MED SURG 2 FINAL ACTUAL EXAM | QUESTIONS AND ANSWERS |
VERIFIED AND ACCURATE ANSWERS | LATEST EXAM UPDATE
Respiratory Functions
- ventilation
- respiration
- acid-base balance
- speech
- sense of smell
- fluid balance
- BP
FiO2
- Room Air: 21%
- 1 Liter: 24%
- add 4% for each liter after that (2=28%,3=32%, etc.)
Nasal cannula
1-6 liters (24-44% FiO2)
Non-rebreather masks
10-15 liters (80-90% FiO2)
- keep bag inflated
High flow nasal cannula
- provides a positive pressure airflow
- can go up to 60 L/min
Smoking: Pack years
packs per day x years of smoking
ex: A client has smoked for 23 years and smokes 2 packs a day. What is the
pack years: 46
Incentive spirometer use
- helps take slow deep breaths
- can help prevent complications like pneumonia
,- sit up straight
- hold spirometer upright
- take a deep breath in and let it out before using
- cover mouthpiece completely with lips
- breathe in slowly, aiming to keep the ball within the target zone and deeply
enough until the piston gets to set mark
- hold breath for 3 seconds, then let it out slowly
Oxygen education
- No smoking/open flames
- Know location of fire extinguisher
- No synthetic/wool fabric (cotton instead)
- Ground electronic devices/make sure electric devices work well
- No alcohol, acetone, petroleum near O2
Crackles
- short, popping, clicking, crackling, bubbling
- air moves through fluid or secretions
Rhonchi
- low pitched snoring/gurgling noise
- air moves through secretions or partial obstruction of larger airways
Wheezes
- high-pitched whistling sound
- air forced through narrowed airways
Stridor
- loud, harsh whistling
- significant blockage or narrowing in upper airway
- is an emergency
Pleural Rub
- creaking/grating sound
- inflamed pleural surfaces rubbing against each other
Nursing interventions to prevent atelectasis & pneumonia
A patient is bedridden, sedated, weak, in pain, paralyzed, etc. is not going to
take deep breaths or move secretions, so your interventions are focused on:
- turn, cough, deep breathe
,- elevate head of bed/positioning
- ambulation (move sec and open airway)
- deep breathing/spirometry (expand airway)
- hygiene (prevent infection)
- immunizations (prevent infection)
- pain control (able to deep breathe and cough better)
- thin secretions
Nursing interventions to thin secretions and avoid dehydration
increase fluids
Nursing interventions to open the airway
- bronchodilators, anticholinergics
- elevate HOB
- tripod position
Nursing interventions to ensure proper nutrition
- small frequent meals (eating can take a lot of energy)
- supplements
Nursing interventions to help with activity intolerance
- block care, energy saving techniques, hardest tasks when you have more
energy
Nursing interventions to prevent infections
- hygiene, immunizations, droplet/airborne precautions, pneumonia prevention
Nursing interventions to decrease hypoxemia/decrease retained CO2 (get
more O2)
- open airway
- pursed lip breathing
- positioning
- oxygen
Nursing interventions to increase CO2
slower breathing/rebreathing
Rhinosinusitis
Infection and inflammation of the nasal and paranasal sinus cavities; involves
nasal cavity and sinuses
, - purulent nasal drainage, nasal obstruction, and face pain; often includes
fever, dental pain, cough, ear fullness
- management: symptom management such as pain relief by OTC analgesics
(acetaminophen, ibuprofen), treatment of infection if bacterial (antibiotics),
corticosteroid nasal spray (fluticasone; reduce inflammation in the nasal
passages)
- complications include: orbital cellulitis or abscess (redness, pain, edema
around eyes)
Influenza
- Incubates up to 72 hours (takes 3 days to feel sick)
- Virus sheds 2-5 days after symptoms appear
- Infectious for up to 10 days
- Droplet precautions
- Prevention: immunization, hand hygiene
- Patient has expected fever, headache, sore throat, nasal congestion, cough,
myalgia, malaise, fatigue
- Swab before antiviral
- Oseltamivir within 24-48 hrs of onset of symptoms (viral shedding;
shortens and lessens effects of virus)
- Symptom control (antipyretics, analgesics)
- Monitor for and prevent secondary infections/complications (SOB, dec O2,
bad lung sounds; pneumonia is most common complication)
Pneumonia
Inflammation of lung parenchyma causing decreased area for gas exchange
- prevent with immunizations (flu and pneumonia)
Manifestations: dyspnea, cough and increased sputum, chest pain with
coughing, abnormal lung sounds, fever, elevated wbc, consolidation on ct/cxr,
decreased SpO2 and PaO2, increased PaCO2, activity intolerance
Warning signs: mental status changes, RR >30, SBP <80, HR >125, Temp
<95 or >104, pH <7.35, Sodium <130 (severe pneumonia), Hgb/Hct low,
VERIFIED AND ACCURATE ANSWERS | LATEST EXAM UPDATE
Respiratory Functions
- ventilation
- respiration
- acid-base balance
- speech
- sense of smell
- fluid balance
- BP
FiO2
- Room Air: 21%
- 1 Liter: 24%
- add 4% for each liter after that (2=28%,3=32%, etc.)
