Respiratory Flashcards
(113 cards)
1
Q
Acidosis Manifestations
A
Alterations in cardiac contractions, decreased vascular response to catecholamines, decreased response to certain medications, decreased LOC
2
Q
Alkalosis Manifestations
A
Impaired neuro and muscular function, muscle twitches, tingling sensations, nervousness
3
Q
PaO2 measures
A
the pressure of O2 dissolved in the blood and how O2 moves from airspace of lungs into the blood
4
Q
PaCO2 measures
A
the pressure of CO2 dissolved in the blood and how it is able to move out of the body
5
Q
pH measures
A
hydrogen ions in the blood
6
Q
HCO3 (bicarb) measures
A
the bicarbonate buffer that keeps pH from becoming too acidic/basic
7
Q
HCO3 (bicarb) measures
A
the bicarbonate buffer that keeps pH from becoming too acidic/basic
8
Q
pH normal range
A
7.35-7.45
9
Q
PaCO2 range
A
35-45
10
Q
HCO3 normal range
A
22-26
11
Q
Common ABG draw sites
A
Radial, brachial, femoral
12
Q
pH abnormal values
A
<7.35 is acidosis, >7.45 is alkalosis
13
Q
CO2 abnormal values
A
<35 is alkalosis, >45 is acidosis
14
Q
HCO3 abnormal values
A
<22 is acidosis, 26 is alkalosis
15
Q
PaCO2 indicates the _____ of the ____
A
efficiency; lungs
16
Q
HCO3 is an indicator of the _____ component of the _____
A
metabolic; kidneys
17
Q
ROME acronym
A
Respiratory opposite, metabolic equal
18
Q
Metabolic acidosis s/s
A
confusion, drowsiness, N/V, low BP, clammy skin, headache, Kussmaul’s breathing, coma
19
Q
Kussmaul’s respirations
A
result of metabolic acidosis; deep, rapid, labored breathing
20
Q
metabolic acidosis values (pH and CO3)
A
pH <7.35, HCO3 <22
21
Q
metabolic acidosis treatment
A
administer bicarb IV, dialysis if R/T kidney failure
22
Q
Respiratory acidosis values
A
pH <7.35, PCO2 >45
23
Q
Respiratory acidosis causes
A
Inadequate ventilation, airway obstruction, pulmonary edema, chest trauma, drug OD
24
Q
Respiratory acidosis S/S
A
increased pulse and BP, mental cloudiness
25
Respiratory acidosis treatment
Improve ventilation; bronchodilators, suctioning, adequate hydration
26
Metabolic alkalosis values
pH >7.45, HCO3 >26
27
Metabolic alkalosis causes
Loss of gastric juices per vomiting or NG suction, overuse of antacids
28
metabolic alkalosis s/s
tingling in fingers and toes, dizziness, lethargy, weakness, muscle twitching, cramps, tetany, decreased BP and gastric motility
29
metabolic alkalosis treatment
restore fluid volume with NaCl containing fluids (kidneys absorb NaCl allowing excretion of bicarb)
30
respiratory alkalosis values
pH >7.45, PCO2 <35
31
Respiratory alkalosis causes
hyperventilation, anxiety, high altitudes
32
respiratory alkalosis s/s
light headedness, numbness and tingling, tinnitus, restlessness, n/v, dysrhythmias
33
respiratory alkalosis treatment
breathe into a paper bag; retention of CO2
34
acidosis pathophysiology
increase in plasma H+ concentration resulting in depression of the nervous system
35
alkalosis pathophysiology
decrease in plasma H+ concentration resulting in over excitability of the nervous system
36
Pneumonia definition
inflammation of the lung parenchyma
37
Types of pneumonia
CAP (community), HAP (hospital), VAP (ventilator), aspiration
38
CAP pneumonia
within the first 48 hours of hospitalization, most common in patients under 60
39
leading bacteria causing CAP
H. influenzae
40
Pneumonia HAP
onset of symptoms occurs more than 48 hours after admission
41
HAP pneumonia bacteria
E. coli, Klebsiella, MRSA
42
Aspiration pneumonia
pulmonary consequences of entry of substances into lower airway
