ATI Oxygenation (Perfusion, Pharm,
Misc)
Pleurisy - correct answer-What it is? A condition in which the pleura — a
membrane consisting of a layer of tissue that lines the inner side of the chest
cavity and a layer of tissue that surrounds the lungs — becomes inflamed.
Also called pleuritis, pleurisy causes sharp chest pain (pleuritic pain) that
worsens during breathing.
What it sounds like?
Loud, scratchy, sand-paper like noises
Upon auscultating the lungs, you hear squeaky, musical sounds. This is a
manifestation of what respiratory condition? - correct answer-bronchospasm-
this is caused by air whooshing through narrowed airways, like pipes
Upon auscultating the lungs, you hear popping sounds. This is a manifestation
of what respiratory condition? - correct answer-Popping is caused by air
moving through deflated airways.
Possible conditions:
Atelectasis: a complete or partial collapse of a lung or lobe of a lung- deflated
alveoli. Usually a post-op complication.
OR
Pneumonia: an infection in one or both lungs. It can be caused by bacteria,
viruses, or fungi causing inflammation in the alveoli. The alveoli fill with fluid or
pus, making it difficult to breathe. (ALSO sounds DULL)
Upon auscultating the lungs, you hear tympany. This is a manifestation of
what respiratory condition? - correct answer-Pneumothorax: a collapsed lung.
A pneumothorax occurs when air leaks into the space between your lung and
chest wall. This air pushes on the outside of your lung and makes it collapse.
In most cases, only a portion of the lung collapses.
Upon auscultating the lungs, you hear flatness. This is a manifestation of what
respiratory condition? - correct answer-Flatness or dullness is associated with
,pleural effusion, or a build up of fluid in the space between the lungs and the
chest wall. Pleural effusion is always a secondary condition:
Liver or kidney disease: Diseases such as cirrhosis may cause fluid to build
up in the body and leak into the chest.
Congestive heart failure: Failure of the heart to pump blood properly can
cause a buildup of liquid in the chest.
Autoimmune disorders: Disorders such as lupus or rheumatoid arthritis may
target the lungs and create problems with the pleura.
Infections: Respiratory infections such as tuberculosis and pneumonia could
progress and cause water on the lung.
Pulmonary embolism: A blockage in the arteries of the lung caused by a blood
clot can cause the pleura to create too much liquid.
Cancer: Typically lung cancer, though any cancer which has progressed to the
lungs or pleura can be the cause.
Upon auscultating the lungs, you hear resonance. This is a manifestation of
what respiratory condition? - correct answer-Chronici bronchitis. It is a loud,
low pitched sound of long duration.
Upon auscultating the lungs, you hear snoring sounds. This is a manifestation
of what respiratory condition? - correct answer-Snoring sounds, AKA rhonchi,
are heard when a client has thick, tenacious secretions in the airways.
What is a pulmonary artery catheter?
What would you tell a patient it is for? - correct answer-Pulmonary artery
catheterization is a procedure using a long, thin tube called a catheter inserted
into a pulmonary artery. IT measures pulmonary artery pressures and cardiac
output.
Pulmonary artery catheterization uses a catheter that has an inflatable balloon
at its tip. The healthcare provider puts this tube through a large vein. The tube
is then moved to the right atrium, one of the heart's upper chambers. It is then
moved on through the right ventricle and out through a pulmonary artery. The
,healthcare provider then inflates the balloon and wedges it into a small
pulmonary blood vessel. With the catheter in place, he or she can learn more
about pressure in the right side of the heart and in the arteries of the lungs.
Blood samples can also be taken at various sites within the heart to
understand blood oxygen flow. The procedure can also tell other important
details, such as heart output.
Define: subdural hematoma
Actions to be taken by nurse? - correct answer-Subdural hematoma: a
collection of blood outside the brain. Usually as a result of a head injury,
life-threatening.
1. Check Oximeter (PRIORITY)
Also: observe for CSF leaking from evacuation site, monitor for manifestations
of increased intracranial pressure, assess for an increase in temperature.
Glasgow Coma Scale assessment? - correct answer-A neurological scale
which aims to give a reliable and objective way of recording the conscious
state of a person
Mild: 13-15
Moderate: 9-12
Severe: 3-8
What is the mnemonic ABCDE stand for? - correct answer-Priority Actions:
Airway
Breathing
Circulation
Disability
Exposure
Chronic Obstructive Pulmonary Disease (COPD)
Nursing actions to comfort patient? - correct answer-chronic inflammatory lung
disease that causes obstructed airflow from the lungs. Symptoms include
breathing difficulty, cough, mucus (sputum) production and wheezing. People
with COPD are at increased risk of developing heart disease, lung cancer and
a variety of other conditions.
