PBDS RETAKE STUDY QUESTIONS AND ANSWERS
PNEUMONIA symptoms - ANSWER Crackles, shortness of breath,
productive cough, fever, chills, loss of appetite, sharp chest pain with deep
breathing, nasal congestion, decreased activity
Pneumonia interventions - ANSWER 1. Assess lung sounds for signs of
crackles, Check RR, TEMP, AND O2 SAT, pulse, BP.
2. Call MD stat
3. Place patient in high fowlers
4. TCDB/Incentive spirometry
5.Collect sputum sample if ordered
6. Anticipate an order for respiratory to obtain breathing treatments
7.Give oxygen if needed
8.Anticipate an order for a chest X-ray, ABG, CBC
9.Give fluids
Pneumonia Rationales - ANSWER 1. Auscultate for sounds of
crackles/mucous in the lungs. Establish a baseline for the vitals obtained and
compare to future assessments.
2. Let MD aware of patients condition, await orders
3. To open up airway in the lungs
4. Tcdb/ Incentive spirometry loosens up secretions in the lungs and makes it
easier to clear out the lungs of these secretions when done routinely.
5.Sputom samples/blood cultures are taken to identify the bacteria involved in the
condition.
6.Anticipate an order for respiratory can deliver nebulizer/inhalant medications
that is beneficial for the patient. Can take ABG
7.Oxygen can improve o2 sat if decreased.
8. Check for an elevated WBC, chest X-ray will show what side of the lungs are
,affected by pneumonia.
9. Prevents dehydration
Pneumonia Consults - ANSWER Infectious disease/ Respiratory therapist
Hypovolemic Shock - ANSWER Tachycardia, Hypotension, Pallor/cyanosis,
Cold skin, weakness, dizziness, fainting, nausea, dehydrated, diminished/absent
peripheral pulses
Hypovolemic Shock interventions - ANSWER 1. Call MD stat
2.Monitor BP, pulse, RR, oz sat and weights daily
3.Place patient's legs elevated
4.Administer fluids
5.Provide oxygen as needed
6.Monitor patients for signs of Fluid overload such as: Crackles in the lungs,
swelling, weight gain
7.Antcipate an order for CBC, Electrolytes, BUN, Creatinine
8. Recheck BP, PULSE, O SAT, and monitor every 1-2 hours.
Hypovolemic shock rationales - ANSWER 1. Notify of status, obtain orders
2. Compare current vitals to baseline, document the significant change.
3.Increases in vascular fluid volume
4.Fluids(NACL/Lactated Ringers) may be used to boost intravascular volume when
there is fluid loss found in hypovolemic shock.
5.When given a large amount of fluids in a short time, fluid overload can occur and
should be monitored very carefully when giving vast amount of fluids at once.
6. Oxygen reduces cyanosis, and increases tissue perfusion.
7. Reevaluate to determine if interventions were successful in stabilizing the
patient.
CVA SYMPTOMS - ANSWER muscle weakness, facial drooping, slurred
speech, numbness of the face/arm/legs, headache, blurred vision.
, CVA Interventions - ANSWER 1.Obtain BP, Pulse, RR, Temp, O2 sat.
-Assess Nuero sys.
-Check Blood Sugar
2.Call Rapid Response
3.Call MD stat
4.Anticipate a CT of head
5. If Ischemic, Anticipate an order for TPA/Anticoagulants. Administer BP meds if
Pressure is elevated.
-If hemorrhagic, await orders for surgery (coiling procedure)
6.Position patient in neutral position (Semi fowlers)
7. Monitor CBC, Electrolytes, PT, PTT, and Platelet levels.
8. Do neuro checks and recheck BP/Pulse O2 sat and Blood sugars every hour until
stable.
9. Reposition every 2 hours after stable
**Transer to ICU**
CVA consults - ANSWER Neurologist, Respiratory therapist, physical
therapy, occupational therapy
CVA Rationales - ANSWER 1. Often caused by a high Blood Pressure,
assessing the patient Heart rate, RR, O2 SAT will identify the cause of the
situation. Neuro checks will show any deficiency in neurology.
2.Hyperglycemia is common in the early phases
3.Help is needed to get the patient stabilized
4. To await orders and to let MD know of situation
5.Thrombolytics can dissolve clots formed in ischemia, anticoagulants thins the
blood and prevent clots from reforming. Coiling is used to fill the sidewall
aneurysm.
