PN2 NUR 2571 Exam 2 Study guide (2020) – Rasmussen College | PN2 NUR2571 Exam 2 Study guide updated 2020

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PN2 NUR 2571 Exam 2 Study guide (2020) – Rasmussen College PN2 Exam #2 Study Guide ASTHMA • Characterized by exacerbations of acute airway inflammation • Airway obstruction occurs d/t br... onchoconstriction, mucous, or inflammation when exposed to trigger Clinical Manifestations: • High pitched, wheezing lung sounds • Cough • SOB • Chest tightness • Worsens at night or when triggers are present Medications: • Short Acting= Albuterol, Proventil, Ventoli • Long Acting= Serevent • Corticosteroids= Serevent, Advair Education: • Avoid triggers • Stop/avoid smoking • Teach which inhaler is rescue Exacerbation Interventions: • Give short-acting beta agonist • IV corticosteroids depending on severity • O2 via nasal cannula • High-fowler’s position • Calm atmosphere Questions: If a pt. is having an asthma attack how would you expect it to affect their VS? • At first RR increased then decreased as attack progresses • Tachycardia >120 • Decreased BP If you give a pt. Albuterol, what type of side effects would you expect to see? • Increased HR • Tremors What are rescue medications for Asthma? • Short-acting beta agonists (Albuterol) EPITAXIS • Nose bleed – d/t trauma, allergies, drug use • Most frequent ED complaint Interventions & Treatment: • Anterior portion of nose = apply direct pressure for 5-10 while leaning forward • Apply silver nitrate • Apply lidocaine/ep with cotton pledge for 5-10 minutes • Nasal packing for 2-5 days • Educate on prevention – Vaseline, humidifiers COPD • Chronic obstructive pulmonary disease – emphysema & chronic bronchitis • Causes= air pollution, occupation, smoking Primary Symptoms: • Cough • Sputum production • DOE – Dyspnea On Exertion Clinical Manifestations: • Wheezes or crackles heard in lungs • Prolonged expiratory phase • Distant heart sounds • Orthopneic position • Barrel chest • Use of accessory muscles • Weight loss (dyspnea with eating) • Late phase= clubbing to nails, right-sided HF, chronic cyanosis Medications: • Avoid frequent use of cough suppressants (antitussives) because coughing is a protective mechanism • Limit narcotic use d/t respiratory depression can worsen hypercapnia • Beta-Adrenergic Agonists: Albuterol, formoterol • Anticholinergics: Atrovent, Spiriva • Corticosteroids: short course only • Methylxanthines: Theophylline (limited) - - - - - - - - - - - - - - ARTERIO & ATHERO-SCLEROSIS • Arteriosclerosis: hardening of the small arteries • Atherosclerosis: accumulation of plaque in large arteries Pathophysiology: • An accrual of lipids, calcium, blood, carbohydrates, fibrous tissue located on the intimal layer of the vessel Risk Factors: • Increased age • Men typically develop earlier than women • African & Mexican-American • Hypertension • High cholesterol • Physical inactivity • Stress • Obesity • Tobacco • Diabetes Mellitus Clinical Manifestations: • Hypertension • Heart disease • Prolonged capillary refill • Temp differences in extremities • Cold extremities • Bruits Nursing Assessment: • Bilateral B/P readings • Apical & radial pulse checks • Need gravity to get increased circulation to lower extremities Diagnostics: • Assess cholesterol levels (LDL levels) • Homocystine level > 15 indicates risk for CAD/PAD • Coagulation studies • Arteriography • MRI: evaluate extent Interventions: • Diet: 30% or less in saturated fat, cholesterol intake <300 mg/day • Increase exercise • Smoking cessation Medications: • Heparin, Lovenox - clot prevention • Aspirin, Plavix - anti-platelet formation • Cholestyramine - lowers blood cholesterol levels • Simvastatin, Pravastatin, Atorvastatin - lowers LDL levels • Tricor (Fenofibrate) – lowers cholesterol and risk for pancreatitis • Niacin (Vitamin B3) – lowers blood lipids [Show More]

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