Med-Surg Exit HESI Exam 2023 Latest Update

Med-Surg Exit HESI Exam 2023 Latest Update Monitor ABGs - ANSWER-PO2 80 mm Hg; PCO2 35-45 mm Hg; HCO3 21-28 mEq/L; pH 7.35-7.45 Chronic bronchitis - ANSWER-Airway destruction Chronic sputum with cough production on a daily basis for a minimum of 3 months in 2 consecutive years Reduced responsiveness of respiratory center to hypoxemia stimuli Precipitating factor: higher incidence in smokers "Blue bloaters" - generalized cyanosis of lips, mucous membranes, face, and nail beds Right-sided heart failure (distended neck veins, crackles) Lowest FiO2 possible to prevent CO2 retention Monitor for fluid overload Maintain PO2 between 55 and 60 Administer bronchodilators and anti-inflammatory agents Emphysema - ANSWER-Alveoli destruction Increased air trapping (increased AP diameter) Increased work, increased O2 consumption Precipitating factor: cigarette smoking "Pink puffers" Barrel chest, pursed-lip breathing, wheezing Lowest FiO2 possible to prevent CO2 retention Administer bronchodilators and anti-inflammatory agents Teach prolonged expiratory phase to clear trapped air Asthma - ANSWER-Unlike COPD, asthma is an intermittent disease with reversible airflow obstruction and wheezing COPD - ANSWER-Emphysema and chronic bronchitis Characterized by bronchospasm and dyspnea Compensation occurs over time in clients with chronic lung disease and ABGs are altered The amount of O2 in the blood decreased (hypoxemia) and the amount of CO2 in the blood increases (hypercapnia) causing chronic respiratory acidosis, which results in metabolic alkalosis as compensation Clients at risk for pneumonia - ANSWER-Altered LOC Depressed or absent gag and cough reflexes Susceptible to aspirating oropharyngeal secretions (alcoholics, anesthetized individuals) Brain injury Drug overdose