Exam 3 review
who is at risk for SIDS
age prone sleeping soft bed co bedding maternal smoking low birth weight low Apgar score recent viral infection sibling of 2 or more sids male native or Africans Americana winter night time
Tuberculosis (TB) is cause by
bacteria in the lungs called M tuberculosis
why does TB affect the lungs the most
because the bacteria associated with Tb is aerobic and it loves oxygen it must have it to grow that's why Tb most commonly affects the upper part of the lungs
when the left ventricle begins to fail
blood backs up into the pulmonary circulation, causing pulmonary interstitial edema other words pulmonary edema
Ethambutol
blurred vision color changes
pulmonary edema lab test
chest x ray abgs bnp ekg echocardiogram ultrasound of the lung
pulmonary edema s/s
cough frothy blood tinged sputum dyspnea wheezing JVD pallor or cyanosis tachycardia apprehensian anxiety
Tuberculosis is spread by
coughing and sneezing (air borne) once its inhale it spread to the lymph nodes and blood stream
modes of pacemakers
demand fixed rate and pacemaker with acids(electric shock)
Acute pharyngitis s/s
fiery-red pharyngeal membrane and tonsils, lymphoid follicles that are swollen and flecked with white-purple exudate, enlarged and tender cervical lymph nodes, and no cough. Fever (higher than 38.3°C [101°F]), malaise, and sore throat also may be present. Occasionally, patients with GAS pharyngitis exhibit vomiting, anorexia, and a scarlatina-form rash with urticaria known as scarlet fever.
Rhinitis Manifestations
headache, nasal irritation/congestion, sneezing, rhinorrhea(runny nose) purulent nasal drainage (anterior, posterior, or both) accompanied by nasal obstruction or a combination of facial pain, pressure, or a sense of fullness (referred to collectively as facial pain-pressure-fullness), or both pain when tilted head forward plus facial pressure
PPD tuberculin skin test (also called Mantoux Test, TST, TB skin test):
his is where purified protein derivative (hence where PPD comes from with the name) is injected with a tuberculin needle on the inner part of the forearm It is read in 48-72 hours.....(the patient must come back to have the test read and if the patient does NOT return within 72 hours the test will have to be repeated) A positive result doesn't necessarily mean the patient has an active infection of TB. It just means they have been exposed to it.
pacemaker after surgery and teaching
immobilize the arm (no raising arm above the head (2 weeks) No living heavy objects Infection ( monitor incision) warm, red, inflamed no tub bath, creams or powders I inspect HR and blood pressure (check pulse every day) teaching its ok to swing and it's ok ti drive after 2 weeks - always have ID card of the pacemaker on you - report s/s dyspnea, dizziness avoid contact sports tight clothing 4ms avoid MRI Microwaves Metal detectors (airports and mall) <p3 earphones and stereos
Sids protective factors
immunization up to date pacifier use at nap or betimes breastfeeding supine sleeping boys are at higher risk than girls low Apgar score at birth ( low 4) infant with caregiver that smoke
Route of Administrations for Mantoux test
intradermal
Pulmonary edema can also develop slowly, especially when it is caused by noncardiac disorders such as
kidneys injury and other condition that cause fluid overload
Pulmonary edema is an acute event that results from
left ventricular failure. it can occur following an acute MI or as an exacerbation of chronic HF.
OSA patient education
lose weight and exercise limit alcohol intake no napping during the day no sedatives at bedtime
Airborne precautions MTV
measles, TB, varicella n95 mask negative pressure room door closed transport patient wear surgical mask
If the cause of atelectasis is bronchial obstruction from secretions
must be removed by coughing or suctioning to allow air to reenter that portion of the lung If respiratory care measures fail to remove the obstruction, a bronchoscopy is performed.
Tuberculosis key signs
night sweats anorexia cough + hemoptysis (blood tinged sputum) dyspnea and SOB fever and chills
can pacemaker patient use transcutaneous electrical nerve stimulation
no
OSA causes
obese sedatives before bed((BENZOS, OPIATES) alcohol
OSA
obstructive sleep apnea When the tongue or muscles in the pharynx block the airway resulting in moments of no breathing & no airflow, called Apnea.
