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Nur 336 > Respiratory - Unit 3 - Assessment, Tests and Interventions > Flashcards

Respiratory - Unit 3 - Assessment, Tests and Interventions Flashcards

1
Q

What are parts of the conducting airways of the upper respiratory tract?

A

Nose, paranasal sinus, pharynx, larynx, trachea

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2
Q

What are parts of the conducting airways for the lower respiratory tract?

A

Bronchi, alveoli, lungs, pleura, pleural cavity

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3
Q

Pulmonary ventilation - def

A

the process of air entering or leaving.

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4
Q

Alveolar Ventilation - def

A

the amount of air leaving the alveoli

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5
Q

inspiration - def

A

breathing in.

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6
Q

expiration - def

A

breathing out.

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7
Q

compliance - def

A

ability of the lung to expand/contract/etc.

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8
Q

Elastic Recoil - def

A

the rebound of the lungs after being stretched.

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9
Q

Intra-pulmonary (intra-alveolar) Pressure =

A

atmospheric pressure when glottis is open and there is no movement of air.

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10
Q

Intra-pleura pressure =

A

negative pressure produced by opposite forces of elastic recoil between lungs and chest wall (prevents lung from collapsing).

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11
Q

Intra-thoracic pressure =

A

generally a negative pressure that equals intrapleural pressure. With forced expiration against a closed glottis (valsalva maneuver), it becomes positive!

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12
Q

Vital Capacity =

A

the maximum amount of air a person can expel from the lungs after a maximum inhalation.

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13
Q

Inspiratory reserve volume =

A

the max amount of air that can be inhaled after a normal inspiration.

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14
Q

residual volume =

A

the volume of air remaining in the lungs after a maximum expiratory effort.

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15
Q

Total Lung Capacity =

A

the volume at the end of a maximal inspiration.

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16
Q

What do the pulmonary arteries do?

A

They carry deoxygenated blood from the heart to the lungs.

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17
Q

What do the pulmonary veins do?

A

They carry oxygenated blood back to the heart!

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18
Q

How does diffusion work in respiratory system?

A

Movement of air and O2 from atmosphere into alveoli —-> O2 crosses into pulmonary capillaries —> CO2 diffuses out of pulmonary capillaries into alveoli

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19
Q

CO2 diffuses better than O2. T/F?

A

true!

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20
Q

What are some respiratory changes associated with aging?

A

Fewer cilia, less effective cough reflex, increased risk of : chocking and aspiration, pneumonia, effects of smoking.

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21
Q

What are some parts of the respiratory assessment?

A

Determine frequency of respiratory problems (astha?), immunization, medications, family history, smoking, etc.

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22
Q

What are some common respiratory health problems?

A

Cough (w/sputum, pain, or without), bloody sputum (hemoptysis), chest pain w/ inspiration, dyspnea, etc.

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23
Q

Pulmonary edema - biggest symptom is…

A

pink, frothy sputum!

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24
Q

What are parts of the physical assessment for respiratory?

A

nose & sinuses, pharynx, trachea, larynx, lungs, and thorax.

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25
Q

What do we inspect for with respiratory?

A

Breathing pattern, rate/depth, symmetry, movement, accessory muscles?, skin color, membranes, clubbing of fingers, etc.

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26
Q

What are some palpation things we do for respiratory?

A

99 - Fremitus (increased = liquid/pneumonia, fibrosis, etc.), decreased = obstructed or collapsed.

Tender areas.

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27
Q

What does hyperresonance mean?

A

Emphysema, pneumothorax

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28
Q

What does decreased resonance mean?

A

tumor, plueural thickening, pneumonia, etc.

29
Q

What are crackles and rales?

A

Crackling/poping with inspiration - rales are harsher - begin in bases and may clear with cough….. Pulmonary edema? Fluid overload?

30
Q

Wheeze - when?

A

W/inspirations and/or expiration —- Asthma?

31
Q

Rhonchus/Course crackles - ?

A

low pitched, snoring, gurgling —- smokers? Aspiration of foreign body?

32
Q

Pleural friction rub - ?

A

Grating, creaking, rubbing === pleural inflammation?

33
Q

Strider - ?

A

rough w/ inspiration. Obstruction of the larynx!

34
Q

Does having trouble breathing make you anxious?

A

YES

35
Q

What is the best position for a respiratory assessment?

A

Sitting upright!

36
Q

What are some radiographic tests for respiratory?

A

Chest XRay, in bed = anterior to posterior, in machine = posterior to anterior,
MRI, Pulmonary Angiogram, ventilation perfusion scan, etc.

37
Q

What’s the preferred method for diagnosing PE?

A

MRI

38
Q

What does pulse oximetry measure?

A

Arterial oxygen saturation

39
Q

What is the pulmonary function test?

A

uses a spirometer to measure lung volumes and capacities during forced breathing.

40
Q

What is a bronchoscopy? When is it contraindicated?

