RESPIRATORY (THEORY 2)

1. _____________ A chronic inflammatory disease of the airways which causes swelling and narrowing
of the airways.

*Most chronic disease of childhood.

2. Treatments

 Medications.

 (Short term or long-term control)—inhaled steroids, bronchodilators.

 (Quick relieve or long relieve)—Ventolin inhalers or nebulizer, oral prednisolone.

 Modifications.

 (Lifestyle and occupational or Diet and Respiratory illness)

 (Environmental Control or Emotional Control)

 “Asthma Action Plan”.

https://www.asthma.ca/adults/control/pdf/AsthmaActionPlan_ENG.pdf

https://www.nhlbi.nih.gov/files/docs/public/lung/asthma_actplan.pdf

3. Think-Pair-Share!

a. Discuss the education plan for a client who is being discharged with asthma.

b. Explore and identify the importance of “Asthma Action Plan”.

C. List 2 nursing diagnoses and appropriate nursing interventions for asthma.

(NEED TO LOOK ANSWERS ON QUIZLET)

Review Questions

1. The nurse in a long-term-care facility is aware of the importance of preventing upper respiratory
infections (URIs) among the residents of the facility. How is this best accomplished?

a. Vigilant handwashing by staff and residents.

b. Providing a high-calorie diet for residents.
c. Encouraging residents' fluid intake.
d. Providing topical decongestants to residents.
2. A client who underwent surgery 12 hours ago has difficulty breathing. He has rashes over his
chest and complains of acute chest pain. What action should the nurse take first?

a. Initiate oxygen therapy.

b. Administer a heparin bolus and begin an infusion at 500 units/hour.
c. Administer analgesics as ordered.
d. Perform nasopharyngeal suctioning.

3. The critical-care nurse is writing a care plan for a patient who has returned from surgery 2 hours
prior. In planning the patient's care, which measure will the nurse implement to decrease the
patient's risk of developing chest infection?

a. Early ambulation.
b. Increased dietary intake of protein.
c. Maintaining the patient in a supine position.
d. Administering aspirin with warfarin.

4. Which of the following is a non-invasive method of continuously monitoring the oxygen saturation
of hemoglobin (SaO2)?

a. Pulse oximetry.
b. Arterial blood gas analysis.
c. Pulmonary function testing.
d. Sputum studies.

5. A 44-year-old homeless man presented to the emergency department with hemoptysis. The
patient was diagnosed with tuberculosis (TB) after diagnostic testing and has just begun treatment
with INH, pyrazinamide, and rifampin (Rifater). When providing patient education, what should the
nurse emphasize?

a. The rationale and technique for using incentive spirometry.

b. The correct use of a metered-dose inhaler (MDI) for bronchodilators.
c. The need to maintain good nutrition and adequate hydration.
d. The importance of adhering to the prescribed treatment regimen.

6. While auscultating the lungs of a client with asthma, the nurse hears a continuous, high-pitched
whistling sound on expiration. The nurse will document this sound as which of the following?

a. Rhonchi.
b. Crackles.
c. Wheezes.
d. Pleural friction rub.

7. Which of the following would be LEAST likely to contribute to a case of hospital-acquired

pneumonia?

a. Host defenses are impaired.

b. Inoculum of organisms reaches the lower respiratory tract and overwhelms the
 host's defenses.
c. A highly virulent organism is present.
d. A nurse washes her hands before beginning patient care.

8. A 79-year-old female resident in the long-term care facility has been experiencing a chronic,
productive cough for the last 3 months. She tells the nurse “this is just my winter cough.” This
client most likely has which of the following conditions?

a. Chronic bronchitis.
b. Asthma.
c. Septicemia.
d. Tuberculosis.

9. You are caring for a client who has been diagnosed with viral pneumonia. You are making a plan of
care for this client. What nursing interventions would you put into the plan of care for a client with
pneumonia?

a. Give antibiotics as ordered.

b. Place client on bed rest.
c. Encourage increased fluid intake.
d. Offer nutritious snacks 2 times a day.

10. A 22-year-old college student recently returned from a backpacking trip to Southeast Asia and has
been experiencing increasing malaise over the past 2 weeks. Today, he is seeking care because
he reports that he coughed up blood during a particularly heavy coughing fit this morning. The
nurse would document the presence of:

a. Apnea.
b. Dyspnea.
c. Cyanosis.
d. Hemoptysis.

PART 2!!!
1. ____________ is a disease characterized by airflow limitation that is not fully reversible.

2. _____________is a chronic inflammation of the lower respiratory tract with excessive mucus
secretion, cough and dyspnea.

3. _____________ is a complex lung disease which involves destruction of the lungs over time.

PART 2: Think-Pair-Share!

1. Emphysema is reversible provided the client stops smoking. True or false? __________

2. What are some of the warning signs and symptoms of a COPD flare-up? ____________...

Part 3:

1.

 __________ An inflammatory process involving the terminal airways and alveoli of the lung.

 Bacteria, viruses, fungi or parasites.

2. Common in _____________ (age?)

3. Types.

______________(streptococcus pneumonia),

______________

_____________

Think-Pair-Share!

1. What would your teaching plan be for pneumonia clients?

2. How is body temperature related to fluid balance?

3. List 2 nursing diagnoses and appropriate nursing interventions.

Case Study
Respiratory Conditions: COPD

Chief Complaint: Mr. Allan Park, a 40-year-old man with episodes of breathlessness, wheezing and dry
coughs.
History: Mr. Allan Park, a 40-year-old man, who started working in an auto body shop 18 months ago
presents to your clinic because of episodes of breathlessness, wheezing and dry coughs.

Subjective Data:
• He notes that his respiratory symptoms are often better over weekends and they disappeared
completely when he had 2 weeks off over the Christmas holidays.
• Has been smoking a pack of cigarettes for past 20 years.
• His wife smokes as well.

Objective Data:
• Vital signs: B/P 130/88.
• No medical problems noted.
• O2 Sat 90-91% on room-air.
• Mild bilateral pitting edema noted on extremities.
• Examination: decreased breath sounds and prolonged expiration on wheezing.

Critical Thinking Questions

1. What are Mr. Park’s risk factors for COPD?

2. Which of Mr. Park’s signs and symptoms suggest COPD?

3. What might be the appropriate treatments for Mr. Park?

4. If Mr. Park had quit smoking, can he still have COPD?

5. What is the teaching plan for Mr. Park?

6. List 2 nursing diagnoses and appropriate interventions for Mr. Park based on the case
study.
DON’T FORGET TO PRACTICE THESE:

UNDER WEEK 12, RESPIRATORY ON EVOLVE!!!

Part 4
1. _______

2. An infectious disease caused by bacteria.

3. Mycobacterium _________.

4. Transmission: _________

5. Infects the lungs but may spread to other _________.

 Think-Pair-Share! (IF YOU CAN ANSWER THIS, YOU SHOULD BE OKAY FOR THE TEST!)

1. What is the course (length) of treatment for TB?

2. List some of the health teaching plans for a client with tuberculosis.

3. List 2 nursing diagnoses and appropriate interventions.