test 3 med s prep u 2

NURSING CARE OF THE PATIENT WITH PNEUMONIA Goals and interventions address:

Improved airway patency Conserving energy Maintenance of proper fluid volume Maintenance of adequate nutrition Understanding of treatment and preventive measures Absence of complications

ATELECTASIS

Patho Risk Factors Manifestations Management: Incentive Spirometry & Chest PT

PNEUMONIA

Pathophysiology Types: -Community-acquired pneumonia -Hospital-acquired pneumonia -Ventilator-associated pneumonia Risk factors Manifestations and assessment

MEDICAL AND NURSING MANAGEMENT OF PNEUMONIA

-Antibiotic therapy -Supportive care -Prevention

The goal for oxygen therapy in COPD is to support tissue oxygenation, decrease the work of the cardiopulmonary system, and maintain the resting partial arterial pressure of oxygen (PaO2) of at least ______ mm Hg and an arterial oxygen saturation (SaO2) of at least ___%.

60 mm Hg; 90%

bronchiectasis

A condition in which the lungs' airways become damaged, making it hard to clear mucus. hronic condition where the walls of the bronchi are thickened from inflammation and infection. People with bronchiectasis have periodic flare-ups of breathing difficulties, called exacerbations

Which is the strongest predisposing factor for asthma?

Allergy

A public health nurse works with numerous patients who live with chronic obstructive pulmonary disease (COPD) in the community and has seen firsthand the effects of many of the risk factors underlying the disease. Which of the following public health initiatives addresses the most salient risk factor for COPD?

An anti-smoking campaign in a junior high school

The nurse should be alert for a complication of bronchiectasis that results from a combination of retained secretions and obstruction that leads to the collapse of alveoli. This complication is known as

Atelectasis

Which statement is true about both lung transplant and bullectomy?

Both procedures improve the overall quality of life of a client with COPD.

chronic obstructive bronchitis he nurse who is providing care for this patient will understand that the effects of the disease are primarily attributable to:

Chronic mucus hypersecretion

Upon assessment, the nurse suspects that a client with COPD may have bronchospasm. What manifestations validate the nurse's concern? Select all that apply.

Compromised gas exchange Decreased airflow Wheezes

The nurse is caring for a 24-year-old patient with an antitrypsin deficiency who states that she has never smoked in her life. An antitrypsin deficiency predisposes the patient to what?

Emphysema

A nurse consulting with a nutrition specialist knows it's important to consider a special diet for a client with chronic obstructive pulmonary disease (COPD). Which diet is appropriate for this client?

High-protein

A nursing student understands the importance of the psychosocial aspects of disease processes. When working with a patient with COPD, the student would rank which of the following nursing diagnoses as the MOST important when analyzing the psychosocial effects?

Ineffective coping related to anxiety

A client has a history of chronic obstructive pulmonary disease (COPD). Following a coughing episode, the client reports sudden and unrelieved shortness of breath. Which of the following is the most important for the nurse to assess?

Lung sounds

ADMINISTERING OXYGEN BY NASAL CANNULA

Most commonly used oxygen delivery device Disposable device with two protruding prongs inserted into the nostrils Connects to an oxygen source with a flowmeter and many times a humidifier Delivers from 1 L per minute to 6 L per minute of oxygen Does not impede eating or speaking; easily used at home Can be easily dislodged and cause dryness of the nasal mucosa

TRACHEOSTOMY

Nurse is responsible for cleaning a non-disposable inner cannula or replacing a disposable one. Tracheostomy dressing must be changed regularly to prevent skin breakdown and infection. A newly inserted tracheostomy may require attention every 1 to 2 hours. Meticulous care using aseptic technique is necessary.

A client is being seen in the emergency department for exacerbation of chronic obstructive pulmonary disease (COPD). The first action of the nurse is to administer which of the following prescribed treatments?

Oxygen through nasal cannula at 2 L/minute

Which terms means an increase in the red blood cell concentration in the blood?

Polycythemia

The nurse is educating a patient with asthma about preventative measures to avoid having an asthma attack. What does the nurse inform the patient is a priority intervention to prevent an asthma attack?

Preparing a written action plan

A patient is being treated for status asthmaticus. What danger sign does the nurse observe that can indicate impending respiratory failure?

Respiratory acidosis

A pneumothorax is a possible complication of COPD. Symptoms will depend on the suddenness of the attack and the size of the air leak. The most common, immediate symptom that should be assessed is:

Sharp, stabbing chest pain

A patient comes to the clinic for the third time in 2 months with chronic bronchitis. What clinical symptoms does the nurse anticipate assessing for this patient?

Sputum and a productive cough

The nurse is instructing the patient with asthma in the use of a newly prescribed leukotriene receptor antagonist. What should the nurse be sure to include in the education?

The patient should take the medication an hour before meals or 2 hours after a meal.

The nurse is caring for a patient with chronic obstructive pulmonary disease (COPD) and is now performing discharge teaching with this patient. What should the nurse include in the teaching about breathing techniques?

Use diaphragmatic breathing.

A cient with cystic fibrosis is admitted to the hospital with pneumonia. When should the nurse administer the pancreatic enzymes that the client has been prescribed?

With meals

primary symptom of COPD?

cough, sputum production, and dyspnea upon exertion. Weight loss is common with COPD.

A nurse is assisting with a subclavian vein central line insertion when the client's oxygen saturation drops rapidly. He complains of shortness of breath and becomes tachypneic. The nurse suspects the client has developed a pneumothorax. Further assessment findings supporting the presence of a pneumothorax include:

diminished or absent breath sounds on the affected side.

The classification of grade I COPD is defined as

mild

Grade II is

moderate COPD

Grade III is

severe COPD

Grade IV is

very severe COPD