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MedSurg > T1-Ch 24: Assessment of the respiratory system > Flashcards

T1-Ch 24: Assessment of the respiratory system Flashcards

1
Q

Difficulty breathing

A

dyspnea

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2
Q

respirations greater than 20 breaths/min

A

tachypnea

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3
Q

respirations less than 12 breaths/min

A

bradypnea

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4
Q

shortness of breath that occurs when lying gown that is relieved when sitting up

A

orthopnea

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5
Q

low levels of oxygen in the blood

A

hypoxemia

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6
Q

alveolar collapse

A

atelectasis

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7
Q

right-sided HF caused by pulmonary disease occurring with bronchitis or emphysema

A

cor pulmonale

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8
Q

symptoms of atelectasis(4)

A

dyspnea
rapid/shallow breathing
wheezing
cough

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9
Q

treatment of atelectasis (6)

A

-deep breathing exercises
-incentive spirometry
-elevate HOB
-early ambulation post-procedures
-bronchodilators
-humidity

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10
Q

alveolar collapse due to giving too much oxygen

A

absorptive atelectasis

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11
Q

nitrogen ________ airways and alveoli; an increase in oxygen ________ the nitrogen, and as the oxygen diffuses into the blood, the alveoli ________

A

-nitrogen maintains patent airways
-increase in oxygen dilutes the nitrogen
-alveoli collapse

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12
Q

signs of atelectasis (2)

A

-new onset of crackles
-decreased breath sounds

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13
Q

5 A’s for treating tobacco use

A

-Ask about use
-Advise to quite
-Assess willingness
-Assist in attempt
-Arrange follow up

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14
Q

Which of the 5 A’s?
Identify and document tobacco use and status at every patient visit

A

Ask

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15
Q

Which of the 5 A’s?
Communication with patient in a clear, strong, and personalized manner

A

Advise

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16
Q

Which of the 5 A’s?
Determine whether user is willing to attempt to quit smoking

A

Assess

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17
Q

Which of the 5 A’s?
OTC nicotine replacement therapy, counseling, support groups, reinforce

A

Assist

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18
Q

Which of the 5 A’s?
Arrange follow-up appointments within the first week after quitting

A

Arrange

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19
Q

Values above normal range:
1. pH:
2. pCO2:
3. pHCO3

A
  1. Basic
  2. Acidic
  3. Basic
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20
Q

Values bellow normal range:
1. pH:
2. pCO2:
3. pHCO3

A
  1. Acidic
  2. Basic
  3. Acidic
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21
Q

Purpose of pCO2 in ABG

A

Determine if its respiratory

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22
Q

Purpose of pHCO3 in ABG

A

Determine if its Metabolic

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23
Q

CO2 or HCO3 are normal while pH is abnormal

A

uncompensated

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24
Q

No values are within normal range

A

partially compensated

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25
Q

pH is within normal range, CO2 and HCO3 are not

A

Compensated

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26
Q

pH is closest in acidity to HCO3

A

Metabolic

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27
Q

pH is closest in acidity to CO2

A

Respiratory

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28
Q

abnormal values are acid

A

acidosis

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29
Q

abnormal values are basic

A

alkalosis

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30
Q

maximum amount of air that can be exhaled as quickly as possible after max inspiration

A

Forced vital capacity (FVC)

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31
Q

Max amount of air that can be exhaled in the first second of expiration

A

Forced Expiratory Volume in 1 sec (FEV1)

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32
Q

FEV1/FVC

A

Expiratory volume in 1 second/ Forced vital capacity

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33
Q

Forced expiratory flow over the 25-75% volume of the FVC

A

Functional Residual Capacity (FRC)

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34
Q

Amount of air in the lungs at the end of max inhalation

A

Total lung capacity (TLC)

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35
Q

amount of air remaining in the lungs at the end of a full, forced exhalation

A

Residual Volume (RV)

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36
Q

Reflects the surface area of the alveolocapillary membrane

A

Diffusion capacity of lung for carbon monoxide(DLCO)

