Week 1 and Week 2 study guide for NUR201

HCO3

21-28 mEq/L elevations indicate possible respiratory acidosis as compensation for a primary metabolic alkalosis decreased levels indicate possible respiratory alkalosis as compensation for a primary metabolic acidosis

PaO2

80-100mmHg elevations indicate possible excessive oxygen administration decreased levels indicate possible COPD, asthma, chronic bronchitis, cancer of the bronchi and lungs, cystic fibrosis, respiratory distress syndrome, anemias, atelectasis or any other cause of hypoxia

short-acting beta agonist (SABA)

primarily used as a fast-acting reliever (rescue) drug to be used either during an asthma attack or just before engaging in activity that usually triggers an attack

Deep and rapid breaths consistent with Kussmaul respiration are found in patients with which type of acid-base imbalance?

metabolic acidosis

Basophils

15-50/mm3 elevations indicate possible inflammation; seen in chronic sinusitis, hypersensitivity reactions decreased levels may be seen in an acute infection

A patient has been diagnosed with TB. Which medications would the nurse expect to be prescribed for the patient?

Isoniazid, rifampin, pyrazinamide (PZA), ethambutol

Lymphocytes

1000-4000/mm3 elevations indicate possible viral infection, pertussis and infectious mononucleosis decreased levels may be seen during corticosteroid therapy

Symptoms of a pneumothorax

-pain on the affected side that is worse at the end of inhalation and the end of exhalation -rapid heart rate -rapid, shallow respirations -a feeling of air hunger -prominence of the affected side that does not move in and out with respiratory effort -trachea slanted more to the unaffected side instead of being in the center of the neck -new onset of "nagging" cough -cyanosis

Leading causes of a pneumothorax

-smoking -chest injury -lung disease -mechanical ventilation -COPD/respiratory diagnosis

Chest tube: Immediately Notify Surgeon or Rapid Response Team for

-tracheal deviation from midline -sudden onset or increased intensity of dyspnea -oxygen saturation less than 90% -drainage greater than 70 ml/hr -visible eyelets on chest tube -chest tube falls out of the patient's chest (first, cover the area with dry, sterile gauze) -chest tube disconnects from the drainage system (first, put end of tube in a container of sterile water and keep below the level of patient's chest) -drainage in tube stops (in the first 24 hours)

Patient teaching for tetracyclines

-use additional contraception -take on empty stomach -sit up 30 minutes after taking...DO NOT LAY DOWN! -avoid calcium products and iron

pH

0-60yrs old: 7.35-7.45 60-90 yrs old: 7.31-7.42 >90 yrs old: 7.26-7.43 elevations indicate metabolic or respiratory alkalosis decreased levels indicate metabolic or respiratory acidosis

Monocytes

100-700/mm3 elevations: see lymphocytes; also may indicate active tuberculosis decreased levels: see lymphocytes

Neutrophils

2500-8000/mm3 elevations indicate possible acute bacterial infection (pneumonia), COPD or inflammatory conditions (smoking) decreased levels indicate possible viral disease (influenza)

PACO2

35-45mmHg elevations indicate possible COPD, asthma, pneumonia, anethesia effects or use of opioids (respiratory acidosis) decreased levels indicate hyperventilation/respiratory alkalosis

WBC count

5-10,000 elevations indicate possible acute infections or inflammations decreased levels may indicate an overwhelming infection, an autoimmune disorder or immunosuppressant therapy

Eosinophils

50-500/mm3 elevations indicate possible COPD, asthma or allergies decreased levels indicate pyogenic infections

SpO2

95-100% decreased levels indicate possible impaired ability of hemoglobin to release oxygen to release oxygen to tissues

Which precaution is a priority for the nurse to teach a client prescribed the gene therapy combination of ivacaftor/tezacaftor in order to prevent harm from this therapy? A. Examine your skin and the whites of your eyes daily for a yellow appearance. B. Apply ice to the injection site for 30 minutes after each dose to keep bleeding to a minimum. C. Wait at least 15 minutes after using other inhaled drugs before inhaling this drug combination. D. Go to your primary health care provider immediately if you develop a fever or other signs of infection.

