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Fall > 314 Oxygenation > Flashcards

314 Oxygenation Flashcards

1
Q

Normal changes in the respiratory system for aging adults are?

A

Rigid chest wall
Decreased lung capacity
Normal o2 sat 93-94%

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2
Q

Right sided heart failure presenting in JVD, ascites, hepatosplenimegaly, ankle edema can be associated with what respiratory disease

A

Chronic bronchitis

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3
Q

Prolonged exhalation, barrel shaped chest, chronic hypercapnia, and shallow respirations can be associated with what respiratory disease

A

Emphysema

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4
Q

What diagnostic tests are used for Copd

A

Spirometry (pulmonary function testing)

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5
Q

What is the role of the nurse with COPD

A

Education of medication management, self management, smoking cessation, o2 management.

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6
Q

What is the greatest risk factor for obstructive sleep apnea?

A

Obesity

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7
Q

What lab test or diagnostic studies are done for obstructive sleep apnea

A

Polysomnographic test

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8
Q

Complications of obstructive sleep apnea

A

Systemic hypertension
Cardiac arrhythmias
Heart failure
Stroke

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9
Q

What is the nursing role with obstructive sleep apnea regarding environmental factors?

A

Effective sleep environment

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10
Q

What is the nursing role with obstructive sleep apnea regarding safety considerations

A

Medications that cause sleepiness

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11
Q

What is the nursing role with obstructive sleep apnea regarding client education

A

Compliance with CPAP!
Avoid risk factors: smoking, alcohol, sedatives

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12
Q

What occurs when a substance enters the venous circulation and forms a blockage in the pulmonary vasculature?

A

Pulmonary embolism

Medical emergency
Person can breathe but blood can not oxygenate

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13
Q

DVT prevention is key to prevent what

A

Pulmonary embolism

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14
Q

Major risk factors for pulmonary embolism

A

Immobility.

Tobacco
Oral contraception
Pregnancy
Cancer
Trauma/ surgery
Advanced age

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15
Q

What diagnostics are used for pulmonary embolism

A

ABG analysis
D-dimer
Chest X-ray (rule out other condition)
Pulmonary angiography (1st choice and expensive)
VQ scan (2nd choice)
- compares ventilation and perfusion

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16
Q

What are treatments for pulmonary embolisms

A

Heparin drip
Thrombolytic therapy
Embolectomy
Vena cava filter placement

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17
Q

What is a pneumothorax

A

Lung collapse

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18
Q

Primary spontaneous pneumothorax usually occurs in what type of clients

A

Males between 20-30 with no underlying conditions

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19
Q

What procedure can increase the risk of a pneumothorax

A

Thorancentesis

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20
Q

A client with asymmetrical lung expansion, decreased breath sounds or absent breath sounds, and respiratory discomfort is presenting symptoms of what?

A

Pneumothorax

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21
Q

Manifestations of pneumothorax plus tachycardia
Hypotension
Tracheal deviation
Cyanosis
Would most likely have what

A

Tension pneumothorax

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22
Q

Blood in the pleural space associated with trauma is what

A

Hemothorax

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23
Q

What is flail chest
And what does it lead to

A

Inability to expand chest adequately with inhalation and contract upon exhalation on one side due to multiple rib fractures.
Leads to hypo ventilation with atelectasis.

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24
Q

Role of nurse with pneumothorax

A

Prepare client for chest tube insertion
Fear due to breathing difficulties and pain.

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25
Q

What conditions indicate chest tubes

A

Pneumothorax
Hemothorax
Pleural effusion
Pulmonary empyema
Post op chest drainage (open heart)

26
Q

When a chest tube is being removed what is nurses role

A

Assist provider
Administer pain meds prior
Instruct patient to bear down (valsalva maneuver)
Cover site with petroleum gauze after
Obtain chest X-rays
Continue to monitor

27
Q

What umbrella term includes acute respiratory failure and acute respiratory distress syndrome

A

Respiratory failure

28
Q

Why are elderly patient more vulnerable to rapid respiratory decline

A

They have decreased lung elasticity.

