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NUR333 > Exam 1 > Flashcards

Exam 1 Flashcards

(70 cards)

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1
Q

tidal volume

A

amount of air exhaled following normal inspiration

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2
Q

crackles/rales

A
  • fine to coarse bubbly sounds, associated with air passing through fluid or collapsed small airways
  • not cleared by cough
  • discontinuous
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3
Q

wheezes

A
  • high pitched whistling, narrow obstructed airways
  • musical noise
  • continuous
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4
Q

rhonchi

A
  • loud low pitched rumbling, fluid or mucous in airways
  • can resolve with coughing or suctioning
  • snore sound
  • continuous
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5
Q

stridor

A
  • choking, children
  • emergency
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6
Q

bronchial

A
  • high pitch
  • normally heard over trachea
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7
Q

bronchial vesicular

A
  • medium pitch
  • heard over mainstream bronchi
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8
Q

vesicular

A
  • low pitch
  • heard over most of normal lung
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9
Q

bradypnea

A
  • rate of breathing is regular but abnormally slow
  • less than 12 breaths/min
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10
Q

tachypnea

A
  • rate of breathing is regular but abnormally rapid
  • greater than 20 breaths/min
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11
Q

hyperpnea

A
  • respirations are labored, increased in depth, and increased in rate
  • greater than 20 breaths/min
  • occurs normally during exercise
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12
Q

apnea

A
  • respirations cease for several seconds
  • persistent cessation results in respiratory arrest
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13
Q

hyperventilation

A
  • rate and depth of respirations increase
  • hypocarbia sometimes occurs
  • removing CO2 father than it is produced by cellular metabolism
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14
Q

hypoventilation

A
  • respiratory rate is abnormally low and depth of ventilation is depressed
  • hypercarbia sometimes occurs
  • inadequate alveolar ventilation to meet demand
  • not enough oxygen and/or too much carbon dioxide
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15
Q

factors affecting oxygenation

A
  • decreased oxygen carrying capacity
  • hypovolemia
  • decreased inspired oxygen concentration
  • chest wall movement
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16
Q

PaO2

A

80-100

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17
Q

PaCO2

A

35-45

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18
Q

SpO2 (oxygenation saturation)

A

greater than 95%

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19
Q

EtCo2

A

35-45

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20
Q

causes of hypoventilation

A
  • medications
  • sedatives
  • alveolar collapse
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21
Q

signs and symptoms of hypoventilation

A
  • mental status changes (early sign)
  • dysrhythmias
  • cardiac arrest
  • convulsions
  • unconsciousness
  • death
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22
Q

causes of hyperventilation

A
  • anxiety attacks (severe)
  • infection/fever
  • drugs
  • acid-base imbalance (pH)
  • aspirin poisoning
  • amphetamine use
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23
Q

signs and symptoms of hyperventilation

A
  • rapid respirations
  • sighing breaths
  • numbness/tingling of hands/feet
  • light-headedness
  • loss of consciousness
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24
Q

