The Respiratory System Flashcards

Question

H-2 Receptor Blocker

Answer 1

blocks production of stomach acid drugs: ranitidine, famotidine.

Answer 2

a group of lung diseases that block airflow and make it difficult to breathe

Answer 3

destruction of the alveoli due to chronic inflammation; decreased surface area results, leading to impaired gas exchange

Answer 4

chronic inflammation of the airway with productive cough, and increasing sputum.

Answer 5

respiratory disease with bronchospasm in the bronchi and chronic inflammation of the airway resulting in excessive mucous production. Damage is irreversible.

Answer 6

Short Term: 1. Airway: intubate; adrenergic agonists (albuterol) 2. Breathing: Oxygen, theophylline, ipratropium, dexamethasone 3. Circulation: IV fluids Long Term: - Inhaled corticosteroids (Budenoside, fluticasone daily) - Leukotreine modifiers [Montelukast (blocks leukotrienes from overresponse to triggers); Theophylline (bronchodilator; must be used regularly); allergy control (clean environment; avoid triggers)

Answer 7

- Status Asthmaticus - Pneumonia - ARDS - Pulmonary Embolism

Answer 8

asthma attack that is refractory to treatment; leads to respiratory failure; can progress to death if untreated Treatment: - bronchodilators - chest physio - increased fluid intake - pursed lip breathing - eat small, frequent meals - avoid abdominal distension Considerations: be careful with O2 administration; hypercarbia stimulates breathing and if you hyper oxygenate the patient, breathing may stop.

Answer 9

inflammation of the lung that impacts the alveoli; alveoli become filled with pus and liquid Types: - Viral -- RSV, adenovirus, influenza - Bacterial - fungal - chemical - aspiration Diagnosis: chest x-ray -- patchy infiltrates and sputum culture S & S: fever, cough, tachypnea, crackles, chest pain, increased WOB Treatment: airway suctioning and spo2 monitoring; breathing assessment (WOB, humid O2), monitor for dehydration, give IV fluids, chest physio, antipyretics, analgesia, expectorants, antibiotics, isolation precautions (droplet for three days).

Answer 10

acute condition characterized by bilateral pulmonary infiltration and severe hypoxemia in the absence of cariogenic pulmonary edema. Fluid collects in the alveoli and deprives the body of oxygen. Causes: Sepsis, trauma, COVID, burns, aspiration, OD, and near drowning. Assessment: chest x-ray -- will show diffuse, bilateral infiltrates; Hypoxemia (pale, cool, dusky mottled skin with low spo2) Treatment: intubation (mechanical ventilation with high pressures); prone positioning; prevent infection.

Answer 11

life-threatening blood clot in the lungs; caused by embolism in vein or clot during surgery; the clot decreases tissue perfusion, causing hypoxemia; can lead to right-sided heart failure if untreated S & S: anxiety, dyspnea, chest pain, hypoxemia, rales, diaphoresis, hemoptysis. Treatment: O2, high fowlers, heparin, ACE inhibitors.

Answer 12

CO poisoning requires aggressive oxygenation at a FiO2 of 100%. A nonrebreather is the only delivery device to provide a FiO2 level of 100% and is used for a client with CO poisoning. ✓ Carbon monoxide binds to a red blood cell approximately 200x more than oxygen ✓ Carbon monoxide poisoning may occur from smoke inhalation from fires, poorly functioning heating systems, and motorboat and motor vehicle exhaust exposure in a closed setting ✓ Manifestations include headache, dizziness, weakness, malaise, altered mental status, and visual changes ✓ This poisoning is tasteless, odorless, and colorless ✓ Treatment includes removing the client from the source of the poison, putting them outside, calling EMS, and administering 100% high-flow oxygen

Answer 13

a severe form of pneumonia and lung inflammation caused by infection known as legionella.

Answer 14

irst, the nurse will perform hand hygiene and identify the patient. Second, hyper-oxygenate the patient to prepare them for the procedure and prevent desaturations. Third, insert the suction catheter without suctioning to the pre-measured depth. The nurse should be sure to not allow the suction catheter to touch anywhere other than the inside of the tracheostomy. It is recommended to insert the suction catheter with the nondominant hand. Fourth, apply intermittent suction and rotate the suction catheter as you remove it from the tracheostomy. The nurse should ensure the suctioning does not exceed 10 seconds. Lastly fifth, replace the cap, mist collar, oxygen mask, or other apparatus to the tracheostomy and monitor the patient to ensure they return to baseline.

