Med Surg Chapter 23

A patient taking isoniazid (INH) therapy for tuberculosis demonstrates understanding when making which statement?

"It is all right if I have a grilled cheese sandwich with American cheese."

The 5 year old survival rate for lung cancer is ___________.

16%

The nurse knows that a sputum culture is necessary to identify the causative organism for acute tracheobronchitis. What causative fungal organism would the nurse suspect?

Aspergillus

No exposure; no infection

Class 0

The nurse is assessing a patient who has ben admitted with possible ARDS. What findings would distinguish ARDS from cardiogenic pulmonary edema?

Elevated B-type natriuretic peptide (BNP) levels

Define the etiology of cor pulmonale.

Enlargement of the right ventricle of the heart because of diseases affecting the structure or functions of the lung

A patient arrives int eh emergency department after being involved in a motor vehicle accident. The nurse observes paradoxical chest movement when removing the patient's shirt. what does the nurse know that this finding indicates?

Flail chest.

The nurse assesses a patient for a possible pulmonary embolism. What frequent sign of pulmonary embolus does the nurse anticipate finding on assessment?

Tachypnea

______________,___________, and _________ are hallmarks of the severity of atelectasis.

Tachypnea, dyspnea, mild to moderate hypoxemia

A patient who wears contact lenses is to be placed on rifampin for tuberculosis therapy. What should the nurse tell the patient?

"You should switch to wearing your glasses while taking this medication."

The nurse is planning the care for a patient at risk of developing pulmonary embolism. What nursing interventions should be included in the care plan? (Select all that apply)

- Encouraging liberal fluid intake - Assisting the patient to do leg elevations above the level of the heart - Using elastic stocking, especially when decreased mobility would promote venous stasis. - Applying a sequential compression device

The nurse is planning for the care of a patent with acute tracheobronchitis. What nursing interventions should be included in the plan of care? (Select all that apply)

- Increasing fluid intake to remove secretions - Encouraging the patient to remain in bed - Using cool-vapor therapy to relieve laryngeal and tracheal irritation.

A patient has a Mantoux skin test prior to being placed on an immunosuppressant for the treatment of Crohn's Disease. What results would the nurse determined is not significant for holding the medication?

0 to 4 mm

Three severe complications of pneumonia are _________, _________, and ____________.

1. Hypotension, 2. Shock 3. Respiratory failure

The diagnosis of hospital-acquired pneumonia is usually associated with the presence of one of three conditions:

1. Impaired host defenses 2. Inoculum of organisms that reach the lower respiratory tract 3. The presence of a highly virulent organism

Three common pathogens that cause aspiration pneumonia are:

1. Streptococcus pneumonia 2. Haemophilus influenza 3. Staphylococcus Aureas

The nurse is administering anticoagulant therapy with heparin. What international Normalized Ratio (INR) would ht nurse know is within therapeutic range?

2.0-2.5

The nurse educating a patient who will be started on an antituberculosis medication regimen. The patient asks the nurse, "How long will I have to be on these medications?" What should the nurse tell the patient?

6 to 12 months

The mortality rate with ARDS is as high as___________. The major cause of death is usually______________________________.

60%; non-pulmonary multiple system organ failure

Pneumonia trends to occur in patients with one or more of these five underlying disorders:

Alcoholism, Chronic Obstructive Pulmonary Disease, Acquired immunodeficiency disease, diabetes, heart failure

A patient with pulmonary hypertension has a positive vasoreactivity test. What medication does the nurse anticipate administering to this patient?

Calcium channel blockers

Exposure; no evidence of infection

Class 1

Latent infection; no disease (e.g.. positive PPD)

Class 2

Disease; not clinically active.

Class 3

Disease; clinically active

Class 4

Suspected disease; diagnosis pending

Class 5

The nurse is having an information session with a women's group at the YMCA about lung cancer. What frequent and commonly experienced symptom should the nurse be sure to include in the session?

Coughing

The nurse is auscultating the patient's lung sounds to determine the presence of pulmonary edema. What adventitious lung sounds are significant for pulmonary edema?

Crackles in the lung bases

A patient who had a colon resection 3 days ago is complaining of discomfort int he left calf. How should the nurse assess Homan's signs to determine if the patient may have a thrombus formation in the leg?

Dorsiflex the foot while the leg is elevated to check for calf pain

A patient is admitted to the hospital with pulmonary arterial hypertension. What assessment finding by the nurse is a significant finding for this patient.

Dyspnea

Name Seven possible clinical manifestations of atelectasis.

Dyspnea, cough, sputum production, tachycardia, tachypnea, pleural pain, and central cyanosis

Identify eight nursing measures that can be used to prevent atelectasis.

Frequent turning, early mobilization, deep breathing maneuvers, assistance with the use of spirometry, suctioning, postural drainage, aerosol nebulizer treatments, and chest percussion

Describe the characteristic and diagnostic feature of ARDS.

Hypoxemia that does not respond to supplemental oxygen

Four respiratory system mechanisms that can lead to acute respiratory failure (ARF) are:

Impaired central nervous system (CNS) Function, Neuromuscular, musculoskeletal, pulmonary dysfunction

The nurse is conductions a community program about prevention of respiratory illness. What illness does the nurse know is the most common cause of death in the United States?

Pneumonia

The nurse caring for a patient with pleurisy. What symptoms does the nurse recognize are significant for this patient's diagnosis?

Stabbing pain during respiratory movement

A patient comes to the clinic with fever, cough, and chest discomfort. The nurse auscultates crackles in the left lower base of the lung and suspects that the patient may have pneumonia. What does the nurse know is the most common organism that causes community-acquired pneumonia.

Streptococcus pneumoniae

Explain the meaning of the term super infection.

Superinfection is suspected when a subsequent infection occurs with another bacterium during antibiotic therapy

The nurse is caring for patient with suspected ARDS with a PO2 of 53. The patient is placed on oxygen via face mask and the Po2 remains the same. What does the nurse recognize as a key characteristic of ARDS?

Unresponsive arterial hypoxemia

When a nonfunctioning nasogastric tube allows the gastric contents to accumulate in the stomach a condition known as _____________ may result.

silent aspiration