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Nursing of Adults I > Chapter 30: Lower Respiratory Problems- Pfieffer > Flashcards

Chapter 30: Lower Respiratory Problems- Pfieffer Flashcards

1
Q

Interprofessional care for pulmonary embolism: _________________ hygiene to prevent atelectasis

A

pulmonary

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2
Q

before chest tubes are inserted, a tension pneumothorax needs this immediate treatment

A

needle decompression

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3
Q

chest trauma initial interventions: __________ impaled objects

A

stabilize

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4
Q

main diagnostic study for lung abscess

A

chest X-ray

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5
Q

pulmonary fungal infections have manifestations similar to this disease

A

bacterial pneumonia

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6
Q

enlargement of the right ventricle caused by a primary respiratory disorder

A

cor pulmonale

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7
Q

emergency treatment of pneumothorax involves covering the wound with ____________ dressing secured on (1, 2, 3, 4) sides

A

occlusive, 3

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8
Q

transmission of pulmonary fungal infections

A

inhalation of spores

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9
Q

normal mean pulmonary artery pressure

A

12-16 mmHg

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10
Q

pain management for fractured ribs can include these three methods

A

NSAIDs
opioids
nerve blocks

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11
Q

massive pulmonary embolisms, hemodynamically unstable patients, and patients in which thrombolytic therapy is contraindicated may need this type of surgery

A

pulmonary embolectomy

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12
Q

type of pneumothorax that occurs due to rupture of small blebs (air-filled sacs) on the surface of the lung

A

spontaneous pneumothorax

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13
Q

diagnostic study for pnemothorax

A

chest X-ray

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14
Q

diagnostic study for flail chest

A

chest X-ray

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15
Q

nursing management for lung abscess involves monitoring for signs of __________ and _________________; applying __________

A

hypoxemia, respiratory distress, oxygen

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16
Q

lung condition characterized by collapsed, airless alveoli

A

atelectasis

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17
Q

name of type of breathing movement in flail chest

A

paradoxical
inspiration: chest sucked in
expiration: chest bulges out

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18
Q

chest trauma: assess for these six signs of cardiovascular compromise

A

rapid, thready pulse
decreased BP with narrowed pulse pressure and/or asymmetric readings
distended neck veins
muffled heart sounds
chest pain
dysrhythmias

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19
Q

most common manifestation of pulmonary embolism

A

dyspnea

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20
Q

elevated pulmonary artery pressure due to an increase in resistance to blood flow through the pulmonary circulation

A

pulmonary hypertension

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21
Q

conservative treatment for chylothorax

A

Octerotide

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22
Q

type of pleural effusion in which the fluid is protein-poor, cell-poor, clear, pale yellow

A

transudate effusion

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23
Q

diagnosis for atypical mycobacteria

A

sputum culture

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24
Q

complication of pulmonary embolism: results from hypoxemia associated with massive (>50%) or recurrent emboli; right ventricular hypertrophy

A

pulmonary hypertension

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25
Q

type of pleural effusion in which the fluid is protein-rich

A

exudative effusion

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26
Q

teaching for lung abscess includes these two things

A

effective coughing
supportive measures (rest, nutrition, fluids)

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27
Q

progression of pulmonary hypertension is indicated by these two things

A

dyspnea at rest
right ventricular hypertrophy

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28
Q

complication of heart and lung diseases characterized by abnormal accumulation of fluid in alveoli and interstitial spaces

A

pulmonary edema

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29
Q

Patient education for pulmonary embolism addresses long-term ________________ therapy, measures to prevent _______, and importance of ________________

A

anticoagulant, VTE, follow-up exams

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30
Q

pneumothorax: stabilize any impaled objects with __________________ but do not pull it out

A

bulky dressing

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31
Q

this method is used to diagnose pulmonary embolism if patient cannot have contrast

A

ventilation-perfusion (V/Q) scan

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32
Q

a tension pneumothorax causes a _________________ and _____________ instability with reduced ______________ and ______________

A

mediastinal shift, hemodynamic, venous return, cardiac output

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33
Q

Prevention of pulmonary embolism involves intermittent ____________________ devices, early ______________, and __________________ therapy.

