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IM 7 Test 2 > Care of the Respiratory Patient > Flashcards

Care of the Respiratory Patient Flashcards

1
Q

V/Q

A

ventilation to perfusion ratio

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2
Q

what is V

A

air moving in and out of the lung

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3
Q

what is Q

A

blood circulating to the areas of the lung

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4
Q

regional mismatches - lung apex and bases

A

apex - less ventilation and perfusion

bases - more ventilation and perfusion

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5
Q

X2 causes of hypoxemic respiratory failure

A

lungs are adequately ventilated but not perfused

the lungs are perfused but inadequately ventilated

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6
Q

intrapulmonary shunt

A

extreme V/Q mismatch or imbalance

blood shunted past collapsed alveoli

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7
Q

what is the first step in reversing hypoxemia

A

oxygen therapy

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8
Q

what is hypoxemic respiratory failure

A

oxygenation failure

insufficient O2 transferred to blood

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9
Q

what is hypercapnic respiratory failure X3

A

ventilatory failure

decreased ventilation or CO2 removal

hypoventilation

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10
Q

Hypoxemic respiratory failure PaO2 and O2

A

PaO2 - <60 mmHg

O2 >60%

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11
Q

hypercapnic respiratory failure PaCO2 and pH

A

PaCO2 >50 mmHg

pH <7.35

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12
Q

X3 conditions that cause hypoxemia

A

V/Q mismatch

shunt around alveoli

blockages in alveoli or bronchioles

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13
Q

X2 conditions that increase O2 demand and contribute to hypoxia

A

anxiety

unrelieved pain

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14
Q

conditions causing impaired ventilation X4

A

CNS problems

NM conditions

Chest wall abnormalities

conditions affecting that airways and/or alveoli

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15
Q

can the body tolerate high CO2 or low O2 better

A

high CO2

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16
Q

increased CO2 leads to X3

A

morning HA

decreased RR

decreased LOC

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17
Q

X5 Clinical s/s of acute respiratory failure

A

increased Co2

cyanosis

dysrhythmias

stupor

lethargy

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18
Q

when is cyanosis a late sign of respiratory failure

A

when PaO2 is <45

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19
Q

late signs of respiratory failure X3

A

dysrhythmias

stupor

lethargy

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20
Q

general s/s of respiratory failure X11

A

AMS

dyspnea

tachypnea

nasal flaring

use of accessory/intercostal muscles

paradoxical breathing

tachycardia

HTN

diaphoresis

fatigue

non-verbal

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21
Q

what should the nurse assess in respiratory failure X6

A

position

work of breathing

breathing pattern

ability to speak

pursed lip breathing

retractions

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22
Q

X3 labs in respiratory failure

A

H&H

ABGs

Albumin

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23
Q

when should nutritional therapy start in acute respiratory failure

A

within 24-48 hours

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24
Q

MAP

A

how well the organs are being perfused

25
Q

ideal MAP

26
Q

tidal volume

A

amount of air that moves in and out of the lungs with each respiratory cycle

27
Q

good tidal volume

A

500 mL in male

400 mL in female

28
Q

tidal volume

A

volume of gas that is moved in and out of the lungs per breath

29
Q

normal tidal volume

30
Q

total lung capacity

A

volume of gas present in lung with maximal inflation

31
Q

vital capacity

A

volume of air breathed out after deepest inhalation

32
Q

FiO2

A

fraction of inspired oxygen

33
Q

room air FiO2

34
Q

Pulmonary embolism s/s X5

A

dull chest pain

pain in calf/thigh

wheezing

coughing up blood

sudden SOB

Loss of consciousness

35
Q

pulmonary embolism lab and why

A

D-Dimer

shows fibrin breakdown

36
Q

how is pulmonary embolism dx

A

CT - shows where/how many

37
Q

PE Meds X4

A

anticoagulants

lovenox

heparin drip

coumadin

38
Q

when would heparin be CI

A

if still actively bleeding r/t trauma

39
Q

PE causes X4

A

DVT**

fatty emboli

bacterial vegetation on heart valves

cancer

40
Q

is ARDS it’s own diagnosis

A

no - caused by something else like pneumonia, sepsis or aspiration

41
Q

what is ARDS

A

sudden, progressive form of acute respiratory failure

42
Q

how is ARDS severity defined

A

PaO2, FiO2 ratio

43
Q

leading COD in ARDS

A

multiorgan dysfunction syndrome (MODS)

44
Q

initial ARDS s/s X4

A

severe dyspnea

rapid, shallow breathing

inspiratory crackles

hypoxemia unresponsive to O2

45
Q

progressing ARDS s/s X3

A

increased work of breathing

tachypnea, intercostal and suprasternal retractions

tachycardia, diaphoresis, AMS, cyanosis, pallor

46
Q

ARDS dx X2

A

serial chest x-rays: classic ground glass/white out appearance

severity per PaO2/FiO2 ratio

47
Q

ARDS labs X2

A

ABG’s

CBC

48
Q

ARDS Tx X4

A

O2

mechanical ventilations

general respiratory failure care

prone positioning

49
Q

normal lung PaO2/FiO2 ratio

50
Q

acute lung injury PaO2/FiO2 ratio

51
Q

ARDS very significant PaO2/FiO2 ratio

52
Q

ARDS severe with high mortality PaO2/FiO2 ratio

53
Q

pneumothorax

A

air leaks into the space between the lungs and chest wall

54
Q

what does a chest tube do

A

returns negative pressure to the lung

55
Q

chest tube collection chamber

A

collects blood in hemothorax - may not have fluid in pneumothorax

56
Q

chest tube water seal chamber

A

provides a seal so air/fluid cannot go back into patient

57
Q

tidaling

A

water goes up in inspiration and down in exhalation

58
Q

constant bubbling in water seal chamber

A

leak in system

59
Q

suction chamber pressure (?)

A

generally 20 cm H2O

IM 7 Test 2 (6 decks)

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