Respiratory Flashcards
(161 cards)
1
Q
reflex, irritation in URT - removing irritant
A
sneezing
2
Q
severe SOB & coughing attacks at night
A
paroxysmal nocturnal dyspnea
3
Q
PFT & spirometry
measures…
A
pulmonary function test
pulmonary volumes & airflow times
4
Q
FEV
measures…
A
forced expiratory volume
how much air a person can forcibly exhale
5
Q
FEV1
A
amt of air exhaled in first second
6
Q
FVC
measures…
A
forced vital capacity
amt of air exhaled during FEV test
7
Q
TLC
measures…
A
total lung capacity
amt of air in lungs at max inspiration
8
Q
exercise tolerance test measures…
A
ability of lungs & heart to supply O2 & remove CO2 before, during, after exercise
9
Q
peak flow meter measures…
A
how well air moves out of lung
10
Q
smooth & even respirations
E > I
A
eupnea
11
Q
rapid superficial breathing
regular or irregular
A
tachypnea
12
Q
slow, deep RR
regular rhythm
A
bradypnea
13
Q
cessation of breathing
A
apnea
14
Q
increased depth of breathing
regular rate & rhythm
A
hyperpnea
15
Q
periods of apnea alternating with climbing & falling respiratory cycles
A
Cheyne-Stokes respirations
16
Q
periods of apnea alternating with shallow breaths of equal depth
A
ataxic breathing
17
Q
deep, regular sighing respirations
high RR
A
Kussmaul respirations
18
Q
long, gasping inspiration
short, inadequate expiration
A
apneusis
19
Q
long, ineffective expiration
shallow
increased RR
A
obstructed breathing
20
Q
brief & inadequate respiratons
labored gasping or snorting
during or following cardiac arrest, CVA
A
agonal
21
Q
high pitched continuous musical sound
I and/or E
narrowed airway
A
wheezes
22
Q
“sonorous wheeze”
deep, low rumbling
respiratory secretions
A
rhonchi
23
Q
high pitched, discontinuous, intermittent popping sounds
heard during early inspiration
air forced through passage/alveoli narrowed by pus, mucus, fluid
A
crackles/rales
24
Q
fine crackles heard during…
A
late inspiration
25
coarse crackles heard during…
early inspiration
26
high pitched monophonic inspiratory wheezing
loudest over anterior neck
partially obstructed URT
stridor
27
low pitched grating noise
I and E
rough, inflamed or scarred pleura rub against one another
pleural friction rub
28
Passage of foreign material into trachea & lungs
aspiration
29
aspiration of gastric acid
chemical pneumonitis
30
aspiration of oral/pharyngeal bacteria
aspiration pneumonia
31
exogenous lipid pneumonia
aspiration of oil
32
aspiration of an object
foreign body aspiration
33
3 populations most affected by aspiration
premature babies
college age people who binge drink
dysphagia pts
34
s/s of aspiration (11)
*coughing; fever*
wheezing
stridor
hoarseness
nasal flaring
chest retraction
chest discomfort
cyanosis
pulmonary edema
resp distress syndrome
35
excess fluid in pleura
increased pressure on lungs
pleural effusion
36
etiology of pleural effusion (2)
↑ fluid production
↓ fluid absorption
37
r/f for pleural effusion (5)
CHF
kidney failure
PE
trauma
infection
38
s/s of pleural effusion
*dyspnea*
chest pain
tachypnea
tachycardia
percussed dullness
absence of breath sounds over area
tracheal deviation
hypotension
39
collapsed lung
alveoli deflated
little/no gas exchange
atelectasis
40
atelectasis uni/bilateral
unilateral (usually)
41
etiology of atelectasis (3)
airway blockage
pressure on lung
↓ surfactant
42
r/f for atelectasis (5)
*obesity*
general anesthesia
OSA
lung disorders
resp distress syndrome