Patients with nasotracheal and nasogastric tubes in place are at the risk for development
of sinus infections. Thus, accurate assessment of patients with these tubes is critical. Removal of the nasotracheal or nasogastric tube as soon as the patient's condition permits allows the sinuses to drain, possibly avoiding septic complications.
acute rhinitis can cause
osteomyelitis bone infection
pulmonary edema medical management
oxygen therapy diuretics-promote the excretion of sodium and water by the kidneys vasodilators- IV nitroglycern or nitroprusside may enhance symptom relief in pulmonary edema position the paitent to promote circulation patient upright legs dangling over the side of the bed Providing Psychological Support-As the ability to breathe decreases, the patient's fear and anxiety rise proportionately, making the condition more severe. Monitoring Medications-The patient receiving diuretic therapy may excrete a large volume of urine within minutes after a potent diuretic is given. A bedside commode may be used to decrease the energy required by the patient and to reduce the resultant increase in cardiac workload induced by getting on and off a bedpan
what diagnostic test are used for Sids
post mortem exam death scence investigation case review
patients are at high risk for atelectasis when
postoperatively when they have a monotonous, low tidal breathing pattern mat cause small airway closure and alveolar collapse. this can result from effect of anesthesia or analgesic agents, supine positing, splinting of the chest wall because of pain or abdominal distention. Secretion retention airway obstruction and an impaired cough reflex may also occur or patient may be reluctant to cough
what are priority nursing action for sids
pre sids assess for risk factors post sids family support family plan process where will they be staying pre sids position on back noting in the crib post sids infant cannot be touched or held until cleared notify appropriate follow up support call requested support for family obtain all necessary contact information
Rhinitis care/education
rest increase fluid intake up to 2000ml/day proper disposal of tissues hand hygiene proper way to cough limit exposure to others complimentary therapies like echinacea, large doses of vitamin c and zinc to promote immune response humidification of the air in the home and the use of warm compresses to relieve pressure. avoid swimming, diving, and air travel during the acute infection. educate about gentle nose blowing, humidification & warm compress
pacemaker
single chambers ( atrial fibrillation) dual chamber(av heart blocks) biventricular (right and left ventricle)
sputum culture diagnosis
sputum culture diagnosis early morning sterile sputum specimen 3 consecutive days (NOT A BLOOD TEST) you have to do this if the patient has active TB
SIDS
sudden infant death syndrome 1 year of age and down
tonsillectomy
surgical removal of the tonsils
pacemaker are use to treat
symptomatic bradycardia (less than 60 bpm) s/s dizziness/syncope, cyanotic, fatigue
pulmanary edema
the abnormal accumulation of fluid in lung tissue, aveolar space of both potential cause anything that can cause fluid overload ex kidney failure, HF medical emergancy
SIDS education
1.place infant in supine postition during sleep -put to sleep on their back in safe crib -dress newborn in wearable blanket , sleep sleep sack 2. breastfeed the infant 3. have up to date vaccination 4. ensure a smoke free environment 5. provide a firm sleep surface for the infant NO NO LIST aviod sleeping with infant ( no bed sharing, no cosleeping) no pillows no loose or soft items blankets, toys stuffed animals no bumper pads on the side of the crib
A cardiac patients resistance to left ventricular filling has caused blood to back up into the patients circulatory system. What health problem is likely to result? A) Acute pulmonary edema B) Right-sided HF C) Right ventricular hypertrophy D) Left-sided HF
A) Acute pulmonary edema A cardiac patients resistance to left ventricular filling has caused blood to back up into the patients circulatory system. What health problem is likely to result? A) Acute pulmonary edema B) Right-sided HF C) Right ventricular hypertrophy D) Left-sided HF
Signs and Symptoms of Tuberculosis (active)
****remember most patients are asymptomatic until they reach the active stage Cough that lasts three weeks or more coughing up blood fever night sweats fatigue unintentional weight loss chills loss of appetite chest pain, or pain with breathing or coughing
tonsillectomy post-op care
-place in lateral or prone position with the head lower than the chest to avoid aspiration of saliva or blood from surgical site -avoid coughing and clearing through -avoid using straw and encourage use of a cup -pain meds Q4 hr for first 24-48 hr to reduce pain and promote comfort Priority Findings Post-Op tonsillectomy 1. Frequent swallowing 2. Restlessness 3. Persistent Coughing (mean so bleed that can get worse)
