What is the emergency treatment for pneumothorax?

Cover wound with dressing secured on 3 sides

How should the nurse position the patient before chest tube insertion?

HOB elevated 30-60 degrees w/ arms raised above the head

Initial Characteristic of Pulmonary TB

dry cough that becomes productive

What is the nurses immediate priority if the chest tube system is disconnected?

reestablish the water-seal system

The nurse is providing teaching to pt with pleurisy. What statement should the nurse include?

"using a pillow to splint when coughing will help alleviate pain."

What is the purpose of the third compartment of the pleural drainage system?

uses column of water to control suction from regulator

When would someone contract ventilator-associated pneumonia?

more than 48 hours after endotracheal intubation

What is the goal of treatment for flail chest?

Facilitate lung expansion & ensure adequate oxygenation

Pleural Effusion that is infected

Patient comes to ED with Fractured Ribs. What s/s would you expect the patient to exhibit?

splinting, shallow breaths, pain on inspiration & cough

Which of the following medications are ineffective against pertussis infection?

Cough suppressants/antihistamines, Bronchodilators, Corticosteroids

If drainage system of chest tube is overturned and water-seal is disrupted, what should the nurse do?

return to upright position, ask pt to deep breathe cough & force exhale

What is Ewart's sign?

dulling percussion under the angle of the left scapula

What is the tell-tale sign of a pneumothorax?

Deviated trachea to unaffected side

Risk factors for aspiration pneumonia (SATA)

difficulty swallowing, insertion of NG tube, Decreased LOC

Which of the following observations from the water-seal chamber should the nurse identify as abnormal?

constant bubbling 48 hours after insertion

What is a saddle embolus?

large thrombus at arterial bifurcation

What is a Chylothorax?

lymphatic fluid in pleural space

Which of the following are manifestations of Pleural Effusion?

decreased breath sounds on affected side, cough, dyspnea w/decreased chest movement, sharp chest pain

Other s/s indicative of pneumothorax

no breath sounds over affected area, dyspnea, use of accessory muscles, cyanosis, pain

Most common s/s of pneumonia

cough, productive or non-productive

When should empiric antibiotic therapy be utilized?

As soon as pneumonia is suspected

Which of the following manifestations r/t chest tube would require HCP be notified?

Changes in quantity or characteristics of drainage, drainage > 200mL in first hr, >100mL after first hr, Subcutaneous emphysema or respiratory distress

Which of the following are s/s of flail chest?

Asymmetric/uncoordinated chest movement - moves air poorly, Rapid, shallow respirations, Inadequate ventilation, crepitus

