Test 2 Respiratory Flashcards

Question

Parietal pleura

Answer 1

Lines the inside of thoracic cavity including upper surface of diaphragm

Answer 2

Produced by cells lining the pleura and lubricates visceral and parietal pleurae Allows them to guide smoothly and painlessly during respiration

Answer 3

Scalene muscles Sternocleidomastoid muscles Trapezius and pectoralis muscles

Answer 4

Smoking Chewing tobacco Allergies Frequent resp. Illness Chest injury Surgery Chemicals/pollutants Crowded living Fam history of infection disease Geographic residence and travel

Answer 5

Provides info regarding anatomic loco and appearance of lungs Cheap easy and quick

Answer 6

A specimen obtained by expectoration or tracheal suctioning to assist in identification of organisms or abnormal cells

Answer 7

Determine purpose Early morning is best 15 mL Rinse prior, several deep breaths, cough deeply

Answer 8

Direct visual exam of larynx, trachea and bronchi with fiberoptic bronchoscope

Answer 9

Informed consent NPO midnight prior Vitals Monitor coagulation studied Remove dentures and glasses Meds for sedation Need crash cart available

Answer 10

Vitals Semi- Fowler Assess gag reflux NPO until gag reflex returns Emesis basin Check for bloody sputum Monitor resp status, especially if had sedative Complications Notify if fever or difficulty breathing

Answer 11

Bronchospasm, bacteremia, bronchial perforation indicated by facial or neck crepitus, dysrhythmias, fever, hemorrhage, hypoxemia, and pneumothorax

Answer 12

Invasive fluoroscopic procedure following injection of iodine or radio plaque or contrast material through a catheter inserted through the antecubital or femoral vein into the pulmonary artery or one of its branches Lights up vasculator of lungs Helps see if they have blood clots

Answer 13

Informed consent and allergies NPO 8 hours prior Monitor vitals Monitor coagulation studies Establish IV access Sedate Crash cart near Instruct that they must lie still and may feel urge to cough or experience flushing, nausea or salty taste

Answer 14

Monitor vitals Don’t take blood pressure in extremity used for IV for 24 hrs Monitor peripheral neurovascular status Assess insertion site for bleeding Monitor for delayed reaction to dye

Answer 15

Removal of fluid or air from pleural space via transthoracic aspiration

Answer 16

Gathering of fluid in the pleural space, can’t respirate well with it Is not pleural fluid, has unwanted matter

Answer 17

Informed consent Baseline vitals Ultrasound or CXR prior if perscribed Assess coagulation studies Sitting upright with arms and hear supported by table at bedside If can’t sit up lay on unaffected side Informed to NOT cough, breathe deeply or move

Answer 18

Monitor vitals and resp status Pressure dressing and assess puncture site for bleeding and crepitus

Answer 19

Pneumothorax, air embolism and pulmonary edema

Answer 20

Include a number of different tests used to evaluate lung mechanics, gas exchange and acid base disturbance through spirometric measurements, lung volumes and arterial blood gases

Answer 21

Determine if any analgesics is being admin Consult physician regarding holding bronchodilators prior to testing Instruct: Void before Wear loose clothing Remove dentures No smoking or eating heavy meals for 4-6 hrs before

Answer 22

Resume to normal diet and bronchodilators that were held prior

Answer 23

Breath in in in as much as possible and then hold How much extra can you take in?

Answer 24

Normal volume of air breathed in and out when not exerting self

Answer 25

The maximum amount of air you can forcible breathe out after a breath

Answer 26

What’s left when a person breaths out as much as possible

Answer 27

Everything you can take in minus the residual volume

Answer 28

Everything you can take in including residual volume

Answer 29

Performed to obtain tissue for analysis by culture or cytologic examinations

Answer 30

Done to identify pulmonary lesions, changes in tissue and the cause of pleural effusion

Answer 31

Informed consent NPO prior Information of local anesthetic but may feel pressure during needle insertion and aspiration Admin analgesics and sedatives as prescribed

Answer 32

Monitor vitals Apply dressing to site and monitor for drainage and bleeding Monitor for resp distress Monitor for signs of pneumothorax and emboli

Answer 33

Perfusion scan: blood flow to lungs is evaluated Ventilation scan: determines patency of the pulmonary airways and detects abnormalities Radionuclide may be injected Sees if arteries match veins

Answer 34

Informed consent Allergies for dye Remove jewelry Review breathing methods Establish IV access Admin sedation if perscribed Crash cart near

Answer 35

An intradermal injection used to assist and diagnosing various infectious diseases

Answer 36

Use test site free of excessive body hair dermatitis and blemishes Apply at upper 1/3 of inner surface of left arm Circle and mark injection test site Document date, time and test site