Peritonsillar abscess nursing management
-semi-fowler's position; prevent aspiration -ice collar, topical anesthetics, throat irrigations, drink fluids, cool or room temp. -observe for respiratory obstruction-dyspnea, restlessness, or cyanosis- or excessive bleeding
A patient admitted to the medical unit with HF is exhibiting signs and symptoms of pulmonary edema. The nurse is aware that positioning will promote circulation. How should the nurse best position the patient? A) In a high Fowlers position B) On the left side-lying position C) In a flat, supine position D) In the Trendelenburg position
A) In a high Fowlers position Proper positioning can help reduce venous return to the heart. The patient is positioned upright. If the patient is unable to sit with the lower extremities dependent, the patient may be placed in an upright position in bed. The supine position and Trendelenburg positions will not reduce venous return, lower the output of the right ventricle, or decrease lung congestion. Similarly, side-lying does not promote circulation.
The nurse is caring for a patient at risk for atelectasis. The nurse implements a first-line measure to prevent atelectasis development in the patient. What is an example of a first-line measure to minimize atelectasis? A) Incentive spirometry B) Intermittent positive-pressure breathing (IPPB) C) Positive end-expiratory pressure (PEEP) D) Bronchoscopy
A) Incentive spirometry Strategies to prevent atelectasis, which include frequent turning, early ambulation, lung-volume expansion maneuvers (deep breathing exercises, incentive spirometry), and coughing, serve as the firstline measures to minimize or treat atelectasis by improving ventilation. In patients who do not respond to first-line measures or who cannot perform deep-breathing exercises, other treatments such as positive end-expiratory pressure (PEEP), continuous or intermittent positive-pressure breathing (IPPB), or bronchoscopy may be used.
A patient is undergoing preoperative teaching before his cardiac surgery and the nurse is aware that a temporary pacemaker will be placed later that day. What is the nurses responsibility in the care of the patients pacemaker? A) Monitoring for pacemaker malfunction or battery failure B) Determining when it is appropriate to remove the pacemaker C) Making necessary changes to the pacemaker settings D) Selecting alternatives to future pacemaker use
A) Monitoring for pacemaker malfunction or battery failure Monitoring for pacemaker malfunctioning and battery failure is a nursing responsibility. The other listed actions are physician responsibilities.
An x-ray of a trauma patient reveals rib fractures and the patient is diagnosed with a small flail chest injury. Which intervention should the nurse include in the patients plan of care? A) Suction the patients airway secretions. B) Immobilize the ribs with an abdominal binder. C) Prepare the patient for surgery. D) Immediately sedate and intubate the patient.
A) Suction the patients airway secretions. As with rib fracture, treatment of flail chest is usually supportive. Management includes clearing secretions from the lungs, and controlling pain. If only a small segment of the chest is involved, it is important to clear the airway through positioning, coughing, deep breathing, and suctioning. Intubation is required for severe flail chest injuries, and surgery is required only in rare circumstances to stabilize the flail segment.
An adult patient has tested positive for tuberculosis (TB). While providing patient teaching, what information should the nurse prioritize? A) The importance of adhering closely to the prescribed medication regimen B) The fact that the disease is a lifelong, chronic condition that will affect ADLs C) The fact that TB is self-limiting, but can take up to 2 years to resolve D) The need to work closely with the occupational and physical therapists
A) The importance of adhering closely to the prescribed medication regimen Successful treatment of TB is highly dependent on careful adherence to the medication regimen. The disease is not self-limiting; occupational and physical therapy are not necessarily indicated. TB is curable
An adult patient has tested positive for tuberculosis (TB). While providing patient teaching, what information should the nurse prioritize? A) The importance of adhering closely to the prescribed medication regimen B) The fact that the disease is a lifelong, chronic condition that will affect ADLs C) The fact that TB is self-limiting, but can take up to 2 years to resolve D) The need to work closely with the occupational and physical therapists
A) The importance of adhering closely to the prescribed medication regimen Successful treatment of TB is highly dependent on careful adherence to the medication regimen. The disease is not self-limiting; occupational and physical therapy are not necessarily indicated. TB is curable.
