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FIRST PUBLISH OCTOBER 2024
NU 155 Exam 2 Questions and Answers
Pleurisy/ pleuritis: inflammation of the pleura - Ans:✔✔-*causes:* infection, medications, lupus,
rheumatoid arthritis
*s/s:* sharp, abrupt! onset, most evident on inspiration, shallow breathing and pleural friction rub
*Tx:* splint affected side during coughing for relief, intercostal nerve block for severe pleuritic pain
vesicular breath sounds - Ans:✔✔--heard in the 6th intercostal space over lung tissue
-sounds low medium pitched, soft whooshing 2-3x length of expiration
Bronchovescular breath sounds - Ans:✔✔--heard main-stem bronchi, below clavicles, beside sternum,
posteriorly, between scapulae
-sounds like moderate high pitches hollow muffled
equal sounds on inspiration and expiration
Bronchial breath sounds - Ans:✔✔--heard over trachea above sternal notch (often indicate atelectasis)
-sounds high pitched, loud harsh tubular quality, inspiration half as long as expiration
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COPD (chronic obstructive pulmonary disease): (PATHO, Dx, S/S, N/I, pt. teaching) - Ans:✔✔--combo of
*chronic bronchitis, asthma, and emphysema*
-caused by: *tobacco smoke (90%)*, occupational hazards like farming, biomass fuels, firefighters
-*Dx*: chest X-ray, EKG, labs like high hematocrit, ABG
-*S/S*: dyspnea, barrel chest, polycythemia (high RBC), hypercapnia (high CO2), coughing up in the
morning
-*N/I* titrate o2 to 92%, bronchodilators, hydrate uncaffeinated liquids
-teach pt: avoid over eating, smaller bites, increase fluid and calcium, adequate protein, rest before
eating and meds, and avoid lying down after
Thyroid Storm (thyroid crisis) - Ans:✔✔--*causes*: drugs or dyes with iodine, pregnancy/child birth, M.I.
or cardiac emergencies, severe emotional distress, trauma, surgery, levothyroxine overdose
-*s/s*: 106ºF +, 200bpm, high b/p, tachypnea, HTN, restlessness, agitation, confusion, if *untreated*
delirium to coma to heart failure to death
-*Tx*: MUST begin as soon as symptoms occur!, reduce temp. slow HR, sedatives, increase fluid avoid
dehydration
DKA -VS- HHS - Ans:✔✔-+DKA (Type 1): hyperglycemic crisis associated with elevated ketones!
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+HHS (Type 2): hyperglycemic crisis without association of ketones!
-*DKA:* BS >300mg/dL *HHS:* BS > 600mg/dL
*DKA* Ketonuria
-*HHS* Older adults at higher risk, and higher mortality r/t severe dehydration and extreme
hyperglycemia (than DKA)
-*DKA:* N/V, abdominal pain, rigidity *HHS:* NO GI NO KETOACIDOSIS
-*DKA:* Kussmaul breathing *HHS:* Seizures
-*DKA:* Acetone (fruit) breath *HHS:* Confusion
-*DKA:* Stupor or coma (late) *HHS:* Coma
Chronic bronchitis emphysema sputum characteristic - Ans:✔✔-thick, tenacious, "ropy" and difficult to
cough up!
pneumococcal pneumonia sputum characteristic - Ans:✔✔-Scant, sticky, rust colored
Pulmonary edema sputum characteristic - Ans:✔✔-Frothy, pinkish, or blood tinged
pulmonary infection sputum characteristic - Ans:✔✔-yellow, yellow-green, or grayish yellow with foul
odor or taste
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