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Respiratory Flashcards

(85 cards)

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1
Q

alveoli

A

gas exchange by diffusion

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2
Q

diffusion in the alveoli

A

CO2 into alveoli, O2 from alveoli into capillaries

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3
Q

10y-adult RR norms

A

12-20

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4
Q

older adult (60y+) RR

A

16-25

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5
Q

bradypnea

A

<12

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6
Q

tachypnea

A

> 20

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7
Q

factors affecting respiratory function -6

A

body position, environment, lifestyle habits, increased work of breathing, rotund abdomen (obesity, pregnant), large chest (fat, muscle)

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8
Q

causes of increased work of breathing

A
  • airway obstruction-reduced diameter, increased airway resistance, more work
  • restricted lung movement: more work, more oxygen
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9
Q

exhalation vs inhalation time and types of processes

A

2x longer than inspiration; passive vs active

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10
Q

reasons for restricted lung movement-4

A

smoking, pneumonia, rib injury, scoliosis

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11
Q

reasons for airway obstruction

A

cystic fibrosis, bronchitis, asthma –anything that inflames

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12
Q

atelectasis

A

alveolar collapse, poor gas exchange; sometimes in combo with pneumonia

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13
Q

Causes of altered respiratory function -5

A

cough, sputum production, shortness of breath, chest pain, emotions

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14
Q

dyspnea

A

trouble breathing, there are levels of this

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15
Q

Respiratory history should focus on four major areas

A
  • risk factors for lung disease
  • signs and symptoms of respiratory dysfunction
  • impact of respiratory status of ADLs
  • adaptive measures for respiratory dysfunction
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16
Q

risk factors for lung disease

A

smoking, occupational exposure to pollutants

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17
Q

S&S of Respiratory dysfunction (3)

A

cough, sputum production, dyspnea

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18
Q

for smoking you need to look at

A

duration and extend, packs X year

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19
Q

potential problems that interfere with respiratory

A

obesity –> snore, O2 stat down during night

CHF

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20
Q

inspection with respiratory

A

observe rate, pattern and breathing effort

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21
Q

Biot breathing pattern

A

fast shallow breathing then stops with apnea in between

Think shallow bitch, can talk fast

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22
Q

what conditions could cause Biot breathing (6)

A

meningitis, encephalitis, head trauma, brain, abscess, heatstroke
Think B for brain

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23
Q

Cheyne Stokes

A

periods of respirations of increased rate and depth alternating with periods of apnea

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24
Q

reasons for Cheyne stokes (4)

