NSG 430 exam 1 (topic 3) Questions with Correct Answers 100% Verified| Guaranteed Success
respiratory acidosis interventions - bronchodilators
- assisted ventilation
- respiratory stimulants
metabolic acidosis interventions - monitor vitals
- monitor respiratory status
- monitor blood gases
- correct cause
- give bicarbonate
respiratory alkalosis interventions - encourage patient to take slow deep breaths
- decrease patient anxiety
- monitor ABG's
metabolic alkalosis interventions - monitor: vitals, neuro status, I&O, ABGs
- warn/teach about taking too many antacids
Severe asthma exacerbations - occur when the patient is dyspneic at rest and the patient
speaks in words, not sentences, because of the difficulty breathing
- accessory muscles in the neck are straining to try and lift the chest wall, and the patient is
often agitated
- the peak flow is 40% of the personal best or less than 150 L
- the breath sounds may be very difficult to hear, and no wheezing is apparent as the airflow is
exceptionally limited
- peak flow is less than 25% of the personal best
,Severe asthma exacerbations: interventions - auscultation may show expiratory wheezing to
start, can include inspiratory wheezing later on with progression
- O2 administered via nasal cannula or mask to achieve a PaO2 of at least 60 mmHg or O2
saturation greater than 90%
- bronchodilator treatment
Severe asthma exacerbations: "silent chest" - severely diminished breath sounds
- absence of wheeze after a patient has been wheezing
- patient obviously struggling to breathe
- life threatening situation
- requires ED and possible ICU admission
- IV magnesium sulfate for smooth muscle relaxation
- 100% oxygen
- hourly or continuous nebulized SABA
- IV corticosteroids
Severe asthma exacerbations: drugs - first line = corticosteroids (IV and inhaled
beclamethasone or budesonide)
- also used = SABA (albuterol) and LABA (fluticasone/salmetrol, budesonide/formoterol)
- anticholinergics = ipratropium and tiotropium
Pulmonary embolism - blockage of one or more pulmonary arteries by a thrombus, fat, or
air embolus or tumor tissue
- obstructs alveolar perfusion
- most commonly affects the lower lobes
- IVC filters are prevention techniques
Pulmonary embolism: interventions - oxygen (may include mechanical ventilation)
, - pulmonary toilet (promote clearance of secretions)
- chest physiotherapy, postural drainage, suctioning, incentive spirometry, coughing/deep
breathing exercises
- fluids, diuretics, analgesics
- massive PE (pulmonary embolectomy)
- IVC filter
Chest trauma - blunt or penetrating - may appear minor externally, can be life-threatening
- urgent needle decompression for tension pneumothorax
Rib fractures - can damage pleura, lungs, and internal organs
- clinical manifestations = pain, splinting, shallow respirations
- atelactasis and pneumonia
Rib fractures: treatment - no strapping or chest binding
- NSAIDs, opioids, nerve blocks
- patient teaching
- deep breathing and coughing
- incentive spirometry
- appropriate use of analgesics
Flail chest - results from the fracture of several consecutive ribs, in two or more separate
places, causing an unstable segment
- paradoxical movement during breathing
- the affected flail area will move in the opposite direction with respect to the intact portion of
the chest
Thoracotomy - surgical incision into the chest cavity
respiratory acidosis interventions - bronchodilators
- assisted ventilation
- respiratory stimulants
metabolic acidosis interventions - monitor vitals
- monitor respiratory status
- monitor blood gases
- correct cause
- give bicarbonate
respiratory alkalosis interventions - encourage patient to take slow deep breaths
- decrease patient anxiety
- monitor ABG's
metabolic alkalosis interventions - monitor: vitals, neuro status, I&O, ABGs
- warn/teach about taking too many antacids
Severe asthma exacerbations - occur when the patient is dyspneic at rest and the patient
speaks in words, not sentences, because of the difficulty breathing
- accessory muscles in the neck are straining to try and lift the chest wall, and the patient is
often agitated
- the peak flow is 40% of the personal best or less than 150 L
- the breath sounds may be very difficult to hear, and no wheezing is apparent as the airflow is
exceptionally limited
- peak flow is less than 25% of the personal best
,Severe asthma exacerbations: interventions - auscultation may show expiratory wheezing to
start, can include inspiratory wheezing later on with progression
- O2 administered via nasal cannula or mask to achieve a PaO2 of at least 60 mmHg or O2
saturation greater than 90%
- bronchodilator treatment
Severe asthma exacerbations: "silent chest" - severely diminished breath sounds
- absence of wheeze after a patient has been wheezing
- patient obviously struggling to breathe
- life threatening situation
- requires ED and possible ICU admission
- IV magnesium sulfate for smooth muscle relaxation
- 100% oxygen
- hourly or continuous nebulized SABA
- IV corticosteroids
Severe asthma exacerbations: drugs - first line = corticosteroids (IV and inhaled
beclamethasone or budesonide)
- also used = SABA (albuterol) and LABA (fluticasone/salmetrol, budesonide/formoterol)
- anticholinergics = ipratropium and tiotropium
Pulmonary embolism - blockage of one or more pulmonary arteries by a thrombus, fat, or
air embolus or tumor tissue
- obstructs alveolar perfusion
- most commonly affects the lower lobes
- IVC filters are prevention techniques
Pulmonary embolism: interventions - oxygen (may include mechanical ventilation)
, - pulmonary toilet (promote clearance of secretions)
- chest physiotherapy, postural drainage, suctioning, incentive spirometry, coughing/deep
breathing exercises
- fluids, diuretics, analgesics
- massive PE (pulmonary embolectomy)
- IVC filter
Chest trauma - blunt or penetrating - may appear minor externally, can be life-threatening
- urgent needle decompression for tension pneumothorax
Rib fractures - can damage pleura, lungs, and internal organs
- clinical manifestations = pain, splinting, shallow respirations
- atelactasis and pneumonia
Rib fractures: treatment - no strapping or chest binding
- NSAIDs, opioids, nerve blocks
- patient teaching
- deep breathing and coughing
- incentive spirometry
- appropriate use of analgesics
Flail chest - results from the fracture of several consecutive ribs, in two or more separate
places, causing an unstable segment
- paradoxical movement during breathing
- the affected flail area will move in the opposite direction with respect to the intact portion of
the chest
Thoracotomy - surgical incision into the chest cavity
