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Flashcards in Pulmonary Rehab Deck (42)
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1

What makes up the Upper and Lower Respiratory tracts?

  1. Upper
    • Nasal + Oral cavity, larynx, pharynx
    • Warms, humidifies, filters inspired air (1st line of pulmonary immune defense)
    • Mucociliary escalator - lines conducting airways ( 2nd line of immune defense)
  2. Lower 
    • Trachea, bronchi, bronchioles, and alveoli
    • Immune cells (macrophages neutrophils) complete pulmonary defense 

2

which side of the lung is more likely to be a site of aspiration?

Right

mainstem bronchus is more aligned vertically

3

what is the V/Q ratio?

Ventilation/Perfusion 

should be 0.8

 

4

Describe the associated terms for V/Q mismatch

  1. Dead space → V is in excess of Q often a result of a pulmonary embolism
  2. Shunt → Q is in excess of V, often a result of alveolar collapse or atelectasis

 

5

List various types of breathing patterns

  1. Apnea
  2. Orthopnea
  3. Bradypnea
  4. Tachypnea
  5. Hyperpnea
  6. Hyperventilation
  7. Hypoventilation
  8. Biot's respiration
  9. Cheyne-Stokes respiration
  10. Kussmaul respiration
  11. Paradoxical ventilation
  12. Sighing respiration
  13. Hoover's sign

 

6

what is hyperpnea and what diseases is it associated with?

increased depth of ventilation, associated w/CHF and pulmonary infections

7

what is Kussmaul respirations and what diseases are associted with it?

increased regular rate and depth of ventilation

associated with diabetic ketoacidosis and renal failure

8

what is paradoxical ventilation and what is it associated with?

inward abdominal or chest wall movement w/inspiration and outward movement with expiration

associated with diaphragm paralysis, ventilation muscle fatigue, chest wall trauma

9

what are sighing respirations and what are they associated with?

the presence of a sigh >2-3x/min

angina, anxiety, dyspnea

10

what are Biot's respirations and what are they associated with?

constant increased rate and depth of respiration followed by periods of apnea of varying lengths

elevated ICP, meningitis

11

What are Cheyne-Stokes respirations and what are they associated with?

Increasing depth of ventilation followed by a period of apnea

elevated ICP, CHF, narcotic OD

12

what is Hoover's sign and what is it associated with?

The inward motion of the lower rib cage during inhalation

flattened diaphragm often related to decompensated or irreversible hyperinflation of the lungs

13

what is an ABG analysis?

Arterial Blood Gases → examines acid-base balance (pH), ventilation (CO2 levels), and oxygenation (O2 levels)

  • guides med or therpay interventions, such as mechanical ventilation settings or breathing assist techniques
  • disturbances in acid-base balance can be caused by pulmonary or metabolic dysfunction

 

14

define related terms for arterial blood gasses

  1. PaO2 → partial pressure of dissolved O2 in plasma
  2. PaCO2 → partial pressure of dissolved CO2 in plasma
  3. pH → degree of acidity or alkalinity in blood
  4. HCO3 → level of bicarbonate in the blood
  5. Percentage of SaO2 → a % of the amount of hemoglobin sites filled/saturated w/O2 

 

15

List normal values for Arterial Blood Gases

  1. PaO2 → greater than 80 mmHg
  2. PaCO2 → 35-45 mmHg
  3. pH → 7.35-7.45
  4. HCO3 → 22-26

 

16

List some common respiratory dysfunction terms

  1. Air trapping
  2. Bronchospasm
  3. Consolidation
  4. Hyperinflation
  5. Hypoxemia
  6. Hypoxia
  7. Respiratory distress 

 

17

what is air trapping?

retention of gas in lungs as a result of partial or complete airway obstruction

18

what is consolidation?

transudate, exudate, or tissue replacing alveolar air

19

what is hyperinflation?

overinflation of the lungs at resting volume as a result of air trapping

20

what is hypoxemia?

a low level of oxygen in the blood, usually a PaO2 less than 60-80 mmHg

21

what is hypoxia?

a low level of oxygen in the tissues available for cell metabolism

22

what is respiratory distress?

the acute or insidious onset of dyspnea, respiratory muscle fatigue, abnormal respiratory pattern and rate, anxiety, and cyanosis related to inadequate gas exchange, the clinical presentation that usually precedes respiratory failure

23

List some pulmonary pathologies

  1. Acute Respiratory Distress Syndrome (ARDS)
  2. Pleural effusion
  3. Pneumothorax
  4. Hemothorax
  5. COPD
    • Asthma
    • Emphysema
    • Chronic Bronchitis
  6. Cystic fibrosis
  7. Atelectasis
  8. Pneumonia
  9. Pulmonary edema
  10. Flail chest 

 

24

Describe ARDS

  1. this is acute inflammation of the lungs
  2. associated w/many conditions
  3. lengthy recovery w/high mortality rate
  4. variable latent pulmonary sequale → from no impairments to mild exertional dyspnea to mixed obstructive-restrictive abnormalities 
  5. Prone positioning in the ICU helps

 

25

what are some conditions associated w/ARDS?

  1. aspiration
  2. drug toxicity
  3. inhalation injury
  4. pulmonary trauama,
  5. shock
  6. systemic infections
  7. muli-organ failure


26

how does prone positioning in the ICU assist with ARDS?

facilitates:

  1. improved aeration to dorsal lung segments
  2. improved V/Q mismatch
  3. secretion draining

 

27

what makes up the PT physcial evaluation for pulmonary patients?

  1. Pt history
  2. Inspection
  3. Palpation
  4. Ascultation
  5. Mediate percussion
  6. Cough examination

 

28

what specific things should be included in the pt history for pulmonary pts?

  1. smoking history
  2. amount of supplemental O2
  3. exposure to toxins
  4. hx of lung conditions
  5. hx of ventilatory assist
  6. episodes of dyspnea
  7. level of activity
  8. sputum production
  9. sleeping position

 

29

what should be included in the inspection of a pulmonary pt?

  1. general apperance
  2. ease of speaking
  3. skin color
  4. chest shape/posture
  5. breathing patterns
  6. digital clubbing
  7. supplemental O2
  8. superfical incisions

 

30

where should you palpate during a pulmonary exam and what things are you looking for?

palpate chest wall in cephalocuadal direction to examine the following:

  1. fremitus (vibration)
  2. pain, tenderness
  3. skin temperature
  4. bony abnormalities, fractures
  5. chest expansion and symmetry
  6. subcutaneous emphysema (bubbles popping under skin from presence of air in subQ tissue)