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NURS 4020 respiratory test 4 with correct answers
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NURS 4020 respiratory test 4 with correct answers
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NURS 4020 respiratory test 4 with correct answersmost important action of the lungs - ** VERIFIED ANSWERS **✔✔gas exchange
pneumonia - ** VERIFIED ANSWERS **✔✔*what*
-inflammation of the lungs caused by microbes
*causes*
-fungi, parasites, *bacteria*, chemicals
*risk factors*
-being on a vent, *older, immobile* (bed rest), *smoking, stroke*
-aspiration pneumonia- elderly, trach patients, dysphagia patients, those with tube feedings
-opportunistic pneumonia- immune compromised (HIV- PCP, cancer)
nursing assessment with pneumonia - ** VERIFIED ANSWERS **✔✔-*fever*, SOB, pleuritic chest
pain (sometimes, worse with breathing and cough), ronchi, crackles, cough
-leukocytosis- increased WBC count (typically over 15 with this)
-sputum color- green and yellow (bacterial), rust (pneumococal, can be TB, PE)
diagnostic tests with pneumonia - ** VERIFIED ANSWERS **✔✔-chest XR- consolidation in certain
lobes, confined, usually not on both lungs
-collect CBC- look at WHITE COUNT
-sputum culture, blood culture (fever, SOB, DO THEM)
interventions with pneumonia - ** VERIFIED ANSWERS **✔✔-maintain patent airway
-*PULSE OX IMPORTANT*
-give *antibiotics*
,-meds for pain/fever (tylenol), fluids to keep secretions thin (small amount), chest PT, incentive
spirometry, education on spirometry, pneumonia vaccine education, oxygen, postural drainage
restrictive lung diseases - ** VERIFIED ANSWERS **✔✔-cannot fill the lungs
-sarcoidosis
COPD - ** VERIFIED ANSWERS **✔✔*what*
-obstructive: air trapping, either have obstruction or can't let it out, CF
-chronic inflammation of the airways/lungs in response to noxious particles: gases or vapors
-have exacerbations: triggered by flu, cold, lungs get even more compressed, even more SOB
*causes*
-cigarettes, second hand smoke, environmental components, AAT deficiency
*risk factors*
-smoking
*2 types*
-*chronic bronchitis*- blue bloaters, have a chronic cough (90%), lot of sputum, get pulm HT and cor
pulmonale which causes right atrium to hypertrophy and they can get heart failure, blue bc have
high CO2 and can get hypoxic
-*emphysema*-pink puffers, enlargement of parenchyma they enlarge and fall apart, skin is pink and
red bc they are tachypnic (body produces more RBCs in response to hypoxia so they get red)
-can have both together
nursing assessment with COPD - ** VERIFIED ANSWERS **✔✔-usually around 40 years old or 10
year smoking history
-will have cough with sputum
-dypsnea on exertion or --> *dypsnea on rest* (bad)
-hyperinflated lung, SOB
, -polycythemia- inc RBCs, skin color red, high H&H
-will develop into late stage: barrel chest, tripod breathing, anorexia (can't breathe, can't eat), will
have changes in pH (acidotic, retain CO2), morning headaches (retain more CO2 when sleeping),
depression, anxiety
diagnostic tests with COPD - ** VERIFIED ANSWERS **✔✔-*pulmonary function test*- measure
volume in and out, volume out will be low
-6 min walk test (will pick up hypoxia)
-ABGs and x-ray are late (diaphragm lower than normal)
interventions with COPD - ** VERIFIED ANSWERS **✔✔-get them to *stop smoking*, may give O2
(late stage), wean oxygen off if possible (drive to breathe)
-bronchodilator, anticholinergic or combination of both= duo neb, corticosteroid (short term
exacerbation), antibiotics (not sure if helps or hurts)
-end of life discussions
-bronchodilator- albuterol (beta 2 agonist), will in HR 20-30 so be careful with pts like afib
-long term- spiriva, advair
-short term is for rescue
-anticholinergic- ipatropium bromide
-their drive to breathe is LOW OXYGEN (ours is high CO2), if give oxygen then brain thinks I'm
breathing I don't need to breathe
-put non-rebreather on to save life, but once they get to 95% ish then wean them down, IT HAS TO
COME OFF, they will stop breathing
-will need extra calories and protein in later stage
-pulmonary rehab, positive pressure ventilation for exacerbations (intubation and vent, BiPAP), hard
to get these pts off the ventilator if they get put on
pulmonary embolism - ** VERIFIED ANSWERS **✔✔*what*
-block of pulmonary artery by thrombus, fat, air, or tissue
*causes*
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