Breathe Easy
Which post-op complication is caused by alveolar collapse, and how is it prevented?
Atelectasis; prevented with incentive spirometry and early ambulation.
An elevated BNP (>100 pg/mL) is an indicator of what condition?
Heart Failure
What is the therapeutic purpose of beta 2-adrenergic agonists like albuterol?
To relax bronchial smooth muscle and relieve bronchospasm in conditions like asthma and COPD.
What does the acronym SBAR stand for?
Situation, Background, Assessment, Recommendation
A patient’s WBC is 15,000 cells/mcL. What does this suggest?
Infection. Assess for fever or wound drainage and notify the provider.
What are two evidence-based nursing interventions to prevent hospital-acquired pneumonia?
Elevate the head of the bed >30 degrees and encourage incentive spirometry.
What is the primary cause of left-sided heart failure?
Chronic hypertension
What is a common side effect of furosemide (Lasix)?
Hypokalemia or dehydration
How long should suctioning be applied per pass when suctioning a tracheostomy?
No longer than 10-15 seconds.
What electrolyte imbalance is associated with spironolactone therapy?
Hyperkalemia
What breathing technique is most effective for COPD patients to prevent air trapping?
Pursed-lip breathing.
A heart failure patient is experiencing fluid overload. What is one priority nursing intervention?
Administer diuretics like furosemide and monitor I&O
Which medication requires monitoring for bradycardia and should be held if HR <60 bpm?
Digoxin or metoprolol
Name one nursing intervention to prevent deep vein thrombosis in post-operative patients.
Apply sequential compression devices or encourage early ambulation.
A patient has a hemoglobin of 7 g/dL. What symptom might occur, and what intervention is needed?
Fatigue. Administer iron or prepare for a blood transfusion if ordered.
A patient using a non-rebreather mask becomes drowsy and confused. What is the priority nursing action?
Check oxygen flow rate and assess for CO₂ retention.
In heart failure, what compensatory mechanisms temporarily maintain cardiac output but ultimately worsen the condition?
Sympathetic nervous system activation (↑HR, vasoconstriction) and Renin-Angiotensin-Aldosterone System (RAAS) activation (fluid retention, ↑preload)
What is the therapeutic action of digoxin?
Increases myocardial contractility and decreases heart rate.
What is the purpose of the surgical time-out procedure?
Prevent wrong-site, wrong-procedure, or wrong-patient errors.
Which lab value must be closely monitored in a patient taking digoxin?
Potassium
A post-op patient refuses to use the incentive spirometer due to pain. What is the nurse’s next action?
Provide pain medication, reassess pain level, and encourage use of incentive spirometry to prevent pneumonia.
A patient with heart failure gains 5 lbs in 3 days and is experiencing dyspnea. What are two priority interventions?
Assess for worsening heart failure (lung sounds, edema, vital signs) and notify the provider. May need diuretic adjustment.
A patient taking furosemide reports leg cramps and muscle weakness. What is the nurse’s priority action?
Check potassium levels and notify provider. May need potassium replacement.
A post-op patient with limited mobility reports new onset of unilateral leg swelling, warmth, and pain. What are three priority nursing actions?
1. Keep the affected leg elevated and immobilized
2. Notify the provider immediately
3. Assess for signs of PE (dyspnea, chest pain) and prepare for anticoagulation therapy. Do not massage the leg due to clot risk.
An elevated D-dimer is indicative of what condition?
Possible blood clot, such as deep vein thrombosis or pulmonary embolism.