NU 155 Exam 2 questions with answers

NU 155 Exam 2 questions with
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answers

Pleurisy/ pleuritis: inflammation of the pleura - CORRECT
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ANSWERS ✔✔*causes:* infection, medications, lupus, rheumatoid
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arthritis
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*s/s:* sharp, abrupt! onset, most evident on inspiration, shallow
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breathing and pleural friction rub |\ |\ |\ |\




*Tx:* splint affected side during coughing for relief, intercostal
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nerve block for severe pleuritic pain
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vesicular breath sounds - CORRECT ANSWERS ✔✔-heard in the
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6th intercostal space over lung tissue
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-sounds low medium pitched, soft whooshing 2-3x length of
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expiration


Bronchovescular breath sounds - CORRECT ANSWERS ✔✔-heard |\ |\ |\ |\ |\ |\ |\


main-stem bronchi, below clavicles, beside sternum, posteriorly,
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between scapulae |\




-sounds like moderate high pitches hollow muffled
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equal sounds on inspiration and expiration
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Bronchial breath sounds - CORRECT ANSWERS ✔✔-heard over
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trachea above sternal notch (often indicate atelectasis)
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-sounds high pitched, loud harsh tubular quality, inspiration half
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as long as expiration
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,COPD (chronic obstructive pulmonary disease): (PATHO, Dx, S/S,
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N/I, pt. teaching) - CORRECT ANSWERS ✔✔-combo of *chronic
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bronchitis, asthma, and emphysema* |\ |\ |\




-caused by: *tobacco smoke (90%)*, occupational hazards like
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farming, biomass fuels, firefighters |\ |\ |\




-*Dx*: chest X-ray, EKG, labs like high hematocrit, ABG
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-*S/S*: dyspnea, barrel chest, polycythemia (high RBC),
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hypercapnia (high CO2), coughing up in the morning |\ |\ |\ |\ |\ |\ |\




-*N/I* titrate o2 to 92%, bronchodilators, hydrate uncaffeinated
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liquids
-teach pt: avoid over eating, smaller bites, increase fluid and
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calcium, adequate protein, rest before eating and meds, and
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avoid lying down after
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Thyroid Storm (thyroid crisis) - CORRECT ANSWERS ✔✔-*causes*:
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drugs or dyes with iodine, pregnancy/child birth, M.I. or cardiac
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emergencies, severe emotional distress, trauma, surgery, |\ |\ |\ |\ |\ |\


levothyroxine overdose |\




-*s/s*: 106ºF +, 200bpm, high b/p, tachypnea, HTN, restlessness,
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agitation, confusion, if *untreated* delirium to coma to heart
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failure to death |\ |\




-*Tx*: MUST begin as soon as symptoms occur!, reduce temp.
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slow HR, sedatives, increase fluid avoid dehydration
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DKA -VS- HHS - CORRECT ANSWERS ✔✔+DKA (Type 1):
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hyperglycemic crisis associated with elevated ketones! |\ |\ |\ |\ |\ |\




+HHS (Type 2): hyperglycemic crisis without association of
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ketones! |\

, -*DKA:* BS >300mg/dL *HHS:* BS > 600mg/dL
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*DKA* Ketonuria
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-*HHS* Older adults at higher risk, and higher mortality r/t severe
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dehydration and extreme hyperglycemia (than DKA)
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-*DKA:* N/V, abdominal pain, rigidity *HHS:* NO GI NO
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KETOACIDOSIS
-*DKA:* Kussmaul breathing *HHS:* Seizures
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-*DKA:* Acetone (fruit) breath *HHS:* Confusion
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-*DKA:* Stupor or coma (late) *HHS:* Coma
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Chronic bronchitis emphysema sputum characteristic - CORRECT
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ANSWERS ✔✔thick, tenacious, "ropy" and difficult to cough up!
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pneumococcal pneumonia sputum characteristic - CORRECT
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ANSWERS ✔✔Scant, sticky, rust colored
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Pulmonary edema sputum characteristic - CORRECT ANSWERS
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✔✔Frothy, pinkish, or blood tinged
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pulmonary infection sputum characteristic - CORRECT ANSWERS
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✔✔yellow, yellow-green, or grayish yellow with foul odor or taste
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T.B., ulcerated pulmonary vessel or bronchogenic carcinoma
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sputum characteristics - CORRECT ANSWERS ✔✔blood tinged,
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bloody, or blood-streaked
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