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NURSING 7450 FINAL SET 2 (1)
NURSING 7450 FINAL SET 2 (1)
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NURSING 7450 FINAL SET 2pulsus paradoxus - CORRECT ANSWER-changes in BP when pt is breathing in
status asthamticus - CORRECT ANSWER-- bronchospasm not reversed by usual measures
- life threatening
Ominous signs of impending death - CORRECT ANSWER-- Silent chest (no audible air
movement)
- Paco2 greater than 70 mm Hg
pneumothorax - CORRECT ANSWER-presence of air or gas in the pleural space
primary (spontaneous) pneumothorax - CORRECT ANSWER-occurs unexpectedly in healthy
individuals
secondary pneumothorax - CORRECT ANSWER-Caused by disease, trauma, injury, or condition
latrogenic pneumothorax - CORRECT ANSWER-caused by medical treatments, especially
transthoracic needle aspiration
open pneumothorax - CORRECT ANSWER-air pressure in the pleural space equals barometric
pressure because air that is drawn into the pleural space during inspiration is forced back out
during expiration
closed pneumothorax - CORRECT ANSWER-air pressure in the pleura space less than the
atmosphere pressure
tension pneumothorax - CORRECT ANSWER-- air pressure in the pleural space greater than the
atmosphere pressure
- one-way valve
- air enters on inspiration but prevents escape by closing up during expiration
- life threatening
pneumothorax s/s - CORRECT ANSWER-- pleural pain
- tachypnea
- possible mild dyspnea
tension pneumothorax s/s - CORRECT ANSWER-- severe hypoxemia
- tracheal deviation away from the affected lung
- hypotension
pneumothorax treatment - CORRECT ANSWER-- Chest tube
- If persistent air leak: Surgery, pleurodesis (instillation of a caustic substance, such as talc, into
the pleural space), or thoracoscopic surgical techniques
pneumonia - CORRECT ANSWER-- infection of the lower respiratory tracts
- responsible for more disease and death than any other infection
- organisms determine where pneumonia originates from
pneumonia diagnosis - CORRECT ANSWER-chest x-ray
,community acquired pneumonia - CORRECT ANSWER-streptococcus pneumoniae
Health care associated pneumonia - CORRECT ANSWER-pneumonia that has been acquired in
other health care facilities, such as nursing homes
Hospital acquired pneumonia - CORRECT ANSWER-acquired during hospitalization
Ventilator-associated pneumonia (VAP) - CORRECT ANSWER-pneumonia that occurs more than
48 hours after endotracheal intubation
Pneumococcal pneumonia - CORRECT ANSWER-- Streptococcus pneumoniae
- causes AlI
- inflammatory cytokines and cells cause alveolar edema
- edema is great medium for multiplication of bacteria and aids in spread of infection
- involved lobe undergoes consolidation
viral pneumonia - CORRECT ANSWER-- Seasonal and usually self-limiting
- can set the stage for secondary bacterial infection
pneumonia s/s - CORRECT ANSWER-- upper respiratory infection (nonproductive cough)
- cough
- dyspnea
- fever
- chills
- malaise
- pleuritic chest pain
Acute Respiratory Failure - CORRECT ANSWER-- gas exchange is inadequate
- PaO2 =/< 60
- PaCO2 >/= 45
- pH =/< 7.35
AlI/ARDS - CORRECT ANSWER-acute lung inflammation and diffuse alveolocapillary injury
ALI/ ARDS Manifestations - CORRECT ANSWER-- injury to the pulmonary capillary endothelium
- increased capillary permeability
- inflammation
- surfactant inactivation
- edema and atelectasis
ALI/ARDS phases - CORRECT ANSWER-- exudative/inflammatory
- proliferative
- fibrotic
exudative/inflammatory phase - CORRECT ANSWER-- within 72 hours
- alveolocapillary membrane damage
- increased capillary membrane permeability
- pulmonary edema
- surfactant inactivated
, proliferative phase - CORRECT ANSWER-- 4 to 21 days
- resolution of the pulmonary edema and proliferation of type 2 pneumocytes, fibroblasts, and
myofibroblasts
- hyaline membranes
- hypoxemia
fibrotic phase - CORRECT ANSWER--14-21 days
-Remodeling and fibrosis
-Alveoli destruction
-Severe right-to-left shunting
-Acute respiratory failure
ALI/ ARDS Manifestations - CORRECT ANSWER--Dyspnea and hypoxemia w/ poor response to
oxygen supplementation
-Hyperventilation and respiratory alkalosis
-Decreased tissue perfusion, metabolic acidosis, and organ dysfunction
-Increased work of breathing, decreased tidal volume, and hypoventilation
-Hypercapnia, respiratory acidosis, worsening hypoxemia
-Respiratory failure, decreased cardiac output, hypotension, and death
hypertension - CORRECT ANSWER-- serious problem for endothelial cells that line the outer layer
of arteries
- over time pressure in arteries silently creep upward
- problem with flow and resistance
primary hypertension - CORRECT ANSWER-denotes high blood pressure from an unidentified
cause; also called essential hypertension
primary hypertension - CORRECT ANSWER-- thought to be caused by a reduction of renal
sodium excretion leading to an increase in plasma volume and an increase in systolic BP
- no none cause
- 90% of cases
secondary hypertension main cause - CORRECT ANSWER-- hyperaldosteronism (Conn
Syndrome)
- Cushing syndrome
- tumor like pheochromocytoma all effects adrenal gland
primary hypertension risk factors - CORRECT ANSWER-- age
- physical inactivity
- obesity
- diabetes (increases in insulin promote sodium retention)
- smoking
- family history
- excess salt
- excess ETOH consumption
secondary hypertension kidneys - CORRECT ANSWER-- Renal artery stenosis, increase in
plasma renin and unilateral atrophy of kidney --> retaining sodium
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