Oxygenation
Describe asthma to me as if I am your patient
(Include: definition, pathophysiology, and cues)
Chronic inflammation in which reversible acute airway obstruction occurs and reduces airflow. Triggered by an inflammation of lower resp tract, airways become swollen and inflamed
Muscles around airway contract and airways produce extra mucous
S/S: hypoxia, coughing, increase R.R, tachycardia, change in LOC, WHEEZING, may use accessory muscles to help w/ breathing
The classifications of fractures and describe them
- complete
-displaced
-incomplete
-open
-closed
-fragility
-fatigue
-compression
-impacted
-spiral
-transverse
-oblique
-comminuted
Celiac disease (pathophysiology, s/s, risk factors, education)
pathophysiology: multi-system autoimmune disease, chronic inflammation of the small intestinal mucosa
S/S: joint and muscle pain and swelling, intestinal pain and nausea, acne, eczema, brittle nails, infertility (females), early menopause, miscarriage, weight loss, malnutrition, diarrhea, bloating, constipation, ulcer and tooth enamel erosion
Risk factors: Combination of genetic, immunologic, and environmental factors
Education:gluten free diet, daily vitamin and mineral supplement may be needed, consult dietician if needed
*CAN CAUSE BOWEL ATROPHY*
Triggers of asthma
- cold/dry air
-aspirin/NSAIDS
-smoke
-airborne irritants
-dust/specific allergens/pollen/pets
-exercise
-strong odors
-anger/stress
-fungus spores
-bugs in home
-fumes
The nurse is caring for an infant with bronchiolitis and diagnostic tests have confirmed RSV. On the basis of this finding, which is the most appropriate nursing action?
A. Initiate strict enteric precautions
B. Move the infant to a private room
C. Leave the infant in the present room, because RSV is not contagious
D. Inform the staff that using standard precautions is all that is necessary when caring for the client
Exercise-Induced Bronchospasm vs Status Asthmatics
Exercise-Induces Bronchospasm: acute, reversible, self- terminating airway obstruction that develops during or after vigorous
Status Asthmatics: Life- threatening acute episode of airway obstruction
Acute complications of fractures
-venous thromboembolism
-osteomyelitis
-acute compartment syndrome
-fat embolism syndrome
Peptic Ulcer Disease
(pathophysiology, S/S, risk factors, pt education, complications)
Pathophysiology: impaired mucosal defense; epithelium not protected from effects of acid and pepsin
Risk factors: long-term NSAID use, familial history, Zollinger-Ellison Syndrome, corticoidsteroid use, chemotherapy use, stress level, diet, alcohol intake, tobacco use
S/S: INFANTS TO 2- hematemisis, melena s/s perforation
CHILDREN 2 TO 6 YEARS- periumbilical pain, poor eating, vomiting, irritability, nighttime waking, hematemesis, melena
CHILDREN UNDER 6- epigastric pain or vague abdominal pain, nighttime waking, hematemesis, melena, anemia possible
ADULTS: epigastric tenderness and pain, dyspepsia, signs of fluid volume deficit
Pt education: Continue medication therapy, eat health, exercise, avoid food & substances that increase gastric acid secretion
Complications: hemorrhage, perforation, pyloric obstruction, intractable disease
*MANY CAUSED BY H. PYLORI AND UPPER GI BLEEDING*
Diagnostic tests for Asthma, COPD, and RSV
Asthma- Labs: ABD, PaO2, PaCO2 Imaging:Pulmonary fnx tests
COPD-Labs: ABG, Sputum samples, H&H, CBC, CMP Imaging: chest x-ray, pulmonary fnx test
RSV: Labs: nasopharyngeal swab, CBC Imaging: chest x-ray
The nurse is planning to teach a client with GERD about substances to avoid. Which items would the nurse include on the list?
