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CHA 1: Unit 6 Respiratory Exam Study Guide

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CHA 1: Unit 6 Respiratory Exam Study Guide Cystic fibrosis (CF) - answerAutosomal-recessive trait Hereditary disorder; altered functions of exocrine glands: Lung, Pancreas, Sweat Gland, Reproductive Organs Characterized by: lung congestion, infection, and malabsorbtion of nutrients by the pancreas symptoms of cystic fibrosis - answerThick mucus Chronic cough Dyspnea Freq respiratory infections Clubbing of fingers Increased AP diameter with hyper-resonant chest Rales, rhonci Failure to gain weight/malnutrition Meconium ileus Always hungry Abdominal distension Steatorrhea Fat soluble vitamin deficiencies (increased bruising) Sweat, tears abnormally salty Decreased or absent sperm count Viscous cervical mucous ©THEBRIGHT EXAM STUDY SOLUTIONS 8/26/2024 11:32 AM Cystic fibrosis pulmonary manifestations - answerRespiratory infections Chest congestion Limited exercise tolerance Cough and sputum production Use of accessory muscles Decreased pulmonary function Changes in chest x-ray Increased anteroposterior diameter Cystic Fibrosis Diagnostic Test - answersweat test-chloride test (excess chloride release) PFT-monitor current status CXR-monitor current status DNA Testing Cystic Fibrosis Treatment Goals - answerClient will absorb adequate nutrients daily Client will maintain patent airway Family demonstrated adequate coping Cystic Fibrosis Treatment - answerPostural drainage and percussion Good hygiene Moistened oxygen Nebulized meds Antibiotics (Tobramycin solution for inhalation) Dornase alfa Pancreatic enzyme ©THEBRIGHT EXAM STUDY SOLUTIONS 8/26/2024 11:32 AM Diet: High calorie & protein, moderate fat Water-miscible forms of Vit A, D, E supp Generally not breast fed, not enough protein Pancreas-lung transplant Tobramycin (TOBI) - answerused to treat chronic P. aeruginosa infection in CF patients Dornase alfa (Pulmozyme) - answerdecreases viscosity of mucus and improves lung function. improvement monitored by pfts. use once daily. Pancreatic Enzyme Replacement - answerPancreatic enzymes (pancreatin and pancrelipase); action: aid in the digestion of starches, fats, protein; side effects: anorexia, N/V, diarrhea, hypersensitivity, sneezing, lacrimation, skin rashes; nursing responsibilities: do not use with antacids, avoid inhaling powder, client education: take with meals Cystic Fibrosis Family Teaching - answerFunctions of oxygen and how to regulate flow Postural drainage Encourage them to think about fitting the treatment/illness into family life (DO both parents work) Respiratory Distress Syndrome (RDS) - answerA respiratory disorder that affects premature infants born without enough surfactant in the lungs. It is treated with respiratory support and surfactant administration Production starts at 24 weeks (gestation) Patho Poorly developed alveoli are difficult to inflate. -alveolar instability/diffuse atelectasis results -Decreased pulmonary vasoconstriction (severe hypoxia) Poor lung perfusion and lack of surfactant

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Subido en
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©THEBRIGHT EXAM STUDY SOLUTIONS 8/26/2024 11:32 AM



CHA 1: Unit 6 Respiratory Exam Study
Guide

Cystic fibrosis (CF) - answer✔✔Autosomal-recessive trait


Hereditary disorder; altered functions of exocrine glands: Lung, Pancreas, Sweat Gland,
Reproductive Organs


Characterized by: lung congestion, infection, and malabsorbtion of nutrients by the pancreas

symptoms of cystic fibrosis - answer✔✔Thick mucus
Chronic cough
Dyspnea
Freq respiratory infections
Clubbing of fingers
Increased AP diameter with hyper-resonant chest
Rales, rhonci
Failure to gain weight/malnutrition
Meconium ileus
Always hungry
Abdominal distension
Steatorrhea
Fat soluble vitamin deficiencies (increased bruising)
Sweat, tears abnormally salty
Decreased or absent sperm count
Viscous cervical mucous

