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PP/PC > Adv Pt Assess > Flashcards

Adv Pt Assess Flashcards

1
Q

what are the key concepts of pt assessment

A 
collect info
analyze info 
identify current status
provide interventions
evaluate outcome
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2
Q

what are the 2 main critical thinking skills

A

analysis - breaking stuff down into components

synthesis - putting the components back together

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3
Q

why do we need to know about diagnostic tests

A

review test results
advise the pt - alleviate concern
give pt prep
tell them where to find more info

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4
Q

define pulmonary ventilation

A

movement of air between atmosphere and alveoli

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5
Q

diffusion of oxygen and carbon dioxide occurs between …

A

alveoli and capillaries

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6
Q

breathing centre location

A

medulla oblongata

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7
Q

define pulmonary edema

A

fluid in interstitial spaces and alveoli causes decreased lymphatic drainage, cardiac diseases, pneumonia, SIS, SOB, cough, tachypnea, substernal pain **can be fatal

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8
Q

define emphysema

A

pathological extension of interstitial/spaces by air loss for of COPD, increased long size, obstruction, decrease surface area, alveoli cant recoil SIS, decrease lung sounds,

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9
Q

define pneumonitis

A

inflam of the lungs due to super sensitivity causes …, aspiration, virus, autoimmune, lupus, SIS fever congestion, pan, cough, fibrosis

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10
Q

define pneumothorax

A

collection, air loss in pleural cavity caused by perforation through chest wall (trauma) or plura (superficial lung ) SIS, sudden onset, side pain, dyspnea, asymmetric chest wall movement

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11
Q

what are some cardiovascular conditions that may effect oxygenation

A

anemia
vascular disease - obstruction
heart damage and muscle changes - infarction
damage to electrical conduction system - pacemaker

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12
Q

what is a pulse oximeter

A

non-invasive device which can be attached to a finger, earlobe, toe, etc. to measure the amount of oxygenated hemoglobin in arterial blood.

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13
Q

what is the normal range of oxygen saturation

when is low enough to be life threatening

A

90-100%
if less than 80 life threatening
if less than 90% need to alert nurse

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14
Q

what are some diagnostic tests that assess function of respiratory system

A
  1. chest imaging
  2. bronchyscopy/laryngoscopy
  3. sputum sample, CBC, biochem, blood gases
  4. pulmonary function tests
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15
Q

what are early signs of hypoxia

A
  1. increased pulse -tachycardia
  2. increased resp, decreased BP (go together)
  3. cyanosis -> dis
  4. anxiety/restlessness
  5. dyspnea, diaphoresis -increased sweating
  6. headache/agitation
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16
Q

what are late signs of hypoxia

A
  1. pulse <60/min (brachycardia)
  2. cough, frothy/bloody sputum
  3. decreased resp, increased bp (go together)
  4. cyanosis
  5. fatigue, restlessness
  6. clubbing of fingers
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17
Q

what are some things to keep in mind when you have a pt who depends on oxygen therapy

A

correct rate of oxygenation
enough tubing/long enough
colour of pt
try not to dislodge or kink tubing when moving pt

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18
Q

people with COPD rely on what stimulus to breathe

why is this dangerous with oxygen therapy

A

CO2 levels

if there is too much oxygen administered this stimulus is gone and they stop breathing

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19
Q

what is important to ensure due to oxygen’s combustive tendancies

A

no smoking in the area

should materials that may generate static electricity or short circuit sparks (wool)

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20
Q

describe oropharyngeal/nasopharyngeal artificial airways

A
  • maintain upper air passages
  • easy to insert
  • low risk of complications
  • triggers gag reflex so ideal for non conscious pt
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21
Q

describe oropharyngeal/nasopharyngeal artificial airways

A
  • maintain upper air passages
  • easy to insert
  • low risk of complications
  • triggers gag reflex so ideal for non conscious pt
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22
Q

describe endotracheal tubes

A
  • commonly for pts under general anesthesia or emergency situations
  • tube terminates at bifurcation of the trachea
  • pt will not be able to speak, need alternate means of communication
  • oral care required
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23
Q

describe tracheostomy

A
  • surgical incision in trachea just below the larynx (usually between 2nd and 3rd cartilage)
  • tracheostomy tube inserted through stoma and into trachea
  • air needs to be humidified cuz it no longer goes through upper respiratory tract
  • when stoma heels the pt will likely not need tube in place
24
Q

what are some vital signs

A 
body temp
heart rate or pulse
respiratory rate
blood pressure
pain - not officially considered
25
Q

what is avg temp of body

A

36-37 degrees

26
Q

how does our body control body temp

A

heat - sweat

cold - shiver/goosebumps

27
Q

what is the most reliable means of temp measurment

A

rectal if inserted properly

28
Q

safest way of testing temp

A

axilla - although unreliable

29
Q

define heart rate

A

pulse per min

30
Q

define heart rhythm

A

patterns of beats

31
Q

define tachycardia

A

fast, rapid HB >100+/min

32
Q

define bradycardia

A

slow HB <60/min

although sometimes normal for some people

33
Q

define arrythmia

A

irregular HB

34
Q

avg HB adults

A

60-90/min

35
Q

avg HB children

A

120+/min or 90-100/min

36
Q

avg HB children

A

120+/min or 90-100/min

37
Q

what are some factors that affect pulse

A

age
exercise
anxiety/excitement/fear/anger
fever

38
Q

describe pulse oximetry

A

a sensor placed on thin part of body
A light containing red and infrared wavelengths is passed from one side to the other and absorbance of each wavelength is measured.

39
Q

what is normal oxygen saturation of blood

A

95-100%

<85% tissues not getting enough

40
Q

normal respiratory rate for adults and children

A

10-20/min

20-30/min

41
Q

what are some things that effect respiration

A

excersize
anxiety
altitude

42
Q

define dyspnea

A

difficulty breathing

43
Q

define apnea

A

absence of breath

44
Q

define tachypnea

A

abnormally rapid breathing

45
Q

orthopnea

A

difficulty breathing when lying down

46
Q

what is normal BP

A

110/60 or 120/80 adults

90/50-120/70 infants

47
Q

what are some factors the affect BP

A 
age -higher with age?
sex -higher in males
exercise
hemorrhage - decrease
arteriosclerosis - increases
after sleeping - decrease
after eating -increase
48
Q

define hypertension

A

120-139 systolic

49
Q

define hypotension

A

systolic consistently <90

50
Q

what happens when the negative pressure between the lung and thorax is lost

A

causes the lung to collapse

51
Q

define pneumothorax

A

collection of air in this plural space

52
Q

define plural effusion

A

aka hemothorax

blood in plural space

53
Q

what is the difference between upper and lower chest tubes

A

upper drains air
lower drains fluid

air floats, liquids dont

54
Q

what are the components of a drainage system

A 
chest tube
drainage system which includes:
-collection chamber
-suction control - decrease pressure in specific areas
-water seal - acts as one way valve
55
Q

why should the entire drainage system be positioned ina rack lower than the pts thorax

A

gravity - if higher than insertion risks back flow and infection
drainage flows better downwards

56
Q

what are you to do if chest tube becomes dislodged or pulls out

A

apply pressure to insertion site with sterile gauze and call for help

57
Q

what are you to do if tubing becomes disconnected from collection container of a drainage system

A

put end of tube in a bowl with saline solution to maintain water seal while a new drainage system is set up

PP/PC (3 decks)

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