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NUR1460 EXAM 3 MODULE 3&4/2025/2026/305 TERMS/QUESTIONS AND ANSWERS/A+
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Inspiration occurs when the pressure inside the lungs goes down. What is the atmospheric pressure regarding inspirations? 760 mm Hg the atmospheric air comes intothe lungs When the pressure goes down to 758mm Hg Expiration occurs once the diaphragm and intercostal muscles are relaxed, the space inside the lungs is reduced, forcing the air out of the lungs2This Photo by Unknown Author is licensed under CC BY
Other Indicators of respiratory adequacy Skin and mucous membrane changes, general appearance, andendurance. D I A G N O S T I C A S S E S S M E N T for inspiration and expiration RBC ABG SPUTUM noninvasive diagnostic assessments for inspiration and expiration Pulse oximetry• Chest X-ray PA/Lat• Capnometry and capnography• End Tidal Carbon Dioxide• PFTs• Tidal volume (TV), Inspiratory &Expiratory Residual Volumes,• Exercise testing• Endoscopic examinations• Bronchoscopy• Thoracentesis• Lung biopsy Stridor is a high-pitched sound made when Breathing is through a narrow or partly blocked airway. Air can't flow through the lungs smoothly, so it's harder to breathe
What is oxygen therapies purpose? to relieve hypoxemia-low levels of oxygen in the blood Hypoxia decreased tissue oxygenation What is the goal for oxygen therapy? use lowest fraction of inspired oxygen for acceptable blood oxygen level without causing harmful side effects Early symptoms of hypoxia early- Restlessness Anxiety Tachycardia/Tachypnea Late symptoms of hypoxia bradycardia, Extreme restlessness, Dyspnea
Peds symptoms of hypoxia Feeding difficulty Inspiratory stridor Nare flare Expiratory grunting Sternal retractions If using 4L of oxygen, what should you use? humidification Upper airway COPD is Chronic Bronchitis Disease of the bronchial epithelium Activates neutrophils & lymphocytes Airways inflammation causing chronic mucus hypersecretion Lower airway COPD is
(true or false) COPD can cause Gi disturbances true. Gi disturbances is a symptom of COPD A person with COPD would have shortened or prolonged expiratory time? prolonged expiratory time Albuterol Sulfate (Salbutamol, Ventolin) tx: Tx- Hand Held-emergency inhaler (Aerosol)is used to treat or prevent bronchospasm inpatients with asthma, bronchitis, emphysema albuterol sulfate adverse side effects Nervousness, shaking of a part of the body, palpitations• Irritation in the throat, cough, Headache, gi upset albuterol contraindications
HTN, DM, CAD, Glaucoma, Seizures Ipratropium Bromide (Atrovent) an anticholinergic bronchodilator Ipratropium Bromide (Atrovent) tx: Tx- COPD, chronic bronchitis, and emphysema Ipratropium Bromide (Atrovent) works by long term- Bronchodilator that relaxes muscles in the airways and increases air flow to the lungs Ipratropium Bromide (Atrovent) side effects: inhibits parasympathetic response-anticholinergic- dries you up- tears, saliva, gimotility, urinary retention Ipratropium Bromide (Atrovent) is given via
** Monitor for signs of Cushing's syndrome- potential for falls- adjustment in HTN & DM meds, patient education to prevent infection** (True or false) You can discontinue prednisone abruptly? FALSE HYPERCORTISOLISM /CUSHINGS DISEASE Excess secretion from the adrenal cortex because of problems in the adrenal cortex or the anterior pituitary, malignancies of the adrenal gland, gi tract, lungs, pancreas• Excess glucocorticoids cause affects metabolism What is the goal for a pt with cushings disease? prevention of fluid overload and pulmonary, kidney, and liver dysfunction Tx for Cushing's disease Tx: adrenocorticotropin hormone antagonists- Mifepristone
Guaifenesin (Mucinex) mucolytic Guaifenesin (Mucinex) tx: COPD Side effects when taking Guaifenesin (Mucinex) May cause some sedation/take only the dosage as directed• Increases the water content of the mucus, thinning it out so that it can be expectorated Priority Focus for COPD: Improve gas exchange and maintain airway clearance What is the min expected O2 for someone with COPD? 88% MIN