6.Promotes confort, Venous drainage that reduces ICP
PNEUMONIA symptoms - ANSWER Crackles, shortness of breath,
productive cough, fever, chills, loss of appetite, sharp chest pain with deep
breathing, nasal congestion, decreased activity
Pneumonia interventions - ANSWER 1. Assess lung sounds for signs of
crackles, Check RR, TEMP, AND O2 SAT, pulse, BP.
2. Call MD stat
3. Place patient in high fowlers
4. TCDB/Incentive spirometry
5.Collect sputum sample if ordered
6. Anticipate an order for respiratory to obtain breathing treatments
7.Give oxygen if needed
8.Anticipate an order for a chest X-ray, ABG, CBC
9.Give fluids
Pneumonia Rationales - ANSWER 1. Auscultate for sounds of
crackles/mucous in the lungs. Establish a baseline for the vitals obtained and
compare to future assessments.
2. Let MD aware of patients condition, await orders
3. To open up airway in the lungs
4. Tcdb/ Incentive spirometry loosens up secretions in the lungs and makes it
easier to clear out the lungs of these secretions when done routinely.
5.Sputom samples/blood cultures are taken to identify the bacteria involved in the
condition.
6.Anticipate an order for respiratory can deliver nebulizer/inhalant medications
that is beneficial for the patient. Can take ABG
7.Oxygen can improve o2 sat if decreased.
8. Check for an elevated WBC, chest X-ray will show what side of the lungs are
,affected by pneumonia.
9. Prevents dehydration
Pneumonia Consults - ANSWER Infectious disease/ Respiratory therapist
Hypovolemic Shock - ANSWER Tachycardia, Hypotension, Pallor/cyanosis,
Cold skin, weakness, dizziness, fainting, nausea, dehydrated, diminished/absent
peripheral pulses
Hypovolemic Shock interventions - ANSWER 1. Call MD stat
2.Monitor BP, pulse, RR, oz sat and weights daily
3.Place patient's legs elevated
4.Administer fluids
5.Provide oxygen as needed
6.Monitor patients for signs of Fluid overload such as: Crackles in the lungs,
swelling, weight gain
7.Antcipate an order for CBC, Electrolytes, BUN, Creatinine
8. Recheck BP, PULSE, O SAT, and monitor every 1-2 hours.
Hypovolemic shock rationales - ANSWER 1. Notify of status, obtain orders
2. Compare current vitals to baseline, document the significant change.
3.Increases in vascular fluid volume
4.Fluids(NACL/Lactated Ringers) may be used to boost intravascular volume when
there is fluid loss found in hypovolemic shock.
5.When given a large amount of fluids in a short time, fluid overload can occur and
should be monitored very carefully when giving vast amount of fluids at once.
6. Oxygen reduces cyanosis, and increases tissue perfusion.
7. Reevaluate to determine if interventions were successful in stabilizing the
patient.
CVA SYMPTOMS - ANSWER muscle weakness, facial drooping, slurred
speech, numbness of the face/arm/legs, headache, blurred vision.
, CVA Interventions - ANSWER 1.Obtain BP, Pulse, RR, Temp, O2 sat.
-Assess Nuero sys.
-Check Blood Sugar
2.Call Rapid Response
3.Call MD stat
4.Anticipate a CT of head
5. If Ischemic, Anticipate an order for TPA/Anticoagulants. Administer BP meds if
Pressure is elevated.
-If hemorrhagic, await orders for surgery (coiling procedure)
6.Position patient in neutral position (Semi fowlers)
7. Monitor CBC, Electrolytes, PT, PTT, and Platelet levels.
8. Do neuro checks and recheck BP/Pulse O2 sat and Blood sugars every hour until
stable.
9. Reposition every 2 hours after stable
**Transer to ICU**
CVA consults - ANSWER Neurologist, Respiratory therapist, physical
therapy, occupational therapy
CVA Rationales - ANSWER 1. Often caused by a high Blood Pressure,
assessing the patient Heart rate, RR, O2 SAT will identify the cause of the
situation. Neuro checks will show any deficiency in neurology.
2.Hyperglycemia is common in the early phases
3.Help is needed to get the patient stabilized
4. To await orders and to let MD know of situation
5.Thrombolytics can dissolve clots formed in ischemia, anticoagulants thins the
blood and prevent clots from reforming. Coiling is used to fill the sidewall
aneurysm.
6.Promotes confort, Venous drainage that reduces ICP