29
Q

Acute respiratory failure (ARF) is a state where a patient is unable to adequately ventilate and is caused how

A

Mechanical abnormality
Oxygenation failure (pneumonia)
Lung disorders

30
Q

Can respiratory failure be seen on ABGs?

A

Yes.
As respiratory acidosis

31
Q

Acute respiratory distress syndrome (ARDS) is caused by what

A

Sepsis, aspiration, pneumonia

32
Q

What condition causes life threatening hypoxemia resulting from edema in the alveoli and loss of elasticity in the lungs

A

ARDS

33
Q

What is VQ mismatch

A

Ventilation / perfusion not working how they should.
2 types
Dead space- ventilation with no perfusion
Intrapulmonary shunting- perfusion with no ventilation

34
Q

Patient positioning for ARDS is how

A

Prone

35
Q

Most common lower respiratory tract infection in children under 2

A

Bronchiolitis

36
Q

Bronchiolitis is mainly viral from what infections

A

RSV
Influenza
Adenovirus

37
Q

Increased risk for Bronchiolitis are patients who…

A

Preterm infants
Lung disease
Congenital heart disease
Immunodeficiency
Young. (Less than 3mo)

38
Q

If a baby has Bronchiolitis what important education is needed for parents

A

Don’t kiss baby
Hand hygiene

39
Q

Role of nurse in Bronchiolitis

A

Encourage hydration
Suction upper airway
Monitor for signs of respiratory failure
Supplement oxygen for less than 90%
PPE
Support family

40
Q

What types of pneumonia are there

A

Bacterial
Viral
Aspiration

41
Q

Who is more at risk for increased incidence of pneumonia

A

Older adults
Chronic lung disease

42
Q

Lab testing diagnostics for pneumonia

A

Chest xray

43
Q

Influenza presents how. (FACTS)

A

Fever
Aches
Chills
Tiredness
Sudden onset

44
Q

What assessment tools are used with asthma patients

A

Vs
Lung sounds
Peak flow
ABG

45
Q

Peak flow less than 50% of your normal is a signal of what

A

Airways narrowing. Medical alert!

46
Q

Status asthmaticus treatment

A

Ventilatory support required!
Medical emergency

47
Q

Pulses paradoxus can be a symptom of what non cardiac event

A

Status asthmaticus

48
Q

What is the difference between pediatric and older adults when considering water in the human body

A

Pediatric have higher %
Older adults have lower %

49
Q

The intravascular fluid, trans cellular fluid and interstitial fluid are components of what

A

Extracellular fluid

50
Q

Crystalloids or colloids. Which is larger?

A

Colloids. Exert oncotic pressure.

51
Q

What’s the difference between hypertonic dehydration and hypotonic dehydration

A

Hypotonic= more Na loss= fluid shifting from ECF to ICF.
Hypertonic = more h2o loss than Na = higher Na level= fluid shifting from iCF to ECF

52
Q

Vital signs of dehydration

A

Hypo or hyperthermia
Tachycardia & weak pulse
Hypotension
Tachypnea

53
Q

Lab values for dehydration

A

Hemo concentration
Increased urine specific gravity

54
Q

How often do you monitor weight during fluid replacement with dehydration

A

Every 8 hr

55
Q

What’s the difference between fluid overload and hypervolemia?

A

Fluid overload = hemodilution
Hypervolemia= no hemodilution

56
Q

Fluid overload signs and symptoms
(Don’t have to name them all…)

A

HTN
Tachycardia -bounding pulse
Tachypnea
Vision changes
Altered LoC
Liver enlargement
Dyspnea
Crackles
Edema
JVD
Increased motility

57
Q

Positioning for fluid volume excess

A

Semi Fowler or Fowler. Reposition frequently for skin maintenance

58
Q

How often do you weigh for fluid overload

A

Daily

59
Q

Fluid volume overload complications

A

Heart failure
Water intoxication
Pulmonary edema

60
Q

Pulmonary edema interventions

A

High fowlers
Supplement O2, cpap/bipap, mechanical vent
Morphine, nitrates, diuretics (must assess BP first!!)

61
Q

A patient present with frothy pink tinged sputum, tachycardia, anxiety, JVD, crackles and Dyspnea at rest. What is suspected

A

Pulmonary edema

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