NU 155 Exam 2 With
Correct Answers
Pleurisy/ pleuritis: inflammation of the pleura - ANSWER *causes:* infection,
medications, lupus, rheumatoid arthritis
*s/s:* sharp, abrupt! onset, most evident on inspiration, shallow breathing
and pleural friction rub
*Tx:* splint affected side during coughing for relief, intercostal nerve block
for severe pleuritic pain
vesicular breath sounds - ANSWER -heard in the 6th intercostal space over
lung tissue
-sounds low medium pitched, soft whooshing 2-3x length of expiration
Bronchovescular breath sounds - ANSWER -heard main-stem bronchi, below
clavicles, beside sternum, posteriorly, between scapulae
-sounds like moderate high pitches hollow muffled
equal sounds on inspiration and expiration
Bronchial breath sounds - ANSWER -heard over trachea above sternal notch
(often indicate atelectasis)
-sounds high pitched, loud harsh tubular quality, inspiration half as long as
expiration
,COPD (chronic obstructive pulmonary disease): (PATHO, Dx, S/S, N/I, pt.
teaching) - ANSWER -combo of *chronic bronchitis, asthma, and
emphysema*
-caused by: *tobacco smoke (90%)*, occupational hazards like farming,
biomass fuels, firefighters
-*Dx*: chest X-ray, EKG, labs like high hematocrit, ABG
-*S/S*: dyspnea, barrel chest, polycythemia (high RBC), hypercapnia (high
CO2), coughing up in the morning
-*N/I* titrate o2 to 92%, bronchodilators, hydrate uncaffeinated liquids
-teach pt: avoid over eating, smaller bites, increase fluid and calcium,
adequate protein, rest before eating and meds, and avoid lying down after
Thyroid Storm (thyroid crisis) - ANSWER -*causes*: drugs or dyes with iodine,
pregnancy/child birth, M.I. or cardiac emergencies, severe emotional distress,
trauma, surgery, levothyroxine overdose
-*s/s*: 106ºF +, 200bpm, high b/p, tachypnea, HTN, restlessness, agitation,
confusion, if *untreated* delirium to coma to heart failure to death
-*Tx*: MUST begin as soon as symptoms occur!, reduce temp. slow HR,
sedatives, increase fluid avoid dehydration
DKA -VS- HHS - ANSWER +DKA (Type 1): hyperglycemic crisis associated
with elevated ketones!
+HHS (Type 2): hyperglycemic crisis without association of ketones!
, -*DKA:* BS >300mg/dL *HHS:* BS > 600mg/dL
*DKA* Ketonuria
-*HHS* Older adults at higher risk, and higher mortality r/t severe
dehydration and extreme hyperglycemia (than DKA)
-*DKA:* N/V, abdominal pain, rigidity *HHS:* NO GI NO KETOACIDOSIS
-*DKA:* Kussmaul breathing *HHS:* Seizures
-*DKA:* Acetone (fruit) breath *HHS:* Confusion
-*DKA:* Stupor or coma (late) *HHS:* Coma
Chronic bronchitis emphysema sputum characteristic - ANSWER thick,
tenacious, "ropy" and difficult to cough up!
pneumococcal pneumonia sputum characteristic - ANSWER Scant, sticky, rust
colored
Pulmonary edema sputum characteristic - ANSWER Frothy, pinkish, or blood
tinged
pulmonary infection sputum characteristic - ANSWER yellow, yellow-green,
or grayish yellow with foul odor or taste
Correct Answers
Pleurisy/ pleuritis: inflammation of the pleura - ANSWER *causes:* infection,
medications, lupus, rheumatoid arthritis
*s/s:* sharp, abrupt! onset, most evident on inspiration, shallow breathing
and pleural friction rub
*Tx:* splint affected side during coughing for relief, intercostal nerve block
for severe pleuritic pain
vesicular breath sounds - ANSWER -heard in the 6th intercostal space over
lung tissue
-sounds low medium pitched, soft whooshing 2-3x length of expiration
Bronchovescular breath sounds - ANSWER -heard main-stem bronchi, below
clavicles, beside sternum, posteriorly, between scapulae
-sounds like moderate high pitches hollow muffled
equal sounds on inspiration and expiration
Bronchial breath sounds - ANSWER -heard over trachea above sternal notch
(often indicate atelectasis)
-sounds high pitched, loud harsh tubular quality, inspiration half as long as
expiration
,COPD (chronic obstructive pulmonary disease): (PATHO, Dx, S/S, N/I, pt.
teaching) - ANSWER -combo of *chronic bronchitis, asthma, and
emphysema*
-caused by: *tobacco smoke (90%)*, occupational hazards like farming,
biomass fuels, firefighters
-*Dx*: chest X-ray, EKG, labs like high hematocrit, ABG
-*S/S*: dyspnea, barrel chest, polycythemia (high RBC), hypercapnia (high
CO2), coughing up in the morning
-*N/I* titrate o2 to 92%, bronchodilators, hydrate uncaffeinated liquids
-teach pt: avoid over eating, smaller bites, increase fluid and calcium,
adequate protein, rest before eating and meds, and avoid lying down after
Thyroid Storm (thyroid crisis) - ANSWER -*causes*: drugs or dyes with iodine,
pregnancy/child birth, M.I. or cardiac emergencies, severe emotional distress,
trauma, surgery, levothyroxine overdose
-*s/s*: 106ºF +, 200bpm, high b/p, tachypnea, HTN, restlessness, agitation,
confusion, if *untreated* delirium to coma to heart failure to death
-*Tx*: MUST begin as soon as symptoms occur!, reduce temp. slow HR,
sedatives, increase fluid avoid dehydration
DKA -VS- HHS - ANSWER +DKA (Type 1): hyperglycemic crisis associated
with elevated ketones!
+HHS (Type 2): hyperglycemic crisis without association of ketones!
, -*DKA:* BS >300mg/dL *HHS:* BS > 600mg/dL
*DKA* Ketonuria
-*HHS* Older adults at higher risk, and higher mortality r/t severe
dehydration and extreme hyperglycemia (than DKA)
-*DKA:* N/V, abdominal pain, rigidity *HHS:* NO GI NO KETOACIDOSIS
-*DKA:* Kussmaul breathing *HHS:* Seizures
-*DKA:* Acetone (fruit) breath *HHS:* Confusion
-*DKA:* Stupor or coma (late) *HHS:* Coma
Chronic bronchitis emphysema sputum characteristic - ANSWER thick,
tenacious, "ropy" and difficult to cough up!
pneumococcal pneumonia sputum characteristic - ANSWER Scant, sticky, rust
colored
Pulmonary edema sputum characteristic - ANSWER Frothy, pinkish, or blood
tinged
pulmonary infection sputum characteristic - ANSWER yellow, yellow-green,
or grayish yellow with foul odor or taste