Acute pharyngitis assessment
Accurate diagnosis of pharyngitis is essential to determine the cause (viral or bacterial Rapid antigen detection testing (RADT) uses swabs that collect specimens from the posterior pharynx and tonsil.
The public health nurse is administering Mantoux tests to children who are being registered for kindergarten in the community. How should the nurse administer this test? A) Administer intradermal injections into the childrens inner forearms. B) Administer intramuscular injections into each childs vastus lateralis. C) Administer a subcutaneous injection into each childs umbilical area. D) Administer a subcutaneous injection at a 45-degree angle into each childs deltoid.
Ans: A The purified protein derivative (PPD) is always injected into the intradermal layer of the inner aspect of the forearm. The subcutaneous and intramuscular routes are not utilized
A patient presents to the ED complaining of increasing shortness of breath. The nurse assessing the patient notes a history of left-sided HF. The patient is agitated and occasionally coughing up pink-tinged, foamy sputum. The nurse should recognize the signs and symptoms of what health problem? A) Right-sided heart failure B) Acute pulmonary edema C) Pneumonia D) Cardiogenic shock
B) Acute pulmonary edema Because of decreased contractility and increased fluid volume and pressure in patients with HF, fluid may be driven from the pulmonary capillary beds into the alveoli, causing pulmonary edema and signs and symptoms described. In right-sided heart failure, the patient exhibits hepatomegaly, jugular vein distention, and peripheral edema. In pneumonia, the patient would have a temperature spike, and sputum that varies in color. Cardiogenic shock would show signs of hypotension and tachycardia.
A perioperative nurse is caring for a postoperative patient. The patient has a shallow respiratory pattern and is reluctant to cough or to begin mobilizing. The nurse should address the patients increased risk for what complication?
B) Atelectasis A shallow, monotonous respiratory pattern coupled with immobility places the patient at an increased risk of developing atelectasis. These specific factors are less likely to result in pulmonary embolism or aspiration. ARDS involves an exaggerated inflammatory response and does not normally result from factors such as immobility and shallow breathing.
. A patient has returned to the cardiac care unit after having a permanent pacemaker implantation. For which potential complication should the nurse most closely assess this patient? A) Chest pain B) Bleeding at the implantation site C) Malignant hyperthermia D) Bradycardia
B) Bleeding at the implantation site Bleeding, hematomas, local infections, perforation of the myocardium, and tachycardia are complications of pacemaker implantations. The nurse should monitor for chest pain and bradycardia, but bleeding is a more common immediate complication. Malignant hyperthermia is unlikely because it is a response to anesthesia administration.
The nurse is caring for a patient suspected of having ARDS. What is the most likely diagnostic test ordered in the early stages of this disease to differentiate the patients symptoms from those of a cardiac etiology? A) Carboxyhemoglobin level B) Brain natriuretic peptide (BNP) level C) C-reactive protein (CRP) level D) Complete blood count
B) Brain natriuretic peptide (BNP) level Common diagnostic tests performed for patients with potential ARDS include plasma brain natriuretic peptide (BNP) levels, echocardiography, and pulmonary artery catheterization. The BNP level is helpful in distinguishing ARDS from cardiogenic pulmonary edema. The carboxyhemoglobin level will be increased in a client with an inhalation injury, which commonly progresses into ARDS. CRP and CBC levels do not help differentiate from a cardiac problem.