studbud

Lower Respiratory 230 pt. 1

100 termsStudBud Administration55 plays

Imported from external platform

Flashcards100 cardsFPractice quizPHost liveL

Questions 100

Answers

1
What is the emergency treatment for pneumothorax?
Cover wound with dressing secured on 3 sides
pull out penetrating material
Chest tube insertion
thoracentesis
2
#1 causative factor of lung cancer
heart failure
COPD
genetics
smoking
3
How should the nurse position the patient before chest tube insertion?
Totally flat and prone
HOB elevated 45-90 degrees with arms at the side
supine with arms raised above the head
HOB elevated 30-60 degrees w/ arms raised above the head
4
Induration for low-risk individuals would indicate a positive TB skin test at what size?
20mm
15mm
5mm
10mm
5
What is the most common cause of Pulmonary Edema?
left-sided heart failure
tension pneumothorax
atelectasis
right-sided heart failure
6
Hospital acquired pneumonia is not present at admission to the hospital.
False
True
7
Initial Characteristic of Pulmonary TB
dry cough that becomes productive
confusion
chest pains
dyspnea
8
Where does Cytomegalovirus pneumonia come from?
Hepatitis A & C
Herpes virus
Fungal pneumonia
HIV
9
What treatment significantly reduces mortality related to Pulmonary Embolism?
Open heart surgery
Thoracentesis
Antihypertensive therapy
Anticoagulant therapy
10
What is the nurses immediate priority if the chest tube system is disconnected?
adjust settings until constant bubbling is observed in water-seal chamber
turn patient to the affected side and encourage deep coughing
clamp off chest tube until HCP can get to patient's room
reestablish the water-seal system
11
The nurse is providing teaching to pt with pleurisy. What statement should the nurse include?
"you're fine, pleurisy isn't even real"
"using a pillow to splint when coughing will help alleviate pain."
"CNS depressants may be prescribed to manage severe pain"
"try to use your accessory muscles to breathe"
12
The painful rubbing together of the lung's two linings is called...
Pneumothorax
Pleurisy
Pleural Effusion
Pleural Friction Rub
13
Normal fluctuation of the water within the water-seal chamber is known as...
Bubbling
Fluctuation
Rippling
Tidaling
14
Which of the following is the definitive diagnostic tool for pneumonia?
MRI
Chest X-ray
Blood cultures
CT scan
15
What is the purpose of the third compartment of the pleural drainage system?
uses column of water to control suction from regulator
fluid stays in; air vents to 2nd compartment
contains 2-cm of water; acts as one-way valve; air goes in, bubbles out
16
When would someone contract ventilator-associated pneumonia?
during a period of mechanical ventilation
more than 48 hours after endotracheal intubation
immediately after extubation of mechanical ventilation
never... this is made up
17
What is the goal of treatment for flail chest?
Teaching on how to prevent future fractured ribs
Facilitate lung expansion & ensure adequate oxygenation
Pain management
Surgical repair of dislodged ribs
18
What is Empyema?
shortness of breath
Pleural Effusion that is infected
fluid in the lungs
collapsed lung
19
Patient comes to ED with Fractured Ribs. What s/s would you expect the patient to exhibit?
dyspnea, feeling of impending doom, pitting edema
splinting, shallow breaths, pain on inspiration & cough
deep, labored breaths, HR 150, productive cough
20
What should the nurse teach the patient with a diagnosis of pleurisy?
splint when coughing
focus on making breaths shallow
stridor is a common occurrence
maintain strict bedrest
21
A small amount of subcutaneous emphysema r/t chest tube is harmless.
True
False
22
Which of the following medications are ineffective against pertussis infection?
Cough suppressants/antihistamines
Bronchodilators
Corticosteroids
Macrolides
23
If drainage system of chest tube is overturned and water-seal is disrupted, what should the nurse do?
return to upright position, ask pt to deep breathe cough & force exhale
leave it where it is and call the physician
clamp the tubing to prevent fluid backup into lungs
replace drainage system
24
What does continuous bubbling in the water-seal chamber indicate?
Chest tube is misplaced
Occlusion of the water-seal
Air leak
This is a normal finding
25
Clot dissolving medication
Fibrinolytic agents
Unfractionated IV heparin
Heparin
Warfarin
26
What is the primary therapy for a lung cancer patient that cannot tolerate surgery?
Surgery, they'll be fine.
Chemotherapy
Palliative care
Radiation therapy
27
What is Ewart's sign?
hypotension, neck vein distention, muffled heart sounds
drop in systolic blood pressure upon inspiration
dulling percussion under the angle of the left scapula
abnormally fast heart rate
28
What is the tell-tale sign of a pneumothorax?
Deviated trachea to unaffected side
pink, frothy sputum
Deviated trachea to affected side
productive, bloody cough
29
Risk factors for aspiration pneumonia (SATA)
asthma
difficulty swallowing
insertion of NG tube
Decreased LOC
30
What is the most common diagnostic test for Pulmonary Embolism (PE)
Chest x-ray
Spiral (helical) CT scan/CTA
V/Q scan
D-Dimer
31
Most common manifestation of Lung Cancer
bloody sputum
persistent cough with sputum
night sweats
dyspnea
32
Flail chest results from the fracture of several consecutive ribs, in two or more places, causing an unstable segment
True
False
33
Who should the nurse recommend the pneumonia vaccine?
20 year old with mild asthma
40 year old woman
school-age children
65-year old man
34
Which of the following observations from the water-seal chamber should the nurse identify as abnormal?
constant bubbling 48 hours after insertion