A

pneumatic compression, ambulation, anticoagulation

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34
Q

abnormal collection of fluid in the pleural space

A

pleural effusion

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35
Q

treatment for pulmonary fungal infections

A

antifungal drugs

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36
Q

this type of fungal pathogen occurs in immunocompromised patients and patients with CF and HIV

A

opportunistic fungal pathogens

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37
Q

these two patients are at risk for atelectasis

A

bedridden patients
postop patients (abdominal, chest)

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38
Q

flail chest results from the fracture of _____ or more consecutive ribs in _____ or more separate places; can also result from fractured ____________ and several consecutive ribs

A

3, 2, sternum

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39
Q

treatment for atypical mycobacteria

A

similar to TB
prolonged antibiotics

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40
Q

mechanism of chest injury involving shearing and compression injuries of chest structures; external appearance may be minor but may have severe internal organ damage

A

blunt

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41
Q

this part of ventilation-perfusion (V/Q) scan involves IV injection of a radioisotope

A

perfusion scanning

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42
Q

collection of purulent fluid in the pleural space

A

empyema

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43
Q

hallmark manifestation of lung abscess

A

dark brown, purulent, foul-smelling, foul-tasting sputum

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44
Q

multiple lung abscesses is known as

A

necrotizing pneumonia

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45
Q

gold standard treatment for pneumothorax

A

chest tubes with water-seal drainage

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46
Q

pulmonary embolisms most commonly affect these lobes of the lung

A

lower lobes

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47
Q

type of pneumothorax that can occur due to laceration or puncture of the lung during medical procedures

A

iatrogenic pneumothorax

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48
Q

Treatment for flail chest involves ensuring adequate _______________ and ______________; ________ management. If needed, _____________ and ____________ ventilation and/or _________ fixation are done.

A

ventilation, oxygenation, pain, intubation, mechanical, surgical

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49
Q

mechanism of chest injury involving foreign object impaling or passing through body tissues creating an open wound

A

penetrating

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50
Q

three diagnostic methods for pulmonary fungal infections

A

skin testing
serology
biopsy (via bronchoscopy)

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51
Q

chest trauma initial interventions: place in ______________ position or on ___________ side after ruling out cervical spine injury

A

semi-Fowler’s, injured

52
Q

two refractory treatment options for chylothorax

A

surgery, pleurodesis

53
Q

type of pleural effusion that occurs mainly in non-inflammatory conditions

A

transudate effusion

54
Q

five risk factors for spontaneous pneumothorax

A

tall, thin, male, family history, previous spontaneous pneumothorax

55
Q

most common cause of pulmonary edema

A

left-sided heart failure

56
Q

Risk factors for pulmonary embolism include ____________ or reduced ___________, _____________ within 3 months, history of ______, ____________, ____________, oral ___________/____________ therapy, _______________, prolonged ______________, ______________, _______________, and ________ disorders.

A

immobility, mobility, surgery, VTE, cancer, obesity, contraceptives, hormone, smoking, air travel, heart failure, pregnancy, clotting

57
Q

in diagnosing pleural effusion, these two methods reveal the volume and location of the effusion

A

chest X-ray, CT

58
Q

Drug therapy for pulmonary hypertension focuses on pulmonary ________________, reducing _______________ overload, reverse __________, managing _________, and preventing ___________ and ___________

A

vasodilation, right ventricular, remodeling, edema, thrombi, hypoxia

59
Q

definitive test to diagnose pulmonary hypertension

A

right-sided heart catheterization

60
Q

Interprofessional care for pulmonary embolism: provide _____________ with intubation if needed

A

oxygen

61
Q

pleurisy: pleural friction rub is heard at the _______ of inspiration

A

peak

62
Q

treatment for pleurisy

A

underlying cause
pain management

63
Q

pleural effusion: this treatment method is done to obliterate the pleural space and prevent reaccumulation of effusion fluid

A

chemical pleurodesis

64
Q

penetrating chest wound in which air enters the pleural space through the chest wall during inspiration

