Week 03 Flashcards
Respiratory Alterations/ Pharmacology/ Blood Administration (182 cards)
1
Q
upper respiratory pathophysiology
A
provides a passage for air to be breathed in and out of the lungs, but it also heats, humidifies, and filters the air and is involved in cough, swallowing and speech
2
Q
lower respiratory pathophysiology
A
pull in air from the upper respiratory system, absorbs oxygen, and releases carbon dioxide in exchange
3
Q
which side of the lungs has more lobes
A
right side
4
Q
what happens to blood pressure on vent patients
A
BP drops
5
Q
what is ventilation
A
mechanical and involves the movement of air
6
Q
what is respiration
A
involves the exchange of gases in the alveoli
7
Q
are rails and crackle lungs sounds wet or dry
A
wet
8
Q
should you use a breathing treatment on a patient with rails or crackle lung sounds
A
no
9
Q
what is the only medication that will help stridor
A
racemic epinephrine
10
Q
what is racemic epinephrine
A
inhalation epi
11
Q
if acidic pH is
A
low
12
Q
if alkaline pH is
A
high
13
Q
what does ROME stand for
A
- R: respiratory
- O: opposite
- M: metabolic
- E: equal
14
Q
what breath sound is due to fluid overload
A
rails
15
Q
subjective assessment data
A
health history, medications, surgeries
16
Q
objective assessment data
A
physical observation, inspect, palpate, auscultate, percuss
17
Q
what position should you inspect the thorax in
A
sitting
18
Q
what are some abnormal lung sounds
A
- fine crackles
- corse crackles
- wheezing
- pleural friction rub
- stridor
- cheye-stokes
19
Q
compensation mechanisms: mechanical buffers
A
- on the scene in seconds
- already present in tissue and will handle minor changes in acid base balance
20
Q
compensation mechanisms: respiratory
A
- retention or elimination of CO2
- happens within minutes
- respiratory compensation can handle mild to moderate acid base shifts
21
Q
compensation mechanisms: renal
A
- regulate bicarb (HCO3) to combat hydrogen losses and gains
- starts within hours but more permanent
22
Q
what happens when first two compensation mechanisms fail
A
the renal system slowly gets to work and requires up to 5 days to complete
23
Q
what should be monitored for a arterial occlusion
A
changes in color, temp, swelling, loss of pulse, pain
24
Q
what side should patient be placed on and position for a air embolism
A
left side in trendelenburg
25
acidosis, normal, or alkalosis
pH: less than 7.35
CO2: greater than 45
HCO3: less than 22
acidosis
26
acidosis, normal, or alkalosis
pH: 7.35 - 7.45
CO2: 35 - 45
HCO3: 22 - 26
normal
27
acidosis, normal, or alkalosis
pH: greater than 7.45
CO2: less than 35
HCO3: greater than 26
alkalosis
28
what is the purpose of endoscopy/ laryngoscopy
visualize the vocal cords, remove foreign objects, obtain tissue samples
29
what is the purpose of mediastinoscopy
insertion above the sternum to the area between the lungs, visualize tumors, obtain tissue samples
30
what is the purpose of a bronchoscopy
permits visualization of the larynx, trachea, and bronchi
31
what is a/the purpose of thoracentesis
a large bore needle is inserted into the pleural space to obtain specimens, instill medications, remove fluid/air
32
upper respiratory conditions
- allergic rhinitis
- bacterial/ viral infection
- sinusitis/ rhinitis
- influenza
- epistaxis
- obstructive sleep apnea
33
lower respiratory conditions
- bronchitis
- pneumonia
- pulmonary TB
- fungal histoplasmosis
34
what is rhinitis
a upper respiratory infection
35
rhinitis pathophysiology
inflammation of the mucosa and sinuses
36
sinusitis/ rhinosinusitis pathophysiology
- inflammation of the mucous membrane of one or more sinuses
- swelling and inflammation block drainage and lead to infection
37
when does sinusitis/ rhinosinusitis occur
after rhinitis
38
bronchitis pathophysiology
inflammation of the bronchi
39
pneumonia pathophysiology
- many causes that result in reduced gas exchange
- excess fluid in the lungs
- acute infection of lung parenchyma
40
what is community acquired pneumonia (CAP)
contracted outside the healthcare system
41
what is healthcare associated pneumonia (HAP)
onset occurs less than 48 hours of hospital admission
42
what is hospital acquired pneumonia (HACP)
onset/ diagnosis greater than 48 hours of hospital admission
43
what is ventilator associated pneumonia (VAP)
onset/diagnosis within 48-72 hours after EET intubation
44
what is aspiration pneumonia
chemical pneumonitis of gastric contents
45
what is necrotizing pneumonia
cavitation of lung and abscess
RARE
46
what is opportunistic pneumonia
immunocompromised leading to pneumocystis jiroveci (PJP) and cytomegalovirus (CMV)
