CEN RESPIRATORY Flashcards
How can a nurse determine if ego phony is present in a patient?
_If the patient says “e” and “a” is heart over a particular area
Bronchophony : ask the patient to say ____in a normal voice. Expected finding is that the words will be _____. It is present when the word is heard
_99; indistinct ; Clearly
Whispered Pectoriloquy: Ask the patient to whisper a sequence of work such a _____normally only ______ sounds are heard. Over areas of tissue abnormality, the ______sounds will be _____ and _____
1, 2, 3; whispered,; clear and distinct.
Factors that could impair the accuracy of pulse ox
Increased bilirubin
Black,blue, brown, greens and gold nails polish can alter pulse ox readings. RED WOULD NOT AFFECT
Ambient light , motion artifact , edema and PIERCED EARLOBE.
Predominant symptoms of acute bronchitis
Cough
Finding found specific to hyperinflation of the lungs and
HyperRESONANCE OF lungs
A complication of CPR in elderly or frail patients is
sternal fracture
When you hear bowel sounds in the thoracic cavity , you would suspect what kind of injury? Because
Diaphragm rupture ; herniation of abdominal contents into the thoracic cavity.
Sing of Diaphragm rupture
bowel sound in the thoracic cavity
undigested food or fecal matter in the chest tube drainage system.
Severe pain will cause a patient to HYPERVENTILATE thus causing what acid-base imbalance
Respiratory Alkalosis
In respiratory alkalosis, the pH is _____and the pCO2 level is ____
high; Low
Common causes of noncardiogenic pulmonary edema:
ARDS, kidney failure, SUBMERSION INJURY, high altitude pulmonary edema, drug overdose.
Virchow’s Triad describes 3 COMMON risk factors for thrombosis formation which are
Venous stasis
Endothelial injury
Hypercoagulable states
the MOST FREQUENT cause of upper airway obstruction in CHILDREN
Acute LARYNGOTRACHEOBRONCHITIS (CROUP)
Coup mostly occur during which season ?_______and affect kids from ____ and ___. There is _______ most frequently at ______ accompanied by a ___________ —– focough. May experience _____and ________
Winter; 6 months; 3 years. Respiratory distress; large barking cough; Tachypnea; tachycardia.
Asthma is characterized by these 3 thing
Hyper-reactivity
Airflow limitation
Inflammation
Four classification of asthma
Intermittent asthma
symptoms 2x/week or less
nighttime sx 2x/month or less
inhaler 2x/week or less
Symptoms does not interfere with activity
Four classification of asthma
Mild Persistent asthma
symptoms more than 2x/week or less but less than once a day
nighttime sx 2x/month or less
inhaler more than 2x/week but not daily
minor limitation with activity
Four classification of asthma
Moderate Persistent asthma
symptoms daily
nighttime sx more than once a week but not daily
inhaler daily
some limitation with activity
Four classification of asthma
Severe Persistent asthma
Continual daytime symptoms
Frequent nighttime symptoms
limited to no control of symptoms
Limitation with normal activities.
Use to located a bleeding site withing the chest
Laryngoscopy
Symptoms of ARDS include
dyspnea
tachypnea
Tachycardia.
Anxiety
To create an emergency airway, where would you do it?
CRICOTHYROID membrane
Infants have _______ oxygen reserve due to _____ oxygen consumption
less; GREATER
Extension of neonate’s head may cause what ?
Tracheal extubation
Flexion of a neonate’s may lead to ____
Mainstem intubation .
Treatment of CO include
Administration of 100% oxygen
CO can lead to ____________; and the antidote is ________because it decreases what?
tissue hypoxia; 100% oxygen ; the half life of CO
This can also be given for CO poisoning
hyperbaric oxygen ; patient breathes oxygen under increased atmospheric pressure.
Pleural effusions can either be
Transudative
Exudative
Transudate fluid is seen in
LV failure
Cirrhosis of liver
hypoalbuminemia
Constrictive pericarditis.
Exudative fluid
Pancreatitis
pneumonia with pus (empyema)
What causes transudate fluid?caused by __________________fluid leaking from the _________ into the pleural space. As a result of ____________ ________pressure or ___________oncotic pressure
Water and protein-free fluid ; capillaries ; Increased intravascular hydrostatic pressure; decreased oncotic pressure.
During expiration , the diaphragm ______ and the intercostals _____
relax; relax
During inspiration, diaphragm ______ , the thorax increases in _______and the lungs are ______
contracts; size; stretched
the lungs lobes are separated by
fissures
How many lobes does the right lung have ____ and how many segments_____
3 lobes; 10 segments
How many lobes does the left lung have _______ and how many segments ____
2 lobes; 8 segments.