A

sucking chest wound

65
Q

pulmonary embolisms are commonly diagnosed with these two tests

A

D-dimer (have a clot but not where it is)
spiral (helical) CT scan

66
Q

two manifestations/assessment findings of large pneumothorax

A

respiratory distress
absent breath sounds over affected area

67
Q

type of hemothorax that occurs with a pneumothorax

A

hemopneumothorax

68
Q

two manifestations of small pneumothorax

A

mild tachycardia and dyspnea

69
Q

six causes of pleurisy

A

infection
cancer
autoimmune disorders
chest trauma
GI disease
some medications

70
Q

cause of atelectasis

A

secretions obstructing small airways

71
Q

two classic manifestations of pulmonary hypertension

A

dyspnea on exertion
fatigue

72
Q

pleurisy: breathing is (deep, shallow) with (increased, decreased) movement

A

shallow, decreased

73
Q

large thrombus lodged at an arterial bifurcation is known as

A

saddle embolus

74
Q

chest trauma initial interventions: cover sucking chest wound with ___________ dressing taped on (1, 2, 3, 4) sides

A

nonporous, 3

75
Q

type of pleural effusion that results from increased capillary permeability due to an inflammatory reaction

A

exudative effusion

76
Q

in a patient with cor pulmonale, a ruddy complexion indicates this

A

polycythemia

77
Q

insertion of this device can prevent migration of clots into the pulmonary system (prevent pulmonary embolism)

A

inferior vena cava (IVC) filter

78
Q

pulmonary embolisms treated with this significantly reduce mortality

A

anticoagulants

79
Q

occurs when positive pressure in pleural space causes lung to partially or fully collapse

A

pneumothorax

80
Q

type of pneumothorax that occurs when the visceral (inner) lining of the pleura is disrupted, allowing air to enter the pleural space from the lung; has no external wound

A

closed pneumothorax

81
Q

chest trauma initial interventions: establish IV access with (1, 2, 3) large-bore catheters and begin _________________________ as appropriate

A

2, fluid resuscitation

82
Q

causes of pleural effusion include increased pulmonary ___________ pressure, decreased ____________ pressure, increased _________________ permeability, and ______________ obstruction

A

capillary, oncotic, pleural membrane, lymph flow

83
Q

patients with cor pulmonale have a (low, normal, high) epoietin level

A

low

84
Q

patient teaching for fractured ribs includes these three things

A

deep breathing and coughing
incentive spirometry
appropriate use of analgesics

85
Q

in a patient with cor pulmonale, elevated BNP indicates this

A

heart failure

86
Q

chest injury complication that involves blood rapidly collecting in pericardial sac which compresses myocardium and prevents ventricles from filling

A

cardiac tamponade

87
Q

necrosis of lung tissue from aspiration of bacteria from periodontal disease; also IV drug use, cancer, pulmonary embolism, lung infarction, tuberculosis, parasitic/fungal disease, sarcoidosis

A

lung abscess

88
Q

most pulmonary embolisms arise from this condition

A

deep vein thrombosis (DVT)

89
Q

chest trauma initial interventions: do this to keep SpO2 >90%

A

apply oxygen

90
Q

long-term antibiotics are typically delivered via a(n) ____________; a ___________ is used if WBCs are high with a risk for infection

A

PICC line; midline

91
Q

manifestations for fractured ribs include _________ with inspiration and coughing, _____________ and ___________ respirations

A

pain, splinted, shallow

92
Q

manifestations include exertional dyspnea, tachypnea, cough, fatigue, right ventricular hypertrophy, increased intensity in S2 heart sound, polycythemia

A

cor pulmonale

93
Q

pleurisy: chest pain is ________ and (better, worse) with movement

A

sharp, worse

94
Q

this disease has 30+ varieties that can cause pulmonary disease, lymphadenitis, skin or soft tissue disease, or disseminated disease

A

atypical mycobacteria

95
Q

manifestations of cardiac tamponade include ___________ heart sounds, _____________, ____________ distention, increased _________________

A

muffled/distant, hypotension, neck vein, central venous pressure

96
Q

three ways to prevent atelectasis

A

deep breathing exercises
incentive spirometry
early mobility

97
Q

chest trauma initial interventions: remove ____________ to assess injury

A

clothing

98
Q

ribs that are most commonly fractured

A

ribs 5-9

99
Q

chest trauma ongoing monitoring of these six things

A

vital signs
LOC
O2 sat
cardiac rhythm
respiratory status
urinary output

100
Q

when antibiotics are ineffective to treat lung abscess, these two treatment methods may be used