A. Examine your skin and the whites of your eyes daily for a yellow appearance.

Which statement about the genetics of cystic fibrosis is true? A. Recessive disorder affecting chloride transport B. Recessive disorder affecting alpha1-antitrypsin levels C. Dominant disorder inhibiting alveoli formation D. Dominant disorder increasing production of interleukin-5

A. Recessive disorder affecting chloride transport

A client with COPD has just been reclassified for disease severity from a GOLD 2 to a GOLD 3. Which client statement about changes in management or lifestyle indicate to the nurse that more teaching is needed to prevent harm? A. "This year I will get the pneumonia vaccination in addition to a flu shot." B. "Now I will try to rest as much as possible and avoid any unnecessary exercise." C. "Maybe drinking a supplement will help me retain weight and have more energy." D. "Perhaps using a spacer with my metered dose inhaler will make the drug work better."

B

A client newly diagnosed with stage I nonsmall cell lung cancer (NSCLC) who is getting ready for curative surgery asks the nurse whether the oncologist might consider this new drug he has seen on television, pembrolizumab, instead of surgery. What is the nurse's best response? A. "This drug will only work on those lung cancers that have the right target and your tumor does not have it." B. "This drug is approved for use in clients whose lung cancer has metastasized not for early-stage cancers." C. "Why would you want to take a drug for months when you may be cured by surgery alone?" D. "You need to talk about this with your oncologist and your surgeon."

B. "This drug is approved for use in clients whose lung cancer has metastasized not for early-stage cancers."

Which specific information will the nurse teach to the client with eosinophilic asthma newly prescribed benralizumab therapy? A. Avoid breathing into the inhaler or getting it wet. B. The drug can only be given by a health care professional. C. Do not chew, crush, or split the tablet containing this drug. D. The drug must be taken at bedtime because of the extreme drowsiness it causes.

B. the drug can only be given by a health care professional - injection to tx severe asthma

When performing a medication reconciliation for a newly admitted client before planned abdominal surgery, the nurse notes that the client is prescribed salmeterol and fluticasone daily for asthma control. What is the priority action for the nurse to take regarding this information to prevent harm? A. Record and display the information in a prominent place within the client's medical record. B. Ask the client how long the drugs have been prescribed and how well the asthma is controlled. C. Collaborate with the surgeon to arrange for continuation of this therapy in the perioperative period. D. Ensure that parenteral forms of these drugs are prescribed for use while the client remains NPO after surgery.

C. Collaborate with the surgeon to arrange for continuation of this therapy in the perioperative period.

A client with COPD has all of the following ABG changes from earlier today. Which change alerts the nurse to take immediate action to prevent harm? A. pH from 7.21 to 7.20 B. HCO3- remains the same at 31 mEq/L C. Paco2 from 45 mm Hg to 68 mm Hg D. Pao2 from 88 mm Hg to 86 mm Hg

C. Paco2 from 45 mm Hg to 68 mm Hg

Why are the terminal bronchioles more prone to collapse than are the other airways? Select all that apply. A. The cartilage is an incomplete C shape rather than a true ring. B. The mucous membrane lining contains minimal active cilia. C. Lung elastic recoil is the only force that keeps them patent. D. Their walls are too thick to permit gas exchange. E. They are surrounded by capillaries. F. The lumens have a small diameter. G. Their walls contain no cartilage.

CFG

The nurse teaching clients precautions to use with drug therapy for primary pulmonary arterial hypertension (PAH) instructs the female clients to use two reliable forms of contraception while taking which drugs? Select all that apply. A. ambrisentan B. bosentan C. epoprostenol D. iloprost E. macitentan F. riociguat G. selexipag H. sildenafil I. tadalafil J. treprostinil

DFG

Antibiotics that you need to avoid sun with AVOID "Fun The Sun"

Fluoroquinolones- levofloxacin Tetraclycine- doxyclycine Sulfa drugs- SUN burns Trimethoprim- sulfa methox azole (Bactrim) other medications that are not antibiotics but you have to avoid the sun: Sulfonylureas (Glyburide) Diuretics (thiazide/loops) key words: photosensitivity, avoid "direct sun exposure", sun burns (wear sun block and avoid sun)

Antibiotics for Super Bugs

Glycopeptides Class :Vancomycin Aminoglycosides Class: Tobramycin Gentamicin Neomycin

FEV1 (forced expiratory volume in 1 sec) records the maximum amount of air that can be exhaled in the first second of expiration...what is the purpose?

