NURS 424 - Exam #1 Questions With Complete Solutions
Management of a pulmonary embolism
- Oxygen therapy
- Anti-coagulant therapy (will not get rid of the clot but will
prevent others from forming while the body breaks down the
PE)
- Vena cava filter (IVC placed in cath lab, does not treat PE but
keeps clots that from in the legs from traveling to the lungs. This
is good for someone who cannot receive anticoagulation)
- Thrombolytic therapy (TPA to dissolve the clot; commonly
given in stroke patients)
- Embolectomy (removal of the embolism, last resort)
Anticoagulant drugs
Heparin, Enoxaparin (Lovenox), Fondaparinux, and Warfarin
Different types of pneumonia
- Aspiration
- Airborne spread
- Direct inoculation
- Bloodstreams
- Adjacent infections (abscess)
Manifestations of Pneumonia
- Acute cough
- Fever
- Chills
,- Purulent sputum (color can help determine whether it is
bacterial or viral)
- Pleuritic chest pain
- SOB
How do we diagnose pneumonia?
- Chest x-ray
- Sputum culture
- Blood cultures
- CBC (looking at white count, will be higher if it is bacterial)
- ABGs (will not diagnose but will tell is if the patient is
compensated with the pneumonia and we can see if the are
going to ARDS)
- Bronchoscopy
- Lung biopsy
- CT scan (not always necessary unless there are other reasons)
What is the main test that helps decide whether it is pneumonia
or not?
chest x-ray because we can see infiltrates on the scan
When is it best to treat pneumonia?
start early with broad spectrum antibiotics then once the lab
returns, narrow down the antibiotic.
Thoracic Surgery
procedures on structures within the chest including heart, lungs,
esophagus, and great vessels
Thoracotomy
, surgical entry into the thorax (goes in through the ribs. It is very
painful so pain management is very important.
Pneumoectomy
removal of one entire lung. is usually done for patients with lung
cancer. When the lung is removed the cavity fills with
serosanguinous fluid and fibrotic tissue. Chest tubes are not
required)
Lobectomy
removal of one or more lobes of the lung
Segmentectomy
removal of one or more portions of a lobe
Wedge resection
removal of a small wedge-like shaped section of the peripheral
portion of the lung. Can be done using Video-Assisted
thoracoscopic surgery (VATS) so that a big incision does not
need to be made.
Post-thoracic surgery management
Pain management:
- PCA
- Epidural
- Splint the incision.
Postoperative pulmonary hygiene:
- Coughing
Management of a pulmonary embolism
- Oxygen therapy
- Anti-coagulant therapy (will not get rid of the clot but will
prevent others from forming while the body breaks down the
PE)
- Vena cava filter (IVC placed in cath lab, does not treat PE but
keeps clots that from in the legs from traveling to the lungs. This
is good for someone who cannot receive anticoagulation)
- Thrombolytic therapy (TPA to dissolve the clot; commonly
given in stroke patients)
- Embolectomy (removal of the embolism, last resort)
Anticoagulant drugs
Heparin, Enoxaparin (Lovenox), Fondaparinux, and Warfarin
Different types of pneumonia
- Aspiration
- Airborne spread
- Direct inoculation
- Bloodstreams
- Adjacent infections (abscess)
Manifestations of Pneumonia
- Acute cough
- Fever
- Chills
,- Purulent sputum (color can help determine whether it is
bacterial or viral)
- Pleuritic chest pain
- SOB
How do we diagnose pneumonia?
- Chest x-ray
- Sputum culture
- Blood cultures
- CBC (looking at white count, will be higher if it is bacterial)
- ABGs (will not diagnose but will tell is if the patient is
compensated with the pneumonia and we can see if the are
going to ARDS)
- Bronchoscopy
- Lung biopsy
- CT scan (not always necessary unless there are other reasons)
What is the main test that helps decide whether it is pneumonia
or not?
chest x-ray because we can see infiltrates on the scan
When is it best to treat pneumonia?
start early with broad spectrum antibiotics then once the lab
returns, narrow down the antibiotic.
Thoracic Surgery
procedures on structures within the chest including heart, lungs,
esophagus, and great vessels
Thoracotomy
, surgical entry into the thorax (goes in through the ribs. It is very
painful so pain management is very important.
Pneumoectomy
removal of one entire lung. is usually done for patients with lung
cancer. When the lung is removed the cavity fills with
serosanguinous fluid and fibrotic tissue. Chest tubes are not
required)
Lobectomy
removal of one or more lobes of the lung
Segmentectomy
removal of one or more portions of a lobe
Wedge resection
removal of a small wedge-like shaped section of the peripheral
portion of the lung. Can be done using Video-Assisted
thoracoscopic surgery (VATS) so that a big incision does not
need to be made.
Post-thoracic surgery management
Pain management:
- PCA
- Epidural
- Splint the incision.
Postoperative pulmonary hygiene:
- Coughing
