NUR 372 Exam 4 (Final) All Topics (Summary)
With Complete Solution. All Topics are Covered.
2024/2025.
trach: assessment
-bleeding
-breath sounds
-work of breathing
trach: complications
-accidental decannulation
-moderate to large amount of bleeding
-pneumothorax
-subcutaneous emphysema
-infection
trach: suctioning
-sterile procedure
-hyperoxygenate PRN
-insert suction until cough reflex is stimulated OR meet resistance
trach: if it comes out
EMERGENCY
-immediately provide oxygen with ambu bag
-stay with patient
-call for help
-MD will attempt to replace
trach: keep at bedside
-obturator
-replacement trach tubes
bronchoscopy: pre-op
-invasive procedure: confirm consent
-ensure NPO status
-ensure IV access, cardiac monitoring, pulse ox, suction available
bronchoscopy: post-op
-monitor vitals
-assess for complications, NPO until cough/gag reflex is returned
bronchoscopy: complications
-stridor
-SOB
-copious bloody secretions
-decreased O2 sat
-pneumothorax
ABG
-measures pH, PaO2, bicarb
-collected via arterial stick or through arterial line
,ABG: nursing implications
-allen's test (occlude each feeding artery at wrist and observe circulation)
-manual pressure afterwards for 5 min
-assess for bleeding
ABG: normal values
-pH: 7.35-7.45
-PaCO2: 35-45
-HCO3: 22-26
COPD: emphysema
destruction of the alveoli
-pink puffer (pursed lip breathing, thin barrel chest, red complexion)
COPD: chronic bronchitis
increased mucus, narrow small airways, thick bronchiole wall
-blue bloater (typically obese, cyanotic, productive cough)
Primary cause of __________ is smoking
COPD
You would expect the ABG of a COPD patient to have high _______ levels and low
__________________
CO2; oxygen saturation
COPD: manifestations
-clubbed fingernails
-barrel chest
-pursed lip breathing
COPD: treatment
-reduce modifiable risk factors
-symptom control
-meds: bronchodilators, anticholinergics, anti-inflammatories, inhaled glucocorticoids
-Bi-pap to improve ventilation and oxygenation
TB
airborne infection
-nurse wears N95
-patient wears mask during transportation
-can affect any organ, but most commonly lungs
TB: high risk populations
-homeless
-incarcerated population
-individuals with HIV/AIDS
-lower socioeconomic groups
-racial and ethnic minorities
TB: manifestations
-flu-like
-rust colored sputum
-PLEURITIC chest pain
TB: diagnosis
-TB skin test (mantoux test): must be read by HCP 48-72 hrs after injection and requires
further testing if positive
, -TB blood test (IGRA): serum blood draw, requires further testing if positive, performed
for TB vaccine recipients and requires a follow-up
-chest x-ray
-sputum culture
TB: treatment
RIPE drug combo
-rifampin (red urine)
-isoniazid (drug induced lupus)
-pyrazinamide (GI symptoms)
-ethambutol (optic neuritis)
pneumonia
inflammation of the lung tissue from a bacterial, viral, or fungal infection
pneumonia: high risk populations
-age 65+
-immunocompromised
-smokers
-chronic resp diseases
-prolonged immobility
-impaired gag/swallow reflexes (aspiration pneumonia)
_________________ can lead to sepsis if bacteria enters the bloodstream
pneumonia
hospital-acquired pneumonia
-encourage patient mobility
-incentive spirometer
-encourage fluid intake
If a patient is receiving antibiotics and needs a sputum culture, get the
____________ first and then start ______________.
culture; antibiotics
pneumonia: treatment
-prevention: vaccine
-ABX
-bronchodilators/anti-inflammatories PRN
myocardial infarction (MI)
destruction of heart muscle from lack of oxygenated blood
NSTEMI
partial occlusion of major coronary artery or complete occlusion of minor coronary artery
-REVERSIBLE heart muscle damage
STEMI
complete occlusion of major coronary artery
-IRREVERSIBLE heart muscle damage
-will have ST segment elevation on monitor
MI: manifesations
-chest pain
-shoulder/arm/jaw pain
MI: diagnosis
With Complete Solution. All Topics are Covered.
