Exam 1 NR 324 Adult Health 1 Questions With Complete
Solutions
When diagnosing a patient with a pulmonary embolism you are
told they cannot have contrast. As the nurse you know what type
of scan will be done?
A ventilation/perfusion (V/Q) scan, it has 2 components and is
most accurate when both are done
1. Perfusion scanning involves IV injection of a radioistope and
a scanning device takes images
2. Ventilation scanning involves inhalation of a radioactive gas
such as xenon and is shown distributed throughout the lung
when scanned
What is the most sensitive and specific test for pulmonary
embolisms?
Pulmonary angiography
-insertion of a catheter through the antecubital or femoral vein,
advancement of the catheter to the pulmonary artery, and
injection of contrast medium
What is D-dimer?
a laboratory test that measures the amount of cross-linked fibrin
fragments
--these are results of clot degradation
-Disadvantage is its neither specific or sensitive
Diagnostic studies for a pulmonary embolism include
,Diagnostic studies:
•Arterial blood gases
•Chest x-ray
•Electrocardiogram
•Troponin levels
•b-type natriuretic peptide
-D-Dimer
-Spiral (helical) CT scan
-Ventilation-perfusion (V/Q) scan
-Pulmonary angiography
-Arterial blood gases (ABGs)
Anticoagulation therapy for a PE includes
Heparin which is the recommended choice of treatment for
patients once a day
**monitor aPTT labs
Warfarin used for atleast 3 months and then reevaluate
**monitor INR labs
What is the antidote for warfarin?
Vitamin K
What is the antidote for heparin?
protamine sulfate
,Risk factors for pulmonary embolism
Deep vein thrombosis, Immobility or reduced mobility, Surgery,
History of DVT, Malignancy, Obesity, Oral contraceptives/
hormones, Smoking, Heart failure, Pregnancy/delivery, Clotting
disorders, Atrial fibrillation, Central venous catheters, Fractures
long bones
Nursing management for pulmonary embolism
Semi-Fowlers position
IV access
Oxygen therapy
Frequent assessments
Monitor laboratory results
Emotional support and reassurance
Prevention of a PE includes
•Sequential compression devices
•Early ambulation
•Prophylactic anticoagulation
Lung cancer
Risk factors: smoking
Assessment: Chronic cough, blood tinged sputum, dyspnea,
weight loss
Tests: Chest X-ray, CT scan, sputum cytology, biopsy
Treatment: surgery, radiation, chemotherapy, target therapy
, Nursing care: health promotion, support, post op care, chest
tubes
Chest trauma
Assessment: rapid respiration, flail chest, paradoxical breathing
Tests: chest x ray, ABG
COPD
Progressive airflow limitation; bronchitis and emphysema
Assessment: cough, dyspnea, fatigue, wheezing, "barrel chest"
Nursing diagnosis: Impaired gas exchange
Nursing care: O2, bronchodilators, corticosteroids, hydration,
nutrition, pursed lip breathing, coughing, smoking cessation
Nutritional therapy for patients with COPD
• Eat high-calorie foods first.
• Limit liquids at mealtimes.
• Rest before meals.
• Try more frequent meals and snacks.
• Increase calories by adding margarine, butter, mayonnaise,
sauces, gravies, and peanut butter to foods.
• Keep favorite foods and snacks on hand.
• Try cold foods, which can make you feel less full than hot
foods.
• Keep ready-prepared meals available for times when you have
increased shortness of breath.
• Eat larger meals when you are not as tired.
• Avoid foods that you know cause gas (e.g., cabbage, beans,
Solutions
When diagnosing a patient with a pulmonary embolism you are
told they cannot have contrast. As the nurse you know what type
of scan will be done?
A ventilation/perfusion (V/Q) scan, it has 2 components and is
most accurate when both are done
1. Perfusion scanning involves IV injection of a radioistope and
a scanning device takes images
2. Ventilation scanning involves inhalation of a radioactive gas
such as xenon and is shown distributed throughout the lung
when scanned
What is the most sensitive and specific test for pulmonary
embolisms?
Pulmonary angiography
-insertion of a catheter through the antecubital or femoral vein,
advancement of the catheter to the pulmonary artery, and
injection of contrast medium
What is D-dimer?
a laboratory test that measures the amount of cross-linked fibrin
fragments
--these are results of clot degradation
-Disadvantage is its neither specific or sensitive
Diagnostic studies for a pulmonary embolism include
,Diagnostic studies:
•Arterial blood gases
•Chest x-ray
•Electrocardiogram
•Troponin levels
•b-type natriuretic peptide
-D-Dimer
-Spiral (helical) CT scan
-Ventilation-perfusion (V/Q) scan
-Pulmonary angiography
-Arterial blood gases (ABGs)
Anticoagulation therapy for a PE includes
Heparin which is the recommended choice of treatment for
patients once a day
**monitor aPTT labs
Warfarin used for atleast 3 months and then reevaluate
**monitor INR labs
What is the antidote for warfarin?
Vitamin K
What is the antidote for heparin?
protamine sulfate
,Risk factors for pulmonary embolism
Deep vein thrombosis, Immobility or reduced mobility, Surgery,
History of DVT, Malignancy, Obesity, Oral contraceptives/
hormones, Smoking, Heart failure, Pregnancy/delivery, Clotting
disorders, Atrial fibrillation, Central venous catheters, Fractures
long bones
Nursing management for pulmonary embolism
Semi-Fowlers position
IV access
Oxygen therapy
Frequent assessments
Monitor laboratory results
Emotional support and reassurance
Prevention of a PE includes
•Sequential compression devices
•Early ambulation
•Prophylactic anticoagulation
Lung cancer
Risk factors: smoking
Assessment: Chronic cough, blood tinged sputum, dyspnea,
weight loss
Tests: Chest X-ray, CT scan, sputum cytology, biopsy
Treatment: surgery, radiation, chemotherapy, target therapy
, Nursing care: health promotion, support, post op care, chest
tubes
Chest trauma
Assessment: rapid respiration, flail chest, paradoxical breathing
Tests: chest x ray, ABG
COPD
Progressive airflow limitation; bronchitis and emphysema
Assessment: cough, dyspnea, fatigue, wheezing, "barrel chest"
Nursing diagnosis: Impaired gas exchange
Nursing care: O2, bronchodilators, corticosteroids, hydration,
nutrition, pursed lip breathing, coughing, smoking cessation
Nutritional therapy for patients with COPD
• Eat high-calorie foods first.
• Limit liquids at mealtimes.
• Rest before meals.
• Try more frequent meals and snacks.
• Increase calories by adding margarine, butter, mayonnaise,
sauces, gravies, and peanut butter to foods.
• Keep favorite foods and snacks on hand.
• Try cold foods, which can make you feel less full than hot
foods.
• Keep ready-prepared meals available for times when you have
increased shortness of breath.
• Eat larger meals when you are not as tired.
• Avoid foods that you know cause gas (e.g., cabbage, beans,