A critical care nurse is planning assessments in the knowledge that patients in shock are vulnerable to developing fluid replacement complications. For what signs and symptoms should the nurse monitor the patient? Select all that apply. A) Hypovolemia B) Difficulty breathing C) Cardiovascular overload D) Pulmonary edema E) Hypoglycemia
B) Difficulty breathing C) Cardiovascular overload D) Pulmonary edema Fluid replacement complications can occur, often when large volumes are administered rapidly. Therefore, the nurse monitors the patient closely for cardiovascular overload, signs of difficulty breathing, and pulmonary edema. Hypovolemia is what necessitates fluid replacement, and hypoglycemia is not a central concern with fluid replacement
When planning the care of a patient with an implanted pacemaker, what assessment should the nurse prioritize?When planning the care of a patient with an implanted pacemaker, what assessment should the nurse prioritize?
B) Heart rate and rhythm For patients with pacemakers, close monitoring of the heart rate and rhythm is a priority, even though each of the other listed vital signs must be assessed.
The nurse caring for a patient whose sudden onset of sinus bradycardia is not responding adequately to atropine. What might be the treatment of choice for this patient? A) Implanted pacemaker B) Trancutaneous pacemaker C) ICD D) Asynchronous defibrillator
B) Trancutaneous pacemaker If a patient suddenly develops a bradycardia, is symptomatic but has a pulse, and is unresponsive to atropine, emergency pacing may be started with transcutaneous pacing, which most defibrillators are now equipped to perform. An implanted pacemaker is not a time-appropriate option. An asynchronous defibrillator or ICD would not provide relief.
Peritonsillar abscess signs
Breath can smell rancid, raspy voice, odynophagia, dysphagia, otalgia severe sore throat, fever, trismus (inability to open the mouth), and drooling. inflammation of the medial pterygoid muscle that lies lateral to the tonsil results in spasm, severe pain, and difficulty in opening the mouth fully.
The nurse is providing discharge teaching for a patient who developed a pulmonary embolism after total knee surgery. The patient has been converted from heparin to sodium warfarin (Coumadin) anticoagulant therapy. What should the nurse teach the client? A) Coumadin will continue to break up the clot over a period of weeks B) Coumadin must be taken concurrent with ASA to achieve anticoagulation. C) Anticoagulant therapy usually lasts between 3 and 6 months. D) He should take a vitamin supplement containing vitamin
C) Anticoagulant therapy usually lasts between 3 and 6 months. Anticoagulant therapy prevents further clot formation, but cannot be used to dissolve a clot. The therapy continues for approximately 3 to 6 months and is not combined with ASA. Vitamin K reverses the effect of anticoagulant therapy and normally should not be taken
he nurse is planning discharge teaching for a patient with a newly inserted permanent pacemaker. What is the priority teaching point for this patient? A) Start lifting the arm above the shoulder right away to prevent chest wall adhesion. B) Avoid cooking with a microwave oven. C) Avoid exposure to high-voltage electrical generators. D) Avoid walking through store and library antitheft devices.
C) Avoid exposure to high-voltage electrical generators. High-output electrical generators can reprogram pacemakers and should be avoided. Recent pacemaker technology allows patients to safely use most household electronic appliances and devices (e.g., microwave ovens). The affected arm should not be raised above the shoulder for 1 week following placement of the pacemaker. Antitheft alarms may be triggered so patients should be taught to walk through them quickly and avoid standing in or near these devices. These alarms generally do not interfere with pacemaker function
The nurse notes that a patient has developed a cough productive for mucoid sputum, is short of breath, has cyanotic hands, and has noisy, moist-sounding, rapid breathing. These symptoms and signs are suggestive of what health problem? A) Pericarditis B) Cardiomyopathy C) Pulmonary edema D) Right ventricular hypertrophy
C) Pulmonary edema As a result of decreased cerebral oxygenation, the patient with pulmonary edema becomes increasingly restless and anxious. Along with a sudden onset of breathlessness and a sense of suffocation, the patients hands become cold and moist, the nail beds become cyanotic (bluish), and the skin turns ashen (gray). The pulse is weak and rapid, and the neck veins are distended. Incessant coughing may occur, producing increasing quantities of foamy sputum. Pericarditis, ventricular hypertrophy, and cardiomyopathy do not involve wet breath sounds or mucus production.
