Unit 2- Respiratory Flashcards
(68 cards)
1
Q
hypoxemia
A
•low oxygen levels in blood
2
Q
hypoxia
A
•decreased tissue oxygenation
3
Q
atelectasis
A
- alveolar collapse
* causes a reduction in gas exchange b/c reduces surface area
4
Q
dyspnea
A
- shortness of breath
* difficulty breathing
5
Q
tachypnea
A
•rapid respiratory rate
6
Q
hemoptysis
A
•blood in sputum
7
Q
paroxysmal nocturnal dyspnea (PND)/sleep apnea
A
•intermittent dyspnea during sleep, causing pt to awaken
8
Q
orthopnea
A
- difficulty breathing when lying down
* relieved by sitting up
9
Q
bronchospasm
A
•narrowing/constriction of bronchial tubes
10
Q
bronchoscopy
A
- visualization of larynx, trachea, and bronchi thru flexible or rigid bronchoscope
- used to visualize abnormalities and obtain biopsies
- can be done under general or conscious anesthesia
11
Q
pulmonary fxn tests (PFTs)
A
- determine lung fxn and breathing difficulties
* measure lung volumes/capacities, diffusion/gas exchange, flow rates/distribution, airway resistance
12
Q
forced expiratory volume in first second (FEV1)
A
•vol. air blown out as hard and fast as possible during first second of most forceful exhalation
13
Q
peak expiratory flow (PEF)
A
•fastest airflow rate at any time during expiration
14
Q
thoracentesis
A
- surgical perforation of chest wall and pleural space w/ large-bore needle
- used to obtain specimens, admin meds, remove fld/air
- local (conscious) sedation
15
Q
asthma
A
•chronic, intermittent condition with reversible airway obstruction
•caused by allergens, irritants, etc
•leads to…
1. inflammation
2. airway hyperresponsiveness, causing bronchoconstriction
16
Q
asthma s/s
A
- audible wheezing (esp. expiration)
- inc. resp. rate
- coughing
- use of accessory muscles
- barrel chest (severe)
- hypoxia
- inc. WBC in allergic
17
Q
ABG levels in asthmatic
A
- hypoxemia- decreased PaO2
* hypercarbia- inc. PaCO2 b/c can’t expel
18
Q
asthma medications
A
- bronchodilators- inhaler
- anti-inflam- steroids/leukotriene agonists
- combo agents- broncho/anti-inflam
19
Q
pneumonia
A
•excess of fluid in lung, resulting from inflammatory process triggered by infectious organism or inhalation of resp. irritants
•if untreated can lead to sepsis (infection in bloodstream) or empyema
•two types
1. community-acquired (CAP)
2. hospital-acquired (HAP/VAP)
20
Q
empyema
A
•infection in pleural space causing collection of pus
21
Q
hospital-aqcuired pneumonia (HAP)
A
- most often ventilator-associated (VAP)
* preventable w/ strict hand hygiene, oral care q6h (w/ chlorohexadine), HOB > 30°
22
Q
pneumonia s/s
A
- flushed, fever, chills
- chest discomfort
- myalgia
- headache
- cough (w/ sputum)
- tachy
- dyspnea (crackles/wheeze)
- hemoptysis
23
Q
myalgia
A
•muscle pain
24
Q
hemothorax
A
•blood accumulation in pleural cavity
25
pneumothorax
* collapsed lung due to air or gas accumulation in pleural space (b/t lungs and chest wall)
* have to insert CT b/c pressure on lungs, heart, etc
26
spontaneous pneumothorax
•air accumulation in pleural space, causing lung collapse w/ no evidence of trauma or dz
27
pleural effusion
•fld accumulation b/t pleural layers
28
chest tube
•catheter inserted thru intercostal space to remove air/fld/blood
•restores neg. pressure in pleural space
•attached to water-seal drainage device
•used after chest surgery and lung collapse
•either wall suction or water seal
*under high MD control
29
chest tube placement
* air- anterior lung apex
* blood/fld- lateral base
* insertion site covered w/ air-tight dressing
30
Pleur-Evac system
* most common disposable chest tube drainage system
| * one piece w/ drainage collection, water seal, and suction regulator chambers
31
drainage collection catheter
* collects fld draining from pt
| * measured hourly for first 24 hr
32
water seal chamber
* prevents air from flowing back into pt's pleural space
* must have 2cm of H2O
* one way valve
* bubbles as air passes thru until it escapes (exhale)
* fld rise/fall from 2 to 4 cm upon inhalation/exhalation
33
suction regulator chamber
* connected to wall suction (usually 20cm)
| * causes continual bubbling
34
bubbling w/ chest tube system
* always occurs when CT is connected to continuous suction
* bubble w/ only water seal indicates air passing thru chamber w/ higher intrathoracic pressure (exhale, cough, sneeze)
* excessive bubbling may indicate leak
35
CT implications
* milk tube to move obstruction (need MD order)
* DON'T clamp (except leak, change, discharge)
* keep lower than pt chest
* keep pt in semi-fowlers for pneumothorax
* keep pt in fowlers for hemothorax/pleural effusion
* measure fld hourly for first 24 hrs
36
CT complications (notify MD)
* redness/swelling/purulence/bleeding
* tracheal deviation
* sudden/increased dyspnea
* SaO2 < 90%
* drainage > 70 mL/hr
* crepitus
* accidental disconnect (immediately submerge in sterile H2O or cover w/ vasoline gauze)
37
crepitus (subcutaneous emphysema)
* coarse crackling sensation palpated over skin
| * indicates air leak into subQ tissue -> pneumothorax
38
dry suction control system
* CT system that allows for high suction pressure
* used for pts w/ massive air leak, emphysema, viscous pleural effusion, or reduction in pulmonary compliance
* constant bubbling
39
pneumostat
* mobile CT w/ one-way valve attached directly to tube to collect fld.
