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2.0 Adult Nursing Exam 4 > Respiratory > Flashcards

Respiratory Flashcards

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
Q

Areas that can be affected by a laryngeal obstruction?

A

Trachea

Larynx

Pharynx

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26
Q

Exercised induced laryngeal obstruction

A

Transient reversible narrowing of larynx that occurs with high intensity exercise that impedes airway and causes stridor, discomfort, and shortness of air

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27
Q

When young athletes have exercise induced laryngeal obstruction, what are they often misdiagnosed as?

A

Exercise induced asthma or bronchoconstriction

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28
Q

Larynx is a ______ box with a ______ lining.

A

stiff box with mucosal lining

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29
Q

When exactly does the laryngeal obstruction dangerous?

A

When there is edema at the opening of the glottis - can obstruct breathing.

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30
Q

What is Sinusitis ?

A

Inflammation of the paranasal sinuses that is adjacanet/around the nasal cavity

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31
Q

What are the main causes of sinusitis?

A

Infection from virus, bacteria, or fungus

Autoimmune reaction to allergies

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32
Q

Explain the autoimmune response causing sinusitis rt allergies

A

Histamine is released which causes inflammation of mucosal lining

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33
Q

Why do doctors refer to sinusitis as rhinosinisutis?

A

Because both the sinuses and the nose are inflamed

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34
Q

With sinusitis, what are the possible sinuses that could be having inflammation?

A

Maxillary

Frontal

Ethmoid

Sphenoid

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35
Q

Maxillary sinusitis symptoms

A

Pain or pressure in the cheek

Toothache or headache

  • they go to the dentist
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36
Q

Frontal sinusitis symptoms

A

Pain or pressure behind the eyes

Headache

Tight eyes

Cool, warm compress

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37
Q

Ethmoid sinitusus symptoms

A

Pain between eyes

38
Q

Sphenoid sinusitis symptoms

A

Pressure or pain on the top of the head

39
Q

What is sinusitis linked to?

What is an extra symptom?

A

Asthma - so the sinusitis may be apart of generalized airway inflammation

Cough may be associated with it ; wheezing and stridor

40
Q

Why use salt saline/spray for sinusitis?

A

It is supposed to relieve congestion and mucus

41
Q

Nonpharm treatment for sinusitis

A

Saline salt washes and sprays

Steam inhalation

Drink fluids

42
Q

You offer a patient with sinusitis steam inhalation. What methods do you use?

A

Hot shower

Hot compress to face

43
Q

Why do patients with sinustitis need to drink plenty of fluids?

A

Avoid dehydration and break up the dry mucous membranes to relieve congestion

44
Q

Pharm treatment for sinustutis

A

Antibiotics to tx infection

Nasal Corticosteroids as nasal spray to decrease inflammation

  • doesn’t always work
45
Q

If patients getting frequent sinusitis, what do you anticipate?

A

Prophylactic antibiotics treatment

46
Q

What if pharm treatment doesn’t work for sinusitis?

A

Surgery

47
Q

What is Acute Tracheobronchitis?

A

Inflammation membranes of trachea and bronchial tree epithelium

48
Q

What does acute tracheobronchitis usually follow?

A

Upper respiratory infection

49
Q

Pathogens that cause acute tracheobronchitis

A

adenovirus

rhinovirus

influenza - parainfluenza, corona, RSV

50
Q

Bacterial causes of Acute tracheobronchitis

A

Staph

Strep

Micoplasma

Pneumonia

Catarolis

Bordetella Pertusis

51
Q

How do irritants cause acute tracheobronchitis?

A

When inhaled, irritants can get into the trachea lining causing a horrible cough

52
Q

First signs of acute tracheobronchitis

A

Convulsive cough when patients is breathing in on inspiration

  • usually occurs at night
53
Q

Why are acute tracheobronchitis infections sometimes hard to treat?

A

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
Q

How do we identify the pathogen that can cause the acute tracheobronchitis?

A

Sputum culture

Bronch wash

55
Q

Pneumonia

A

Inflammation of the lung parenchyma and air sacs of one or both lungs that fills with fluid and puss

56
Q

What is included when we say lung parenchyma?

