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NUR 2571Exam 2 Review-finished
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Exam 2 Review-finished. GRADED A1) Child with allergic rhinitis
○ patho: exposure to sensitizing agent, body initiates inflammatory response releasing
histamines and leukotriene. Blood vessels of nasal mucosa vasodilate causing
increase permeability to affected area
○ causes swelling and nasal congestion
○ exhibit a triad of signs:
i) the allergic shiner-a darkening of the lower eyelid because of
suborbital edema)
ii) the allergic crease-a transverse line above the tip and below the bridge of
the nose
iii) the allergic salute (frequent wiping of the nose with the palm of the hand)
Other signs commonly present are a nasal quality to the voice, constant
coughing from a postnasal drip, chapped lips, and a dry mouth from
mouth breathing.
○ Can be infectious or non-infectious: Infectious = common cold. Non = allergic (seasonal)
and nonallergic (pregnancy, inhaled drugs, humidity)
2) Anti-histamine that doesn’t cause drowsiness
○ Allegra (can be in the form of nasal spray or saline spray)
○ (1st gen = benedryl, 2nd gen = allegra – no drowsiness, fatigue, or dry mouth)
Side effects: anticholinergic effects (dry mouth, constipation), GI
discomfort (N/V, constipation), Acute toxicity (flushed face, high fever,
tachycardia, dry mouth, urinary retention, pupil dilation), excitation,
hallucinations, incoordination, and seizures
*SEDATION EFFECT*
○ -Use with caution with clients with asthma, urinary retention,
open-angle glaucoma, hypertension, and BPH
○ -can cause respiratory depression
○ -Do not give to clients with cardiac dysrhythmias, hepatic disease,
and MAOI therapies
3) Teaching for client w/allergic rhinitis
○ keep windows closed*
○ run air conditioning*
○ remove carpeting to reduce pollen and humidity. *
○ remove pets if possible, If unable to remove pet, keep it out of the bedroom*
○ do not use feather pillows, and put pillows in zippered, dust proof encasings,
Replace feather or down-filled covers and pillows with synthetic items*
○ wash linen in hot water*
○ POLLENS
i) • Avoid freshly cut grass; do not mow the lawn. • Keep windows and doors
closed during allergy season. • Shower after outdoor activities to remove
pollen from clothing and skin.
○ MOLDS
, Exam 2 Review-finished. GRADED A
i) • Clean damp areas frequently, at least once a week, with a chlorine
bleach solution. • Ventilate areas well (bathrooms, kitchens, and
basements).
• Consider a dehumidifier if living in a humid climate.
○ PETS
i) • Reduce cat allergen by bathing the cat every two weeks
○ IRRITANTS
i) • Avoid cigarette smoke, perfumes, aerosol sprays, strong cleaning products
4) Tonsillectomy: know what to expect after and what is abnormal post op
Diagnostics:
○ Throat culture for group A strep. & bacterial infection
○ CT if infection present to see if it spread to neck region
○ Pre-op CBC to assess for anemia/infections
Tonsillectomy Education:
○ Report= signs of hemorrhage, fever, excessive vomiting of bright red blood,
unrelieved pain, excessive coughing or swallowing (means a child can be swallowing
blood)- abnormal
○ pt will have pain, difficulty swallowing, and difficulty talking
○ Drink minimum 8 glasses of water a day
○ Soft foods for first few days
○ Avoid smoking & heavy lifting
○ No gargling – can irritate surgical site
○ Sore throat is expected for approximately 1 week postop
○ Provide pain control with analgesics and ice collar postop
○ Offer clear, chilled fluids or ice pops to relieve pain and reduce inflammation
when awake and alert
○ avoid red-colored liquids because emesis of these fluids could be mistaken for blood
5) Pneumonia risk factors
○ from slide: most at risk for pneumonia os sickle cell pt with a cough!
○ Acute or chronic infection of one or both lungs caused by bacteria or virus,
upper respiratory infection
○ Increased age (group in nursing homes, over 50 yrs)
○ Immunocompromised (infants typically between 6 and 23 months, pregnancy
women during flu season, long term treatment with steroids)
○ smokers
○ Diabetes
○ CHF
○ Active malignancies (cancer pts)
○ Chronic diseases (i.e. sickle cell anemia, asthma, kidney diseases, diabetes)
(*if a question pops up about nsg intervention, PUSH FLUIDS TO LOOSEN UP SECRETIONS)
6) COPD physical assessment (question will only regard COPD not CHF)
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