43
Aspiration pneumonia causes
normal bacteria from upper airway, gastric contents, chemicals, gases, foods
44
Pneumonia clinical manifestations (age dependent consideration)
Fever, pain, cough with blood or thick sputum, tachypnea, orthopnea, cyanosis
45
Pneumonia breath sounds
diminished, absent, adventitious
46
Adventitious sounds
crackles (rales), wheezes, gurgles (rhonci), friction rub
47
Pneumonia geri considerations
May be primary problem or complication of chronic illness (ex: COPD), classic s/s may be mission, general deterioration, abdominal symptoms, confusion, weakness, much higher rate of mortality
48
Pneumonia medical management
Antibiotic (culture dependent), oxygen, antipyretics, antitussives, antihistamines, hydration, respiratory therapy, rest
49
COPD types
Chronic bronchitis and emphysema
50
Bronchitis (acute) definition
inflammation of the bronchial tree often following an URTI
51
Bronchitis (acute) S/S
mucous in sputum, noisy inspirations, sternal soreness from coughing, fever, general malaise
52
Bronchitis (acute) treatment
(symptomatic treatment) cool steam inhalation, increased fluid intake (2-3L/24 hours), bedrest, antibiotics after sputum culture
53
Bronchitis (chronic) s/s
productive cough lasting minimum of three months a year for two or more consecutive years, hx of frequent respiratory infections, common cigarette smoke or pollution exposure
54
Bronchitis (chronic) diagnosis mechanisms
ABGs, x-ray, pulmonary functions testing (shows a decrease in vital capacity and forced expiratory volume)
55
Bronchitis (chronic) treatment
bronchodilators, postural drainage, increase fluids 2-3L/24 hours, rest, corticosteroids if client fails to respond
56
Emphysema (definition/explanation)
Alveolar walls are destroyed, leading to permanent distention of airspaces, increased WOB because there is decreased functional tissue
57
Emphysema S/S
Progressive dyspnea on exertion, thin client, tachypnea with prolonged expiration, anterior/posterior chest diameter enlarged (Barrel chest), accessory muscle use
58
Emphysema Treatment
bronchodilators and steroids, oxygen (1-3L -- be careful not to use too much because it can obliterate respiratory drive), moist mucous membranes, cluster NSG care, pursed lip breathing
59
Asthma pathophysiology
chronic inflammatory process and disorder of the bronchial airways characterized by episodes of bronchospasm and narrowing of airways
60
Asthma S/S
Dyspnea, cough, chest tightness, nasal flaring, pursed lip breathing, expiratory wheeze, anxiety
61
Status asthmatics duration
over 24 hours
62
status asthmatics definition
acute episode of asthma, life threatening complication with severe bronchospasms, paradoxical pulse, hypoxemia, acidosis, and can cause cardiac arrest
63
Asthma treatment: SABA (strong acting beta agonists)
Albuterol, Xopenex, Maxair
64
Asthma treatment: anticholinergics
Atrovent
65
Asthma treatment: Anti-inflammatory
Corticosteroid (ex: prednisone)
66
Asthma treatment: Bronchodilators
Long acting beta agonists (Advair), theophylline
67
Asthma treatment: Leukotriene modifiers
Singular
68
Asthma treatment (non pharm)
Low dose O2, hydration, energy conservation, maintain patent airway, maintain effective gas exchange
69
Asthma treatment for ineffective bronchodilators
Nebulizer of atropine sulfate or epinephrine, Theophylline IV or steroids IV
70
TB test results are read within ____ Hours
48-72
71
What can cause a false positive in a TB test?
