NUR 229 EXAM 1 RESPIRATORY REVIEW QUESTIONS AND CORRECT ANSWERS
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Course
NUR 229
Institution
NUR 229
Assess the pt or get the base line of cardiopulmonary status like chest x-ray, ECG, ABGS, PT, INR (Normal is 2-3), CBC & BUN ETC *Teach patient use of o2, *possible intubation*, IV fluids *Reassure pain meds will be given or use of PCA pumb *TCBD & use of incentive spirometer will be practiced b4 s...
NUR 229 EXAM 1
RESPIRATORY REVIEW QUESTIONS
AND CORRECT ANSWERS
Assess the pt or get the base line of cardiopulmonary status like chest x-ray, ECG,
ABGS, PT, INR (Normal is 2-3), CBC & BUN ETC
*Teach patient use of o2, *possible intubation*, IV fluids
*Reassure pain meds will be given or use of PCA pumb
*TCBD & use of incentive spirometer will be practiced b4 surgery
*splint d incision c pillow;this will help c deep breathing
*ROM on the surgical part: this will increase perfusion and oxygen supply to the injured
site* ✅What are the preoperative care for a chest surgery?
Pulmonary Embolism (PE) ✅What disease process occurs when a blood clot or fat/ air
embolus travels through the venous circulation and becomes lodged in the pulmonary
organ? This is a life threatening emergency and must be handled quickly b/c pt may die
within hours.
('FAT BAT')
Fat, Air, Thrombus, Bacteria, Amniotic fluid, Tumor, DVT of the legs goes to pulmonary
artery can cause this too.
*The goal of PE treatment t is to increase gas exchange, improve pulmonary perfusion,
minimize risk for further thromboembolism and prevent complications ✅What are the
causes of PE?
*What is the goal of PE Management?
* Central Venous Lines or drug IV use
*Immobilization
*Hypercoagulable pts
*CT scan is the definitive to dx pulmonary embolism* ultrasound will be used to rule out
dvt. d-dimmer will show embolus but CT SCAN is d best way ✅What are the risk
factors for PE? and what is the definitive way to diagnose PE?
*SOB* AKA Dyspnea: due to impaired gas exchange r/t to circulation
*Pleuritic Chest Pain*: occurs c breathing described as sharp pain
*Tachypnea and Tachycardia*: pts breaths too fast or rapidly to improve o2
*Hemoptysis* aka Bloody sputum
*Hypoxemia*( low o2 in the blood): due to impaired gas ex. in d lungs
*Crackles and wheezing*: due to hypoxia
*Anxiety, Dyspnea, Fever and Diaphoresis*
*cough
*Apprehension and restlessness
*Cyanosis*
, *Distended Neck distension*
*Hypotension*
*petechiae* over the chest and axilla
*Shallow respiration* ✅What are the assessment findings in Pulmonary embolism?
*Give anticoagulants *(IV not oral route)* to dissolve the clot and restore perfusion b/c if
left untreated, death might occur within 1st hr of onset e. give enoxaparin (subcut) in
acute PE
*Remember to monitor bleeding and bruising
*Listen or access lung sounds frequently.
*Asses circulation b/c it can lead to tissue death
*Elevate HOB, Early ambulation, Compression devices
*Prepare to obtain arterial blood gas
*Give o2 as ordered.(high flow o2 using mask or
*Prepare to admin HEPARIN THERAPY or other therapy e.g embolectomy or
PLACEMENT OF VENA CAVA FILTER* if necessary cannula
*Have IV access (Large bore IV line) for fluids & meds
*Teach will be on anticoagulants for at least 3 months*, smoking cessation and SCD's
✅What are the Treatments for PE?
Lung Abscess ✅----------refers from a bacteria swallowed from a pt c *periodontal
disease*. This produces foul smelling or sour tasting sputum and it causes *pleuritic
pain*?
*Pneumonia (Infection): This is a primary way of getting lung abscess
*Aspirations e.g obstructions ✅What are the ways to get this lung abscess?
*Intubated Patients c or w/out feeding*
*Patient c seizures
*Pts c head injuries*
*pts c decreased LOC*
*Stroke pts*
*difficulty swallowing
*alcohol intake ✅Who is at risk for Aspiration?
*Cough= classic sign* Dark brown or cough up purulent sputum
*Hemoptysis* = coughing out blood is common
*High fever*
*Chest pain* aka pleuritic chest pain
*chills
*Dyspnea aka SOB
*Anorexia, weight loss
*Lungs are DULL to percussion*
*Deceased breath sounds on auscultation*
*Crackles* = Late sign ✅What are the clinical Manifestations of Lung Abscesses?
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