Nursing Science 3- Test 1 Review

50 multiple choice questions

CRISIS: A sudden unanticipated or unplanned for event which necessitates immediate action to resolve the
problem. “a turning point”

may be positive or negative

Characteristics Of Crises- Sudden with no preparation for the event (Spouse is having an affair)

-Ultimately life threatening (real or perceived)

-Communication is difficult (May remove themselves from others)

-Displacement or disconnected from loved ones

-Degree of loss (real or perceived)

Phases in Crisis Development- Phase 1 - exposure to stressor

-Anxiety increases

Balancing factors in a Crisis: -Problem-solving techniques implemented

-Individual’s perception of the event Phase 2 – If problem-solving unsuccessful, anxiety increases again
Realistic vs unrealistic -Unsuccessful coping creates feelings of
-Availability of situational support hopelessness

Who can help? -Begins to feel confused & disorganized

Is there support? Phase 3 – uses all possible resources to solve problem

-Availability of adequate coping mechanisms -May begin to use all possible resources available
even if out of character
Self – help
Phase 4- stress reaches breaking point, major disorganization occurs
Exercise, reading, hobbies, socializing
-Anxiety reaches panic level

-Emotions are labile and inappropriate

-May have psychotic thinking

Types of Crises:

Crisis resulting from Traumatic stressUnexpected external stressor over which the victim has no control; Natural disasters, accidents, health
issue

Maturational/Developmental CrisisCrisis that result due to a person not having developed the coping skills yet to deal with a situation. May also
be caused by unresolved conflicts that involve; Death of parent: must care for the family; marriage & parenthood @ young age

Crisis reflecting PsychopathologyIndividual already has psychopathology & therefore adaptation to stress is impaired; Anxiety disorders

Psychiatric emergencies Crisis situation in which general ability to function is impaired & person is incompetent; suicide
 CHRONIC ILLNESS: Chronic “long disease course that may be incurable”

Health problems that persist over extended periods of time

-Usually require a minimum of 3 months management

-Are usually (but not always) associated with disability

Implications of Chronic Illness:

More than just managing medical problemsPsychological & social issues must be addressed, $ issues; Role changes

Different phases

Persistent adherence to medical regimens

One chronic disease can lead to another

Affects the whole family

Home rather than hospital is the center of care

Management is sometimes a discovery process

Management is a collaborative process

Expensive - especially unconventional treatments  IE lights for psoriasis

Means living with uncertainty

About two thirds of deaths in Canada each year result from chronic diseases

MODIFIABLE & NON-MODIFIABLE RISK FACTORS: Risk factors are conditions that increase your risk of
developing a disease. Risk factors are either modifiable,
meaning you can take measures to change them, or non-
modifiable, which means they cannot be changed.