Answer 15

- assess respiratory status, trach ties, skin integrity, and need for suctioning - set up sterile field then remove and clean the inner cannula. If disposable, replace with new one. - cleanse stoma site, then tracheostomy plate, ensuring no fluids enter. - replace ties if soiled; secure before removing old ties; one finger width - document amount of secretions, appearance of stoma and surrounding skin, and the client's response.

Answer 16

CO poisoning is odorless, colorless, and tasteless. This potentially lethal poison initially causes clients to develop symptoms such as headache, reduced visual acuity, and slight breathlessness. As the CO level increases, it causes hypotension, confusion, and vertigo and then progresses to death. A common misconception about CO poisoning is that it causes a decrease in SpO2. This is not accurate because pulse oximetry does not differentiate COHb from oxyhemoglobin. It is entirely plausible and likely that the client has a normal SpO2. CO poisoning would not cause hyperarousal. Instead, it would cause the client to experience dizziness and lethargy. Tachycardia is commonly seen as a compensatory mechanism from the falling cardiac output, not bradycardia. ✓ Carbon monoxide binds to a red blood cell approximately 200x more than oxygen ✓ Carbon monoxide poisoning may occur from smoke inhalation from fires, poorly functioning heating systems, and motorboat and motor vehicle exhaust exposure in a closed setting ✓ Manifestations include headache, dizziness, weakness, malaise, altered mental status, and visual changes ✓ This poisoning is tasteless, odorless, and colorless ✓ Treatment includes removing the client from the source of the poison, putting them outside, calling EMS, and administering 100% high-flow oxygen

Answer 17

Diabetes mellitus is a common co-morbidity associated with cystic fibrosis (CF). The damage that CF may cause to the pancreas may induce diabetes. Thus, random blood glucose levels and quarterly hemoglobin A1C levels are commonly ordered throughout the course of the illness. A random blood glucose level greater than 200 mg/dL may suggest the presence of diabetes. Complications Associated with Cystic Fibrosis * Pneumonia Pneumothorax Diabetes mellitus Depression * Failure to thrive * Vitamin deficiencies Osteoporosis * Pancreatitis Infertility

Answer 18

A pneumothorax has clinical features such as reduced breath sounds on the affected sides, tachypnea, dyspnea, and pleuritic chest pain. Some clients may be asymptomatic, depending on the size of the pneumothorax. Pneumothorax may be caused by trauma to the chest wall secondary to a traumatic injury. Pneumothorax may also adversely develop during the placement of a subclavian or intrajugular central line. The priority treatment for clients unstable with pneumothorax is the placement of a chest tube.

Answer 19

Tracheal suctioning is often needed to clear the secretions and maintain an open airway. It is important for the RN to understand the complications of tracheal suctioning. If the nurse notices a change in vital signs (tachycardia, tachypnea) while suctioning a patient, the nurse should stop the suctioning and check the oxygen saturation immediately. When the client becomes tachycardic and tachypneic while suctioning, it is a sign of distress which indicates that the client is not tolerating the suctioning. Hence, suctioning needs to be immediately discontinued to prevent further distress and the cause of the distress should be explored. Hypoxemia is an important cause of tachycardia and cardiac arrhythmias during suctioning. If hypoxemia is noted, 100% oxygen should be administered quickly. Other things to monitor for would be bradycardia, changes in the heart rhythm (arrhythmias), desaturations, or cyanosis.

Answer 20

Mucus plugging is caused by slowed smooth muscle contraction brought about by bradykinin, not histamine.

Answer 21

Erythema, tissue swelling, and shock are caused by the dilation of blood vessels and increased vascular permeability brought about by histamine. Shortness of breath and wheezing are caused by the constriction of smooth muscles in the bronchial airways brought about by histamine. Histamine release over-stimulates the nerve endings causing itchiness and painful skin.

