RESPIRATORY PT. 2 |MEDSERG EXAM 2 | GUARANTEED
SUCCESS STARTS HERE! LEARN, PRACTICE & EXCEL!
Nursing Care of the Patient With Cancer: Airway clearance Answer: Deep-breathing
exercises
CPT
Directed coughing
Suctioning
Bronchodilator meds
Bronchoscopy
Describe atelectasis Answer: Closure or collapse of alveoli (airless condition of alveoli)
Atelectasis can be caused by Answer: Hypoventilation
Blockage that obstructs passage of air to and from the alveoli
Excessive pressure on the lung tissue (compression)
Who is at very high risk for developing atelectasis Answer: Post-op patient
Clinical manifestations of atelectasis (8) Answer: Development usually insidious
Dyspnea
Cough
Sputum production
low-grade fever
Respiratory distress
Anxiety
Hypoxia if large lung areas are effected
Clinical manifestations of acute atelectasis (6) Answer: Respiratory distress
Tachycardia
Tachypnea
Pleural pain
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
,Central cyanosis
Difficulty breathing in supine position, and are anxious
Diagnostic findings of Atelectasis Answer: Generally characterized by increased work of
breathing and hypoxemia. Decreased breath sounds & crackers are heard over the effected
area
Chest x-ray
Atelectasis: Prevention is the first line treatment, describe Answer: Frequent turning: Want
to position patient in semi to high fowlers (NOT supine)
Early Mobilization
Incentive spirometer Q1-2hrs
Secretion management techniques
-directed coughing
-Suctioning
-turn, cough, deep breath
-Perform postural drainage and chest percussion, if indicated
-Administer opioids and sedatives judiciously to prevent respiratory depression
Atelectasis nursing management Answer: VS
CXR assessment
Routine lung field assessment
Suctioning
Respiratory medications
Supplemental O2
Strategies to remove secretions in atelectasis patient Answer: Coughing exercises
Suctioning
Aerosol therapy
CPT (chest physiotherapy, chest percussion and postural drainage)
In patients who do not respond to first line measures, other treatments such as PEEP,
CPPB, or bronchoscopy may be used
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
, Bronchoscopy to remove secretions
Treatment of atelectasis if the cause is compression of the lung Answer: With large pleural
effusion that is compressing lung tissue and causing alveolar collapse, treatment may
include thoracentesis (removal of fluid by needle aspiration) or insertion of a chest tube
Atelectasis oxygen therapy Answer: Endotracheal tube intubation
Mechanical ventilation
Pulmonary infections: Describe Severe acute respiratory syndrome (SARS) Answer: Viral
respiratory illness caused by a coronavirus, called SARS-associated coronavirus
No cases reported since 2004
Severe acute respiratory syndrome (SARS) how is it transmitted Answer: Via respiratory
droplets
Severe acute respiratory syndrome (SARS) treatment Answer: Currently no treatment
except supportive care is recommended
Infection control measures specific to SARS: use of negative pressure isolation rooms,
PPE, hand hygiene, environmental cleaning and disinfection techniques, and source
control measures to contain patient secretions
Most patients with Severe acute respiratory syndrome (SARS) will develop what Answer:
Pneumoni
Pulmonary infection: Lung abscess (pg.591), what is the most common cause Answer:
Most are a complication of bacterial pneumonia or are caused by aspiration of anaerobic
bacteria
Patients at risk for developing a lung abscess Answer: Impaired cough reflexes who cannot
close the glottis, and those with swallowing difficulties
Lung Abscess Assessment & diagnostic Findings Answer: Physical examination of the
chest may reveal dullness on percussion and decreased or absent breath sounds with an
intermittent pleural friction rub (grating or cracking sound) on auscultation
Confirmation of diagnosis is made by chest x-ray, sputum culture, and in some cases
fiberoptic bronchoscopy
APPHIA – Crafted with Care and Precision for Academic Excellence.