Non-modifiable: age, gender, race, height

Modifiable: Weight, smoking cessation, physical activity

DIFFERENCE BETWEEN HOSPICE, PALLIATIVE AND END OF LIFE/ PALLIATIVE CARE:
-In Canada, “palliative care” and “hospice” are often used interchangeably.
-Hospice palliative care refers to the convergence of hospice and palliative care into the same time as treatment. Hospice care
one movement, with the same principles and norms of practice.
- End-of-life (EOL) care: Care provided in the last days or weeks of life; Focuses on is not going to survive the illness.
physical and psychosocial needs at the end of life for the patient and the patient’s
family
-Goals of EOL care: Provide comfort and supportive care during the dying process;
Improve the quality of the remaining life; Help ensure a dignified death
Palliative Care and Hospice:
-Medically supervised interdisciplinary team of professionals and volunteers
-Hospice nurse is an integral partPivotal role in coordination of hospice team;
Educated in pain control, symptom management
-Hospice palliative care sometimes a difficult decisionLack of information about
hospice palliative care; Physician may view decline as personal failure; Patients or
family may see it as giving up
***Both palliative care
and hospice care provide comfort. But
palliative care can begin at diagnosis, and at
begins after treatment of the disease is
stopped and when it is clear that the person
Hospice
-A concept of care that provides compassion, concern, and
support for the dying
-Exists to provide support and care for persons in the last
phases of incurable diseases so that they might live as fully and
as comfortably as possible at home or in a homelike setting
-Homecare programs work in collaboration with community
services and hospice organizations
-Inpatient hospice settings are deinstitutionalized, relaxed, and
as homelike as possible
 WHAT HAPPENS TO BODY AT END OF LIFE: DeathThe irreversible cessation of circulatory and respiratory
function OR The irreversible cessation of all functions of the entire
brain, including the brainstem
Pronouncement of Death:
-In many jurisdictions and agencies,
registered nurses are legally able to
pronounce death
-Pronouncement of death differs from
certification of death
-Pronouncement of death: Determination
that life has ceased, based on a physical
assessment
-Certification of death: The legally required
completion of a death certificate stating the
cause of death. Can only be undertaken by a
physician or a coroner
- When pronouncing death: Begin by
recognizing the family (“I’m sorry for your
loss . . . ”, “This must be very difficult for you
. . .”); The family can be invited to stay in the
room for the pronouncement; Ask if the
family wishes to speak with a chaplain if one
is not already present.
- Pronouncement of death: Confirm identity
by checking the armband; Note general
appearance of body and ascertain that
patient does not rouse to verbal or tactile
stimuli; Check for absence of heart sounds
and carotid pulse; Look and listen for
absence of spontaneous respirations and
pupillary light reflex.
- In the health record: Document time, date,
and findings of assessment and whether
family has been notified or autopsy
required; Check agency policy to determine
whether to notify provincial/territorial
coroner.
Occurs when all vital organs and systems cease to function.
Death might be closer to a process than an instant.
Trauma and disease affect physical manifestations
Metabolism is ↓
Body gradually slows down until all function ends
Generally, respirations cease first ; Heart stops beating within a few
minutes
Hearing usually last sense to disappear :
↓Sensation; ↓Perception of pain and touch
Taste, smell, and sight: ↓ with disease progression; Blurring of
vision; Sinking and glazing of eyes; Blink reflex absent; Eyelids remain
half-open.
Mottling on hands, feet, arms, and legs; Cold, clammy skin; Cyanosis
on nose, nail beds, knees; “Waxlike” skin when very near death.
 Respiratory System: ↑ respiratory rate; Cheyne-Stokes
respirations; Inability to cough or clear secretions; Grunting, gurgling,
or noisy, congested breathing; Irregular breathing; Slowing down to
terminal gasps.
Urinary System: Gradual ↓ in urinary output; Incontinent of urine;
Unable to urinate.
 Gastrointestinal System: Slowing of digestive tract and possible
cessation of function; Accumulation of gas; Distension and nausea;
Loss of sphincter control; Bowel movement may occur before
imminent death or at the time of death.
 Musculoskeletal System: Gradual loss of ability to move; Sagging of
jaw resulting from loss of facial muscle tone; Difficulty speaking;
Swallowing can become more difficult; Difficulty maintaining body
posture and alignment; Loss of gag reflex; Jerking seen in patients on
large amounts of opioids (myoclonus).
 Cardiovascular System: ↑ Heart rate (Later slowing and weakening
of pulse); Irregular rhythm; Decrease in blood pressure; Delayed
absorption of drugs administered intramuscularly or subcutaneously.
 Brain Death: Brain arrest; The final clinical expression of complete
and irreversible neurological failure.

SINUSITIS: Sinusitis can be caused by three things: Viruses, Bacteria, Fungi

Treatment:

Viral sinus infections usually go

away on their own within 10 to
14 days. Antibiotics don't work
 The same viruses that cause the common cold cause most cases of sinusitis.

When the lining of the sinus cavities gets inflamed from a

viral infection like a cold, it swells. This is viral sinusitis. The
swelling can block the normal drainage of fluid from the
sinuses into the nose and throat. If the fluid cannot drain
and builds up over time, bacteria or fungi (plural of fungus)
may start to grow in it. These bacterial or fungal infections
can cause more swelling and pain. They are more likely to
last longer, get worse with time, and become chronic.