Is effort dependent and declines normally with age. It is reduced in certain obstructive and restrictive disorders

FVC (forced vital capacity) records the maximum amount of air that can be exhaled as quickly as possible after maximum inspiration...what is the purpose?

Indicates respiratory muscle strength and ventilatory reserve. Reduced in obstructive and restrictive diseases

which condition places a patient at risk for developing metabolic alkalosis?

blood transfusion, nasogastric suctioning, total parenteral nutrition

Antibiotics that need to be taken on empty stomach

MTF Macrolides-Azithromycin Tetracycline- doxycycline Fluoroquinolones- levofloxacin

#1 drug for CDIFF

Metronidazole -avoid alcohol during and 3 days after tx -dark urine -metallic taste -report rash

2. There is a narrow margin between the therapeutic and toxic levels of lithium carbonate. Symptoms of toxicity are most likely to appear when the serum levels exceed: a. 0.15 mEq/L b. 1.5 mEq/L c. 15.0 mEq/L d. 150 mEq/L

b. 1.5 mEq/L

Antibiotics that were SUPER Toxic (Kidney + Ears)

Vancomycin Gentamicin Neomycin Key points: PEAK & trough Too HIGH = Kidneys DIE Too Low = Infections Grows REPORT: Signs of toxicity EAR DAMAGE "Ototoxicity" -vertigo -tinnitus KIDNEY DAMAGE "Nephrotoxic" REPORT IMMEDIATELY! -creatinine OVER 1.3= Bad Kidney -BUN Over 20 -Urine output 30ml/hr or LESS (kidney distress)

which lab result would lead the nurse to implement neutropenic precautions when reviewing the health record for a patient who received chemotherapy 10 days ago?

WBC 2.6 cells/mm3

6. A client who is prescribed haloperidol is observed to be staring at the ceiling and says he cannot move his eyes. The nurse notices that he also appears to have muscle spasms in his legs and hands. What is the most appropriate action for the nurse to take at this point? a. Conduct an AIMS test. b. Administer prn benztropine (Cogentin). c. Withhold the next dose of antipsychotic medication. d. Contact the physician.

b. Administer prn benztropine (Cogentin).

10.Which of the following hormones has been implicated in the etiology of mood disorder with seasonal affective disorder? a. Increased levels of melatonin b. Decreased levels of oxytocin c. Decreased levels of prolactin d. Increased levels of thyrotropin

a. Increased levels of melatonin

4. Antipsychotic medications are thought to decrease psychotic symptoms by: a. Blocking reuptake of norepinephrine and serotonin b. Blocking the action of dopamine in the brain c. Inhibiting production of the enzyme MAO d. Depressing the CNS

b. Blocking the action of dopamine in the brain

11. Psychotropic medications may act at the neural synapse to accomplish which of the following? (Select all that apply.) a. Inhibit the reuptake of certain neurotransmitters, creating more availability b. Inhibit catabolic enzymes, promoting more availability of a neurotransmitter c. Block receptors, resulting in less neurotransmitter activity d. Add synthetic neurotransmitters found in the drug

a. Inhibit the reuptake of certain neurotransmitters, creating more availability b. Inhibit catabolic enzymes, promoting more availability of a neurotransmitter c. Block receptors, resulting in less neurotransmitter activity

10. Which of these actions by the nurse demonstrates an application of the QSEN competency related to informatics? a. Learns how to effectively communicate information using electronic health records b. Provides a verbal report of client behavioral issues at shift change c. Asks the supervisor for guidelines on how to prevent lawsuits d. Reads journals to learn information about new treatments and approaches to nursing care

a. Learns how to effectively communicate information using electronic health records

5. Part of the nurse's ongoing assessment of the client taking antipsychotic medications is to observe for extrapyramidal symptoms. Which of the following are examples of extrapyramidal symptoms? a. Muscular weakness, rigidity, tremors, facial spasms b. Dry mouth, blurred vision, urinary retention, orthostatic hypotension c. Amenorrhea, gynecomastia, retrograde ejaculation d. Elevated blood pressure, severe occipital headache, stiff neck

a. Muscular weakness, rigidity, tremors, facial spasms

6. Which of the following parts of the brain is concerned with hearing, short-term memory, and sense of smell? a. Temporal lobe b. Parietal lobe c. Cerebellum d. Hypothalamus

a. Temporal lobe

anti-inflammation

all of these drugs help improve bronchiolar airflow and increase gas exchange by decreasing the inflammatory response of the mucous membranes in the airways. they do not cause bronchodilation

which factor is associated with a cause of respiratory alkalosis?