The nurse is caring for a patient who has developed obvious signs of pulmonary edema. What is the priority nursing action? A) Lay the patient flat. B) Notify the family of the patients critical state. C) Stay with the patient. D) Update the physician.
C) Stay with the patient. Because the patient has an unstable condition, the nurse must remain with the patient. The physician must be updated promptly, but the patient should not be left alone in order for this to happen. Supine positioning is unlikely to relieve dyspnea. The family should be informed, but this is not the priority action.
OSA innervation
CPAP 1 action for a client on a CPAP with low O2 stat -check the tightness of straps and mask if a patient is not compliant with cpap use a bipap
Preventing Atelectasis
Change patient's position frequently, especially from supine to upright position, to promote ventilation and prevent secretions from accumulating. Encourage early mobilization from bed to chair followed by early ambulation. Encourage appropriate deep breathing and coughing to mobilize secretions and prevent them from accumulating. Educate/reinforce appropriate technique for incentive spirometry . Administer prescribed opioids and sedatives judiciously to prevent respiratory depression. Perform postural drainage and chest percussion, if indicated. Institute suctioning to remove tracheobronchial secretions, if indicated
Tuberculosis Risk Factors
Close contact with someone who has active TB. Inhalation of airborne nuclei from an infected person is proportional to the amount of time spent in the same air space, the proximity of the person, and the degree of ventilation. Immunocompromised status (e.g., those with HIV infection, cancer, transplanted organs, and prolonged high-dose corticosteroid therapy). Substance abuse (IV/injection drug users and alcoholics). Any person without adequate health care (the homeless; impoverished; minorities, particularly children <15 years and young adults between ages 15 and 44 years).
Peritonsillar abscess
Collection of pus or fluid around the tonsil collection of purulent exudate between the tonsillar capsule and the surrounding tissue after acute tonsillar infection. Edema can cause airway obstruction that can be life threatening
The nurse is assessing a patient who had a pacemaker implanted 4 weeks ago. During the patients most recent follow-up appointment, the nurse identifies data that suggest the patient may be socially isolated and depressed. What nursing diagnosis is suggested by these data? A) Decisional conflict related to pacemaker implantation B) Deficient knowledge related to pacemaker implantation C) Spiritual distress related to pacemaker implantation D) Ineffective coping related to pacemaker implantation
D) Ineffective coping related to pacemaker implantation Depression and isolation may be symptoms of ineffective coping with the implantation. These psychosocial symptoms are not necessarily indicative of issues related to knowledge or decisions. Further data would be needed to determine a spiritual component to the patients challenges.
What should the nurse recommend a patient with pharyngitis avoid? A.ENDS use B.Exposure to extreme heat C.Secondhand smoke D.A and C
D. A and C Rationale: Patients diagnosed with chronic pharyngitis should avoid alcohol, tobacco, secondhand smoke, ENDS use, exposure to cold and environment and occupational pollutants. The patient can wear a disposable face mask to filter out small particles such as dust and mold. This patient should also stay hydrated with oral fluids and use lozenges or gargle with warm saline solution to relieve throat discomfort.