Nasal allergies or other problems that block the nasal

passages and allow fluid to build up in the sinuses can also
lead to sinusitis.

The main symptoms of sinusitis are a runny or stuffy nose

and pain and pressure in your head and face. You may also
have a yellow or green drainage or drip from your nose or
down the back of your throat (post-nasal discharge).
Where you feel the pain and tenderness depends on which sinus is affected.

Other common symptoms of sinusitis may include: A headache, Bad breath, A cough that
produces mucus, A fever, Pain in your teeth, A reduced sense of taste or smell.

Bacterial infections can be treated with antibiotics. You will probably feel better in a few days, but some symptoms may last for
several weeks. You may need to take the medicine for a longer time if you have chronic sinusitis.

If you have a fungal infection—which is not common—antibiotics won't clear up your sinusitis. With this type of infection, you
may need treatment with antifungal medicines, steroid medicines, or surgery.

If you have taken antibiotics and other medicines for a long time but still have sinusitis symptoms, you may need surgery. You
may also need surgery if the infection is likely to spread or if you have other problems, such as a growth (polyp) blocking the nasal
passage.

EPITAXIS: Epistaxis is defined as acute hemorrhage

from the nostril, nasal cavity, or nasopharynx.

METHODS FOR DIAGNOSING RESPIRATORY DISEASES:

Chronic respiratory disease (CRD) is an
 umbrella term to describe diseases that affect the
lungs and airways. Common types include: asthma,
chronic obstructive pulmonary disorder (COPD),
cystic fibrosis, lung cancer and sleep apnea. Risk
factors for CRDs include tobacco smoke, air
pollution, occupational chemicals and dusts and
childhood respiratory infections.

Spirometry This is the simplest and most common lung test. You
breathe in and out as hard as you can through a
tube, and your doctor measures how much air goes
in and out of your lungs. It can help diagnose
conditions that affect how much air your lungs can
hold, like chronic obstructive pulmonary disease
(COPD). During this test, your doctor may give you
medication to open your airways and help you
breathe more easily.

Challenge test Your doctor will do spirometry first, then ask you to
breathe in a spray of a drug called methacholine,
which can irritate your airways and make them
narrow. Your doctor will do another spirometry to
see how the spray affects your breathing. They’ll
repeat this with small doses until you start to
wheeze or feel short of breath. Your doctor may give
you medicine to open your airways again. This test
can be used to rule out asthma. If your doctor thinks
you have a condition called exercise-induced
asthma, they may do a similar version of this test
called an exercise challenge. Instead of
methacholine, your doctor will ask you to use a
treadmill or stationary bike and see how that
physical activity affects your breathing.

FeNO test With this, you blow slowly and steadily into a device,
and it measures how much nitric oxide is in the air
you breathe out. It’s used with people who have
certain types of asthma to see if there’s any
inflammation in their lungs and how well steroids
are working to control inflammation.

Peak flow measurement This uses a small plastic device to see how much air
you can blow out of your lungs. You take a deep
breath and then breathe out as fast and hard as you
can. It’s most often used in people with asthma, a
condition that narrows the air passages that lead to
your lungs. The test compares each result with your
best reading. A number above 80% of your best
result is good; a number below 50% means you
 should get help right away. This test can give you
advance warning of an asthma attack.

Pulse oximetry, or “pulse ox.”
This test uses a device that measures how much
oxygen your red blood cells are carrying. The device
is usually clipped onto your fingertip, but it can be
attached to your nose, foot, ears, or toes. The results
are shown as a percentage, with a good result being
over 90%. If your numbers are below 90%, your
doctor may give you oxygen to help you breathe.