A

CHF, drug overdose, increased intracranial pressure, impending death

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25
kussmaul
increased rate and depth of respirations; look like been exercising
26
conditions where we would see kussmaul
metabolic acidosis, diabetic ketoacidosis, renal failure
27
clubbing
related to chronic cyanosis and chronic hypoxia
28
look at breathing effort
are they using accessory muscles?
29
mucus secretions- clear vs yellow
normal; infection
30
hemoptysis
blood in secretions
31
inspect color
around lips, hands, nails, capillaries-should be pink not blue
32
palpation (5)
- check extent and pattern of thoracic expansion and trachea position - check fremitus for characteristics - temperature, tenderness, lesions
33
barrel chest is due to
chronic use of accessory muscles
34
percussion
detect fluid filled or consolidated portions of the lungs
35
consolidation
air is replaced with something else either fluid or solid within lungs, does not move with change of position
36
normal lung tissue sound
resonance
37
auscultation start in
front diaphragm, supraclavicular (apex of lungs) and compare each side
38
qualities to look for with auscultation
intensity, pitch, duration and quality
39
with auscultation wait for
full inhalation and exhalation
40
discontinuous sounds and example
hear on inspiration or exhalation; crackles (rales)
41
continuous sounds
hear on both insp and exhalation; rhonchi, wheezes, stridor, pleural friction rub
42
normal sounds
trachea: bronchiole breath sounds bronchioles: bronchiovesicular parenchyma (lung tissue): vesicular
43
abnormal sounds are called
adventitious sounds
44
two types of crackles
coarse and fine
45
landmarks of anterior and posterior chest wall
anterior, posterior, left lateral, right lateral
46
bronchial sounds description
blowing hollow sounds over trachea | Remember B for bronchial and blowing
47
bronchial sound intensity
expiration longer and louder
48
bronchovesicular description
intermediate sounds
49
vesicular description
soft and breezy sounds all over lung except airways
50
characteristics of fine crackles
high pitches, short POPPING sounds during inspiration, cannot be cleared
51
conditions for fine crackles; and conditions for those that occur early in inspiration
pneumonia and CHF; early in inspiration: bronchitis, asthma and emphysema
52
coarse crackles
low pitched bubbling, moist sounds
53
conditions for coarse crackles
pneumonia, pulmonary edema/fibrosis
54
rhonchi
-OR sonorous wheezes; low pitches snoring or moaning, primarily heard in expiration; may be cleared with coughing
55
conditions for rhonchi
bronchitis or singular bronchus obstruction THINK BRONCHI RHONCHI
56
wheezes (sibilant)
high pitched musical sounds, primarily during expiration
57
sibilant wheezes found in what conditions
acute asthma or chronic emphysema
58
pleural friction rub description
low pitched dry grating sound, superficial, during both inspiration and expiration
59
pleural friction rub due to
pleuritis
60
mechanisms for testing for respiratory
pulse oximetry, sputum culture
61
where do we hear fine crackles
alveoli
62
where do we hear coarse crackles, rales
peripheral airways
63
where do we hear rhonchi
large airways
64
where do we hear sibilant wheezes
large or small airways
65
where do we hear pleural friction rub
pleural surfaces
66
if someone is SOB, and you reposition them, what are you looking for
look at breathing (RR, how hard working, O2 stat)
67
what do we want O2 stat at
93
68
oxygen is considered and possible toxicity
a med, can have toxicity
69
NEWolder adults considerations (5)
- not taking deep breaths: incr secretions - gas exchange impaired, incr chance for infection - thoracic wall is more rigid - normal PaO2 decreases - lung capacity not the same
70
health promotion: prevent and monitor
prevent respiratory infections; monitor peak flow
71
health promotions: provide and position
providing adequate hydration; positioning and ambulation
72
health promotion: deep breathing, use of
incentive spirometer for deep breathing; inhalation, mL of air
73
stacked cough
cough 3 times with same breath, hold glottis in b/w
74
oxygen therapy goals (4)
reverse hypoxemia improve tissue oxygenation decrease work of breathing in patient with dyspnea decrease work of heart in patients with cardiac disease
75
when should supplemental oxygen start
O2 stat is below 93%
76
nasal cannula
1-6L/min, low flow, 22-44% oxygen | can be drying, could be mouth breather
77
venturi mask
more accurate -control over Oxygen | 3-8L/min, 24-50% oxygen, (plastic piece tells %)
78
face mask (5)
6-10L/min, 40-60% more controlled, covers mouth breathers humidifies can cause aspiration
79
secretion mobilization exercises
coughing and deep breathing
80
Reservoir bag-non rebreather purpose
to prevent hypoxemia, urgent- last step before intubation
81
reservoir bag: non-rebreather characteristics
10-15L/min, 90-100% O2 keep bag inflated ! 2 holes on side: CO2 goes out and breath from reservoir bag; no mixing of CO2 and O2
82
pillows for splinting
gives resistance and comfort, for abdominal and cardio thoracic patients
83
oxygen safety concerns
combustible, no smoking or near something that sparks
84
oxygen devices
home oxygen systems --unlimited, make continuously
85
E cylinders
limited supply, below 500 PSI need to change or alert for new

Fundamentals (5 decks)

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