100% satisfaction guarantee Immediately available after payment Both online and in PDF No strings attached
logo-home
NURS 272 Final Exam Questions and Answers- Respiratory System, CV System, Musculoskeletal Disorders, Sleep and Health Disparities $18.49   Add to cart

Exam (elaborations)

NURS 272 Final Exam Questions and Answers- Respiratory System, CV System, Musculoskeletal Disorders, Sleep and Health Disparities

 5 views  0 purchase
  • Course
  • NURS 272
  • Institution
  • NURS 272

Explain the anatomical components of the respiratory system. > respiratory zone muscles - major muscle = diaphragm *controlled by the phrenic nerve (C3-C5 of the neck), so any pt w an injury to the spine/phrenic nerve will require ventilatory support! - accessory muscles = intercostals, abdomina...

[Show more]

Preview 4 out of 35  pages

  • August 2, 2024
  • 35
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • NURS 272
  • NURS 272
avatar-seller
twishfrancis
NURS 272 Final Exam Questions and Answers - Respiratory System , CV System , Musculoskeletal Disorders , Sleep and Health Disparities Explain the anatomical components of the respiratory system. ✅> respiratory zone muscles - major muscle = diaphragm *controlled by the phrenic nerve (C3 -C5 of the neck), so any pt w an injury to the spine/phrenic nerve will require ventilatory support! - accessory muscles = intercostals, abdominals, trapezius, sternocleidomastoid To move air into the lungs...respiratory muscles generate negative intrapleural pressure = allows air inflowing via the pressure gradient btwn atmospheric pressure at the mouth (zero pressure) & alveolar pressure (negative pressure) > conduction zone muscles = trachea, bronchi & bronchioles - influenced by SNS' B2 -adrenergic receptors (relaxation) & acetylcholine receptors (constriction) > gas exchange surfaces = alveoli - chronic smoking & chewing tobacco = decr alveoli surface area *important to ask abt smoking history! - atelectasis = alveoli collapse resulting from trapped air or fluid buildup (ex: pts who are bedridden *important to encourage mobility & coughing) What are some of the risk factors for pulmonary disease? ✅> pollution & travel > 2nd hand/3rd hand smoke > chemical exposure > freq respiratory infections > pre -existing/congenital conditions (ex: CF, chest injury, living in confined environs) What are some of the common diagnostics used to screen for respiratory disease? ✅1) chest X -ray (CXR) = 2 view X -ray of PA (posterior & anterior) & Lateral (side) to help produce an accurate image of the pt's heart/lungs/BV/bones > looking for inflation of the lungs (COPD), fluid build up (pneumonia & HF), atelectasis, broken bones (ribs), heart size (cardiomyopathy = enlarged heart), foreign bodies - most common! cheap & inexpensive 2) CT scan (contrast) = uses contrast dye to produce more detailed images of soft tissue damage/injuries > looking for lesions, blood clots, etc - make sure to flush dye out to ppx kidney toxicity! 3) Pulse Oximeter = measures SaO2 > SaO2 = amt of O2 attached to Hgb/how much O2 being perfused via the blood - factors that influence readings = dark nail polish, long nails, acrylics, cold temp, bright lights, & anything that decr circulation to the finger - pts w darker skin, will have falsely high readings even when desaturating 4) Pulmonary function tests > looking for lung functioning in cases of COPD & asthma 5) Sputum Culture > looking for lung infection? 6) ABGs > looking for acid -base imbalances? & desaturation? 7) Bronchoscopy/Thoracoscopy = uses endoscopy to view respiratory structures > collecting biopsies & cultures - broncho (via mouth) & thoraco (via chest tube) - performed in ICU or OR w minimal sedation 8) Thoracentesis > pulling fluid build up in pleural lining off - important to assess baseline coagulation (order sets) to ppx excessive post -op bleeding 9) V/Q Scan = looks at ventilation (pt uses inhaler) vs. perfusion (radioactive substance is injected into blood) > detecting PE = indicated by altered V/Q - no longer commonly used 10) Mantoux test = ID injection > testing for TB What are the various components of a respiratory assessment? ✅1) lung sounds = use systematic approach! (ex: R > L moving down) - clear? bilateral? 2) breathing patterns = rate & quality - tachypnea? dyspnea? SOB? - difficulty breathing? shallow? 3) O2 saturation = 95 -99% expected 4) accessory muscle usage = indicates acute respiratory distress 5) hypoxia S/Sx - early.