Editing Medical-Surgical Nursing – LPN Flashcards (section)

== Cardiovascular and Respiratory ==

;When to hold digoxin in an adult
:Hold and report when the apical pulse, listened to at the fifth intercostal space at the left midclavicular line and counted for a full 60 seconds, is below 60 beats per minute. Also report nausea, loss of appetite, vomiting, blurred vision, or yellow-green halos around lights, which suggest toxicity.

;Teaching for a patient taking a blood pressure medication who feels fine
:Keep taking it. High blood pressure usually causes no symptoms, and stopping the medication allows damage to the heart, brain, and kidneys to continue. Also teach standing up slowly to prevent dizziness and falls.

;Daily home teaching for a patient with heart failure
:Weigh every morning after urinating and before eating, limit salt, take medications as prescribed, balance activity with rest, and call the provider for a gain of 2 to 3 pounds in a day or 5 pounds in a week, or for increased shortness of breath.

;Safe positioning for a patient who is short of breath
:Sit the patient upright in high Fowler position or leaning forward on an overbed table. Lying flat makes breathing harder because abdominal contents press against the diaphragm.

;Pursed-lip breathing and who benefits
:The patient inhales through the nose and exhales slowly through pursed lips, as if blowing out a candle, taking about twice as long to exhale as to inhale. It keeps small airways open so trapped air can escape and helps patients with chronic obstructive pulmonary disease.

;Correct order for using a rescue inhaler and a steroid inhaler
:Rescue bronchodilator first, wait the instructed time, then the inhaled corticosteroid, then rinse the mouth to prevent thrush. Using a spacer improves delivery.

;Rule about changing an oxygen flow rate
:The flow rate is a prescribed order. The nurse does not increase or decrease it independently. If the patient is short of breath, reposition, stay with the patient, and report to the registered nurse.

;Purpose of the incentive spirometer and how it is used
:It prevents atelectasis and pneumonia by expanding the lungs. The patient sits upright, seals the lips around the mouthpiece, inhales slowly and deeply, holds for a few seconds, and repeats about ten times each hour while awake, splinting the incision with a pillow when coughing.