Adult Respiratory Flashcards
Chest tube suction control chamber
- Gentle bubbling
Chest tube water seal chamber
- tidaling
- if not, check tube for fibrin clots
- intermittent bubbling
- keep below insertion site
Chest tube drainage collection chamber
- no tidaling
- no bubbling
- serosanguinous (pink) drainage
Assess tactile fremitus
- client repeats “ninety-nine”
- intercostal spaces
- If vibrations are uneven, it may indicate pneumothorax, inflamed lung tissue, or fluid build-up.
Thoracentesis
- needle aspiration of pleural fluid or air using ultrasound
- client sitting, lean forward
Complications following thoracentesis
- most common risk is pneumothorax
- other risks include
- tachypnea
- tachycardia
- nagging cough
- decreased oxygen saturation
- crackling sound
Purpose of the chest tube
- create negative pressure
- remove excess air
- rarely clamp
- bottle of sterile water is ESSENTIAL to keep at bedside
Crepitus
- air trapped in and under the skin, known as subcutaneous emphysema
- notify PHCP
Pneumothorax
- sudden-onset chest pain
- tachycardia
- shortness of breath
- using neck muscles to breathe
- rapid/shallow breathing
- absent breath sounds on affected side
- cyanosis
collpased lung
Respiratory acidosis
- low pH and high CO2
- inability to expel carbon dioxide
- airway obstruction
- decreased ventilation
- CPAP and BiPap machine lowers CO2 levels
- give bronchodilator
Agonal breathing
gasping for air
Cheyne-Stokes
apnea alternating with periods of rapid breathing
Neurogenic hyperventilation
excessive and rapid breathing without the alternating pattern of apnea
Apneustic breathing
prolonged inhalation with shortened exhalation
Ataxic breathing
- irregular and unpredictable
- no specific pattern
Cluster breathing
- clusters of breath with irregular pauses in between
- associated with lesions of the medulla or lower pons
Early signs of hypoxia
altered mental status and restlessness
Discontinue chest tube kit
- suture removal kit
- occlusive gauze
- dry, sterile gauze
- biohazard bag
- clamp
- give pain medicine prior to removing
Bag-valve mask
- keep bedside during mechanical ventilation
Asthma
- MUST HAVE WHEEZING
- hyperresponsiveness
- bronchoconstriction
- decreased forced expiratory volume
- ventilation-perfusion mismatch
- increased lactic acid
Endotracheal tube placement
- X-ray
- end-tidal carbon dioxide (EtCO2)
- 20-40 mmHg
- suction when needed
- elevated HOB to MORE than 30 degrees
Pulmonary embolism
- CHEST PAIN WITH COUGH, chest heaviness, SOB
- can be CAUSED by IMMOBILITY
- hypoxia = HYPOTENSION
- tachypnea
- tachycardia
- give oxygen = PRIORITY
- place in high Fowler’s
- no petechiae like in fat embolism
- DIAGNOSE
- CT angiogram with dye!!!!!
- D-dimer
- troponin
- bnp
Barrel chest
- seen in COPD
- develops over time
Obstructive sleep apnea (OSA)
- issue isnt oxygen
- tongue and neck muscles relax
- causes displacement and obstruction
- retains carbon monoxide
- CPAP machine is gold standard, not supplemental oxyfen
- lose weight!
- exercise!
- side sleeping with pillow helps
Laryngotracheobronchitis
- AKA croup = swollen voice box
- give nebulized racemic epinephrine
- caused by viral infection
- influenza both types
- adenovirus
- RSV
- measles
- not abrupt, slow progression
- bark type cough
- hoarseness
- restlessness from coughing too much
- low fever
- stridor
- give steroids, fluids, nebulized epinephrine
- NO THROAT PAIN
- NO DYSPHAGIA
CPAP machine
- positive pressure to prevent airway collapse
- used as weaning mode to get client extubated
Acute respiratory distress syndrome (ARDS)
- previous pneumonia without improvement
- REFRACTORY HYPOXIA
- hypoxia not corrected despite oxygenation
- may have to ventilate
- causes pulmonary edema
- tachycardia
- restlessness
- respiratory alkalosis
- transitions to acidosis if left untreated
