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Med-Surg Respiratory 2022 Exam

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Med-Surg Respiratory
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Nursing Plan for the patient with chronic bronchitis and emphysema Lowest FiO2 possible to prevent CO2 retention Monitor for signs and symptoms of fluid overload Maintain PaO2 between 55 and 60 Baseline ABGs Teach purse-lip breathing and diaphragmatic breathing Teach Tripod position Administer bronchodilators and anti-inflammatory agents Normal Blood gas pH in adults? Children? Adults - 7.35-7.45 Children - 7.36-7.44 Normal PCO2 blood gas 35-45 mmHg; same in adults and children Normal PO2 blood gas 80-100 mmHg; same in adults and children Normal HCO3 blood gas 21-28 mEq/L; same in adults and children Patients with COPD (emphysema and chronic bronchitis) are in a state of chronic? respiratory acidosis which results in metabolic alkalosis as compensation

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HESI Med-Surg Respiratory


What is a common adverse effect of the tetracycline antibiotics?

Photosensitivity

Why should tetracyclines be avoided in pregnant clients and children under 8 years?

It can cause yellow-brown discoloration of teeth and growth retardation

Antibiotics ending in -mycin are usually?

nephrotoxic and ototoxic

What is the patho behind chronic bronchitis?

Chronic sputum with cough production on a daily basis for a minimum of 3 months in each of 2
consecutive years

chronic hypoxemia, cor pulmonale

increase in mucus, cilia production

increase in bronchial wall thickness which obstructs air flow

reduced responsiveness of the respiratory center to hypoxemic stimuli

Assessment of a patient with chronic bronchitis

Generalized cyanosis "blue bloater"
Right-sided heart failure
distended neck veins
crackles
expiratory wheezes

Patho behind Emphysema

Reduced gas exchange surface area

Increased air trapping - increased AP diameter "barrel chest"

decreased capillary network

increased work, increased O2 consumption

Assessment of a patient with emphysema

Normal skin pigmentation "pink puffer"
Barrel Chest

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  • nursing plan for the patient with chronic bronchitis and emphysema lowest fio2 possible to prevent co2 retention monitor for signs and symptoms of fluid overload maintain pao2 between 55 and 60 baseli

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