NU 308 Exam 2 Blueprint Part 2
chronic bronchitis
This is apart of COPD: cough and sputum production for at least 3 months in each of 2 consecutive years?
emphysema
This is part of COPD: abnormal distention of air spaces beyond the terminal bronchioles with destruction of the walls of the alveoli?
- environmental factors - genetic predisposition - alterations in function of the immune system
What are the factors that are apart of inflammatory bowel disease?
o Bronchodilators, MDIs (Beta-adrenergic agonists, Muscarinic antagonists (anticholinergics), Combination agents o Corticosteroids o Antibiotics o Mucolytics o Antitussives
What are the medications used to treat COPD?
Pneumoconiosis
What is this: role of nurse is to be the employee advocate and provide health education on preventive measures to reduce lung injury?
IBD
What is this: some agent or combination of agents triggers an overactive, inappropriate, sustained immune response?
Miliary TB
What is this: the diagnosis are examination and culture of a sample from the infected area, tuberculin skin test, blood tests to detect tuberculosis, a chest x-ray?
Multi-drug resistant TB
What is this: transmitted same way as drug-susceptible TB, and no more infectious?
Miliary TB
What is this: treatment are antibiotics, corticosteroids, sometimes surgery?
acute atelectasis
What is this: which occurs most often in the postoperative setting or in people who are immobilized and have a shallow?
Pneumoconiosis
What is this: · Occupational lung diseases and includes asbestosis, silicosis and coal workers' pneumoconiosis?
acute episode "quick relief" medications
What medication for COPD is this: short-acting beta agonists, short acting anticholinergics; IM, IV or PO steroids; antibiotics if related to bacterial infection?
beta-adrenergic agonist
What medication is this: first-line medications in the treatment of airway narrowing, bronchial asthma and chronic obstructive pulmonary disease?
Fluoroquinolones
What medication is this: it is indicated for various infections caused by aerobic gram-negative and other microorganisms?
Fluoroquinolones
What medication is this: may be used to treat infections of the respiratory, genitourinary and GI tracts as well as infections of bones, joints, skin and soft tissues?
mast cell stabilizers
What medication is this: used as an alternative but not preferred medication for prophylaxis of acute asthma attacks in patients with mild, persistent asthma?
15 and 25 years
Inflammatory bowel disease may occur at any age, what is the onset peak?
Fluoroquinolones
What medication is this: used for acute sinusitis, lower respiratory infections, pneumonia, skin and soft tissue infections, prostatitis and urinary tract infections?
No
Is the cause of IBD known?
ulcerative colitis
What IBD is this: barium studies are Diffuse involvement, no narrowing of colon, no mucosal edema, stenosis rare, shortening of colon?
Crohn's Disease
What IBD is this: barium studies are regional, discontinuous skin lesions, narrowing of colon, thickening of bowel wall, mucosal edema, stenosis, fistulas?
Crohn's Disease
What IBD is this: bleeding does not usually occur, the perianal involvement is common as are fistulas?
ulcerative colitis
What IBD is this: colonoscopy are friable mucosa with pseudopolyps or ulcers in descending colon?
Crohn's Disease
What IBD is this: colonoscopy is distinct ulcerations separated by relatively normal mucosa in ascending colon?
Crohn's Disease
What IBD is this: diarrhea is less several, abdominal mass is common?
ulcerative colitis
What IBD is this: diarrhea is severe and abdominal mass is rare?
ulcerative colitis
What IBD is this: exacerbations, remissions and early pathophysiology are mucosal ulceration?
Crohn's Disease
What IBD is this: late pathology is deep, penetrating granulomas?
ulcerative colitis
What IBD is this: late pathophysiology is minute, mucosal ulcerations?
ulcerative colitis
What IBD is this: location is in the rectum, descending colon and the bleeding is common and can be severe?
Crohn's Disease
What IBD is this: location is the ileum, ascending colon?
ulcerative colitis
What IBD is this: perianal involvement is rare and mild, fistulas are rare?
Crohn's Disease
What IBD is this: prolonged variable, early pathology is transmural thickening?
ulcerative colitis
What IBD is this: sigmoidoscopy is abnormal inflamed mucosa?