anxiety

which information would the nurse include when teaching a patient who received 5-flurouracil for the treatment of colorectal cancer regarding ways to prevent mucositis?

apply topical anesthetics before meals, refrain from spicy/salty/acidic foods, perform oral hygiene

Fine crackles, fine rales, high-pitched rales are associated with what disorders

asbestosis atelectasis interstitial fibrosis bronchitis pneumonia chronic pulmonary diseases

which recommendation would the nurse make to a patient and family about the prevention of pneumonia?

avoid indoor pollutants eat a healthy, balanced diet avoid crowded areas during flu season and holidays

4. Which of the following statements by a client are examples of adaptive coping mechanisms? a. "I like to take the edge off by having a few drinks." b. "I need to pay more attention to my calorie intake because I gained 10 pounds in the last month." c. "When the stress gets to be too much, I feel better after I kick the dog." d. "I try to stay away from people because it's less stressful than arguing with everybody."

b. "I need to pay more attention to my calorie intake because I gained 10 pounds in the last month."

1. The nurse decides to go against family wishes and tell the client of his terminal status because that is what she would want if she were the client. Which of the following ethical theories is considered in this decision? a. Kantianism b. Christian ethics c. Natural law theories d. Ethical egoism

b. Christian ethics

6. A client regularly develops nausea and vomiting when she is faced with a stressful situation. Which of the following should be considered when attempting to identify predisposing factors associated with Cindy's response? (Select all that apply.) a. Identify what happened right before she had the most recent episode of nausea and vomiting. b. Consider genetic influences. c. Identify any existing physical conditions that might make the client more vulnerable to respond in this way. d. Explore past experiences that may have resulted in this becoming a learned response.

b. Consider genetic influences. c. Identify any existing physical conditions that might make the client more vulnerable to respond in this way. d. Explore past experiences that may have resulted in this becoming a learned response.

3. The nurse, who is an adult child of an alcoholic, is working with a client who abuses alcohol. The client has experienced a successful detoxification process and is beginning a rehabilitation program. He says to the nurse, "I'm not going to go to those stupid AA meetings. They don't help anything." The nurse, whose father died of complications from alcoholism, responds with anger: "Don't you even care what happens to your children?" The nurse's response is an example of which of the following? a. Transference b. Countertransference c. Self-disclosure d. A breach of professional boundaries

b. Countertransference

2. Which of the following tasks are associated with the orientation phase of relationship development? (Select all that apply.) a. Promoting the patient's insight and perception of reality b. Creating an environment for the establishment of trust and rapport c. Using the problem-solving model toward goal fulfillment d. Obtaining available information about the patient from various sources e. Formulating nursing diagnoses and setting goals

b. Creating an environment for the establishment of trust and rapport e. Formulating nursing diagnoses and setting goals

5. Anna has been grieving the death of Lucky for 3 years. She is unable to take care of her normal activities because she insists on visiting Lucky's grave daily. What is the most likely reason that Anna's daughter has put off seeking help for Anna? a. Women are less likely than men to seek help for emotional problems. b. Relatives often try to normalize behavior rather than label it mental illness. c. She knows that all older people are expected to be a little depressed. d. She is afraid that the neighbors will think her mother is "crazy."

b. Relatives often try to normalize behavior rather than label it mental illness.

9. A client with schizophrenia appears very watchful of others and tells the nurse, "There are infiltrators everywhere and I think they are trying to kill me." Which of these actions by the nurse would best promote development of trust with this client? a. Touch the client's shoulder and state, "I want you to feel safe here." b. State to the client, "I'm interested in hearing your thoughts. Would you like to talk more about this?" c. Ask the client, "Why would you think such a thing?" d. Tell the client, "It is an expectation that we will not talk about things that aren't real."

b. State to the client, "I'm interested in hearing your thoughts. Would you like to talk more about this?"