Nasal cannula
1-6 liters (24-44% FiO2)
Non-rebreather masks
10-15 liters (80-90% FiO2)
- keep bag inflated
High flow nasal cannula
- provides a positive pressure airflow
- can go up to 60 L/min
Smoking: Pack years
packs per day x years of smoking
ex: A client has smoked for 23 years and smokes 2 packs a day. What is the
pack years: 46
Incentive spirometer use
- helps take slow deep breaths
- can help prevent complications like pneumonia
,- sit up straight
- hold spirometer upright
- take a deep breath in and let it out before using
- cover mouthpiece completely with lips
- breathe in slowly, aiming to keep the ball within the target zone and deeply
enough until the piston gets to set mark
- hold breath for 3 seconds, then let it out slowly
Oxygen education
- No smoking/open flames
- Know location of fire extinguisher
- No synthetic/wool fabric (cotton instead)
- Ground electronic devices/make sure electric devices work well
- No alcohol, acetone, petroleum near O2
Crackles
- short, popping, clicking, crackling, bubbling
- air moves through fluid or secretions
Rhonchi
- low pitched snoring/gurgling noise
- air moves through secretions or partial obstruction of larger airways
Wheezes
- high-pitched whistling sound
- air forced through narrowed airways
Stridor
- loud, harsh whistling
- significant blockage or narrowing in upper airway
- is an emergency
Pleural Rub
- creaking/grating sound
- inflamed pleural surfaces rubbing against each other
Nursing interventions to prevent atelectasis & pneumonia
A patient is bedridden, sedated, weak, in pain, paralyzed, etc. is not going to
take deep breaths or move secretions, so your interventions are focused on:
- turn, cough, deep breathe
,- elevate head of bed/positioning
- ambulation (move sec and open airway)
- deep breathing/spirometry (expand airway)
- hygiene (prevent infection)
- immunizations (prevent infection)
- pain control (able to deep breathe and cough better)
- thin secretions
Nursing interventions to thin secretions and avoid dehydration
increase fluids
Nursing interventions to open the airway
- bronchodilators, anticholinergics
- elevate HOB
- tripod position
Nursing interventions to ensure proper nutrition
- small frequent meals (eating can take a lot of energy)
- supplements
Nursing interventions to help with activity intolerance
- block care, energy saving techniques, hardest tasks when you have more
energy
Nursing interventions to prevent infections
- hygiene, immunizations, droplet/airborne precautions, pneumonia prevention
Nursing interventions to decrease hypoxemia/decrease retained CO2 (get
more O2)
- open airway
- pursed lip breathing
- positioning
- oxygen
Nursing interventions to increase CO2
slower breathing/rebreathing
Rhinosinusitis
Infection and inflammation of the nasal and paranasal sinus cavities; involves
nasal cavity and sinuses
, - purulent nasal drainage, nasal obstruction, and face pain; often includes
fever, dental pain, cough, ear fullness
- management: symptom management such as pain relief by OTC analgesics
(acetaminophen, ibuprofen), treatment of infection if bacterial (antibiotics),
corticosteroid nasal spray (fluticasone; reduce inflammation in the nasal
passages)
- complications include: orbital cellulitis or abscess (redness, pain, edema
around eyes)
Influenza
- Incubates up to 72 hours (takes 3 days to feel sick)
- Virus sheds 2-5 days after symptoms appear
- Infectious for up to 10 days
- Droplet precautions
- Prevention: immunization, hand hygiene
- Patient has expected fever, headache, sore throat, nasal congestion, cough,
myalgia, malaise, fatigue
- Swab before antiviral
- Oseltamivir within 24-48 hrs of onset of symptoms (viral shedding;
shortens and lessens effects of virus)
- Symptom control (antipyretics, analgesics)
- Monitor for and prevent secondary infections/complications (SOB, dec O2,
bad lung sounds; pneumonia is most common complication)
Pneumonia
Inflammation of lung parenchyma causing decreased area for gas exchange
- prevent with immunizations (flu and pneumonia)
Manifestations: dyspnea, cough and increased sputum, chest pain with
coughing, abnormal lung sounds, fever, elevated wbc, consolidation on ct/cxr,
decreased SpO2 and PaO2, increased PaCO2, activity intolerance
Warning signs: mental status changes, RR >30, SBP <80, HR >125, Temp
<95 or >104, pH <7.35, Sodium <130 (severe pneumonia), Hgb/Hct low,