47
best position for pneumonia/ respiratory patients
high-fowler's
48
most used medication for pneumonia
penicillin and cephlosporins
49
latent TB pathophysiology
- TB lives but doesn't grow in the body
- don't make a person feel sick or have symptoms
- can't spread
- can advance to TB disease
50
TB disease pathophysiology
- Tb is active and grows in the body
- makes a person feel sick and have symptoms
- can spread from person to person
- can cause death if not treated
51
pulmonary TB medications
- Isoniazid (INH)
- Rifampin (RIF)
- Pyrazinamide (PZA)
- Ethambutol
- Streptomycin Sulfate
52
what is histoplasmosis
fungal infection
53
histoplasmosis pathophysiology
inhalation of spores, not transmittable
54
biggest risk factor to contracting histoplasmosis
bird and bat droppings
55
histoplasmosis treatment
amphotericin B-IV
56
what is epistaxis
nosebleed
57
when is a nosebleed considered an emergency
- non stop bleeding for 20 minutes
- significant blood loss
- caused by severe trauma
- patient has high BP
- can taste blood
58
obstructive sleep apnea pathophysiology
obstruction or narrowing of air passages r/t relaxation
59
healthy alveoli look like what compared to unhealthy alveoli
healthy look like popcorn
unhealthy look like turtle chocolate candy
60
respiratory alkalosis s/s
- seizures
- rapid deep breathing
- hyperventilation
- tachycardia
- low or normal BP
- hypokalemia
- numbness and tingling of extremities
- lethargy and confusion
- light headedness
- N/V
61
respiratory alkalosis causes
- hyperventilation
- mechanical ventilation
62
respiratory acidosis s/s
- hypoventilation > hypoxia
- rapid shallow respirations
- skin/ mucosa pale to cyanotic
- headache
- dysrhythmias
- increase potassium
- drowsiness, dizziness, disorientation
- muscle weakness, hyperreflexia
63
respiratory acidosis causes
- respiratory distress
- airway obstruction
- pneumonia, COPD, ARDS, PE
64
metabolic alkalosis s/s
- confusion
- dysrhythmia (tachy from decrease K+)
- compensatory hypoventilation
- dizzy
- increased irritability
- N/V, diarrhea
- anxiety
- seizures
- tremors, muscle cramps, tingling of fingers and toes
65
metabolic alkalosis causes
- increased HCO3 (antacids)
- NG suctioning
- prolonged vomiting
- hypercortisolism
66
metabolic acidosis s/s
- headache
- low BP
- muscle twitching
- warm flush skin
- n/v
- decrease muscle tone/ reflexes
- kussmaul respirations
67
metabolic acidosis causes
- DKA
- hyper metabolism
- renal failure
- dehydration
- liver failure
- diarrhea
- fistulas
68
metabolic acidosis treatment
- bicarbonate
- fluids
- for DKA: IV insulin, normal saline, K+, D50
69
metabolic alkalosis treatment
- fluid and electrolyte repletion
- decrease n/v
70
respiratory acidosis treatment
- bronchodilator
- antibiotics
- fluids
- ventilation
71
respiratory alkalosis treatment
- reventilate (paper bag)
- oxygen
- anti-anxiety/ sedative meds
72
pH: 7.32
CO2: 36
HCO3: 19
uncompensated metabolic acidosis
73
pH: 7.1
CO2: 43
HCO3: 13
uncompensated metabolic acidosis
74
pH: 7.87
CO2: 39
HCO3: 33
uncompensated metabolic alkalosis
75
pH: 7.32
CO2: 53
HCO3: 30
partially compensated respiratory acidosis
76
pH: 7.36
CO2: 36
HCO3: 25
normal
77
pH: 7.36
CO2: 47
HCO3: 27
fully compensated respiratory acidosis
78
pH: 7.54
CO2: 37
HCO3: 31
uncompensated metabolic alkalosis
79
pH:7.28
CO2: 31
HCO3: 16
partially compensated metabolic acidosis
80
pH: 7.59
CO2: 43
HCO3: 38
uncompensated metabolic alkalosis
81
pH: 7.2
CO2: 49
HCO3: 29
partially compensated respiratory acidosis
82
what does amantadine (symmetreal) treat
parkinsons disease
83
what should be monitored when taking amantadine (symmetreal)
- renal function
- mental status including psychosis, hallucinations, depression, suicidal ideations, and dizziness
- blood and urine test, patients may become agitated, irritable, or display abnormal behaviors
84
what does rimantadine (flumadine) treat
used to prevent flu A in patients older than 17
85
rimantadine (flumadine) side effects
extreme drowsiness, suddenly fall asleep, lightheadedness
86
how long should rimantadine (flumadine) be prescribed for
5-7 days, do not miss any doses
87
what is ribavirin (rebetol) used to treat
hepatits C
88
what are contraindications of ribavirin (rebetol)
heart problems
89
when taking ribavirin (rebetol) let your doctor know if this symptom presents
chest pain
90
what can ribavirin (rebetol) lead to in patients with heart issues
heart attack
91
what does zanamivir (relenza) used to treat
infection caused by the flu virus
92
dosing for zanamivir (relenza)
inhale at least 12 hours apart and at the same time daily