Plethysmography  This gives your doctor a more exact measurement of

how much air your lungs can hold. You’ll sit in a
booth with a clip holding your nose shut while you
breathe through a mouthpiece. This can tell your
doctor if your airways have narrowed or how much
an ongoing problem like asthma or COPD has hurt
your breathing. It can also help your doctor decide
what medicines you need or if you might need
surgery.

Diffusion capacity test  This measures how well your lungs pass oxygen to
your blood. You’ll breathe in and out through a tube
for several minutes, and your doctor may take a
sample of your blood to help calculate the results.
This test can show if your lungs have been damaged
or if you have problems with blood flow.

Chest X-ray  This can be used to look for problems like

pneumonia, an infection that makes fluid build up in
your lungs. It also can help diagnose cancer or a
buildup of scar tissue in your lungs known as
pulmonary fibrosis.

Computerized tomography (CT) or positron emission tomography (PET) scans

These are more advanced imaging tests that can be

used to find problems that an X-ray might not until
they’re further along, like cancer. A CT scan is a
series of X-rays taken from different angles that are
put together to make a more complete picture. A
PET scan uses a special dye that lets your doctor see
parts of your body more clearly.

Chest ultrasound.  This uses high-frequency sound waves to make a

detailed image of your lungs. It can help your doctor
see if there’s any fluid buildup in or around your
lungs.

Pulmonary angiogram This is a type of CT scan that focuses on the

pulmonary arteries -- the blood vessels that connect
your heart and lungs. It’s used to spot a potentially
 life-threatening blood clot in your lungs known as a
pulmonary embolism

Bronchoscopy.  Your doctor will slide a small tube with a camera on

the end into your airways. The camera lets them
look inside those passages for things like mucus,
blood, or tumors. You’ll be given medicine to make
you sleepy or to numb your air passages before the
test, and you may get oxygen during the test. You
may have a sore throat afterward. A bronchoscope
can also collect small samples of tissue for testing.
This is known as a biopsy, and it’s commonly used to
look for diseases like cancer

Mediastinoscopy.  This uses a similar tool to look at the space between

your right and left lung lobes behind your
breastbone. But doctors have to cut a small hole into
your chest to put the device in. Because of that,
you’ll be given medicine to make you sleep during
the procedure. It’s usually done to take out lymph
nodes and look for signs of cancer that has spread
from your lungs. This can help doctors figure out the
best way to treat the disease.

Pleural biopsy Your lungs are surrounded by a layer of tissue called

the pleura, and some health problems can make
fluid build up in the space between the pleura and
your lungs. If that’s the case, this test might help
your doctor figure out what’s causing it. A pleural
biopsy usually uses a needle to get a sample of the
tissue. The needle goes into your chest between the
ribs on your back. Your doctor will give you medicine
to numb the skin around that spot before the test.

PULMONARY EDEMA: A condition caused by excess fluid in the lungs. This fluid collects in the numerous air
sacs in the lungs, making it difficult to breathe.

RISK FACTORS FOR PULMONARY EDEMA:

People with heart problems or heart failure are the

most at risk for pulmonary
edema. Other factors that
may put a person at risk
include: history of
pulmonary edema. history
of lung disease, such as
tuberculosis or chronic
obstructive pulmonary
disorder (COPD), vascular
(blood) disorders. You can
also decrease your risk for
 heart failure, the most common cause of pulmonary edema with the following steps:
Visit your doctor regularly; Don’t smoke or use recreational drugs; Get regular exercise;
Eat healthy foods; Maintain a normal weight.

PNEUMONIA: Pneumonia usually starts when you breathe the germs into your lungs. You may
be more likely to get the disease after having a cold or the flu. These illnesses
make it hard for your lungs
to fight infection, so it is
easier to get pneumonia.
Having a long-term, or
chronic, disease like asthma,
heart disease, cancer, or
diabetes also makes you
more likely to get
pneumonia.
Pneumonia is swelling
(inflammation) of one or both
lungs that is usually caused by
an infection. Many different
germs can cause pneumonia,
including bacteria, viruses, and
fungi. When you breathe in
these germs, they can settle in
the air sacs (alveoli) of your
lungs. Deep in your lungs, the germs may grow and overcome your body's normal
defenses.

