NURS 2207 Exam 1: Resp And Endocrine – Questions
With Verified Answers
Manifestations of laryngeal obstruction Right Ans - •Subcutaneous
emphysema or crepitus
•Voice changes
•Dysphagia
•Pain with swallowing
•Inspiratory stridor- in upper
•Coarse sound in lower
•Hemoptysis
•Cough
•Signs of asphyxia: use of accessory muscles
late signs of laryngeal obstruction Right Ans - •Retracting of ribcage- late
symptom. Impending resp collapse
what should the nurse ask about during the assessment for a pt with
suspected partial/total laryngeal obstruction? Right Ans - -Alcohol use
-New meds- especially ace inhibitors
-Allergies
- Activity
how long does a nurse have to perform rapid interventions before a laryngeal
obstruction becomes fatal? Right Ans - 3 mins
- BRAIN NEEDS O2
arytenoidectomy Right Ans - surgical widening of laryngeal tract
total laryngectomy Right Ans - Surgical removal of the entire larynx
- vocal cords, epiglottis, thyroid cartilage
•Permanent tracheostomy or laryngectomy tube
- Permanent loss of voice
post op care for total laryngectomy pts Right Ans - - NPO 7 days
- IV fluids
- Parenteral/ enteral feedings: NG or PEG
- semi fowler's position- helps ventilate and decreases pressure at incision
,-JP drain post op as well- measure I&O- removed when there is less than 30 ml
output in 2 consecutive days
-O2- humidified
complications of laryngectomies Right Ans - - Unintelligible speech
- Frequent coughing
- Chest infections
- Dryness & irritation of the windpipe
how often should you clean/change the inner cannula for a laryngectomy/
tracheostomy tube? Right Ans - every 8 hours
difference between tracheostomy and laryngectomy tubes Right Ans -
tracheostomy pts still have their upper airway
- puts them more at risk for aspiration
how can TB be spread? Right Ans - airborne
- pts placed in negative pressure rooms
ghon lesion or focus (HALLMARK SIGN OF TB) Right Ans - represents a
calcified TB granuloma- primary TB infection
- body's attempt to kill it. ends up walling off the acid fast bacilli and stops
further spreading
when can TB symptoms manifest? Right Ans - 2-10 weeks
Progressive tuberculosis Right Ans - tuberculosis that becomes reactivated
XDR tuberculosis Right Ans - resistant to isoniazid, rifampin,
fluoroquinolones, and at least 1 of 3 available second line injectable drugs.
primary TB infection Right Ans - •When bacteria are inhaled and initiate an
inflammatory reaction
•majority of people mount effective immune responses to encapsulate these
organisms for the rest of their lives
latent TB infection Right Ans - •Infected but no active disease
•have a positive skin test but are asymptomatic
•cannot transmit the TB bacteria to others
,Active TB disease Right Ans - •Primary TB - active disease develops within
the first 2 years of infection
•Reactivation TB (post-primary) - TB disease occurring 2 or more years after
the initial infection
tuberculosis manifestations Right Ans - •Initial dry cough that becomes
productive
•Fatigue
•Malaise
•Anorexia
•Weight loss
•Low-grade fever
•Night sweats
•Dyspnea
•Fever
•Hemoptysis = late symptoms
•Chills, generalized flu-like symptoms
•Pleuritic pain
•Productive cough
•Crackles and/or adventitious breath sounds
tuberculin skin test (AKA : Mantoux test, PPD) Right Ans - •Assess for
induration in 48 - 72 hours
•Presence of induration (not redness) at injection site indicates development
of antibodies secondary to exposure to TB
•Positive if ≥15 mm induration in any person
•Positive if ≥10 mm induration in persons with chronic disease, recent
immigrants, IV drug users
•Reactions ≥5 mm considered positive in immunosuppressed
Interferon-γ gamma release assays (IGRAs) Right Ans - Detects T-cells in
response to Mycobacterium tuberculosis
QuantiFERON-TB and T-SPOT.TB tests Right Ans - •used for people who
have the vaccine and have antibodies since they will always test positive on a
PPD.