= restlessness, anxiety, confusion, <95% SaO2 - compensation = tachypnea, tachycardia, SOB - later = bradypnea, bradycardia, hypotension, decr LOC, cyanosis, & pallor 6) Crepitus (SQ emphysema) = air trapped in/under the skin - caused by chest injury, blunt force trauma, etc... - palpable as rice krispies under the skin 7) percussion = using 2 fingers tapping on 2 fingers - good for assessing w limited resources - dull sound (compromised lung) vs. resonate sound (healthy lung) What are some examples of abnormal breath sounds commonly heard during lung auscultation? ✅> fine crackles/rales = air moving into deflated airways, "popping, velcro, rolled hair" - ex: atelectasis, pneumonia, COPD > coarse crackles = "lower pitched rattling" *have pt cough to see if they can clear their airway - ex: pneumonia, flu, COVID, COPD, tumors > wheeze = narrowed airway w inflammation/secretions, "squeeky, musical" - ex: asthma, COPD, bronchospasms > rhonchi = obstruction, "low pitched wheeze, snore" - ex: anatomical (enlarged tonsils or adenoids), nasal congestion, thick secretions, tumor > stridor = something stuck in the trachea, "harsh grating" - ex: physical obstruction > pleural rub = inflamed pleural surfaces rubbing together, "loud, rough, grating, scratching" - ex: TB, pneumonia, lung cancer > decr breath sounds = over inflation of the lung or airway blockage - ex: pneumonia, HF, pleural effusion (fluid build up around pleural lining) T or F: New onset of confusion in older adults is often associated with underlying infection. ✅T confusion is often used as an indicator of infection in older adults bc fever & weakness are no longer reliable measures ex: UTI or pneumonia What are the various respiratory interventions/treatments used to support pts w respiratory conditions? ✅> O2 therapy > suctioning > Inhaled Medications > Pulmonary Toileting = Percussion Vest (HFCWO) > Positioning What are some of age related changes of respiratory system? ✅1) Alveolar = changes in surface area, diffusion, & elasticity > impaired gas exchange 2) Lungs = incr residual volume, barrel chest, decr gas exchange & elasticity 3) Pharynx & Larynx = muscle atrophy, slackened vocal cords 4) Pulmonary Vasculature = incr SVR, decr pulmonary capillary blood flow, & decr perfusion 5) decr Activity Tolerance = decr O2 & incr CO2 > incr HR & RR to compensate/tolerate activity 6) decr Muscle Strength = decr ability to cough 7) Chest Wall changes = incr AP diameter, kyphosis, shrinking thorax, decr cilia > incr risk for respiratory conditions Explain the different types of O2 therapy available. ✅*Low O2 therapy devices* > COPD or pneumonia 1) Nasal Cannula = 24 -44% O2, 1 -6L > PRN or continuous tx - Nursing Considerations = lubricate nares (water -based lubricant), assess skin integrity, change tubing regularly, & document 2) Simple Mask = 24 -44% O2, 6 -8L > short term & emergency tx - do NOT administer <5L = risk for CO2 retention - Considerations = assess skin integrity, monitor for N/V (aspiration risk), perform food trials w meals (monitoring pts on nasal cannula O2 while they eat) *Rebreathers* > unstable pts who may require intubation or ICU transfer 3) Partial Non -Rebreather = 60 -75% O2, 6 -11L > 2 valves + reservoir bag (allows for rebreathing of ⅓ of exhaled air that is high in O2) - Considerations = ensure bag is ⅓ -½ inflated w each breath (to ensure adequate amt of air for rebreathing) 4) Non -Rebreather = 80 -95%, 10 -15L > 1 way valve btwn mask & reservoir bag w flaps (allow exhaled air to be released & prevent backflow of air) - high O2 conc but low flow *High O2 therapy devices* 5) Face Tent = 24 -100%, 10L minimum > facial trauma, burns, & surgery = promotes healing & decr pain - O2 w high humidity 6) Intubation (T - piece) = 24 -100%, 10L minimum > tube placed in pts trachea for airway maintenance *Non -invasive positive pressure ventilation* > sleep apnea & COPD exacerbation

The benefits of buying summaries with Stuvia:

Guaranteed quality through customer reviews

Guaranteed quality through customer reviews

Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.

Quick and easy check-out

Quick and easy check-out

You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.

Focus on what matters

Focus on what matters

Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!

Frequently asked questions

What do I get when I buy this document?

You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.

Satisfaction guarantee: how does it work?

Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.

Who am I buying these notes from?

Stuvia is a marketplace, so you are not buying this document from us, but from seller twishfrancis. Stuvia facilitates payment to the seller.

Will I be stuck with a subscription?

No, you only buy these notes for $18.49. You're not tied to anything after your purchase.

Can Stuvia be trusted?

4.6 stars on Google & Trustpilot (+1000 reviews)

72042 documents were sold in the last 30 days

Founded in 2010, the go-to place to buy study notes for 14 years now

Start selling
$18.49
  • (0)
  Add to cart