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Respiratory Flashcards

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1
Q

What is our stimulus for breathing?

A

CO2

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2
Q

What is the stimulus for breathing of a pt with COPD?

A

O2 - pt retains so much CO2 that the sensors become “used” to it so when O2 is introduced, it stimulates

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3
Q

What is eupnea?

A

normal breathing

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4
Q

Should you be concerned that your pt’s inspiration rate to expiration rate is 1:2?

A

No, the expiration rate is longer than the inspiration

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5
Q

What is normal RR for an infant/baby?

A

30-60bpm

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6
Q

How does the body’s position affect respiration?

A

Sitting up: lungs can maximally expand

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7
Q

What environment factors affect respiration?

A
  • Allergens
  • Pollutants
  • Humidity
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8
Q

How do lifestyle habits affect respiration?

A
  • Smoking
  • Drugs
  • Alcohol
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9
Q

Your pt has increased WOB. What does WOB mean?

A

work of breathing

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10
Q

What are two conditions that increase WOB?

A
  • restriction of lung movement
  • obstructive of the lung (airway)
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11
Q

What characterizes restrictive lung movement/disease and how does it increase WOB?

A

while both restrictive and obstructive conditions cause SOB, restrictive lung disease (RLD) is defined by difficulty filling the lungs with air during inhalation

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12
Q

RLD is characterized by the following:

A
  • Decreased elasticity of the lungs
  • Decreased total volume of air and capacity
  • Decreased expansion of the chest wall during inhalation
  • Stiffening of the lungs (ex. idiopathic pulmonary fibrosis)
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13
Q

Your pt is diagnosed with pneumonia, what is happening in their lungs?

A

Accumulation of pus or fluid in the alveoli d/t inflammation, which causes consolidation

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14
Q

Your pt now has atelectasis, what does that mean?

A

Lung collapsed (alveoli collapse)

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15
Q

Pneumothorax vs Atelectasis

A

Pneumothorax: air trapped; tension causes a shift in your chest
Atelectasis: alveoli collapse and cause the lung to partially or completely collapse

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16
Q

What characterizes obstructive lung disease and how does it increase our WOB?

A

obstruction in the air passages causing more difficulty with exhaling air, which causes an increase in residual air volume

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17
Q

What is happening with airway obstruction and how does it increase WOB?

A

The diameter of the airway is decreased and the resistance is increased

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18
Q

What are some examples of Obstructive Lung Disease?

A

asthma and COPD

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19
Q

What are the 3 main components of Obstructive Lung Disease?

A

bronchoconstriction, mucus, inflammation

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20
Q

What is COPD?

A

airways in the lungs become inflamed and thickened and the tissue where O2 is exchanged is destroyed - CO2 retention

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21
Q

Your pt has COPD, what symptoms would you expect to see?

A
  • DOE
  • SOB
  • Cough with mucous
  • Fatigue
  • Prone to lung infections
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22
Q

You have two additional pts, one has emphysema and one has bronchitis. Are these different than COPD?

Study These Flashcards
A

COPD includes both conditions

23
Q

Your pt is using accessory muscles to breathe, what does that mean?

Study These Flashcards
A
  • SOB
  • Dyspnea
  • Increased WOB
  • Using your trapezius muscles, abdominal muscles, intercostal muscles; or any other muscle other than the diaphragm
24
Q

The pt is having difficulty breathing, what position are they in to attempt to breathe easier?

25
Pt admitted into ED, what signs/symptoms would you see that indicate altered respiratory function?
- Cough - Sputum - Accessory muscle use - Cyanosis (late symptom) - SOB/Dyspnea - Chest pain - Tachypnea, Bradypnea, Cheyne Stokes - Adventitious breathing sounds
26
What is Cheyne-Stokes breathing?
Breathing fast with deep breathes then you stop breathing for a period (apnea) - Cyclic, end-stage
27
What is Stridor?
- High pitch sound (adventitious) - Inhalation sound - Commonly seen in kids - Associated with upper airway obstruction and/or edema
28
What type of pts would you see with Clubbing?
pts with chronic cardiac/respiratory disease
29
What causes clubbing?
lack of O2 from chronic tissue hypoxia
30
What are some interventions to improve respiratory function?
- deep breathing - repositioning - tell them to cough - hydration - ambulation
31
Metered Dose Inhaler (MDI)
Device use for a measured delivery of respiratory medication to the lungs
32
Peak Flow Meter
Measures the peak expiratory volume with forced exhalation - record before and after treatment
33
Acapella
Uses positive expiratory pressure to force air behind the sputum and move it upward
34
Spacer
Ensures the pt receives all the medication and decreases the bad taste of the med
35
Nebulizer Treatment
Delivers aerosolized medicine directly to the lungs
36
What are the 3 principles of O2 therapy?
- lowest concentration for the shortest period of time - Assess the pt's respiratory status - monitor ABG's and O2 sat
37
If O2 is >3L, how should you deliver it?
humidified
38
What is the typical order for O2?
2L/min OR keep sats >95%
39
What does low flow mean?
mixed with room air - does not meet all pt ventilatory demand
40
What are some examples of low-flow devices?
- nasal cannula (1-6L/min; 24-60% O2) - partial rebreather (10-15L/min; 30-60% O2) - simple face mask (5-10L/min; 40-60% O2) - non-rebreather (10-15L/min; 55-90% O2)
41
What does high flow mean?
- meets all the ventilatory demands - fixed concentration
42
What are some examples of high-flow devices?
- high-flow nasal cannula (60L/min; heated and humidified) - tracheostomy collar (28-98%; high humidity) - O2 hood ( >60%; high humidity) - Venturi mask (COPD pts; colored valves ranging 24-60%)
43
When do you use a partial rebreather?
hyperventilation - losing too much CO2
44
When do you use a nonrebreather?
pt in need of a high concentration of O2
45
Your pt is admitted with pneumonia, RR 28, pulse Ox 94% - Which O2 delivery system would you use?
Low Flow - Nasal cannula or simple face mask - no other signs of WOB or respiratory distress
46
Smith is admitted with an exacerbation of COPD. She is SOB. What O2 delivery system would you use?
Venturi mask
47
35 y/o admitted to ED, suspected to have a panic attack. She is lightheaded, SOB, and complaining of tingling and numbness around her mouth. RR is 40bpm, what O2 delivery system should you use?
Partial rebreather - she is losing too much CO2 so you want her to rebreath some of that CO2 back
48
Pt admitted to ED with pneumonia and ARD; symptoms include SOB and cough, RR 38, HR 106, and Chest Pain - What O2 delivery system should you use?
Non-rebreather
49
What to do when you're weaning a pt off O2
Assessment: pulse ox, breath sounds, WOB, RR - manage according to what the pt can tolerate
50
What is the purpose of tracheal suctioning?
remove secretions --> keeping the airway open
51
What is a stoma?
surgical opening to a pt's airway
52
How do we assess the need for suctioning?
- Increase WOB - Abnormal upper airway sounds: gurgling - Sats drop - Adventitious breath sounds - Cyanosis (late indicator) - Restlessness and agitation (early indicator) - Tachypnea
53
What are the principles of suctioning?
- only suction on the way out; intermittently - rotate the catheter as you apply suction - no more than 3x (no more than 3 passes in one session) - 10-15 seconds in the airway (adults); 5-10 seconds (children) - hyper-oxygenate the pt between passes - suction to the end of the tube
54
What are some complications of suctioning?
- Decannulation - Edema, obstruction - Hypoxia/Bronchospasm - Infection - Hemorrhage - Skin Breakdown

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