After the lungs become infected, the air sacs (alveoli) in the lungs fill with pus and
mucus. This swelling (inflammation) of the air sacs makes them less stretchy and keeps
oxygen from properly reaching your blood stream.

As you work harder to breathe and give your body oxygen, you can feel short of breath.
The swelling also causes many of the other symptoms of pneumonia like cough, fever,
and chest pain.

Pneumonia can be life-threatening. It's a leading cause of death and hospitalization in

seniors and in people with long-term (chronic) diseases. The good news is that there are
many things you can do to lower your risk of getting pneumonia.

ATELACTASIS: A complete or partial collapse of the entire lung or area (lobe) of the lung. It occurs when the tiny
air sacs (alveoli) within the lung become deflated or possibly filled with alveolar fluid.
 One of the most common
respiratory complications
after surgery. It's also a
possible complication of
other respiratory problems,
including cystic fibrosis,
lung tumors, chest injuries,
fluid in the lung and
respiratory weakness. You
may develop atelectasis if
you breathe in a foreign
object.

Atelectasis can make

breathing difficult,
particularly if you already
have lung disease.
Treatment depends on the
cause and severity of the collapse.

There may be no obvious signs or symptoms of atelectasis. If you do have signs and symptoms, they may include: Difficulty
breathing; Rapid, shallow breathing; Wheezing; Cough.

PLEURISY: Pleurisy is an inflammation of the pleura. The pleura is a two layered membrane that both
Treatment Chest physiotherapy, Surgery, Breathing treatments (breathing enclosestube,
the lung and lines positive
Continuous the chestairway
cavity. pressure
(CPAP) may be helpful in some people who are too weak to cough andPeople
have low
haveoxygen levels one
two pleurae, (hypoxemia) after
around each
surgery.) lung. The pleurae act as a protective
wrapping, fitting snugly over your lungs.
Pleurae are made up of two layers.
Normally, there is no space between the
inner and outer layer. The layers are joined
at the edges, so that the pleura might be
compared to a balloon with no air,
completely empty of air and wrapped
tightly around the outside of each of the
lungs.

Normally, there is nothing but a thin layer

of lubricating fluid between the inner
pleural lining and the outer pleural lining.
The smooth pleura linings and lubricating
fluid allow your lungs to move freely in your chest, as they do in normal breathing. In people with
pleurisy, the two layers of pleura get inflamed (red and swollen).

Diagnosing: Blood tests, Chest X-Ray, CT scan, Ultrasound, EKG

Diagnostic Procedure: Thoracentesis (needle between ribs to remove fluid), Thoracoscopy/ Pleuroscopy (internal visualization of
chest)

Treating: Treatments used in pleurisy and pleural effusion focus primarily on the underlying cause. For example, if bacterial
pneumonia is the cause, an antibiotic will control the infection. If the cause is viral, pleurisy will resolve on its own.

The outcome of pleurisy treatment depends on the seriousness of the underlying disease. If the condition that caused pleurisy is
diagnosed and treated early, a full recovery is typical.
EMPHYSEMA: A lung condition that causes shortness of breath. In people with emphysema, the air sacs in the
lungs (alveoli) are damaged. Over time, the inner walls of the air sacs weaken and rupture —
creating larger air spaces
instead of many small
ones. This reduces the
surface area of the lungs
and, in turn, the amount of
oxygen that reaches your
bloodstream.

When you exhale, the

damaged alveoli don't work
properly and old air becomes
trapped, leaving no room for
fresh, oxygen-rich air to
enter.

Most people with

emphysema also have chronic
bronchitis. Chronic bronchitis
is inflammation of the tubes
that carry air to your lungs
(bronchial tubes), which leads
to a persistent cough.

