Respiratory
What is the nursing care following a bronchoscopy?
- position in semi fowlers
- turn/cough/deep breath
- assess gag reflex prior to PO intake
- frequent vital signs
What are some rx factors for hypertension?
Modifiable vs. non-modifiable?
Modifiable:
- obesity, diet, sedentary lifestyle, diabetes, smoking, excessive alcohol use, chronic stress, sleep apnea
Non-modifiable:
- Age, ethnicity, gender, family hx
What are some modifiable rx factors for CAD?
- tobacco use
- obesity
- Poor diet choices (high fat, sodium, sugar)
- hypertension
- sedentary lifestyle
- uncontrolled diabetes
- excessive alcohol consumption
- chronic stress
- sleep apnea
What are the precipitating factors for angina?
- physical exertion
- emotional stress
- temperature extremes
- heavy meals
- smoking
- stimulants
- hypertension
What are some s/s of pneumonia?
- Consolidation on an x-ray, cough, sputum production (yellow, green, or rust colored), SOB, chest pain, crackles/rales, diminished breath sounds
Vitals:
Tachypnea, tachycardia, febrile (hypothermia in older adults), hypoxia
What lifestyle modifications are recommended for patients with hypertenion?
- regular physical activity
- decreased caffeine
- diet modification
- maintaining medication therapy
- monitoring s/s
- reducing stress
- taking physical breaks when needed
What are common signs/symptoms of CAD
- Chest pain
- Dyspnea
- fatigue/ weakness
- palpitations
- dizziness
- nausea
- diaphoresis
What is the primary rx factor for heart failure?
- Hypertension
What are the signs and symptoms of acute bronchitis?
- Cough
- Wheezing
- fever
- malaise
- sputum production
- SOB
- clear lung sounds after coughing
- no consolidation on chest x-ray
What are the signs and symptoms of a hypertensive crisis?
Neurological:
Confusion, altered mental status, agitation
Seizures
Severe headache
Stroke symptoms (weakness, numbness, difficulty speaking, loss of balance)
Visual loss (retinopathy, papilledema)
Cardiovascular:
Chest pain (may indicate myocardial infarction or aortic dissection)
Shortness of breath (from pulmonary edema or heart failure)
Back pain (possible aortic dissection)
Palpitations
Renal:
Decreased urine output or dark urine (acute kidney injury)
Other:
Severe fatigue or weakness
Swelling (edema) due to fluid overload
List the nursing intervention for a patient post cardiac catheterization?
- monitor the site for bleeding (if bleeding apply pressure)
- bed rest 1-2 hours post procedure
- Frequent vitals/assessments
- monitor neurovascular status, especially distal to the cath site
What are key features of chronic stable angina?
- predictability
- related to exertion, cold exposure, or heavy meals
- subsides with rest/nitro
- brief (typically 3-5 minutes)
What education should the nurse provide to a patient experiencing frequent epistaxis?
- Can result from:
Dry indoor air (especially in winter)
Nose picking or frequent blowing
Use of anticoagulants or antiplatelet medications (e.g., aspirin, warfarin)
Nasal trauma or irritants (smoke, dust, strong odors)
Allergies or sinus infections
Uncontrolled hypertension
Keep nasal passages moist: saline sprays, humidifiers
Avoid strenuous activity post nosebleed
What are some nursing interventions for a hypertensive crisis?
- Neuro checks
- Q15 vitals until stable
- I/O monitoring for renal damage
- continuous cardiac monitoring
- supplemental O2
- Administer meds to help lower BP gradually
What education should the nurse provide to a patient who is newly prescribed nitroglycerin for chest pain?
How to Take Nitroglycerin (Sublingual Tablets or Spray)
- Sit or lie down before taking it (to prevent dizziness or fainting).
- Place one tablet under the tongue (or one spray under the tongue).
- Do NOT chew or swallow the tablet — let it dissolve completely.
- Wait 5 minutes after the first dose: If pain is not relieved, take a second tablet. If still not relieved after 3 doses in 15 minutes, call 911 immediately — may indicate a heart attack.
Side effects:
- Flushing, dizziness, headache
What are some signs/symptoms of heart failure?
- Classify left versus right
Left (first) - reduced ejection fraction(systolic), pulmonary hypertension, fatigue, SOB, activity intolerance, cyanosis, crackles, clubbing
Right - edema, fatigue, sudden weight gain (more than 3lb in a week or 1lb in a day), JVD, ascites, hepatomegaly/splenomegaly, anorexia, nausea
What is some discharge teaching the nurse would provide to a patient with pneumonia?
- Finish all of the antibiotics
- Follow up with PCP
- use antipyretics as directed for fever/malaise
- Cough/deep breath/ utilize IS every 1-2 hours while awake to help keep lungs open
- Drink plenty of fluids
- Rest as needed, avoid over exertion
What are common causes of the following
Metabolic alkalosis
Respiratory alkalosis
Metabolic acidosis
Respiratory acidosis
Metabolic alkalosis:
- vomiting, NG suctioning, diuretic therapy, excessive antacid use, hypokalemia
Respiratory alkalosis:
- anxiety/panic attack, hypoxemia, medical overventilation
Metabolic acidosis:
- DKA, renal failure, diarrhea, lactic acidosis,
Respiratory acidosis:
- COPD, asthma, respiratory depression, airway obstruction
What is acute coronary syndrome and what are the signs and symptoms?
What nursing interventions are expected when a patient presents with acute coronary syndrome?
- sudden, reduced blood flow to the heart muscle due to partial or complete blockage
- Chest pain unrelieved by rest or nitro, diaphoresis, agitation, feeling of impending doom
- Immediately stop activity and have them sit down, administer supplemental O2, administer morphine, nitroglycerin, aspirin, beta blockers, telemetry
What education would the nurse provide about dietary modification to a patient newly diagnosed with HF?
- Low sodium
- Fluid restriction - pt dependent
- reduced caffeine intake - pt dependent
- DASH/Mediterranean diet
Fruits and vegetables
Whole grains
Lean proteins (skinless poultry, fish, beans)
Low-fat dairy
Healthy fats (olive oil, nuts, avocado)