When using percussion on a patient with pneumonia, you would expect the sound to be ___.
Dull
You are caring for a patient with severe COPD. Their O2 sat is 90%. What should you do?
Nothing- this is ok for severe COPD. Need to avoid CO2 retention.
List 4 risk factors for contracting TB.
Close contact; immunocompromised, travel to high prevalence areas, inadequate healthcare, overcrowded housing, healthcare worker, living in an institiution
What medications are part of the 4-drug regimen for TB treatment?
INH, Rifampin, Pyrazinamide (PZA), Ethambutol
Quantiferon Gold is used to diagnose active TB. True or False?
False; It is a screening tool to see if past exposure
An FEV1 of 93% is expected in a patient with Grade 2 COPD. True or False?
False; 50-80% predicted
How long does a patient need to hold their breath after inhaling from inhaler?
5-10 seconds
You are assessing a patient's capillary refill. What is a normal capillary refill?
< 3 seconds (can be higher with advanced COPD)
What do you do if your patient has an abdominal evisceration?
call for help (stay with patient), notify provider, sterile towels/gauze, sterile gloves, cover contents with moist sterile towels/gauzents
How often should patients with moderate or severe asthma monitor their peak flow measurements?
Daily
Your patient has been diagnosed with pneumonia. This patient comes to the clinic 2x/week for dialysis. What classification of pneumonia does this patient have?
Health Care Associated
Asthma symptoms usually worsen with age. True or False
False; usually improve with age
What are signs of malignant hyperthermia?
Muscle Rigidity, Fever, Tachycardia, Hypotension, Increased RR
Describe the semi-restricted surgical zone.
Scrub clothes and caps required
How can a client prevent an asthma attack?
Medication compliance, symptom knowledge, avoiding triggers
Rifampin caused urine to turn orange. True or False
True, this is expected. Inform patient this is OK.
Which medication may be given prophylactically to a person living with someone with active TB?
INH (isoniazid)
What is the role of the circulating nurse?
Overall coordination, updating family, report off to PACU, verify site marking and patient ID, monitoring surgical procedure
What are the 2 most common tests to diagnose pneumonia?
CXR and Sputum Culture
What is the best way to prevent pneumonia?
Vaccination (and don't smoke)
Long term oral corticosteroids are recommended for treatment of COPD and Asthma. True or False
False
The CRNA's role includes administering anesthesia and intubation.
True
List 3 symptoms of TB.
Fever, fatigue, cough, hemoptysis, night sweats, loss of appetite, weight loss
Your patient is diagnosed with pneumonia on CXR. What treatment is likely to be ordered?
broad spectrum antibiotic (if no drug resistance history)
Wheezing that disappears during status asthmaticus is a sign that the patient is improving. True or False
False- As obstruction worsens, so does wheezing. Sign of respiratory failure. May need to be intubated.
Chronic bronchitis and emphysema can be caused by COPD?. True or False
False- they are forms of COPD