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

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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*
20-Respiratory
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)
S/S
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
persistent.
Atelectasis
*prevention (post op)
Atelectasis can arise from abdominal/thoracic surgery
Teach pt. cough deep breathing (splint pillow on incision)
Incentive spirometer
Frequent turning
Ambulating
PEEP for pt. that cannot perform the basic measures (listed above)- positive end
expiratory pressure.
Pneumonia
*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
years.
 Irritants causes mucous production, which then impedes airflow, mucous plug decreases cilliary
function.
 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
infection
Nursing management for COPD
 Achieve airway clearance
o Adm bronchodilators or corticosteroids
o Eliminate pulmonary irritants like smoking (reduces ciliary function) can lead to
pneumonia
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
TB
 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
2
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 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.

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

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