Crohn's Disease
What IBD is this: sigmoidoscopy may be unremarkable unless accompanied by perianal fistulas?
Crohn's Disease
What IBD is this: systemic complications are Small bowel obstruction, right-sided hydronephrosis, nephrolithiasis, colon cancer, cholelithiasis, arthritis, uveitis, erythema nodosum?
ulcerative colitis
What IBD is this: systemic complications are toxic megacolon, perforation, hemorrhage, colon cancer, pyelonephritis, nephrolithiasis, cholangiocarcinoma, arthritis, uveitis, erythema nodosum?
ulcerative colitis
What IBD is this: therapeutic management are Corticosteroids, aminosalicylates useful in preventing recurrence; Immunodulators; Bulk hydrophilic agents, antibiotics, proctocolectomy with ileostomy; Rectum can be preserved in only a few patients "cured" by colectomy?
Crohn's Disease
What IBD is this: therapeutic management are Corticosteroids, aminosalicylates, immunodulators, antibiotics, parenteral nutrition, partial or complete colectomy with ileostomy or anastomosis, rectum can be preserved in some patients, recurrence common?
- weight loss due to dyspnea - barrel chest - clubbed fingers
What are the clinical manifestations of COPD?
o Respiratory insufficiency and failure o Pneumonia o Chronic atelectasis o Pneumothorax o Cor pulmonale
What are the complications of COPD?
· Electrolyte imbalance · Cardiac dysrhythmias · GI bleeding with fluid loss · Perforation of the bowel
What are the complications of IBD?
o Obtain history o Review of diagnostic tests o Achieving airway clearance o Improving breathing pattern (Positioning, oxygen, medications, smoking cessation) o Improving activity tolerance o Educate patient and care givers about disease and medications (Inhalation med administration needs to be taught and demonstrated) o Coordinate past discharge care (Home oxygen, Visiting nurses)
What are the nursing management of COPD?
- cigarette smoking - occupational chemicals and dust - air pollution - infection - heredity - aging
What are the risk factors for COPD?
o Bullectomy o Lung volume reduction o Lung transplant
What are the surgical managements for COPD?
- chronic cough - sputum production - dyspnea
What are the three primary symptoms of COPD?
- controller medications - acute episode quick relief medications
What are the two main types of medications for COPD?
-ulcerative colitis - Crohn's disease
What are the two most common inflammatory bowel disease?
volume or flow
What are the two types of spirometry tests?
coughing and deep breathing
What does the C stand for in ICOUGH?
getting out of bed at least three times daily
What does the G stand for in ICOUGH?
head-of-bed elevation
What does the H stand for in ICOUGH?
Incentive spirometry
What does the I stand for in ICOUGH?
oral care (brushing teeth and using mouthwash twice a day)
What does the O stand for in ICOUGH?
understanding (patient and staff education)
What does the U stand for in ICOUGH?
for the management of atelectasis
What is ICOUGH used for?
post-surgery
What is an indication for needing to use a spirometry?
o Explain procedure o Have self-inflating bag and mask ready in case ventilatory assistance is required immediately after extubation o Suction the tracheobronchial tree and oropharynx, remove tape, and then deflate the cuff o Give 100% oxygen for a few breaths, then insert a new, sterile suction catheter inside tube o Have the patient inhale
What is the care for extubation (remobal of endotracheal tube)?
o Give heated humidity and oxygen by facemask and maintain the patient in a sitting or high Fowler's position o Monitor respiratory rate and quality of chest excursions o Monitor the patient's oxygen level using a pulse oximeter o Keep patient NPO, or give only ice chips for next few hours o Provide mouth care o Educate the patient about how to perform coughing and deep-breathing exercises
What is the care of a patient following extubation?
o Streptococcus pneumonia o Myeoplasma pneumonia o Haemophilus influenza o C. pneumonia o Respiratory viruses
What is the cause of community acquired pneumonia?
o Health history o Pulmonary function tests o Spirometry o Arterial blood gas o Chest x-ray
What is the diagnosis of COPD?
