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2.0 Adult Nursing Exam 4 > Respiratory > Flashcards

Respiratory Flashcards

(90 cards)

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1
Q

What parts of the body are involved in the upper respiratory system?

A

Nose

Paranasal sinuses

Pharynx

Larynx

Trachea

Bronchi

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2
Q

T/F

Most upper respiratory infections and disorders are serious

A

False. Most of them are actually minor. However some of them can progress to be serious.

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3
Q

Most common upper respiratory infection?

A

Common cold that requires no treatment

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4
Q

Upper respiratory infections are the most common reason for …. (2)

A

Seeking healthcare

Absences from school/work

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5
Q

What type of infection are 90% of upper respiratory infections caused by?

A

Virus

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6
Q

Obstructive sleep apnea

A

Recurrent apnea during sleep

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7
Q

Risk factors for obstructive sleep apnea

A

Obese males

Large necks

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8
Q

Common symptom of obstructive sleep apnea

A

Snoring

Hearing periods where they aren’t breathing

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9
Q

Nursing interventions you need to do for obstructive sleep apnea patients? (2)

A

Make sure the alarm is on

Reposition the patient to maintain the airway

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10
Q

Why is repositioning a priority for patient with obstructive sleep apnea?

A

By repositioning, we are trying to maintain their airway

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11
Q

Your patient is expressing symptoms of obstructive sleep apnea but they are undiagnosed. What do you do?

A

Make a referral to physician to get RT on board and get a CPAP

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12
Q

What is a deviated septum?

A

Sideways displacement of the walls between the nostrils of the nose

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13
Q

Will your patients know they have a deviated septum?

A

Usually not

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14
Q

What is the cause of a deviated septum?

A

Nasal injury of some sort

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15
Q

If a patient does have symptoms from their deviated nasal septum, what kind would you expect?

A

Nose bleed

Mild congestion

Loud noisie breathing during sleep

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16
Q

Treatment for deviated septum patients

A

Decongestants

Antihistamines

Nasal steroids if its bad

Refer to ENT specialist if bad

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17
Q

Why are nose fractures so common?

A

Due to the location making it more susceptible. It’s bony too.

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18
Q

What can a nose fracture result in?

A

Hematoma

Infection

Abscess

Avascular or septic necrosis

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19
Q

Why are we concerned about infection with a nose fracture?

A

Bacteria growth in mucus membranes of the nose

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20
Q

Why are worried about avascular necrosis from a nose fracture?

A

Blood flow to the area is reduced with a fracture and can cause the avascular necrosis.

  • so don’t let a patient avoid the specialist
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21
Q

Epistaxis

A

Nose bleed due to rupture of tiny vessels in nose

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22
Q

What if epistaxis is frequent?

A

Go see ENT if it is frequent in order to figure out why

  • high bp could be the reason
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23
Q

A big reason why patients have frequent epistaxis?

A

High BP

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24
Q

Laryngeal obstruction

A

When upper breathing passage is narrowed or blocked causing difficulty in breathing

