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HESI Med Surg Hints/Study Guide, 2022-Why does fever cause dehydration? - excessive fluid loss due to diaphoresis increased temperature increased metabolism increase O2 demands clients at high risk for pneumonia - -altered LOC -depressed or absent gag and cough reflexes -susceptible ...

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  • March 12, 2022
  • 30
  • 2022/2023
  • Other
  • Unknown

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  • why does fever cause dehydration excessive fluid loss due to diaphoresis increased temperature increased metabolism increase o2 demands clients at high risk for pneumonia altered loc depre

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HESI Med Surg Hints/Study Guide, 2022
Why does fever cause dehydration? - excessive fluid loss due to diaphoresis

increased temperature

increased metabolism

increase O2 demands

clients at high risk for pneumonia - -altered LOC
-depressed or absent gag and cough reflexes
-susceptible to aspirating oropharyngeal secretions, including alcoholics, anesthetized individuals
-brain injury
-drug overdose
-stroke victims
-immunocompromised

Where are bronchial breath sounds located? - areas of density or consolidation

early signs of cerebral hypoxia - Irritability and restlessness

pneumonia preventives - 1) Older adults: flu shots; pneumonia immunizations; avoiding sources of
infection and indoor pollutants (dust, smoke, and aerosols); no smoking
2) Immunosuppressed and debilitated persons: Flu shots, pneumonia, immunizations, infection
avoidance, sensible nutrition, adequate intake, balance of rest and activity
3) Comatose and immobile persons: Elevation of head of bed to feed and for 1 hour after feeding;
frequently turning
4) Patients with functional or anatomic asplenia*: Flu and pneumonia immunizations
asplenia - absence of normal spleen function and is associated with serious infection risks

primary cause of COPD - smoking

signs of worsening COPD - hypoxemia
hypercapnia
respiratory acidosis

Which bed position facilitates a productive cough and comfort? - semi-Fowler
high-Fowler

pink puffer - barrel chest indicative of emphysema

caused by use of accessory muscles to breath

oxygen intake is still adequate for perfusion

blue bloater - chronic bronchitis

,insufficient oxygenation leads to generalized cyanosis and right-sided heart failure

diets for respiratory dysfunction - soft mechanical

key to respiratory status - assessment of breath sounds

visualization of client

if breath sounds are clear but the client is cyanotic and lethargic, adequate oxygenation is not
occurring

s/s of laryngeal cancer - tongue and mouth often appear white, gray, dark brown, or black and may
appear patchy

tracheostomy care - cleansing the inner cannula

suctioning

applying clean dressings

i pact of laryngectomy on air humidification - the natural humidifying pathway is gone for the client

secretions thicken and crust

patient teaching for coughing with laryngectomy clients - teach glottal stop technique:
- take deep breath
- momentarily occlude the tracheostomy tube
- cough
- simultaneously remove the finger from the tube

assessment for TB skin test - a positive test is exhibited by an induration of 10mm or greater after 48-
72 hours

Which type of vaccine of invalidates a TB test? - bacillus Calmette-Guerin (BCG)

leads to false positive; must do chest radiograph

patient teaching for TB - - long term drug therapy (6+ months)

- drug adherence is vital (public health hazard can result from premature termination)

patient teaching for rifampin - (TB drug)

reduces effectiveness of oral contraceptives

orange-tinted body fluids

, stains contact lenses

patient teaching for isoniazid - (TB drug)

increased phenytoin (Dilantin) levels

patient teaching for ethambutol - (TB drug)

check vision before starting therapy and then monthly

course of treatment may be 1-2 years

patient teaching for drug combination to treat TB - teach reasoning for increased compliance

resistance to drugs develops slowly if several are being used at once

Why are chest tubes not used following the resection of large lung tumors? - it is helpful if the
mediastinal cavity, where the lungs used to be, fills up with fluid

this helps to prevent the shift of the remaining chest organs into filling the empty space

What should you do if a chest tube becomes disconnected from the box? - do not clamp

place the end of the tube in a container of sterile water

What should you do if a chest tube becomes disconnected from the patient? - cover with dray sterile
dressing

cover 3 sides; do not occlude

notify the provider

What does tidaling in the chest tube indicate? - fluctuations in the fluids will occur if there is no
external suction

this is a good indicator that the system is intact

if fluctuations cease, check for kinked tubing, accumulation of fluid, or client repositioning

4 common symptoms of pneumonia - Tachypnea, fever with chills, productive cough, bronchial
breath sounds

4 nursing interventions for assisting the client to cough productively - deep breathing

3L/day fluid in take

humidifier

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