NURS 3661Exam 2 Blueprint. Exam 2 Blueprint
Respiratory – about 17 questions
1. Explain & discuss assessment findings manifest in lower respiratory disorders (COPD, asthma,
pneumonia, tuberculosis), and relate them to underlying pathophysiological processes.
• COPD
o Dyspnea upon exertion
o Productive cough that is worse in the morning
o Hypoxemia
o Crackles and wheezes
o Rapid and shallow respirations
o Use of accessory muscles
o Barrel chest or increased chest diameter
o Hyperresonance on percussion due to “trapped air”
o Thin extremities and enlarged neck muscles
o Dependent edema secondary to right-sided HF
o Clubbing of fingers and toes
o Pallor and cyanosis of nail beds and mucous membranes
o Decreased oxygen saturation levels slightly lower in dark colored skin
• Asthma
o Dyspnea
o Chest tightness
o Anxiety or stress
o Coughing
o Wheezing
o Mucus production
o Use of accessory muscles
o Prolonged exhalation
o Low O2 sat
o Increased chest diameter
• Pneumonia
• Tuberculosis
o Persistent cough longer than 3 week
o Chest pain
o Weakness
o Weight loss
o Anorexia
o Hemoptysis purulent sputum, blood streaked
o Dyspnea
o Fever
o Night sweats
o chills
2. Outline the medical, pharmacological and nursing management for persons with oxygenation disorders.
a) Health promotions
a. Smoking cessation
b. Early diagnosis and treatment decrease in progression of disease
c. Family with history of COPD need to be aware of possible genetic link
b) Acute intervention
a. Bronchodilators, corticosteroids
b. Position to minimize respiratory efforts
, NURS 3661Exam 2 Blueprint. Exam 2 Blueprint
c. Mtn clear airway by effective cough
d. Return to baseline respiratory function
c) Ambulatory care & home care
a. Pulmonary rehabilitation
b. Activity consideration – conserve energy
c. Sexual and sexual activity
d. Sleep
e. Psychosocial considerations
3. Identify appropriate nursing diagnoses/problems and therapeutic nursing goals, interventions, and evaluations
of patients with lower respiratory, obstructive disorders and oxygenation problems.
a) Smoking cessation
b) Drug therapy – reduce symptoms
a. Bronchodilators
b. LABA
c. Inhaled corticosteroids
d. Long-acting bronchodilators
c) Oxygen therapy
a. Goal to maintain O2 > 90%
b. Always start with a low liter flow
d) Breathing Retraining
a. Purse lipped breathing – prolong exhalation prevent air trapping, bronchiolar collapse
b. Diaphragmatic breathing
e) Airway clearance techniques
a. Effective coughing
b. Chest physiotherapy (CPT)
c. Postural drainage
d. Airway clearance e devices
f) Nutrition therapy
a. Fluid intake 3 liters per day (unless contraindicated)
b. Conserve energy 30 min prior to meal
c. Use bronchodilator prior to meal
d. If underweight may need additional protein and calories
g) Surgical therapy for COPD
a. Lung volume reduction surgery
4. Discuss nursing assessment, independent and collaborative management of dyspnea.
• Position client in high-fowler’s for maximum ventilation
• Encourage coughing or suction to remove secretions
• Encourage incentive spirometer
• Administer oxygen as prescribed.
5. Analyze the effects of dyspnea on the physical & psychosocial functioning of the patient.
6. Identify and describe assessments priorities for patient with respiratory
problems. Acute Respiratory Failure
Content:
A. Lower Respiratory Problems
1. pneumonia
a) Risk fractors
o History of aspiration
Respiratory – about 17 questions
1. Explain & discuss assessment findings manifest in lower respiratory disorders (COPD, asthma,
pneumonia, tuberculosis), and relate them to underlying pathophysiological processes.
• COPD
o Dyspnea upon exertion
o Productive cough that is worse in the morning
o Hypoxemia
o Crackles and wheezes
o Rapid and shallow respirations
o Use of accessory muscles
o Barrel chest or increased chest diameter
o Hyperresonance on percussion due to “trapped air”
o Thin extremities and enlarged neck muscles
o Dependent edema secondary to right-sided HF
o Clubbing of fingers and toes
o Pallor and cyanosis of nail beds and mucous membranes
o Decreased oxygen saturation levels slightly lower in dark colored skin
• Asthma
o Dyspnea
o Chest tightness
o Anxiety or stress
o Coughing
o Wheezing
o Mucus production
o Use of accessory muscles
o Prolonged exhalation
o Low O2 sat
o Increased chest diameter
• Pneumonia
• Tuberculosis
o Persistent cough longer than 3 week
o Chest pain
o Weakness
o Weight loss
o Anorexia
o Hemoptysis purulent sputum, blood streaked
o Dyspnea
o Fever
o Night sweats
o chills
2. Outline the medical, pharmacological and nursing management for persons with oxygenation disorders.
a) Health promotions
a. Smoking cessation
b. Early diagnosis and treatment decrease in progression of disease
c. Family with history of COPD need to be aware of possible genetic link
b) Acute intervention
a. Bronchodilators, corticosteroids
b. Position to minimize respiratory efforts
, NURS 3661Exam 2 Blueprint. Exam 2 Blueprint
c. Mtn clear airway by effective cough
d. Return to baseline respiratory function
c) Ambulatory care & home care
a. Pulmonary rehabilitation
b. Activity consideration – conserve energy
c. Sexual and sexual activity
d. Sleep
e. Psychosocial considerations
3. Identify appropriate nursing diagnoses/problems and therapeutic nursing goals, interventions, and evaluations
of patients with lower respiratory, obstructive disorders and oxygenation problems.
a) Smoking cessation
b) Drug therapy – reduce symptoms
a. Bronchodilators
b. LABA
c. Inhaled corticosteroids
d. Long-acting bronchodilators
c) Oxygen therapy
a. Goal to maintain O2 > 90%
b. Always start with a low liter flow
d) Breathing Retraining
a. Purse lipped breathing – prolong exhalation prevent air trapping, bronchiolar collapse
b. Diaphragmatic breathing
e) Airway clearance techniques
a. Effective coughing
b. Chest physiotherapy (CPT)
c. Postural drainage
d. Airway clearance e devices
f) Nutrition therapy
a. Fluid intake 3 liters per day (unless contraindicated)
b. Conserve energy 30 min prior to meal
c. Use bronchodilator prior to meal
d. If underweight may need additional protein and calories
g) Surgical therapy for COPD
a. Lung volume reduction surgery
4. Discuss nursing assessment, independent and collaborative management of dyspnea.
• Position client in high-fowler’s for maximum ventilation
• Encourage coughing or suction to remove secretions
• Encourage incentive spirometer
• Administer oxygen as prescribed.
5. Analyze the effects of dyspnea on the physical & psychosocial functioning of the patient.
6. Identify and describe assessments priorities for patient with respiratory
problems. Acute Respiratory Failure
Content:
A. Lower Respiratory Problems
1. pneumonia
a) Risk fractors
o History of aspiration