2. Why is stress management so important in one's overall health? a. Stress-related disorders strengthen the immune system. b. Sustained response to stress can increase vulnerability to a variety of diseases and maladaptive coping responses. c. Relaxation exercises are effective in preventing disorders such as depression and suicide. d. All of the above.

b. Sustained response to stress can increase vulnerability to a variety of diseases and maladaptive coping responses.

4. Which of the following parts of the brain integrates all sensory input (except smell) on the way to the cortex? a. Temporal lobe b. Thalamus c. Limbic system d. Hypothalamus

b. Thalamus

Which assessment finding would the nurse expect when caring for a patient with spinal cord compression?

back pain incontinence muscle weakness decreased sensation absent deep tendon reflexes

anosognosia

being unaware of any psychological problems

monoclonal antibodies

bind to and block the actions of proinflammatory cytokines (interleukin 5) or cell surface sites of IgE that trigger and maintain asthma attacks

which medication may be used to treat hypercalcemia temporarily in a patient who has cancer?

bisphosphonate

leukotriene modifer

blocks the leukotriene receptor, preventing the inflammatory mediator from stimulating inflammation. Purpose is to prevent asthma triggered by inflammation or allergens

which method of radiation treatment delivery uses radioactive isotopes either in solid form or within body fluids?

brachytherapy

Coarse crackles, low-pitched crackles are associated with what disorders

bronchitis pneumonia tumors pulmonary edema

3. The nurse decides to tell the client of his terminal status because she believes it is her duty to do so. Which of the following ethical theories is considered in this decision? a. Natural law theories b. Ethical egoism c. Kantianism d. Utilitarianism

c. Kantianism

5. Which of the following parts of the brain deals with sensory perception and interpretation? a. Hypothalamus b. Cerebellum c. Parietal lobe d. Hippocampus

c. Parietal lobe

3. Initial symptoms of lithium toxicity include: a. Constipation, dry mouth b. Dizziness, thirst c. Vomiting, diarrhea d. Anuria, arrhythmias

c. Vomiting, diarrhea

Radiation

can be an effective treatment for locally advanced lung cancers confined to the chest. Best results are seen when radiation is used in addition to surgery or chemotherapy. Radiation may be performed before surgery to shrink the tumor and make resection easier.

which therapy is effective in returning antidiuretic hormone production to normal levels in a patient with melanoma?

cancer therapy with radiation

cholinergic antagonist

causes bronchodilation by inhibiting the parasympathetic nervous system, allowing the sympathetic system to dominate, releasing norepinephrine that activates beta receptors. Purpose is to prevent asthma attacks or COPD bronchospasms and improve gas exchange, although some are considered reliever drugs

long-acting beta agonist (LABA)

causes bronchodilation through relaxing bronchiolar smooth muscle by binding to and activating pulmonary beta receptors. Onset of action is slow with a long duration. Primary use is prevention of an asthma attack

which finding is the most common indicator for pneumonia in an older patient?

confusion

which assessment finding suggests a patient has acidosis?

confusion, warm/flushed/dry skin

7. Which of the following parts of the brain has control over the pituitary gland and autonomic nervous system, as well as regulation of appetite and temperature? a. Temporal lobe b. Parietal lobe c. Cerebellum d. Hypothalamus

d. Hypothalamus

Which of the following parts of the brain is associated with multiple feelings and behaviors and is sometimes referred to as the "emotional brain"? a. Frontal lobe b. Thalamus c. Hypothalamus d. Limbic system

d. Limbic system

6. Lucky's accident occurred when he got away from Anna while they were taking a walk. He ran into the street and was hit by a car. Anna cannot remember the circumstances of his death. This is an example of what defense mechanism? a. Rationalization b. Suppression c. Denial d. Repression

d. Repression

corticosteroids

disrupt production pathways of inflammatory mediators the main purpose is to prevent an asthma attack caused by inflammation or allergies (controller drug)

which manifestation may occur if superior vena cava syndrome is left untreated?

engorged blood vessels erythema of the upper body edema in the arms and hands

which occurrence is an early manifestation of superior vena cava syndrome in a patient with cancer?

facial edema

which clinical manifestation is usually present when an older adult has pneumonia?

