Medical-Surgical: Respiratory

Sinusitis

inflammation of sinus mucosa -Acute/Chronic , bacterial infection, viral illness, allergies, NG tube - S/S: local pain, purulent nasal drainage, fever fould breath - Complications: Osteomyelitis, orbital cellulitus, abscess, meningitis - SNC: relieve pain, nasal irrigation, medication, increase fluids, warm, moist packs.

A nurse is assisting with discharge teaching for a client who is postoperative following a rhinoplasty. What instruction should the nurse include?

"Lie on your back with your head elevated 30 degrees when resting"

A nurse in a clinic is reinforcing teaching with a client who is to have a tuberculin skin test. What information should the nurse include?

"you must return to the clinic to have the test read in 2-3 days"

A nurse is reinforcing preoperative teaching with a client who is to undergo a pneumonectomy. The client states, "I am afriad it will hurt to cough after surgery." What statement should the nurse make?

'I will show you how to splint you incision while coughing"

Crackles

(rales) wet popping sounds

A nurse on medical unit is assissting with the care of a client who has a possible closed pneumothorax and significant brusing of the left chest following a motor-vehicle crash. The client reports severe left chest pain on inspiration. The nurse should hear what finding when auscultating the clients lungs?

Absence of breath sounds

A nurse is preparing to assist a provider to withdrawl arterial blood from a client's radial artery for measurment of ABG. What action should the nurse plan to take?

Check the circulation in the client's ulnar artery prior to obtaining the specimen

A nurse is assisting with the development of a teaching plan about how to prevent an acute asthma attack for a young adult client. What point shoudl the nurse plan to discuss?

Determine the client's preception of the disease process and what might hace triggered the current attack

A nurse is in an urgent care clinic is collecting data from a cleint who reports exposure to anthrax. What finding is an indication of the prodromal stage of inhalation anthrax?

Dry cough

A nurse is assisting with the plan of care for a client who has chronic obstructive pulmonary disease and is malnourished. What recommendation to promote nutritional intake should the nurse include in the plan?

Eat high-calorie foods first

Laryngitis

Inflammation of larynx lining -Irritation -Viral, enviormental, bacterial, fungal - S/S: hoarse, cough, dysphagia, fever - SNC: rest, increase fluids, humidified air, medications

Alternate airway

Intubation and postitive pressure ventilation (PPV)

A nurse is reinforcing teaching about pursed-lip breathing for a client who has chronic obstructive pulmonary disease and emphysema. The nurse should explain that this breathing technqiue does what?

Keeps the airways open on exhalation

A nurse is a provider's office collecting data from a client who states he was recently exposed to TB. What finding is a clinical manifestation of pulmonary TB?

Night sweats

Epistaxis

Nose bleed -Anterior/Posterior -S/S: Dry/cracked mucous membranes, trauma, nose picking, blowing, disease process -SNC: lean forward, pressure, ice packs (vasoconstriction), packing, airway obstruction, avoid bending over

A nurse on a medical unit is assisting with the care of a client who aspirated gastric contents prior to admission. The provider prescribed 100% oxygen by nonrebreather mask after the client reported severe dyspnea. What finding is a clinical manifestation of acute respiratory distress syndrome (ARDS)?

PaO2 50 mm Hg

A nurse is caring for an older adult who has chronic obstructive pulmonary disease and pneumonia. The nurse should monitor the client for what acid-base imbalance?

Respiratory acidosis is a common complication of COPD

A nurse is assissting the provider to prepare a client for thoracentesis. The nurse should instruct the client that what position will be used for this procedure?

Sitting while leaning forward over the bedside table

Pharyngitis

Sore throat, inflammation of pharynx - bacterial or viral - Strep throat (streptococci) - S/S: Sore throat, dysphagia, exudate, fever, headache, stomach ache/vomiting (children) - SNC: Throat culutre, medications, increase fluids, rest

Tonsillitis

Strep throat - Infection of tonsil tissue - Viral (most common) or bacterial - S/S: sore throat, fever, chills, dysphagia, pain, myalgia, red, swollen, exudate - SNC: Throat culture, medications, increase fluids, rest, saline gargles, tonsillectomy

A nurse on a med-surg unit is caring for a client who is postop following a hip replacement. The client reports feeling apprehensive and restless. The nurse collects additional data from the client. What finding is an indication of pulmonary embolism?

Sudden onset of dyspnea

A nurse is assisting with the plan of care for a client following placement of a chest tube 1 hr ago. What action should the nurse include in the plan of care?

Tape all connections between the chest tube and drainage system

A nurse is caring for a client who has a tracheostomy with an inflated cuff in place. What finding indicates that the nurse should suction the client's airwat secretions?

The client has coarse crackles in the lung fields

A nurse is collecting data form a client who has a prescription for cisplatin IV to trreat lung cancer. What client finding is an adverse effect of this med?

Tinnitus

A nurse is reinforcing teaching with a client who has cystic fibrosis and a prescription for daily chest physiotherapy. The nurse should instruct the client that what is the purpose of these treatments?

To mobilize secretions in the airways

A nurse is reinforcing teaching with a client about pulmonary function tests. What test measures the volume of air the lungs can hold at the end of max inhalation

Total lung capacity

Influenza

Viral infection of respiratory tract - Droplet and Contact transmission - S/S: abrupt onset, fever, chills, myalgia, sore throat, cough, malaise, headache, 2-5 days intense symptoms - SNC: Nasal swab, symptom treatment, no curative treatment, medication, increase fluids, rest, respiratory assessment

Tinnitus

adveres effect of cisplation is ototoxicity

A nurse is assisting with the care for a client who had a chest tube inserted 12 hr ago. The nurse notes a crackling sensation upon palpation of the skin on the right side of the client's chest. The nurse should notify the charge nurse that the client is demonstrating a clinical manifestation of....

crepitus

Postive pressure ventilation (PPV)

independent breathing-cannot maintain blood gases (RDS, sleep apnea, ALS)

Friction rub

scratching or squeaking sound

Tracheotomy

surgical opening into trachea

Intubation

tube into trachea to maintain oxygenation (short-term)

Tracheostomy

tube to maintain patency (cancer, trauma, tumor, prolonged ventilation, excessive secretions)

Tactile fremitus

vibration of the chest wall