NUR 322 EXAM 2 WITH PERFECT SOLUTIONS
what can PUD be caused by? - infection of the H. pylori or Zollinger-Ellison bacteria
what is PUD typically caused by? - erosion from infection from H. pylori (does not cause
ulcers in all people)
*acquired from food/water, person-person
risk factors f...
NUR 322 EXAM 2 WITH PERFECT SOLUTIONS what can PUD be caused by? - infection of the H. pylori or Zollinger -Ellison bact eria what is PUD typically caused by? - erosion from infection from H. pylori (does not cause ulcers in all people) *acquired from food/water, person -person risk factors for PUD - NSAIDs (ibuprofen, aspirin) infection w H. pylori excessive secretion of HCl stress smoking alcohol family hx COPD or CKD s/sx PUD - dull, gnawing pain burning sensation in back pyrosis (heartburn) vomiting constipation diarrhea bleeding when is pain felt w gastric ulcers? - immediately after eating when is pain felt w duodenal ulcers? - 2-3 hrs. after a meal *more people w duodenal ulcers wake up w pain during the night patients w which type of ulcers are more likely to feel better from antacids? - duodenal ulcers diagnostic procedure for PUD - upper endoscopy* physical exam stool testing PUD meds - antibiotics proton pump inhibitors bismuth salts H2 blockers (if not fro H. pylori) do NOT use NSAIDs nurses beware of these for PUD patients - 1. hemorrhage 2. perforation/penetration 3. gastric obstruction perforation vs. penetration - -perforation: erosion through ulcer into peritoneum -penetration: erosion through gastric serosa into adjacent structures **both require immediate surgery where is referred pain for perforation/penetr ation felt? - right shoulder or back gastric outlet obstruction - -complication from PUD -distal area of pyloric sphincter becomes scarred when ulcer heals and breaks down nebulizer therapy - -breathe through mouth and take slow and deep breaths -encourages post therapy cough metered -dose inhaler (MDI) - aerosolizes medications dry powder inhaler (DPI) - medication released upon inhalation ways to promote proper breathing - -deep breathing -diaphragmatic breathing -pursed -lip breathing -incentive spirometer (IS) -chest physiotherapy (CPT) when should you administer bronchodilators and mucolytics r/t chest physiotherapy (CPT)? - prior to CPT to optimize movement and removal of secretions postural drainage - use of body positioning to assist in removal of secretions from specific lobes of the lung, bronchi, or lung cavities percussion/vibration - -alternate percussion with vibration -patient use diaphragmatic breathing -protect skin by covering -stop if pain increases, SOB, weakness, dizziness, hemoptysis assess need for oxygen (O2) by - 1. arterial blood gas (ABGs) 2. pulse oximetry (SpO2) 3. clinical evaluation oxygen therapy measurement - L/min low flow O2 delivery systems - -does not provide constant and precise concentration of oxygen due to mixing with inspired room air -cannula -nasal catheter -mask (simple, partial -rebreathing, non -rebreathing) high flow O2 delivery systems - -provides constant and precise concentration of O2 -total of inspired air not dependent on patient's breathing -transtracheal catheter -mask (venturi, aerosol) -tracheostomy collar -T-piece -face tent Ambu bag (BVM) - -manual resuscitator -used on patients who are not breathing or are not breathing adequately on their own -force -feeds O2 or air upper respiratory tract disorders - -acute and chronic pharyngitis -obstructive sleep apnea lower respiratory tract disorders - -atelectasis -TB -COPD (bronchitis + emphysema) -asthma upper respiratory structures - nose, paranasal sinuses, pharynx, larynx, trachea lower respiratory structures - bronchi, bronchioles, alveoli functions of respiratory system - 1. O2 transport 2. gas exchange 3. respiration 4. ventilation (inspiration + expiration) 4 lung volumes - tidal volume, residual volume, inspiratory reserve volume, expiratory reserve volume 4 lung capacities - vital cap acity, inspiratory capacity, functional residual capacity, total lung capacity s/sx of respiratory tract problems - dyspnea cough sputum production chest pain wheezing hemoptysis clubbing of fingers
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