fatigue, weakness, confusion and poor appetite

Hemoglobin, total

females: 12-16 g/dl males: 14-18 g/dl elevated levels are often related to the excessive production of erythopoietin in response to a chronic hypoxic state, as in COPD and from living at high altitude decreased levels indicate possible anemia, hemorrhage or hemolysis

Hematocrit

females: 37-47% males: 42-52% elevated levels are often related to the excessive production of erythopoietin in response to a chronic hypoxic state, as in COPD and from living at high altitude decreased levels indicate possible anemia, hemorrhage or hemolysis

Red blood cells

females: 4.2-5.4x 10^6 mcl males: 4.7-6.1 x 10^6 mcl elevated levels are often related to the excessive production of erythopoietin in response to a chronic hypoxic state, as in COPD and from living at high altitude decreased levels indicate possible anemia, hemorrhage or hemolysis

which symptom of pneumonia may present differently in the older adult than in the younger adult?

fever

which factor is a pathophysiologic basis for the clinical manifestation of pneumonia?

fluid accumulation in the receptors of the respiratory system triggers the coughing mechanism pulmonary capillary shunting leads to hypoxemia stimulation of chemoreceptors and decreased lung compliance lead to an increased respiratory rate and dyspnea

which complications may occur due to bone metastasis?

fractures, hypercalcemia, spinal cord compression

A patient has developed hypercalcemia secondary to cancer. Which drug would the nurse expect to administer to increase urine excretion of calcium?

furosemide

which body tissue cell has the capacity of dividing throughout one's life span?

hair, uterus, bone marrow, stomach

which arterial blood gas laboratory values would be seen in metabolic alkalosis?

high pH and bicarbonate 32

A patient received chemotherapy 2 weeks ago and presents with possible septic shock. Which finding in the health record would support this diagnosis?

high temperature and low white blood cell count

which electrolyte abnormality would the nurse anticipate when reviewing laboratory data for a patient admitted with metabolic acidosis?

hyperkalemia

A patient admitted with diabetic ketoacidosis was treated for metabolic acidosis with IV fluids and insulin. Which electrolyte imbalance would the nurse monitor for as the acid-base imbalance resolves?

hypokalemia

Aclidinium (inhaled drug for prevention only) Ipratropium (inhaled drug for relief and prevention) Tiotropium (inhaled drug) Umeclidinium (inhaled drug for prevention only)

if patient is to use any of these as a reliever drug, teach him or carry it at all times because it can stop or reduce life-threatening bronchoconstriction for drugs delievered by MDI, teach patient to shae the inahler well before using because the drugs separate easily teach patient to increase daily fluid intake because the drugs cause mouth dryness teach patient to observe for and report blurred vision, eye pain, headache, nausea, palpitations, tremors and inability to sleep as these are systemic symptoms of overdose and require intervention teach patient the correct technique for using the MDI or DPI to ensure that the drug reaches the site of action

FRC (functional residual capacity) is the amount of air remaining in the lungs after normal expiration. FRC test requires use of the helium dilution, nitrogen washout, or body plethysmography technique.

increased FRC indicates hyperinflation or air trapping, often from obstructive pulmonary disease. FRC is normal or decreased in restrictive pulmonary diseases

TLC (total lung capacity) is the amount of air in the lungs at the end of maximum inhalation..

increased TLC indicates air trapping from obstructive pulmonary disease. Decreased TLC indicates restrictive disease.

which expected outcome for a patient with pneumonia would be supported by the use of incentive spirometry?

increased inspiratory muscle action and decreased atelectasis

which disease-related consequence will contribute to sensory and motor deficits in a patient who is receiving cancer treatment?

increased risk for peripheral neuropathy

which mechanism in the body compensates for a low pH?

increases respiratory rate

FEV1/FVC is the ratio of expiratory volume in 1 sec to FVC...what is the purpose?

indicates obstruction to airflow. this ratio is the hallmark of obstructive pulmonary disease . it is normal or increased in restrictive disease

bronchodilators

induce rapid bronchodilation through relaxing bronchiolar smooth muscle by binding to and activating pulmonary beta receptors

Wheezes are associated with what disorders

inflammation bronchospasm edema secretions pulmonary vessel engorgement

Chemotherapy

is often the treatment of choice for lung cancers, especially small cell lung cancer (SCLC). It may be used alone or as adjuvant (add-on) therapy in combination with surgery for non-small cell lung cancer (NSCLC). The combination of drugs used depends on tumor response and the overall health of the patient; however, most include platinum-based agents.