A

trachea/bronchial treat. Contraindicated in asthmatics - try not to take an unstable patient back as well unless absolutely necessary!

CHECK FOR GAG REFLEX AFTER to tell them when they can eat!

41
Q

What is a laryngoscopy?

A

Larynx. Pre-op = meds, vitals, consent, allergies to drugs, npo, remove dentures, O2 given, etc.

42
Q

What are some post op things to do for an endoscopy?

A

Keep patient on side when unconscious and semi-fowler’s when conscious. Check vitals, gag reflex, assess breath sounds, o2, ABG’s, etc.

43
Q

What is a thoracentesis?

A

Aspiration of pleural fluid or air from the pleural space through a needle.

44
Q

How should a patient lie when having a thoracentesis done?

A

Either hunched forward or on unaffected side!

45
Q

What are some complications for a thoracentesis?

A

Pneumothorax (watch for diminished/no breath sounds), hemothorax, infection, injury to diaphram, liver, or spleen.

46
Q

What is a lung biopsy?

A

They sick a needle in and biopsy a part. That’s about it! The usual stuff after - like assessing, breath sounds, etc.

47
Q

What are some lab tests for respiratory?

A

Maxtoux test, ABG’s, CBC, WBC, cultures, sputum analysis, skin testing, etc.

48
Q

If you need to collect sputum, when should it be done?

A

First thing in the morning, if possible!

49
Q

What’s the preferred way to open an airway?

A

Head tilt & chin lift.

50
Q

If the patient has a suspected neck injury, use the __ ___ maneuver to open the airway

A

Jaw-thrust (you thrust the jaw up!)

51
Q

What are some general nursing interventions for respiratory?

A

Elevated HOB (#1!!!!), stop smoking, oral hygiene (to prevent pneumonia), increase hydration, balance nutrition, early and frequent assessments, infection control, mental health support, etc.

52
Q

What are some respiratory therapies?

A

O2 therapy, IPPB (intermittent pressure positive breathing), Incentive Spirometry, Chest Physiotherapy (diaphragmatic breathing, pursed-lip breathing (slows down expiration), coughing, postural drainage

53
Q

What are some things that a respiratory therapist does?

A

CPAP, BiPAP, O2, IS, trach care, pulmonary functioning tests, CODES, etc.

54
Q

What are some antitussives (used to stop non-productive coughs) ?

A

Opioids (codeine, hydrocodone), nonopioids (benzonatate - tessalon perles), Robittusin - dextromethorphan)

55
Q

What are some decongestants/vasoconstrictors? Used for????

A

Used for nasal allergies, opening nasal passages - Naphazoline, Phenylephrine, Pseudophedrine (Sudefed)

56
Q

What are expectorants?

A

liquifies sputum and increased mucous flow, stimulates a productive cough. Guaifenesin!

57
Q

Mucolytic - def? example?

A

Administered by inhalation to liquify secretions, facilitates sputum removal. Used for the common cold and sinusitis - acetylcysteine.

58
Q

What are a few examples of bronchodilators?

A

Beta 2 Agonists & Methyl Xanthenes

59
Q

What do beta 2 agonists do?

A

Relax bronchial smooth muscle to relieve bronchospasms and produce bronchodilations. Used for acute asthma attack. Watch with patients who have tachycardia. Albuterol, Salmeterol, etc = examples.

60
Q

What are (Methyl) Xanthenes?

A

Bronchial dilation - due to smooth muscle relaxation. Used to treat bronchial constriction with COPD, status asthmaticus. Has stimulating effects on CNS - aminophyline, theophyline are examples.

61
Q

With theophyline, can it be given IV?

A

Yes - monitor VS, EKG, give with histamine blockers (pepcid), draw blood levels ever 6-12 months for toxicity!

62
Q

What do corticosteroids?

A

Inhibit inflammatory response in airways. Reduce edema and may aid in increasing responsiveness in bronchial smooth muscle to beta-agonists.

63
Q

What are some examples of an intranasal steroid?

A

Dexamethasone, Fluticasone, Flunisolide, Budesonide

64
Q

What are antihistamines used for in respiratory problems?

A

treat allergies, hayfever, urticaria, dries mucosal membranes and reduces edema.

65
Q

What are some nonsedating antihistamines?

A

Fexofenadine, Loratadine

66
Q

What are some sedating antihistamines?

A

Chlorpheniramine (Chlortrimetron), Promethazine (Phenergan)

67
Q

What do mast-cell stabilizers do and what are some examples?

A

They are for allergies, exercise asthma - examples = cromolyn sodium, intal, crohom

68
Q

What do leukotriene receptor antagonist’s do - examples?

A

protects against allergy triggers, reduces asthmatic symptoms. Examples = montelukast and zafirlukast.

69
Q

What do anticholinergics/vagal blockers do? Examples?

A

Prevent bronchospasm and reduces mucous production. Example = ipratropium (Atrovent)

Nur 336 (26 decks)

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