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25
Areas that can be affected by a laryngeal obstruction?
Trachea Larynx Pharynx
26
Exercised induced laryngeal obstruction
Transient reversible narrowing of larynx that occurs with high intensity exercise that impedes airway and causes stridor, discomfort, and shortness of air
27
When young athletes have exercise induced laryngeal obstruction, what are they often misdiagnosed as?
Exercise induced asthma or bronchoconstriction
28
Larynx is a ______ box with a ______ lining.
stiff box with mucosal lining
29
When exactly does the laryngeal obstruction dangerous?
When there is edema at the opening of the glottis - can obstruct breathing.
30
What is Sinusitis ?
Inflammation of the paranasal sinuses that is adjacanet/around the nasal cavity
31
What are the main causes of sinusitis?
Infection from virus, bacteria, or fungus Autoimmune reaction to allergies
32
Explain the autoimmune response causing sinusitis rt allergies
Histamine is released which causes inflammation of mucosal lining
33
Why do doctors refer to sinusitis as rhinosinisutis?
Because both the sinuses and the nose are inflamed
34
With sinusitis, what are the possible sinuses that could be having inflammation?
Maxillary Frontal Ethmoid Sphenoid
35
Maxillary sinusitis symptoms
Pain or pressure in the cheek Toothache or headache * they go to the dentist
36
Frontal sinusitis symptoms
Pain or pressure behind the eyes Headache Tight eyes Cool, warm compress
37
Ethmoid sinitusus symptoms
Pain between eyes
38
Sphenoid sinusitis symptoms
Pressure or pain on the top of the head
39
What is sinusitis linked to? What is an extra symptom?
Asthma - so the sinusitis may be apart of generalized airway inflammation Cough may be associated with it ; wheezing and stridor
40
Why use salt saline/spray for sinusitis?
It is supposed to relieve congestion and mucus
41
Nonpharm treatment for sinusitis
Saline salt washes and sprays Steam inhalation Drink fluids
42
You offer a patient with sinusitis steam inhalation. What methods do you use?
Hot shower Hot compress to face
43
Why do patients with sinustitis need to drink plenty of fluids?
Avoid dehydration and break up the dry mucous membranes to relieve congestion
44
Pharm treatment for sinustutis
Antibiotics to tx infection Nasal Corticosteroids as nasal spray to decrease inflammation * doesn't always work
45
If patients getting frequent sinusitis, what do you anticipate?
Prophylactic antibiotics treatment
46
What if pharm treatment doesn't work for sinusitis?
Surgery
47
What is Acute Tracheobronchitis?
Inflammation membranes of trachea and bronchial tree epithelium
48
What does acute tracheobronchitis usually follow?
Upper respiratory infection
49
Pathogens that cause acute tracheobronchitis
adenovirus rhinovirus influenza - parainfluenza, corona, RSV
50
Bacterial causes of Acute tracheobronchitis
Staph Strep Micoplasma Pneumonia Catarolis Bordetella Pertusis
51
How do irritants cause acute tracheobronchitis?
When inhaled, irritants can get into the trachea lining causing a horrible cough
52
First signs of acute tracheobronchitis
Convulsive cough when patients is breathing in on inspiration * usually occurs at night
53
Why are acute tracheobronchitis infections sometimes hard to treat?
Because it is often viral (80%) - and obviously you can't treat them. If it is bacterial, they'll go ahead and do antibiotics and anti-inflammatories.
54
How do we identify the pathogen that can cause the acute tracheobronchitis?
Sputum culture Bronch wash
55
Pneumonia
Inflammation of the lung parenchyma and air sacs of one or both lungs that fills with fluid and puss
56
What is included when we say lung parenchyma?
Any form of lung tissue which includes bronchioles, bronchi, vessels, interstitial, and alveoli
57
Pneumonia symptoms
Fever Chills Difficulty breathing
58
What organisms can cause pneumonia by getting in the lungs?
bacteria viruses fungi
59
What age groups is pneumonia serious?
Infants & kids Elderly +65 Hx of pneumonia - increased predisposition for microbial invasion
60
Who does pneumonia typically kill?
Children under the age of 5
61
What type of pneumonia is typically the most common? Who is it most common in?
viral pneumonia * most common in kids and not adults
62
A kid with viral pneumonia has come in. What do you need to make sure gets done?
Make sure to watch their symptoms but also make sure they get that chest x ray
63
Where can patient acquire pneumonia?
Hospital Out in the community
64
What is meant by hospital acquired pneumonia?
Ventilator patients often acquire it from the vent itself
65
What instances can have aspiration pneumonia in general?
OG tubes Vent patients Poor gag reflex Stroke patients
66
How do you prevent pneumonia?
Immuminizations
67
What populations do we really try to push immunizations for?
Young Elderly
68
What nutrition can help with pneumonia?
Need adequate nutrition for protein levels to fight infection
69
Why do we look at the environmental factors around the patient when they have pneumonia?
Environments like the dorms, long term care facilities, and day care can spread it
70
What does pneumonia affect pathology wise (2)
Ventilation Diffusion
71
Explain how pneumonia can cause death
Blood will lack oxygen, rbc cannot deliver oxygen, infection risk increases and spreads \>\> death
72
What does exudate in alveoli due to pneumonia do?
Blocks diffusion of oxygen and co2 gas exchange
73
What components of pneumonia occlude ventilation?
The secretions + edema occlude breathing/ventilation
74
When pneumonia causes the vent-perfusion mismatch, what reading do you look for and why?
Look at the partial pressure of oxygen in arterial blood (paO2) for artieral hypoxia. * less than 80 mmhg on room air is indicative of the hypoxia
75
Clinical manifestations of pneumonia
Headache Low grade fever Pleuritic pain (pleurisy on the side of lungs) Myalgia Pharyngitis Cough +Purulent sputum Orthopnea Elderly - confusion + lethargy
76
What do you as the nurse need to do before the patient gives their sputum culture?
We need their sputum for cultures so we need them to brush their teeth first and then spit in the cup.
77
Why will not all pneumonia patients present the same way?
Underlying conditions could alter the symptoms
78
What criteria do we use for diagnosis of pneumonia?
Chest x ray Full history of patient with immunizations list Full physical exam Sputum cultures
79
Antibiotics for pneumonia
Zithromax for 3 days
80
How can we help patients loosen up secretions and mucus?
Drink plenty of fluids! We want them to be able to get rid of the mucus
81
How can we control fever for pneumonia?
Tylenol
82
Why do we want patients to avoid cough suppressants if they have pneumonia?
It defeats the purpose of them coughing up their secretions. We want them to get that stuff out of there.
83
Patient with pneumonia says they have plans to go to the gym later. What do you need to educate them on?
The importance of **rest**
84
Your patient has viral pneumonia. They've been started on antibiotics and want to know how long it takes to work. What do you tell them?
Antibiotics don't help viral pneumonias
85
What do we need to monitor for when it comes to the pneumonia patients?
Monitor for shock and respiratory failure
86
What labs/measurements can we use to monitor for shock and respiratory failure?
Lactate CRP WBC RR Sao2 HR/pulse BP UO CVP
87
Why do we need to be on top of making sure elderly are eating?
They tend to lose appetite and so we don't want to make anything worse.
88
What do we want to encourage when it comes to managing pneumonia?
Fluids Coughing Deep breathing
89
What is CPT?
Chest physiotherapy - to loosen up secretions
90
After doing all your interventions, what do you need to do as the nurse?
Evaluate your interventions always

2.0 Adult Nursing Exam 4 (8 decks)

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