Tachypnea
What are some signs and symptoms a nurse may note in a pediatric unit if an infant is struggling to exchange oxygen?
Low O2, s/s of hypoxia, intercostal retractions
What is hypercapnia?
In patient that is breathing too slowly so the level of CO2 in their body is increased.
Which life events for older adults put them at a higher risk for developing depression?
Death of spouse, death of friends, retirement, relocation
SUPPORT
What tasks can be delegated to a nursing assistant?
Positioning, ambulating, I/O
Surfactant
How do we assess the costovertebral angle and why do we assess this?
Complete percussion on the lower back. Fluid in lungs or kidneys
What are the signs and symptoms or obstructive sleep apnea?
Hypopnea, hypoxia, shallow breathing, decreased airflow, narrowing of air passages, frequent waking up at night, not feeling well rested
What is polypharmacy, what are some patient teaching related to this, and which physicological change in older adults will affect drug metabolism?
Patients taking more than one prescription, herbal supplement, OTC medications.
Use the same pharmacy for all medications, keep an updated list of medications, use a pill planner, utilize the pharmacist for questions related to medications
Liver mass shrinking, decreased kidney perfusion
Complete admission assessment, Initiating nursing care plan, Evaluation
What are the signs and symptoms of chronic hypoxia?
clubbing of nails, fatigue, barrel chest(COPD)
Where is the Angle of Louis and what are we looking for when we assess this?
Directly above the diaphragm on the chest. We are assessing where the trachea bifurcates.
What interventions should the nurse anticipate for a patient that is experiencing s/s of pneumonia?
Chest xray, antibiotics, breathing treatments, incentive spirometer, acetaminophen, oxygen, frequent liquid intake, sputum culture, ABG, complete blood cell count with differential, raise HOB, frequent repositioning, preforming hand hygiene
What are some nursing actions for an elderly patient with dementia that is exhibiting aggression and wandering behaviors?
Room near nurses station, remind patient who and where they are, give distracting tasks for the patient (organizing or folding), using gauze to cover the patient's IV tubing
Which type of patients should be assigned to a new nurse or a float nurse?
Easy tasks, Easy teaching, no new post op, no new-onset conditions, most STABLE patients
What should be included in teaching about tuberculosis?
Traveling, nursing residents, and inmates are at increased risk
A induration of greater than 10mm is a positive
S/s are night sweats, hemoptysis, and SOB
How do the signs and symptoms differ between an UPPER respiratory infection and a LOWER respiratory infection?
Upper: Runny nose, fever, headache, sore throat, dry cough
Lower: Productive cough, fever, crackles in lungs, wheezing
What patients are a risk for developing pneumonia?
TPN patients, immunocompromised, comatose patients, recent surgeries, CHF
What teaching can the nurse give to the elderly to help prevent falls?
Rugs, a cup of water next to the bed, stray cords
Pinch the bridge of the nose and remain in a neutral position
What teaching will need to be provided to a patient with a new tracheostomy tube?
Food preparation, care for surgery site, alteration in ADLS
Please explain the disease process for asthma.
Bronchioles in the lungs swell when allergens enter the lungs.
What is a hemothorax and what are the signs and symptoms?
Blood in the lungs, generally 1 side. Labored breathing, absent lung sounds on 1 side, coughing blood
What is the difference between delirium and dementia?
Delirium is acute. Dementia is chronic.
How to r/o delirium: ask behavior of previous days leading up to episode
Hypoxia is a decrease in oxygen throughout the tissues in the body
Hypoxemia: low arterial blood oxygen level
How do you properly administer an inhaler without a spacer?
Shake inhaler
Tilt head and take 1 breath
Open mouth and press on inhaler and breath in
Hold breath for 10 seconds
Breath normally for 2 mins then take 2nd dose