brisk bubbling 1 hour post-op
intermittent with cough, exhalation or sneezing
no bubbling should ever be observed from the water-seal chamber
35
Which of the following types of pneumothorax is an accumulation of air resulting in intrapleural pressure
Hemothroax
Tension
Spontaneous
Latrogenic
36
Another name for Pertussis
Common Cold
Sore throat
Red Fever
Whooping Cough
37
What is a saddle embolus?
large thrombus at arterial bifurcation
piggyback medications to treat pulmonary embolism
fluid accumulation in the pleural space
blockage in the pulmonary artieries
38
Blockage of one or more pulmonary arteries by thrombus, fat or air embolus, or tumor tissue is....
Pulmonary artery failure
Pleural Effusion
Pulmonary Embolism
Pulmonary Edema
39
What is a Chylothorax?
lymphatic fluid in pleural space
air in the pleural space
blood and air in the pleural space
blood in the pleural space
40
Which of the following are manifestations of Pleural Effusion?
stridor auscultated on affected side
decreased breath sounds on affected side, cough
dyspnea w/decreased chest movement
sharp chest pain
41
Other s/s indicative of pneumothorax
abdominal pain
no breath sounds over affected area
dyspnea
use of accessory muscles, cyanosis, pain
42
"whooping" sound when coughing may not be present in teens and adults that are vaccinated.
True
False
43
Cytomegalovirus pneumonia is most common life-threatening complication of hematopoietic stem cell transplantation.
True
False
44
All adolescents and adults require a Pertussis vaccine, even if they've already had a Tdap vaccine.
True
False
45
Confirming Diagnostic test for Cardiac Tamponade?
Ultrasound or echocardiogram
Blood cultures
Chest x-ray
Beck's Triad
46
Most common s/s of pneumonia
cough, productive or non-productive
confusion
pleurisy
shortness of breath
47
Nurse is caring for pt with acute bronchitis that develops a fever and dyspnea. What should the nurse do?
treat with cortiosteroids
Lay patient flat to assist with dyspnea
Call the Physician
Nothing, this is normal with acute bronchitis
48
How should placement of the chest tube be verified?
MRI
Chest x-ray
Bronchoscopy
ECG
49
When should empiric antibiotic therapy be utilized?
After sputum culture comes back
As soon as pneumonia is suspected
ONLY for community acquired pneumonia
Never, this is outdated
50
Which of the following manifestations r/t chest tube would require HCP be notified?
Changes in quantity or characteristics of drainage
drainage > 200mL in first hr, >100mL after first hr
Subcutaneous emphysema or respiratory distress
Drainage system overturned and water-seal disrupted
51
Which of the following are s/s of flail chest?
Deep, uncontrollable coughing
Asymmetric/uncoordinated chest movement - moves air poorly
Rapid, shallow respirations
Inadequate ventilation, crepitus
52
Lung Cancer may be masked by a chronic cough
False
True
53
What would be the purpose of a patient having two chest tubes?
one drains air (2nd IC space) and one drains fluid (lower, 6th IC space)
this is detrimental to patient condition and should never be done
when the patient has excess buildup of fluid, to remove it quicker
so the upper tube can drain fluid from the esophagus
54
s/s of pulmonary edema
wheezing, blue-tinged lips, cold clammy skin
a strange sense of calm; a cough that produces yellow mucus
extreme SOB/dyspnea that worsens w/activity or lying down
a cough that produces pink, frothy sputum; irregular heartbeat
55
Gold standard for TB diagnosis?
TB skin test
PET scan
Tb culture
chest x-ray
56
Which of the following types of pneumothorax is caused by medical procedures?
Tension
Spontaneous
Hemothorax
Latrogenic
57
Pleurodesis is...
Chest tube insertion
Chemical instilled into chest tube to decrease chance of pneumothorax
Lobe resection of the lung
Fluid drainage from the lungs
58
Which of the following is the hallmark characteristic of Pertussis?
Severe shortness of breath
Violent, uncontrollable coughing
stabbing chest pains
pink, frothy sputum
59
Which of the following are complications related to fractured ribs?
Pulmonary Embolism
Atelectasis
Pneumonia
Pleural Effusion
60
What is the goal of having a chest tube inserted?
Allow lung to expand & drain pleural space
Reestablish blood flow from the heart to the lungs
Reestablish negative pressure
venting air out of pleural space into the abdominal cavity
61
Where should the chest tube system be placed and why?
above chest level to assure drainage is occuring
at heart level to assure proper functioning
below chest level to assure fluid is draining back into the lungs
below chest level to prevent fluid draining back into lungs
62
It is important to notify the health department of active TB infection.
True
False
63
Which of the following is not a stage of Pertussis
Catarrhal
Paroxysmal
Ischemic
Convalescent
64
What should the nurse monitor for post-thoracentesis?
signs of hypoxia & pneumothorax
encourage deep breathing and incentive spirometry
verify breath sounds
assure patient is lying on affected side at all times
65
Patients with pneumonia can stop their antibiotics when their symtoms cease
True
False
66
Which of the following are manifestations of Pleurisy?
deep, violent coughing
shallow breathing w/reduced movement
pleural friction rub auscultated at peak of inspiration
pain that is sharp and worse with inspiration
67
Which of the following describes a spontaneous pneumothorax?
blood in the pleural space
accumulation of air in pleural space that can't escape results in pressure
caused by medical procedures
rupture of blebs (air-filled sacks) located on the surface of lung
68
What breath sounds should the nurse expect when assessing a patient with a diagnosis of Acute Bronchitis?