43
s/s of atelectasis (5)
*dyspnea; cough*
tachycardia
chest pain
cyanosis
44
collapsed lung
may be open, closed, tension
pneumothorax
45
etiology of closed pneumothorax (3)
spontaneous
idiopathic
ruptured emphysematous bleb
46
etiology of open, tension pneumothorax
puncture wound
47
s/s of pneumothorax
s/s of 3 types
increased, labored respirations; dyspnea; tachycardia; pleural pain; asymmetrical chest movement
* _Closed_ - absent breath sounds; hypoxemia
* _Open_- “sucking” noise; tracheal swing; ↓ BP; moderate hypoxemia
* _Tension_ - absent breath sounds; tracheal deviation to unaffected side
48
tx for open pneumothorax
protect wound
as wound starts to heal, cover with 3-sided bandage so air can move out, but not into lung
49
tx for tension pneumothorax
needle decompression
chest tube to keep pressure from returning
50
Portion of ribcage removed from part of chest wall
flail chest
51
complications of flail chest (6)
hypoxia
pneumothorax
hemothorax
pulmonary contusion
pneumonia
atelectasis
52
URI most likely type of pathogen
virus
53
r/f for URI (6)
*smoking*
young age
chronic disease
altered immune system
stress
crowding
54
s/s of URI (9)
*cough*
congestion
runny nose
sinus pressure
excessive mucus
sore throat
mild fever
body aches
itchy eyes
55
influenza season
Oct - March
56
inflammation/swelling of epiglottis
epiglottitis
57
epiglottitis mostly caused by…
*Haemophilus influenzae* bacteria
58
r/f for epiglottitis (3)
male
unvaccinated
immunocompromised
59
s/s of epiglottitis
*fever*
sore throat
stridor
painful swallowing
drooling
anxiety
**leaning forward** (instinctively protecting airway from saliva)
60
interventions for epiglottitis
do NOT look in pt's mouth or ask pt to open their mouth
keep them leaning forward
61
complications of epiglottitis (4)
meningitis
abscess
pneumonia
death with airway obstruction
62
immunization for epiglottitis
Hib vaccine series for babies
63
Bronchioles infection only in children
bronchiolitis
64
most likely pathogen causing bronchiolitis
viral
*Human metapneumovirus* (HMPV)
65
r/f for bronchiolitis (7)
child
heart or lung condition
2nd hand smoke
never been breastfed
crowding
siblings
daycare
66
s/s of bronchiolitis (5)
*cough; fever*
rhinitis
stuffy nose/congestion
wheezing
67
complications of bronchiolitis (4)
dehydration
hypoxia
apnea
cyanosis
68
infection of alveoli
pneumonia
69
r/f for pneumonia (5)
*older age; smoking*
recent hospitalization
chronic illness
immunosuppressed
70
s/s of pneumonia (7)
*fever; fatigue; cough; dyspnea*
chest pain
nausea
confusion in older pts
71
immunizations for pneumonia
which populations are they for
* _PCV13_ - \<2yo
* _PCV23_ - \>65yo OR smokers \>19yo
72
Infection by *Histoplasma capsulatum* fungus found in bird & bat feces in humid areas
histoplasmosis
73
histoplasmosis mode of transmission
inhaling fungal spores
74
3 forms of histoplasmosis
* Acute primary
* Chronic cavitary
* Progressive dissemination
75
r/f for histoplasmosis
age \<2 or \>55
weak immune system
being around caves, barns
76
s/s of histoplasmosis (10)
*fever*
myalgia
chest pain
malaise
pneumonia
pulmonary lesions
worsening cough and dyspnea
hepatomegaly
lymphadenopathy
wt loss
77
complications of histoplasmosis (2)
meningitis
Addison's disease
78
encapsulated TB on chest x-ray
latent TB
79
latent TB may become active if…
immune system is weakened/compromised
80
r/f for TB (6)
