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314 Oxygenation Flashcards

1
Q

Normal changes in the respiratory system for aging adults are?

A

Rigid chest wall
Decreased lung capacity
Normal o2 sat 93-94%

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2
Q

Right sided heart failure presenting in JVD, ascites, hepatosplenimegaly, ankle edema can be associated with what respiratory disease

A

Chronic bronchitis

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3
Q

Prolonged exhalation, barrel shaped chest, chronic hypercapnia, and shallow respirations can be associated with what respiratory disease

A

Emphysema

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4
Q

What diagnostic tests are used for Copd

A

Spirometry (pulmonary function testing)

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5
Q

What is the role of the nurse with COPD

A

Education of medication management, self management, smoking cessation, o2 management.

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6
Q

What is the greatest risk factor for obstructive sleep apnea?

A

Obesity

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7
Q

What lab test or diagnostic studies are done for obstructive sleep apnea

A

Polysomnographic test

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8
Q

Complications of obstructive sleep apnea

A

Systemic hypertension
Cardiac arrhythmias
Heart failure
Stroke

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9
Q

What is the nursing role with obstructive sleep apnea regarding environmental factors?

A

Effective sleep environment

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10
Q

What is the nursing role with obstructive sleep apnea regarding safety considerations

A

Medications that cause sleepiness

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11
Q

What is the nursing role with obstructive sleep apnea regarding client education

A

Compliance with CPAP!
Avoid risk factors: smoking, alcohol, sedatives

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12
Q

What occurs when a substance enters the venous circulation and forms a blockage in the pulmonary vasculature?

A

Pulmonary embolism

Medical emergency
Person can breathe but blood can not oxygenate

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13
Q

DVT prevention is key to prevent what

A

Pulmonary embolism

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14
Q

Major risk factors for pulmonary embolism

A

Immobility.

Tobacco
Oral contraception
Pregnancy
Cancer
Trauma/ surgery
Advanced age

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15
Q

What diagnostics are used for pulmonary embolism

A

ABG analysis
D-dimer
Chest X-ray (rule out other condition)
Pulmonary angiography (1st choice and expensive)
VQ scan (2nd choice)
- compares ventilation and perfusion

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16
Q

What are treatments for pulmonary embolisms

A

Heparin drip
Thrombolytic therapy
Embolectomy
Vena cava filter placement

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17
Q

What is a pneumothorax

A

Lung collapse

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18
Q

Primary spontaneous pneumothorax usually occurs in what type of clients

A

Males between 20-30 with no underlying conditions

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19
Q

What procedure can increase the risk of a pneumothorax

A

Thorancentesis

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20
Q

A client with asymmetrical lung expansion, decreased breath sounds or absent breath sounds, and respiratory discomfort is presenting symptoms of what?

A

Pneumothorax

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21
Q

Manifestations of pneumothorax plus tachycardia
Hypotension
Tracheal deviation
Cyanosis
Would most likely have what

A

Tension pneumothorax

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22
Q

Blood in the pleural space associated with trauma is what

A

Hemothorax

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23
Q

What is flail chest
And what does it lead to

A

Inability to expand chest adequately with inhalation and contract upon exhalation on one side due to multiple rib fractures.
Leads to hypo ventilation with atelectasis.

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24
Q

Role of nurse with pneumothorax

A

Prepare client for chest tube insertion
Fear due to breathing difficulties and pain.

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25
What conditions indicate chest tubes
Pneumothorax Hemothorax Pleural effusion Pulmonary empyema Post op chest drainage (open heart)
26
When a chest tube is being removed what is nurses role
Assist provider Administer pain meds prior Instruct patient to bear down (valsalva maneuver) Cover site with petroleum gauze after Obtain chest X-rays Continue to monitor
27
What umbrella term includes acute respiratory failure and acute respiratory distress syndrome
Respiratory failure
28
Why are elderly patient more vulnerable to rapid respiratory decline
They have decreased lung elasticity.
29
Acute respiratory failure (ARF) is a state where a patient is unable to adequately ventilate and is caused how
Mechanical abnormality Oxygenation failure (pneumonia) Lung disorders
30
Can respiratory failure be seen on ABGs?
Yes. As respiratory acidosis
31
Acute respiratory distress syndrome (ARDS) is caused by what
Sepsis, aspiration, pneumonia
32
What condition causes life threatening hypoxemia resulting from edema in the alveoli and loss of elasticity in the lungs
ARDS
33
What is VQ mismatch
Ventilation / perfusion not working how they should. 2 types Dead space- ventilation with no perfusion Intrapulmonary shunting- perfusion with no ventilation
34
Patient positioning for ARDS is how
Prone
35
Most common lower respiratory tract infection in children under 2
Bronchiolitis
36
Bronchiolitis is mainly viral from what infections
RSV Influenza Adenovirus
37
Increased risk for Bronchiolitis are patients who…
Preterm infants Lung disease Congenital heart disease Immunodeficiency Young. (Less than 3mo)
38
If a baby has Bronchiolitis what important education is needed for parents
Don’t kiss baby Hand hygiene
39
Role of nurse in Bronchiolitis
Encourage hydration Suction upper airway Monitor for signs of respiratory failure Supplement oxygen for less than 90% PPE Support family
40
What types of pneumonia are there
Bacterial Viral Aspiration
41
Who is more at risk for increased incidence of pneumonia
Older adults Chronic lung disease
42
Lab testing diagnostics for pneumonia
Chest xray
43
Influenza presents how. (FACTS)
Fever Aches Chills Tiredness Sudden onset
44
What assessment tools are used with asthma patients
Vs Lung sounds Peak flow ABG
45
Peak flow less than 50% of your normal is a signal of what
Airways narrowing. Medical alert!
46
Status asthmaticus treatment
Ventilatory support required! Medical emergency
47
Pulses paradoxus can be a symptom of what non cardiac event
Status asthmaticus
48
What is the difference between pediatric and older adults when considering water in the human body
Pediatric have higher % Older adults have lower %
49
The intravascular fluid, trans cellular fluid and interstitial fluid are components of what
Extracellular fluid
50
Crystalloids or colloids. Which is larger?
Colloids. Exert oncotic pressure.
51
What’s the difference between hypertonic dehydration and hypotonic dehydration
Hypotonic= more Na loss= fluid shifting from ECF to ICF. Hypertonic = more h2o loss than Na = higher Na level= fluid shifting from iCF to ECF
52
Vital signs of dehydration
Hypo or hyperthermia Tachycardia & weak pulse Hypotension Tachypnea
53
Lab values for dehydration
Hemo concentration Increased urine specific gravity
54
How often do you monitor weight during fluid replacement with dehydration
Every 8 hr
55
What’s the difference between fluid overload and hypervolemia?
Fluid overload = hemodilution Hypervolemia= no hemodilution
56
Fluid overload signs and symptoms (Don’t have to name them all…)
HTN Tachycardia -bounding pulse Tachypnea Vision changes Altered LoC Liver enlargement Dyspnea Crackles Edema JVD Increased motility
57
Positioning for fluid volume excess
Semi Fowler or Fowler. Reposition frequently for skin maintenance
58
How often do you weigh for fluid overload
Daily
59
Fluid volume overload complications
Heart failure Water intoxication Pulmonary edema
60
Pulmonary edema interventions
High fowlers Supplement O2, cpap/bipap, mechanical vent Morphine, nitrates, diuretics (must assess BP first!!)
61
A patient present with frothy pink tinged sputum, tachycardia, anxiety, JVD, crackles and Dyspnea at rest. What is suspected
Pulmonary edema

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