* used for small or partial pneumothorax
* doesn't allow for high suction pressures
40
Heimlich valve
* mobile CT w/ one-way flutter valve that allows air to escape, but keeps it from re-entering
* used for small/partial pneumothorax
* doesn't allow for fld. collection or high suction pressures
41
pneumonectomy
* removal of entire lung
* no upper CT needed b/c no lung to expand
* no lower CT needed b/c expect fluid to fill empty space
42
acute respiratory distress syndrome
* progressive hypoxemia despite supplemental O2 admin
| * initial s/s include restlessness, apprehension, anxiety
43
flail chest
* portion of chest wall pulls inward on inspiration and expands outward on exertion (floats)
* indicates fracture of 2+ ribs
44
chronic obstructive pulmonary disease (COPD)
* most often caused by smoking
* other causes include fumes, dust, pollution, genetic disorder
* two types: emphysema & chronic bronchitis (most have both)
45
emphysema
* type of COPD
* major changes in lung elasticity and hyperinflation
* results in dyspnea, tachypnea
46
Chronic bronchitis
* type of COPD
* inflammation of bronchi/bronchioles
* results in cough, mucus production, and SOB
47
severe COPD complications
* hypoxemia
* hypercarbia
* respiratory acidosis
* respiratory infection
* dysrhythmias
* HF
* decrease resp. drive (NEVER give > 2 L)
48
indication of tension pneumothorax
•tracheal deviation to side opposite of pneumothorax
49
#1 preventable cause of prematures dz/death
•tobacco use
| *Healthy People 2020 goal is to reduce to 12% or less
50
why medication assistance for tobacco use cessation
```
•relieves withdrawal symptoms
•reduces cravings
•reduces satisfaction from use
•helps control weight gain
*patch, gum, lozenge, inhaler, nasal spray, Zyban, Chantix
```
51
how does atelectasis reduce gas exchange
•reduced alveolar surface
52
pt w/ 2 chest tubes on R side; clients trachea is pointing toward L upper chest. What's RN's best action
•notify MD or Rapid Response team
53
elderly w/ pneumonia has symptoms of
•altered mental status and dehydration
54
which pathophysiological mechanisms of lung parenchyma allows pneumonia to develop?
•inflammation
55
atelectasis and brochiectasis indicate...
•collapse of portion of airway
56
what finding confirms diagnosis of asthma
•inspiratory and expiratory wheezing
57
7 y/o tachypneic, afebrile, RR=38, and nonproductive cough. PT most likely has
•acute asthma
58
19 y/o in ED w/ acute asthma attach; RR=44 bpm; acute resp. distress. Which action should RN take first
•give bronchiodilator by nebulizer
59
79 y/o w/ bacterial pneumonia who is vegetarian and OCD about germs, What is predisposing factor for pneumonia?
•age
60
what data significant from pt w/ pneumonia
* quality of breath sounds
* chest pain
* color of nail beds
61
pt w/ bacterial pneumonia is to be started on IV abx. what must be completed first?
•sputum culture to determine which abx to use
62
what should be included in plan of care for pneumonia pt?
•frequent linen changes b/c likely diaphoretic and at risk for skin breakdown
63
pleuritic chest pain is...
•moderate pain that worsens on inspiration
64
which measure most likely to reduce pleuritic chest pain?
•teach pt to splint rib cage b/c talking about pain
65
what indicates presence of resp infection in pt w/ asthma
•cough productive of yellow sputum
66
30 y/o male w/ stab wound has CT inserted b/c...
•CT serve as method of draining blood/fld
67
what are expected findings of CT after thoractomy
* 50 mL drainage in chamber
| * drainage system below pt chest
68
continuous bubbling in suction control chamber requires...
•no action