Stridor or Rhonchi
Rhonchi
Crackles or Wheezes
Pleural Friction Rub
69
What is the purpose of the first compartment of the pleural drainage system?
uses column of water to control suction from regulator
contains 2-cm of water; acts as one-way valve; air goes in, bubbles out
fluid stays in; air vents to 2nd compartment
70
Multi-Drug resistant TB is resistant to which of the following medications
rifampin
isoniazid
vancomycin
pseudoephedrine
71
What should the nurse do r/t chest tube removal?
encourage incentive spirometry, check pain lvl & o2 sat
assess for respiratory distress, ambulate asap
observe wound for drainage and reinforce if necessary
pre-medicate w/ pain meds 30-60 min before
72
When should pneumothorax be suspected?
after any major surgery
associated with GSW to the leg
after any trauma to the chest wall
only after chest tube insertion
73
When is pneumonia most likely to occur?
When defense systems become incompetent or are overwhelmed
in COPD patients only
after infection of surgical site or open wound
Every winter for most people
74
What is a hemopneumothorax?
chest wall trauma
air in the pleural space
both blood and air in the pleural space
blood in the pleural space
75
Which of the following observations about the chest tube system placed 8hrs ago should be of concern?
Fluid output for the last hour was 88mL
Connections are taped and tight
Tubing is clamped for IV med administration
intermittent bubbling is observed in the water-seal chamber
76
TB is transmitted by....
contact
airborne
droplet
sharing food
77
What should the nurse monitor for with a chest tube in place?
vital signs, lung sounds, pain
drainage amount and drainage site infection
peripheral edema
subcutaneous emphysema (crepitus)
78
Directly observed therapy is ... (SATA)
providing drugs & watching patients swallow
used to manage community noncompliance
out of practice and no longer used
expensive
79
How should the nurse position the patient to prepare for Thoracentesis procedure?
Upright with elbows on overbed table & feet supported
Side-lying with knees bent
Prone with legs flexed
Laying flat on the bed with ankles elevated
80
What is the purpose of an IVC filter
to catch clots and prevent embolism
re-filter the blood in the vena cava
produce white blood cells and filter them into the blood
To assist the heart in circulating the blood
81
Necrotizing pneumonia is
Rare complication of bacterial lung infection
Fake news
Complication of necrotizing fasciitis
Community acquired
82
Where can a chest tube insertion take place?
ED, OR, or at bedside
OR only
in x-ray
procedure is only done at the bedside
83
Pertussis is highly contagious
True
False
84
How do you treat pneumothorax?
Needle decompression and chest tube
Lobectomy
Bronchoscopy
Thoracentesis
85
What is the purpose of the second compartment of the pleural drainage system? (water-seal chamber)
fluid stays in; air vents to 2nd compartment
contains 2-cm of water; acts as one-way valve; air goes in, bubbles out
uses column of water to control suction from regulator
86
Nursing care of a developed Pulmonary Embolism includes applying TEDs and SCDs
True
False
87
Which of the following describes aspiration pneumonia?
Abnormal entry of oral or gastric material into lower airway
pneumonia that is present 48 hours or more after hospital admission
fungal type of pneumonia acquired from choking on vegetables
Rare complication of bacterial pneumonia
88
What is abnormal accumulation of fluid in alveoli and interstitial spaces that is a complication of heart/lung disease?
Pitting Edema
Pulmonary Edema
Pleural Effusion
Pleural Friction Rub
89
At hourly rounds, the nurse notices the drainage system overturned and water-seal disrupted. What should nurse do first?
Return unit to upright position, then ask pt to cough/deep breathe/exhale
Ask another nurse to bring in a replacement chest tube, and replace it.
Clamp off the tubing and contact HCP immediately
Manually replace water-seal and refill collection chamber
90
When should the collection chamber be emptied?
Never, the collection chamber is custom made to each patient
Every hour to assess intake and output
At the end of each shift to assure clean system for next nurse
Only if collection chamber is full - do not empty, but change unit
91
What are the components of Beck's Triad?
Hypotension
Hypertension
Neck vein distention
Muffled, distant heart sounds
92
If your immuno-compromised patient develops pneumonia, which type would be suspected first?
Opportunistic
Ventilator-associated
CMV
Necrotizing
93
Other treatments for pneumothorax
tracheostomy
stapling
pleurodesis
partial pleurectomy
94
When an older patient develops pneumonia, what s/s would the nurse expect to see?
productive cough
hyperthermia
dyspnea
confusion
95
What is the definitive diagnosis for lung cancer?
Chest x-ray
Lung biopsy
Sputum cytology
blood cultures
96
What makes a hemothorax different than a pneumothorax?
fluid instead of air
infection in the air space
chest trauma
blood instead of air
97
What are some indicators of Atelectasis?
dullness on percussion
referred pain in the lower back
auscultation of stridor in left lower lobe
decreased or absent breath sounds
98
Strapping or binding the chest is imperative in treatment for fractured ribs
True
False
99
What is Pulsus Paradoxus?
drop in systolic blood pressure upon inspiration
abnormally fast heart rate
dulling percussion under the angle of the left scapula
hypotension, neck vein distention, muffled heart sounds
100
What is Atelectasis?
collapsed alveoli
collapsed lung
chest trauma
fluid in the lungs

Lower Respiratory 230 pt. 1 Flashcards | StudBud