3
SUCCESS STARTS HERE! LEARN, PRACTICE & EXCEL!
Nursing Care of the Patient With Cancer: Airway clearance Answer: Deep-breathing
exercises
CPT
Directed coughing
Suctioning
Bronchodilator meds
Bronchoscopy
Describe atelectasis Answer: Closure or collapse of alveoli (airless condition of alveoli)
Atelectasis can be caused by Answer: Hypoventilation
Blockage that obstructs passage of air to and from the alveoli
Excessive pressure on the lung tissue (compression)
Who is at very high risk for developing atelectasis Answer: Post-op patient
Clinical manifestations of atelectasis (8) Answer: Development usually insidious
Dyspnea
Cough
Sputum production
low-grade fever
Respiratory distress
Anxiety
Hypoxia if large lung areas are effected
Clinical manifestations of acute atelectasis (6) Answer: Respiratory distress
Tachycardia
Tachypnea
Pleural pain
APPHIA – Crafted with Care and Precision for Academic Excellence.
1
,Central cyanosis
Difficulty breathing in supine position, and are anxious
Diagnostic findings of Atelectasis Answer: Generally characterized by increased work of
breathing and hypoxemia. Decreased breath sounds & crackers are heard over the effected
area
Chest x-ray
Atelectasis: Prevention is the first line treatment, describe Answer: Frequent turning: Want
to position patient in semi to high fowlers (NOT supine)
Early Mobilization
Incentive spirometer Q1-2hrs
Secretion management techniques
-directed coughing
-Suctioning
-turn, cough, deep breath
-Perform postural drainage and chest percussion, if indicated
-Administer opioids and sedatives judiciously to prevent respiratory depression
Atelectasis nursing management Answer: VS
CXR assessment
Routine lung field assessment
Suctioning
Respiratory medications
Supplemental O2
Strategies to remove secretions in atelectasis patient Answer: Coughing exercises
Suctioning
Aerosol therapy
CPT (chest physiotherapy, chest percussion and postural drainage)
In patients who do not respond to first line measures, other treatments such as PEEP,
CPPB, or bronchoscopy may be used
APPHIA – Crafted with Care and Precision for Academic Excellence.
2
, Bronchoscopy to remove secretions
Treatment of atelectasis if the cause is compression of the lung Answer: With large pleural
effusion that is compressing lung tissue and causing alveolar collapse, treatment may
include thoracentesis (removal of fluid by needle aspiration) or insertion of a chest tube
Atelectasis oxygen therapy Answer: Endotracheal tube intubation
Mechanical ventilation
Pulmonary infections: Describe Severe acute respiratory syndrome (SARS) Answer: Viral
respiratory illness caused by a coronavirus, called SARS-associated coronavirus
No cases reported since 2004
Severe acute respiratory syndrome (SARS) how is it transmitted Answer: Via respiratory
droplets
Severe acute respiratory syndrome (SARS) treatment Answer: Currently no treatment
except supportive care is recommended
Infection control measures specific to SARS: use of negative pressure isolation rooms,
PPE, hand hygiene, environmental cleaning and disinfection techniques, and source
control measures to contain patient secretions
Most patients with Severe acute respiratory syndrome (SARS) will develop what Answer:
Pneumoni
Pulmonary infection: Lung abscess (pg.591), what is the most common cause Answer:
Most are a complication of bacterial pneumonia or are caused by aspiration of anaerobic
bacteria
Patients at risk for developing a lung abscess Answer: Impaired cough reflexes who cannot
close the glottis, and those with swallowing difficulties
Lung Abscess Assessment & diagnostic Findings Answer: Physical examination of the
chest may reveal dullness on percussion and decreased or absent breath sounds with an
intermittent pleural friction rub (grating or cracking sound) on auscultation
Confirmation of diagnosis is made by chest x-ray, sputum culture, and in some cases
fiberoptic bronchoscopy
APPHIA – Crafted with Care and Precision for Academic Excellence.
3
