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Complex Care Concepts > Respiritory > Flashcards

Respiritory Flashcards

(48 cards)

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1
Q

Risk factors

A 
Prolonged immobilization 
Sentra venous catheters 
Surgery 
Obesity 
Advancing age 
Conditions that increase blood clotting 
History of thromboembolism
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2
Q

Clinical manifestations

A 
Dyspnea 
Tachypnea 
Chest pain
Dry cough
Hemoptysis 
Distended neck veins 
Tachycardia 
Hypotension 
S3, s4
Fever, petechiae, flu-like
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3
Q

Labs

A

ABGs
D-dimer
BNP
Cardiac

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4
Q

Dx

A

CT

Gold standard: pulmonary angiography

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5
Q

No surgical management

A 
O2
Monitor 
20 gauge in AC
Continuous O2 sat
Drugs
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6
Q

Drugs

A

Anticoagulant

Fibrinolytics

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7
Q

Heparin drip

A

Check PTT

Goal: 1.5 to 2.5 times normal

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8
Q

INR

A

Goal 2-3

Takes 5 days

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9
Q

Critical values of acute respiratory failure

A

Pao2 <60
OR
Paco2 >45 with pH <7.35

AND

Sao2 <90 in both cases

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10
Q

Ventilatory failure

A problem with how air moves

A 
Physical problem with lungs or chest wall
Defect in brain
Poor diaphragm 
Extrapulmonary causes 
Intrapulminary causes
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11
Q

Oxygenation failure

A 
Ventilation normal, lung perfusion decreased 
Right to left shunting 
VQ mismatch 
Low O2
Abnormal hemoglobin 
At alveolar level *
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12
Q

Combined ventilatory and oxygenation failure

A

COPD

Asthma

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13
Q

Dyspnea intervention

A 
O2 therapy 
Position of comfort 
Relaxation 
Engraftment conserving measures 
Drugs
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14
Q

Drugs

Respiratory

A

Albuterol
Metered dose inhaler
Steroids

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15
Q

ARDS

A 
Persist despite 100% O2
Decreased compliance 
Dyspnea
Not cardiac related 
Ground glass on x ray
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16
Q

ARDS often occurs

A 
Lung injury
No hx of pulmonary problems 
Sepsis
Burns 
Pancreatitis 
Trauma
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17
Q

Causes of lung injury in ARDS

A

Systemic inflammatory response is common pathway

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18
Q

Alveolar capillary membrane injured

A

Intrinsic- sepsis, shock

Extrinsic- aspiration, inhalation

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19
Q

They key

A

Early recognition for those with increased risk

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20
Q

Dx of ARDS

Study These Flashcards
A 
Low O2 on ABG
Refractory hypoxemia 
Ground glass
No cardiac involvement on ECG
Low to normal PCWP
21
Q

S/Sx of ARDS

Study These Flashcards
A

Increased work of breathing
Change in mental status
Normal breath sounds
Cyanotic, pallor, intercostal retractions

22
Q

Why the normal breath sounds?

Study These Flashcards
A

Changes in sound occur in interstitial spaces, not airways

23
Q

Interventions for ARDS

Study These Flashcards
A 
Monitor VS hourly
Higher levels of O2 
Intubation 
Ventilation 
CXR
24
Q

Carina

Study These Flashcards
A

Where the trachea splits off

25
ET tube rests
2cm above carina
26
When to do a tracheostomy
If ventilation is needed more than 10-14 days
27
Verifying tube placement
End tidal carbon dioxide levels CXR Breath sounds bilaterally Symmetrical chest movement
28
ET nursing care
``` Assess placement(tooth and nose) Chest movement and sounds Check pilot balloon Soft wrist restraints Sedation ```
29
Assist-control ventilation
Takes over breathing for pt
30
Synchronized intermittent mandatory ventilation
Allows for spontaneous breathing at pts own rate
31
BiPAP
Non invasive Nasal or face mask For OSA and muscle fatigue
32
Tidal volume
Volume of air pt receives with each breath
33
Rate
Usually 10-14
34
Fraction inspired O2
Based in ABGs | 21-100 of air
35
CPAP
Keeps alveoli open during inspiration, prevents collapse during expiration
36
PEEP
Positive-end expiratory pressure Prevents alveoli from collapsing Always partially filled
37
Flow
How fast each breath is delivered | 40L/min
38
Complications
``` GI Nutritional Infections Atrophy Ventilator dependence ```
39
Oral care
Every 2 hrs Chlorahexidine Sterile suction
40
Extubation
``` Hyperoxygenate Suction Deflate cuff Pull straight out at peak inspiration Cough Monitor every 5 minutes ``` Stridor
41
Rib fracture
Not splinted Decrease pain Avoid analgesics that cause respiratory depression
42
Flail chest
Sucking inward during inspiration | Puffing out during expiration
43
Pneumothorax
Air in pleural space
44
Pneumothorax assessment
``` Decreased breath sounds Loud booming sound Chest expansion Deviation of trachea away Pain Tachypnea Subq emphysema ```
45
Tension pneumothorax
Air leak in lung or chest wall Air enters, but does not leave Compresses vessels and heart
46
Tension pneumothorax assessment
``` Asymmetry of thorax Trachea movement Respiratory distress Absent breath sounds Distended neck veins Cyanosis ```
47
Tension pneumothorax tx
Chest tube | Needle thoracoatomy
48
Hemothorax
Simple less than 1000 | Massive more than 1000

Complex Care Concepts (25 decks)

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