NSG 223 Exam 2 Blue Print
Topic Loca9on Student Notes
Pulmonary Embolism NSG 223.04.01 Commonly caused by DVT dislodgment , an occlusion of the outlaw tract of pulmonary artery, thrombus may parJally of
- Pathophysiology fully obstruct pulmonary artery creaJng impaired gas exchange.
S/SX: Dyspnea chest pain (may mimic angina) anxiety, tachypnea, cough, fever diaphoresis, hemoptysis, syncope, and
- Signs/Symptoms rapid weak pulse, shock, possible sudden death.
- Assessment DX/ Assessment: Chest x-ray(infiltrates, atelectasis, elevaJon of the diaphragm) , ABG, D-dimer assay, pulmonary
- Nursing Care - arteriogram, V/Q scan.
Medical Medical MG: Dissolve emboli with thrombolyJc agents which reduces pulmonary hypertension, improving perfusion &
oxygenaJon, NOT GIVEN if stroke in the last 2 months, surgery within 10 days, ac9ve bleeding, intracranial issues.
Management
Embolectomy (surgical removal) recommended if clot busJng is contraindicated.
IVC filter screens inferior vena cava , serves as a net catching large emboli
AnJcoagulaJon therapy is recommended for those W/O cardiopulmonary symptoms, this may last 10 days - 6 months.
Following P.E, maybe extended for high risk paJents.
ARDS NSG223.04.02 ARDS: Severe inflammatory process causing alveolar damage resulJng in sudden and progressive pulmonary edema,
- Pathophysiology - increasing lung infiltrates and hypoxemia unresponsive to oxygen supplementaJon. Caused by direct injury such as
smoke inhalaJon, or indirect insult to the lungs.
Nursing
Alveoli collapse due to inflammatory infiltrate, blood, fluid bronchial obstruc9on.
Management S/SX: resemble pulmonary edema at first , dyspnea, bilateral lung infiltrates, sJff lungs, crackles, intercostal retracJons,
- Medical BNP is monitored.
management Medical MGT: SupporJve therapy ET intubaJon, mechanical venJlaJon, circulatory support, adequate fluid, nutriJonal
support, Ven9latory PEEP, helps reverse alveolar collapse keeping alveoli open, improving arterial oxygena9on &B
reducing V/Q imbalance.
Nursing Interven9ons: MONITOR for hyperinfla9on of the lungs, low blood pressure, prone posi9on changes, prevent
complica9ons: pressure injuries, blood clots, infec9on, pneumothorax.
Respiratory Failure NSG223.04.03 Failure to provide adequate oxygenaJon or venJlaJon for the blood.
- Signs/Symptoms S/SX: restlessness, fa9gue, headache, air hunger, dyspnea, tachycardia, increased blood pressure, confusion,
lethargy, central cyanosis, diaphoresis.
- Nursing
Medical MGT: ET intubaJon, mechanical venJlaJon.
Management Nursing MGMT: assist w/intuba9on, mechanical ven9la9on, monitor level of responsiveness, ABG, Pulse ox, vital
- Medical signs, posi9on changing, oral care, skin care.
Management
, Acid-base balance NSG223.05.01
- ABG interpretaJon
Acid-base imbalances
- Pathophysiology
- Sign & Symptoms -
Treatment
Assessments
-
PancreaJJs NSG223.06.01 S/SX: Severe abdominal pain, tenderness, back pain , fever, jaundice, respiratory distress, hypocalcemia.
- Signs/Symptoms NSG223.06.02 Assessment: midepigastrium region pain usually occurs a_er meals, acute onset 24-48 hours, unrelieved with
antacids. Abdominal distenJon, decreased peristalsis, vomiJng and nausea, abdominal guarding,board like abdomen,
- Assessment - bruising on the back or around the umbilicus.
Nursing Med. management - PPI, insulins, anJemeJc, opioids, Avoid NSAID use due to GI bleed risk
Management Nursing Management - pain relief w/ opioids , decrease secre9on of pancrea9c enzymes, NPO, NG suc9on,
Medical Management bedrest,m simple instruc9ons due to confusion, frequent posi9on changing.
