Respi

Question 1

Lifestyle affecting oxygenation

Answer 1

Obesity
Sedentary lifestyle
Cigarette smoking

Question 2

Hyperventilation

Answer 2

RR>20-) more alkalotic

Symptoms: chest pain, numbness

Question 3

Hypoventilation

Answer 3

RR<8
Causes: alcohol, medication
Symptoms: fatigue, headache

Question 4

Sneezing
Occasional cough
Persistent cough
Dry / unproductive cough
Productive cough thick mucus

Answer 4

Sneezing: reflex of irritation in the upper respiratory tract
Occational cough: okay
Persistent cough: respiratory disease
Unproductive cough: irritation of airway
Productive cough: beneficial for clearing airway
Thick mucus: difficult to raise, usually elderly

Question 5

Sputum

Answer 5

Normal: clear
Yellow: bacterial infection
Purulent viral infection
Blood-tinged: dried blood
Hemoptysis: bleeding

Question 6

Some weird respiratory

Answer 6

Cheyne-stoke: increase and decrease rr with apnea
Ataxic breathing: irregular up and down with apnea
Kussmaul respiration: deep regular sighing respiration
Apneusis: long short long short
Obstructed breathing: long & ineffective breathing with shallow, increasing respiration

Question 7

Respi assesment: ask question

Answer 7

Are you able to cough up sputum?
What is the colour of your sputum?
When did your wheezing start?
Do you have chest pain?

Question 8

Common test for respi assesment

Answer 8

Vital sign
Spirometer
Chest x-ray

Question 9

Common test for respi assesment

Answer 9

Vital sign
Spirometer
Chest x-ray

Question 10

Diagnostic test:

Answer 10

ABG test
Measures blood acidity, oxygen and co2

Bronchoscopy
Diagnose tumor or infection

Question 11

Promote oxygenation:

Answer 11

Incentive spirometer: increase lung volume

Pursed-lip breathing; improve gas exchange

Oxygen therapy: non-rebreathing mask, nasal cannula, venturi mask

Question 12

Nasal cannula

Answer 12

1-6(>4L may have drying mucosa)

Question 13

Nasal cannula

Answer 13

1-6L

Question 14

Simple face mask

Answer 14

6-10L

Question 15

Venturi mask

Answer 15

3-15L

Use colour code & adaptor

For COPD because of precise and consistent oxygen comcentration

Question 16

Non-rebreathing mask

Answer 16

For critically ill patient who need high concentration of air10-15L, must remain 1/3 inflated

Question 17

FLO2Max oxygen mask

Answer 17

30-99% oxygen
Cost effective

Question 18

Purpose of oxygen therapy

Answer 18

Improve oxygenation
Support respiratory function

Question 19

Nursing intervention for oxygen therapy

Answer 19

1. Assess sign of hypoxia, measure vital sign, spo2
2. Verify oxygen therapy device and ensure proper fit
3. Regular checking of kinking
4. Report any status to nurse

Question 20

Voluntary cough vs involuntary cough

Answer 20

Voluntary:
Induced consciously
Essential in pre and postoperative
Combine with deep breath

Involuntary:
Reflexive, usually from irritant
Cause: irritate by respiratory infection
Effect: clear up airway

Question 21

Breathing exercise

Answer 21

Sit up, slow deep breath and hold for 3 sec
3-6 cycles

Question 22

Coughing exercise: ACBT

Answer 22

Active cycle of breathing technique

1. Breathing control
2. Deep breathing exercise
3. Huffing / Forced expiratory technique

Question 23

Cough medications

Answer 23

Expectorants: clear out the respiratory secretions

Cough suppressant: depress cough reflex

Cough lozenges: relieve mild, non-productive cough

Question 24

Inhaled medications

Answer 24

Nebulizer: high flow oxygen to disperse medicine

Meter-dosed inhaler: controlled amount for each puff, close mouth technique or valved holding chamber

Dry powder inhaler: breath-activate device

Question 25

Dos and dont for using meter-dosed inhaler

Answer 25

Yes: 1. Firmly insert the inhaler into holder 2. Remove the cap amd shale for 5-15sec 3. Exhale slow and completely 4. Hold the holder up side down and seal with lips 5. Press and hold for 3-5 sec 6. Hold breath for 5-10s 7. Release the canister, remove inhaler from mouth, exhale. Dont: 1. Block the opening with tongue or teeth 2. Exhale to the mouthpiece 3. Mist or powder seen 4. Put the canister into water

Question 26

Chest physiotherapy

Answer 26

1. Posture drainage 2. Percussion 3. Vibration Help loosen & mobilise secretion Contraindication: head injury patient

Question 27

Suction 3 types

Answer 27

Nasopharynx suctioning Endotracheal suctioning Tracheal suctioning To maintain a patent airway To facilitate ventilation To remove saliva, mucus or secretion

Question 28

Contraindication of suctioning

Answer 28

Bleeding disorder Severe hypoxia Head injury, may cause cerebrospinal fluid leak

Question 29

Complication of suctioning

Answer 29

Hypoxia Atelectasis Trauma to airway Infection Arrhythmias Cough Bleeding

Question 30

Reduce risk of infection for suctioning

Answer 30

Only perform if needed Ppe shd be worn Only use sterile catheter Dont re-insert catheter Suction catheter should be discarded not rinsed

Question 31

Key for collecting specimen

Answer 31

Preparation: confirm physician’s order Patient identification: name & hospital number Aseptic technique: use proper hand hygiene and wear ppe, ensure equipments are sterile Collection method: correct technique: venipuncture / midstream urine Handling: prevent damage Document: document the collection for time, method and any changes

Question 32

Artificial airway

Answer 32

Oropharyngeal tube Nasopharyngeal tube Endopharyngeal tube Tracheostomy tube

Question 33

Oropharyngeal vs nasopharyngeal vs tracheostomy tube

Answer 33

Oro: airway obstruction cuz relaxation of upper respiratory tract Naso: patient who can spontaneously breath but have upper respi tract obstructed due to mucus Tracheostomy tube: for patient who cannot maintain airway

Question 34

Bag valve mask

Answer 34

Provide positive pressure of oxygen to patient for ventilation Bad: skill required, fitting poorly may lead to inadequate ventilation

Question 35

Prevention of respiratory infection

Answer 35

Frequent hand hygiene Use of ppe Vaccinatio Respiratory hygiene Patient education: importamce of hand hygiene