The primary functional units of the Lungs are
Lobules.
karate kick injury or CLOTHELINE Injury to the neck MOST LIKELY result in
Tracheobronchial disruption
Acid gain leads to
Acidosis
Acid loss leads to
Alkalosis
After failed intubation, the nurse should prepare the patient for
CRICOTHYROTOMY
What the MOST COMMONLY SEEN rib fractures?
ribs 4 through 9
What is the total volume of air that the lungs can HOLD?
5500-6000 ml
What is the total volume of air that can be inhaled?
3500ml
What is the total volume of air that can be exhaled?
4500ml
What is the most common and potentially LIFE THREATENING chest injury>
Pulmonary contusion
Blood pH level less than 7.35 is _____ and the process that creates it is called __________
Acidemia; acidosis
Blood pH level less than 7.45 is _____ and the process that creates it is called __________
Alkalemia; alkalosis.
RSV is the MOST COMMON Virus responsible for CAUSING which pediatric illness
BRONCHIOLITIS
Vocal fremitus decreased, causes could be
bronchial obstruction
emphysema
pleural effusion
pneumothorax.
Vocal fremitus INCREASED causes could be
Pneumonia overly large airways Tumor Pulmonary infarction pulmonary fibrosis
ARDS characterized by
Diffuse alveolar injury
loss of surfactant
DECREASED LUNG compliance
Emphysema will cause an increase in
Intra-thoracic volume
What can cause increase in intra-abdominal volume?
Abdominal distention
Ascites
pregnancy
Hepatomegaly
Tumors lead to pleural effusion by
Obstructing the flow of lymphatic drainage.
An acute infection of DISTAL airways, lung interstitium and infection of alveoli is knowns as
PNEUMONIA
2 most common causes of PNA
Streptococcus Pneumoniae
Haemophillus Influenzae
SUBMERSION injury AKA _________ leads to respiratory impairment from submersion in liquid
near-drowning
Treatment of submersion injury or near-drowning is
slowing and preventing the progression of neurologic impairment
Breath sound that sound like “snoring “ are
Rhonchi
Grating or scratching breath sound are called
Pleural friction rub.
High pitched whistle that you DONT NEED A STETHOSCOPE to hear
STRIDOR
Normal calcium level for a child______and for adult _____
- 8-10.8
9. 0-10.5
When pH is decreased what happens to the respiratory rate?
Rate and depth increases
The most important lab for CO poisoning
Carboxyhemoglobin level.
Vesicular breath sounds
Soft intensity, low pitch, rustling quality
Broncho-vesicular breath sound
medium intensity, medium pitch, breezy quality
Bronchial breath sounds
Loud intensity, high pitch, hollow quality,
The most common AIRWAY OBSTRUCTION in children
Tongue.
Percussion tone most likely heard in normal lungs________and in Hyperinflated lungs
RESONANT; hyperresonant
The upper portion of the trachea that connects the trachea with the LARYNGOPHARYNX
LARYNX
Airway passage located through the vocal cords
Glottis
Obligate nose breathers are
0-6 months
Most appropriate intervention for infant with FB
Administer 5 back blows
and 5 chest thrusts.
An _________myocardial workload is an indication for oxygen therapy not a (n)_____
Increased; decrease
Whooping cough is associated with________patient should be _____precautions; it is caused by _______- ______
acute bacterial infection with an incubation period of 7-10 days; droplet; Bordetella pertussis.
Bronchi are supported by
Cartilage
Smooth muscle
What is the most IMPORTANT chemical buffer of acid-base regulation
BICARBONATE
HyPOPNEA defined as
Shallow ventilation or SLOWER than normal rate
Regular ventilation with slow rate
BRADYPNEA
Diffusion is the
movement of gas between ALVEOLI, RBCs, and plasma
Perfusion is
Movement of blood through the pulmonary capillaries.
Ventilation is
movement of air between the atmosphere and alveoli.
__________ is an acid regulated by the lungs
carbonic
___________is an acid regulated by the stomach
Hydrochloric acid
__________is an acid regulated by the muscles
Lactic
__________ acids build protein from food
Amino
What are the four sinuses that surrounds and drain into the nasal cavity?
Ethmoid
Frontal
Maxillary
Sphenoid
An initial indication that the patient has hypoxia is ____________ which is then followed by ______
restlessness; confusion
If there is a new _______the ventilator may alarm
pneumothorax
Meningitis, encephalitis, and head trauma may causes of which respiratory rhythms
Biot’s
Kussmaul’s respiration caused by
metabolic acidosis
Peritonitis
What are the 3 D’s of Epiglottitis
Drooling
Dysphagia
Distress.
