Breath Easy?
Sit upright
Lean forward
Direct lateral pressure to the sides of nose
What is managing a nose bleed?
Vaccinations (flu and pneumococcal)
Handwashing
Respiratory etiquette (coughing into sleeve); wearing a mask and social distancing
What are ways to prevent Flu and/or PNA
Negative pressure airflow room
N-95 mask (fitted respirator mask)
PPE
What are precautions needed for caring for a hospitalized patient with confirmed TB?
88-91%
What is acceptable O2 saturation for COPD
Requires immediate treatment
No more than 25% in first hour
What is Hypertensive Emergency?
Your patient, Stanley, is post op for a tonsillectomy and frustrated because they have to keep swallowing.
What will you say/do?
What is:
Frequent swallowing could indicate a posterior bleeding. Place patient in semi-fowlers, try to visualize with penlight. Contact PROVIDER
c/o fatigue
fever (103.2F),
Chest is tight when with breathing
Coughing up thick green mucus
What is Possible PNA.
Care: V/S to include pulse ox. to ensure hemodynamically stable. Auscultate lungs. CXR, sputum Cx for C&S and antibiotics.
Possible EKG to r/o cardiac w/ c/o chest "tightness"
Persistent cough or change in cough
Dyspnea
Hemoptysis or blood tinged sputum
Altered lung sounds (possible wheezing)
Pleural effusions
What are signs of possible Lung Ca?
Tanya is taking Rifampin.
List 3 things that are important for her know?
*Medication is used for TB. *Do not stop taking it as it could cause TB to become resistant. *It can make skin and/or urine reddish/orange tinged. *Use alternate form of contraception b/c it can decrease effectiveness of oral contraception. *Do not drink--WATCH for s/ of liver toxicity. *Follow up with provider to make sure clear.
Intermittent claudication
Diminished hair growth
Pale or mottled dry, scaly skin
Cool to touch distal assessment
Diminished pulses
What are signs of PAD (peripheral arterial disease/insufficiency)?
What is Stridor?
Progressive restrictive lung disease that happens after lung injury causing fibrosis and scarring. Usually older people who are exposed to inhalation irritants
Life expectancy is < 5 years
Decreased FVC. antifibrotic meds and steroids. Only cure is lung transplant.
What is pulmonary fibrosis?
Use Lotion and sunscreen
Wear loose fitted clothing,
Use gentle soaps
Do not shave.
Voice may become hoarse, consider alternate communication.
What is patient education for radiation care with laryngeal cancer?
COPD patients should limit food intake because it is too difficult to eat and breath and they will just drop their O2 saturation making it more difficult to breath. T/F? why or why not?
False. COPD patients have an increased metabolic need and require increased calories, protein, and dietary supplements.
Acute inflammation of the lymphatic channels as evidenced by red streaks from a local infection requiring antibiotic treatment
What is lymphangitis?
Rest
Hydrate
Intranasal Saline lavage
Decongestants/Antihistamines
Humidified air &/or Warm compresses
What is:
Treatment for acute viral rhinosinusitis.
Positive Sweat Chloride Test
Thick tenacious sputum
Recurrent resp infections
Need daily CPT.
Non pulmonary: GERD, Foul stool, steatorrhea, malnourishment, vitamin deficiencies, Diabetes, osteoporosis as grow to adult
What is Cystic Fibrosis?
LaVerne's mantoux was (+). Now what?
+ mantoux indicates exposure to TB, but does not indicate the disease is present. Further testing may include symptom screen, an AFB sputum culture and a CXR.
Hypoallergenic bedding products
Using a HEPA filter
Removal of Home Carpeting
What are environmental changes for patients with allergies?
Gnawing back pain
Abdominal Pulsation
Risk for sudden rupture
What is an Abdominal Aortic Aneurysm
A child weighs 33 lb 12 oz.
What is the weight in kg? Round to the nearest tenth (one decimal place)
What is 15.3kg
A medication order states, infuse 0.9% Normal Saline (NS) 400 mL IV bolus over 30 minutes. The IV pump must be set to _______mL/hr?
800
Obese
Loud snoring--short neck, large uvula, enlarge tonsils
Irritable
Headaches, sleepy, difficulty concentrating
Unhappy Spouse
What are signs of possible Obstructive Sleep Apnea?
A medication order states
Ciproflaxin 300mg IVPB q 12h
The pharmacy sends Ciproflaxin 300mg in a 100ml NS to infuse over 2 hours.
The IV pump must be set at _____ml/hr
50
Patient weighing 90kg, with a peripheral arterial embolism to their R arm is prescribed Heparin @ 16u/kg/hr.
Available: Heparin 25,000u/250ml D5W
How many ml/hr will you set the IV pump?
(round to nearest whole number)
14