NURS 272 TEST 2 STUDY GUIDE WITH COMPLETE
SOLUTION BASED ON FINAL EXAM!!
COPD Interventions
Smoking cessation
Exercise
Eat small frequent meals: high calorie, high protein: not drinking before meals,
avoid high fiber, watch carbs
Monitor for cachexia
Home O2 education/safety
answers: Pursed lip breathing
Diaphragmatic breathing
Tri-pod position
Inhaler education
How to use an inhaler
Assess for Cor Pulmonale!
Respiratory Anatomy
risk factors: obstructions, fluid build up, geographic location, heart failure,
smoking, family history, occupation/environmental exposure, TB: endemic, chest
injury
answers: upper respiratory tract: nose, pharynx, larynx
lower respiratory tract: trachea, bronchus, bronchioles, alveolar duct, alveoli
atelectasis
answers: collapsed lung: chest x-ray, see it
,fluid build up from congestive heart failure, pneumonia, or sedentary
which respiratory organ is the site of gas exchange?
answers: alveoli
Diagnostics
CXR: Posterior/Anterior & Lateral view, most common: look at lungs:
hyperinflated: air trapping, COPD, heart: size, chest, bones: rib fracture = prevent
taking deep breaths, foreign bodies, spine, blood vessels
answers: CT, contrast dye: flush out: soft tissue, blood clots
Pulse oximetry: nail polish, cold
Pulmonary function tests: assess for asthma/COPD and treatment
Assessment
Lung sounds: both sides, upper/lower, avoid bony prominences, under clothes
Tachypnea, bradypnea: rate & quality
O2 saturation
answers: Accessory muscle usage: COPD, resp failure
Restlessness, confusion, anxiety
Pallor, cyanosis
Crepitus: subcutaneous emphysema: chest trauma, air trapped under skin: rice
crispies
Percussion
Sputum culture: phlegm, cough into cup, TB
ABGs
Bronch/thoraoscopy: see, biopsy, cultures
, Thoracentesis: remove fluid or air from around the lungs
answers: V/Q scan: comparing ventilation to perfusion: mismatch = pulmonary
embolism
Mantoux test: skin test for TB
a client is admitted to the surgical floor with chest pain and shortness of breath, and
hypoxemia after having a knee replacement. what diagnostic test should the nurse
expect to help confirm the diagnosis?
answers: ct scan
Adventitious Breath Sounds
Fine crackles, rales: popping, "velcro", rolled hair = diseases/laying on one side
Coarse crackles: lower pitched, rattling = strong cough break up build up,
suctioning, breathing treatment
answers: Rhonchi, low pitch wheeze: lower pitch, coarse, "snoring" = tenacious
sputum, tumor
Stridor: harsh, grating, trachea
Wheeze: squeaky, musical = narrowing from inflammation, spasm
answers: Pleural rub: loud, rough, grating, scratching = TB, pneumonia, lung
cancer
decreased breath sounds
the nurse understands that the expected assessment for the older adult related to the
natural aging process of the resp system includes which finding
answers: decrease in resp muscle strength
Age Related Changes