atelectasis

A
  • collapsed alveoli
  • prevents normal respiratory gas exchange
  • can lead to lung collapse
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25
conditions associated with atelectasis
- immobility - obesity - sleep apnea - chronic lung conditions
26
hypoxia
- inadequate tissue oxygenation
27
causes of hypoxia
- decreased hemoglobin levels/low oxygen-carrying capacity - diminished oxygen concentration of inspired oxygen - inability of tissues to get oxygen from blood - decreased diffusion of oxygen from alveoli to blood-infections/pneumonia - poor perfusion with oxygenated blood - impaired ventilation from traumas
28
signs and symptoms of hypoxia
- apprehension - restless - inability to concentrate - decreased LOC - behavioral changes - difficultly lying flat - cyanosis (late sign of hypoxia)
29
central cyanosis
- tongue - soft palate - conjunctiva of the eye - hypoxemia
30
peripheral cyanosis
- extremities - nail beds - ear lobes - vasoconstriction
31
early signs of hypoxia
- restlessness - anxiety - tachycardia/tachypnea
32
late signs of hypoxia
- bradycardia - extreme restlessness - dyspnea
33
chronic hypoxia
- associated with chronic lung conditions - COPD most common
34
common findings in chronic hypoxia
- cyanotic nailbeds - sluggish capillary refill - clubbing - barrel chest
35
dyspnea
- subjective sensation of difficult or uncomfortable breathing - associated with hypoxia - related to shortness of breath
36
signs and symptoms of hypoxia
- use of accessory muscles - nasal flaring - increased rate/depth
37
cough
- protective reflex to clear trachea, bronchi and lungs of irritants and secretions - adequate hydration and coughing helps patient maintain airway patency
38
nursing diagnoses related to oxygenation
- ineffective airway clearance - risk for aspiration - impaired gas exchange - activity intolerance
39
long term preventative measures
- vaccinations - healthy lifestyle - environmental and occupational exposures
40
dyspnea management
- difficult to treat - treat the underlying condition - oxygen therapy - pharmacologic treatment
41
airway maintenance
- CAB: circulation, airway, breathing - maintaining patent airway is a nursing priority
42
managing pulmonary secretions
- mobilize - hydrate - humidification - medications
43
positioning
- position for maximum respiratory function - change frequently - helps prevent atelectasis - helps mobilize secretions - upright, unsupported position is optimal
44
cough and deep breath
- helps keep airways clear - nursing intervention - cough every 2 hours - deep breathing increases air to the lower lobes of the lungs
45
chest physiotherapy
- mobilize pulmonary secretions
46
postural drainage
- lay on unaffected side to promote drainage of one particular lobe
47
chest percussion
- used frequently in those with chronic diseases - neuromuscular conditions - cystic fibrosis
48
suctioning
- indicated when patients cannot clear secretions on their own through coughing or CPT
49
suctioning
- indicated when patients cannot clear secretions on their own through coughing or CPT
50
incentive spirometer
- promotes lung expansions through deep breathing - prevents or treats atelectasis
51
oxygen therapy
- prevent or relieve hypoxia - gives oxygen at higher concentration than our ambient air (21%) - must have healthcare order to administer
52
oxygen therapy guidelines
- can delegate to CNA to apply nasal cannula, oxygen mask - nurse must assess respiratory system, response to therapy, setup, adjustment responses
53
nasal cannula
- 1-6L/min 22-44% - safe and well tolerated - FiO2 can very, skin breakdown, tubing dislodges - use humidification if greater than 4L of flow
54
simple face mask
- 6-12L/min 33-55% - best for short periods, transportation - not great for claustrophobic patients, skin breakdown, higher risk of aspiration - assess for fit, watch for aspiration
55
partial rebreather mask
- FiO2: 6-11 L/min; 60-75% - used for short periods of dyspnea or other increased oxygen needs - rebreather up to 1/3 of exhaled air - helps with humidification - keep reservoir bag partially inflated - watch for aspiration and assess every hour
56
non-rebreather mask
- higher non-invasive oxygen delivery - FiO2: 10-15 L/min; 80-95% - best for patient in critical need of oxygen - watch for aspiration and assess every hour
57
venturi mask
- FiO2: 4-12 L/min; 24-60% - provides the ability to deliver precise oxygen concentration with humidity - not preferable for long periods of time - used for patients who need highly regulated oxygen concentrations (chronic lung disease)
58
face tent (aerosol mask)
- fits loosely around face and neck - 24-100% oxygen - provides relatively high humidity - post-operative
59
oxygen humidification
- prevents drying out of mucous membranes - use with oxygen greater than 4LPM or greater than 24 hours supplemental oxygen
60
complications of oxygen therapy
- drying effects of respiratory mucous membranes - oxygen toxicity - skin breakdown
61
artificial airway
- inserted in a patient who may or may not be breathing on their own
62
tracheostomy tube
- plastic or metal tube that fits through a stoma in the neck
63
trach indications
- acute airway obstruction - airway protection - facilitate removal of secretions - prolonged intubation
64
shiley trach
- plastic, short-term - disposable inner canula, cuff, obturator
65
Jackson trach
- metal, long-term - reusable inner canula, no cuff, obturator
66
purpose of trach cuff
helps create a snug fit in trachea - prevent aspiration - help ventilator give stronger breaths
67
inflated cuffs
- patient mechanically ventilated - inflation specifically ordered by physician
68
dangers of prolonged or over-inflation of cuff
- increased mucosal pressure - causing ischemia - softening cartilage - mucosal erosion
69
Passy-muir speaking valve
- cuff is deflated when in use - do not use if in respiratory distress
70
nursing problems for patient with a trach
- ineffective airway clearance - impaired verbal communication - risk for infection - impaired swallowing - body image disturbance - anxiety - pain

NUR333 (6 decks)

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