NU 155 Exam 2 Questions with 100% Verified
Correct Answers
Pleurisy/ pleuritis: inflammation of the pleura
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
-heard in the 6th intercostal space over lung tissue
-sounds low medium pitched, soft whooshing 2-3x length of expiration
Bronchovescular breath sounds
-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
-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)
-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)
-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
+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
Correct Answers
Pleurisy/ pleuritis: inflammation of the pleura
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
-heard in the 6th intercostal space over lung tissue
-sounds low medium pitched, soft whooshing 2-3x length of expiration
Bronchovescular breath sounds
-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
-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)
-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)
-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
+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
