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Summary Nurs 325 Exam 3 Study Guide $10.49
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Summary Nurs 325 Exam 3 Study Guide

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This is a comprehensive and detailed study guide on Exam 3 for Nurs 325. *Essential Study material!! *For you, at a price that's fair enough!! Enjoy!!

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  • September 2, 2024
  • 21
  • 2022/2023
  • Summary

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Test 3: Breakdown of test questions
 Please note this is not an all-inclusive list of test items
 Test 3 is not cumulative. However, some concepts will from the early modules will be applied on this test (e.g.
patient teaching principles and postoperative care).
 Test 3 has 50 questions. Most items are multiple choice, but a few items may be multiple answer (select all that
apply).
 The time limit is 75 minutes.
 Partial credit is not awarded for select all that apply/multiple response items.
o Note: “Select all that apply”/multiple response questions may have 2 or more correct answers. It is
possible for all of the options to be correct for these types of questions.
 Generic names and pharmacotherapeutic class will be provided for medications

Unit 10 Pulmonary: 18 questions

 Pneumonia

o What is it: Acute infection of the lung parenchyma caused by virus, bacteria or an atypical organism
 All pneumonia starts as an inflammatory response
 On an x-ray: the alveoli are filled with thick mucous and is noted as consolidation
o Clinical manifestations
 Sudden onset of fever
 Shaking chills
 SOB
 Cough productive of purulent sputum
 Pleuritic chest pain (pain with deep breathing or coughing)
 Adventitious breath sounds
 Non-Specific:
 Headaches, muscle ache, diaphoresis, anorexia (loss of appetite)
 Signs and symptoms:
 Accessory muscle use
 Tachypnea
 Leaning forward
 Gasping
 Nasal flaring
 OLDER ADULTS:
 Change in level of consciousness or orientation
o WHAT IS IMPORTANT TO ASSESS: asses oxygen (O2 Saturation)
o Diagnostic findings:
 CBC: elevated WBC
 ABG
 At first: normal or decreased PaO2: mild respiratory alkalosis
 Then: decreased PaO2: respiratory acidosis
 Positive sputum
 Abnormal chest x-ray

,o Priorities for nursing care
 Collect a sample first
 If they cannot produce sputum let the provider know but still start antibiotic
 START antibiotic ASAP
 The earlier initiated the better to decrease serious illness or death
 Oxygen for hypoxemia
 NC
 Watch O2 closely
 Fluid intake @ least 3L per day
 Caloric intake @ least 1500 per day
o Implementation
 At risk patients
 Elevate HOB 30 to 45 degrees for patients with feeding tubes
 Aspiration precautions
 Turn and reposition patient
o Do not let them stay supine
 Encourage coughing
 Specimen collection
 Respiratory assessment, pulse ox
 O2 therapy
 Hydrate
o Medications (general principles—antibiotics, expectorants, antipyretics, pain)
 Need to rest to promote recovery
 Antibiotics
 Take full course of meds
 Do not stop taking if they feel better
 Analgesic for chest pain
 Can take Tylenol
 Antipyretics
 Considered fever if above 101.5
 Acetaminophen is not the first action
 Expectorants
 Robitussin (no extra things in it) to help liquify the sputum to help excrete it
 Follow-up with chest x-ray in 6-8 weeks to evaluate

,  Tuberculosis

o What is it: infectious disease caused by Mycobacterium tuberculosis that’s spreads via airborne droplets
 Replicates slowly and spreads via lymphatic system
 Latent TB
 screen testing (secondary prevention) or blood testing, generally do not have any
symptoms
 Not transmissible but they can’t still develop full TB
 Classifications:
 0 = no TB exposure (never exposed)
 1 = TB exposure, NO infection
o Negative test
 2 = Latent TB, no disease
o Positive skin test but NO infection, no x-ray findings
 3 = TB, clinically active
o Positive test with x-ray evidence
 4 = TB, but not clinically active (has history of it)
 5 = TB suspect (briefly)
 Clinical Manifestations:
 Early stages are free of symptoms
 Can see
o Fatigue, malaise, anorexia, weight loss, night sweats
 Acute symptoms = generalized flu symptoms
o Interpretation of tuberculin skin testing
 Intradermal admin of tuberculin
 The test is read and inspected 48-72 hours later
 Positive reactions
 > 5 mm—immunocompromised patients, people with close personal contact to infected
person (positive reaction)
 > 10 mm—recent immigrants from areas with increased TB incidence, IV drug users,
residents or employees of prisons, SNFs, homeless shelters
 > 15 mm—no known risk factors
 When it becomes positive = it is an immune response because they already have it (they
will always be positive)
 Measures the indurated area (feels hard)
o Palpate to the hard area and measure that
 Two-step testing for individuals who will be tested periodically (only done ONCE)
 Skin test assess for immune response
o Adherence to therapy
 Hospitalization not necessary for most patients (outpatients)
 Drug therapy used to prevent or treat active disease (treatment lasts several months)
 Active disease
 Four drugs are used in initial phase for maximum effectiveness.
o (Isoniazid, rifampin, pyrazinamide, and ethambutol)
 Treatment is aggressive to combat resistant strains of TB.
 Liver function should be monitored (advised not to drink alcohol at ALL)
o Medications can cause inflammation to the liver
 Directly observed therapy (DOT)
 Noncompliance is major factor in multidrug resistance and treatment failures.
 Requires watching patient swallow drugs
 Preferred to ensure adherence

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