NSG 1240 MS1: Exam 3 Respiratory & Hematology Review
NSG 1240 MS1: Exam 3 Review
Respiratory System
Obstructive Disorders
What disorders are considered Obstructive Disorders?
Asthma, emphysema, chronic bronchitis
Laryngeal Cancer (Voice Box)
What are the signs and symptoms (manifestations)?
Hoarseness, dry cough, sore throat for two weeks
What are the major factors that cause Laryngeal Cancer?
Smoking and alcohol (ETOH)
Laryngectomy
What is a Laryngectomy?
Taking the larynx out (reference page 286)
What are the risk factors of laryngectomy?
- Plan of alternate mode of communication
- Risk of losing their voice
- Risk for bleeding, aspiration, airway obstruction
Mucous
What is the importance of mucous in our bodies?
Acting as a protective barrier, trapping and removing harmful particles and pathogens in our bodies
Can we thin mucous secretions?
Yes, by the increase of fluids (electrolytes)
Tuberculosis (TB)
What is Tuberculosis (TB)?
Airway disease – negative air pressure – Airborne precautions
What are the signs and symptoms?
Persistent cough lasting more than three weeks, night sweats, anorexia (weight loss), low-grade fever (often in the afternoon), and fatigue
What puts people at an increased risk of TB?
Prison, big community areas, nursing homes, adults over 65, and immunocompromised people
What medication do we treat TB with, and what kind of education should we give the patient about this medication?
Rifampin: this will turn your secretions orange
Chronic Obstructive Pulmonary Disease (COPD)
What is COPD?
Smoking, bad air quality, environmental factors
What causes COPD?
Cough, dyspnea, cough worse in the morning, barrel chest.
What are the signs and symptoms of COPD?
Cough (worse in the morning), shortness of breath, dyspnea on exertion, barrel chest
What are the treatments of COPD?
Bronchodilators, respiratory rehab programs, anti-inflammatory medication
What kind of diet should we educate COPD patients about?
Increase protein
What is a Barrel Chest, and what causes this to appear the way it does?
Hyperinflation, overinflation of the chest, and decreased elasticity
Asthma
What is Asthma?
Obstruction of the airway; this is reversible
What are the major risk factors that contribute to asthma?
Environmental and genetics
Status Asthmaticus
What is Status Asthmaticus?
This is an attack that is not getting better; it is life-threatening, needs immediate intervention, and requires bronchodilators
Clubbing of Fingers
What does Clubbing of the fingers indicate?
Low blood levels of oxygen
Cystic Fibrosis
What is Cystic Fibrosis?
This is a genetic disease more common among white individuals. Must have a positive sweat test, and they have excessive mucus production
Pneumothorax
What is a Pneumothorax?
This is a condition where a partial or total collapse of the lung or both lungs occurs
Epistaxis
What is Epistaxis?
This is a bloody nose
How should we instruct the patient to stop bleeding?
Sit forward and apply direct pressure by pinching the nose just below the bone
Alveoli
What is the purpose of Alveoli?
Blood exchange of oxygen and carbon dioxide during the process of breathing in and out
Cilia
What are Cilia?
Tiny, hair-like structures that extend from the surface of cells (receptor cells)
Sinusitis
What is Sinusitis?
Inflammation of the mucosal lining of the sinuses can be caused by infection or allergy
How does Sinusitis manifest?
Accumulates in the sinuses; pressure builds up, causing pain and tenderness over the sinuses, purulent drainage from the nose, nasal obstruction, sometimes causes a nonproductive cough
Cyanosis
What is Cyanosis?
Blue tinge to the skin or mucous membranes
How do we check for Cyanosis?
Skin, lips, nail beds, ear lobes
Do we check differently with patients who have darker skin tones?
Nail beds, gums, and around the eyes
Emphysema
What is Emphysema?
Aggressive lung disease that damages the air sacs (alveoli) in the lungs, causes chronic inflammation and obstruction in the airways
How should we tell the patients to sit to increase aeration?
Sitting upright and leaning over a bed table
Age-Related Respiratory Changes
What age-related changes happen to our respiratory tract?
A decline in lung elasticity, reduced respiratory muscle strength, and a decrease in cough reflexes
Sleep Apnea
What is Sleep apnea?
When breathing repeatedly stops and starts
How does this manifest in patients?
Snoring
Tracheostomy
What is a Tracheostomy?
Surgical incision to the trachea for the purpose of inserting a tube through to help the patient breathe
Obturator
What is an Obturator?
Metal piece that goes inside the trach that pushes it back in there…you have to know the size
Tracheal Suctioning
How do you tracheal suction a patient?
Gently insert a sterile suction catheter into the trach tube, apply suction intermittently by covering the hole, then remove the catheter in a swirling motion.
Can patients with a tracheostomy talk?
YES
How can we educate patients to clear secretions and adventitious lung sounds?
Hematology
Disseminated Intravascular Coagulation (DIC)
What is Disseminated Intravascular Coagulation (DIC)?
Due to severe trauma or sepsis, clotting and bleeding occur simultaneously; this is life-threatening
Blood Transfusion Reactions
What do blood transfusion reactions look like?
Shortness of breath, itching, hypotension, flushing, rash, fever
What should the LPN do if this is present?
Stop transfusion immediately; report to RN
How quickly should blood be administered when sent from the laboratory?
30 minutes
Thrombocytopenia
What is Thrombocytopenia?
Low platelet count
What is the normal range for thrombocytes?
Under 150,000
Sickle Cell Anemia/ Sickle Cell Trait
What is Sickle Cell Anemia/ Sickle Cell Trait?
Crescent cell shapes; this is a genetic trait passed on to the children; this is more prominent in the African American community
How does this manifest?
Pain, lethargy, swelling
What do we need to treat?
Treat sickle cell crisis; put on oxygen and ensure good fluid intake
Pernicious Anemia
What is Pernicious Anemia?
B12 deficiency
How do we treat Pernicious Anemia?
IM B12 injections
White Blood Cells (WBCs)
What is the importance of White Blood Cells (WBCs)?
What is the range of WBC?
4,500 to 11,000
What is the average life span of WBC?
13 to 20 days
What is another name for WBCs?
Leukocytes
Red Blood Cells (RBCs)
What is the importance of Red Blood Cells (RBCs)?
Carry oxygen to the tissues/cells
What is the life span of RBCs?
120 days
What is another name for RBC’s?
Erythrocyte
Fibrinogen
What is Fibrinogen?
Clotting factor
Why is it important?
Essential for formation of blood clots
Iron Deficiency Anemia
What is Iron deficiency Anemia?
What does this affect?
This affects the hemoglobin and ability to carry oxygen
Components of Blood
What are the components of Blood?
White blood cells, red blood cells, plasma
Functions of Blood
What are the functions of blood?
Regulation of body temperature, transporting, regulating of fluid volume and electrolyte balance
Erythropoietin
What is Erythropoietin, and where is it produced?
Promotes erythrocyte production and bone marrow; this is a hormone located in the kidney
Aplastic Anemia
What is Aplastic Anemia?
Bone marrow depression develops after a viral infection or reaction to drugs
Neutropenic Precautions
What are Neutropenic Precautions?
Use protective isolation, treating ourselves as if we are the infection. You need PPE, no fresh fruits, no flowers, no raw veggies