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NCLEX-RN (5) Adult Health > Respiratory > Flashcards

Flashcards in Respiratory Deck (76)
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1

What are the early symptoms that a client may not be getting enough oxygen?

tachypnea and restlessness

2

What are 2 very common interventions with any respiratory problem?

  1. give oxygen
  2. sit up in a high Fower's position

3
Teaching:

Prevent pneumonia

To prevent pneumonia teach clients to:

  • turn, cough, and deep breathe
  • use an incentive spirometer

4

Why would a client get a chest x-ray?

Chest x-rays are used to look for abnormalities in the heart or lungs.

 

5

What are the steps to get a sputum sample?

  1. rinse mouth with water
  2. take a few deep breaths
  3. then cough
  4. get 15 mL of sputum (not just saliva)
  5. send to lab

6

What is a laryngoscopy or bronchoscopy?

A laryngoscopy or bronchoscopy is inserted down the throat and into the lungs to look for abnormalities.

7

What is the priority concern after a bronchoscopy or lung biopsy?

After a bronchoscopy or lung biopsy assess for pneumothorax and bleeding due to possible puncture.

8

What is a pulmonary function test (PFT)?

A pulmonary function test (PFT) is a noninvasive test that shows how well the lungs are working.

The test measures lung volume, capacity, rates of flow, and gas exchange.

9

What is the teaching before the client undergoes a pulmonary function test? 

  • hold bronchodilators
  • no large meals
  • no smoking beforehand

 

10

What is a thoracentesis?

A thoracentesis is removal of fluid or air from the pleural space using a needle.

11

What is the best position during a thoracentesis?

  • leaning over the bedside table or
  • in bed with the affected side up

These positions promote separation of the ribs in order to reach the pleural space better and get the excess fluid out.

 

12

What is chest physiotherapy?

Chest physiotherapy is using percussion, vibration and postural drainage to get rid of respiratory secretions.

13

Which medical conditions would chest physiotherapy be used for?

Chest physiotherapy is used for conditions when thick secretions get stuck in the lungs such as:

  • cystic fibrosis
  • lower lung pneumonia
  • COPD (chronic bronchitis)

14

When would chest physiotherapy be contraindicated?

  • head injury
  • increased ICP
  • chest trauma

15

When is low flow nasal cannula used?

Low flow nasal cannula is low dose oxygen administration used with:

  • chronic conditions such as COPD (2 liters/minute)
  • post-operatively after receiving anesthesia

16

When is high flow nasal cannula used?

High flow nasal cannula is high dose oxygen administration used with:

  • mild to moderate respiratory distress
  • up to 10 Liters/minute

17

What is an oxygen face mask?

Oxygen face masks: to give oxygen for short term emergencies

18

What is a CPAP and BiPAP machine?

A CPAP and BiPAP machine is an electronic breathing device used in the treatment of sleep apnea, lung disease, and to treat respiratory weakness. 

It helps to improve oxygenation and is typically worn at night.

19

What are the causes of a high-pressure ventilator alarm?

Causes of a high-pressure ventilator alarm are due to obstructions such as:

  • increased secretions
  • water or kink in tube
  • client coughs, gags, bites tube
  • client is anxious and fights ventilator

20

What are the causes of a low-pressure ventilator alarm?

Causes of a low-pressure ventilator alarm are due to:

  • air leak
  • disconnection of a tube
  • clients stops breathing

21
Describe:

Flail chest

Imminent complication

Flail chest is when a segment of the rib cage breaks due to trauma and becomes detached from the rest of the chest wall.

There can also be rib fractures.

22

What is the characteristic sign of flail chest?

Flail chest sign - paradoxical respirations

The injured area moves in during inspiration and moves out during expiration.

 

23
Interventions:

Flail chest

  • give pain meds
  • encourage turn cough and deep breath to prevent pneumonia
  • possible intubation and ventilator

24
Describe:

Pneumothorax

Immediate complication

A pneumothorax is a collapsed lung with air in the pleural space.

It is caused by trauma. The client will get chest tubes.