A

Any form of lung tissue which includes bronchioles, bronchi, vessels, interstitial, and alveoli

57
Q

Pneumonia symptoms

A

Fever

Chills

Difficulty breathing

58
Q

What organisms can cause pneumonia by getting in the lungs?

A

bacteria

viruses

fungi

59
Q

What age groups is pneumonia serious?

A

Infants & kids

Elderly +65

Hx of pneumonia - increased predisposition for microbial invasion

60
Q

Who does pneumonia typically kill?

A

Children under the age of 5

61
Q

What type of pneumonia is typically the most common?

Who is it most common in?

A

viral pneumonia

  • most common in kids and not adults
62
Q

A kid with viral pneumonia has come in. What do you need to make sure gets done?

A

Make sure to watch their symptoms but also make sure they get that chest x ray

63
Q

Where can patient acquire pneumonia?

A

Hospital

Out in the community

64
Q

What is meant by hospital acquired pneumonia?

A

Ventilator patients often acquire it from the vent itself

65
Q

What instances can have aspiration pneumonia in general?

A

OG tubes

Vent patients

Poor gag reflex

Stroke patients

66
Q

How do you prevent pneumonia?

A

Immuminizations

67
Q

What populations do we really try to push immunizations for?

A

Young

Elderly

68
Q

What nutrition can help with pneumonia?

A

Need adequate nutrition for protein levels to fight infection

69
Q

Why do we look at the environmental factors around the patient when they have pneumonia?

A

Environments like the dorms, long term care facilities, and day care can spread it

70
Q

What does pneumonia affect pathology wise (2)

A

Ventilation

Diffusion

71
Q

Explain how pneumonia can cause death

A

Blood will lack oxygen, rbc cannot deliver oxygen, infection risk increases and spreads >> death

72
Q

What does exudate in alveoli due to pneumonia do?

A

Blocks diffusion of oxygen and co2 gas exchange

73
Q

What components of pneumonia occlude ventilation?

A

The secretions + edema occlude breathing/ventilation

74
Q

When pneumonia causes the vent-perfusion mismatch, what reading do you look for and why?

A

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
Q

Clinical manifestations of pneumonia

A

Headache

Low grade fever

Pleuritic pain (pleurisy on the side of lungs)

Myalgia

Pharyngitis

Cough +Purulent sputum

Orthopnea

Elderly - confusion + lethargy

76
Q

What do you as the nurse need to do before the patient gives their sputum culture?

A

We need their sputum for cultures so we need them to brush their teeth first and then spit in the cup.

77
Q

Why will not all pneumonia patients present the same way?

A

Underlying conditions could alter the symptoms

78
Q

What criteria do we use for diagnosis of pneumonia?

A

Chest x ray

Full history of patient with immunizations list

Full physical exam

Sputum cultures

79
Q

Antibiotics for pneumonia

A

Zithromax for 3 days

80
Q

How can we help patients loosen up secretions and mucus?

A

Drink plenty of fluids! We want them to be able to get rid of the mucus

81
Q

How can we control fever for pneumonia?

A

Tylenol

82
Q

Why do we want patients to avoid cough suppressants if they have pneumonia?

A

It defeats the purpose of them coughing up their secretions. We want them to get that stuff out of there.

83
Q

Patient with pneumonia says they have plans to go to the gym later. What do you need to educate them on?

A

The importance of rest

84
Q

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?

A

Antibiotics don’t help viral pneumonias

85
Q

What do we need to monitor for when it comes to the pneumonia patients?

A

Monitor for shock and respiratory failure

86
Q

What labs/measurements can we use to monitor for shock and respiratory failure?

A

Lactate

CRP

WBC

RR

Sao2

HR/pulse

BP

UO

CVP

87
Q

Why do we need to be on top of making sure elderly are eating?

A

They tend to lose appetite and so we don’t want to make anything worse.

88
Q

What do we want to encourage when it comes to managing pneumonia?

A

Fluids

Coughing

Deep breathing

89
Q

What is CPT?

A

Chest physiotherapy - to loosen up secretions

90
Q

After doing all your interventions, what do you need to do as the nurse?

A

Evaluate your interventions always

2.0 Adult Nursing Exam 4 (8 decks)

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