Answer 37

Determine hypersensitivity or previous reactions to skin tests

Answer 38

Instruct not to scratch to prevent infection and abscess formation and to avoid scrubbing Interpret reaction at injection site 24-72 hours after Assess site for amount of induration (hard swelling) and presence of erythema and blister like elevations

Answer 39

Measures the dissolved O2 and CO2 in the arterial blood and reveals the acid base state and how well the O2 is being carried in the body Allen test

Answer 40

35-45 mmHg

Answer 41

22-27 mmHg

Answer 42

80-100 mmHg

Answer 43

Perform Allen test on both writsts Have rest for 30 minutes prior to Avoid suctioning prior to drawing blood Do not turn off O2 unless blood gases are ordered on room air

Answer 44

Place specimen on ice Not temp on lab form Note O2 and type of ventilation Apply pressure to site for 5-10 minutes (longer if on anticoagulants or have bleeding disorder) Transport the specimens to lab w/in 15 minutes

Answer 45

Noninvasive test that registers O2 saturation of hemoglobin After a hypoxia client uses up the readily available O2 reserve O2 attached to the hemoglobin is drawn on the provided O2 to tissues Alerts hypoxemia before clinical signs occur

Answer 46

Acute inflammation of parenchymal tissues functional parts = alveoli and bronchioles Affects 1% of pop each year 4 mil cases a year 6th leading cause of death Most common cause of death from infectious disease

Answer 47

Resistance factor of pneumonia Remove particles from air and destroy invading organisms Risks: hay fever, common cold, nasal trauma

Answer 48

Host resistance for pneumonias Prevents aspiration into tracheobroncial tree Risk factors: stroke, abdominal or chest surgery, sedation, NG tube

Answer 49

Host resistance for pnnemonias Remove secretions microorganisms and particles Risk factors: smoking, inhalation if irritating gases

Answer 50

Host resistance of pneumonias Removes microorganisms Risk factors: alcohol intoxication and smoking

Answer 51

Bacteremia/septicemia Empyema Lung abscess

Answer 52

Droplet inhalation Bacterial: streptococcus pneumonia, diplococcus pneumonia Viral: influenza, parainfluenza, RSV, CMV Other: mycoplasma pneumoniae Smoke inhalation Aspiration

Answer 53

Lassitude and severe malaise Chest pain that increases with inspiration, dyspnea

Answer 54

^ temp ^ RR, HR, use of accessory muscles, orthopedia Cough and sputum Gray complexion Raleigh (fine crackles) Rhonchi Decreased breath sounds over consolidation Friction rub Dull to percussion E > A changes

Answer 55

Pneumococcal: purulent, rusty Staphylococcal: yellow, blood streaked Klebsiella: red gelatinous Mycoplasma: non productive that advances to muciod

Answer 56

^ WBC and ESR CXR is patchy or lobar pulmonary infiltrates Sputum/blood cultures

Answer 57

Hypoxemia Respiratory alkalosis

Answer 58

Congestion 4-24 hrs Red hepatization 48 hrs Gray hepatization 1 week Resolution 7-12 days

Answer 59

Serous exudate from initial inflammatory response pours into alveoli

Answer 60

Extravasation of RBCs, fibrin, PMNs into alveoli Tissue is firm and red

Answer 61

Fibrin accumulates and granulates, RBCS and PMNs start disintegrating

Answer 62

Pneumococcal: penicillins and cephalosporins Gram negative: gentamycin or tobramycin

Answer 63

Asthma Chronic bronchitis Emphysema Chronic obstructive pulmonary disease Cystic fibrosis

Answer 64

Pleural effusion Hemothorax Pneumothorax Pneumoconioses Thoracic cage disorders Adult respiratory distress syndrome

Answer 65

Hyper-responsive, reversible form of airway disease caused by restriction in airway size from bronchospasm, chronic inflammation and increased airway secretion - bronchial and bronchiolar narrowing from ^ smooth muscle tone - mucosal edema - hypersecretion of mucus

Answer 66

9-12 mil in US ^ incidence prevalence and mortality Most common cause of chronic illness in <17

Answer 67

Immediate hypersensitivity response mediated by IgE Mast cells release histamine and prostaglandins on exposure to allergens Usually have fam history of allergies, urticaria or hay fever Usually affects children Good prognosis - complete remission in adolescence

Answer 68

Adult onset (> 30) Chronic mucopurulent bronchitis More serious, more difficult to control Poorer prognosis

Answer 69

40-90% Triggers: hypocapnia, cool air with less water vapor

Answer 70

Cold air - loss of heat and water Exercise Emotional upset - vagal pathways Exposure to bronchial irritants - receptors and vagal reflex

