PULMO Flashcards
(153 cards)
1
Q
Number of respiration per minute
A
RATE
2
Q
12-21 bpm
A
Normal Rate
3
Q
<12 bpm
A
Bradypnea
4
Q
> 21 bpm
A
Tachypnea
5
Q
Give medication (MAMCHOB) at what rate
A
> 16 bpm
6
Q
DO NOT give medication at what rate
A
< 16 bpm
7
Q
To promote maximal lung expansion
A
BODY POSTURE
8
Q
Normal for Body Posture
A
High fowlers/Sitting position
9
Q
For COPD
A
Tripod/Orthopneic position
10
Q
For Seizure
A
Side-Lying Position
11
Q
Objective sign for Seizure
A
Frothy secretions
12
Q
For Unconscious
A
Side-Lying Position
13
Q
1 cause of airway obstruction
A
Tongue
14
Q
Strongest Substance in the body
A
Enamel
15
Q
Strongest bone(s)
A
Tibia and Femur
16
Q
Strongest muscle that can carry without any leverage
A
Tongue
17
Q
Medications that can decrease RR or known as downers
A
MAMCHOB Morphine Alcohol Meperidine Codeine Heroin Opiates Barbituates/Benzodiazepine
18
Q
Nursing Diagnosis for < 8 RR
A
Ineffective Breathing Pattern
19
Q
Nursing Diagnosis for with Phlegm
A
Ineffective Airway Clearance
20
Q
Nursing Diagnosis for O2 sat <45%
A
Ineffective Gas Exchange
21
Q
Regularity of respiration
A
RHYTHM
22
Q
Normal Rhythm
A
Eupnea
23
Q
Short period of apnea
A
Cheyne-stokes Respiration
24
Q
Seen in patients with head injuries, cerebral hemorrhage, when crying (for normal individuals)
A
Cheyne-stokes Respiration
25
Involves crescendo-decrescendo pattern of respiration
Cheyne-stokes Respiration
26
Hyperventilation due to metabolic acidosis
Kausmaul's Respiration
27
Clustered severe depressed breathing
Biot's Respiration
28
Long period of apnea (greater than 30 seconds of apnea)
Biot's Respiration
29
Worst prognosis and can be seen in dying patients or overdose of narcotics
Biot's Respiration
30
Sound and effort of breathing
QUALITY
31
Normal quality
Soundless and effortless
32
Vase of the lungs; loudest due to decrease airway size
Vesicular
33
In the Bronchus; in between, there can be loud/soft sound
Bronchovesicular
34
In the Trachea; soft (mahina) due to increase airway size
Tubular
35
Soft whistling (sounds musical)
Wheezes
36
Wheezes can be heard through?
Heard during Exhalation and through clinical ears
37
Cause of Wheezes
Due to bronchoconstriction which is common in asthma patients
38
Harsh, loud sound
Stridor
39
Functions of the respiratory system
1. Provides oxygen for metabolism
| 2. Maintains acid-base balance
40
Stridor can be heard through?
Heard during Inhalation and through clinical ears
41
Cause of Stridor
Happens due to airway edema
42
Airway is still open
Longer stridor
43
Airway closed
Absence of stridor
44
If airway is closed, what should be done?
Tracheostomy is needed ASAP to open airway
45
Popping sound
Crackles
46
Crackles can be heard through?
Heard ONLY through auscultation
47
Cause of Crackles
Due to fluid-filled lungs/alveoli which is common in patient with pulmonary edema and left-sided heart failure
48
Grating sound of 2 inflamed pleura
Pleural Friction Rub
49
Pleural Friction Rub can be heard through?
Heard through auscultation
50
Cause of Pleural Friction Rub
Due to pleurisy which is common with a patient with pneumonia or water in lungs
51
Loud, phlegmatic sound
Ronchi
52
Ronchi can be heard through?
Either through inhalation/exhalation and through clinical ears/auscultation
53
Cause of Ronchi
Due to excessive secretion; sputum in airway which are common in patients with COPD or smokers
54
The respiratory system only expels excess CO2 upon exhalation, and not the entire CO2. Why?
We still need a little bit of CO2 in our lungs because it is the drive for breathing.