,Emphysema and chronic bronchitis are the two most common conditions that
contribute to COPD.
Chronic bronchitis is inflammation of the lining of the bronchial tubes, which
carry air to and from the air sacs (alveoli) of the lungs. It's characterized by
daily cough and mucus (sputum) production.
Emphysema is a condition in which the alveoli at the end of the smallest air
passages (bronchioles) of the lungs are destroyed as a result of damaging
exposure to cigarette smoke and other irritating gases and particulate matter.
Comfort cares:
Fluids to thin secretions
Semi-Fowler position to decrease respiratory effort
Offer supplemental O2
Upon auscultating the lungs, you hear This is a manifestation of what
respiratory condition? - correct answer-Chronic bronchitis:
Priority actions with anaphylaxis? - correct answer-Count respirations and
administer oxygen
Manifestations of pulmonary tuberculosis - correct answer-Definition:
Manifestations:
Night sweats
Low-grade fever
Blood in sputum
Anthrax
Transmission
Symptoms
Treatment - correct answer-Contracted through inhalation of the spores
Bacillus anthraces, or by direct contact with infected animal products.
Symptoms:
,Ingestion: Fever, nausea, vomiting, abdominal pain, bloody diarrhea, and
ascites.
Inhalation: Respiratory distress, stridor, cyanosis, hypotension, and shock.
Treatment: Vasoconstrictors to support the circulatory system and treat shock,
provide other respiratory support.
Pulmonary Embolism, priority action? - correct answer-Administer O2
Then:
- Initiate cardiac monitoring: decreased tissue perfusion, monitor the T wave
and ST segment, as well as Right ventricular failure or MI.
- Start an IV of Lactated Ringer's
Via continuous bolus to maintain cardiac output, and preven shock
- Manage pain, because this can reduce oxygen consumption and limit the
harmful effects of catecholamines
Meds Contraindicated with asthma? - correct answer-Beta Blockers
Blocking beta receptors can cause bronchospasms because it blocks the
sympathetic stimulation which (when unblocked) allows smooth muscle
relaxation.
Beta-blockers are also contraindicated in clients with cariogenic shock, AV
heart block.
Can be used for Migraines.
Parenteral Nutrition - correct answer-(pa-ren-ter-ull)
Usually referred to as Total Parenteral nutrition (TPN).
Feeding of a person through IV.
TPN bypasses the digestive system entirely and goes directly into the
bloodstream, bypassing eating and digestion.
The solution is given through a catheter that has been placed in a
vein.bypassing the usual process of eating and digestion.
, The person receives nutritional formulae that contain nutrients such as
glucose, salts, amino acids, lipids and added vitamins and dietary minerals.
Enteral Nutrition/Feeding - correct answer-Enteral (pronounced en-ter-al)
nutrition is also called tube feeding.
Enteral nutrition is used when a person's digestive system works to some
extent.
The feeding tube is given directly into part of the digestive system. It can be
through a gastrostomy tube (g-tube) in the stomach or a jejunostomy tube
(j-tube) in the small intestine.
Enteral solution is thicker than TPN. It may have the consistency of a
milkshake.
PICC line - correct answer-Peripheral Inserted Central Catheter
A form of intravenous access that can be used for a prolonged period of time
(e.g., for long chemotherapy regimens, extended antibiotic therapy, or total
parenteral nutrition)
How is it placed?
A specially trained nurse or doctor will use an ultrasound machine to find the
veins in your upper arm.
Your arm will be cleaned and covered with a sterile cloth to prevent infection.
Medicine is used to numb the area where the PICC will be placed. The PICC
will be inserted into a vein just above the bend of your elbow and guided into a
large vein in your chest. Most patients feel little or no discomfort during this
procedure.
Once the PICC is in place, it is held to your arm with special tape and covered
with a sterile dressing.
A chest x-ray is taken afterwards to make sure the PICC is in the right place.
You will be able to bend your arm and use your arm just as you would without
the PICC in place.
Benefits of a PICC?
A PICC is more comfortable compared with the many "needle sticks" that
would have been needed for giving medications and drawing blood. The goal
is to spare your veins from these frequent "needle sticks."
