...characterized by airway inflammation that is triggered by allergens or irritants. Although the cause is unknown, it appears to be the result of Innate immunity, genetics, and environmental factors.
Asthma
asthma signs and symptoms
coughing, wheezing, tachycardia, hypoxia,tachycardia, tachypnea, reactive airway disease.
severe , persistent bronchospasm is called------. which if not treated it can lead to right side heart failure, pneumothorax, worsening hypoxemia, acidosis and cardiac arrest.
status asthmaticus
...a type of medications that is used to relieve nasal congestion.
...reduce swelling of mucous membranes.Used to treat nasal discharge, common cold.
Ex. Sudafed.
decongestant
...suppresses cough reflex, controls non productive cough or cough
That interferes with rest or wound healing.
Ex: Codeine, dextromethorphan.
Antitussive
...Block allergic response, dry respiratory secretions, prevent motion sickness.
Also has sedative effects.
Ex. Benadryl (diphenhydramine)
Antihistamine
...thin secretions for easier exploitation.
Ex. Robitussin/Guaifenesin
Expectorants
...kill or inhibit the growth of bacteria,viruses or fungi.
Ex: Aminoglycosides, tetracyclines, erythromycin.
Antimicrobial agent
...they are used to treat airway obstruction from respiratory
Disorders such as asthma and COPD.
Bronchodilators
...relax smooth muscles in the bronchial tree to relieve
Bronchial constriction.
Bronchodilators
...important in the treatment of asthma because they reduce
Inflammation and edema in the respiratory tract.
Side effects: HYPERGLYCEMIA and REDUCED RESISTANCE
TO INFECTION.
Ex. Solumedrol, Prednisone
corticosteroids
...are anti inflammatory drugs that may be administered orally,
Parenterally and by
corticosteroids
...reduce the viscosity thickness) and elasticity of mucus.
Ex. Mucomyst
mucolytics
....infection that usually begin in nasal passage and is caused by bacteria or virus and occasionally fungus.
sinusitis
serious neurologic complications should be suspected with sinusitis if the patient develops what?
high fever and seizures
which are the common problem the nurse monitors in a patient who has had nasal surgery?
dyspnea, pain, anxiety
what is the major problem for a patient following a nasal surgery?
hemorrhage
drug used to treat allergic rhinitis and are primarily intranasal corticosteroids
antihistamine
drug that help relieve(but not cure) rhinitis
decongestant
why is heparin used in the treatment of pulmonary emboli?
prevent more emboli from forming, blocks extension of existing emboli
which is a symptom of hypoxemia
low hemoglobin
----foreign body in the bloodstream when travel to the heart and id forced into the pulmonary artery.
pulmonary emboli
--- is An invasive procedure, a STERILE procedure Directly visualize the trachea, bronchi and bronchioles, use to diagnose Or to treats disorders of the respiratory system.
BRONCHOSCOPY
which are goals of medical treatment for COPD? select all that applies?
1. attain symptom relief
2.slow disease progression
3.improve exercise tolerance
4.prevent and treat complications
5.radiotherapy and chemotherapy treatment
1,2,3,4
in the treatment of copd, the initial flow of oxygen is usually 1-3 liters/min. why are high levels of oxygen not administered to copd patient?
because patient may rely on hypoxic drive to breath.
which conditions most frequently occur in conjunction with COPD? select all that applies?
1.asthma
2.right-side heart failure
3.pneumonia
4.chronic bronchitis
5.emphysema
chronic bronchitis, emphysema
explain why the red blood cell count is typically elevated in patients with chronic hypoxemia?
to compensate for inadequate paO2
drugs that are prescribed to decrease airway resistance and the work of breathing for the patient with COPD is called?
bronchodilators
what is the recommended daily fluid intake to help thin secretions in a patient with inadequate oxygenation
2500-3000 ml
the most common preventive drug therapy for tuberculosis is:
isoniazid
which problem develops when status asthmaticus is not treated? select all that apply.
1.pneumothorax
2.acidosis
3.right-side heart failure
4. renal failure
5.liver failure
1,2,3
following a laryngectomy, patient take nothing by the mouth until:
the gag reflex returns
are of the patient with a laryngectomy include:
...
radical neck dissection
...
suctioning
...
tracheostomy
...
Pneumonia signs & symptoms include:
Sputum production, Hemoptysis, dyspnea headache and fatigue
in the immediate postoperative period after total laryngectomy, the nurse's assessment focuses on what?
circulation,comfort, oxygenation
the nurse is taking care of a pt who has had a laryngectomy. the nurse monitors the need for suctioning by observing what?
increase pulse, restlessness, audible or visible mucus
the nurse is taking care of a pt who has had a laryngectomy. which factors affect the respiration status of this patient?
humidification, positioning, fluid intake
antibiotic treatment for pneumonia include
Macrolide: Zithromax/azithromycin, Biaxin/clarithromycin
treatment for pneumonia usually consist of:
increase fluid intake,bed rest,antipyretics and analgesics
commonly known as hay fever classified as intermittent(seasonal) or persistent(perennial)?
allergic rhinitis
Difference between acute and chronic bronchitis
Most cases of acute bronchitis clear up in a few days with no long-lasting problems. Chronic bronchitis is a serious, ongoing condition and pair up with emphysema.
describe as a condition marked by progressive, largely irreversible airflow obstruction that can not be explain by any other diagnosis such as asthma.