OSA S/S
Daytime: • Morning headaches • Daytime sleepiness • Chronic fatigue • Irritability, mood swings, depression Night Time: • Snoring • Episodes of apnea
obstructive sleep apnea
Excessive daytime sleepiness Frequent nocturnal awakening Insomnia Loud snoring Morning headaches Intellectual deterioration Personality changes, irritability Impotence Systemic hypertension Dysrhythmias Pulmonary hypertension, cor pulmonale Polycythemia Enuresis
Rifampin
Give on empty stomach (anti-tuberculosis) remember Rifampin causes red urine RED-FAMPIN key points - red, orange, tears urine sweat are normal teach wear glasses instead of contacts due to discoloration of teats 2.oral contraceptive ineffective use non hormonal back up birth control monitort for jaundice
Isoniazid (INH)
I- interferes with absorption of B6 when we don't have b6 peripheral neuropathy can happen so teach client to take vitamin b6 25-50 day N- neuropathy Report -new numbness tingling extremities ataxia Hepatoxicity report immediately jaundice yellow skin/sclera dark urine fatigue elevated liver enzymes (hold the med)
ICOUGH Program
Incentive spirometry Coughing and deep breathing Oral care (brushing teeth and using mouthwash twice a day) Understanding (patient and staff education) Getting out of bed at least three times daily Head-of-bed elevation
how do you assess the induration for TB
Induration is a hard or swollen area that is raised on the skin. This will be measured in millimeters (mm). Redness is not measured...the induration is measured 15 millimeters (mm) or more: Positive in all persons (doesn't matter if the person does not have any risk factors) 10 mm or more: positive if the person is an immigrant, IV drug user, working or living in tight living quarters, child less than 4 5 mm or more: positive if person have HIV, in contact with someone with TB, organ transplant patient, or immunosuppressed
TB diagnostic tests
Intradermal TB skin test done by intradermal injection requires 2-3 days for reading if positive ill show a 15mm induration on the skin but additional test is need to see if it's in active from
The signs and symptoms of pulmonary TB are insidious Clinical Manifestations
Most patients have a low-grade fever, cough, night sweats, fatigue, and weight loss. The cough may be nonproductive, or mucopurulent sputum may be expectorated. Hemoptysis also may occur
Droplet precautions pimp my ride mtv
P- pertussis I- influenza M - meningitis P- pneumonia surgical mask and goggles single room
Acute pharyngitis nursing mangment
Prepare to administer prescribed antibiotics, analgesics, antitussives and decongestants. Encourage the client to gargle with warm saline gargles and use throat lozenges. Instruct the client that the temperature of saline should be sufficiently high to be effective and should be as hot as the client can tolerate. Instruct the client to apply an ice collar to severe sore throats. Instruct the client on proper mouth care. Instruct the client to have a liquid or soft diet. Encourage the client to increase fluid intake to 2,000 ml/per day Discourage the client from eating spicy foods and drinking juices that are acidic. If the client is unable to drink, fluids may be administered IV. Instruct the client to take all antibiotics, even if he is feeling better. Encourage the client to avoid exposure to irritants, smoking, secondhand smoke, and exposure to cold and alcohol. Encourage the client to avoid contact with individuals with upper respiratory infections. Encourage the client to use a disposable mask when exposed to environmental and occupational pollutants.
TB Drugs: RIPE
Rifampin Isoniazid Pyrazinamide Ethambutol
The nurse is assessing a patient who is known to have right-sided HF. What assessment finding is most consistent with this patients diagnosis? A) Pulmonary edema B) Distended neck veins C) Dry cough D) Orthopnea
Right-sided HF may manifest by distended neck veins, dependent edema, hepatomegaly, weight gain, ascites, anorexia, nausea, nocturia, and weakness. The other answers do not apply.
What is septic shock?
Septic shock Pathophysiology results from a septic widespread bloodborne infection that overwhelms the body typically caused by a bacterial infection like Pneumonia - infection in the lungs or even UTI or kidney infection that gets worse. A systemic cytokine release inside the bloodstream causes extreme vasodilation & fluid leakage from capillaries
Septic Shock S/S
Severely low blood pressure Low blood pressure (Less than 80/systolic) Cold, clammy skin (pale & cool extremities) Delayed capillary refill Confusion Disorientation Mental Status change High WBC (over 10,000) Temp. High or very low (96°F
Tonsillitis key sign
Sore throat with difficulty opening mouth and swallowing ( priority patient must be asses first)
TB memory trick
T terrible cough (blood tinged) Bad infection( fever night sweats and weight loss)
atelectasis hallmark
Tachypnea, dyspnea, and mild-to-moderate hypoxemia are hallmarks of the severity of atelectasis
A patient the nurse is caring for has a permanent pacemaker implanted with the identification code beginning with VVI. What does this indicate? A) Ventricular paced, ventricular sensed, inhibited B) Variable paced, ventricular sensed, inhibited C) Ventricular sensed, ventricular situated, implanted D) Variable sensed, variable paced, inhibited
The identification of VVI indicates ventricular paced, ventricular sensed, inhibited.