chest Xray Right Ans - •Cannot make diagnosis solely on x-ray
, •May appear normal in a patient with TB
•Upper lobe infiltrates, cavitary infiltrates, lymph node involvement, and
pleural and/or pericardial effusion suggest TB
sputum stains Right Ans - •Required for diagnosis
•Consecutive sputum samples were obtained on 3 different days
med management considerations for TB Right Ans - •Infectious for first 2
weeks after starting treatment if sputum
active TB disease drug therapy Right Ans - •Treatment is aggressive
•Two phases of treatment
•Initial (8 weeks)
•Continuation (18 weeks)
four drug regimen used for TB Right Ans - - Rifampin
- Isoniazid
- Pyrazinamide
- Ethambutol
rifampin (Rifadin) Right Ans - Orange-colored body secretions are a side
effect of rifampin
Isoniazid (Hydra, Isovit) Right Ans - •monitor LFTs
•take one hour before meals or on an empty stomach
Pyrazinamide (Rifater, Tebrazid) Right Ans - arthralgia
Ethambutol (Myambutol) Right Ans - ocular toxicity; color discrimination
drug therapy for latent TB infection Right Ans - •Usually treated with
Isoniazid for 6 to 9 months
•HIV patients should take Isoniazid for 9 months
•Alternative 3-month regimen of Isoniazid and rifapentine OR 4 months of
rifampin
Bacille-Calmette-Guérin (BCG) vaccine Right Ans - - prevent TB In the
United States, not recommended except for very select individuals
- Can result in a positive PPD reaction
With Verified Answers
Manifestations of laryngeal obstruction Right Ans - •Subcutaneous
emphysema or crepitus
•Voice changes
•Dysphagia
•Pain with swallowing
•Inspiratory stridor- in upper
•Coarse sound in lower
•Hemoptysis
•Cough
•Signs of asphyxia: use of accessory muscles
late signs of laryngeal obstruction Right Ans - •Retracting of ribcage- late
symptom. Impending resp collapse
what should the nurse ask about during the assessment for a pt with
suspected partial/total laryngeal obstruction? Right Ans - -Alcohol use
-New meds- especially ace inhibitors
-Allergies
- Activity
how long does a nurse have to perform rapid interventions before a laryngeal
obstruction becomes fatal? Right Ans - 3 mins
- BRAIN NEEDS O2
arytenoidectomy Right Ans - surgical widening of laryngeal tract
total laryngectomy Right Ans - Surgical removal of the entire larynx
- vocal cords, epiglottis, thyroid cartilage
•Permanent tracheostomy or laryngectomy tube
- Permanent loss of voice
post op care for total laryngectomy pts Right Ans - - NPO 7 days
- IV fluids
- Parenteral/ enteral feedings: NG or PEG
- semi fowler's position- helps ventilate and decreases pressure at incision
,-JP drain post op as well- measure I&O- removed when there is less than 30 ml
output in 2 consecutive days
-O2- humidified
complications of laryngectomies Right Ans - - Unintelligible speech
- Frequent coughing
- Chest infections
- Dryness & irritation of the windpipe
how often should you clean/change the inner cannula for a laryngectomy/
tracheostomy tube? Right Ans - every 8 hours
difference between tracheostomy and laryngectomy tubes Right Ans -
tracheostomy pts still have their upper airway
- puts them more at risk for aspiration
how can TB be spread? Right Ans - airborne
- pts placed in negative pressure rooms
ghon lesion or focus (HALLMARK SIGN OF TB) Right Ans - represents a
calcified TB granuloma- primary TB infection
- body's attempt to kill it. ends up walling off the acid fast bacilli and stops
further spreading
when can TB symptoms manifest? Right Ans - 2-10 weeks
Progressive tuberculosis Right Ans - tuberculosis that becomes reactivated
XDR tuberculosis Right Ans - resistant to isoniazid, rifampin,
fluoroquinolones, and at least 1 of 3 available second line injectable drugs.
primary TB infection Right Ans - •When bacteria are inhaled and initiate an
inflammatory reaction
•majority of people mount effective immune responses to encapsulate these
organisms for the rest of their lives
latent TB infection Right Ans - •Infected but no active disease
•have a positive skin test but are asymptomatic
•cannot transmit the TB bacteria to others
,Active TB disease Right Ans - •Primary TB - active disease develops within
the first 2 years of infection
•Reactivation TB (post-primary) - TB disease occurring 2 or more years after
the initial infection
tuberculosis manifestations Right Ans - •Initial dry cough that becomes
productive
•Fatigue
•Malaise
•Anorexia
•Weight loss
•Low-grade fever
•Night sweats
•Dyspnea
•Fever
•Hemoptysis = late symptoms
•Chills, generalized flu-like symptoms
•Pleuritic pain
•Productive cough
•Crackles and/or adventitious breath sounds
tuberculin skin test (AKA : Mantoux test, PPD) Right Ans - •Assess for
induration in 48 - 72 hours
•Presence of induration (not redness) at injection site indicates development
of antibodies secondary to exposure to TB
•Positive if ≥15 mm induration in any person
•Positive if ≥10 mm induration in persons with chronic disease, recent
immigrants, IV drug users
•Reactions ≥5 mm considered positive in immunosuppressed
Interferon-γ gamma release assays (IGRAs) Right Ans - Detects T-cells in
response to Mycobacterium tuberculosis
QuantiFERON-TB and T-SPOT.TB tests Right Ans - •used for people who
have the vaccine and have antibodies since they will always test positive on a
PPD.
chest Xray Right Ans - •Cannot make diagnosis solely on x-ray
, •May appear normal in a patient with TB
•Upper lobe infiltrates, cavitary infiltrates, lymph node involvement, and
pleural and/or pericardial effusion suggest TB
sputum stains Right Ans - •Required for diagnosis
•Consecutive sputum samples were obtained on 3 different days
med management considerations for TB Right Ans - •Infectious for first 2
weeks after starting treatment if sputum
active TB disease drug therapy Right Ans - •Treatment is aggressive
•Two phases of treatment
•Initial (8 weeks)
•Continuation (18 weeks)
four drug regimen used for TB Right Ans - - Rifampin
- Isoniazid
- Pyrazinamide
- Ethambutol
rifampin (Rifadin) Right Ans - Orange-colored body secretions are a side
effect of rifampin
Isoniazid (Hydra, Isovit) Right Ans - •monitor LFTs
•take one hour before meals or on an empty stomach
Pyrazinamide (Rifater, Tebrazid) Right Ans - arthralgia
Ethambutol (Myambutol) Right Ans - ocular toxicity; color discrimination
drug therapy for latent TB infection Right Ans - •Usually treated with
Isoniazid for 6 to 9 months
•HIV patients should take Isoniazid for 9 months
•Alternative 3-month regimen of Isoniazid and rifapentine OR 4 months of
rifampin
Bacille-Calmette-Guérin (BCG) vaccine Right Ans - - prevent TB In the
United States, not recommended except for very select individuals
- Can result in a positive PPD reaction
