Test1 cf and rn

While caring for a patient with cystic fibrosis, the nurse suspects that the patient has acquired an infection. Which laboratory finding supports the nurse's suspicion?

11,000 white blood cells per microliter Cystic fibrosis is a genetic disorder that lethally impairs lung function. Cystic fibrosis associated with infection results in an elevated white blood cell count. The normal range of white blood cells is 4500 to 10,000 per microliter. Therefore, 11,000 white blood cells per microliter indicates infection in the patient. White blood cell counts of 5000, 7000, and 9000 per microliter are within the normal range.

While assessing and reviewing the laboratory reports of a patient with cystic fibrosis, the nurse suspects that the disease has progressed to the end stage. Which findings support the nurse's suspicion? Select all that apply.

Acidosis, Severe dyspnea, Increased crackles Cystic fibrosis is a genetic disease which lethally impairs lung function. When the disease has progressed to the end stage, the arterial blood gas studies will show acidosis. Chest congestion will be increased because of mucus in the respiratory tract, which may result in severe dyspnea. Increased crackles are observed during the end stage of the disease. Arterial blood gas studies show increased bicarbonate levels and increased arterial carbon dioxide.

The occupational nurse is discussing a recent influenza outbreak with employees. Which medications are given to prevent influenza in individuals if they are exposed to someone with influenza? Select all that apply.

Amantadine, Rimantadine Amantadine and rimantadine are both used for prevention of influenza for those individuals who have been exposed to influenza. Ribavirin is used for the treatment of severe influenza B. Zanamivir and oseltamivir are used to shorten the duration of both influenza A and B.

A patient with cystic fibrosis is admitted to the emergency department because of severe exacerbations. Which drug therapies does the nurse expect will be beneficial for this patient? Select all that apply.

Colistin, Tobramycin, Meropenem Intravenous administration of antibiotics is preferred during severe exacerbations of cystic fibrosis. Aminoglycosides such as colistin and tobramycin are effective in the treatment of severe exacerbation because they effectively penetrate the sputum of patients. Meropenem is an ultra-broad spectrum injectable antibiotic used to treat a wide variety of infections and is therefore used in cystic fibrosis to treat severe exacerbation. Budesonide and beclometasone are steroids that are used in the management of cystic fibrosis.

A patient who has frequent respiratory infections and chronic chest congestion has a sweat chloride level of 85 mEq/L. The nurse suspects this laboratory value indicates which disease process?

Cystic fibrosis A sweat chloride level between 60 and 200 mEq/L is positive for cystic fibrosis (CF) because the defect in chloride movement that is characteristic of CF prevents absorption of sodium chloride in the sweat glands and increased chloride in a patient's sweat. This does not occur with asthma, bronchitis, or emphysema.

What education will be provided for the family of a patient being treated for tuberculosis convalescing at home?

Everyone must undergo tuberculosis testing. The family members living with a patient diagnosed with tuberculosis will have to undergo testing. Airborne precautions are unnecessary because the family members have already been exposed to the TB. The patient should be instructed to place used tissues in a plastic bag, and cover mouth and nose when sneezing, but this instruction is not specific to family members.

Which non-pulmonary manifestation of cystic fibrosis is commonly seen in this patient population?

Excessive Fat in Stools Cystic fibrosis causes steatorrhea, a non-pulmonary manifestation which is characterized by excessive fat in the stools resulting from malabsorption and malnourishment. Vitamin deficiencies, not vitamin toxicities, also contribute to this. A patient with cystic fibrosis is thin, not overweight, as a result of malabsorption. Pancreatic function is decreased in cystic fibrosis patients resulting in diabetes mellitus; therefore insulin production is decreased.

What should the nurse include in the plan of care for a patient with tuberculosis? Select all that apply.

Institute airborne precautions, Wear an N-95 mask when in the room, Assign the patient to a negative airflow room Tuberculosis is transmitted through the air, so the nurse should institute airborne precautions. The nurse should also wear an N-95 mask to prevent exposure to the tuberculosis bacterium. In addition, the nurse should assign the patient to a negative airflow room to prevent the bacteria from leaving the room. The nurse does not need to institute droplet precautions as these are for patients with pertussis and mumps. Oral metronidazole and vancomycin is administered for the treatment of clostridium difficile (C. difficile).

A patient who has been homeless and has spent the past 6 months living in shelters has been diagnosed with confirmed tuberculosis (TB). Which medications does the nurse expect to be ordered for the patient?

Isoniazid, rifampin, pyrazinamide (PZA), ethambutol The combination of isoniazid, rifampin, pyrazinamide, and ethambutol is used to treat tuberculosis. Metronidazole is used to treat anaerobic bacteria and some parasites but is not effective against tuberculosis. Acyclovir is used to treat viral infection. Flunisolide is a corticosteroid that is useful in asthma or other airway diseases to prevent wheezing. Prednisone is a steroid. Guaifenesin is a mucolytic. Ketorolac is an NSAID that is used for short-term pain relief. Salmeterol and cromolyn sodium would most likely be given to patients with respiratory difficulties such as poorly controlled asthma from allergic sources. Dexamethasone is a steroid.

What signs and symptoms does the nurse anticipate to find in a patient diagnosed with tuberculosis? Select all that apply.

Lethargy, Night sweats, Low-grade fever Expected assessment findings in a patient diagnosed with tuberculosis include lethargy, night sweats, and a low-grade fever. Dyspnea does not occur with tuberculosis. Weight loss and anorexia occur in patients with tuberculosis.

Which statement is true about surgical procedures for a patient with cystic fibrosis?

Patients remain in the intensive care unit for a few days after transplantation. Patients remain in the intensive care unit for several days after transplantation to monitor for any symptoms of transplant rejection. Patients having a double-lung transplant need a bypass. Patients having a single-lung transplant do not need a bypass because the single lung can deliver the oxygen. Patients undergoing a lung transplant will receive tissue from both a live donor and a cadaver.

A patient with suspected initial infection of tuberculosis (TB) is admitted to the respiratory intensive care unit (ICU). The nurse caring for the patient reviews the patient's recent chest x-ray. Where on the patient's chest x-ray will the nurse most likely find evidence of the patient's infection? Select all that apply.

Right middle lobe, Right lower lobe, Left lower lobe Initial infection of tuberculosis (TB) is most often seen in the middle or lower lobes of the lung. The upper lobes of the lung are not the primary location of initial infection of TB.

Which diagnostic tests aid in the diagnosis of cystic fibrosis? Select all that apply.

Stool for fat, Sweat chloride analysis Sweat chloride analysis assesses for elevated chloride levels in the sweat. Levels of 60 to 200 mEq are diagnostic of cystic fibrosis (CF). Steatorrhea or excessive fat in the stool is also present in CF since the pancreatic enzymes necessary for digestion are blocked due to the thick secretions produced. A bronchoscopy is usually done following a diagnosis of CF to look for any signs of infection. An intestinal mucosa biopsy will not aid in diagnosing CF because while the pathology affects the gastrointestinal tract, it does not cause the disease. Duodenal fluid, not stool, should be tested for decreased or absence of trypsin.

A patient with pulmonary tuberculosis is being started on combination therapy. What does the nurse explain to the patient as the purpose of combination therapy?

To shorten therapy by 6 months Combination medication shortens therapy by 6 to 12 months. Tuberculosis medications should be taken as ordered without missing a dose. Combination therapy is not related to disease resistance. Medications may be changed based upon the patient's ability to tolerate drugs.