, ©THEBRIGHT EXAM STUDY SOLUTIONS 8/26/2024 11:32 AM


Cystic fibrosis pulmonary manifestations - answer✔✔Respiratory infections
Chest congestion
Limited exercise tolerance
Cough and sputum production
Use of accessory muscles
Decreased pulmonary function
Changes in chest x-ray
Increased anteroposterior diameter

Cystic Fibrosis Diagnostic Test - answer✔✔sweat test-chloride test (excess chloride release)


PFT-monitor current status


CXR-monitor current status


DNA Testing

Cystic Fibrosis Treatment Goals - answer✔✔Client will absorb adequate nutrients daily


Client will maintain patent airway


Family demonstrated adequate coping

Cystic Fibrosis Treatment - answer✔✔Postural drainage and percussion
Good hygiene
Moistened oxygen
Nebulized meds
Antibiotics (Tobramycin solution for inhalation)
Dornase alfa
Pancreatic enzyme

, ©THEBRIGHT EXAM STUDY SOLUTIONS 8/26/2024 11:32 AM


Diet: High calorie & protein, moderate fat
Water-miscible forms of Vit A, D, E supp
Generally not breast fed, not enough protein
Pancreas-lung transplant

Tobramycin (TOBI) - answer✔✔used to treat chronic P. aeruginosa infection in CF patients

Dornase alfa (Pulmozyme) - answer✔✔decreases viscosity of mucus and improves lung
function. improvement monitored by pfts. use once daily.

Pancreatic Enzyme Replacement - answer✔✔Pancreatic enzymes (pancreatin and pancrelipase);
action: aid in the digestion of starches, fats, protein; side effects: anorexia, N/V, diarrhea,
hypersensitivity, sneezing, lacrimation, skin rashes; nursing responsibilities: do not use with
antacids, avoid inhaling powder, client education: take with meals

Cystic Fibrosis Family Teaching - answer✔✔Functions of oxygen and how to regulate flow


Postural drainage


Encourage them to think about fitting the treatment/illness into family life (DO both parents
work)

Respiratory Distress Syndrome (RDS) - answer✔✔A respiratory disorder that affects premature
infants born without enough surfactant in the lungs. It is treated with respiratory support and
surfactant administration


Production starts at 24 weeks (gestation)


Patho
Poorly developed alveoli are difficult to inflate.
-alveolar instability/diffuse atelectasis results
-Decreased pulmonary vasoconstriction (severe hypoxia)


Poor lung perfusion and lack of surfactant

, ©THEBRIGHT EXAM STUDY SOLUTIONS 8/26/2024 11:32 AM


-Increased alveolar capillary permability
-Fluid and protein are leaking into the interstitial area and alveoli, hyaline membrane formation

atelectasis - answer✔✔collapsed lung; incomplete expansion of alveoli

Normal Newborn Assessment - answer✔✔-RR 30-60 /minute
-Brief periods of apnea (less than 15 seconds) with no color or HR change
-HR 120-160 while awake (sleeping can be as low as 80 and crying as high as 180)
-Synchronous chest and abdominal movement

respiratory distress syndrome (RDS) Symptoms - answer✔✔-RR >60/min, shallow & irregular
-Apnea longer than 20 seconds
-Labored breathing (retractions, grunting, nasal flaring, chin tug, head bobbing, decreased BS)
-Frothy sputum and expiratory grunt
-Hypothermia-inadequate functioning of metabolic process that require O2 to produce heat
-Flaccid & unresponsive d/t severe hypothermia
-Cyanosis & peripheral edema
-BP falls

Flaccid - answer✔✔(adj.) limp, not firm; lacking vigor or effectiveness

Cyanosis - answer✔✔a bluish discoloration of the skin resulting from poor circulation or
inadequate oxygenation of the blood.

Hypothermia - answer✔✔abnormally low body temperature

Frothy sputum - answer✔✔pulmonary edema

Respiratory Distress Syndrome (RDS) Treatment(s) - answer✔✔1st prevent labor
-Dobutamine (stop labor), may develop tachycarida for mon
-Magnesium sulfate (slows contractions)-Assess Deep tendon reflexes for toxicity


Determine fetal lung development via amniocentesis
-L/S ratio (lecithin/sphingomyelin)-at 32 weeks lecithin increases and sphingomyelin decreases,
resulting ratio is 2:1
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