close contact c infected
immunocompromised
homelessness
close quarters (prison, shelters etc)
drug/alcohol abuse
occupation
81
s/s of TB (7)
*fever; fatigue; cough*
wt loss
hemoptysis
night sweats
chills
82
immunization for TB
BCG vaccine
not used in USA
83
difficulty exhaling
obstructive disorders
84
difficulty inhaling
restrictive disorders
85
etiology of OSA in adults & children
* _Adults_ - tongue and throat relax, soft tissue at back of throat blocks airway
* _Children_ - large tonsils/adenoids in upper airway
86
r/f for OSA (7)
*obesity; DM; smoking; family hx*
male
asthma
narrow airway
87
s/s of OSA (7)
snoring
noisy breathing
tiredness after sleeping
morning h/a
dry mouth
waking gasping for air
observed apneic spell
88
A gene changes in a protein regulating salt movement
causes a thick, sticky mucus in resp, GI, reproductive systems
cystic fibrosis
89
best for these patients not to gather together
because…
CF
can pass resistant forms of bacteria to one another - less capable of getting rid of them
90
s/s of CF (9)
persistent cough
wheezing
chronic/resistant infection
exercise intolerance
steatorrhea (fat in stool)
poor wt gain
intenstinal blockage
constipation
salty sweat
91
steatorrhea indicates…
CF
92
genetic condition that increaes risk for contracting a resistant infection
CF
93
tx for CF
percussion to help clear airways
94
avg CF lifespan
37 years
95
Chronic, intermittent
overresponse of immune system to an allergen
inflames & narrows airways in lungs
excessive production of mucus
remodelling of airways
asthma
96
r/f of asthma (6)
*family hx; obesity*
male
African American
exposure to toxins
poverty (exposed to more triggers)
97
which populations is asthma more common in?
males
African Americans
in poverty
98
s/s of asthma (7)
*cough; dyspnea*
chest tightness
nighttime coughing
wheezing
use of accessory muscles
↓ O2 sat
99
common asthma triggers
danders; cockroach droppings; viral illness; smoking; pollutants; physical activity
100
2 diseases included in COPD
emphysema
chronic bronchitis
101
“pink puffer”
emphysema
102
“blue bloater”
chronic bronchitis
103
overinflation of alveoli
emphysema
104
chronically inflamed bronchi produce excessive mucus
chronic bronchitis
105
etiology of emphysema
irreversible breakdown of alveolar walls
permanent holes in lower lung tissue
106
etiology of chronic bronchitis
repeated irritation/damage to airways
107
major risk factor/cause of emphysema
smoking
108
other r/f for COPD besides smoking
exposure to toxins
109
EMPHYSEMA OR CHRONIC BRONCHITIS
rhonchi & wheezing
CB
110
EMPHYSEMA OR CHRONIC BRONCHITIS
diminished lung sounds
emphysema
111
EMPHYSEMA OR CHRONIC BRONCHITIS
excessive sputum
both
112
EMPHYSEMA OR CHRONIC BRONCHITIS
hypercapnia
both
113
EMPHYSEMA OR CHRONIC BRONCHITIS
pursed lip breathing
emphysema
114
EMPHYSEMA OR CHRONIC BRONCHITIS
cyanosis
CB
115
EMPHYSEMA OR CHRONIC BRONCHITIS
hyperresonance
emphysema
116
EMPHYSEMA OR CHRONIC BRONCHITIS
orthopnea
emphysema
117
EMPHYSEMA OR CHRONIC BRONCHITIS
thin with barrel chest
emphysema
118
EMPHYSEMA OR CHRONIC BRONCHITIS
overweight
CB
119
EMPHYSEMA OR CHRONIC BRONCHITIS
prolonged expiratory time
emphysema
120
EMPHYSEMA OR CHRONIC BRONCHITIS
tachypnea
both
121
EMPHYSEMA OR CHRONIC BRONCHITIS
anxiety, fatigue, short sentences
emphysema
122
EMPHYSEMA OR CHRONIC BRONCHITIS
use of accessory muscles to breath
both
123
EMPHYSEMA OR CHRONIC BRONCHITIS
