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Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher/
27 - Lower Respiratory ProblemsAce Your Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher Classes and Exams with Picmonic: #1 Visual Mnemonic Study Tool for Practical Nurse (LPN) Students
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Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher | Practical Nurse (LPN) School Study Aid
Pneumonia Assessment
- Risk Factors
- Older Adult
- Immunocompromised
- Long Term Care
- Assessment
- Shortness of Breath (SOB)
- Hypoxemia
- Cough and Sputum Production
- Wheezing or Crackles
- Fever
- Pleuritic Pain
- Diagnosis
- Chest X-ray
2 mins
Pneumonia Intervention
- Interventions
- Humidified Oxygen
- Deep Breathing Exercises
- Position of Comfort
- Increase Fluid Intake
- Manage Fever
- Medications
- Antibiotics
- Mucolytics
- Expectorants
- Considerations
- Pneumococcal Vaccine
- Sepsis
- Acute Respiratory Failure (ARF)
- Prevention Education
2 mins
Vancomycin
- Mechanism of Action
- Inhibits Bacterial Cell Wall Synthesis
- Indications
- Serious Gram-Positive Infections
- Side Effects
- Nephrotoxicity
- Ototoxicity
- Red Man Syndrome
- Thrombophlebitis
- Nursing Considerations
- Culture Samples First
- Infuse IV Over 60 Minutes
- Take Around the Clock
2 mins
Macrolides
- End in "-thromycin"
- Mechanism of Action
- Bacteriostatic
- Indications
- Alternative for Penicillin Allergy
- Respiratory Infections
- Pneumonia
- Side Effects
- QT Prolongation and Sudden Death
- C.Diff Overgrowth
- GI Distress
- Considerations
- Slow IV Infusion
2 mins
Fluoroquinolones
- End in "-floxacin"
- Mechanism of Action
- Bactericidal
- Indications
- Variety of Infections
- Side Effects
- GI Distress
- Photosensitivity
- Achilles Tendon Rupture
- Contraindications
- Pregnancy
- Children
- Myasthenia Gravis
- Considerations
- Avoid Milk Products or Antacids
- Slow IV Infusion
2 mins
Acyclovir (Zovirax)
- Mechanism
- Guanosine Analog
- Inhibits Viral Replication
- Thymidine Kinase Activation
- Indications
- Herpes Simplex Virus (HSV)
- Varicella Zoster Virus (VZV)
- Side Effects (Oral)
- Headache
- GI Distress
- Side Effects (IV)
- CNS Toxicity
- Nephrotoxicity (Crystalline Nephropathy)
- Considerations
- Prevents Recurrent Episodes
- Slow IV Infusion
2 mins
Tuberculosis Assessment
- Etiology
- Airborne Droplet
- Assessment
- 3 Week Productive Cough
- Night Sweats
- Chest Pain
- Fever
- Weight Loss
- Fatigue
- Diagnosis
- Chest X-Ray
- Blood Tests
- Mantoux Skin Test
- 3 Positive Sputum Tests
1 min
Tuberculosis Intervention
- Hospital Care
- Airborne Isolation
- Drug Therapy
- Combination Drug Therapy (RIPE)
- 6-12 Months
- Considerations
- DOT
- BCG Vaccination
- Medication Education
- 3 Negative Sputum Specimens
- Infection Control
2 mins
Tuberculosis Skin Mantoux Test (PPD)
- Delayed Hypersensitivity (Cell Mediated Response)
- Intradermal Injection
- Read 48-72 hours
- Positive Results
- ≥ 5 mm Induration
- Immunosuppressed
- ≥ 10 mm Induration
- High Risk Patients
- ≥ 15 mm Induration
- Considerations
