pharmacology
A client with a positive skin test for TB isn’t showing signs of active disease. To help prevent the development of active TB, the client should be treated with isoniazid, 300 mg daily, for how long?
D. 9-12 months
An elderly client with pneumonia may appear with which of the following symptoms first?
Altered mental state and dehydration
When auscultating the chest of a client with pneumonia, the nurse would expect to hear which of the following sounds over areas of consolidation?
Bronchial.
Chest auscultation reveals bronchial breath sounds over areas of consolidation. When bronchial sounds are heard in areas distant from where they normally occur, the patient may have consolidation (as occurs with pneumonia) or compression of the lung. These conditions cause the lung tissue to be dense.
Clients with chronic illnesses are more likely to get pneumonia when which of the following situations is present?
A. Dehydration
B. Group Living
C. Malnutrition
D. Severe Periodontal Disease
B. Group Living
Clients with chronic illnesses generally have poor immune systems. Often, residing in group living situations increases the chance of disease transmission. Pneumonia is a fairly prevalent disease and carries a heavy burden in all populations.
A diagnosis of pneumonia is typically achieved by which of the following diagnostic tests?
A. ABG analysis
B. Chest X-Ray
C. Blood Cultures
D. Sputum culture and Sensitivity
D. Sputum culture and sensitivity
Sputum C & S is the best way to identify the organism causing the pneumonia. If good quality, sputum evaluation may reveal more than 25 WBC per low-power field and less than 10 squamous epithelial cells.
What are the four "RIPE" medications administered to active TB patients?
R-rifampin
I-Isoniazid
P- Pyrazinamide
E- Ethambutol
A client has active TB. Which of the following symptoms will he exhibit?
A. Chest and lower back pain.
B. Chills, fever, night sweats, and hemoptysis.
C. Fever of more than 104*F and nausea.
D. Headache and photophobia.
B. Chills, fever, night sweats and hemoptysis
A client with pneumonia develops dyspnea with a respiratory rate of 32 breaths/minute and difficulty expelling his secretions. The nurse auscultates his lung fields and hears bronchial sounds in the left lower lobe. The nurse determines that the client requires which of the following treatments first?
A. Antibiotics
B. Bedrest
C. Oxygen
D. Nutritional intake
C. Oxygen
The client is having difficulty breathing and is probably becoming hypoxic. As an emergency measure, the nurse can provide oxygen without waiting for a physician’s order. Anticipate the need for supplemental oxygen or intubation if the patient’s condition deteriorates.
What are some risk factors for aspiration pneumonia?
loss of conciousness, stroke patients, difficulty swallowing, NG tube insertion
A client with primary TB infection can expect to develop which of the following conditions?
A. Active TB within 2 weeks
B. Active TB within 2 months
C. A fever that requires hospitalization
D. A positive skin test
D. A positive skin test
What are some symptoms that a patient taking Rifampin should notify a HCP?
Signs of hepatitis.
Flu-like symptoms.
Unusual bleeding or bruising.
A client is diagnosed with active TB and started on triple antibiotic therapy. What signs and symptoms would the client show if therapy is inadequate?
D. Positive acid-fast bacilli in a sputum sample after 2 months of treatment
A 24-year-old client comes into the clinic complaining of right-sided chest pain and shortness of breath. He reports that it started suddenly. The assessment should include which of the following interventions?
A. Auscultation of the breath sounds
Because the client is short of breath, listening to breath sounds is a good idea. He may need a chest x-ray and an ECG, but a physician must order these tests.
A client’s ABG analysis reveals a pH of 7.18, PaCO2 of 72 mm Hg, PaO2 of 77 mm Hg, and HCO3- of 24 mEq/L. What do these values indicate?
D. Respiratory acidosis
Respiratory acidosis is a state in which there is usually a failure of ventilation and an accumulation of carbon dioxide. The primary disturbance of elevated arterial PCO2 is the decreased ratio of arterial bicarbonate to arterial PCO2, which leads to a lowering of the pH. To compensate for the disturbance in the balance between carbon dioxide and bicarbonate (HCO3-), the kidneys begin to excrete more acid in the forms of hydrogen and ammonium and reabsorb more base in the form of bicarbonate. This compensation helps to normalize the pH.
Which of the following diagnostic tests is definitive for TB?
C. Sputum culture
The sputum culture for Mycobacterium tuberculosis is the only method of confirming the diagnosis. Mycobacterial culture is the gold standard for diagnosis.
What is the pharmacological treatment for viral pneumonia?
there is none, it is self-limiting in 3-4 days
An 87-year-old client requires long-term ventilator therapy. He has a tracheostomy in place and requires frequent suctioning. Which of the following techniques is correct?
C. Using intermittent suction while withdrawing the catheter.
Intermittent suction should be applied during catheter withdrawal. To prevent hypoxia, suctioning shouldn’t last more than 10-seconds at a time. Suction shouldn’t be applied while the catheter is being advanced. Ensure preoxygenation with 100% FiO2 was done with adequate pulse oximetry measurements. Preoxygenation is required because airway suctioning procedure may be associated with significant hypoxemia.
What diet would a nurse recommend to a pneumonia patient?
High calorie, small frequent meals.
Which of the following methods is the best way to confirm the diagnosis of a pneumothorax?
C. Take a chest x-ray
A chest x-ray will show the area of collapsed lung if pneumothorax is present as well as the volume of air in the pleural space. Chest radiography, ultrasonography, or CT can be used for diagnosis, although diagnosis from a chest x-ray is more common.
Other than antibiotics, what are some other medications that would be prescribed for a pneumonia patient?
Analgesics (for chest pain)
Antipyretics
Empiric Therapy
What is an emergency protocol for a tracheostomy dislodgment when the nurse is unable to replace the tube? (Three steps)
1. Position patient in semi-fowler.
2. cover stoma w/sterile dressing
3. ventilate w/BVM until help arrives
What are some nursing interventions to help prevent and problem solve a potential dislodgment of a tracheostomy? Select all that apply.
A. Replacement tube at bedside
B. Don't change ties within 24 hours
C. Physician performs 1st tube change.
D. Suction on a regular basis
A. Replacement tube at bedside
B. Don't change ties within 24 hours
C. Physician performs 1st tube change.