Active TB
the immune system isn't able to contain the bacteria so it takes over (ex: weaken immune system due to HIV). Most cases of active TB are due to a latent case that turns into an active case -Therefore, the person is: CONTAGIOUS AND HAS SIGNS/SYMPTOMS, positive PPD or blood test, will have an ABNORMAL chest x-ray and positive sputum culture. -The bacteria can now spread via the lymphatic system throughout the body and affect other areas of the body like the brain, spine, joints etc.
Tonsillitis key teaching
to avoid bleeding after surgery ● AVOID coughing, blowing nose ● AVOID sharp foods: chips, nuts ● NO milk products ● NO hard brushing or gargling
Tonsillitis Treatment & Nursing Care
to avoid bleeding after surgery: Tonsillectomy: simple surgery to remove the tonsils, HUGE RISK for bleeding.
pacemaker external outside
transcutaneous pacing emergency 911 cardiac arrest epicardial pacing- after open heart surgery endocardial pacing - 3rd degree heart block awaiting for permanent pacemaker
Risk Factors for developing Tuberculosis "TB Risk" (remember these factors for tests)
Tight living quarters: long-term health care facilities, homeless shelters, prisons etc. Below or at the poverty line (poor...homeless) Refugees (high incidence of TB in their home country) Immune system issues: HIV Substance abusers (IV drugs, ETOH) Kids less than the age of 4-5....weak immune system
Tonsillitis & Abscess
Tonsillitis is the inflammation of tonsils, the little soft tissue masses located near the rear of the throat. When these guys get inflamed it can lead to a life-threatening airway obstruction! (peritonsillar abscess)
Peritonsillar abscess treatment
Treated with antimicrobial agents and corticosteroids Needle aspiration of the abscess to decompress and drain
Prevention of pulmonary edema
Vigilant monitoring in HF pts and increase diuretics PRN Admin IV at a slower rate in older adults Exercise Diet -low sodium -fluid restrictions Smoking cessation Follow medication regimen In its early stage, pulmonary edema may be alleviated by increasing dosages of diuretics and by implementing other interventions to decrease preload. For instance, placing the patient in an upright position with the feet and legs dependent reduces left ventricular workload.
The nurse is caring for a patient who has had a biventricular pacemaker implanted. When planning the patients care, the nurse should recognize what goal of this intervention? A) Resynchronization B) Defibrillation C) Angioplasty D) Ablation
a)Resynchronization Biventricular (both ventricles) pacing, also called resynchronization therapy, may be used to treat advanced heart failure that does not respond to medication. This type of pacing therapy is not called defibrillation, angioplasty, or ablation therapy
Acute pharyngitis
Viral infection causes most cases of acute pharyngitis. Responsible viruses include the adenovirus, influenza virus, Epstein-Barr virus, and herpes simplex virus. Bacterial infection accounts for the remainder of cases.
pulmonary edema risk factors
acure mI sepsis HTN left side HF Drug overdose Trauma high altitude/deep sea diving
Rhinitis cause
viral or bacterial is most common it cane be transmission by droplets from sneezing, coughing, direct touch other conditions and activities that can block the normal flow of sinus secretions include abnormal structures of the nose, enlarged adenoids, diving and swimming, tooth infection, trauma to the nose, tumors, and the pressure of foreign objects. change in temp humid oders infection age disease over counter medication forgin body food
pulmonary edema nursing care
vitals 15 min until stable 1+o monitoring abgs + electrolytes maintain a patient airway/ suction high fowler position legs dangling high flow rebreather mask (BiPAP/ vent) Fluid restriction weight meds(lasix, morphine, antihypertensives head to toe be supportive
Assessment and Diagnosis of atelectasis
• Characterized by increased work of breathing and hypoxemia • Decreased breath sounds and crackles over the affected area• Chest x-ray may suggest a diagnosis of atelectasis before clinical symptoms appear • Pulse oximetry (SpO2) may demonstrate a low saturation of hemoglobin with oxygen (less than 90%