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37
Q

non-invasively identifies hemoglobin saturation with oxygen (SpO2)

A

Pulse Oximetry

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38
Q

Perks of using pulse oximetry

A

Can detect desaturations before symptoms of respiratory distress appear

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39
Q

Normal SpO2 value

A

95-100%

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40
Q

T/F: SpO2 saturation is usually higher in those with darker skin

A

False; SpO2 is usually lower

41
Q

Low SpO2 indicates:

A

impaired ability of hemoglobin to release oxygen to tissues

42
Q

SpO2 <_____% in patients w/out chronic respiratory issues are emergent

A

91%

43
Q

SpO2<_____% is emergent in all patients

A

86%

44
Q

SpO2 <_____% is life threatening

A

80%

45
Q

SpO2 measurement locations (5)

A

-finger
-toe
-nose
-earlobe
-forehead

46
Q

Nursing consideration: Things that can cause low reading (7)

A

-movement
-hypothermia
-decreased peripheral blood flow
-ambient light
-decreased hemoglobin
-edema
-fingernail polish

47
Q

Most accurate location for SpO2 measurement:

A

forehead

48
Q

Nursing consideration for SpO2: readings are ______ accurate at lower values

A

Less accurate

49
Q

digital images to evaluate chest and pulmonary status

A

chest x-ray

50
Q

chest x-rays are often used for comparison with :

A

previous or future images

51
Q

chest x-rays are taken in ______ and ____ positions

A

-posteroanterior (back to front)
-left lateral

52
Q

Chest x-rays can be used to identify: (6)

A

-pneumonia
-atelectasis
-pneumothorax
-tumor
-fluid
-tube/catheter placement

53
Q

Nursing consideration: chest x-ray may appear normal with: (3)

A

-severe chronic bronchitis
-asthma
-emphysema

54
Q

insertion a tube in the airway as far as the secondary bronchi to view airway structures and obtain tissue samples

A

bronchoscopy

55
Q

purpose of a bronchoscopy (7)

A

-diagnose and manage pulmonary disease
-evaluate airway
-verify placement of ET tube
-collect specimens
-diagnose infections
-stent placement
-staging of lung cancer

56
Q

two types of bronchoscopy:

A

-rigid
-flexible

57
Q

rigid bronchoscopy requires _______ anesthesia

A

general

58
Q

flexible bronchoscopy can be performed under _____ in ICU or _____

A

-mild sedation
-endoscopy

59
Q

Preparation for bronchoscopy (4)

A

-consent
-labs
-NPO 4-8 hours
-premedication

60
Q

Labs required for bronchoscopy (5)

A

-CBC
-Platelets
-PTT
-Electrolytes
-chest x-ray

61
Q

premedication for bronchoscopy: (2)

A

benzodiazepine or opioids

62
Q

nursing consideration for bronchoscopy: benzocaine spray used as a topical anesthetic may cause:

A

methemoglobinemia leading to hypoxia

63
Q

During bronchoscopy, nurse: (2)

A

-monitors vitals
-provides supplemental oxygen as needed

64
Q

Follow-up care for bronchoscopy: (2)

A

-monitor until sedation wears off and gag reflex has returned
-VS and lung sounds Q-15min for first 2 hours

65
Q

needle aspiration of pleural fluid or air pleural space for diagnosis or management

A

Thoracentesis

66
Q

purpose of thoracentesis (3)

A

-relieve blood vessel or ling compression
-resolve respiratory distress from cancer, empyema, pleurisy, or TB
-instill drugs into pleural space

67
Q

During thoracentesis, nurse: (2)

A

-assist patient to sitting position on side of bed and provide support from the front as needle is inserted
-assess for signs of respiratory distress throughout procedure

68
Q

follow up care for thoracentesis (4)

A

-chest x-ray to rule out pneumothorax or mediastinal shift
-monitor VS and puncture site for complications
-promote deep breathing exercises
-document procedure