A

percutaneous drainage of abscess
surgery (lobectomy or pneumonectomy)

101
Q

physical examination of flail chest reveals ________ and ___________ respirations, _____________ and _____________ chest movement, inadequate __________, ______________, and ________ near fractures

A

rapid, shallow, asymmetric, uncoordinated, ventilation, splinting, crepitus

102
Q

chest trauma: assess for these seven signs of respiratory distress

A

dyspnea
cough (with or without hemoptysis)
cyanosis
tracheal deviation
decreased breath sounds
decreased oxygen saturation
frothy secretions

103
Q

four manifestations of tension pneumothorax

A

severe dyspnea
marked tachycardia
neck vein distention
profuse diaphoresis

104
Q

atelectasis is characterized by these breath sounds and this percussion

A

decreased/absent breath sounds
dullness on percussion

105
Q

found in tap water, soil, house dust, or bird feces

A

atypical mycobacteria

106
Q

this type of fungal pathogen causes infection in healthy people and immunocompromised people in certain areas

A

endemic fungal pathogens

107
Q

type of pneumothorax that occurs when air enters the pleural space but cannot escape, resulting in increased intrapleural pressure

A

tension pneumothorax

108
Q

treatment for cor pulmonale requires early _________________, ________ therapy, and _______________ diet

A

identification, O2, low sodium

109
Q

treatment for lung abscess

A

IV antibiotics initially, then switched to oral antibiotics

110
Q

four complications of lung abscess

A

pulmonary abscess
bronchopleural fistula
bronchiectasis
empyema

111
Q

chest trauma initial interventions: prepare for emergency _________________

A

needle decompression

112
Q

this disease presents similarly to tuberculosis

A

atypical mycobacteria

113
Q

type of pneumothorax characterized by accumulation of blood in the pleural space from injury to the chest wall, diaphragm, lung, blood vessels, or mediastinum

A

hemothorax

114
Q

Immediate treatment of pulmonary embolism involves bed rest in ___________________ position; assessing _______________ status; administering _____________, IV ___________, and IV __________________; and monitoring for _________________ and ___________________.

A

Semi-Fowler’s, cardiopulmonary, oxygen, fluids, medications, coagulation, complications

115
Q

Patient support for pulmonary embolism involves these four aspects

A

anxiety, pain, dyspnea, fear of death

116
Q

blockage of one or more pulmonary arteries by a thrombus, fat or air embolus, or tumor tissue

A

pulmonary embolism

117
Q

this part of ventilation-perfusion (V/Q) scan involves inhalation of a radioactive gas, such as xenon

A

ventilation scanning

118
Q

treatment for hemothorax

A

chest tubes

119
Q

two complications that can occur from fractured ribs

A

atelectasis, pneumonia

120
Q

complication of pulmonary embolism: occlusion of medium or large-sized vessel, inadequate collateral blood flow, and preexisting lung disease results in alveolar necrosis and hemorrhage which may result in abscess and pleural effusion

A

pulmonary infarction

121
Q

most common cause of cor pulmonale

A

COPD

122
Q

goals of treatment of pulmonary embolism are ensuring adequate ________________ and __________ function and prevention of ____________ and ______________

A

tissue perfusion, respiratory, thrombi, embolization

123
Q

type of pneumothorax characterized by the presence of lymphatic fluid in the pleural space

A

chylothorax

124
Q

Early recognition to stop progression of pulmonary hypertension involves reporting unexplained _______, ________, ________ discomfort, and _______ of feet and ankles

A

SOB, syncope, chest, edema

125
Q

treatment for cardiac tamponade

A

immediate pericardiocentesis (needle decompression) with surgical repair as appropriate

126
Q

mean pulmonary artery pressure with pulmonary hypertension

A

> 20 mmHg

127
Q

type of pneumothorax in which air enters through an opening in the chest wall and parietal (outer) lining of the pleura

A

open pneumothorax

Nursing of Adults I (21 decks)

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