person to person by droplet in the air or sneezing
How does Tb spread to other organs of the body?
by blood or lymphatic system, if immune system is compromised
What is the name of the test performed to test for TB?
Intradermal PPD test (Mantoux)
How much PPD is injected for a TB test?
0.1 ML - intradermally
When is a TB test read for results?
48-72 hrs after PPD is injected
What determines a positive TB reading?
a RAISED area, greater than 15mm
Peripheral Neuropathy can be a problem for those who are malnourished, have diabetes, or alcoholics while taking this medication?
Isoniazid
What should be administerd if an adverse reaction to isoniazid occurs?
Pyridoxine (vitamin B6)
This particular medication turns the body fluids orange, as well as possibly turning soft contact lenses orange?
Rifampin
With Cystic Fibrosis, which enzyme is deficient?
Pancreatic Enzyme
With Cystic Fibrosis, what is elevated in your sweat concentrations?
Sodium and Chloride
Associated with respiratory
Stricture = ?
Emphysema
Associated with Respiratory
Mucus Production =
Bronchitis & Cystic Fibrosis
Associated with Respiratory
Constriction =
Asthma
TB is spread by _____ when an infected person coughs, sneezes, speaks or sings?
Droplet
True or False...
TB is easy to catch?
False - it is not easy to catch - it requires hours with the infected person to catch the disease
If a person catches TB, a local inflammatory process occurs, causing what to form?
A Granulomatous Lesion
What happens to the TB organism if a granulomatous lesion is formed in a person with a healthy immune system?
The lesions are walled off and person is free of disease
What happens to the TB organism if a granulomatous lesion is formed in a person with an unhealthy immune system?
The disease cannot be contained and spreads
What is considred an active case of TB?
That the disease/ lesions have spread in the body to other organisms
True or False...
If TB is closed off in the lung- and not spreading - its considered to no longer be alive?
False - even though its walled off inthe lung, its considered dormant - but still alive...
What TB is this considered?
-Has been infected, but no active disease
- Can reactivate later if not treated
Latent TB
What TB is this considered?
Has initial infection- may or may not be active
Primary / Active TB
What TB is this considered?
Latent disease that becomes active when the immune system is surpressed
Reactivation TB
Why are there two seperate PPD test a week apart to test for TB?
Because a delayed hypersensitivity could occur
What size reading is positive for a patient with symptoms of TB or someone who has come in close contact with someone with the disease?
positive if > 5-9mm
Does a positive skin test mean you have TB?
No - it only shows poitive antibodies to TB, must have a sputum culture for positive ID
What size of a raised area after a PPD skin test - for TB, is considered a positive for everyone?
positive if >15mm
What is rapid indicator test for TB?
Sputum Smear
A definitive diagnosis for TB takes how long?
4-8 wks
What test for TB, usually shows dense lesions and possible cavity formation?
Chest X-Ray
If using a Chest X-Ray to diagnose TB, what are you looking for?
Dense lesions & possible cavity formation
What should happen if a positive skin test occurs or a close household contact with someone with active TB- to not spread TB?
Prophylactic treatment starts
What is the medication for prophylactic treatment for TB?
Isoniazid - 300mg/ day for 6-12 months
If given Isoniazid for prophylactic treatment of TB, how long is this usually given?
and what dose?
6-12 months
300 mg/ day
What type of patients is taking isoniazid contradicted in?
Liver Disease
A newly diagnosed TB patients initial drug therapy regimen is what?
4- oral anitubercular drugs daily for 2 months
Isoniazid, Rifampin, pyrazinamide, and ethambutol
What therapy is followed after the inital newly diagnosed TB regimen of 4 oral drugs daily for 2 months?
another 4 months of Isoniazid and Rifampin
If the patient with TB has HIV, how are they treated?
Treated with Isoniazid and Rifampin for at least 9 months
Single drug therapy for TB patients leads to?
Drug resistance
Since compliance is a must for a patient with active TB, who oversees that the patient is compliant with taking their medication?
DOTS (Directly Observed Treatment Short-Course)
What is the responisbility of DOTS?
They oversee the compliance of the patient taking their meds with active TB, to prevent spreading of the disease
What is required if the drug has a resistant strain to TB?
Susceptability testing is done to determine drug resistance before starting therapy
Virtually all patients that are compliant to taking their medications, have a negative sputum cluture after how long?
3 months
If a Tb patient is in the hospital, what type of isolation room should they be in?
Negative Airflow room
What type of mask should be used around a TB patient?
Hepa Filter mask
True or False...
as long as you have on a mask around a TB patient, you will not get the disease because your mounth and nose is covered?
False - it must be a Hepa Filtered mask
How does someone get cystic fibrosis?