hypoxia, cyanosis, clubbing
CB
124
EMPHYSEMA OR CHRONIC BRONCHITIS
recurrent productive cough (daily for more than 3 months)
CB
125
EMPHYSEMA OR CHRONIC BRONCHITIS
cardiac enlargement
CB
126
EMPHYSEMA OR CHRONIC BRONCHITIS
peripheral edema
CB
127
2 restrictive lung disorders
chest wall abnormality
pulmonary fibrosis
128
chest wall abnormality etiology examples
kyphosis; scoliosis; poliomyelitis; ALS; botulism; muscular dystrophy
129
Chronic, progressive
alveoli become scarred & stiff
makes gas exchange difficult/impossible
pulmonary fibrosis
130
s/s of pulmonary fibrosis (6)
*dyspnea; cough*
clubbing
wt loss
myalgia
rapid shallow breathing
131
Fluid accumulates in tissue & alveoli of lungs, making gas exchange difficult
pulmonary edema
132
etiology of pulmonary edema
left-sided HF
133
r/f for pulmonary edema (7)
*DM; obesity; HTN; HLD*
HF
medications
IV fluids
134
s/s of pulmonary edema (12)
*dyspnea*
coughing frothy pink sputum
feeling like suffocating (especially lying)
wheezing
orthopnea
cold clammy skin
tachycardia
irregular heartbeat
palpitations
anxiety
cyanosis
death
135
blood clot blocks artery in lungs
pulmonary embolism
136
r/f for PE (10)
*smoking; HTN; obesity*
clotting disorder
**pregnancy/30-60 days postpartum**
oral contraceptive
arrhythmia
**surgery**
injury
**decreased mobility**
137
s/s of PE (6)
*dyspnea; weakness*
**sudden onset**
severe chest pain
hemoptysis - usually frank blood
syncope
dizziness
138
vessels in lungs blocked or destroyed leading to increased BP
pulmonary HTN
139
pulmonary HTN affects…
lungs
right side of heart
140
etiology of pulmonary HTN (5)
vessel destruction
left side HF
lung disease
chronic PE
comorbidities
141
r/f for pulmonary HTN (5)
*family hx; obesity*
medications
high altitudes
congenital CV diseases
142
s/s of pulmonary HTN (10)
*dyspnea; fatigue*
dizziness
syncope
chest pain
edema
ascites
palpitations
tachycardia
cyanosis
143
surfactant deficiency in neonates
infant respiratory distress syndrome
144
first 30 days of life
neonate
145
r/f for IRDS
prematurity
146
s/s of IRDS
rapid labored breathing
grunting
visible ICS (suprasternal & substernal retractions)
flaring of nostrils
lethargy
cyanosis
irregular breathing
apnea
cardiac failure
147
fluid builds up in alveoli from response of immune system
acute respiratory distress syndrome
148
etiology of ARDS
damaged membrane between alveoli & blood vessels
149
r/f for ARDS (6)
hospitalization
sepsis
smoke inhalation
pneumonia
injury
underlying disease
150
tx for ARDS
ventilation
151
most cancer deaths/year in US caused by…
lung cancer
152
2 types of lung cancer
small cell
non small cell
153
small cell lung cancer occurs in…
heavy smokers
154
localized small cell prognosis
56%
155
localized non small cell prognosis
16%
156
metastasized lung cancer prognosis
16%
157
pack life =
packs/day x years person has smoked
158
screening for lung cancer
low-dose computed tomography (LDCT) for people 55-80yo with a 30-year hx and have smoked in the last 15 years
159
after ___ years of not smoking, the risk for lung cancer is the same as someone who never smoked
15
160
5 A's of encountering a smoker patient
* Ask pt if they use tobacco products
* Advise pt that smoking is bad for them
* Assess willingness to quit smoking
* Assist pt in quitting
* Arrange a follow up evaluation for pt
161
abnormal heart sound associated with pulmonary HTN
split S2
