Editing Medical-Surgical Nursing – RN Flashcards (section)

== Respiratory ==

;Meaning of a suddenly quiet chest in a patient with severe asthma
:Airflow has become so limited that no wheeze can be generated. It signals impending respiratory failure and requires immediate escalation, not reassurance.

;Oxygen target in advanced chronic obstructive pulmonary disease and the reason
:Roughly 88 to 92 percent. Excess oxygen worsens ventilation-perfusion matching and can blunt respiratory drive in chronic carbon dioxide retainers, but oxygen is never withheld from a hypoxemic patient.

;Continuous bubbling in the water seal chamber of a chest drainage system
:Indicates an air leak in the system. Assess the dressing, insertion site, connections, and tubing. Never clamp for a prolonged period, because that can create a tension pneumothorax, and never strip or milk the tubing.

;Tuberculosis medication adverse effects the nurse teaches
:Rifampin turns body fluids orange and reduces oral contraceptive effectiveness. Isoniazid is hepatotoxic and causes peripheral neuropathy, prevented with pyridoxine. Pyrazinamide is hepatotoxic and raises uric acid. Ethambutol causes optic neuritis, so any vision or color change is reported.