- Chest X-Ray
3 mins
Isoniazid (INH)
- Mechanism
- Interferes with DNA Metabolism
- Indications
- Tuberculosis (TB)
- Side Effects
- Optic Neuritis
- Nausea and Vomiting
- Hepatotoxicity
- Peripheral Neuropathy
- Considerations
- Vitamin B6 Prophylaxis
- Monitor AST/ALT
2 mins
Ethambutol (Myambutol)
- Mechanisms
- Inhibits RNA Synthesis
- Bacteriostatic
- Indications
- Tuberculosis (TB)
- Side Effects
- Optic Neuritis
- Red/Green Color Blindness
- Gouty Arthritis
- Consideration
- Monitor Vision Acuity
2 mins
Amphotericin B
- Indications
- Systemic Mycosis
- Fungal Meningitis
- Last Resort for Protozoan infections
- Mechanism
- Polyene
- Binds Ergosterol
- Forms Membrane Pores
1 min
Azoles (Ketoconazole)
- "-azole" suffix
- Indications
- Local and Less Serious Systemic Mycosis
- Mechanism
- Inhibits Ergosterol Synthesis
- Inhibits P450
- Side Effects
- Liver Dysfunction
- Inhibition of Testosterone Synthesis
1 min
Lung Cancer Assessment
- 2nd Most Common Cancer
- Assessment
- Chronic Cough
- Hoarseness
- Abnormal Breath Sounds
- Hemoptysis
- Chest Pain
- Anorexia or Weight Loss
- Considerations
- Symptoms Appear Late in Disease
2 mins
Cisplatin (Platinol)
- Mechanism
- Alkylating Agent
- Cross-Links DNA
- Indications
- Testicular Cancer
- Ovarian Cancer
- Side Effects
- Nausea and Vomiting
- Myelosuppression
- Nephrotoxicity
- Ototoxicity
- Peripheral Neuropathy
- Considerations
- Antiemetics Before Administration
- Aggressive Hydration
3 mins
Pneumothorax
- Mechanism
- Air Enters Pleural Space
- Assessment
- Sudden Dyspnea
- Absent or Restricted Movement on Affected Side
- Decreased or Absent Breath Sounds on Affected Side
- Chest Pain
- Tracheal Deviation
- Vital Sign Changes
- Crepitus
- Considerations
- High Fowler's Position With Oxygen
- Prepare For Chest Tube Placement
- Educate High Risk Patients
2 mins
Flail Chest
- Cause/Mechanism
- Trauma
- Assessment
- Shallow Respirations
- Chest Pain
- Paradoxical Chest Movement
- Interventions
- Mechanical Ventilation
- Analgesics
- Intercostal Nerve Blocks
- Considerations
- Surgical Rib Fixation
- Monitor Pulmonary Contusion
2 mins
Cardiac Tamponade
- Mechanism
- Fluid in the Pericardial Sac
- Pericarditis
- Decreased Cardiac Output
- Signs/Symptoms
- Beck's Triad
- Hypotension
- Jugular Venous Distention (JVD)
- Distant Heart Sounds
- Pulsus Paradoxus
- Electrical Alternans
- Treatment
- Pericardiocentesis
1 min
Chest Tubes: Management and Care
- Confirm suction order
- Assessment
- Crepitus
- Kinking
- Shortness of Breath (SOB)
- Infection
- Excessive bubbling
- Quick Interventions
- If tube dislodges from patient, use petroleum gauze taped 3 ways
- If drainage system is damaged, place disconnected drainage tube in sterile water
1 min
Restrictive vs. Obstructive Lung Diseases
- Restrictive Lung Disease
- Decreased Lung Volume
- FEV1/FVC Ratio Normal to Increased
- Obstructive Lung Disease
- Increased Lung Volume
- Decreased FEV1/FVC Ratio
2 mins
Pulmonary Embolism Causes
- Causes
- FAT BAT Mnemonic
- Fat
- Air
- Deep Vein Thrombosis (DVT)
- Bacteria
- Amniotic Fluid
- Tumor
