NURS 3561 MED SURG EXAM TWO STUDY GUIDE latest update
2022/2023
Respiratory System - HAYLEE
Explain & discuss assessment findings manifest in lower
respiratory disorders (COPD, asthma, pneumonia,
tuberculosis), and relate them to underlying
pathophysiological processes.
COPD consists of emphysema and chronic bronchitis –
irreversible. Chronic bronchitis causes structural and
inflammation changes. Emphysema damages and enlarges
alveoli (air sacs) causing breathlessness.
Risk factors: smoking!!!, occupational chemicals and dust, air
pollution, infection and some genetic factors (AAT deficiency).
Develops slowly, chronic intermittent cough may occur first.
Dyspnea is progressive, occurring with exertion. Unable to take a
deep breath. Will interfere with ADLs. With advanced COPD,
you'll see weight loss despite adequate intake, fatigue, wheezes,
adventitious or decreased breath sounds, severe cough leading to
fainting/breaking a rib, barrel chest, relief in tripod position,
pursed lip breathing, usage of accessory muscles, hypoxemia,
blue/red color of skin, retaining CO2 (look at ABGs), edema in the
ankles secondary to right sided heart involvement (aka cor
pulmonale). Patients with COPD are at a high risk of respiratory
NURS 3561 MED SURG EXAM TWO STUDY GUIDE latest update
2022/2023
,NURS 3561 MED SURG EXAM TWO STUDY GUIDE latest update
2022/2023
failure. Use of beta-adrenergic blockers (atenolol) can improve
survival rate and decrease risk of exacerbations.
Nurse assessment in acute exacerbation event: increase in
dyspnea, sputum volume and purulence, malaise, insomnia,
fatigue, depression, confusion, decrease in exercise tolerance,
confusion, increase in wheezing, may have a fever.
Nursing considerations: if the patient retains CO2, careful
monitoring when on oxygen or during surgery and post op is
crucial. They might appear to be resting comfortably, but actually
aren't. Abdominal surgery can lead to ineffective ventilation and
respiratory failure due to the inability to take deep breaths.
Diagnostics: spirometry – must confirm obstruction. Pulmonary
function test. Chest x-ray will show a flat diaphragm, hyper
inflated lungs. Serum and antitrypsin level (genetics), ABGs. 6
minute walk test, COPD assessment test, BODE index.
Medications/treatments for COPD exacerbation event:
bronchodilators, supplemental oxygen, short acting
anticholinergic, corticosteroids,
NURS 3561 MED SURG EXAM TWO STUDY GUIDE latest update
2022/2023
,NURS 3561 MED SURG EXAM TWO STUDY GUIDE latest update
2022/2023
noninvasive mechanical ventilation (CPAP).
Expected SPO2: 90% goal of oxygen therapy
Inflammatory Disorder - Asthma
A chronic inflammatory response in the lungs, chronic. Usually
reversible. Can be severe and life-threatening. When a patient is
exposed to a trigger, it leads to inflammation, a bronchospasm
and narrowing of airways to make it difficult to breathe. Risk
factors: genetics, immune response, allergens, exercise, air
pollution, occupational hazards, respiratory tract infections, nose
and sinus issues, drug and food allergens/additives, GERD,
psychological factors (extreme emotion can cause an episode).
Types of triggers: strong odors, pollution, anger, stress, pets,
exercise, pollen, bugs, chemicals, cold air, spores, dust and
smoke. There are different triggers from person to person.
Peak flow meter: used to see where they are at, to plan for their cares. FEV
– forced expiratory volume for 1 second. Aerochamber: seals the
medication in the chamber – helpful when patient is coughing
while trying to take medication so they don't lose it.
Asthma classifications (Per the lecture, we don't need to
know specifics, but we need to be aware of them):
Intermittent – symptoms are less than 2 days a week, 0-1
exacerbations per year. No limitations.
NURS 3561 MED SURG EXAM TWO STUDY GUIDE latest update
2022/2023
, NURS 3561 MED SURG EXAM TWO STUDY GUIDE latest update
2022/2023
Persistent mild – Symptoms are greater than 2 days a week, not
daily. Exacerbations 2x a year. FEV1 = >80% predicted.
Persistent moderate – daily symptoms, night >1/week. SABA
usage daily. Some limitations. FEV1 = 60-80% predicted.
Persistent severe – symptoms are continuous, nighttime often.
SABA several times a day. FEV1 = <80% predicted.
Goal of asthma tx: achieve and maintain control. Monitoring
the disease and assess at severity.
Asthma medications (Meds are the examples mentioned in
the lecture).
LONG TERM MEDS: Anti-inflammatories (Singulair) such as
corticosteroids (inhaled or oral), leukotriene modifiers, Anti-igE.
Bronchodilators (Atrovent, Serovent) such as long-acting B2-
adrenergic agonists and methylxanthines (rarely used).