Answer 22

When a client is intubated via ETT, the initial verification methods include a chest x-ray and end-tidal carbon dioxide (EtCO2). A chest x-ray will verify that the tube terminates 2-3 cm above the carina. End-tidal carbon dioxide (EtCO2) monitoring is a device that may be added and typically changes color when the tube is in the appropriate place. End-tidal carbon dioxide ranges between 20 and 40 mm Hg. ✓ When a client is being mechanically ventilated, airway patency is the priority. ✓ A bag-valve mask should be readily available during a power failure or emergency resuscitation. ✓ Review ventilator settings frequently and collaborate with respiratory therapy to assist in ventilator management. ✓ The client's head of the bed should be more than 30 degrees when supine to decrease the risk for aspiration and ventilator-associated pneumonia (VAP). ✓ VAP can be prevented by Oral care using an antiseptic Minimizing exposure to proton pump inhibitors Meticulous hand hygiene by nursing staff/visitors Pulmonary hygiene measures such as chest physiotherapy When caring for a client on a ventilator, you should be familiar with the following settings: Mode (Volume [SIMV, A/C] or Pressure [PSV]) Rate (Number of breaths per minute) Tidal volume (the amount of gas delivered to the client) Fraction of inspired oxygen (FiO2 - the percentage of oxygen given per breath) PEEP (pressure added at exhalation to keep the small airways open and mitigate atelectasis) Pressure support (PS - provides added pressure when the client takes a spontaneous breath)

Answer 23

Impaired mobility in older adults creates a risk for airway collapse, reduced air exchange, hypoxia, hypercapnia, and acidosis. Reduced gag and cough reflexes can place older people at risk for aspiration of secretions and, potentially, aspiration pneumonia. There is a possibility of postoperative respiratory complications because of impaired cough reflex, weaker muscles, and decreased inspiratory capacity. Older adults are at increased risk of respiratory complications due to stress. The nurse should pay attention to maintaining adequate ventilation, keeping lung volumes high, clearing secretions, and positioning to prevent aspiration.

Answer 24

Bronchovesicular sounds occur over major bronchi where there are fewer alveoli. They are moderate in pitch and amplitude and are normally equal during inspiration and expiration. Posteriorly, bronchovesicular breath sounds can be auscultated between the scapulae.

Answer 25

Crackles and rales are indicative of pulmonary congestion. Because this child has coarctation of the aorta, there is too much blood backing up in the lungs. It is impossible for the left side of the heart to move sufficient blood forward working against the coarctation. This causes the back up of blood in the lungs, and therefore the crackles and rales are indicative of pulmonary congestion.

Answer 26

In the absence of an emergency, the cuff should never be deflated during the initial 24-hour period. In order to minimize the risk of bleeding around the insertion site for the initial 24 hours following a tracheostomy, the nurse must minimize the number of tracheostomy manipulations that occur. Each time a tracheostomy tube is manipulated, there is an opportunity for complications and associated morbidity. Every manipulation carries the risk of trauma to the tracheostomy wound and accidental decannulation. Tracheostomies are common surgical procedures used for long-term airway management that involves creating a permanent connection between the anterior neck and trachea. Indications include upper airway obstruction, prolonged mechanical ventilation, long-term management of secretions, severe obstructive sleep apnea, and/or head/neck surgery. Tracheostomies are placed inferior to the cricothyroid membrane, most commonly between the second and third tracheal rings. For mechanically ventilated clients, tracheostomies generally occur between days 7 and 21 of mechanical ventilation.

Answer 27

The high-pressure alarm signifies an obstruction in the tubing caused by the client biting on the tube or secretions in the ETT. The nurse should assess the client to determine if they are in pain as the prescribed propofol is not pain medication. If pain is not the cause of the alarm, the nurse should assess the client for the need to be suctioned. Tachypnea decreased oxygen saturation, and rhonchi in the lung fields would support the need for the client to be suctioned. The low-pressure alarm may indicate that the client has extubated themselves, disconnected from the ventilator, or has low cuff pressure. Ventilator alarms should always be enabled to alert the nurse of potential complications. The first action the nurse should take when responding to an alarm is to assess the client. Essential items to have at the bedside while a client is mechanically ventilated are a bag-valve mask and oxygen.

Answer 28

When caring for a client with a tracheostomy, the nurse should have the necessary safety equipment at the bedside, and this includes – Two extra inner cannulas - one fitting the client and one smaller size. Obturator Suction equipment Oxygen source/tank

Answer 29

Asthma typically begins in early life, whereas symptoms of CHF and COPD usually develop later in life. Bronchiectasis typically presents with signs and symptoms of a recent infection, including large amounts of bronchial secretions. Asthma symptoms tend to come and go with symptoms being worse at night. There is often a family history of asthma, and it usually occurs in obese patients.