2024/2025.
trach: assessment
-bleeding
-breath sounds
-work of breathing
trach: complications
-accidental decannulation
-moderate to large amount of bleeding
-pneumothorax
-subcutaneous emphysema
-infection
trach: suctioning
-sterile procedure
-hyperoxygenate PRN
-insert suction until cough reflex is stimulated OR meet resistance
trach: if it comes out
EMERGENCY
-immediately provide oxygen with ambu bag
-stay with patient
-call for help
-MD will attempt to replace
trach: keep at bedside
-obturator
-replacement trach tubes
bronchoscopy: pre-op
-invasive procedure: confirm consent
-ensure NPO status
-ensure IV access, cardiac monitoring, pulse ox, suction available
bronchoscopy: post-op
-monitor vitals
-assess for complications, NPO until cough/gag reflex is returned
bronchoscopy: complications
-stridor
-SOB
-copious bloody secretions
-decreased O2 sat
-pneumothorax
ABG
-measures pH, PaO2, bicarb
-collected via arterial stick or through arterial line
,ABG: nursing implications
-allen's test (occlude each feeding artery at wrist and observe circulation)
-manual pressure afterwards for 5 min
-assess for bleeding
ABG: normal values
-pH: 7.35-7.45
-PaCO2: 35-45
-HCO3: 22-26
COPD: emphysema
destruction of the alveoli
-pink puffer (pursed lip breathing, thin barrel chest, red complexion)
COPD: chronic bronchitis
increased mucus, narrow small airways, thick bronchiole wall
-blue bloater (typically obese, cyanotic, productive cough)
Primary cause of __________ is smoking
COPD
You would expect the ABG of a COPD patient to have high _______ levels and low
__________________
CO2; oxygen saturation
COPD: manifestations
-clubbed fingernails
-barrel chest
-pursed lip breathing
COPD: treatment
-reduce modifiable risk factors
-symptom control
-meds: bronchodilators, anticholinergics, anti-inflammatories, inhaled glucocorticoids
-Bi-pap to improve ventilation and oxygenation
TB
airborne infection
-nurse wears N95
-patient wears mask during transportation
-can affect any organ, but most commonly lungs
TB: high risk populations
-homeless
-incarcerated population
-individuals with HIV/AIDS
-lower socioeconomic groups
-racial and ethnic minorities
TB: manifestations
-flu-like
-rust colored sputum
-PLEURITIC chest pain
TB: diagnosis
-TB skin test (mantoux test): must be read by HCP 48-72 hrs after injection and requires
further testing if positive
, -TB blood test (IGRA): serum blood draw, requires further testing if positive, performed
for TB vaccine recipients and requires a follow-up
-chest x-ray
-sputum culture
TB: treatment
RIPE drug combo
-rifampin (red urine)
-isoniazid (drug induced lupus)
-pyrazinamide (GI symptoms)
-ethambutol (optic neuritis)
pneumonia
inflammation of the lung tissue from a bacterial, viral, or fungal infection
pneumonia: high risk populations
-age 65+
-immunocompromised
-smokers
-chronic resp diseases
-prolonged immobility
-impaired gag/swallow reflexes (aspiration pneumonia)
_________________ can lead to sepsis if bacteria enters the bloodstream
pneumonia
hospital-acquired pneumonia
-encourage patient mobility
-incentive spirometer
-encourage fluid intake
If a patient is receiving antibiotics and needs a sputum culture, get the
____________ first and then start ______________.
culture; antibiotics
pneumonia: treatment
-prevention: vaccine
-ABX
-bronchodilators/anti-inflammatories PRN
myocardial infarction (MI)
destruction of heart muscle from lack of oxygenated blood
NSTEMI
partial occlusion of major coronary artery or complete occlusion of minor coronary artery
-REVERSIBLE heart muscle damage
STEMI
complete occlusion of major coronary artery
-IRREVERSIBLE heart muscle damage
-will have ST segment elevation on monitor
MI: manifesations
-chest pain
-shoulder/arm/jaw pain
MI: diagnosis