25
Describe:

Spontaneous pneumothorax

Immediate complication

A spontaneous pneumothorax is when there is a sudden onset of a collapsed lung with no obvious cause.

26
Describe:

Hemothorax

Immediate complication

A hemothorax is a collapsed lung with blood in the pleural space.

27

What are the characteristic signs and symptoms of a pneumothorax and hemothorax?

  • absent breath sounds on affected side
  • tracheal deviation
  • sucking sound with an open chest wound
  • chest pain
  • hypotension (heart is being squeezed)
  • crepitus: cracking sound when tissue is pressed

28
Treatment:

Pneumothorax and hemothorax

Chest tubes

29
Describe:

Acute respiratory failure (ARF)

Immediate complication

Acute respiratory failure is when there is not enough oxygen to get to the lungs or alveoli (air sacs) and CO2 builds up in the blood.

The client becomes hypoxic and hypercapnic.

 

30

What respiratory diseases can cause acute respiratory failure?

  • cystic fibrosis
  • COPD
  • pneumonia

31

Which types of trauma can cause acute respiratory failure?

  • fire/smoke inhalation
  • spinal cord injuries
  • chest trauma
  • opioid overdose

32

Which types of neuro diseases can cause acute respiratory failure?

  • stroke
  • myasthenia gravis
  • Guillain barre

33
Interventions:

Acute respiratory failure

  • give oxygen
  • bronchodilators
  • intubation with ventilator

34
Describe:

Acute respiratory distress syndrome (ARDS)

Immediate complication

ARDS is a form of ARF that causes inflammation and fluid to build up in the alveoli. The client is unable to get enough oxygen.

The client will be intubated and placed on a ventilator.

35
Cause:

Acute respiratory distress syndrome

Immediate complication

ARDS is caused by many life-threatening conditions that cause systemic inflammation or prevent the client from breathing:

  • shock
  • sepsis
  • burns
  • fluid volume overload
  • aspiration and inhalation of toxic substances
  • trauma
  • neuro injuries

36
Describe:

Asthma

Asthma is chronic inflammation in the lungs caused by allergies, irritants or exercise.

The bronchioles become constricted preventing oxygen exchange.

37

What are the characteristic signs and symptoms of asthma?

  • wheezing
  • chest tightness
  • coughing

38
Interventions:

Asthma

  • oxygen
  • Inhalers
    • bronchodilators
    • steroids

39
Describe:

Chronic obstructive pulmonary disease (COPD)

COPD is a group of inflammatory lung diseases that block airflow and make it difficult to breathe.

40
Pathophysiology:

Chronic obstructive pulmonary disease

  1. alveoli get damaged by inflammation and lose elasticity
  2. air gets trapped and respiratory rate increases
  3. CO2 is produced faster than it can be eliminated

This causes respiratory acidosis and low oxygen levels of about 88%-93%.

41

What is the number 1 cause of COPD?

Smoking

42

What 2 diseases fall under the category of COPD?

  1. emphysema
  2. chronic bronchitis

 

43
Describe:

Emphysema

Emphysema is when the alveoli (air sacs) in the lungs are damaged and enlarged, resulting in hyperinflation and breathlessness.

44
Describe:

Chronic bronchitis

Chronic bronchitis is when the bronchial tubes become inflamed and excessive mucus production occurs as a result from irritants or injury.

 

45

What are the characteristic signs and symptoms of COPD?

  • barrel chest with emphysema
  • accessory muscles for breathing
  • orthopnea

46

What acid-base imbalance does a client with COPD usually have?

Respiratory acidosis

It's normal with COPD for the client to hold on to acid.

47

How much oxygen should a client with COPD be allowed to have?

Keep oxygen levels between 88%-93%, which is an average of 2-3 liters/minute of oxygen. The client may need more oxygen if O2 level goes below 88%.

The drive to breath for COPD is a low oxygen level.

48
Interventions:

Chronic obstructive pulmonary disease (COPD)

  • nebulizers: bronchodilators and steroids
  • chest physiotherapy
  • mucolytics
  • oxygen nasal cannula 2-3 liters/minute

49

What is pursed lip breathing?

