

• Bronchial hygiene
• rest
• complete full medication courses

Question 17

What is pneumonia

Answer 17

inflammation of the lung parenchyma from various microorganisms (bacteria, mycobacteria, fungi and viruses)

Question 18

What are the classifications of pneumonia

Answer 18

• Community acquired
• Healthcare associated
• Hospital acquired
• Ventilator associated

Question 19

What is community acquired pneumonia

Answer 19

• Community setting or within first 48 hrs of being admitted
• pneumococcus is the most common cause
• Viral origin in infants and children

Question 20

What is healthcare associated pneumonia

Answer 20

• Caused by multi-drug resistant organisms
• Early diagnosis and treatment are critical, hard to treat

Question 21

What is hospital acquired pneumonia

Answer 21

• Developed 48 hrs post admission
• High mortality rate
• Multi organisms dur to overuse of antimicrobial agents
• Common with ppl who don’t have sputum production as it sits in lungs and becomes infected

Question 22

What is common with hospital acquired pneumonia

Answer 22

pleural effusion, high fever, tachycardia

Question 23

What is ventilator associated pneumonia

Answer 23

• received mechanical ventilation for at least 48 hrs

Question 24

What is pneumonia in immunocompromised host

Answer 24

• Agents: pneumocystis, fungi and TB
• Subtle onset with progressive dyspena, fever, and nonproductive cough

Question 25

What are some risk factors for pneumonia

Answer 25

- Heart failure - diabetes - alcoholism - COPD - AIDS - Flu - CF - resp therapy with dirty equipments

Question 26

What are the clinical manifestations of streptococcal pneumonia

Answer 26

- sudden onset of chills, fever, pleuritic chest pain, tachypnea, resp distress

Question 27

What is assessment for pneumonia

Answer 27

- Health Hx - Physical exam (listen to lung fields) - Chest x ray - Blood cultures - Sputum exam - Bronchoscopy

Question 28

What is the medical management of pneumonia

Answer 28

- Admin of ATBs appropriately - Supportive treatments of fluids, O2, antipyretics, antitussives, decongestants, antihistamines

Question 29

How can you assess someone with bacterial pneumonia

Answer 29

- Vitals - Secretions (amt, odor, color) - Cough - Tachypnea, SOB - Inspect and auscultate chest - Changes in mental status, fatigue, edema, dehydration, concomitant heart failure, esp in older adults

Question 30

What are some problems with bacterial pneumonia for patients

Answer 30

- Continuing symptoms after therapy - Sepsis and septic shock - Resp failure - Atelectasis - Pleural effusion - Delirium

Question 31

What are some goals for patients with pneumonia

Answer 31

- improved airway patancy - increased activity - maintenance of proper fluid volume - maintenance of adequate nutrition - Understanding of the treatment protocol and preventive measures - Absence of complications

Question 32

What are some nursing interventions for bacterial maintenance

Answer 32

- Oxygen with humidification - coughing - Chest PT - position changes - IS - Nutriton - Hydration - Rest - Activity as tolerated - Self care

Question 33

What is aspiration

Answer 33

- Inhalation of foreign material into the lungs

Question 34

What does it look like when someone aspitates

Answer 34

tachycardia dyspnea cyanosis hyper/hypotension death

Question 35

What can happen if you aspirate GI contents

Answer 35

destructive to alveoli and capillaries

Question 36

How can you prevent aspiration

Answer 36

- Swallow study - Keep HOB elevated - Avoid stiming gag reflex with suctioning - check for placement before using tube - Soft diet, small bites, no straws

Question 37

How is pulmonary tuberculosis spread

Answer 37

airbone transmission through droplets

Question 38

What is diagnostic findings and tests of tuberculosis

Answer 38

- History and physical - TB skin test - TB blood test - Sputum culture and testing

Question 39

How long are you treated with an anti TB agent for

Answer 39

6-12 months

Question 40

What are the phases of treatment for TB

Answer 40

- Initial treatment phase: 8 weeks - Continuation phase: 4-7 months

Question 41

What are some nursing management for TB

Answer 41

- Promoting airways clearance - Advocating adherence to the treatment regimen - Promoting activity and nutrition - Preventing transmission

Question 42

What do pleural conditions involve

Answer 42

- membranes that cover the lungs and surface of the chest wall - they affect the pleural space

Question 43

What is Pleurisy

Answer 43

- Inflammation of both layers of pleurae, occurs in conjunction with pneumonia/URI

Question 44

What are key characteristics of pleurisy

Answer 44

Pleuritic pain, pain with deep breath, coughing, sneezing

Question 45

What are some diagnostic testing for pleurisy

Answer 45

chest x rays, sputum analysis, thoracentesis

Question 46

How can you treat pleurisy

Answer 46

- Analgesia - teaching to splint rib cage when coughing

Question 47

What is pleural effusion

Answer 47

Collection of fluid in pleural space

Question 48

What can pleural effusion be a complication from

Answer 48

heart disease TB URI pneumonia

Question 49

What are some diagnostic tests for pleural effusion

Answer 49

- physical exam - Chest x ray - chest ct - thoracentesis

Question 50

What is the treatment for pleural effusion

Answer 50

- treat underlying cause - prevent accumulation of fluid - relieve discomfort

Question 51

What is pulmonary embolism

Question 52

What is pulmonary edema