D (diffusion capacity of the lung for carbon monoxide) reflects the surface area of the alveolocapillary membrane. The patient inhales a small amount of CO, holds for 10 sec, and then exhales. The amount inhaled is compared with the amount exhaled

is reduced whenever the alveolocapillary membrane is diminshed (emphysema, pulmonary hypertension, and pulmonary fibrosis). It is increased with exercise and in conditions such as polycythemia and heart disease

which sign or symptom would the nurse anticipate in a patient diagnosed with tuberculosis?

lethargy, night sweats, low-grade fever

which type of cancer has been associated with Down syndrome?

leukemia

which organ(s) plays a major role in maintaining pH balance in the body?

lungs and kidneys

When patient seeks holistic tx for cancer....

make sure you respect wishes but advise pt to use viable sources

which drug reduces the severity of infection and mortality rate during a pandemic flu?

zanamivir oseltamivir

when evaluating the lab results of a patient with diabetic ketoacidosis, which lab value indicates the body has fully compensated from this acid-base imbalance?

normal pH on arterial blood gases

Interleukin antagonists: Benralizumab (subcut injection) mepolizumab (subcut injection) reslizumab (slow IV infusion only)

only for use in patients who have eosinophilic asthma because these drugs clock the actions of interleukin-5 which activates eosinophils and increase their numbers do not administer these drugs as a reliever drug because they do not relieve acute symptoms monitor patient for at least 2 hours after injection for indications of severe hypersensitivity and anaphylaxis because these drugs contain a foreign protein that has an increased risk for severe allergic reactions

which action from the "ventilator bundle" has been shown to reduce the incidence of ventilator-associated pneumonia?

oral care hand hygiene head-of-bed elevation

which feature does a benign tumor cell have?

orderly growth patterns, grow by hyperplastic expansion, encapsulated by fibrous connective tissue

which group is at greatest risk for drug-resistant Streptococcus pneumoniae?

over 65 yrs people who have not received an influenza vaccine adults with a chronic health condition requiring steroids

which patient should receive education about pneumococcal vaccine?

over 65 yrs old HIV positive Alcoholism Chronic lung disease

Which mechanism causes acidosis in a patient in diabetic ketoacidosis?

overproduction of hydrogen ions

which mechanism causes acidosis in a patient in diabetic ketoacidosis?

overproduction of hydrogen ions

Antibiotics that are safe for pregnant patients

pencillin and cephalosporins

Pleural friction rub is associated with what disorders

pleurisy tuberculosis pulmonary infarction pneumonia lung cancer

which component is released into the bloodstream after the destruction of tumor cells?

potassium

Actions the nurse who instruct the assistive personnel (AP) to perform for a patient placed on neutropenic precautions because of chemotherapy?

provide good handwashing, obtain vital signs every 4 hours, notify the nurse of skin breakdown, avoid serving fresh fruits and vegetables and assist with daily bathing and hygiene

which acid-base imbalance would the nurse anticipate that a patient with morbid obesity may develop?

respiratory acidosis

after a motor vehicle crash, the nurse is consoling a patient in the ER who is hysterical and hyperventilating after being notified of the death of a family member. Which acid-base imbalance is this patient likely to develop?

respiratory alkalosis

repression

retreating in response to stress to an earlier level of development and the comfort measures associated with that level of functioning

which upper respiratory condition is often triggered by a hypersensitivity reaction to airborne allergens?

rhinitis

cor pulmonale

right-sided heart failure caused by pulmonary disease occurring with bronchitis or emphysema

which class of medications treats chemotherapy-induced nausea and vomiting?

serotonin antagonists

to which other site does prostate cancer commonly metastasize?

spine

Cromome

stabilizes the membranes of mast cells and prevents the release of inflammatory mediators. Purpose is to prevent asthma attack triggered by inflammation or allergens

Prednisone (oral drug)

teach patient about expected side effects because knowing which side effects to expect may reduce anxiety when they appear teach patient to avoid anyone who has an upper respiratory infection because the drug reduces all protective inflammatory responses, increasing the risk for infection teach patient to avoid activities that lead to injury because blood vessels become more fragile, leading to bruising and petechiae teach patient to take drug with food to help reduce the side effect of GI ulceration teach patient not to suddenly stop taking the drug for any reason because the drug suppresses adrenal production of corticosteroids, which are essential for life