BCG vaccination
72
Tuberculosis is cause by
mycobacterium tuberculosis
73
TB affects the
lung parenchyma
74
Risk factors for TB
poverty, malnutrition, living in close quarters, inadequate healthcare
75
Tuberculosis pathophysiology
First time infection is "primary" and then cells undergo the process of necrotic degeneration
76
What happens to the lung tissue when TB has invaded?
It grows tubercules that liquify masses of dead WBC and the invading bacteria. (those then heal over time after being coughed up but leave scar tissue)
77
Reasons for TB reinfection
Advanced age, HIV, malnutrition, alcoholism, institutionalized, severe disease states (immunosuppression)
78
Only definitive diagnostic TB test
sputum
79
Medications for TB
isoniazid, rifampin, streptomycin, pyrazinamide
80
TB treatment includes ___ antibiotics
multiple (R/T killing any resistant organism)
81
Patient is non-infectious after TB after ___ weeks of starting medication
2-3
82
Lung Abscess causes
aspiration, mechanical or functional obstruction, infections that result in necrosis
83
Lung abscess S/S
Fever, chills, pleuritic pain, cough, copious sputum (foul or bloody), decreased breath sounds, dullness to percussion, friction rub over affected area, crackles as abscess drains
84
Lung Abscess diagnosis
CXR, CT scan, sputum, bronc
85
Lung Abscess treatment
antibiotics, therapeutic bronc, postural drainage, frequent mouth care, high calorie and high protein diet, lobectomy
86
Pleural Effusion causes
CHF (usually w/o pleuritic pain), Liver/renal failure, infections, TB, lupus, arthritis, cancer, trauma, lymphatic obstruction
87
Pleurisy is inflammation of the
pleurae (parietal and visceral layers of the lungs)
88
____ pleura has nerve endings
parietal
89
_____ pleura does not have nerve endings
visceral
90
Pleurisy s/s
pleuritic pain, sharp, severe, knifelike on one side and felt suddenly with deep inspiration, sneezing, and coughing
91
Pleurisy medical management
Treat the pain and find underlying cause
92
Pleural effusion primary diagnostic test
Thoracentesis to remove excess fluid, obtain specimen and relieve dyspnea
93
Pleural effusion is a _____ of _____ in the _____ space
collection, fluid, pleural
94
Pleural effusion s/s
SOB, lies/sites in position of comfort, decreased chest wall excursion, dry and non-productive cough, pleurisy (pain), dull percussion
95
Respiratory medications (list of types)
Bronchodilators, antihistamines, expectorants, cough suppressants
96
List of bronchodilators
Albuterol, ipratropium, metaproteranol, aminophylline, theophylline
97
List of antihistamines
vistaril, atropine, Benadryl, phenergan, epinephrine
98
list of expectorants
Robitussin (guiafenesin), mucinex
99
List of cough suppressants
codeine, dextromethorphan
100
List of antifungals
Diflucan, amphotericin B
101
List of corticosteroids
Hydrocortisone (IV) prednisone (PO) dexamethasone (inhaler)
102
Nursing precautions for corticosteroids
take PO steroids with food, don't skip or alter doses, don't stop taking suddenly
103
Potential long term problems with corticosteroids
cataracts, osteoporosis, ulcers
104
Fremitus definition
vibrations felt with speech
105
bronchophony definition
voice sounds over a consolidated lung
106
ego phony definition
change in the sound of "e" as in bee to "a" as in say when auscultated
107
Resonance lung sound
heard over normal lungs, usually low pitched
108
hyper resonance lung sounds
low pitched but lower than normal, heard over hyper-inflated lungs
109
Flat Percussion sound
High pitched with soft quality, heard over dense tissue where there is no air
110
Dull percussion sound
medium pitch, heard where there is a combination of solid and fluid-filled area
111
tympany percussion sound
drum-like and heard from a gas filled area as well as a pneumothorax
112
Best time of the day to get a sputum sample is the
morning
113
optimal pH range for most life
6.2-8.5