Pursed lip breathing is a technique used for COPD to move more oxygen into the lungs and carbon dioxide out of the lungs

When you exhale with your lips pursed, there is increased pressure. This helps to keep airways open longer to remove the air that is trapped in the lungs. This slows down the breathing rate and relieves shortness of breath.

50

What diet is recommended with COPD?

COPD diet is based on issues with chronic fatigue and breaking up secretions:

  • small frequent meals
  • high calorie, high protein diet with supplements
  • fluid intake up to 3000 mL/day to keep secretions thin

51

What position is best for clients with COPD to breathe easier?

Fowler's position and leaning forward to aid in breathing.

 

52
Describe:

Pleural effusion

A pleural effusion is when fluid goes into the pleural space or layers of the lungs.

It can be caused from CHF, kidney failure or infection.

53
Treatment:

Pleural effusion

Thoracentesis

 

54
Describe:

Pulmonary edema

Immediate complication

Pulmonary edema is when fluid gets backed up into the lungs.

It can be caused by left-sided heart failure, kidney failure or liver failure.

55

What is the characteristic sign of pulmonary edema?

Frothy sputum

It is foamy and contains bubbles.

56
Interventions:

Pulmonary edema

Interventions for pulmonary edema focus on getting rid of extra fluids and maximizing oxygen:

  • high-Fowler's position
  • give oxygen
  • diuretics and morphine (morphine eases breathing)
  • foley for strict intake and output
  • last resort is intubation and ventilator

57
Describe:

Pulmonary embolism

Immediate complication

A pulmonary embolism is when a blood clot goes to the lungs.

It is usually caused by a DVT.

58

What is the characteristic sign of a pulmonary embolism?

Blood-tinged sputum

59
Interventions:

Pulmonary embolism

  • oxygen by face mask
  • heparin IV to prevent more clots from forming

60
Describe:

Pneumonia

A pneumonia is an infection in the lungs.

 

61
Causes:

Pneumonia:

62
Interventions:

Pneumonia

  • encourage fluids
  • antibiotics

63
Describe:

Influenza

Influenza is an acute viral respiratory infection.

64

How is influenza prevented?

Get the yearly vaccination.

65
Interventions:

Influenza

There is no cure, just treat the symptoms:

  • encourage rest and fluids
  • antipyretics to reduce fever
  • antitussives to prevent cough

66
Describe:

Empyema

Empyema is pus in the lungs caused by infection or a lung abscess.

 

67
Treatment:

Empyema

  • antibiotics
  • thoracentesis or chest tubes

68
Describe:

Tuberculosis

Tuberculosis is a highly infectious bacterial respiratory disease that is spread from person-to-person by breathing in infectious airborne droplet nuclei.

69

What are the precautions with tuberculosis?

  1. wear an N95 particulate respirator mask
    • possible gown, gloves, and googles
  2. private room
  3. negative air pressure with at least 6 air exchanges per hour

 

70

What populations are most at risk of getting tuberculosis?

  • homeless
  • living in large groups
  • immunosuppressed
  • IV drug users

71

What are the characteristic signs and symptoms of tuberculosis?

  • low-grade fever
  • chills
  • night sweats
  • persistent cough

72
Diagnostic tests:

Tuberculosis

  • TB skin/Mantoux test
  • blood test
  • sputum cultures

Chest x-ray is not a definitive test for TB.

73

How often is a sputum culture obtained for TB?

Sputum culture for TB is obtained once every 2 - 4 weeks.

After 3 negative sputum cultures, the client is no longer considered infectious.

74

How long are tuberculosis medications taken for?

Take TB meds for 6 - 12 months.

75

How long after tuberculosis meds are started are clients not likely to infect others?

After 2 - 3 weeks of taking TB meds, the client is unlikely to infect others.

76

Is respiratory isolation necessary at the home of a tuberculosis client when around other family members?

No. Family members have already been exposed.

Family members will take prophylactic medications for at least 6 months to prevent infection.