Emphysema and chronic bronchitis are two conditions that make up chronic obstructive pulmonary disease
(COPD). Smoking is the leading cause of COPD. Treatment may slow the progression of COPD, but it can't
reverse the damage.
LUNG CANCER: Lung cancer is cancer that starts in the lungs. Cancer is a disease where cancer cells grow out of
control, taking over normal cells and organs in the body.

There are two major types of lung cancer. Each type of lung cancer
grows and spreads in different ways. Each type may be treated
differently.

-Non-small cell lung cancer

This is the most common type of

lung cancer. It usually spreads more slowly
than other lung cancers. There are three
major types of non-small cell lung cancer:

1-Squamous cell carcinoma

2-Adenocarcinoma

3-Large cell carcinoma

-Small cell lung cancer

This is a less common type of lung

cancer and it spreads faster than non-small-
cell lung cancer. - -Small cell lung cancer is
named for the size of cancer cells, which
can only be seen under a microscope. There
are three major types of small cell lung
cancer: 1 -Small cell carcinoma

2-Mixed small cell/large cell

3-Combined small cell carcinoma

There are also other types of

lung cancer.

SurgeryLaser surgery: a high-energy beam of light destroy the cancer cells in a

tumour.

ChemotherapyChemotherapy is medicine that fights cancer. Some kinds of

chemotherapy come in pills. Other kinds are delivered into your bloodstream by
intravenous drip (IV), where a machine slowly drips medicine into tubes that go into
your veins. Some chemotherapy is given by injection (a shot).
CHRONIC BRONCHITIS: Bronchitis means swelling in your air passages (bronchi). Bronchi are the air
passages that connect your windpipe (trachea) with tiny air sacs (alveoli) in your
lungs. The air sacs are where your body absorbs the oxygen you breathe in.

Bronchitis is an inflammation of the bronchi. This inflammation means the walls

of your bronchi are swollen and filled with extra sticky mucus. Airflow into and
out of your lungs is partly blocked because of the swelling and extra mucus in
your bronchi. This makes you
cough.
 There are two kinds of bronchitis:

-Acute bronchitis makes you sick for a

while, but gets better after two to three
weeks.

-Chronic bronchitis doesn't go away.

With chronic bronchitis, you have a
cough with mucus most days for three
months of the year.

RHINITIS: Inflammation and swelling of the mucous membrane of the nose, characterized by a runny nose
and stuffiness and usually caused by the common cold or a seasonal allergy. Colds and allergies
are the most common causes of rhinitis. Symptoms of rhinitis include a runny nose, sneezing, and
stuffiness.

ARDS-ACUTE RESPIRATORY DISTRESS SYNDROME:

Acute respiratory distress syndrome (ARDS)
is a lung problem. It happens when fluid builds up
in the lungs, causing breathing failure and low
 oxygen levels in the blood. ARDS is life-threatening, because it keeps organs like the brain and kidneys from getting
the oxygen they need to work.

ARDS occurs most often in people who are being treated for another serious illness or injury. Most of the time,
people who get ARDS are already in the hospital for another reason.

This is a very serious condition that causes death in many people. About two-thirds of people who develop ARDS
survive.

ARDS is treated in the intensive care unit. Treatment focuses on getting oxygen to the lungs and other organs, and then treating the cause of
ARDS.

Oxygen therapy may be given through a mask that fits over the mouth. If you still have trouble breathing, your doctor may insert a breathing
tube that is connected to a machine (ventilator). The breathing tube will help you breathe until you can breathe on your own.

Your doctor may also give you medicines, such as antibiotics, to treat an infection if it is causing ARDS. You may also be given fluids through an IV
to help you recover.

ASTHMA: Asthma is a chronic disease that makes your lungs very sensitive and hard to breathe. Asthma
can’t be cured, but with proper treatment, people with
asthma can lead normal, active lives.

If you have asthma, your airways (breathing passages) are very sensitive.