A. coffee
B. chocolate
C. Peppermint
D. Nonfat milk
E. Fried chicken
F. Scrambled eggs
Asthma Medications
Rescue inhalers or nebulizer treatments
Bronchodilators
Oral Corticosteroids
Allergy shot
Chronic complications of fractures
- avascular necrosis
- delayed bone healing
- complex regional pain syndrome
Gastroesophageal Reflux Disease
(pathophysiology, risk factors, S/S, diagnostic tests, pt education, biggest complication)
Pathophysiology: results from backward flow of stomach contents into esophagus
Risk Factors: NO SINGLE CAUSATIVE AGENT, pregnancy, obesity, other factors that increase intrabdominal and intragastric pressure, 30-39 years old
S/S: INFANTS- spitting up, regurgitation, vomiting, excessive crying, irritability, arching of the back w neck extension, stiffening, weight loss, failure to grow, resp. problems, hematemesis, apnea
CHILDREN- heartburn, abdominal pain, non-cardiac chest pain, chronic cough, dysphagia, nocturnal asthma, recurrent pneumonia
ADULT- regurgitation, dyspepsia, belching, epigastric pain, nausea, hoarseness, tooth erosion, flatulence, chest pain
Diagnostic tests: upper GI series, esophagogastoduodenoscopy (EGD), ambulatory esophageal pH monitoring, esophageal manometry
Pt education: sit upright after eating (1 hr min), do not eat acidic things 2-3 hours before bed
Biggest complication: esophageal cancer
Stages if bone healing and length
Stage 1: 24-72 hrs
Stage 2: 2-3 weeks
Stage 3: 3-6 weeks
Stage 4: 3-8 weeks
Stage 5: final stage
The nurse is monitoring a client with a diagnosis of peptic ulcer. Which assessment finding would most likely indicate perforation of the ulcer?
A. Bradycardia
B. Numbness in the legs
C. Nausea and vomiting
D. A rigid, boardlike abdomen
Emphysema vs Chronic Bronchitis
Emphysema: lung disease that causes destruction of the fragile walls and elastic fibers of alveoli
S/S: increased CO2, INHALATION STARTS BEFORE EXHALATION ENDS, chest tightness, FINGER CLUBBING, wheezing/cough, diminished breath sounds
Chronic Bronchitis: Bronchial tube lining of the airways is constantly irritated and inflamed. Results in vasodilation, mucosal edema, congestion, and bronchospasm
S/S: cough, PRODUCTION OF MUCUS, nasal congestion, dyspnea, whistling or squeaky sound when breathing, tightness in chest
Low Back Pain
(@ risk, health promotion & maintenance, interventions)
@ risk: older adults, obese pts, congenital defects, types of jobs
-health promotion & maintenance: change modifiable risk factors, ergonomic plan for workplace, reg. exercise, good body alignment, healthy BMI, adequate calcium intake)
-interventions: exercise, PT, positioning, NSAIDS, massage, muscle relaxants, surgery
Differentiate the types of ulcers
Duodenal: most common, in upper portion of duodenum, deep, sharply demarcated lesions
Gastric: in antrum of the stomach, result from back-diffusion of acid or dysfunction of the pyloric sphincter gastric emptying is often delayed in pts w gastric ulceration, pain when eating
Stress: acute gastric mucosal lesions occuring after an acute medical crisis or trauma, associated with lengthened hospital stay and increased mortality, bleeding causes by gastric erosion in the main manifestation of acute stress ulcers
Factors affecting bone healing
Age, severity of trauma, type of bone injury, how fracture is managed and/or presence of complications
A client has sustained a closed fracture and has just had a cast applied to the affected arm. The client is complaining of intense pain. The nurse elevated the limb, applies an ice bag, and administers an analgesic, with little relief. Which problem could be causing this pain?
A. Infection under cast
B. The anxiety of the client
C. Impaired tissue perfusion
D. The recent occurrence of the fracture
Describe RSV to me like I am the parent of your patient who has RSV
(Include: Definition, pathophysiology, s/s, teaching)
Definition: Common acute resp. virus that affects bronchioles, most common in winter and early spring
Pathophysiology: Inflammation of bronchi and bronchioles that leads to obstruction and hyperinflation
S/S: mild, cold like symptoms, runny nose, decreased appetite, wheezing, sneezing, cough, apnea (under 1), crackles, cyanosis, fever over 100
Teaching: NO NSAIDS, NO COUGH MEDS FOR CHILDREN UNDER 4, how to administer meds, droplet isolation, cool mist humidifiers, rest, fluids, HAND HYGIENE, disinfect surfaces
Fracture interventions
-bone reduction
-splints
-casts
-traction
-drug therapy
-PT and/or OT
-surgery
-traction
What medications treat PUD?
PPI's, antacids, protectants, histamine 2 antagonists, antibiotics
What are the classifications of low back pain?
acute, subacute, and chronic,persistant
The nurse is caring for a client being treated for fat embolus after multiple fractures. Which data would the nurse evaluate as the most favorable indication of resolution of the fat embolus?
A. Clear mentation
B. Minimal dyspnea
C. Oxygen saturation of 85%
D. ABG level of 78 mm Hg