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NU122 Test #3
notes for test
| Question | Answer |
|---|---|
| Tuberculosis high risk groups: | Exposed persons Immigrants-Asia, Africa, Latin Amer. HIV and immune compromised Drug abuser/homeless High risk minority and medically underserved Congregate living-prisons |
| Tuberculosis causative agent/transmission: | Mycobacterium tuberculosis Acid Fast Aerobic Rod Droplet transmission |
| Tuberculosis Screening: | PPD/Mantou intradermally in forearm to form a wheel |
| Positive PPD test | >10mm |
| Diagnosis with chest x-ray: | lower lobes-atelectosis pleural effusion consolidation tubercle lesion cavitation Done at exposure and repeated 2-3 months later, annually |
| Diagnosis with sputum: | Positive Acid Fast Stain and Smear Early morning 1st sputum for 3 consecutive days. |
| Other ways to diagnose TB: | Bronchoscopy and Gastric washings |
| Active TB: | 5-10% of exposed develop TB 90% wage an immune response |
| Latent form of TB: | exposed as a child and lies dormant, reactivated later in life. |
| Mililary TB: | carried by the blood stream to the kidney and bone |
| TB symptoms: | Cough >3 weeks sputum production/hemoptasis night sweats anorexia with weight loss lymphadenopathy-swollen glands fatigue and fever |
| TB treatment: | Combo medications for 6-9 months Baseline liver fx. tests before starting drugs. Four drug regimen |
| TB 4 drug regimen | Isoniazid(INH) Rifampin Pyrazimamide(PZA) Ethambutol Rifadin |
| Isoniazide(INH) side effects | neuropathy-numbness for fingers and toes- Vit. B6 in diet or supplement-pyriatoxine hepatitis-most common resistance especially among HIV patients and world wide |
| Rifampin side effects | hepatitis deep orange color to secretions |
| Ethambutol side effects | optic neuritis vision loss-test eyes/vision before |
| Rifadin | used for HIV related TB |
| Latent TB treatment | 6-9 months of Isoniazid with monthly mandatory monitoring for side effects. |
| COPD | normal flow of air is blocked by excess mucus and inflammation |
| Chronic Bronchitis diagnosis | Cough up mucus and feel short of breath 3 months or more each year for at least 2 years. |
| Chronic Bronchitis patho | Lining of bronchioles become inflamed and produce too much mucus. Swelling and excess mucus narrow airways and restrict airflow Cilia is also damaged-unable to remove the excess mucus. |
| Emphysema | Destroys the alveoli, making it difficult for lungs to absorb enough O2 or expel enough CO2 CHRONIC form of obstructive pulm disease Leads to right side heart failure |
| Emphysema patho | Walls of alveoli lose elasticity and enlarge. The diaphragm flattens. Bronchioles become less elastic, and narrow or collapse as exhale CO2 gets trapped in airways and prevents O2 from getting to blood. |
| Chronic Asthma | Hypersensitivity of the airways to allergens and irritants. Increase resistance Bronchospasm |
| Chronic Asthma patho | Bronchiole lining inflamed, causes swelling, the muscles in the walls tighten and go into spasm May also produce excess mucus, which blocks airway. Wheezing |
| Emphysema etiology | cigarette smoking second hand smoke smog |
| Emphysema assessment | "pink puffer" |
| Emphysema diagnostic tests | ABG Chest x-ray-flattened diaphragm, hyperinflated lungs PFT's- decreased expiratory volume |
| Emphysema meds | Immunization against pneumonia & influenza. Antibiotics prn Bronchodialators to reduce dyspnea Anticholinergics(atrovent)-most effective for COPD |
| Chronic Bronchitis etiology | cigarette smoking chronic inflammation and infections children-second hand smoke |
| Chronic Bronchitis assessment | "blue bloater" tendency for obesity and bluish-red skin color polycythemia frequent cough and pulm. infections |
| Chronic Bronchitis diagnostic tests | Elevated RBC count chest x-ray- congested lung fields and increased heart size PFT's increased residual volume, decreased FEV Increased hematocrit |
| Chronic bronchitis meds | Bronchodilators immunizations antibiotics mucolytic-inhalation that helps liquefy secretions to help excrete secretions |
| Asthma etiology | physical, psychological stress allergic reactions widespread spasms of bronchiole smooth muscle with airway edema |
| Asthma assessment | severe dyspnea wheezing with expiration cough chest tightness restlessness anxious |
| Asthma diagnostic tests | elevated eosinophils PFT's decreased forced expiratory volume and peak expiratory flow |
| Asthma meds | Rescue drugs Stress reduction Smoking cessation |
| A.S.T.H.M.A. | ADRENERGICS(ALBUTEROL) STEROIDS THEOPHYLLINE HYDRATION MASK O2 ANTICHOLINERGICS(ATROVENT) |
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