Triggers (allergens, exercise…) can make your airways

become:

-Swollen and filled with mucus – the swelling

and mucus makes your airways narrower, so it
is hard for air to pass through

-Small and tight – your airways might also

become twitchy and squeeze together and
tighten. This makes your airways narrower and
hard for air to pass through.
MEDICATIONS RELATED TO ASTHMA:

PULMONARY EMBOLISM: Pulmonary embolism happens when one or more of your

arteries in your lungs gets blocked by a blood clot, fat or tumour. The
most common type of
pulmonary embolism
is caused by a blood
clot that moves
through your blood
stream, goes through
your heart and blocks
off an artery in your
lung.

Most
pulmonary embolisms
are caused from clots originating in the lower extremities (deep vein
thrombosis), and many resolve on their own. However in some cases,
pulmonary embolism can cause sudden death.

Pulmonary embolism can be caused by:

 -Clots from the venous circulation from the right side
of the heart or tumours that have invaded the circulatory
system

-Think FAT BAT = fat, air, thrombus, bacteria,

amniotic fluid, tumor.

Treatment

Treatment is aimed at keeping the blood clot from

getting bigger and preventing new clots from
forming. Prompt treatment is essential to prevent
serious complications or death.

Medications:

-Blood thinners (anticoagulants). These drugs

prevent new clots from forming while your body
works to break up the clots. Heparin is a frequently
used anticoagulant that can be given through the
vein or injected under the skin. It acts quickly and is
often overlapped for several days with an oral
anticoagulant, such as warfarin, until it becomes
effective, which can take days. A newer class of
anticoagulants, referred to as novel oral
anticoagulants (NOACs), has been tested and
approved for treatment of venous
thromboembolism, including pulmonary embolism.
These medications work quickly and have fewer
interactions with other medications. Some NOACs
have the advantage of being given by mouth,
without the need for overlap with heparin. However,
all anticoagulants have side effects, with bleeding
being the most common.

-Clot dissolvers (thrombolytics). While clots usually

dissolve on their own, there are medications given
through the vein that can dissolve clots quickly.
Because these clot-busting drugs can cause sudden
and severe bleeding, they usually are reserved for
life-threatening situations.

Surgical and other procedures:

-Clot removal. If you have a very large, life-

threatening clot in your lung, your doctor may
suggest removing it via a thin, flexible tube (catheter)
threaded through your blood vessels.

-Vein filter. A catheter can also be used to position a

filter in the body's main vein — called the inferior
vena cava — that leads from your legs to the right
side of your heart. This filter can help keep clots from
being carried into your lungs. This procedure is
typically reserved for people who can't take
anticoagulant drugs or when anticoagulant drugs
don't work well enough or fast enough. Some filters
can be removed when they are no longer needed.
TENSION PNEUMOTHORAX: Tension pneumothorax is accumulation of air in the pleural space under
pressure, compressing the lungs and decreasing
venous return to the heart.

THORACENTISIS: A thoracentesis is a procedure that drains fluid or air from the space between the lungs
and the wall of the chest (the pleural space). It is done using a hollow needle or a plastic
tube inserted through the chest wall. Normally only a small amount of fluid is in the
pleural space.

A thoracentesis is done to
diagnose and treat certain
lung problems. It may be
done to:

-collect fluid to look

at under a microscope

-remove excess fluid

from the pleural cavity
(pleural effusion)
 -remove air that is trapped in the pleural cavity and causing heart and lung
problems (tension pneumothorax)

CYSTIC FIBROSIS: Cystic fibrosis (CF) is the most common, fatal genetic disease affecting young
Canadians. Cystic fibrosis mainly affects people's lungs and
digestion.

People with cystic fibrosis have an unusually thick, sticky

mucus that clogs their lungs, makes it hard to breathe, and
can lead to life-threatening lung infections. CF also affects
the pancreas: thick secretions there stop the release of the
digestive enzymes that normally help break down food,
making it hard for people to digest and absorb nutrients.
The mucus can also block the bile duct in the liver, which
eventually causes permanent liver damage in some people
with CF.
 COPD INTERVENTIONS: Chronic Obstructive Pulmonary Disease (COPD) is a lung disease that includes chronic
bronchitis and emphysema.

