NSG 6020 Midterm Exam
Study Guide 2022
,NSG 6020 Midterm Exam Study Guide
1. Be familiar with s/s of Bronchitis, Pneumonia, Tuberculosis, and Pulmonary Edema.
Bronchitis
Cough, may be dry or productive. Acute, often viral, illness generally without fever
or dyspnea; at times with burning retrosternal discomfort
Pneumonia
Sputum is mucoid or purulent; may be blood-streaked, diffusely pinkish, or rusty.
Acute illness with chills, often high fever, dyspnea, and chest pain. Commonly from
streptococcus pneumonia, haemophilus influenza, moraella catarrhails, klebsiella in
alcoholism, especially if underlying smoking, chronic bronchitis and copd,
cardiovascular disease, diabetes.
Tuberculosis
Cough, dry, or with mucoid or purulent sputum, may be blood-streaked or bloody.
Early= no symptoms. Later= anorexia, weight loss, fatigue, fever, and night sweats.
Pulmonary Edema
Pink frothy sputum, dyspnea, orthopnea, difficulty breathing when laying down,
waking up at night breathless, rapid weight gain in lower extremities.
2. S/S of Dyspnea
Subjective sense of discomfort or difficulty breathing. Pt’s c/o SOB, chest tightness, or
simply difficulty breathing or trying to catch their breath.
3. Changes in Gastrointestinal system in aging adult
During the middle and later years, the abdominal muscles tend to weaken, there is
decreased activity of lipoprotein lipase, and fat may accumulate in the lower abdomen
, and near the hips even when the weight is stable. These changes often produce a
softer, more protruding, abdomen which patients may interpret as fluid or evidence of
disease. The change in abdominal fat distribution increases the risk of cardiovascular
disease.
Aging can blunt the manifestations of acute abdominal disease. Pain may be less
severe, fever is often less pronounced, and signs of peritoneal inflammation, such as
guarding and rebound tenderness, may be diminished or even absent.
4. Best technique to assess skin temperature
Skin temperature is best assessed by the dorsal aspects of the hand and fingers.
Situations that increase skin temperature include increased blood flow to the skin or
underlying structures; thermal or chemical burns; local infections; and generalized,
systemic infections and fever. Decreased skin temperature may result from
atherosclerosis and shock
5. Assessment of Thyroid Gland in pregnant patients
During pregnancy the thyroid is hyperstimulated.
Thyroid function changes include an increase in thyroid-binding globulin due
to rising levels of estrogen and stimulation of thyroid-stimulating hormone (TSH)
receptors by HCG. This results in a slight increase, usually in the normal range, in
serum concentrations of free T3 and T4, while serum TSH concentrations
appropriately decrease. This transient apparent “hyperthyroidism” should be
considered physiologic
6. Proper methods of auscultation of heart
sounds Listen at the 2nd right and left
interspaces, down the
left sternal border to the 4th and 5th interspaces, and across to the apex the six
listening areas with the diaphragm, then the bell (see p. 391). As indicated, listen at
the lower right sternal border for right-sided murmurs and sounds, often
accentuated with inspiration, withthe diaphragm and bell.
Study Guide 2022
,NSG 6020 Midterm Exam Study Guide
1. Be familiar with s/s of Bronchitis, Pneumonia, Tuberculosis, and Pulmonary Edema.
Bronchitis
Cough, may be dry or productive. Acute, often viral, illness generally without fever
or dyspnea; at times with burning retrosternal discomfort
Pneumonia
Sputum is mucoid or purulent; may be blood-streaked, diffusely pinkish, or rusty.
Acute illness with chills, often high fever, dyspnea, and chest pain. Commonly from
streptococcus pneumonia, haemophilus influenza, moraella catarrhails, klebsiella in
alcoholism, especially if underlying smoking, chronic bronchitis and copd,
cardiovascular disease, diabetes.
Tuberculosis
Cough, dry, or with mucoid or purulent sputum, may be blood-streaked or bloody.
Early= no symptoms. Later= anorexia, weight loss, fatigue, fever, and night sweats.
Pulmonary Edema
Pink frothy sputum, dyspnea, orthopnea, difficulty breathing when laying down,
waking up at night breathless, rapid weight gain in lower extremities.
2. S/S of Dyspnea
Subjective sense of discomfort or difficulty breathing. Pt’s c/o SOB, chest tightness, or
simply difficulty breathing or trying to catch their breath.
3. Changes in Gastrointestinal system in aging adult
During the middle and later years, the abdominal muscles tend to weaken, there is
decreased activity of lipoprotein lipase, and fat may accumulate in the lower abdomen
, and near the hips even when the weight is stable. These changes often produce a
softer, more protruding, abdomen which patients may interpret as fluid or evidence of
disease. The change in abdominal fat distribution increases the risk of cardiovascular
disease.
Aging can blunt the manifestations of acute abdominal disease. Pain may be less
severe, fever is often less pronounced, and signs of peritoneal inflammation, such as
guarding and rebound tenderness, may be diminished or even absent.
4. Best technique to assess skin temperature
Skin temperature is best assessed by the dorsal aspects of the hand and fingers.
Situations that increase skin temperature include increased blood flow to the skin or
underlying structures; thermal or chemical burns; local infections; and generalized,
systemic infections and fever. Decreased skin temperature may result from
atherosclerosis and shock
5. Assessment of Thyroid Gland in pregnant patients
During pregnancy the thyroid is hyperstimulated.
Thyroid function changes include an increase in thyroid-binding globulin due
to rising levels of estrogen and stimulation of thyroid-stimulating hormone (TSH)
receptors by HCG. This results in a slight increase, usually in the normal range, in
serum concentrations of free T3 and T4, while serum TSH concentrations
appropriately decrease. This transient apparent “hyperthyroidism” should be
considered physiologic
6. Proper methods of auscultation of heart
sounds Listen at the 2nd right and left
interspaces, down the
left sternal border to the 4th and 5th interspaces, and across to the apex the six
listening areas with the diaphragm, then the bell (see p. 391). As indicated, listen at
the lower right sternal border for right-sided murmurs and sounds, often
accentuated with inspiration, withthe diaphragm and bell.