Answer 30

t is appropriate for the nurse to finish counting the client's respirations and continue to monitor them as normal. Fluctuations of water in the water-seal chamber with inspiration and expiration are a sign that the drainage system is patent. Normally, the water level will increase when the client breathes in, and then decrease when they breathe out. This is due to changes in intrathoracic pressures.

Answer 31

Formoterol is a maintenance medication indicated for asthma. Fometerol is a long-acting bronchodilator and would not help treat acute laryngotracheobronchitis.

Answer 32

Albuterol is a short-acting bronchodilator. It is used as a rescue inhaler and is helpful in acute asthma attacks. In croup, the upper airways are edematous and inflamed, causing stridor and airway obstruction. Albuterol is not beneficial in the management of croup because it does not target the upper airways.

Answer 33

Montelukast is a leukotriene inhibitor. It is given two hours before exercise to prevent/ reduce the symptoms of exercise-induced asthma.

Answer 34

✓ Croup (laryngotracheitis and laryngotracheobronchitis) is commonly caused by a viral infection (influenza types A and B, adenovirus, RSV, and measles) that is slowly progressive ✓ It typically features a brassy (barking) cough, hoarseness, restlessness because of the frequent coughing, low-grade fever, and inspiratory stridor. The inflammation and swelling of the upper airways result in stridor. In severe croup, the child should be evaluated very carefully not to cause any additional discomfort because any increase in agitation or crying can further worsen the airway narrowing. ✓ Treatment is with corticosteroids, fluids, and nebulized epinephrine in severe cases

Answer 35

✓ Aspiration pneumonitis and pneumonia are caused by inhaling toxic and/or irritant substances, most commonly large volumes of upper airway secretions or gastric contents, into the lungs ✓ Symptoms include cough and dyspnea ✓ Diagnosis is based on clinical presentation and chest x-ray findings ✓ Treatment and prognosis differ by aspirated substance ✓ The term "aspiration pneumonia" is used when the ability to protect the lower airway is compromised and/or a large volume is aspirated

Answer 36

✓ An array of conditions, including pneumonia, may cause acute respiratory distress syndrome (ARDS) ✓ ARDS is classically manifested by hypoxemia despite the client receiving supplemental oxygen ✓ ARDS causes pulmonary edema, infiltrates, decreased compliance, and hypoxemia (despite supplemental oxygen) ✓ Early recognition is key to survival, and an indicator of ARDS is refractory hypoxemia ✓ Treatment is oxygenation and potentially mechanical ventilation via an endotracheal tube (ETT) ✓ Manifestations of ARDS include hypoxemia despite receiving supplemental oxygen, tachycardia, restlessness, respiratory alkalosis, which transitions to acidosis if untreated `

Answer 37

A client who experiences a pneumothorax may initially experience shortness of breath and chest pain. When the pneumothorax increases in size the client will display an increased respiratory rate, cyanosis, diminished breath sounds, and subcutaneous emphysema.

Answer 38

Hemoglobinuria is a classic manifestation associated with a hemolytic reaction. The hemolysis caused by incompatible blood is caused the body to spill hemoglobin in the urine. If this is assessed, the nurse should stop the transfusion, disconnect the tubing, and infuse isotonic saline. The tubing and unit of blood should be returned to the blood bank. Finally, a urine analysis should be obtained to confirm this finding. ✓ For the unconscious client (or the client receiving mechanical ventilation), the nurse must use expert skills to determine the presence of a transfusion reaction ✓ Weak pulse, fever, tachycardia or bradycardia, hypotension, visible hemoglobinuria, oliguria, or anuria are manifestations associated with a reaction

Answer 39

A bronchoscopy is a procedure used to examine the lungs and collect tissue samples for biopsy. Although rare, a pneumothorax does occur in 2-5% of post-transbronchial biopsy clients. Manifestations of this complication may include dyspnea, tachypnea, tachycardia, and coughing. The nurse should not feed the client until the gag reflex has returned.

Answer 40

Hyperressonance is an abnormal finding over adult lung tissue. It indicates an abnormal increase in the amount of air present, such as with emphysema.

The Respiratory System Flashcards

(64 cards)