Med Surg Test 2 Review - Lecture notes exam 2[2024] STUDY GUIDE

Med Surg Test 2 Review - Lecture notes exam 2[2024] STUDY GUIDERespiratory System - Explain & discuss assessment findings manifest in lower respiratory disorders (COPD, asthma, pneumonia, tuberculosis), and relate them to underlying pathophysiological processes. COPD consists of emphysema and chronic bronchitis – irreversible. Chronic bronchitis causes structural and inflammation changes. Emphysema damages and enlarges alveoli (air sacs) causing breathlessness. Risk factors: smoking!!!, occupational chemicals and dust, air pollution, infection and some genetic factors (AAT deficiency). Develops slowly, chronic intermittent cough may occur first. Dyspnea is progressive, occurring with exertion. Unable to take a deep breath. Will interfere with ADLs. With advanced COPD, you'll see weight loss despite adequate intake, fatigue, wheezes, adventitious or decreased breath sounds, severe cough leading to fainting/breaking a rib, barrel chest, relief in tripod position, pursed lip breathing, usage of accessory muscles, hypoxemia, blue/red color of skin, retaining CO2 (look at ABGs), edema in the ankles secondary to right sided heart involvement (aka cor pulmonale). Patients with COPD are at a high risk of respiratory failure. Use of beta-adrenergic blockers (atenolol) can improve survival rate and decrease risk of exacerbations. Nurse assessment in acute exacerbation event: increase in dyspnea, sputum volume and purulence, malaise, insomnia, fatigue, depression, confusion, decrease in exercise tolerance, confusion, increase in wheezing, may have a fever. Nursing considerations: if the patient retains CO2, careful monitoring when on oxygen or during surgery and post op is crucial. They might appear to be resting comfortably, but actually aren't. Abdominal surgery can lead to ineffective ventilation and respiratory failure due to the inability to take deep breaths. Diagnostics: spirometry – must confirm obstruction. Pulmonary function test. Chest x-ray will show a flat diaphragm, hyper inflated lungs. Serum and antitrypsin level (genetics), ABGs. 6 minute walk test, COPD assessment test, BODE index.