Answer 71

Exert effects through inflammatory response IgE mediated response to allergens - dust mite and cockroach excrement - molds and mildew - animal dander

Answer 72

Immediate bronchoconstriction on exposure to inhaled irritant or antigen Sx’s w/in 10-20 min Recovery 60-90 min Caused by re;ease of chem mediators from IgE coated mast cells on mucosa

Answer 73

Develops 3-5 hours after exposure to trigger may last for days or weeks Involves inflammation and increased airway responsiveness Caused by release of chemical mediators from mast cells, macrophages and epithelial cells (induce migration and activation of other inflammatory cell) Produces epithelial edema and injury changes in mucociliary function, reduced clearance or secretions ^ airway responsiveness

Answer 74

Bronchi widen and lengthen on inspiration BUT collapse on expiration Expiration becomes difficult d/t edema, narrowing and mucus obstruction Primary problem is getting air out of lungs Expiration requires use of accessory muscles

Answer 75

Decreased FEV and PEFR Dyspnea - orthopnea Wheezing esp. on expiration PaO2 60-72 mmHg PaCO2 low initially D/t ^ RR but ^ D/t decrease in alveolar ventilation V/Q mismatch Cyanosis Intercostal retraction Fatigue

Answer 76

Most frequent admitting dx in children’s hospitals Sex: 10-15% of boys 7-10% of girls Onset: 30% by age 1, 80-90% by age 4-5 Fam links: 1 parent = 25% risk, both = 50% Polygenic / multifactorial determinants

Answer 77

Beta 2 adrenergic bronchodilator - albuterol - epinephrine - xanthines Anticholinergic bronchodilator: Ipratropium (atovent) Corticosteroids - beclomethasone - hydrocortisone, methylprednisolone, IV if severe Heukotriene receptor antagonists Mast cell stabilizers FOR PREVENTION ONLY - cromolyn sodium

Answer 78

Aka chronic obstructive lung disease (COLD) or chronic airway obstruction (CAO) Group of diseases that result in obstruction of airflow

Answer 79

Chronic bronchitis Emphysema

Answer 80

Inflammation on bronchial walls with hypertrophy of the mucous goblet cells Characterized by a chronic productive cough (copious mucus) Present for at least 3 months out of year OR 2 months/yr for 2 successive years Often have frequent and recurrent respiratory infections “blue bloater”

Answer 81

Cigarette smoking Inhalation of industrial gases and other toxic substances

Answer 82

Air pollution, smoking, chronic respiratory infections, exposure to molds and fungi, allergic reactions

Answer 83

Inhibits cilia and macrophages Inflammation of major and small airways Hypertrophy of mucosal glands Excessive secretion Narrowing and smooth muscle constriction

Answer 84

DOE Decreased PaO2 ^ PaCO2 D/t decreased alveolar ventilation V/Q mismatch Hypoventilation of of alveoli d/t air trapping, hypoxemia, hypercapnia, cyanosis Scattered rhonchi and rales on forced expiration Abnormal ABGs Chronic cough Copious yellow green sputum Exercise intolerance Plycythemia Clubbing of fingers

Answer 85

Destruction of walls of alveoli Dilatation and less of elasticity of airspaces distal to terminal bronchioles and loss of normal elastic recoil Results in air trapping with ^ AP diameter “barrel chest” Larger airways become thinned and atrophied > become more collapsible Less prone to acute bronchitis or pneumonia but is very serious or fatal when they do get it “Pink Puffer”

Answer 86

Cigarette smoking Often genetically determined - autosomal recessive - esp. early onset and severe progression - deficiency of alpha antitrysin which inhibits proteolytic enzymes of leukocytes - loss of inhibition -> digestion of lung tissue with bacteria

Answer 87

Assoc. with smoking Affects respiratory bronchioles and alveolar ducts Unevenly distributed BUT affects upper and posterior portions of lungs more severely

Answer 88

Destruction and enlargement of alveoli distal to terminal bronchioles Results of genetic abnormality or progression of chronic bronchitis * lower portions of lung more affected

Answer 89

Dyspnea even at rest Tachypnea V/Q mismatch NOT prominent d/t loss of capillaries with alveoli - cyanosis and heart failure less prominent - pink puffers Usually little cough or sputum ABGs usually normal or respiratory alkalosis d/t hyperventilation May be unable to eat Hyperinflation of lungs “barrel chest” Slowly debilitating

Answer 90

Control of environment irritants and infection Nutritional support Exercise training Breathing exercises and retraining Managing secretions Pharmacologic treatment Oxygen therapy Psycho-emotional support

Test 2 Respiratory Flashcards

(115 cards)