93
zanamivir (relenza) adverse effects
SOA, trouble breathing, wheezing
94
what is oseltamivir (tamiflu) used to treat
infections caused by viruses
95
how long does a patient have to start oseltamivir (tamiflu) after being exposed to the flu
2 days
96
oseltamivir (tamiflu) adverse effects
agitation, irritability, abnormal behaviors
97
what does penicillin treat
infection caused by bacteria
98
when should you take penicillin
take with a full glass of water on an empty stomach 1 hour before meals or 2 hours after meals
99
penicillin adverse effects
anaphylaxis, hives, rash, itching
100
what does cephalosporins treat
wide range of infections from gram-positive to gram-negative bacteria
101
what should be monitored for when taking cephalosporins
superinfection and rash
102
adverse effects of cephalosporins
seizures and encephalopathy
103
what does isoniazid treat
TB or to prevent its return
104
isoniazid adverse effects
tired and weak
105
what doe rifampin treat
TB
106
when should rifampin be taken
1 hour before meals or 2 hours after
107
what can happen to body fluids when taking rifampin
turn orange/ reddish color
108
what is pyrazinamide used to treat
used to kill growth of bacteria that causes TB
109
pyrazinamide adverse effects
fever, joint pain, swelling, easy bruising, nausea, dark urine, feeling tired, not hungry, upset stomach, stomach pain, light colored stools, vomiting, yellow skin/eyes
110
what is ethambutol used to treat
kills certain bacterias that causes TB
111
ethambutol contrainindications
kidney disease, gout, eye disorders such as cataracts
112
ethambutol adverse effects
blurry vision, red/green color blindness, loss of vision, numbness, tingling, burning pain, weakness, skin rash
113
what is streptomycin sulfate used to treat
active TB
114
what should you not do during streptomycin sulfate therapy
get pregnant
115
streptomycin sulfate adverse effects
damage to hearing and sense of balance
116
what is amphotericin B used treat
serious and potentially life threatening fungal infections
117
amphotericin B adverse effects
n/v, fever, hypertension, hypotension, hypoxia
118
what is prednisone used to treat
asthma, allergic reaction, arthritis, inflammatory bowel diseases, adrenal/ blood/ bone marrow disorders
119
what does prednisone do to the immune system
may decrease your ability to fight infection and may prevent you from developing symptoms if you get an infection
120
prednisone adverse effects
elevated blood sugar, mood swings, memory/ behavior issues, confusion, delirium, upset stomach
121
what is prednisolone used to treat
allergies, blood disorders, skin diseases, inflammation, infections, certain cancers, prevent organ rejection after a transplant
122
how to prevent stomach upset when taking prednisolone
take with breakfast
123
prednisolone side effects
hunger, retain water
124
what is triamcinolone used for
topical treatment for itching, redness, dryness, crusting, scaling, inflammation, discomfort of various skin conditions, psoriasis
125
what issue is associated with triamcinolone
adrenal gland issues
126
what is methylprednisolone used for
inflammation, severe allergies, adrenal problems, arthritis, blood or bone marrow problems, eye or vision issues, lupus, skin conditions, kidney problems, ulcerative colitis, flare ups of MS
127
methylprednisolone contraindications
liver, kidney, heart, or intestinal disease
128
what can methylprednisolone cause changes in
mood or behavior
129
what is dexamethasone used for
relief from inflamed areas of the body
130
when should you take dexamthasone
in the mornings to avoid messing with sleep
131
what can happen with longterm dexamethasone use
thinner bones, eyesight problems, slower growth in children and teens
132
what is albuterol used to prevent/treat
wheezing, difficulty breathing, chest tightness, coughing d/t lung diseases ( asthma, COPD)
133
what should be monitored during albuterol therapy
RR, O2, lung sounds
134
albuterol adverse effects
tachycardia, palpitations
135
what is ipratropium used to manage
symptoms of lung diseases such as asthma, chronic bronchitis, and emphysema
136
what should you do while inhaling ipratropium
close your eyes so it dont get in them
137
ipratropium adverse effects
eye pain or discomfort, blurred vision, seeing halos
138
what is salmeterol used for
to PREVENT asthma attacks, treat COPD
139
how/when to use salmeterol
same time every day, twice daily every 12 hours
140
salmeterol adverse effects
welts, rash, angioedema, bronchospasm, headache, tremors, anaphylaxis
141
what are patients that use salmeterol at risk for and how to prevent it