Misc)
Pleurisy - correct answer-What it is? A condition in which the pleura — a
membrane consisting of a layer of tissue that lines the inner side of the chest
cavity and a layer of tissue that surrounds the lungs — becomes inflamed.
Also called pleuritis, pleurisy causes sharp chest pain (pleuritic pain) that
worsens during breathing.
What it sounds like?
Loud, scratchy, sand-paper like noises
Upon auscultating the lungs, you hear squeaky, musical sounds. This is a
manifestation of what respiratory condition? - correct answer-bronchospasm-
this is caused by air whooshing through narrowed airways, like pipes
Upon auscultating the lungs, you hear popping sounds. This is a manifestation
of what respiratory condition? - correct answer-Popping is caused by air
moving through deflated airways.
Possible conditions:
Atelectasis: a complete or partial collapse of a lung or lobe of a lung- deflated
alveoli. Usually a post-op complication.
OR
Pneumonia: an infection in one or both lungs. It can be caused by bacteria,
viruses, or fungi causing inflammation in the alveoli. The alveoli fill with fluid or
pus, making it difficult to breathe. (ALSO sounds DULL)
Upon auscultating the lungs, you hear tympany. This is a manifestation of
what respiratory condition? - correct answer-Pneumothorax: a collapsed lung.
A pneumothorax occurs when air leaks into the space between your lung and
chest wall. This air pushes on the outside of your lung and makes it collapse.
In most cases, only a portion of the lung collapses.
Upon auscultating the lungs, you hear flatness. This is a manifestation of what
respiratory condition? - correct answer-Flatness or dullness is associated with
,pleural effusion, or a build up of fluid in the space between the lungs and the
chest wall. Pleural effusion is always a secondary condition:
Liver or kidney disease: Diseases such as cirrhosis may cause fluid to build
up in the body and leak into the chest.
Congestive heart failure: Failure of the heart to pump blood properly can
cause a buildup of liquid in the chest.
Autoimmune disorders: Disorders such as lupus or rheumatoid arthritis may
target the lungs and create problems with the pleura.
Infections: Respiratory infections such as tuberculosis and pneumonia could
progress and cause water on the lung.
Pulmonary embolism: A blockage in the arteries of the lung caused by a blood
clot can cause the pleura to create too much liquid.
Cancer: Typically lung cancer, though any cancer which has progressed to the
lungs or pleura can be the cause.
Upon auscultating the lungs, you hear resonance. This is a manifestation of
what respiratory condition? - correct answer-Chronici bronchitis. It is a loud,
low pitched sound of long duration.
Upon auscultating the lungs, you hear snoring sounds. This is a manifestation
of what respiratory condition? - correct answer-Snoring sounds, AKA rhonchi,
are heard when a client has thick, tenacious secretions in the airways.
What is a pulmonary artery catheter?
What would you tell a patient it is for? - correct answer-Pulmonary artery
catheterization is a procedure using a long, thin tube called a catheter inserted
into a pulmonary artery. IT measures pulmonary artery pressures and cardiac
output.
Pulmonary artery catheterization uses a catheter that has an inflatable balloon
at its tip. The healthcare provider puts this tube through a large vein. The tube
is then moved to the right atrium, one of the heart's upper chambers. It is then
moved on through the right ventricle and out through a pulmonary artery. The
,healthcare provider then inflates the balloon and wedges it into a small
pulmonary blood vessel. With the catheter in place, he or she can learn more
about pressure in the right side of the heart and in the arteries of the lungs.
Blood samples can also be taken at various sites within the heart to
understand blood oxygen flow. The procedure can also tell other important
details, such as heart output.
Define: subdural hematoma
Actions to be taken by nurse? - correct answer-Subdural hematoma: a
collection of blood outside the brain. Usually as a result of a head injury,
life-threatening.
1. Check Oximeter (PRIORITY)
Also: observe for CSF leaking from evacuation site, monitor for manifestations
of increased intracranial pressure, assess for an increase in temperature.
Glasgow Coma Scale assessment? - correct answer-A neurological scale
which aims to give a reliable and objective way of recording the conscious
state of a person
Mild: 13-15
Moderate: 9-12
Severe: 3-8
What is the mnemonic ABCDE stand for? - correct answer-Priority Actions:
Airway
Breathing
Circulation
Disability
Exposure
Chronic Obstructive Pulmonary Disease (COPD)
Nursing actions to comfort patient? - correct answer-chronic inflammatory lung
disease that causes obstructed airflow from the lungs. Symptoms include
breathing difficulty, cough, mucus (sputum) production and wheezing. People
with COPD are at increased risk of developing heart disease, lung cancer and
a variety of other conditions.
