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Saunders Comprehensive Review For The NCLEX-PN Examination, 8 Ed.
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Chapter 32. Eye, Ear, Throat, and Respiratory Problems

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Saunders Comprehensive Review For The NCLEX-PN Examination, 8 Ed. | Practical Nurse (LPN) School Study Aid

Chapter 32. Eye, Ear, Throat, and Respiratory Problems
21 Picmonics to Learn | 40 mins
Otitis Media Assessment
Red or Bulging Tympanic Membrane
Ear Pain
Pulling at Ear
Fever
Upper Respiratory Infection
Considerations
More Common in Young Children
Eustachian Tube Narrower
Conductive Hearing Loss
Smoking Increases Risk
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2 mins
Otitis Media Interventions
Antipyretics
Analgesics
Antibiotics
Irrigation
Position on Affected Side
Myringotomy
Tympanostomy Tube
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2 mins
Tonsillitis
Cause
Bacterial or Viral Inflammation
Assessment
Sore Throat
Dysphagia
Interventions
Throat Culture
Antibiotics
Tonsillectomy
Considerations
Often Streptococcus
Monitor for Acute Glomerulonephritis
Monitor for Rheumatic Heart Disease
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3 mins
Tonsillectomy
Indications
Recurrent Tonsillitis
Considerations
Saline Gargles
Ice Chips
Monitor for Bleeding
Within 24 Hours
After 5-7 days
Soft Foods
Do Not Cough, Clear Throat, or Blow Nose
Do Not Use Straws
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2 mins
Epiglottitis Assessment
Cause/Mechanism
Haemophilus Influenzae
Assessment
Drooling
Fever
Stridor
Restlessness
Dyspnea
Cough
Tripod Position
Considerations
Emergency Treatment
Do Not Examine Throat
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2 mins
Epiglottitis Interventions
Interventions
Maintain Airway
Upright/Sitting Position
Humidified Oxygen
Intubation/Tracheostomy Supplies At Bedside
IV Antibiotics
Decrease Anxiety
Considerations
NPO
Vaccine
Restrain to Prevent Extubation
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2 mins
Croup (Laryngotracheobronchitis)
Mechanism
Parainfluenza Virus
Assessment
3 Months to 3 Years
Nighttime
Barking Seal Cough
Inspiratory Stridor
Interventions
Cool Humidified Air
Dexamethasone
Racemic Epinephrine
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2 mins
Chronic Bronchitis Assessment
Clinical Findings
Chronic Productive Cough
> 3 Months for 2 Years
Increased Mucus Production
Dyspnea
Cyanosis
Wheezes
Complications
Right Side Heart Failure
Jugular Venous Distention (JVD)
Peripheral Edema
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2 mins
Chronic Bronchitis Interventions
Tripod Position
Humidified Oxygen
Pursed Lip Breathing
Increase Fluid Intake
ABGs
Early Detection of Exacerbation
Considerations
Lowest O2 Therapy
Assisted Ventilation
Increased Infection Risk
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2 mins
Respiratory Syncytial Virus (RSV) Assessment
Mechanism
Viral Infection Affecting Epithelial Cells
Signs and Symptoms
Begins After a Upper Respiratory Infection
Copious Secretions
Coughing and Sneezing
Wheezing
Otitis Media or Conjunctivitis (Possible Ear or Eye Drainage)
Poor Feeding
Tachypnea
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2 mins
Respiratory Syncytial Virus (RSV) Interventions
Prophylaxis
Palivizumab (Synagis)
Management
Hospitalization
Contact Precautions
Oxygen
Separate Room
Maintain Fluid Intake
Short-acting Beta-Agonist Bronchodilator
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2 mins
Pneumonia Assessment
Risk Factors
Older Adult
Immunocompromised
Long Term Care
Assessment
Shortness of Breath (SOB)
Hypoxemia
Cough and Sputum Production
Wheezing or Crackles
Fever
Pleuritic Pain
Diagnosis
Chest X-ray
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2 mins
Pneumonia Intervention
Interventions
Humidified Oxygen
Deep Breathing Exercises
Position of Comfort
Increase Fluid Intake
Manage Fever
Medications
Antibiotics
Mucolytics
Expectorants
Considerations
Pneumococcal Vaccine
Sepsis
Acute Respiratory Failure (ARF)
Prevention Education
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2 mins
Asthma Assessment
Assessment
Triggers (Cold air, Dander, Dust, Infection, Mold, Pollen, Smoke)
Shortness of Breath (SOB)
Tachypnea and Tachycardia
Wheezing
Diaphoresis
Accessory Muscles
Decreased Pulmonary Function Tests
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2 mins
Asthma Implementation and Education
Medication
Oxygen
Corticosteroids
Ipratropium (Anticholinergic)
Albuterol
Implementation
Inhaler/nebulizer
Pulse Oximetry
Pursed Lip Breathing
Education
Carry Inhaler
Rinse Mouth after Inhaler
Identify Trigger (Cold Air, Dander, Dust, Infection, Mold, Pollen, Smoke)
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2 mins
Stages of Asthma Treatments
Mild Intermittent
Short-acting Inhaled Beta-Agonist
Mild Persistent
Low-Dose Inhaled Corticosteroid
Montelukast (Leukotriene Receptor Antagonist)
Moderate Persistent
Low to Medium-dose Inhaled Corticosteroid
Zileuton
Severe Persistent
High-Dose Inhaled Corticosteroid
Systemic Corticosteroids
Omalizumab (Allergies)
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2 mins
Cystic Fibrosis Assessment
Thickened Mucus
Recurrent Pulmonary Infections
Pulmonary Congestion
Pancreatic Insufficiency
Steatorrhea
Fat-Soluble Vitamin Deficiencies
Salty Taste to Skin
Meconium Ileus
Delayed Growth and Poor Weight Gain
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2 mins
Cystic Fibrosis Interventions
Bronchodilators
N-Acetylcysteine (Mucolytics)
Inhaled Hypertonic Saline
Early Antibiotics
Dornase Alfa (Mucolytic Agent)
Postural Drainage with Percussion
Fat Soluble Vitamin Supplements
Pancreatic Enzymes with Every Meal
High Protein, High Calorie Diet
Added Dietary Salt
Glucose Monitoring
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2 mins
Tuberculosis Assessment
Etiology
Airborne Droplet
Assessment
3 Week Productive Cough
Night Sweats
Chest Pain
Fever
Weight Loss
Fatigue
Diagnosis
Chest X-Ray
Blood Tests
Mantoux Skin Test
3 Positive Sputum Tests
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1 min
Tuberculosis Intervention
Hospital Care
Airborne Isolation
Drug Therapy
Combination Drug Therapy (RIPE)
6-12 Months
Considerations
DOT
BCG Vaccination
Medication Education
3 Negative Sputum Specimens
Infection Control
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2 mins
Tuberculosis Skin Mantoux Test (PPD)
Delayed Hypersensitivity (Cell Mediated Response)
Intradermal Injection
Read 48-72 hours
Positive Results
≥ 5 mm Induration
Immunosuppressed
≥ 10 mm Induration
High Risk Patients
≥ 15 mm Induration
Considerations
Chest X-Ray
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3 mins

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