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Med Surg > Respiratory > Flashcards

Respiratory Flashcards

1
Q

The normal AP to Lateral ratio is 2:1. If a patient has a ratio of 1:1, what could this indicate? (4)

A
  • barrel chest
  • air trapping
  • COPD
  • chronic asthma
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2
Q

__________ is the aspiration of pleural fluid or air from pleural space.

A

Thoracentesis

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3
Q

After a thoracentesis a _______ ________ is always performed in order to rule out a pneumothroax.

A

Chest x-ray

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4
Q

Major complication of a thoracentesis is a tension pneumothorax. What are the signs and symptoms of tension pneumothorax? (5)

A
  • SOB (air hunger)
  • decreased O2 sats (in the 80%); cyanosis
  • unilateral expansion
  • tracheal deviation to unaffected side (very pronounced)
  • cough (lung trying to inflate)

*sudden increase in HR indicates the lungs are not perfusing!

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5
Q

During a post-up nursing assessment of a patient that just underwent a lung biopsy, what are the big issues you should be concerned about? (2)

A
  • hemoptysis (coughing up blood)
  • monitor for signs of pneumothorax

*report reduced or absent breath sounds immediately

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6
Q

What are the two major components of asthma?

A
  1. Inflammation (constricted airways, increase mucous)
  2. Bronchospasm (impaired gas perfusion- can cause chronic cough)

**asthma cough is usually “barky”, “seal-like” and non-productive

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7
Q

What are some risk factors for asthma? (4)

A
  • allergies
  • smoking
  • pollution
  • family history (genetically linked)
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8
Q

Assessment Findings of Asthma (5)

A
  • SOB
  • EXPIRATORY wheeze (caused by obstruction in the lungs)
  • use of accessory muscles
  • decreased O2 sats (cyanotic, especially around lips)
  • increased respirations
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9
Q

Peak Flow Meter

  • what is it
  • readings
  • when is baseline obtained
A
  • tube that is blown into to see how well the lungs are working
  • best of 3 readings
  • done when not having any symptoms to obtain a baseline
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10
Q

Important teaching topics for asthmatic patients (5)

A
  • no smoking
  • avoid triggers
  • continue exercise as tolerated
  • stay on medications
  • monitor peak flow
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11
Q

What are the components of COPD?

A
  1. Emphysema (alveoli die off due to chronic exposure to pollutants)- lungs hyper inflated; lost of elasticity
  2. Chronic bronchitis (inflammation of bronchioles with increased mucous production)
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12
Q

Assessment Findings of COPD (8)

A
  • barrel chest
  • SOB
  • tripod position
  • acidotic (O2 levels are high)
  • decrease in O2 sats
  • diaphoresis
  • ashy-type skin complexion (pale)
  • clubbing (due to chronic decreased oxygen)
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13
Q

What are diagnostic tests used for patients with COPD? (4)

A
  • ABG’s
  • chest x-ray
  • pulse oximetry
  • blood: Hgb & Hct is increased due to erythropoietin because of chronic low oxygen levels
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14
Q

What is the preferred position for maximum breathing?

A

Up-right or in High Fowler’s position

*Orthopnea- sleeping in a upright position

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15
Q

Important teachings for patients with COPD (3)

A
  • stop smoking
  • important to get pneumonia & flu vaccine
  • teach “pursed lip” breathing
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16
Q

Risks Factors of Pneumonia (4)

A
  • age
  • smoking
  • chronic lung disease
  • dysphasia
17
Q

Assessment Findings of Pneumonia (5)

A
  • fever (usually very high) causing the pt to be red & diaphoretic
  • increase respirations & HR (due to anxiety)
  • chest pain
  • decreased O2 sats (~85%)
  • cough->yellow mucous
18
Q

When osculating a patient with pneumonia, what are the 3 different sounds that may be heard?

A
  1. Rhonchi- due to mucous and inflammation
  2. Crackles-due to inflammation and fluid
  3. Tactile fremitus-louder over areas of consolidation
19
Q

Nursing Interventions Appropriate for Patients with Pneumonia (5)

A
  • turn, cough, & deep breath
  • nutrition is a huge issue!!! (pt has high fever increasing metabolism)
  • increase fluids to at least 2L/day (to thin mucous)
  • rest
  • may get an order for O2 (want sats at or above 95%)
20
Q

Important Teachings for Patients with Pneumonia (3)

A
  • get up and move around
  • finish antibiotics
  • monitor body temperature

Med Surg (5 decks)

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