Its a autosomal recessive disorder - meaning- both parents have to have the Gene for a child to get the disease
This is the most common LETHAL disease in Caucasian Americans
Cystic Fibrosis
What respiratory disease does Cystic Fibrosis cause in early childhood and early adulthood
COPD
What is the consistency of the secretions in a patient with cystic fibrosis?
thick and sticky (instead of thin) and tend to plug up tubes, ducts, and passageways
What is often the 1st sign of cystic fibrosis in newborns?
Meconium Ileus
Failure to thrive (grow) is a classic sign of what?
Cystic Fibrosis in new borns
Parents first notice a salty taste on their childs skin is a classic sign of what?
Cystic Fibrosis
Poor weight gain, depsite the voracious appetite and clubbing of the finger tips and toes are signs of what disease?
Cystic Fibrosis
When testing for cystic fibrosis and doing a Pilocarpine Iontophoresis Sweat Chloride Test- What is a positive diagnosis for cystic fibrosis?
Test shows elevated chloride levels
What test are ran when testing for cystic fibrosis show a patient has hypoxemia?
ABG & SaO2 levels
What type of medication is used for a patient with cystic fibrosis to help them breathe from the reduced lung capacity and sputum build up in their lugs?
Bronchodilators
How should someone with cystic fibrosis take their antibiotics? and why?
With meals - to absorb the nutrients
What is the only treatment for Cystic Fibrosis, but yet is not a guarantee?
Lung Transplant
What two diseases could use the same nursing diagnosis as they are nearly similar in their signs and symptoms?
Cystic Fibrosis & COPD
Cystic fibrosis patients should be on what kind of diet?
High calorie - bc they tire out quick and need the proper nutrition since not taking in much food
At what age is someone with cystic fibrosis vailable for a lung transplant?
18
RSV - Respiratory Syncytial Virus - subsides in what part of the lungs?
The lower repiratory tract
How is RSV spread? And how long does the virus live on contaminate surfaces?
- Droplet
- Lives for hours on contaminated surfaces
Who is at risk for serious RSV infection?
- Infants < 6 months old
- Infants premature
- Children with weakend immune system
- Older adults, epecially with COPD or CHF
When do symptoms typically occur in patients with RSV?
- 4-6 days after exposure
What is the peak period for RSV infection?
48-72 hours
A child who's nasals are flaring, has tachypnea, coughing, and body is contracting, would rather sit up than lie down, and mild cyanosis is propbably experiencing what?
RSV
What test are ran to diagnose RSV?
- Nasal Washing
- CBC & Chest X-Ray
- Pulse Ox
How is a patient treated with a severe case of RSV?
- Hospitalized, IV Fluids, Bronchodialators, antibiotics, and placed on droplet isolation
Is RSV a Viral or Bacterial Infection?
Viral - so, an antibiotic used would be used to treat the symptoms, not the virus
Croup is an infection in what part of the lungs?
Upper Respiraory Tract
This is a severe inflammation & obstruction of the upper respiratory tract?
Croup
This is a an upper respiratory tract infection, that usually occurs in Fall to Spring, that is an abstructive airway disease that affects young children?
Croup
When season does Croup most often occur?
Fall to Spring
A loud, harsh cough, similar to a barking seal, and often wakes a child at night is a classic symptom of what?
Croup
Inspiratory Stridor and Marked retractions in a child is common with this virus?
Croup
What are some home treatments that are helpful in respirations with someone with Croup?
Humidifiers, moist steamy bathroom, cool air, sit child upright
If child goes to ER for symptoms of Croup, what treatments will they likely do in the hospital?
Racemic Epinephrine (Nebulizer) and Corticosteroids
What can occur if a childs gag reflex is stimulated or when the child is crying is they have Croup?
Laryngospasm with a total occlusion
What are common drugs for upper repiratory disorders?
Antihistamines
* Remember the "ine" family
Tuberculosis is transmitted via which route?
A- Direct Contact
B- Respiratory Secretions
C- Sweat
D- Saliva
B- Repiratory Secretions
Cystic Fibrosis is known for causing damage of the respiratory system. What other system is significantly affected by Cystic Fibrosis?
A- Neurologic
B- Renal
C- Gastrointestinal
D- Skin
C- Gastrointestinal
Croup involves which portion of the respiratory tract? (select all that apply)
A- Alveoli
B- Bronchioles
C- Trachea
D- Esophagus
E- Bronchi
F- Larynx
C- Trachea
E- Bronchi
F- Larynx
RSV occurs only in children. True or False?
False
Which precautions need to be taken to avoid transmission of cystic fibrosis?
A- Droplet
B- Standard
C- Genetic
D- Hepa Mask
C- Genetic
The nurse evaluating a tuberculin test result 72 hrs after it was administered notes an area of induration 9m in diameter. What additional information would indicate to the nurse that this is a positive result?
A- The patient resides in a long term care facility
B- The patient was born is Southeast Asia
C- The patient has HIV
D- The patient is an injection drug user
C- The patient has HIV
Author
ssoucie
ID
213327
Card Set
Exam 4 content part 1
Description
Ventilation Disorders & Common Respiratory Disorders