- Risk Factors
- Hypercoagulable
- Central Venous Lines
- Immobilized
1 min
Pulmonary Embolism Assessment
- Assessment
- Shortness of Breath (SOB)
- Pleuritic Chest Pain
- Tachypnea
- Hemoptysis
- Hypoxemia
- Considerations
- Sudden Death
52 secs
Alteplase
- Mechanism
- Tissue Plasminogen Activator
- Indications
- Thrombosis
- Side Effects
- Bleeding
- Contraindications
- Intracranial Hemorrhage
- Internal Hemorrhaging
- Considerations
- Minimize Bleeding
- Monitor for Shock
- Antidote
- Aminocaproic Acid
2 mins
Heparin Induced Thrombocytopenia (HIT)
- Pathophysiology
- 5-10 Days After Heparin Exposure
- Heparin-Platelet Factor 4 Complex
- Autoantibodies Form Against Complex
- Heparin-Platelet Factor 4-Antibody Complex Binds Platelets
- Platelet Aggregation
- Procoagulant Release
- Symptoms
- Thrombocytopenia
- Diagnosis
- Serotonin Release Assay (SRA)
- Treatment
- Stop Heparin, Start Direct Thrombin Inhibitor
2 mins
Cardiac Enzyme Evaluation: Troponin
- Measures
- Cardiac Muscle Injury
- Time Ranges
- Detection in Blood: 4 Hours
- Peak: 24 - 36 Hours
- Return to Normal: 5 - 14 Days
- Considerations
- Most Specific for Cardiac Muscle
- Treat Aggressively
2 mins
Warfarin (Coumadin)
- Mechanism of Action
- Inhibits Clotting Factors
- Indications
- Atrial Fibrillation
- Venous Thrombosis
- Pulmonary Embolism
- Assessment
- PT/INR Levels
- Observe for Bleeding
- Contraindications
- Pregnancy
- Nursing Considerations
- Vitamin K and Fresh Frozen Plasma
- Prolonged Therapeutic Onset
- Maintain Same Diet
2 mins
Enoxaparin (Lovenox)
- Mechanism of Action
- Inhibits Clotting Factors
- Factor Xa
- Indications
- Clot Formation Prevention
- Side Effects
- Heparin Induced Thrombocytopenia (HIT)
- Bleeding
- Considerations
- Medication Education
- Subcutaneous Injection
- 2 Inches from Umbilicus or Incisions
- Antidote
- Protamine Sulfate
2 mins
Heparin (Unfractionated)
- Mechanism of Action
- Suppresses Coagulation
- Indications
- Deep Vein Thrombosis (DVT)
- Pulmonary Embolism
- Side Effects
- Hemorrhage
- Heparin-Induced Thrombocytopenia (HIT)
- Considerations
- Monitor aPTT
- Preferred (Safe) During Pregnancy
- Antidote
- Protamine Sulfate
2 mins
Calcium Channel Blockers (Verapamil and Diltiazem)
- Mechanism of Action
- Slows AV Conduction
- Indications
- Angina Pectoris
- Arrhythmias
- Essential Hypertension
- Side Effects
- Bradycardia
- Hypotension
- Constipation
- Peripheral Edema
- Gingival Hyperplasia
- Nursing Consideration
- Medication Education
2 mins
Prednisone (Glucocorticoids)
- Mechanism
- Glucocorticoid
- Indications
- Inflammatory Conditions
- Organ Transplant Rejection
- Side Effects
- Cataracts and Glaucoma
- Cushing's Syndrome
- Osteoporosis
- Immunosuppression
- Hyperglycemia
- Ulcers
- Considerations
- Adrenal Insufficiency
- Taper Gradually
2 mins
Tacrolimus (Prograf) Overview
- Mechanisms
- Immunosuppressant
- Inhibits Calcineurin, Decreasing IL-2
- Indications
- Transplant Rejection
- Atopic Dermatitis
- Considerations
- Increased Lymphoma Risk
- Avoid Grapefruit Juice
1 min
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