The underlying pathophysiology of COPD

The abnormal inflammatory response in the lungs occurs primarily in:

Two diseases common to the etiology of COPD

The term "blue bloater) refers to which of the following conditions?

The most important environmental risk factor for emphysema

A 66 year old client has marked dyspnea at rest, is thin and uses accessory muscles to breathe. He is tachypneic, with a prolonged expiration phase. He has no cough. He leans forward with his arms braced on his knees to support his chest and shoulder for breathing. This client has symptoms of which of the following disorder?

Clients w obstructive bronchitis are given diuretic therapy. Which of the following reasons explain why?

Teaching for a client with COPD should include which of the following topics?

A nurse plans care for a client with chronic obstructive pulmonary disease, knowing that the client is most likely to experience what type of acid- base imbalance?

Causes of COPD (SATA)

PRIMARY symptom of COPD

In a patient with emphysema, ______ results from a more fixed position of the ribs from loss of elasticity

Single most cost effective intervention to reduce risk of developing COPD

Complications of COPD: (SATA)

Helps confirm diagnosis of COPD, determine severity & monitor dse progression

Used to evaluate airway obstruction, which is determined by the ratio of FEV1 to forced vital capacity

Patient CXR with emphysema may reveal: (SATA)

A patient CXR with bronchitis may reveal: (SATA)

Test to determine cause of dyspnea whether functional abnormality is obstructive or restrictive, estimate degree of dysfunction and evaluate effects of therapy

Most often ABG analysis in bronchitis and emphysema

This test assess diffusion in lungs Carbon monoxide is used to measure gas diffusion across the alveocapillary membrane

______ the only obstructive disease that causes diffusion dysfunction

Bronchogram in a patient with emphysema shows: (SATA)

Bronchogram on patients with bronchitis may reveal:

CBC results in patients with advanced emphysema:

____ is measured to verify deficiency and diagnosis of primary emphysema

ECG in patients with severe asthma

ECG in patients with bronchitis

ECG in patients with emphysema AND bronchitis

ECG in patients with emphysema

Pharmacologic Treatment: Relieves bronchospasm by altering smooth muscle tone and reduce airway obstruction (SATA)

Pharmacologic treatment for COPD (SATA)

First line therapy of management of exacerbations

Surgical management for COPD (SATA)

In nursing management of COPD, instruct the patient in: (SATA)

A nurse is caring for several clients. Which of the ff clients are at risk for having a pulmonary embolism? (SATA)

A nurse is reviewing prescriptions for a client who has acute dyspnea and diaphoresis. The client states that she is anxious because she feels as if she cannot get enough air. Vital signs are 117/ min Heart Rate, 38/min Respiratory Rate,, 38.4 C (101.2 F) temperature and a blood pressure of 100/ 54 mmHg. Which of the following actions is priority action at this time?

A male patients xray result reveals bilateral white- outs indicating ARDS. This syndrome results from:

A nurse is caring for a male client with ARDS. Which of the following would the nurse expect to note in the client?

a client has a pulmonary embolism. Which of the clinical manifestations should the nurse expect? (SATA)

You're providing care to a patient who is being treated for aspiration pneumonia. The patient is on a 100% non- rebreather mask. Which of the following is a HALLMARK sign and symptom that the patient is developing ARDS?

A male adult client is hospitalized for treatment of pulmonary embolism develops respiratory alkalosis. Which clinical findings commonly accompany respiratory alkalosis?

A client is suspected of having pulmonary embolism. A nurse assesses the client, knowing that which of the following is a common clinical manifestation of pulmonary embolism?

A patient has been hospitalized in the ICU for a near drowning event. The patient's respiratory function has been deteriorating over the last 24 hours. The physician suspects acute respiratory distress syndrome. A STAT Xray is ordered. What finding on the CXR is indicative of ARDS?

Which patient below is at MOST risk for developing ARDS and has the worst prognosis?

The nurse assesses a patient for pulmonary embolism. The nurse looks for the most frequent sign of:

The following are nursing interventions to prevent pulmonary embolism in a hospitalized patient EXCEPT

You are caring for a patient with ARDS. As the nurse you know that prone positioning can be beneficial for some patients with this condition. Which findings below indicate this type of positioning was beneficial for your patient with ARDS? (SATA)

A patient is experiencing respiratory failure due to pulmonary edema. The physician suspects ARDS but wants to rule out a cardiac cause. A pulmonary artery wedge pressure is obtained. As the nurse, you know that what measurement reading indicates that this type of respiratory failure is NOT cardiac related?

Which of the following is a type of embolism?

An obstruction of the pulmonary artery or one of its branches by a thrombus and it is a common disorder related to DVT

This is a thrombus formation in the deep veins, usually in the calf or thigh but sometimes the arm especially in patients with peripherally inserted catheters

Types of emboli (SATA)

A type of emboli that usually come from intravenous devices

A type of emboli that clogs the arteries (cholesterol or fatty substances)

A type of emboli that originates from a bacterial invasion

A type of emboli that's leaked towards the arteries

Pathophysiology of Pulmonary Embolism

Causes of Pulmonary Embolism (SATA)

Most frequent SYMPTOM of pulmonary embolism

Most frequent SIGN of pulmonary embolism

DVT prevention (SATA)

Complications of Pulmonary Embolism (SATA)

This test may show infiltration, atelectasis, elevation of diaphragm or pleural effusion on patients with PE

ECG in patients with PE usually shows: (SATA)

A test that allows for direct visualization under flouroscopy of the arterial obstruction and accurate assessment of perfusion deficit

This evaluates the different regions of the lung and allows comparisons of the percentage of ventilation and perfusion in each area

The PRIMARY method for managing acute DVT and PE

Thrombolytic therapy in severely compromised patients with PE (SATA)

This is the surgical removal of the actual clot (PE) that is performed by the cardiovascular surgical team.

In performing a surgical embolectomy, the patient must be under:

It is a technique in which a vacuum cupped catheter is introduced transvenously into the affected pulmonary artery

This approach prevents dislodged thrombi from being swept into the lungs while allowing adequate blood flow.

It is a form of breathing failure that can occur in very ill or severely injured people

Swelling of tissue in the lungs and build up of fluid in the tiny air saca that transfer oxygen to the bloodstream therefore leads to low blood oxygen levels

Direct causes of ARDS (SATA)

Indirect causes of ARDS

Cigarette smokers, people with chronic lung disease and those who are over age 65 are more at risk of developing ARDS

Symptoms of ARDS (SATA)

A CXR of a patient with ARDS shows _______ in the air sacs of both lungs and blood tests show ___________ in the blood

Treatment of ARDS (SATA)