HESI Med Surg Hints/Study Guide, 2022-Why does fever cause dehydration? - excessive fluid loss due to diaphoresis
increased temperature
increased metabolism
increase O2 demands
clients at high risk for pneumonia - -altered LOC
-depressed or absent gag and cough reflexes
-susceptible ...
why does fever cause dehydration excessive fluid loss due to diaphoresis increased temperature increased metabolism increase o2 demands clients at high risk for pneumonia altered loc depre
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HESI Med Surg Hints/Study Guide, 2022
Why does fever cause dehydration? - excessive fluid loss due to diaphoresis
increased temperature
increased metabolism
increase O2 demands
clients at high risk for pneumonia - -altered LOC
-depressed or absent gag and cough reflexes
-susceptible to aspirating oropharyngeal secretions, including alcoholics, anesthetized individuals
-brain injury
-drug overdose
-stroke victims
-immunocompromised
Where are bronchial breath sounds located? - areas of density or consolidation
early signs of cerebral hypoxia - Irritability and restlessness
pneumonia preventives - 1) Older adults: flu shots; pneumonia immunizations; avoiding sources of
infection and indoor pollutants (dust, smoke, and aerosols); no smoking
2) Immunosuppressed and debilitated persons: Flu shots, pneumonia, immunizations, infection
avoidance, sensible nutrition, adequate intake, balance of rest and activity
3) Comatose and immobile persons: Elevation of head of bed to feed and for 1 hour after feeding;
frequently turning
4) Patients with functional or anatomic asplenia*: Flu and pneumonia immunizations
asplenia - absence of normal spleen function and is associated with serious infection risks
primary cause of COPD - smoking
signs of worsening COPD - hypoxemia
hypercapnia
respiratory acidosis
Which bed position facilitates a productive cough and comfort? - semi-Fowler
high-Fowler
pink puffer - barrel chest indicative of emphysema
caused by use of accessory muscles to breath
oxygen intake is still adequate for perfusion
blue bloater - chronic bronchitis
,insufficient oxygenation leads to generalized cyanosis and right-sided heart failure
diets for respiratory dysfunction - soft mechanical
key to respiratory status - assessment of breath sounds
visualization of client
if breath sounds are clear but the client is cyanotic and lethargic, adequate oxygenation is not
occurring
s/s of laryngeal cancer - tongue and mouth often appear white, gray, dark brown, or black and may
appear patchy
tracheostomy care - cleansing the inner cannula
suctioning
applying clean dressings
i pact of laryngectomy on air humidification - the natural humidifying pathway is gone for the client
secretions thicken and crust
patient teaching for coughing with laryngectomy clients - teach glottal stop technique:
- take deep breath
- momentarily occlude the tracheostomy tube
- cough
- simultaneously remove the finger from the tube
assessment for TB skin test - a positive test is exhibited by an induration of 10mm or greater after 48-
72 hours
Which type of vaccine of invalidates a TB test? - bacillus Calmette-Guerin (BCG)
leads to false positive; must do chest radiograph
patient teaching for TB - - long term drug therapy (6+ months)
- drug adherence is vital (public health hazard can result from premature termination)
patient teaching for rifampin - (TB drug)
reduces effectiveness of oral contraceptives
orange-tinted body fluids
, stains contact lenses
patient teaching for isoniazid - (TB drug)
increased phenytoin (Dilantin) levels
patient teaching for ethambutol - (TB drug)
check vision before starting therapy and then monthly
course of treatment may be 1-2 years
patient teaching for drug combination to treat TB - teach reasoning for increased compliance
resistance to drugs develops slowly if several are being used at once
Why are chest tubes not used following the resection of large lung tumors? - it is helpful if the
mediastinal cavity, where the lungs used to be, fills up with fluid
this helps to prevent the shift of the remaining chest organs into filling the empty space
What should you do if a chest tube becomes disconnected from the box? - do not clamp
place the end of the tube in a container of sterile water
What should you do if a chest tube becomes disconnected from the patient? - cover with dray sterile
dressing
cover 3 sides; do not occlude
notify the provider
What does tidaling in the chest tube indicate? - fluctuations in the fluids will occur if there is no
external suction
this is a good indicator that the system is intact
if fluctuations cease, check for kinked tubing, accumulation of fluid, or client repositioning
4 common symptoms of pneumonia - Tachypnea, fever with chills, productive cough, bronchial
breath sounds
4 nursing interventions for assisting the client to cough productively - deep breathing
3L/day fluid in take
humidifier
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