Exam (elaborations)
NUR 304 FINAL WITH COMPLETE SOLUTION LATEST 2024/25
- Course
- Institution
NUR 304 FINAL WITH COMPLETE SOLUTION LATEST 2024/25
[Show more]
Content preview
NUR 304 FINAL WITH COMPLETESOLUTION LATEST 2024/25
A. Neck lymph nodes - Correct Answers What should the nurse palpate when
assessing for an upper respiratory tract infection?
A. Neck lymph nodes
B. Nasal mucosa
C. Tracheal mucosa
D. All of the above
A) Patient with seizures
B) Patient with head injury
E) Patient who is receiving nasogastric tube feeding - Correct Answers For which
patients with pneumonia would the nurse suspect aspiration as the likely cause of
pneumonia (Select all that apply)?
A) Patient with seizures
B) Patient with head injury
C) Patient who had thoracic surgery
D) Patient who had a myocardial infarction
E) Patient who is receiving nasogastric tube feeding
Acute Pharyngitis - Correct Answers - Causes: viral, bacterial (most commonly B-
Hemolytic Strep), fungal, and others
- Clinical Manifestations: "scratchy throat" to severe pain especially with swallowing,
fever, anterior cervical node enlargement, exudate
- Nursing Management: symptom relief and prevention
- Complications: peritonsillar abscess
Acute Respiratory Distress Syndrome (ARDS) - Correct Answers - Risk factors for
ARDS: smoke inhalation, SHOCK, drug ingestion or overdose, DIC, sepsis, trauma, fat
or air embolism
- Characterized by sudden, progressive pulmonary edema, increasing bilateral lung
infiltrates visible on chest x-ray, and absence of an elevated left atrial pressure
- Rapid onset of severe dyspnea
* Hypoxemia that does not respond to supplemental oxygen therapy
Medical Management
- Identification and treatment of underlying cause
- Intubation, mechanical ventilation with PEEP to keep alveoli open
- Hypovolemia treated
,- Prone positioning is best for oxygenation, frequent repositioning to safeguard
integumentary system
- Nutritional support, enteral feedings preferred
- Reduce anxiety
Advantages of Tracheostomy vs. Endotracheal Tube - Correct Answers - More
secure airway
- Increased mobility
- Less risk of long-term damage to airway
- Easier breathing
- Increased comfort
- Patient can eat and speak
Allergic Rhinitis - Correct Answers - Reaction of the nasal mucosa to a specific
allergen
- Manifestations include: nasal congestion, sneezing, watery/itchy eyes and nose,
altered sense of smell, thin watery nasal discharge
- Nasal turbinate's become swollen and press against the nasal septum obstructing
sinus aeration and/or drainage
- This leads to HAs, congestion, pressure, post nasal drip and nasal polyps -- Pt can c/o
cough, hoarseness and constant clearing of throat → can cause snoring
Nursing and Collaborative Management:
- Most important step in managing allergic rhinitis involves identifying and avoiding
triggers of allergic reactions
- Keep a diary
- Drugs: nasal sprays, antihistamines and decongestants -- may need prescription nasal
corticosteroid sprays to ↓ inflammation
Aspiration Pneumonia - Correct Answers - Aspirated material triggers inflammatory
response
- Primary bacterial infection most common
- Empiric therapy based on severity of illness, where infection acquired, and probable
causative organism
- Aspiration of acid gastric contents initially causes chemical (noninfectious)
pneumonitis
Aspiration
- Inhalation of foreign material into the lungs
- Serious complication of pneumonia
- Clinical picture: tachycardia, dyspnea, central cyanosis, hypertension, hypotension,
and potential death
- Will hear crackles
- Risk factors: siezures, a brain energy, decreased LOC, stroke, cardiac arrest,
swallowing disorders
- Nursing interventions:
, 1. Keep HOB elevated >30 degrees
2. Avoid stimulation of gag reflex with suctioning or other procedures
3. Check for placement before tube feedings
4. Thickened fluids for swallowing problems
Asthma - Correct Answers - A chronic inflammatory disease of the airways that
causes hyper-responsiveness, mucosal edema, and mucus production
- Is reversible, either spontaneously or with treatment
- Allergy is the strongest predisposing factor
- Inflammation leads to cough, chest tightness, wheezing, and dyspnea
Pathophysiology
- Inflammation that leads to long-term airway narrowing.
- Narrowing causes bronchoconstriction, airway edema, airway hyper-responsiveness,
airway remodeling
- Involves many inflammatory, structural cells, and mediators
* Mast cells, macrophages, T lymphocytes, neutrophils, eosinophils
* Mast cells release chemicals- histamine, bradykinin, prostanoids, cytokines,
leukotrienes, and other mediators
Risk Factors
- Respiratory infections
- Air pollution, allergen exposure, occupational sensitizers
- Active/passive smoking
- Diet, small size at birth
- Atopy: genetic tendency to develop some sort of allergic disease
- Female gender
Clinical Manifestations
- Cough, dyspnea, wheezing
- Exacerbations
* Cough, productive or not
* Generalized wheezing
* Chest tightness and dyspnea
* Diaphoresis
* Tachycardia
* Hypoxemia and central cyanosis
Medication Management
- Stepwise, refer to Figure 24-7
- Quick-relief medications
* Beta2-adrenergic agonists
* Anticholinergics
- Long-acting medications
* Corticosteroids
* Long-acting beta2-adrenergic agonists
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller STUVATE. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $11.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
75759 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now