Case study, chapter 23, management of patients with chest and lower respiratory tract disorders

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Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th Ed., Hinkle & Cheever | Registered Nurse (RN) School Study Aid

Lung Sounds - Pleural Friction Rub

Anterior Lateral LungDry, Rubbing, or SqueakingRubbing a Balloon with FingerInflamed Pleura

Tuberculosis Skin Mantoux Test (PPD)

Delayed Hypersensitivity (Cell Mediated Response)Intradermal InjectionRead 48-72 hours≥ 5 mm IndurationImmunosuppressed≥ 10 mm IndurationHigh Risk Patients≥ 15 mm IndurationChest X-Ray

Lung Cancer Assessment

2nd Most Common CancerChronic CoughHoarsenessAbnormal Breath SoundsHemoptysisChest PainAnorexia or Weight LossSymptoms Appear Late in Disease

Acute Respiratory Distress Syndrome (ARDS) Assessment

Damaged Alveolar-Capillary MembraneRestlessness DyspneaRefractory HypoxemiaDecreased PaO2Diffuse Pulmonary InfiltratesAtelectasisPulmonary Hypertension

Acute Respiratory Distress Syndrome (ARDS) Interventions

Closely Monitor PatientABG's (Arterial Blood Gases)OxygenAssess for O2 Toxicity Mechanical VentilationPEEPAssess for PneumothoraxPermissive HypercapniaHigh Mortality Rate

Pneumonia Assessment

Older AdultImmunocompromisedLong Term CareShortness of Breath (SOB)HypoxemiaCough and Sputum ProductionWheezing or CracklesFeverPleuritic PainChest X-ray

Pneumonia Intervention

Humidified OxygenDeep Breathing ExercisesPosition of ComfortIncrease Fluid IntakeManage FeverAntibioticsMucolyticsExpectorantsPneumococcal VaccineSepsisAcute Respiratory Failure (ARF)Prevention Education

Pneumothorax

Air Enters Pleural SpaceSudden DyspneaAbsent or Restricted Movement on Affected SideDecreased or Absent Breath Sounds on Affected SideChest PainTracheal DeviationVital Sign ChangesCrepitusHigh Fowler's Position With OxygenPrepare For Chest Tube PlacementEducate High Risk Patients

Pulmonary Embolism Assessment

Shortness of Breath (SOB)Pleuritic Chest PainTachypneaHemoptysisHypoxemiaSudden Death

Tuberculosis Assessment

Airborne Droplet3 Week Productive CoughNight SweatsChest PainFeverWeight LossFatigueChest X-RayBlood TestsMantoux Skin Test3 Positive Sputum Tests

Tuberculosis Intervention

Airborne IsolationCombination Drug Therapy (RIPE)6-12 MonthsDOTBCG VaccinationMedication Education3 Negative Sputum SpecimensInfection Control

Ethambutol (Myambutol)

Inhibits RNA SynthesisBacteriostaticTuberculosis (TB)Optic NeuritisRed/Green Color BlindnessGouty ArthritisMonitor Vision Acuity

Isoniazid (INH)

Interferes with DNA MetabolismTuberculosis (TB)Optic NeuritisNausea and VomitingHepatotoxicityPeripheral NeuropathyVitamin B6 ProphylaxisMonitor AST/ALT

Cardiac Tamponade

Fluid in the Pericardial SacPericarditisDecreased Cardiac OutputBeck's TriadHypotensionJugular Venous Distention (JVD)Distant Heart SoundsPulsus ParadoxusElectrical AlternansPericardiocentesis

Pulmonary Embolism Causes

FAT BAT MnemonicFatAirDeep Vein Thrombosis (DVT)BacteriaAmniotic FluidTumorHypercoagulableCentral Venous LinesImmobilized

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