NURS5084 EXAM STUDY GUIDE – 100% CORRECT ANSWERS

NURS5084 EXAM STUDY GUIDE – 100% CORRECT ANSWERS What are nursing interventions for increased ICP and head injury? - Answer-- maintain oxygenation and perfusion of cerebral area - prevent ischemia - monitor neurological status (GCS scale) What is bacterial meningitis, what causes it, and how does this occur? - Answer-A medical emergency, inflammation of the meninges, caused by pathogens including streptococcus pneumoniae, neisseria meningitidis, staphylococcus aureus. These pathogens enter through the respiratory tract, blood stream, skull wounds, or fractured sinuses. Describe signs and symptoms of bacterial meningitis. - Answer-Fever, headache, stiff neck, mental changes, increased ICP, nausea, vomiting, seizures, skin rash (if neisseria meningitidis). What are the complications of bacterial meningitis? - Answer-Acute cerebral oedema causing seizures, bradycardia, coma, and death. If caused by neisseria meningitidis, also may lead to shock, adrenal haemorrhage. How would a nurse manage bacterial meningitis? - Answer-- antibiotic therapy - monitor neurological status - monitor seizure risk - monitor vital signs - hydration - urinary output - acute pain - droplet precautions What is viral meningitis, causes, and symptoms? - Answer-Viral infection of meninges, not life threatening, caused by enterovirus, HIV, HSV, causing headache, fever, stiff neck. How would a nurse manage viral meningitis? - Answer-Would begin antibiotics due to risk of bacterial meningitis, and then symptomatic management including pain management. What is viral encephalitis? - Answer-Acute inflammation of the brain tissue, with similar symptoms to meningitis plus behavioural changes, hallucinations, seizures. Causes include HSV, chickenpox, diseases from ticks and mosquitoes. How would a nurse manage viral encephalitis? - Answer-Administer medications including antivirals, and anti-seizure medication. What is a brain abscess? - Answer-Spread from nearby or remote infection, or from head trauma or surgical procedure. How would a nurse manage brain abscess? - Answer-Administer antibiotics, aspiration and drainage. How would a nurse manage brain tumours? - Answer-- ensure ICP within normal limits - fluid intake and output, fluid balance chart - maintain electrolyte balance - control pain and discomfort - ensure optimal nutritional status - refer to psychotherapy if needed What is involved in respiratory control? - Answer-- central chemoreceptors: mainly sense changes in CO2 levels, and hence change ventilation rate to be varied - peripheral chemoreceptors: respond to hypoxaemia What is compliance in regard to lungs? - Answer-Measure of the ease of expansion of the lungs (stiff vs expansive lungs). Compliance is affected by conditions including pulmonary oedema, pneumonia, pulmonary fibrosis, and pleural effusion. What are the two types of respiratory failure - Answer-Type 1: failure of oxygenation (pneumonia, oedema) Type 2: failure of ventilation (asthma, COPD) When is oxygen therapy indicated? - Answer-Hypoxaemia measured by SPO2. Describe the potential harms of inappropriate oxygen therapy. - Answer-Potentially fatal hypercapnia (increased risk in chronic obstructive lung disease, obesity, neuromuscular diseases, respiratory muscle weakness, use of respiratory depressant drugs), and hyperoxaemia which may cause inflammation, atelectasis, pulmonary toxicity. What are the different delivery options for oxgen? - Answer-- nasal prongs - high flow nasal prongs - face mask - venturi mask - non-rebreather masks - CPAP/BiPAP - mechanical ventilation - ECMO Describe some respiratory defence mechanisms. - Answer-Nasal hairs allow filtration, ciliary move and catch particles, mucous allows removal, cough reflex. What is the correct name for the common cold, what are some potential complications? - Answer-Acute viral rhinitis, inflammation of the nasal mucosa in response to infection of upper respiratory tract. Complications include laryngitis, tonsillitis, and secondary infection. How would a nurse manage the common cold? - Answer-Symptomatic relief, including pain management and comfort. Antibiotics only if there is secondary infection. What are the types, causes, symptoms, and complications of pneumonia? - Answer-Pneumonia may be community acquired, hospital acquired, or ventilator associated. It may be caused by micro aspiration, direct inhalation, macro aspiration. Symptoms include fever, chills, dyspnoea, chest pain, green and yellow sputum. Complications include pleural effusion, bacteraemia, sepsis, meningitis, pneumothorax. How would a nurse manage pneumonia? - Answer-- antibiotics - deep breathing and coughing - oxygen therapy if hypoxemic - pain management - hydration - nutritional support What are nursing management strategies currently for COVID-19? - Answer-- antivirals - symptomatic relief - antibody therapy - decrease inflammation - oxygen therapy in severe disease - refer to psychosocial help - assist with proning - reduce anxiety and misinformation What is pulmonary oedema? - Answer-Medical emergency of abnormal accumulation of fluid in the alveoli and spaces of the lungs, often a complication of left sided heart failure, or pulmonary disease. What are types of chest injury that may cause fractured ribs? - Answer-Blunt force or penetrating injuries, requiring analgesics and anti-inflammatories. Fractured ribs cause inappropriate chest movement, pneumothorax (air in pleural cavity leading to complete or partial lung collapse), haemothorax, pleural effusion. What is pulmonary embolism, symptoms, complications? - Answer-Pulmonary embolism is characterised by blockage of pulmonary arteries, leading to dyspnoea, tachypnoea, cough, chest pain. Complications include pulmonary infarction, pulmonary hypertension. How might a nurse manage PE? - Answer-- semi-fowlers position - IV access - oxygen therapy - frequent assessments - monitor lab results - immobility risk - emotional support - patient teaching Describe asthma. - Answer-Asthma is characterised by chronic airway inflammation and increased airway hyper-responsiveness leading to symptoms of wheeze, cough, chest tightness and dyspnoea. Air flow obstruction is variable and reversible with treatment. Aetiology is complex and multiple factors involved. Predisposing factors are childhood infections (respiratory syncytial virus), allergen exposure (house dust mite, pets), indoor pollution and dietary deficiency of antioxidants. What is the immediate, late, and chronic response of asthma? - Answer-Initially, immune cells respond and cause bronchoconstriction and increased secretions. Later, inflammation occurs, and chronic inflammation leads to bronchial hypersensitivity. How would a nurse assess asthma severity? - Answer-Can the person walk, speak whole sentences, do they display increased work of breathing, are they conscious, exhausted, is SPO2 less than 90%. Describe COPD. - Answer-Chronic airflow limitation due to inhalation of noxious particles and gases, leading to inflammation, airway remodelling, vascular changes. Hence, mucous hyper-secretion, chronic cough, airflow limitation occurs. These patients also develop high tolerance for CO2, changing chemoreceptors. Care when administering oxygen. Complications include acute exacerbations.