,Emphysema and chronic bronchitis are the two most common conditions that
contribute to COPD.
Chronic bronchitis is inflammation of the lining of the bronchial tubes, which
carry air to and from the air sacs (alveoli) of the lungs. It's characterized by
daily cough and mucus (sputum) production.
Emphysema is a condition in which the alveoli at the end of the smallest air
passages (bronchioles) of the lungs are destroyed as a result of damaging
exposure to cigarette smoke and other irritating gases and particulate matter.
Comfort cares:
Fluids to thin secretions
Semi-Fowler position to decrease respiratory effort
Offer supplemental O2
Upon auscultating the lungs, you hear This is a manifestation of what
respiratory condition? - correct answer-Chronic bronchitis:
Priority actions with anaphylaxis? - correct answer-Count respirations and
administer oxygen
Manifestations of pulmonary tuberculosis - correct answer-Definition:
Manifestations:
Night sweats
Low-grade fever
Blood in sputum
Anthrax
Transmission
Symptoms
Treatment - correct answer-Contracted through inhalation of the spores
Bacillus anthraces, or by direct contact with infected animal products.
Symptoms:
,Ingestion: Fever, nausea, vomiting, abdominal pain, bloody diarrhea, and
ascites.
Inhalation: Respiratory distress, stridor, cyanosis, hypotension, and shock.
Treatment: Vasoconstrictors to support the circulatory system and treat shock,
provide other respiratory support.
Pulmonary Embolism, priority action? - correct answer-Administer O2
Then:
- Initiate cardiac monitoring: decreased tissue perfusion, monitor the T wave
and ST segment, as well as Right ventricular failure or MI.
- Start an IV of Lactated Ringer's
Via continuous bolus to maintain cardiac output, and preven shock
- Manage pain, because this can reduce oxygen consumption and limit the
harmful effects of catecholamines
Meds Contraindicated with asthma? - correct answer-Beta Blockers
Blocking beta receptors can cause bronchospasms because it blocks the
sympathetic stimulation which (when unblocked) allows smooth muscle
relaxation.
Beta-blockers are also contraindicated in clients with cariogenic shock, AV
heart block.
Can be used for Migraines.
Parenteral Nutrition - correct answer-(pa-ren-ter-ull)
Usually referred to as Total Parenteral nutrition (TPN).
Feeding of a person through IV.
TPN bypasses the digestive system entirely and goes directly into the
bloodstream, bypassing eating and digestion.
The solution is given through a catheter that has been placed in a
vein.bypassing the usual process of eating and digestion.
, The person receives nutritional formulae that contain nutrients such as
glucose, salts, amino acids, lipids and added vitamins and dietary minerals.
Enteral Nutrition/Feeding - correct answer-Enteral (pronounced en-ter-al)
nutrition is also called tube feeding.
Enteral nutrition is used when a person's digestive system works to some
extent.
The feeding tube is given directly into part of the digestive system. It can be
through a gastrostomy tube (g-tube) in the stomach or a jejunostomy tube
(j-tube) in the small intestine.
Enteral solution is thicker than TPN. It may have the consistency of a
milkshake.
PICC line - correct answer-Peripheral Inserted Central Catheter
A form of intravenous access that can be used for a prolonged period of time
(e.g., for long chemotherapy regimens, extended antibiotic therapy, or total
parenteral nutrition)
How is it placed?
A specially trained nurse or doctor will use an ultrasound machine to find the
veins in your upper arm.
Your arm will be cleaned and covered with a sterile cloth to prevent infection.
Medicine is used to numb the area where the PICC will be placed. The PICC
will be inserted into a vein just above the bend of your elbow and guided into a
large vein in your chest. Most patients feel little or no discomfort during this
procedure.
Once the PICC is in place, it is held to your arm with special tape and covered
with a sterile dressing.
A chest x-ray is taken afterwards to make sure the PICC is in the right place.
You will be able to bend your arm and use your arm just as you would without
the PICC in place.
Benefits of a PICC?
A PICC is more comfortable compared with the many "needle sticks" that
would have been needed for giving medications and drawing blood. The goal
is to spare your veins from these frequent "needle sticks."