55
What are the types of cells seen in alveoli?
Type 2 Alveolar Cells
56
What are the functions of Type 2 Alveolar cells
They secrete surfactants which reduces the surface tension of alveoli
57
What happens if there are is decreased surfactant secretion in the Type 2 alveolar cells?
No reduction of surface tension, which leads to alveolar collapse
58
Two Types of Breathing
Costal breathing
| Diaphragmatic breathing
59
Type of breathing in adolescents of adults
Costal breathing
60
Type of breathing in babies; it is abdominal breathing
Diaphragmatic breathing
61
The 4 regulators of respiration
1. Medulla Oblongata
2. Pons
3. Baroreceptors
4. Proprioceptors
62
This is the primary regulator of respiration.
Medulla oblongata
63
Responsible for initiation, proper rhythm, depth and rate of breathing.
Medulla Oblongata
64
Two centers found/Two functions in the pons
Pneumotaxic center and apneustic center
65
This center of the pons is responsible for the cessation of breathing
Pneumotaxic center
66
This center of the pons is responsible for the detection of apnea, and stimulates deep long inspiration
Apneustic
67
It detects pressure
Baroreceptors
68
Hallmark of Pleural Friction Rub
Pleurisy; pain during inhalation
69
3-way bottle system
CLOSED TUBE TRACHEOSTOMY (CTT)
70
1st bottle
Drainage bottle
71
2nd bottle
Daterseal bottle
72
3rd bottle
Suction bottle
73
Removal of fluid, pus, air or blood in the patient
CLOSED TUBE TRACHEOSTOMY (CTT)
74
Transfer of fluid from one portion to the other
CLOSED TUBE TRACHEOSTOMY (CTT)
75
Suction bottle
Continuous bubbling
76
Drainage bottle
No bubbles/ bubbling, straight from the pleural cavity of the patient
77
Waterseal bottle
Intermittent bubbling
78
2 Conditions in waterseal bottle
Continuous bubbling & No bubbles
79
Is continuous bubbling normal or abnormal?
Abnormal
80
Cause of the continuous bubbling
leakage
81
Effect of continuous bubbling
pneumothorax
82
Bubbling
Suction bottle, Drainage bottle, and Waterseal bottle
83
Oscillation
Rise (inhale) and fall (exhale) of H2O in the waterseal
84
Oscillation
Best way to know that the 3-way bottle system is working
85
Anatomical position, location and lung appearance
Chest X-ray
86
To identify the organism in the sputum
Sputum Specimens
87
approximate mL of sputum
15 mL
88
Removal of fluid, pus, air or blood in the patient
CLOSED TUBE TRACHEOSTOMY (CTT)
89
Aspiration/ removal of fluid, pus, air or blood from the pleural cavity
THORACENTESIS
90
Actual direct visualization and examination of larynx, trachea, bronchi with fiberoptic bronchoscope
LARYNGOSCOPY & BRONCHOSCOPY
91
What test should be done to patient with tracheal injury
LARYNGOSCOPY & BRONCHOSCOPY
92
```
Before thoracentesis:
Informed consent should be
obtained by __
served by __
given by __
```
MD
nurse
patient
93
If expectoration of blood:
| Immediate action/ Primary RN: Notify the MD → due to __
Perforation of lungs (Pneumothorax)
94
deadliest complication; absence of breath sounds
Pneumothorax
95
Transfer of fluid from one portion to the other
CLOSED TUBE TRACHEOSTOMY (CTT)
96
continuous bubbling
Suction bottle
97
no bubbles/ bubbling
Drainage bottle
98
Waterseal bottle
Intermittent bubbling
99
2 conditions in waterseal bottle
Continuous bubbling in the water seal bottle;
| No bubbles in the water seal bottle
100
Rise (inhale) and fall (exhale) of H2O in the waterseal
Oscillation
101
If the bottle is intact:
reconnect the tube
102
If the bottle is broken:
Immerse in a new bottle
103
Normal PaCO2
35-45 mmHg
104
Determines patency of pulmonary airways and detects abnormal ventilation
VENTILATION/PERFUSION SCAN (V/Q)
105
Evaluates blood flow (perfusion) in the lungs
VENTILATION/PERFUSION SCAN (V/Q)
106
The test used to evaluate lung mechanism, gas exchange, acid base balance: thru spirometric measurements, lung volume, & ABG test
PULMONARY FUNCTION TEST
107
Used to diagnose pulmonary embolism
SPIRAL (HELICAL) CT SCAN
108
There is a scanner that rotates your body and gives you 3D picture of all the regions of your lungs
SPIRAL (HELICAL) CT SCAN
109
What to use If the patient cannot be injected with dye?