In 80-90% of cases, it is caused

by smoking. Other causes of COPD can
include:

-genetic
reasons (alpha-1
antitrypsin deficiency)

-occupational
dusts and chemicals

-second hand
smoke

-frequent
lung infections as a
child

-wood smoke
and other
biomass (animal dung, crop residues) fuel used for cooking.

COPD develops over time. In most cases, COPD is diagnosed in people

over 40 years of age. Someone with COPD may not realize that they
are becoming more short of breath until it becomes very hard to do
simple tasks like walking up stairs. When you have COPD, your lungs
are obstructed or blocked, making it hard to breathe.

In chronic bronchitis, your airways become swollen and can be filled

There's no cure for COPD, but treatment can with mucus, which can make it hard for you to breathe.
help ease symptoms, lower the chance of
In emphysema, the air sacs (alveoli) in your lungs are damaged which
complications, and generally improve quality of can make it hard for you to breathe.
life. Medications, supplemental oxygen
therapy, and surgery are some forms of
treatment.
KNOW

ABG’S: An ABG is a blood test that

measures the acidity, or pH, and the levels of
oxygen (O2) and carbon dioxide (CO2) from
an artery. The test is used to check the
function of the patient's lungs and how well
they are able to move oxygen and remove
carbon dioxide.
Ph is 7.35-7.45 ROME-respiratory opposite, metabolic even
TB TESTS/ VACCINES WITH TB: Doctors usually find latent TB by doing a tuberculin skin test.
During the skin test, a doctor or nurse will inject TB antigens under your
skin. If you have TB bacteria in your
body, within 2 days you will get a red
bump where the needle went into
your skin. The test can't tell when you
became infected with TB or if it can be
spread to others. A blood test also can
be done to look for TB.

To find pulmonary TB, doctors

test a sample of mucus from the lungs
(sputum) to see if there are TB bacteria
in it. Doctors sometimes do other tests
on sputum and blood or take a chest X-
ray to help find pulmonary TB.

To find extrapulmonary TB, doctors can take a sample of tissue

(biopsy) to test. Or you might get a CT scan or an MRI so the doctor can
see pictures of the inside of your body.
TB AS A WHOLE: Tuberculosis (TB) is a serious disease caused by breathing in a bacteria called
Mycobacterium tuberculosis. TB usually infects the
lungs. TB can also infect other parts of the body,
including the kidneys, spine and brain.

People can have TB

and not be sick, this is called
latent TB. Latent TB is when
a person has the TB bacteria
in their body but it is not
growing. The latent TB can
become active TB at any
time and make you very
sick. If you have inactive TB
infection you need to get
treatment to cure your TB
infection.

TB is contagious.
People who are sick with
active TB disease spread TB germs through the air. It's important for people with TB to
get treatment right away. TB treatments can cure TB and prevent it from spreading to
others.
THERAPY: Diagnostic evaluation of lung function and therapeutic procedures that help maintain good lung
health.

Medications and aerosol therapy.

Pulmonary function tests.

Oxygen therapy.

Blood gas determinations.

Airway management.

Mechanical ventilation.

Maneuvers designed to facilitate removal of secretions from the lungs.

NURSING DIAGNOSIS FOR RESPIRATORY DISTRESS: Oxygen. The primary goal of ARDS treatment is to ensure a
person has enough oxygen to prevent organ failure. A doctor
may

administer oxygen by mask. A mechanical ventilation

machine can also be used to force air into the lungs and
reduce fluid in the air sacs
DISEASES- KNOW
THE NURSING
INTERVENTIONS:
What measures can the nurse implement to promote a patient's oxygenation?

Breathing exercises include techniques to improve ventilation and oxygenation. The three basic techniques are
deep-breathing and coughing exercises, pursed-lip breathing, and abdominal-diaphragmatic breathing. Involves
deep inspiration and prolonged expiration through pursued lips to prevent alveolar collapse.