QUICK RELIEF MEDS: Bronchodilators (Albuterol,
Proventil) such as short acting inhaled B2 adrenergic agonists,
anticholinergic drugs. Anti-
NURS 3561 MED SURG EXAM TWO STUDY GUIDE latest update
2022/2023
2022/2023
Respiratory System - HAYLEE
Explain & discuss assessment findings manifest in lower
respiratory disorders (COPD, asthma, pneumonia,
tuberculosis), and relate them to underlying
pathophysiological processes.
COPD consists of emphysema and chronic bronchitis –
irreversible. Chronic bronchitis causes structural and
inflammation changes. Emphysema damages and enlarges
alveoli (air sacs) causing breathlessness.
Risk factors: smoking!!!, occupational chemicals and dust, air
pollution, infection and some genetic factors (AAT deficiency).
Develops slowly, chronic intermittent cough may occur first.
Dyspnea is progressive, occurring with exertion. Unable to take a
deep breath. Will interfere with ADLs. With advanced COPD,
you'll see weight loss despite adequate intake, fatigue, wheezes,
adventitious or decreased breath sounds, severe cough leading to
fainting/breaking a rib, barrel chest, relief in tripod position,
pursed lip breathing, usage of accessory muscles, hypoxemia,
blue/red color of skin, retaining CO2 (look at ABGs), edema in the
ankles secondary to right sided heart involvement (aka cor
pulmonale). Patients with COPD are at a high risk of respiratory
NURS 3561 MED SURG EXAM TWO STUDY GUIDE latest update
2022/2023
,NURS 3561 MED SURG EXAM TWO STUDY GUIDE latest update
2022/2023
failure. Use of beta-adrenergic blockers (atenolol) can improve
survival rate and decrease risk of exacerbations.
Nurse assessment in acute exacerbation event: increase in
dyspnea, sputum volume and purulence, malaise, insomnia,
fatigue, depression, confusion, decrease in exercise tolerance,
confusion, increase in wheezing, may have a fever.
Nursing considerations: if the patient retains CO2, careful
monitoring when on oxygen or during surgery and post op is
crucial. They might appear to be resting comfortably, but actually
aren't. Abdominal surgery can lead to ineffective ventilation and
respiratory failure due to the inability to take deep breaths.
Diagnostics: spirometry – must confirm obstruction. Pulmonary
function test. Chest x-ray will show a flat diaphragm, hyper
inflated lungs. Serum and antitrypsin level (genetics), ABGs. 6
minute walk test, COPD assessment test, BODE index.
Medications/treatments for COPD exacerbation event:
bronchodilators, supplemental oxygen, short acting
anticholinergic, corticosteroids,
NURS 3561 MED SURG EXAM TWO STUDY GUIDE latest update
2022/2023
,NURS 3561 MED SURG EXAM TWO STUDY GUIDE latest update
2022/2023
noninvasive mechanical ventilation (CPAP).
Expected SPO2: 90% goal of oxygen therapy
Inflammatory Disorder - Asthma
A chronic inflammatory response in the lungs, chronic. Usually
reversible. Can be severe and life-threatening. When a patient is
exposed to a trigger, it leads to inflammation, a bronchospasm
and narrowing of airways to make it difficult to breathe. Risk
factors: genetics, immune response, allergens, exercise, air
pollution, occupational hazards, respiratory tract infections, nose
and sinus issues, drug and food allergens/additives, GERD,
psychological factors (extreme emotion can cause an episode).
Types of triggers: strong odors, pollution, anger, stress, pets,
exercise, pollen, bugs, chemicals, cold air, spores, dust and
smoke. There are different triggers from person to person.
Peak flow meter: used to see where they are at, to plan for their cares. FEV
– forced expiratory volume for 1 second. Aerochamber: seals the
medication in the chamber – helpful when patient is coughing
while trying to take medication so they don't lose it.
Asthma classifications (Per the lecture, we don't need to
know specifics, but we need to be aware of them):
Intermittent – symptoms are less than 2 days a week, 0-1
exacerbations per year. No limitations.
NURS 3561 MED SURG EXAM TWO STUDY GUIDE latest update
2022/2023
, NURS 3561 MED SURG EXAM TWO STUDY GUIDE latest update
2022/2023
Persistent mild – Symptoms are greater than 2 days a week, not
daily. Exacerbations 2x a year. FEV1 = >80% predicted.
Persistent moderate – daily symptoms, night >1/week. SABA
usage daily. Some limitations. FEV1 = 60-80% predicted.
Persistent severe – symptoms are continuous, nighttime often.
SABA several times a day. FEV1 = <80% predicted.
Goal of asthma tx: achieve and maintain control. Monitoring
the disease and assess at severity.
Asthma medications (Meds are the examples mentioned in
the lecture).
LONG TERM MEDS: Anti-inflammatories (Singulair) such as
corticosteroids (inhaled or oral), leukotriene modifiers, Anti-igE.
Bronchodilators (Atrovent, Serovent) such as long-acting B2-
adrenergic agonists and methylxanthines (rarely used).
QUICK RELIEF MEDS: Bronchodilators (Albuterol,
Proventil) such as short acting inhaled B2 adrenergic agonists,
anticholinergic drugs. Anti-
NURS 3561 MED SURG EXAM TWO STUDY GUIDE latest update
2022/2023
