NURS 0123 MED SURG MOD 6|complete latest solution guide.

Med-Surg CH. 24  Patient-centered care: cultural/spiritual considerations o Pulse oximetry results may be lower in adults with dark skin.  This is due to deeper coloration of the nail bed and does not reflect true oxygenation status.  Use additional respiratory assessment techniques to assess gas exchange in adults with dark skin, such as examination of the color within the oral cavity and arterial blood gas results  Action Alert o Document any known allergies, especially to drugs, and the specific type of allergic response experienced in a prominent place in the patient’s medical record  Current health problems o Cough:  S i g n of lung disease  Ask the patient how long the cough has been present and whether it occurs at a specific time of day  Ask whether the cough produces sputum or is dry, tickling, or hacking o Sputum production  an important symptom associated with coughing  Check the color, consistency, odor, and amount of sputum o Hemoptysis  Blood in sputum  May be seen in patients with chronic bronchitis or lung cancer  Grossly bloody sputum: tuberculosis, pulmonary infarction, lung cancer, or lung abscess o Dyspnea  Difficulty in breathing or breathlessness Important Respiratory Assessment Issues o Smoking history o Childhood illnesses  Asthma  Pneumonia  Communicable diseases  Hay fever  Allergies  Eczema  Frequent colds  Croup  Cystic fibrosis o Adult illnesses  Pneumonia  Sinusitis  Tuberculosis  HIV and aids  Lung disease such as emphysema and sarcoidosis  Diabetes  Hypertension  Heart disease  Influenza, pneumococcal, BCG vaccinations o Surgeries of upper/lower resp system o Hospitalizations o Date of last CXR, PFT, TB Test, other DX tests o Recent weight loss o Night sweats o Sleep disturbances o Lung disease and condition of family members o Geographic areas of recent travel o Occupation and leisure activities  Subjective perception, varies among patients o Orthopnea  SOB when lying down, relieved by sitting up  Assessment o Inspection  Observe the rate, rhythm, and depth of inspirations and the symmetry of chest movement o Palpitation  Crepitus:  Air trapped in and under the skin  Aka: subcutaneous emphysema  Felt as a crackling sensation beneath the fingertips o Auscultation  Lung auscultation is listening with a stethoscope for normal breath sounds, abnormal sounds, and voice sound