NU 155 Exam 2 Questions and Answers

NU 155 Exam 2 Questions and Answers Pleurisy/ pleuritis: inflammation of the pleura - Ans:-*causes:* infection, medications, lupus, rheumatoid arthritis *s/s:* sharp, abrupt! onset, most evident on inspiration, shallow breathing and pleural friction rub *Tx:* splint affected side during coughing for relief, intercostal nerve block for severe pleuritic pain vesicular breath sounds - Ans:--heard in the 6th intercostal space over lung tissue -sounds low medium pitched, soft whooshing 2-3x length of expiration Bronchovescular breath sounds - Ans:--heard main-stem bronchi, below clavicles, beside sternum, posteriorly, between scapulae -sounds like moderate high pitches hollow muffled equal sounds on inspiration and expiration Bronchial breath sounds - Ans:--heard over trachea above sternal notch (often indicate atelectasis) -sounds high pitched, loud harsh tubular quality, inspiration half as long as expiration ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 2/17 COPD (chronic obstructive pulmonary disease): (PATHO, Dx, S/S, N/I, pt. teaching) - Ans:--combo of *chronic bronchitis, asthma, and emphysema* -caused by: *tobacco smoke (90%)*, occupational hazards like farming, biomass fuels, firefighters -*Dx*: chest X-ray, EKG, labs like high hematocrit, ABG -*S/S*: dyspnea, barrel chest, polycythemia (high RBC), hypercapnia (high CO2), coughing up in the morning -*N/I* titrate o2 to 92%, bronchodilators, hydrate uncaffeinated liquids -teach pt: avoid over eating, smaller bites, increase fluid and calcium, adequate protein, rest before eating and meds, and avoid lying down after Thyroid Storm (thyroid crisis) - Ans:--*causes*: drugs or dyes with iodine, pregnancy/child birth, M.I. or cardiac emergencies, severe emotional distress, trauma, surgery, levothyroxine overdose -*s/s*: 106ºF +, 200bpm, high b/p, tachypnea, HTN, restlessness, agitation, confusion, if *untreated* delirium to coma to heart failure to death -*Tx*: MUST begin as soon as symptoms occur!, reduce temp. slow HR, sedatives, increase fluid avoid dehydration DKA -VS- HHS - Ans:-+DKA (Type 1): hyperglycemic crisis associated with elevated ketones! ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 3/17 +HHS (Type 2): hyperglycemic crisis without association of ketones! -*DKA:* BS 300mg/dL *HHS:* BS 600mg/dL *DKA* Ketonuria -*HHS* Older adults at higher risk, and higher mortality r/t severe dehydration and extreme hyperglycemia (than DKA) -*DKA:* N/V, abdominal pain, rigidity *HHS:* NO GI NO KETOACIDOSIS -*DKA:* Kussmaul breathing *HHS:* Seizures -*DKA:* Acetone (fruit) breath *HHS:* Confusion -*DKA:* Stupor or coma (late) *HHS:* Coma Chronic bronchitis emphysema sputum characteristic - Ans:-thick, tenacious, "ropy" and difficult to cough up! pneumococcal pneumonia sputum characteristic - Ans:-Scant, sticky, rust colored Pulmonary edema sputum characteristic - Ans:-Frothy, pinkish, or blood tinged pulmonary infection sputum characteristic - Ans:-yellow, yellow-green, or grayish yellow with foul odor or taste ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 4/17 T.B., ulcerated pulmonary vessel or bronchogenic carcinoma sputum characteristics - Ans:-blood tinged, bloody, or blood-streaked Pneumonia or Bronchitis sputum characteristics - Ans:-LARGE AMOUNTS Asthma sputum characteristics - Ans:-Scanty Inadequate hydration sputum characteristics - Ans:-very THICK and viscious Bronchiectasis sputum characteristics - Ans:-Large amounts of foamy, purulent, foul odor *GOITER* (Benign or malignant) a greatly enlarged thyroid gland caused by deficient iodine - Ans:-- *S/S* ^TSH, enlargement of front of neck, difficulty swallowing or breathing indicates severity -*N/I* Give iodine through straw avoid teeth staining -Adverse effects: GI upset, metallic taste, skin rash, allergic reaction, epigastric pain -Pt. on thyroid supplements may have palpations or be tachycardic