· The patient may be treated initially with IV anitbiotics at home · If oral antibiotics are prescribed, the nurse educates the patient about their proper administration and potential side effects · The nurse encourages breathing exercises to promote secretion clearance and volume expansion · Stop smoking · Drink plenty of liquids: water, juice, or weak tea · Do not drink alcohol
What is the discharge teaching for pneumonia?
1. Check symmetry of chest expansion 2. Auscultate breath sounds of anterior and later chest bilaterally 3. Obtain capnography or end-tidal CO2 s indicated 4. Ensure chest x-ray obtained to verify proper tube placement 5. Check cuff pressure every 6 to 8 hours 6. Monitor for signs and symptoms of aspiration 7. Ensure high humidity; a visible mist should appear in the T-piece or ventilatory tubing 8. Administer oxygen concentration as prescribed by the primary provider 9. Secure the tube to the patient's face with tape, and mark the proximal end for position maintenance 10. Use sterile suction technique and airway care to prevent iatrogenic contamination and infection
What is the nursing care of the ET tube?
o Promote smoking cessation o Reducing risk factors o Managing exacerbations o Providing supplemental oxygen therapy o Primary prevention of COPD exacerbations (Pneumococcal vaccine, Influenza vaccine) o Pulmonary rehabilitation o Managing exacerbations
What is the overall medical management for COPD?
1. airflow limitation is progressive, associated with abnormal inflammatory response to noxious particles or gases 2. chronic inflammation damages tissue 3. scar tissue in airway results in narrowing 4. scar tissue in the parenchyma decreases elastic recoil 5. scar tissue in pulmonary vasculature causes thickened vessel lining and hypertrophy of smooth muscle
What is the pathophysiology of COPD?
1. Sit upright in a chair or in bed 2. Put mouthpiece in your mouth and close your lips tightly 3. Breathe in slowly through your mouth as deeply as you can 4. Try to get the piston as high as you can, while keeping the indicator between the arrows
What is the position a person needs to be in for a spirometry test?
Multi-drug resistant TB
What is this: MDR TB caused by bacteria resistant to best TB drug, isoniazid and rifampin?
COPD
What is this: a slowly progressive respiratory disease of airflow obstruction?
IBD
What is this: an autoimmune disease; involves an immune reaction to a person's own intestinal tract?
Multi-drug resistant TB
What is this: caused by organisms resistant to one or more TB drug?
IBD
What is this: chronic inflammation of the GI tract?
Multi-drug resistant TB
What is this: delay in detecting drug resistance may prolong period of infectiousness because of delay in starting correct treatment?
spirometry
What is this: device encourages patient to inhale slowly and deeply to maximize lung inflation and alveoli expansion; used to prevent or treat atelectasis?
COPD
What is this: emphysema and chronic bronchitis?
spirometry
What is this: is used to evaluate airflow obstruction, which is determined by the ratio of FEV to forced vital capacity?
miliary tb
What is this: may affect one organ or several organs or occur throughout the body, it most often affects the lungs, liver and bone marrow but may affect any organ, including the tissues that cover the brain and spinal cord?
atelectasis
What is this: observed in patients with a chronic airway obstruction that impedes or blocks the flow of air to an area of the lung?
COPD
What is this: preventable and treatable, but not fully reversible; involving the airways, pulmonary parenchyma, or both?
Pneumoconiosis
What is this: preventable not treatable; reduce exposure, protective gear/device?
Pneumoconiosis
What is this: refers to a nonneoplastic alteration of the lung resulting from inhalation of mineral or inorganic dust?
atelectasis
What is this: refers to closure or collapse of alveoli and often is described in relation to chest x-ray findings and/or clinical signs and symptoms. May be acute or chronic and may cover a broad range of pathophysiologic changes?
community acquired pneumonia
What is this: reoccurring in the community or < 48 hours after hospital admission or institutionalization of patients who do not meet the criteria for health care-associated pneumonia?
Multi-drug resistant TB
What is this: resistant to both isoniazid and rifampin?
IBD
What is this: results in widespread inflammation and tissue destruction with periods of remission are interspersed with periods of exacerbation and the exact cause is unknown?
controller medications
What medication of COPD is this: prevent exacerbation: long-acting beta agonist, inhaled steroids, muscarinic antagonists?