COPD
An umbrella term used to describe pulmonary disorders affecting reduced expiratory airflow. (inspiratory may also be affected)
COPD
sign and symptoms of copd include:
exertional dyspnea (cough, wheezing sob), infection and inflammation, anorexia, productive cough, barrel chest.
treatment for copd may include drug therapy such as:
bronchodilators including beta-adrenergic and anticholinergic. Corticosteroids - Oral and Inhaled
COPD O2 Administration
o2 may be prescribe but must be use cautiously. Oxygen Therapy - Low flow rate:
TB high risk groups are:
homeless, HIV infected or immunosuppressed individuals, iv drug users, alcoholics, elderly, living with high risk people, African Americans, infants and children
------ is a tb med (with INH), causes body fluid to become orange.
Side effects - more toxic, expensive, hypersensitivity reactions,
Leukopenia, thrombocytopenia, hepatitis.
RIFAMPICIN
first tb medication develop is -------. also damage to 8th cranial nerve ( vertigo and deafness)
Streptomycin
post op care for Lobectomy
deep breathing exercises and coughing methods to help lungs re-expand after surgery, may need oxygen after surgery
---Inflammation of the pleura
S/S: pain on one side of the chest
Pleurisy
types of Penetrating chest wounds:
gunshots, stabbing, crashing injuries, explosive, accident
causes of pleurisy
pneumonia, tb, glucose, pulmonary impart, chest trauma and malignancy
...decreased 02 in the blood
hypoxemia
rapid breathing
tachypnea
-----is the removal of an entire lobe or lung. the remaining lung will over expand to fill the space.
Lobectomy
fracture of two or more adjacent ribs. loose segment of the chest wall become paradoxical to the expansion and contraction on the rest of the chest wall.
flail chest
...is the surgical opening of the chest wall.
thoracotomy
excessive acidity of body fluids
acidosis
if necessary, how is accumulated fluid removed from a patient with pleurisy?
thoracentesis
------ is an Insertion of a large born needle through the chest wall into the pleural space to remove the accumulated fluid.
thoracentesis
---- is air in the pleural cavity that causes the lung on the affected side to collapse.
S/S: asymmetric chest wall movement and anxiety
Pneumothorax
--- is Removal of an entire lung to decrease the size of the space on the affected side, the Surgeon will sever the phrenic nerve and diaphragm on The side. The area is paralyzed in the elevated position. (Ribs May be removed).
pneumonectomy
Removal of a small area of a disease tissue of diseased tissue, triangular section of the lung
Wedge Resection
----Is an extensive dissection and removal of a section of the lung, one or more lung segments such as the bronchiole and
And its alveoli. The remaining lung over-expand to
Fill the space.
Segmental Resection
...is the removal of the ribs.
Thoracoplasty
...is stripping of the membrane that covers the visceral pleura.
Decortication
Which of the following is the function of the turbinates in the internal nose?
To warm inspired air
A training program for new nurses in a long-term care facility includes common anatomic and physiologic changes in older people. Which of the following changes in the nose, sinuses, and throat should be included?
Thinning of the mucous membrane, Nasal obstruction more common, Decreased mucus production, Decreased sense of smell
Why is it important to limit the time that suction is applied during tracheal suctioning?
Suctioning removes oxygen that may cause hypoxemia.
After nasal surgery, a patient has packing in place and a nasal drip ("mustache") dressing on the upper lip. When the mustache dressing has become saturated, which of the following should you do?
Change the mustache dressing.
Mr. P. is going to surgery for a supraglottic laryngectomy and Mr. S. is going to have a total laryngectomy. Which of the following describes the differences in their postoperative needs? (Select all that apply.)
Mr. S. will be able to swallow more easily than Mr. P., Mr. P. will have a temporary tracheostomy; Mr. S.'s tracheostomy will be permanent., Mr. P. will be at greater risk of aspiration than Mr. S.
What is the nursing implication when a patient with COPD has hypoxic drive?
The patient's O2 therapy should not exceed 3 L/min
The nurse is preparing a review of asthma drugs for nursing staff. She should inform the audience that appropriate drugs for relieving acute symptoms of asthma include:
Beta2-receptor agonistsAnticholinergics
A patient who has pneumonia has become restless; vital signs are as follows: temperature 100�F (37.8�C), pulse 110 bpm, respiration 28 breaths per minute, blood pressure 130/72 mm Hg. You should suspect
hypoxemia
Several days after thoracic surgery, your patient's respiratory status is normal. When checking the chest tube drainage system, you observe no bubbling in the water seal chamber. Which statement might explain this?
The patient's affected lung has reexpanded
The nurse completes a functional assessment of a patient who is hospitalized with pneumonia. Which is the best example of the nurse's documentation of the respiratory assessment?
The patient expectorated a moderate amount of tenacious, green sputum
The postoperative nursing care plan for a patient who had a total laryngectomy 24 hours ago includes the nursing diagnosis below. Which is the priority nursing diagnosis for this patient?
Ineffective airway clearance
The most serious complication of sinusitis is
Meningitis
A patient who had nasal surgery is restless. His pulse rate has increased from 70 to 90 bpm and his respiratory rate is 20 breaths per minute. His nasal dressing has no fresh bleeding. What should you do
Inspect the back of his throat