69
Q

Nursing considerations for thoracentesis: procedure has risks of __________ within the first 24 hours filling the procedure

A

subcutaneous emphysema that will make crackling sounds with pressure and pneumothorax

70
Q

Respiratory assessment of external nose:

A

-deformities
-symmetry
-size
-shape

71
Q

respiratory assessment of internal nose:

A

-color
-swelling
-drainage
-bleeding
-polyps

72
Q

pale, engorged, or bluish-gray mucosa within nose

A

allergic rhinitis

73
Q

S-shaped septum

A

septal deviation

74
Q

present if light shines from one naire into the other

A

perforated septum

75
Q

perforated septum are common in:

A

cocaine users

76
Q

pale, shiny, gelatinous lumps on the turbinates

A

nasal polyps

77
Q

When performing respiratory assessment of lungs, inspect: (4)

A

-front and back of the thorax while patient is sitting up
-respirations
-type of breathing
-AP diameter

78
Q

inspection of respirations should include: (4)

A

-rate
-rhythm
-depth
-symmetry of chest movement

79
Q

Different types of breathing include: (3)

A

-pursed-lip
-diaphragmatic
-use of accessory muscles

80
Q

AP diameter should be ______ but may be _____ in patients with emphysema

A

-1 : 1.5
-1 : 1

81
Q

Palpation of lungs is done to:

A

check for bilateral symmetry

82
Q

crackling sensation under the skin

A

crepitus
or
subcutaneous emphysema

83
Q

vibration of the chest wall when patient speaks, which should be diminshed

A

fremitus

84
Q

auscultation of the lungs includes checking for ____, ____, and ____ lung sounds

A

-anterior
-posterior
-lateral

85
Q

Bronchial normal breath sound:
Pitch:
Amplitude:
Duration:
Quality:
Location:

A

Pitch: High
Amplitude: Loud
Duration: Inspiration < Expiration
Quality: harsh, hollow, tubular
Location: Trachea & Larynx

86
Q

Bronchovesicular normal breath sound:
Pitch:
Amplitude:
Duration:
Quality:
Location:

A

Pitch: Moderate
Amplitude: Moderate
Duration: Inspiration = Expiration
Quality: Mixed
Location: Bronchi, upper sternum, posterior scapulae

87
Q

Vesicular normal breath sound:
Pitch:
Amplitude:
Duration:
Quality:
Location:

A

Pitch: Low
Amplitude: Soft
Duration: Inspiration > expiration
Quality: Rustling
Location: Peripheral Lung fields

88
Q

Adventitious breath sound: popping, velcro, late in inspiration

A

Fine crackles

89
Q

fine crackles is also known as

A

rales

90
Q

Fine crackles/rales is associated with (6)

A

-Asbestosis
-Atelectasis
-Interstitial fibrosis
-Bronchitis
-Pneumonia
-Chronic Pulmonary Disease

91
Q

Adventitious breath sound:
rattling sound due to fluid or secretions in large airways

A

Coarse crackles

92
Q

Coarse crackles is associated with (4)

A

-bronchitis
-pneumonia
-tumors
-pulmonary edema

93
Q

adventitious breath sounds: squeaky, musical, continuous
does not improve w/cough

A

wheeze

94
Q

wheezing is associated with: (5)

A

-inflammation
-bonchoscpasm
-Edema/secretions
-pulmonary vessel
-engorgement

95
Q

adventitious breath sounds: low-pitched continuous snoring from large airways

A

Rhonchi

96
Q

Rhonchi is associated with (4)

A

-Thick secretions
-Sputum production
-Foreign body obstruction
-Tumors

97
Q

Adventitious breath sound: grating, scratching sounds associated with pain on deep inspiration; present in lateral lung field

A

Pleural friction rub

98
Q

Pleural friction rub is associated with: (5)

A

-Pleurisy
-Tuberculosis
-Pulmonary infarction
-Pneumonia
-Lung cancer

MedSurg (14 decks)

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