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HESI Med Surg III Review

• increasing temperature has what effect on the body's metabolism?

what can fever cause✔✔ increasing temp increases the body's demand for nutri- ents and oxygen...fever can cause dehydration r/t excessive fluid loss d/t diaphoresis

• why is hydration important w/ PNA✔✔ thins out mucus trapped in

bronchi- oles/alveoli--facilitates expectoration replacement of fluid lost by lungs through evaporation

• early s/s of cerebral hypoxia✔✔ irritability and restlessness

4. preventing PNA: flu shot/pneumovax

vaccine avoid sick people, indoor pollutants, no smoking adequate nutrition/fluids

if comatose--elevate HOB when before and after feeding, turn pt frequently

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• As COPD worsens, what happens to a patient's O2/CO2 levels in

their blood and what is the condition that results?

is this more of a problem for emphysema or chronic bronchitis✔✔ as COPD worsens, hypoxemia and hypercapnia result--leading to respiratory acidosis

emphysema leads more toward hypercapnia bc the alveoli are effected

• what bed position facilitates productive cough✔✔ semi-fowler or high-

fowler

• Emphysema vs. Chronic Bronchitis: CB: airway problem (chronically

in- flamed)---chronic sputum production, increased bronchial wall thickness--obstruc- tion of airflow, chronic hypoxemia, cor pulmonale (s/s RSHF) --->blue bloater, cyanosis, RSHF---JVD, crackles/expiratory wheezes

Emphysema--alveoli problem--air trapping, compensatory hyperventilation--barrel chest -->pink puffer--pursed lip breathers, diminished breath sounds

8. tx for COPD: mucolytics

bronchodilators (SABA/LABA--theophylline, albuterol, ipratropium) anti-inflammatory drugs (fluticasone)

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tripod position, pursed-lip breathing, diaphragmatic breathing

low FIO2 to prevent CO2 retention monitor for s/s of fluid overload

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