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Nova Southeastern University Primary Adult Nursing II (NUR 4110) Med Surg 2 Study Guide

James Moore
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Med Surg 2 Final Study Guide
Primary Concepts Of Adult Nursing II (NUR 4110) Nova Southeastern University

* What’s in bold she verbally mentioned*
Asthma (3 questions)
*Bronchodilator teaching- appropriate time?
Can used prophylactic before activity such as walking and eating
Prescribed for PRN or for regular basis
Proper usage: exhale first, seal lips around pump, press down and inhale and hold for 10
seconds, repeat puffs as directed but allow 15-30 in between.
Asthma patho
Chronic inflammatory disease, reversible condition, causes airway hyper responsiveness,
mucosal edema and mucous production.
Inflammatory response occurs= mast cells, macrophages, t lymphocytes, neutrophils,
eosinophils, IgE(causes direct bronchoconstriction)
Cough, chest tightness, wheezing (on expiration), dyspnea
*Monitor airway patency due to mucous from the inflammatory process.
Status Asthmaticus- is when an asthma attack doesn’t respond to therapy. Rapid onset severe and
*prevention (post op)
Atelectasis can arise from abdominal/thoracic surgery
Teach pt. cough deep breathing (splint pillow on incision)
Incentive spirometer
Frequent turning
PEEP for pt. that cannot perform the basic measures (listed above)- positive end
expiratory pressure.
*Nursing Interventions
Remove secretions (if pt. cant cough, possible suctioning)

encourage hydration/humidifier-lossens secretions
High humidity face mask
Encourage coughing
Lung expansion maneuvers- IS, deep breathing and coughing

 Chest physiotherapy
 Oxygen therapy- for better oxygenation
 Semi fowlers and change position frequently to assist in moving secretions
 Moderate activity during initial treatment b/c this will increase oxygen demands
 Monitor fevers r/t pneumonia- this increases workload which dehydrates the pt. this is why you
their increase fluids (2L/day)
 Maintain nutrition- Gatorade or ensure, small frequent meals
 Educate pt.
 Complications- possible intubation, if pleural effusion is present = thoracentesis
Chronic Bronchitis (COPD)
 Diseased airway, defined by cough and sputum production for at least 3 months in a matter of 2
 Irritants causes mucous production, which then impedes airflow, mucous plug decreases cilliary
 Alveolar near bronchioles become damaged, fibroses, which alter the alveolar macrophage
functions, their functions, is to destroy foreign particles and bacteria. This can lead to respiratory
Nursing management for COPD
 Achieve airway clearance
o Adm bronchodilators or corticosteroids
o Eliminate pulmonary irritants like smoking (reduces ciliary function) can lead to
o Encourage coughing
o Chest physiotherapy with postural drainage
o Increase fluid intake, humidifier
o Diaphragmatic/purse lip breathing exercises
o Administer antibiotics to treat respiratory tract infections
o Administer oxygen
o Check ABG levels
o Provide small frequent meals
o Listen to breath sounds
o Teach client about breathing exercises
 PPD – time frame – (48-72hrs) = if patient comes in after 48hrs and the reading is too big
have them come back when the 72hrs are met it may be too soon
 Geriatric population present with different s/s and a negative skin test but this does not rule
out the disease therefore, a repeated skin test has to be done 1-2 weeks after the first one.
 Sputum culture is the confirmation diagnosis
Nursing management
 Airway clearance by adequate hydration, and proper posture
 Medication adherence
 Promoting activity adequate nutrition- bc of coughing pts may feel fatigue, small frequent meal
and liquid supplements aid in caloric requirements
 Preventing transmission-monitor for fever, signs of worsening or spread of disease
 Place Pt. in a negative air pressure room.


Nova Southeastern University Primary Adult Nursing II (NUR 4110) Med Surg 2 Study Guide

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