V/Q SCAN
110
Measures the dissolved O2 & CO2 in arterial blood indicating the acid-base state & how well O2 is being cared out all throughout the body
ARTERIAL BLOOD GAS (ABG)
111
Device that measures O2 saturation levels before any s/sx of hypoxemia develops
PULSE OXIMETRY
112
What to perform before procedure to assess ABG supply in hand (radial artery)
Allen’s Test
113
Normal value: pH
7.35-7.45
114
Normal value: HCO3
22-26 mg/dL
115
Normal value: PaCO2
35-45 mmHg
116
ROME:
pH: 7.30 ↓
pCO2: 61 ↑
Respiratory Acidosis
117
ROME:
pH: 7.50 ↑
PaCO2: 18 ↓
HCO3: 22 = normal
Respiratory Alkalosis
118
ROME:
pH: 7.25 ↓
HCO3: 18 ↓
Metabolic Acidosis
119
Blood test to measure clot formation and lysis (result from fibrin degradation)
D-DIMER
120
Most sensitive organ for hypoxia
Brain
121
> 5 mins without circulation
Irreversible brain damage
122
↓ RBC / ↓O2:
There's anemia (pallor)
123
(Color of O2 Tank)
| red tank:
fire extinguisher
124
(Color of O2 Tank)
| black tank:
compressed air
125
(Color of O2 Tank)
| green tank:
oxygen
126
2 types of pulse oximetry
Adhesive;
| Clips
127
Normal D-Dimer level:
≤ 250 ng/mL
128
Normal fibrinogen:
200-400 mg/dL or 2-4 g/L
129
Normal O2 Saturation:
95-100%
130
Initial sign of hypoxia
restlessness
131
To ↓ use of accessory muscles
BREATHING RETRAINING
132
promotes CO2 elimination. (Exhalation>inhalation)
Pursed lip breathing
133
How many deep breaths by pursed-lip breathing (lean forward + deep breaths)?
3-4 deep breaths
134
How many times coughing during exhalation?
3-4 times
135
Patient in sitting/upright position
Incentive Spirometry
136
End of incentive spirometry is close to the ___
Mouth
137
Advice to inhale slowly and maintain the flow rate indicator between ___
600-900 marks
138
How many seconds should the px hold his/her breathing during incentive spirometry
5 seconds
139
Best done during early morning upon rising before meals
CHEST PHYSIOTHERAPY
140
Why is chest physiotherapy best done during early morning?
to remove all secretions and not food
141
Postural drainage → Positioning
Place on unaffected side
142
Right percussion = __
popping/ booming sound
143
Receptor formed in the muscle and joints
Proprioceptors
144
What to use during percussion in chest physiotherapy
Use cupped / scoping hand with forceful strikes on the skin with a good morning towel
145
Rationale of using cupped / scoping hand with forceful strikes on the skin with a good morning towel
To prevent hurting the patient and irritation on the skin
146
Waxing and waving respiration and short periods of apnea
Cheyne-Stokes Respiration
147
Respiration with diabetic ketoacidosis
Kausmaul's Respiration
148
If the bottle is intact
reconnect the tube
149
If the bottle is broken
Immerse in a new bottle
150
Post-Thoracostomy earliest sign
↓ LOC (Loss of consciousness)
151
Allergic reaction in the airways
Asthma
152
The Causative agent of Asthma
Precipitant results to an immediate obstruction and/or late bronchial obstruction reaction
153
Precipitants of Asthma
Allergens, Irritants, Sprays, Changes in temperature, Stress, Viral URTI, Medication, Occupational - toxic materials and Food additives