Salmeterol (inhaled drug) Indacaterol (COPD only) (inhaled drug) Formoterol Arformoterol (COPD only)

teach patient to not use these drugs as reliever drugs because they have a slow onset of action and do not relieve acute symptoms teach patient the correct technique for using the MDI or DPI to ensure that the drug reaches the site of action

Fluticasone (MDI inhaled drug) Beclomethasone (MDI inhaled drug) Budesonide (MDI inhaled drug)

teach patient to use the drug daily, even when no symptoms are present, because maximum effectiveness requires continued use for 48-72 hours and depends on regular use teach patient to use good mouth care and to check mouth daily for lesions or drainage because these drugs reduce local immunity and increase the risk for local infections, especially Candida albicans (yeast) teach patient to not use these drugs as reliever drugs because they have a slow onset of action and do not relieve acute symptoms teach patient the correct technique for using the MDI to ensure that the drug reaches the site of action

montelukast (oral drug)

teach patient to use the drug daily, even when no symptoms are present, because maximum effectiveness requires continued use for 48-72 hrs and depends on regular use teach patient not to decrease the dose of or stop taking any other asthma drugs unless instructed by the health care professional because this drug is for long-term asthma control and does not replace other drugs, especially corticosteriods and reliever (rescue) drugs

Nedocromil (inhaled drug)

teach patient to use the drug daily, even when no symptoms are present, because maximum effectiveness requires continued use for 48-72 hrs and depends on regular use teach patient to not use this drug as a reliever drug because it has a slow onsent of action and does not relieve acute symptoms teach patient the correct technique for using the MDI to ensure that the drug reaches the site of action

albuterol (inhaled drug) levalbuterol (inhaled drug)

teach patients to carry drug with them at all times because it can stop or reduce life-threatening bronchoconstriction teach patient to monitor heart rate because excessive use causes tachycardia and other systemic symptoms when taking any of these drugs with other inhaled drugs, teach patient to use them at least 5 minutes before the other inhaled drugs to allow the bronchodilation effect to increase the penetration of other inhaled drugs teach patient the correct technique for using the MDI or DPI to ensure that the drug reaches the site of action

suppression

the voluntary blocking of unpleasant feelings and experiences from one's awareness

The nurse recognizes that patients with cancer are at an increased risk for infection for which reason?

they have a decreased production of white blood cells (WBCs)

Rhonchus (rhonchi) is associated with what disorders

thick, tenacious secretions sputum production obstruction by foreign body tumors

FEF records the forced expiratory flow over the 25%-75% volume (middle half) of the FVC

this measure provides a more sensitive index of obstruction in the smaller airways

which disorder is indicated in a patient with cancer with a platelet level of 35,000/ml?

thrombocytopenia

IgE antagonist: Omalizumab (subcut injection)

used only for patients who have a known allergy that triggers asthma attacks because the drug works by antagonizing IgE monitor patient for at least 2 hours after injection for indications of severe hypersensitivity and anaphylaxis because the drug contains a foreign protein that has an increased risk for severe allergic reactions do not administer this drug as a reliever drug because it does not relieve acute symptoms

which nursing intervention is focused on preventing the spread of severe acute respiratory syndrome (SARS)?

using strict airborne isolation techniques handwashing before and after all patient care disinfecting contaminated surfaces and equipment using contact precautions with people suspected to have SARS

Which drug is used in the treatment of superior vena cava syndrome because of a tunneled central venous catheter?

warfarin

which information would the nurse provide to prevent skin damage to the scalp for a patient who presents with chemotherapy-induced alopecia?

wear a hat and use sunscreen

Warning Signals Associated with Lung Cancer

• Hoarseness • Change in respiratory pattern • Persistent cough or change in cough • Blood-streaked sputum • Rust-colored or purulent sputum • Frank hemoptysis • Chest pain or chest tightness • Shoulder, arm, or chest wall pain • Recurring episodes of pleural effusion, pneumonia, or bronchitis • Dyspnea • Fever associated with one or two other signs • Wheezing • Weight loss • Clubbing of the fingers