summary rasmussen college pn 2 pn2 exam 2 study guide complete latest guide
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Rasmussen College
PN 2 (PN2)
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PN2 Exam #2 Study Guide
ASTHMA
Characterized by exacerbations of acute airway inflammation
Airway obstruction occurs d/t bronchoconstriction, mucous, or inflammation when exposed to
trigger
Clinical Manifestations:
High pitched, wheezing lung sounds
Cough
SOB
Chest tightness
Worsens at night or when triggers are present
Medications:
Short Acting= Albuterol, Proventil, Ventoli
Long Acting= Serevent
Corticosteroids= Serevent, Advair
Education:
Avoid triggers
Stop/avoid smoking
Teach which inhaler is rescue
Exacerbation Interventions:
Give short-acting beta agonist
IV corticosteroids depending on severity
O2 via nasal cannula
High-fowler’s position
Calm atmosphere
Questions:
If a pt. is having an asthma attack how would you expect it to affect their VS?
At first RR increased then decreased as attack progresses
Tachycardia >120
Decreased BP
If you give a pt. Albuterol, what type of side effects would you expect to see?
Increased HR
Tremors
What are rescue medications for Asthma?
Short-acting beta agonists (Albuterol)
EPITAXIS
Nose bleed – d/t trauma, allergies, drug use
Most frequent ED complaint
Interventions & Treatment:
Anterior portion of nose = apply direct pressure for 5-10 while leaning forward
Apply silver nitrate
Apply lidocaine/ep with cotton pledge for 5-10 minutes
Nasal packing for 2-5 days
Educate on prevention – Vaseline, humidifiers
, COPD
Chronic obstructive pulmonary disease – emphysema & chronic bronchitis
Causes= air pollution, occupation, smoking
Primary Symptoms:
Cough
Sputum production
DOE – Dyspnea On Exertion
Clinical Manifestations:
Wheezes or crackles heard in lungs
Prolonged expiratory phase
Distant heart sounds
Orthopneic position
Barrel chest
Use of accessory muscles
Weight loss (dyspnea with eating)
Late phase= clubbing to nails, right-sided HF, chronic cyanosis
Medications:
Avoid frequent use of cough suppressants (antitussives) because coughing is a protective
mechanism
Limit narcotic use d/t respiratory depression can worsen hypercapnia
Beta-Adrenergic Agonists: Albuterol, formoterol
Anticholinergics: Atrovent, Spiriva
Corticosteroids: short course only
Methylxanthines: Theophylline (limited)
Interventions & Education:
Pursed lipped breathing
Controlled coughing
Controlled O2 therapy (1-2 L)
Low sodium diet
Diaphragmic breathing
Conserve energy
Small frequent meals
Increase fluids
BiPAP
RAYNAUD’S DISEASE
Bilateral vasospasms; peripheral artery occlusive disease triggered by cold & stress
Clinical Manifestations:
Pain & cyanosis followed by redness and pain (when warmed up)
Pain is intermittent, extremities are numb & cold & may have swelling/ulcerations
Education:
Stop smoking
Exercise
Control stress
Avoid extreme temperatures
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