Used every day, regardless of symptoms Theophylline (Elixophyllin, Theo-24)- Methylxanthine tx: Tx: for immediate relief of symptoms when Albuterol has not been effective (second-line medication) Theophylline (Elixophyllin, Theo-24)- Methylxanthine side effects: Unfortunately, theophylline has a narrow therapeutic window, and even levels slightly above this therapeutic window can have many adverse effects in the setting of acute and chronic toxicity. 15- mcg/mL• Persistent vomiting, cardiac arrhythmias, and intractable seizures may be fatal Montelukast (Singular) tx: Tx - asthma, and the symptoms of allergic rhinitis and to prevent exercise-induced asthma. Montelukast (Singular) is ideal for children (true or false) Ideal for children
Montelukast (Singular) side effects Headache. Gi disturbances• Dizziness, fever, stuffy nose, sore throat, cough, hoarseness Montelukast (Singular) dosing: Take with food, take at bedtime Status asthmaticus treatment Treatment:• IV fluids, potent systemic bronchodilator, (Albuterol) steroids, epinephrine, oxygen Priority nursing actions for asthma care: focus on patient education about using his or her personal asthma action plan, which includes drug therapy and lifestyle management strategies to help him or her understand the disease and its management
Therapeutic management of RSV humidified oxygen, adequate fluid intake, airway maintenance, 02 sat monitoring, hydration- IV fluids initially-acute phase-, medications (bronchodilators, corticosteroids)- PO fluids in the recovery phase Drug for RSV, specifically for hospitalized children. Ribavirin, an antiviral agent (synthetic nucleoside analog), is the only specific therapy approved for hospitalized children; however, the use of this drug is controversial because of concerns about the high cost, aerosol route of administration, potential toxic effects on exposed health care personnel (teratogenicity), and conflicting results of efficacy trials Are antibiotics given to people with RSV? antibiotics not given unless confirmed bacterial infection Perfusion refers to the flow of blood through arteries and capillaries, delivering nutrients and oxygen to cells
Central Perfusion generated by cardiac output which is the amount of blood pumped by the heart each minute. Requires adequate cardiac function, blood pressure, and blood volume Cardiac output (CO) = Stroke volume ×heart rate Tissue-local perfusion Volume of blood that flows to target tissueRequires patent vessels, adequatehydrostatic pressure, and capillarypermeability when does impairment of central perfusion occur? occurs when cardiac output is inadequate Reduced cardiac output results in a reduction of oxygenated blood reaching the body tissues (systemic effect) Impairment of tissue perfusion
Symptoms of a hypertensive crisis? morning headaches, blurred vision, dyspnea, and /or symptoms of uremia (accumulation in the blood of substances ordinarily eliminated in the urine.) Patients are often by the age of 30-50 with a systolic BP greater than 180 mm Hg. Causes of a hypertensive crisis? Nervous System disorders, TBI, cerebral infarction or hemorrhage- withdrawal of HTN meds, renovascular disease A person with malignant hypertension without intervention could lead to... kidney failure, left ventricular heart failure, stroke, or death Ideal diet for hypertension? DASH diet (low sodium) Beta 1 blockers affect
heart Beta 2 blockers affect lungs Atherosclerosis involving the formation of plaque within the arterial wall• leading risk factor for cardiovascular disease Peripheral arterial and peripheral venous caused by atherosclerosis, partial or complete occlusion• Changes in the natural flow of blood through• the arteries and veins of the peripheral circulation Peripheral arterial and peripheral venous side effects causing decreased perfusion to body tissues.• Affects the legs much more frequently than the arms.