thrush, rinse mouth after use
142
what is Flonase use for
seasonal allergies, yearlong allergic and non allergic nasal symptoms such as stuffy nose, itching, and sneezing
143
Flonase adverse effects
nosebleeds, nasal ulcers, headaches, sore throat, nausea, cough, nasal burning/ itching
144
what is Flovent used for
helps prevent asthma symptoms by reducing inflammation in the airways
145
how to use flovent
- breathe in a deep breath
- hold for 10 seconds
- breathe out
- rinse mouth with water without swallowing after each inhalation
146
Flovent adverse effects
rash, itching/ swelling of face, tongue, or throat, severe dizziness, trouble breathing
147
what is guaifenesin used for
to help clear mucus or phlegm from the lungs
148
guaifenesin adverse effects
headache, n/v, rash, itching/swelling of face, tongue, throat, severe dizziness, trouble breathing
149
what is dextromethorphan used for
temporally relieve cough caused by the common cold, flu, or other conditions
150
who should not use dextromethorphan for cough
- chronic cough from smoking
- asthma
- emphysema
- if there are unusually large amounts of mucus with cough
151
what is inhaled epinephrine used for
temp relief for mild symptoms of a weak type of asthma
152
inhaled epi adverse effects
pulmonary edema, chest pain, difficult/ fast/ noisy breathing, blue lips or fingernails, pale skin, increased sweating, cough (may be pink frothy sputum), swelling in legs or ankles, sudden worsening of breathing problem/ asthma
153
what are calcium channel blockers used for
to treat conditions of the heart and blood vessels such as hypertension, angina, some abnormal heart rhythms, and Raynaud's phenomenon
154
calcium channel blocker adverse effects
ankle swelling, flushing, and palpitations, constipations, dizziness, fatigue
155
what is bosentan used for
first line treatment for pulmonary artery hypertension
156
bosentan adverse effects
liver damage, pain/tenderness in the upper stomach, pale stool, dark urine, loss of appetite, n/v, yellow eyes/skin
157
what is treprostinil used for
certain types of pulmonary arterial hypertension
158
treprostinil dosing
take when you wake up, no more than every 4 hours
159
treprostinil adverse effects
SOA, fainting, dizziness, diarrhea, flushing
160
what is sildenafil used for
relax blood vessels in the lungs to allow blood to flow easily, ED
161
how often can you take sildenafil
once a day
162
what can you not have while taking sildenafil
grapefruit juice
163
sildenafil adverse effects
headache, flushing, dyspepsia, abnormal vision, nasal congestion, back pain, nauseam dizziness, rash
164
what is bumex used for
swelling from the heart, kidneys, liver disease by making you pee more to remove salt and excess water from your body
165
bumex adverse affects
unusual bleeding, bruising, black tarry stools, blood in urine or stool, pinpoint red spots on your skin, muscle cramps
166
what is furosemide used for
treat edema
167
how should you take furosemide
on empty stomach, 1 hour before food or 2 hours after due to food interfering with absorption
168
adverse affect of furosemide
severe stomach pain which could reach through to the back
169
how long is blood type and crossmatch good for before and after a transfusion
before: up to 30 days
after: 72 hours after the first unit
170
what is the max blood administration time
4 hours
171
how long before blood infusion should pre infusion meds be administered
30 minutes
172
type O can receive blood from
only type O
173
type A can receive blood from
A and O
174
type B can receive blood from
type B and O
175
type AB can receive blood from
AB, A, B, and O
176
Rh+ can receive blood from
Rh+ and Rh-
177
Rh- can receive blood from
only Rh-
178
mild to moderate blood transfusion reactions
mental status change, itching, anxiety, changes in vital signs, n/v, flushing, headache
179
severe blood transfusion reactions
increased heart rate, fever, anxiety, n/v, back pain, chest tightness, SOA, dyspnea
180
what to do during a suspected blood transfusion reaction
- STOP THE TRANSFUSION
- disconnect the IV tubing from the patient
- obtain new IV tubing to run NS
- obtain a set of vital signs
- assess respiratory and cardiac status
- notify provider
- notify blood bank
- monitor cardiac, respiratory, and urinary status
- document reaction, treatment, and response
- advise patient to report reaction to future providers
181
at what times should vitals be check during a blood transfusion
- before
- 15 minutes after started
- every hour thereafter
182
what is the only solution you can run with blood during a transfusion
NS