Medical management - if necroJzing pancreaJJs is found surgical debridement or inserJon of drains may be necessary
Topic Loca9on Student Notes
Pulmonary Embolism NSG 223.04.01 Commonly caused by DVT dislodgment , an occlusion of the outlaw tract of pulmonary artery, thrombus may parJally of
- Pathophysiology fully obstruct pulmonary artery creaJng impaired gas exchange.
S/SX: Dyspnea chest pain (may mimic angina) anxiety, tachypnea, cough, fever diaphoresis, hemoptysis, syncope, and
- Signs/Symptoms rapid weak pulse, shock, possible sudden death.
- Assessment DX/ Assessment: Chest x-ray(infiltrates, atelectasis, elevaJon of the diaphragm) , ABG, D-dimer assay, pulmonary
- Nursing Care - arteriogram, V/Q scan.
Medical Medical MG: Dissolve emboli with thrombolyJc agents which reduces pulmonary hypertension, improving perfusion &
oxygenaJon, NOT GIVEN if stroke in the last 2 months, surgery within 10 days, ac9ve bleeding, intracranial issues.
Management
Embolectomy (surgical removal) recommended if clot busJng is contraindicated.
IVC filter screens inferior vena cava , serves as a net catching large emboli
AnJcoagulaJon therapy is recommended for those W/O cardiopulmonary symptoms, this may last 10 days - 6 months.
Following P.E, maybe extended for high risk paJents.
ARDS NSG223.04.02 ARDS: Severe inflammatory process causing alveolar damage resulJng in sudden and progressive pulmonary edema,
- Pathophysiology - increasing lung infiltrates and hypoxemia unresponsive to oxygen supplementaJon. Caused by direct injury such as
smoke inhalaJon, or indirect insult to the lungs.
Nursing
Alveoli collapse due to inflammatory infiltrate, blood, fluid bronchial obstruc9on.
Management S/SX: resemble pulmonary edema at first , dyspnea, bilateral lung infiltrates, sJff lungs, crackles, intercostal retracJons,
- Medical BNP is monitored.
management Medical MGT: SupporJve therapy ET intubaJon, mechanical venJlaJon, circulatory support, adequate fluid, nutriJonal
support, Ven9latory PEEP, helps reverse alveolar collapse keeping alveoli open, improving arterial oxygena9on &B
reducing V/Q imbalance.
Nursing Interven9ons: MONITOR for hyperinfla9on of the lungs, low blood pressure, prone posi9on changes, prevent
complica9ons: pressure injuries, blood clots, infec9on, pneumothorax.
Respiratory Failure NSG223.04.03 Failure to provide adequate oxygenaJon or venJlaJon for the blood.
- Signs/Symptoms S/SX: restlessness, fa9gue, headache, air hunger, dyspnea, tachycardia, increased blood pressure, confusion,
lethargy, central cyanosis, diaphoresis.
- Nursing
Medical MGT: ET intubaJon, mechanical venJlaJon.
Management Nursing MGMT: assist w/intuba9on, mechanical ven9la9on, monitor level of responsiveness, ABG, Pulse ox, vital
- Medical signs, posi9on changing, oral care, skin care.
Management
, Acid-base balance NSG223.05.01
- ABG interpretaJon
Acid-base imbalances
- Pathophysiology
- Sign & Symptoms -
Treatment
Assessments
-
PancreaJJs NSG223.06.01 S/SX: Severe abdominal pain, tenderness, back pain , fever, jaundice, respiratory distress, hypocalcemia.
- Signs/Symptoms NSG223.06.02 Assessment: midepigastrium region pain usually occurs a_er meals, acute onset 24-48 hours, unrelieved with
antacids. Abdominal distenJon, decreased peristalsis, vomiJng and nausea, abdominal guarding,board like abdomen,
- Assessment - bruising on the back or around the umbilicus.
Nursing Med. management - PPI, insulins, anJemeJc, opioids, Avoid NSAID use due to GI bleed risk
Management Nursing Management - pain relief w/ opioids , decrease secre9on of pancrea9c enzymes, NPO, NG suc9on,
Medical Management bedrest,m simple instruc9ons due to confusion, frequent posi9on changing.
Medical management - if necroJzing pancreaJJs is found surgical debridement or inserJon of drains may be necessary
